Epidemiology, Clinical Features, and Outcome in a Cohort of Adolescents With Cerebral Venous Thrombosis

Objective:We aimed to analyze the epidemiological, clinical, and paraclinical features of adolescents with cerebral venous thrombosis (CVT) and its therapeutic management and outcome.Methods:This multicenter retrospective cohort included patients aged 10–18 years hospitalized for a first episode of CVT in two French regions between 1999 and 2019. The number of cases was compared to the number recorded by the French health insurance system. The Lariboisière hospital's CVT registry allowed comparisons with adults.Results:102 patients were included (52·9% female;median age 15·1 years). Estimated incidence was 0·37–0·38/100,000 adolescents/year. 45·5% of patients presented with focal deficits or seizures or in a coma. Male patients were younger than female patients (14·2 vs 15·6 years;p<0·01) and more often admitted to intensive care (52·1% vs 24·1%;p=0·0035). The lateral sinus was the most common CVT location (72·3%), and 29·4% of adolescents had associated venous infarction and/or hematoma. Most patients (94·1%) received anticoagulation. Treatment also included an endovascular procedure (2·9%), decompressive craniectomy (4·9%), and CSF shunt (6·9%). The most frequently identified CVT-associated condition was local infection in male (18·6%) and systemic disease in female patients (14·8%;p<0·001). The proportion of CVTs in adolescents without an identified associated condition or risk factor was low (1·9% vs 11·4% in adults;p<0·002). Adverse outcome at 1 year was more frequent than in adults (33·3% vs 11·8%;p=0·0001).Interpretation:CVT in adolescents is rare and complex, with specific epidemiology, including differences in clinical presentation and associated conditions between sexes, and more severe outcomes than in adults. Careful specialized management and follow-up are therefore recommended.

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An Audit of Treatment of Genital Warts: Opening the Feedback Loop

International Journal of STD & AIDS ◽

10.1177/095646249300400410 ◽

1993 ◽

Vol 4 (4) ◽

pp. 226-231 ◽

Cited By ~ 4

Author(s):

M Reynolds ◽

M Murphy ◽

M A Waugh ◽

C J N Lacey

Keyword(s):

Specific Treatment ◽

Genital Warts ◽

Therapeutic Modality ◽

First Episode ◽

Anogenital Warts ◽

Treatment Protocols ◽

Female Patients ◽

General Infirmary ◽

Male Patients ◽

Time Of Presentation

An audit of the treatment of patients (100 men and 90 women) presenting with a first episode of anogenital warts to the Genitourinary Medicine Department at Leeds General Infirmary was performed. Treatment of patients was monitored for a period of 6 months from the time of presentation. The management of patients with genital warts lacked a clearly defined strategy and treatment was unselective and poorly monitored. Excluding patients who defaulted, at follow-up 44 (44%) men and 36 (38%) women still had genital warts at 3 months. Of those patients clear of warts at 3 months, the mean time to remission for men and women was 7.1 and 8.3 weeks respectively. Podophyllin 25% in tincture of benzoin was by far the predominant therapeutic modality used. A total of 96 (96%) men and 76 (84%) women received treatment with podophyllin. Both male and female patients had a mean of 5 treatments with podophyllin 25% (range 1–19 and 1–12 respectively). Physical methods of treatment i.e. cryotherapy and electrocautery, were underutilized, both as primary therapies and when topical agents had failed. Patients saw an average of 3 (range 1–7) doctors over the course of their treatment. Patients with warts affecting 2 or more sites, male patients with anal/perianal warts, and female patients with cervical and vaginal warts had higher failure rates from treatment at 3 months. On the basis of these findings, specific treatment protocols for the management of anogenital warts have been devised.

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The Effect of Treatment on the Melancholias (Depressions)

The British Journal of Psychiatry ◽

10.1192/bjp.140.3.223 ◽

1982 ◽

Vol 140 (3) ◽

pp. 223-230 ◽

Cited By ~ 24

Author(s):

Max Hamilton

Keyword(s):

Depressive Illness ◽

Open Trial ◽

Female Patients ◽

Effect Of Treatment ◽

Male Patients ◽

Better Than

SummaryThe results described are based on data from 47 male and 83 female patients randomly assigned to treatment with imipramine or phenelzine in an open trial. All were fresh (untreated) cases diagnosed as suffering from depressive illness (melancholia). They were rated before treatment and 2 and four months later. Imipramine did not give results which were significantly better than phenelzine. With both drugs it was found that patients had done either very well or very poorly at follow-up, i.e. the distribution of scores was U-shaped (or bimodal at the least).The 55 men and 90 women who were unsuitable for treatment with drugs or who had failed to respond to such treatment were given a course of ECT and followed-up at corresponding intervals. The improvement after ECT was better than with drugs and the distribution of scores is quite different. An earlier series of male patients treated with ECT in the pre-drug days did not show as good a response to the treatment.

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Thalamic Hemorrhagic Stroke in the Term Newborn: A Specific Neonatal Syndrome With Non-uniform Outcome

Journal of Child Neurology ◽

10.1177/0883073817703503 ◽

2017 ◽

Vol 32 (8) ◽

pp. 746-753 ◽

Cited By ~ 6

Author(s):

Laura Merlini ◽

Sylviane Hanquinet ◽

Joel Fluss

Keyword(s):

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Hemorrhagic Stroke ◽

Late Onset ◽

Predicting Factors ◽

Anterior Thalamus ◽

Cerebral Sinus Venous Thrombosis ◽

Cerebral Sinus ◽

Deep Cerebral Venous Thrombosis

Background: Neonatal thalamic hemorrhagic stroke is related to cerebral sinus venous thrombosis and associated with neurological sequelae. Predicting factors are however lacking. Methods: Clinical and radiological findings at onset and on follow-up of 5 neonates with thalamic hemorrhage stroke are described. Results: All neonates presented with abrupt lethargy, ophistotonos, irritability and/or seizures. The thalamic hemorrhagic stroke was most often unilateral (4/5), involving the posterior/entire thalamus in 3 cases and the anterior thalamus in 2. Cerebral venous thrombosis was identified in a single patient. At follow-up, children with unilateral anterior thalamic hemorrhagic stroke demonstrated thalamic atrophy without neurological symptoms, whereas children whose thalamus lesion was extensive exhibit a porencephalic cavity and presented with late-onset epilepsy. Discussion: Although deep cerebral venous thrombosis is probably the cause of neonatal thalamic hemorrhagic stroke, its radiological evidence is challenging. Outcome seems dependent of the size and location of thalamic hemorrhagic stroke. Epilepsy is a frequent morbidity after thalamic hemorrhagic stroke.

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Assessment of psychosocial impact of genital warts among patients in Singapore

Sexual Health ◽

10.1071/sh13189 ◽

2014 ◽

Vol 11 (4) ◽

pp. 313 ◽

Cited By ~ 3

Author(s):

Lucinda S. Tan ◽

Martin T. W. Chio ◽

Priya Sen ◽

Yong Kuei Lim ◽

Joseph Ng ◽

...

Keyword(s):

Negative Impact ◽

Tertiary Education ◽

Short Form ◽

Local Population ◽

Genital Warts ◽

First Episode ◽

Female Patients ◽

Patient Profile ◽

Sf 36 ◽

Male Patients

Background Genital warts (GW) are a common sexually transmissible infection (STI) among young adults and are associated with poor quality of life (QoL). We investigated the functional and psychosocial effect of GW on Singaporean patients and evaluated for any variations in QoL between genders. Methods: Patients with GW completed a standard questionnaire containing the Short Form-36 (SF-36) health survey and the Cuestionario Específico para Condiloma Acuminado in a cross-sectional survey. QoL deficits were determined by comparing the SF-36 scores with local population norms. Variations in SF-36 (norm-based) scores among patients with different characteristics were examined using multiple linear regressions. All data analyses were performed for male and female patients separately. Results: The mean age of male (n = 100) and female patients (n = 80) was 31 years. The typical patient profile was male, ethnic Chinese, single, tertiary education level and presenting with recurrent warts and a history of prior STIs. Compared with the general population, male patients had similar or better functioning and wellbeing, whereas female patients had lower levels of productivity, mental health and general health. Among male patients, individuals afflicted with their first episode of GW and currently with a partner had better QoL. In contrast, for females, tertiary education, older age and being a nonsmoker were positively associated with better QoL. Conclusions: Patients with GW have a significant psychosocial burden, with differences in certain aspects of QoL between genders. We hope that with active intervention, we will be able to mitigate the associated negative impact to QoL.

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Gender aspects in cardiooncology

European Journal of Public Health ◽

10.1093/eurpub/ckab146 ◽

2021 ◽

Author(s):

Anna Hohneck ◽

Florian Custodis ◽

Stephanie Rosenkaimer ◽

Ralf Hofheinz ◽

Sandra Maier ◽

...

Keyword(s):

Breast Cancer ◽

Gender Differences ◽

Vitamin D ◽

Cancer Diagnosis ◽

Cancer Susceptibility ◽

Mortality Rates ◽

Female Patients ◽

Male Patients ◽

Gender Aspects

Abstract Background Cardiooncology is a relatively new subspeciality, investigating the side effects of cytoreductive therapies on the cardiovascular (CV) system. Gender differences are well known in oncological and CV diseases, but are less elucidated in cardiooncological collectives. Methods Five hundred and fifty-one patients (278 male, 273 female) with diagnosed cancer who underwent regular cardiological surveillance were enrolled in the ‘MAnnheim Registry for CardioOncology’ and followed over a median of 41 (95% confidence interval: 40–43) months. Results Female patients were younger at the time of first cancer diagnosis [median 60 (range 50–70) vs. 66 (55–75), P = 0.0004], while the most common tumour was breast cancer (49.8%). Hyperlipidaemia was more often present in female patients (37% vs. 25%, P = 0.001). Male patients had a higher cancer susceptibility than female patients. They suffered more often from hypertension (51% vs. 67%, P = 0.0002) or diabetes (14% vs. 21%, P = 0.02) and revealed more often vitamin D deficiency [(U/l) median 26.0 (range 17–38) vs. 16 (9–25), P = 0.002] and anaemia [(g/dl) median 11.8 (range 10.4–12.9) vs. 11.7 (9.6–13.6), P = 0.51]. During follow-up, 140 patients died (male 77, female 63; P = 0.21). An increased mortality rate was observed in male patients (11.4% vs. 14%, P = 0.89), with even higher mortality rates of up to 18.9% vs. 7.7% (P = 0.02) considering tumours that can affect both sexes compared. Conclusions Although female patients were younger at the time of first cancer diagnosis, male patients had both higher cancer susceptibility and an increased mortality risk. Concomitant CV diseases were more common in male patients.

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Autologous Osteochondral Transplantation for Osteochondral Lesions of the Talus: Does Gender Impact Outcomes?

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00227 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0022

Author(s):

Arianna L. Gianakos ◽

Olasunmbo Okedele ◽

Sean Flynn ◽

John G. Kennedy ◽

Christopher W. DiGiovanni

Keyword(s):

Osteochondral Lesions ◽

Symptom Duration ◽

Osteochondral Transplantation ◽

Autologous Osteochondral Transplantation ◽

Duration Of Symptoms ◽

Male And Female ◽

Female Patients ◽

Male Patients ◽

The Mean

Category: Ankle; Arthroscopy Introduction/Purpose: Autologous osteochondral transplantation (AOT) is commonly used in the treatment of osteochondral lesions (OCL) of the talus. There is limited data comparing gender differences in the incidence, presentation, and outcomes following AOT. The purpose of this study is to compare these differences between male and female patients. Methods: Eighty-five consecutive patients who underwent AOT were retrospectively reviewed. Patients were divided into two groups based on gender. Demographic data and OCL defect characteristic data were recorded. Functional outcomes were assessed pre- and post-operatively using the Foot and Ankle Outcome Score (FAOS). The Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score was used to assess cartilage incorporation. The mean clinical follow-up was 47.2 months, with mean MRI follow-up of 24.8 months. Results: Fifty-five (65%) males and 30 (35%) females were included. OCL defect size was significantly larger in men (112.8mm2) when compared with women (88.7mm2) (p<0.0001). Male patients had a significantly longer duration of symptoms (p<0.001) and OCLs were more likely traumatic in nature (p=0.0006) when compared with female patients. Mean FAOS improved pre- to postoperatively from 50 to 81(P < .001) with a statistically significant increase in men (p<0.0001). The mean MOCART score was 82.1 and 86.7 in male and female patients, respectively (p<0.0001). Lesion size was negatively correlated with MOCART score (r = -0.36,P = .004). No differences were found in knee donor site morbidity, complication rate, or revision surgery. Conclusion: Our study demonstrates that male patients typically present with talar OCLs that are larger in size, traumatic in nature, and with longer symptom duration when compared with female patients. In addition, male patients had greater improvement in FAOS scores following AOT. Therefore, understanding these differences may influence the management and treatment of talar OCLs in male and female patients.

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Chinese Systemic Lupus Erythematosus Treatment and Research Group (CSTAR) Registry XI: gender impact on long-term outcomes

Lupus ◽

10.1177/0961203319839845 ◽

2019 ◽

Vol 28 (5) ◽

pp. 635-641

Author(s):

S Zhang ◽

Z Ye ◽

C Li ◽

Z Li ◽

X Li ◽

...

Keyword(s):

Systemic Lupus Erythematosus ◽

Lupus Erythematosus ◽

Causes Of Death ◽

Survival Rates ◽

Systemic Lupus ◽

Male And Female ◽

Female Patients ◽

American College Of Rheumatology ◽

Male Patients

Objective The objective of this paper is to assess the role of gender on survival rate and causes of death and organ damage in systemic lupus erythematosus (SLE) patients in China from 2009 to 2015. Methods We conducted a multicenter cohort study to analyze the differences in outcome data between male and female SLE patients. A group of 1494 SLE patients who fulfilled the 1997 American College of Rheumatology SLE classification criteria were enrolled in the Chinese Systemic Lupus Erythematosus Treatment and Research Group (CSTAR) registry from April 2009 to February 2010. All enrolled patients were followed up at least once per year from 2009 to 2015. For patients who could not attend the outpatient clinic, follow-up was conducted by telephone interview. We collected demographic data, clinical manifestations and damage scores (System Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI)). Survival rates were evaluated using the Kaplan-Meier method. Results This study included 1352 women and 142 men. The five-year survival rates were 92.0% for men and 97.6% for women. The survival rates of males were significant lower than for females ( p = 0.019). Male patients received methylprednisolone pulse therapy and cyclophosphamide significantly more than female patients ( p = 0.010). During follow-up, 12 male patients and 66 female patients died. The most common cause of death was infection (41.7%) for men and active SLE disease (27.3%) for women. At the end of the study, the major accumulated organ damages included renal (8.5%) and musculoskeletal (7.7%), and nervous system (5.6%) for men and renal (8.8%) and musculoskeletal (6.7%) for women. There were no significant differences in SDI scores between the two groups at baseline and at the end of the study. Conclusions Male SLE patients had lower survival rates than female patients. Male patients received more methylprednisolone pulse and cyclophosphamide therapy. The most common causes of death were infection for male patients and active SLE disease for female patients. The major accumulated organ damages were renal, musculoskeletal, and nervous system both for male and female SLE patients in China.

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Functional outcome in patients following cartilage regenerative treatement: outcome at minimum follow-up of 12 months

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00319 ◽

2020 ◽

Vol 8 (5_suppl4) ◽

pp. 2325967120S0031

Author(s):

Thore Zantop ◽

Christian Zantop ◽

Anja Hönninger ◽

Dominik Hauner ◽

Przemyslaw Warminski ◽

...

Keyword(s):

Functional Outcome ◽

Knee Flexion ◽

Cartilage Regeneration ◽

Lysholm Score ◽

Cartilage Defects ◽

Return To Sports ◽

Male And Female ◽

Female Patients ◽

Male Patients

Aims and Objectives: Full thickness cartilage defects may be devastating for the patients. Even though, the surgical options have improved, only limited information for returning to sports. Aim of this study was therefore to compare the functional outcome and the return to sports rate of patients following cartilage regenerative treatment at a minimum follow up of 12 months. Materials and Methods: A total of 50 Patients (32 male, 18 female) undergoing cartilage regeneration using a Matrix-associated chondrocyte transplantation (MACT, Novocart, TETEC, Aesculap) (27 femorotibial, 23 patellofemoral) were evaluated at a minimum follow-up of 12 months. Follow-up was performed using a multifactorial functional analysis including isokinetic strength measurements (BTE-primus), proprioceptive tests (MTF tests), a tapping test and a 3d-motion analysis (myomotion, Noraxon) during single leg squats, bilateral drop jumps and single leg hop tests. Agility was assessed using a lateral speedchase (Globalspeed, Hemsbach). Clinical results were recorded using Tegner and Lysholm score. Results: Patients showed a Lysholm score of 86,3 +/-10,3 and 84,0 +/-13,9 for male and female, respectively. The tegner score was significantly reduced when compared to preoperatively (male 4,72 +/-1,6, female 4,75 +/-1,5). Thigh circumference was reduced by an average of 3,6 cm for male and 4,4 cm for female patients. The tapping test revealed no differences between male and female patients providing a leg symmetry index (LSI) of 102,0 (+/-8,4) with an overall average frequency of 10,14 (+/-1,27). During single leg squat male patients had a significantly lower knee flexion of 55,8 (+/-8,5) of the postoperative leg compared to the non-injured leg (62,2 +/-8,2) whereas the knee abduction was -6.8 (+/-15,1) and -11,8 -11,82 (+/-16,6) for the postoperatively and non-injured leg, respectively. Evaluating the single leg hop, the LSI of distance values was 90,8 (+/-11,9) and for height values 84,0 (+/-16,0) for the male patients. There was a trend towards reduced ROM with regard to knee flexion of the injured leg to the non-injured. Cutting time during lateral speedchase showed a LSI of 98,29 (+/-13,8) and 99,44 (+/-8,2) for male and female patients, respectively. Conclusion: This prospective analysis of patients following cartilage regeneration implicates that the use of a multifactorial “return-to-sports” analysis 12 months postoperatively provides a good correlation to the clinical outcome and scores. At this FU point, Patients following MACT show knee joint function that is close to normal.

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Cerebral venous thrombosis after caesarean section

Česká gynekologie ◽

10.48095/cccg2021339 ◽

2021 ◽

Vol 86 (5) ◽

pp. 339-342

Author(s):

Lucie Drábková ◽

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Case Report ◽

Caesarean Section ◽

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Interdisciplinary Collaboration ◽

Contextual Knowledge ◽

Follow Up Care

Objective: Case report of a patient with cerebral venous thrombosis after caesarean section. Case report: We present a case of a 22-year-old patient after an acute caesarean section, which was complicated by cerebral venous thrombosis. The etiology of the thrombosis was multifactorial. Diagnosis was determined using imaging methods once the neurological symptoms were expressed. Follow-up care for the patient included comprehensive care in the intensive care unit, including a temporary decompresive craniectomy. Conclusion: Cerebral venous thrombosis is a rare disease with a varied clinical manifestation whose development is aff ected by a number of acquired and congenital factors. The incidence is increased in women in the puerperium, but we can also see it in gynecological practice in young contraception users. Contextual knowledge is essential in early dia gnosis as well as using a correct treatment strategy with a multidisciplinary approach and interdisciplinary collaboration. Key words: cerebral venous thrombosis – caesarean section – laparotomy dehiscence – headache

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Cerebral Venous Thrombosis

10.4018/978-1-7998-7433-1.ch007 ◽

2022 ◽

pp. 113-119

Author(s):

Ozcan Demetgul

Keyword(s):

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Clinical Symptoms ◽

Rare Condition ◽

Epileptic Seizures ◽

Lateral Sinus ◽

Younger Adults ◽

Sagittal Sinus ◽

Vital Functions ◽

Visual Problems

Cerebral venous thrombosis (CVT) is a rare condition involving various symptoms that is mainly seen in younger adults. The most commonly involved are the superior sagittal sinus, lateral sinus, and simoid sinus. About 1% of all ischemic strokes are considered CVT. It is seen 3-fold more in young women. The incidence was estimated to be approx. 1/1000000. Cerebral venous sinuses are superficial and deep spaces, and they have vital functions. There are many symptoms. The most common complaint is headache (89%). Studies reported many different clinical symptoms. Neurological signs including motor and sensorial losses, impaired consciousness, speech disorder, epileptic seizures, visual problems (hemianopia, nystagmus, diplopia, and papilledema), and cranial nerve signs may be seen. The diagnosis is made primarily by suspecting the clinical condition and radiological presentation of thrombosis. The most basic diagnostic method is cranial imaging. Anticoagulants are the main method of treatment. The prognosis has improved over the last years thanks to early diagnosis.

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