High Rate of Recurrent Meniscus Tear and Lateral Compartment Osteoarthritis in Patients Treated for Symptomatic Lateral Discoid Meniscus: A Long-Term Population-Based Study

Objectives: Little is known about the natural history and long-term outcome of a surgically treated symptomatic lateral discoid meniscus. The goals of this study were to describe the rate and factors associated with recurrent lateral meniscus tears and progression to symptomatic lateral compartment osteoarthritis (OA) in patients surgically treated for a symptomatic lateral discoid meniscus. Patients with surgically treated lateral discoid meniscus have a high incidence of meniscus re-tear and progression to lateral compartment OA. Methods: A large, geographic database was reviewed to identify and confirm patients presenting with symptomatic lateral discoid meniscus between 1998 and 2015. Charts were reviewed to document treatment and outcomes at a minimum clinical follow-up of two years. Results: 70 discoid meniscus patients (30 F, 40 M) with a mean age of 27 years (Range: 2.0-66.0) were followed for an average of 5.8 years (Range 2.0-23.7). Sixty patients underwent surgical management: 49 (82%) patients underwent partial lateral meniscectomy and 11 (18%) underwent meniscus repair (including saucerization). Tear-free survival following surgery was 93% at 2 years, 69% at 5 years, and 40% at 8 years. Overall progression to symptomatic lateral compartment OA in the surgical group was 10% at 2 years, 23% at 5 years, and 48% at 8 years. Of those patients who developed lateral compartment OA, 55% (11/20) had a Kellgren-Lawrence score 2 or greater at last radiographic follow-up. Young age and open growth plates were associated with increased incidence of postoperative re-tear (HR: 0.96, CI: 0.93-0.99, p = 0.01). Increased age at diagnosis and BMI ≥ 30 were associated with increased risk of progression to lateral compartment OA on final radiographs. Conclusion: Patients with a surgically treated lateral discoid meniscus tear had a high rate of recurrent meniscus tear at long-term follow-up (60% at 8 years) that was associated with young age. Approximately 48% of surgically treated patients developed symptomatic lateral compartment OA at eight years from initial presentation. The risk of progression to OA increased with older age at diagnosis and BMI ≥ 30.

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Traumatic stifle injury in 72 cats: a multicentre retrospective study

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x211028834 ◽

2021 ◽

pp. 1098612X2110288

Author(s):

Mario Coppola ◽

Smita Das ◽

George Matthews ◽

Matteo Cantatore ◽

Luis Silva ◽

...

Keyword(s):

Lateral Collateral Ligament ◽

High Rate ◽

Ligament Injury ◽

Meniscal Injury ◽

Short Term ◽

Term Outcome ◽

Long Term Outcome ◽

Long Term Follow Up

Objectives The aim of the study was to describe traumatic stifle injury in cats and report complications and long-term outcome. Methods The medical records from seven veterinary hospitals of cats treated for traumatic stifle injury were reviewed. Long-term follow-up data were collected from referring veterinarians and using the Feline Musculoskeletal Pain Index, collected from owners. Results Seventy-two cats were included in the study. The most common combination of ligament injury involved both cruciate ligaments and the lateral collateral ligament (25.4%). Medial meniscal injury was more common (66.2%) than lateral meniscal injury (59.4%). A temporary transarticular pin was used intraoperatively to aid reduction in 23/73 (31.5%) surgeries. Postoperative immobilisation was applied in 41/72 (56.9%) cats with a mean duration of 4.8 weeks. Short-term complications occurred in 40/64 (62.5%) cats. Long-term complications occurred in seven (17.5%) cats. Overall outcome was excellent in 25/61 (41%) cats, good in 13/61 (21.3%) cats, fair in 11/61 (18%) cats and poor in 12/61 (19.7%) cats. Mean length of follow-up was 29.6 months (range 0.5–204). A significantly poorer outcome was observed in cats with medial meniscal injury and those undergoing revision surgery. Use of a transarticular pin when left in situ for postoperative immobilisation was associated with a poorer outcome (P = 0.043) and a higher risk of complications (P = 0.018). Postoperative immobilisation was not related to outcome. Conclusions and relevance Traumatic stifle injury in cats can lead to rupture of multiple ligaments causing significant instability of the joint. Surgical treatment is associated with a high rate of short-term complications, although long-term outcome may still be good to excellent in the majority of cats (62.3%). In cats where follow-up was available, postoperative immobilisation had no positive effect on outcome and may not be required. Leaving a transarticular pin for postoperative immobilisation is not recommended as it was significantly associated with a poorer outcome and a higher complication rate.

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OUTCOMES OF DISCOID MENISCUS REPAIRS IN CHILDREN AND ADOLESCENTS

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00030 ◽

2019 ◽

Vol 7 (3_suppl) ◽

pp. 2325967119S0003

Author(s):

Crystal Perkins ◽

Michael Busch ◽

Melissa Christino ◽

S. Clifton Willimon

Keyword(s):

Lateral Meniscus ◽

Meniscus Repair ◽

Meniscus Tear ◽

Discoid Lateral Meniscus ◽

Discoid Meniscus ◽

Tear Pattern ◽

Reoperation Rates ◽

Meniscus Surgery

Background: Discoid meniscus tear patterns vary, but typically involve horizontal cleavage tears of the central discoid component with or without anterior or posterior meniscocapsular tears. Classically, the central discoid component is saucerized and meniscocapsular tears are repaired. Recent data suggests that meniscal preservation provides long-term benefits over resection1-2. However, many meniscal transplants are performed secondary to unsalvaged or unsalvageable discoid meniscus tears3. Reoperation rates after meniscus repairs vary greatly4-6, with some series reporting high rates of reinjury and reoperation, but there are no large series of pediatric discoid meniscus repairs in the literature. The purpose of this study is to describe the outcomes of meniscus repair and saucerization in pediatric patients with symptomatic discoid menisci. Methods: A single-institution retrospective review was performed of consecutive pediatric patients with surgical treatment of a discoid meniscus tear over a five-year period. Inclusion criteria were age less than 18 years, a symptomatic torn discoid meniscus treated with knee arthroscopy with meniscus repair, and minimum 4-month follow-up. A chart review was performed to describe tear location, tear pattern, and repair type (inside-out, outside-in, all-inside, and hybrid). Hybrid repair constructs were defined as those that used 2 or more repair types. The primary outcome was revision meniscus surgery. Results: Forty-four patients were identified to meet inclusion criteria. There were 23 males and 21 females with a mean age of 12.4 years (range 5 – 17 years). The right knee was affected in 61% of patients. The lateral meniscus was involved in all patients. Tear patterns included anterior meniscocapsular (19 patients, 43%), posterior meniscocapsular (14 patients, 30%), radial (7 patients, 16%), and bucket-handle (5 patients, 11%). Tears most commonly involved the posterior horn and body (21 patients, 48%) or posterior horn (16 patients, 36%) Arthroscopic meniscus repair was performed in all patients. Forty-three patients (98%) also underwent saucerization. Marrow stimulation, as a biological approach to improve repair healing, was performed in 14 patients (32%). The distribution of repair types and number of sutures for each type is listed in the table below. Mean follow-up was 19 months (range 4 – 70 months). Four patients (9%) underwent revision meniscus surgery following the primary repair, including 2 all-inside repairs and 2 partial meniscectomies. There were no statistically significant differences between patients who did or did not require a secondary surgery with respect to sex, age, tear location, tear pattern, repair type, or number of sutures. During follow-up, 9 patients (20%) had surgery for a symptomatic discoid meniscus in the contralateral knee. Conclusions: Saucerization and repair of discoid lateral meniscus tears in the pediatric population have good outcomes with low rates of reoperation. Appropriate saucerization, followed by an arthroscopic assessment of stability and tear patterns is critical to successful treatment of symptomatic discoid menisci. If tissue quality permits, meniscal preservation should be considered in all patients to avoid the consequences of subtotal meniscectomy. [Table: see text] Manzione M, Pizzutillo PD, Peoples AB, et al. Meniscectomy in children: a long-term follow-up study. Am J Sports Med 1983;11:111-115. Ahn JH, Kim KI, Wang JH, et al. Long-term results of arthroscopic reshaping for symptomatic discoid lateral meniscus in children. Arthroscopy 2015;31(5):867-873. Kocher MS, Tepolt FA, Vavken P. Meniscus transplantation in skeletally immature patients. J Pediatr Orthop B 2016;25(4)343-348. Steadman JR, Matheny LM, Singleton SB, et al. Meniscus suture repair: minimum 10-year outcomes in patients younger than 40 years compared with patients 40 and older. Am J Sports Med 2015;43(9):2222-2227. Paxton ES, Stock MV, Brophy RH. Meniscal repair versus partial meniscectomy: a systematic review comparing reoperation rates and clinical outcomes. Arthroscopy 2011;27(9):1275-1288. Shieh AK, Edmonds EW, Pennock AT. Revision meniscal surgery in children and adolescents: risk factors and mechanisms for failure and subsequent management. Am J Sports Med 2016;44(4):838-843.

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Natural History of Allergic Fungal Rhinosinusitis: A 4- to 10-Year Follow-Up

Otolaryngology ◽

10.1067/mhn.2002.129806 ◽

2002 ◽

Vol 127 (5) ◽

pp. 361-366 ◽

Cited By ~ 51

Author(s):

Bradley Marple ◽

Mark Newcomer ◽

Nathan Schwade ◽

Richard Mabry

Keyword(s):

Natural History ◽

Initial Treatment ◽

High Rate ◽

Recurrence Rates ◽

Long Term Outcome ◽

Fungal Rhinosinusitis ◽

Allergic Fungal Rhinosinusitis ◽

History Of

BACKGROUND: Numerous studies have noted the high rate of recidivism after the initial treatment of allergic fungal rhinosinusitis (AFS). Short–term studies have revealed varying recurrence rates based on therapy; however, little is currently known about the long–term natural history of the disease. OBJECTIVE: Our goal was to address the question of long–term outcomes in AFS patients and make observations about the natural history of the disease. PATIENTS AND METHODS: Seventeen patients with follow–up ranging from 46 to 138 months were examined and interviewed, and their charts were reviewed. A quality–of–life survey was completed, and blood was drawn to measure immunoglobulin levels. RESULTS: All patients initially underwent treatment with a combination of surgery, systemic and/or topical corticosteroids, and immunotherapy to pertinent fungal and nonfungal antigens. Normalization of sinonasal mucosa (Kupferberg stage 0) was seen in 5 (29%) of 17 patients, whereas 76% demonstrated either normal or slight mucosal edema (Kupferberg stage 0 or 1). Serologic testing revealed fungus-specific IgE significantly elevated in all 17 patients. CONCLUSION: The initial choice of therapy did not appear to affect the long–term outcome, and patients tended to be doing well overall. These results suggest that after successful initial treatment and control of AFS, many patients can achieve a quiescent disease state.

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History before diagnosis in childhood craniopharyngioma: associations with initial presentation and long-term prognosis

Acta Endocrinologica ◽

10.1530/eje-15-0709 ◽

2015 ◽

Vol 173 (6) ◽

pp. 853-862 ◽

Cited By ~ 24

Author(s):

Anika Hoffmann ◽

Svenja Boekhoff ◽

Ursel Gebhardt ◽

Anthe S Sterkenburg ◽

Anna M M Daubenbüchel ◽

...

Keyword(s):

Tumor Size ◽

Age At Diagnosis ◽

Neurological Deficits ◽

Term Outcome ◽

Specific Symptom ◽

Long Term Outcome ◽

Long Term Prognosis ◽

Prospective Longitudinal

ObjectiveChildhood craniopharyngiomas (CP) are often diagnosed after a long duration of history (DOH). Tumor size, hypothalamic involvement (HI), and obesity are associated with reduced overall survival (OS) and functional capacity (FC). The effect of DOH and specific symptoms in history on presentation at initial diagnosis and long-term prognosis are unknown.DesignRetrospective analysis of patients' records and prospective longitudinal follow-up.MethodsHistories of 411 CP patients recruited in HIT Endo, KRANIOPHARYNGEOM 2000 were retrospectively evaluated for DOH, symptoms, and characteristics. The effect of specific manifestations and DOH on clinical presentation and tumor characteristics at time of initial CP diagnosis and long-term outcome were analyzed. Main outcome measures were 10-year OS and progression-free survival (PFS), FC, and BMI during longitudinal follow-up.ResultsMedian DOH was 6 months (range: 0.1–108 months) and correlated with age at diagnosis. Tumor size, HI, degree of resection, and BMI at diagnosis were not related to DOH. In multivariate analysis adjusted for age at diagnosis, only hydrocephalus was found to have a relevant influence on DOH. Visual and neurological deficits were associated with larger initial tumor size and impaired 10-year OS. Weight gain and growth failure were observed with longest DOH. PFS and FC were not related to any specific symptom. Endocrine deficits at diagnosis were associated with long DOH.ConclusionsCP is frequently diagnosed after long DOH, especially in older children. However, DOH was not associated with tumor size, HI, survival, or FC. Visual and neurological deficits necessitate rapid diagnostic workup.

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Long-Term Outcome of Potential Celiac Disease in Genetically at-Risk Children: The Prospective CELIPREV Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm8020186 ◽

2019 ◽

Vol 8 (2) ◽

pp. 186 ◽

Cited By ~ 6

Author(s):

Elena Lionetti ◽

Stefania Castellaneta ◽

Ruggiero Francavilla ◽

Alfredo Pulvirenti ◽

Giulia Naspi Catassi ◽

...

Keyword(s):

Celiac Disease ◽

Normal Diet ◽

Intestinal Biopsy ◽

Positive Serology ◽

Serological Screening ◽

Term Outcome ◽

Long Term Outcome ◽

Risk Of Progression

Background: The long-term outcome of potential celiac disease (CD) is still a debated issue. We aimed to evaluate the progression of potential CD versus overt CD after 10-years of follow-up in a cohort of children genetically predisposed to CD. Methods: The CELIPREV study is prospectively following from birth 553 children with CD-predisposing HLA genes. Children with a diagnosis of potential CD continued to receive a normal diet and repeated the serological screening for CD every year. An intestinal biopsy was taken in presence of persistent positive serology. Results: Overall, 26 (4.7%) children received a diagnosis of potential CD (50% females, median age 24 months). All children were symptom-free. Twenty-three children continued a gluten-containing diet; at 10 years from the first biopsy, three children developed overt CD (13%), 19 (83%) became antibodies negative at 1 year from the first biopsy and remained negative up to 10 years of follow-up and one subject (4%) had fluctuating antibody course with transiently negative values and persistently negative biopsy. Conclusions: In children genetically predisposed to CD with a diagnosis of potential CD the risk of progression to overt CD while on a gluten-containing diet is very low in the long-term.

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Features and Outcome of Chronic Myeloid Leukemia (CML) at Very Young Age: Data from the International Pediatric CML Registry (I-CML-Ped Study)

Blood ◽

10.1182/blood-2018-99-112905 ◽

2018 ◽

Vol 132 (Supplement 1) ◽

pp. 1748-1748 ◽

Cited By ~ 3

Author(s):

Adalet Meral Gunes ◽

Frédéric Millot ◽

Krzysztof Kalwak ◽

Birgitte Lausen ◽

Petr Sedlacek ◽

...

Keyword(s):

Pubertal Development ◽

Young Age ◽

Molecular Techniques ◽

Response To Therapy ◽

Molecular Response ◽

Imatinib Treatment ◽

Long Term Outcome ◽

International Pediatric

Abstract Introduction: CML is rare in the first two decades of life comprising only 3% of pediatric and adolescent leukemias. The overall annual incidence is approximately 1 per million children and adolescents and it increases with age (median: 12 yrs, range: 1-18) resulting in an extreme rarity of children affected in the first years of life. Data regarding the clinicopathologic characteristics and response to therapy of childhood CML diagnosed at age <3 years has not been reported yet. Aims and objectives: We studied the epidemiologic and clinical features of patients(pts) with CML <3 years of age and evaluated treatment and long term outcome. Material and Methods: Data from pediatric CML pts (age at diagnosis 0-18 yrs) registered from 2010 until 2017 into the International Pediatric CML Registry (Poitiers, France) under the umbrella of the I-BFM Study Group were retrospectively analyzed. Characteristics and treatment outcome of pts <3 yrs at diagnosis were evaluated from standardized forms. Results: 22/479 pts (4.6%, ratio male/female: 14/8) were enrolled with a median age of 22 months (10-34) and a median weight and height were 9.3 kg (8.1-15.5) and 78 cm (73-98), respectively. The median time period from the first symptoms until final diagnosis was 21 days (2-182). Median spleen size was 12 cm (2-20) and median liver size was 3 cm (2-6) below the costal margins. Major complains and symptoms comprised asthenia (30%), fever (30%), abdominal pain (20%), extramedullary signs (14%), hemorrhage (5%), and weight loss (5%). Median WBC, Hb and platelet counts were 154 600/µl (23 000-892 000), 8.7 g/dl (5,6-11,5) and 311 000/µl (51 000-1 820 000), respectively. All pts underwent BM aspiration but, BM biopsy was performed only in 8/22 children. Philadelphia chromosome and BCR-ABL1 gene rearrangement were detected by cytogenetic and/or molecular techniques (FISH and RQ-PCR). In only 2 (9%) children, additional chromosomal abnormalities were detected by cytogenetics classifying one patient in accelerated phase. Overall 19/22 (86%) children were diagnosed in chronic phase and the remaining 3 pts were in advanced phase (CML-AP: n= 2, CML-BP: n= 1). Median follow-up of the cohort was 78 months (7-196). Treatment: 21/22 pts initially received imatinib at the recommended dose of 260-300 mg/sqm/day while one child received IFN + ARA-C. Imatinib was changed to either dasatinib (n= 5) or nilotinib (n= 1) in 6 children (29%). Thus, 15 pts continued on imatinib. During follow-up, 9/22 (41%) pts underwent HSCT including 2 pts after switching to dasatinib. Molecular response: Major molecular response (MR) was achieved in 10/21 (48%) children on TKI. One child (1/21) on TKI was not followed for MR, but he developed complete cytogenetic remission 4 mo after imatinib treatment. The remaining cohort (6/22; 27%) is alive on TKI without major MR with a median follow-up of 77 m (7-186) and 5/22 (23%) achieved complete MR following HSCT. Adverse effects (AE): 194 AE episodes were reported in 18/22 (82%) pts. Most frequently observed AEs were hematologic (20%), gastrointestinal (16%), infectious (14%), musculoskeletal (14%), skin (12%), metabolic (6%), and HSCT-related (GvHD, 5%). Less frequently AEs comprised psychological (3%), edema (3%), tooth development delay (2%), allergic (2%), neurologic (PRESS syndrome,1%), and renal colic (1%). At last follow up, assessment of puberty status revealed that the majority of children were in Tanner stage 1 or 2 (17/22, 77%). Among these, 7 were >10 years old and showed puberty delay, while pubertal development was normal in the remaining 5/22 pts. Data on growth and development was available in 15/22 (68%) children. The majority had experienced decline of height (93%) and weight (73%). In 4 (27%) and 2 (13%) pts, respectively, measurements were found below the 3rd-10th percentiles. Delta z-score analysis for height and weight revealed that the z-scores in total 3 pts were below -2. Survival: 21/22 (95%) children are alive while one patient died of GvHD. Two pts' last molecular status is unknown. 7/19 pts (37%) are in molecular CR following HSCT and the other 12/19 (63%) are still on TKI. Out of these, 3/12 pts achieved durable CMR with TKI (PCR negative) while the remaining 9/12 pts show either fluctuating (n= 3 ) or no major MR (n= 6). Conclusion: This report demonstrates for the first time the efficacy and long term side effects of upfront imatinib in the so far largest cohort of children with CML diagnosed at very young age. Disclosures Kalwak: Sanofi: Other: travel grants; medac: Other: travel grants.

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Long-Term Outcome of a cohort of 272 patients undergoing sialendoscopy

10.22541/au.162694151.18279656/v1 ◽

2021 ◽

Author(s):

Arike Vanden Daele ◽

Joekio Drubbel ◽

Charlotte Van Lierde ◽

Jeroen Meulemans ◽

Pierre Delaere ◽

...

Keyword(s):

Unknown Origin ◽

High Rate ◽

Term Outcome ◽

Long Term Outcome ◽

Residual Symptoms ◽

Entire Cohort ◽

Chronic Sialadenitis ◽

Related Quality

Objectives: To assess the cohort of patients undergoing sialendoscopic intervention for improvement of symptoms and gland-related quality of life at long-term follow up. Design: retrospective review of medical records with a prospective follow-up by questionnaire. Methods: All patients undergoing sialendoscopy between March 2008 and June 2020 were analyzed in detail regarding indications, technical aspects and postoperative course. To maximize follow-up, patients also received a questionnaire by e-mail. Results: 272 sialendoscopies were performed in 221 patients. Median follow-up time was 37 months. The sialendoscopies were performed in 130 patients for lithiasis, in 66 for stenosis, in 14 for recurrent parotitis of childhood, in 8 for recurrent sialadenitis of unknown origin and in 3 for radio-iodine induced sialadenitis. Complications occurred in 11 of 272 sialendoscopies (4%). Those were iatrogenic perforations, temporary lingual nerve paresthesia and swelling of the floor of the mouth. 53% of patients returned the questionnaire, for a total of 146 evaluable sialendoscopies. The majority of the responders indicated that sialendoscopy had improved their symptoms (83.6%). Salivary glands could be preserved in 89% of the responder group. The highest percentage of patients reporting residual symptoms was found in the RPC group (81.3%) and the lowest in the lithiasis group (16.2%). Besides age, no statistical differences in demographic and pathological features between the responder and non-responder groups were found, supporting generalization of the responders’ results to the entire cohort. Conclusions: This study confirms the good long-term outcomes of sialendoscopic interventions in patients with chronic sialadenitis of different etiologies and a high rate of gland preservation.

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Long Term Outcome of Pulmonary Atresia with Major Aorto-Pulmonary Collaterals: Data from a Pooled Analysis

Journal of Integrative Cardiology Open Access ◽

10.31487/j.jicoa.2020.02.08 ◽

2020 ◽

pp. 1-9

Author(s):

Paolo Ferrero ◽

Isabelle Piazza ◽

Matteo Ciuffreda ◽

Paolo Ferrero ◽

Youcef Sadou

Keyword(s):

Full Text ◽

Pulmonary Atresia ◽

Pooled Analysis ◽

High Rate ◽

Term Outcome ◽

Long Term Outcome ◽

Group 3 ◽

Group 2

Prognosis of Tetralogy of Fallot and Pulmonary atresia with MAPCAs is variable. We aimed to assess the outcome of patients who had undergone repair of TOF and PA with MAPCAs by different institutions and approaches, pooling together data on mortality and reinterventions. Abstracts were screened and full text papers were examined retrieving data on mortality, reinterventions and percentage of complete repair. Variables abstracted from the studies were pooled together and compared among different strategies. 28 papers out of 124 were selected, accounting for 1983 patients. 704 patients had undergone single stage unifocalization, 544 recruitment of PAs, 645 patients multistage and combined approaches. Median follow up was 49 months (36-70). 93 deaths occurred in the first month (5.4 %): 38 in group one (5.8%), 10 in group 2 (2.3%) and 45 in group 3 (8.6%), p<0.0001. At last follow up a total of 305 deaths occurred (16%) and did not differ among the three groups: 0.21 (0.15-0.25), 0.18 (0.07-0.26), 0.32 (0,13-0.38) deaths/100patients year, respectively p=0.43. 465 out of 969 patients, underwent at least one re-intervention (47.9%). Reintervention rate was similar among the three subsets and inversely correlated with the volume of institution (r= -0.45, p= 0.04). Although strategies of pulmonary atresia with MAPCAs repair are based on contrasting philosophies and extreme anatomic varibility, pooling together data from different studies, outcomes do not differ significantly and are characterized by a high rate of reinterventions. The latter appears to be significantly influenced by the volume of patients.

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Long-Term Outcome of Patients with TPO Mutations

Journal of Clinical Medicine ◽

10.3390/jcm10173898 ◽

2021 ◽

Vol 10 (17) ◽

pp. 3898

Author(s):

Leraz Tobias ◽

Ghadir Elias-Assad ◽

Morad Khayat ◽

Osnat Admoni ◽

Shlomo Almashanu ◽

...

Keyword(s):

Thyroid Carcinoma ◽

Minimal Invasive ◽

High Rate ◽

Thyroid Peroxidase ◽

Term Outcome ◽

Long Term Outcome ◽

Long Term Follow Up ◽

Enzymatic Defect

Introduction: Thyroid peroxidase (TPO) deficiency is the most common enzymatic defect causing congenital hypothyroidism (CH). We aimed to characterize the long-term outcome of patients with TPO deficiency. Methods: Clinical and genetic data were collected retrospectively. Results: Thirty-three patients with primary CH caused by TPO deficiency were enrolled. The follow-up period was up to 43 years. Over time, 20 patients (61%) developed MNG. Eight patients (24%) underwent thyroidectomy: one of them had minimal invasive follicular thyroid carcinoma. No association was found between elevated lifetime TSH levels and the development of goiter over the years. Conclusions: This cohort represents the largest long-term follow up of patients with TPO deficiency. Our results indicate that elevated TSH alone cannot explain the high rate of goiter occurrence in patients with TPO deficiency, suggesting additional factors in goiter development. The high rate of MNG development and the risk for thyroid carcinoma indicate a need for long-term follow up with annual ultrasound scans.

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Klinische Langzeitergebnisse der perkutanen transluminalen Angioplastie bei Patienten mit peripherer arterieller Verschlusskrankheit

VASA ◽

10.1024/0301-1526.31.1.36 ◽

2002 ◽

Vol 31 (1) ◽

pp. 36-42 ◽

Cited By ~ 3

Author(s):

. Bucek ◽

Hudak ◽

Schnürer ◽

Ahmadi ◽

Wolfram ◽

...

Keyword(s):

Success Rate ◽

Clinical Stage ◽

Ankle Brachial Index ◽

Clinical Situation ◽

Clinical Results ◽

Transluminal Angioplasty ◽

Term Outcome ◽

Long Term Outcome

Background: We investigated the long-term clinical results of percutaneous transluminal angioplasty (PTA) in patients with peripheral arterial occlusive disease (PAOD) and the influence of different parameters on the primary success rate, the rate of complications and the long-term outcome. Patients and methods: We reviewed clinical and hemodynamic follow-up data of 166 consecutive patients treated with PTA in 1987 in our department. Results: PTA improved the clinical situation in 79.4% of patients with iliac lesions and in 88.3% of patients with femoro-popliteal lesions. The clinical stage and ankle brachial index (ABI) post-interventional could be improved significantly (each P < 0,001), the same results were observed at the end of follow-up (each P < 0,001). Major complications occurred in 11 patients (6.6%). The rate of primary clinical long-term success for suprainguinal lesions was 55% and 38% after 5 and 10 years (femoro-popliteal 44% and 33%), respectively, the corresponding data for secondary clinical long-term success were 63% and 56% (60% and 55%). Older age (P = 0,017) and lower ABI pre-interventional (P = 0,019) significantly deteriorated primary clinical long-term success for suprainguinal lesions, while no factor could be identified influencing the outcome of femoro-popliteal lesions significantly. Conclusion: Besides an acceptable success rate with a low rate of severe complications, our results demonstrate favourable long-term clinical results of PTA in patients with PAOD.

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