scholarly journals Neurocognitive and functional impairment in adult and paediatric tuberculous meningitis

2019 ◽  
Vol 4 ◽  
pp. 178 ◽  
Author(s):  
Angharad G. Davis ◽  
Sam Nightingale ◽  
Priscilla E. Springer ◽  
Regan Solomons ◽  
Ana Arenivas ◽  
...  
Keyword(s):  
Functional Impairment ◽  
Tuberculous Meningitis ◽  
Observational Studies ◽  
Severe Illness ◽  
Socioeconomic Level ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Cognitive Delay ◽  
Neurological Infections

In those who survive tuberculous meningitis (TBM), the long-term outcome is uncertain; individuals may suffer neurocognitive, functional and psychiatric impairment, which may significantly affect their ability to lead their lives as they did prior to their diagnosis of TBM. In children who survive, severe illness has occurred at a crucial timepoint in their development, which can lead to behavioural and cognitive delay. The extent and nature of this impairment is poorly understood, particularly in adults. This is in part due to a lack of observational studies in this area but also inconsistent inclusion of outcome measures which can quantify these deficits in clinical studies. This leads to a paucity of appropriate rehabilitative therapies available for these individuals and their caregivers, as well as burden at a socioeconomic level. In this review, we discuss what is known about neurocognitive impairment in TBM, draw on lessons learnt from other neurological infections and discuss currently available and emerging tools to evaluate function and cognition and their value in TBM. We make recommendations on which measures should be used at what timepoints to assess for impairment, with a view to optimising and standardising assessment of neurocognitive and functional impairment in TBM research.

scholarly journals Dexamethasone and Long-Term Outcome of Tuberculous Meningitis in Vietnamese Adults and Adolescents

PLoS ONE ◽  
2011 ◽  
Vol 6 (12) ◽  
pp. e27821 ◽  
Author(s):  
M. Estée Török ◽  
Nguyen Duc Bang ◽  
Tran Thi Hong Chau ◽  
Nguyen Thi Bich Yen ◽  
Guy E. Thwaites ◽  
...  
Keyword(s):  
Tuberculous Meningitis ◽  
Term Outcome ◽  
Long Term Outcome

The Galway Study of Panic Disorder III

1996 ◽  
Vol 168 (4) ◽  
pp. 462-469 ◽  
Author(s):  
D. O'rourke ◽  
T. J. Fahy ◽  
J. Brophy ◽  
P. Prescott
Keyword(s):  
Panic Disorder ◽  
Controlled Trial ◽  
Clinical Status ◽  
Complete Recovery ◽  
Acute Stage ◽  
Severe Illness ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Research Interview

BackgroundThe aim was to evaluate long-term outcome of DSM–III–R panic disorder at a mean of 5.3 years following a controlled trial of treatment that included antidepressants and behavioural counselling.MethodSixty-eight (86%) subjects were evaluated by lengthy research interview.ResultsThirty-four per cent recovered and remained well, 46% were minimally impaired and 20% had persistent panic disorder of whom half remained significantly impaired. Anxious–fearful personality dysfunction was the most important predictor of poor outcome, followed by poor clinical status at discharge and inability at baseline to recall vividly the initial panic attack. Those who dropped out from the original trial did badly.ConclusionsComplete recovery can occur even after many years of severe illness in a large minority of subjects who receive both antidepressants and behavioural counselling in the acute stage of treatment. The comparative prognostic value of personality, severity and chronicity need to be more fully addressed in future studies.

Evaluation of published reports of foam sclerotherapy: what do we know conclusively?

2009 ◽  
Vol 24 (6) ◽  
pp. 275-280 ◽  
Author(s):  
K A Myers ◽  
S Roberts
Keyword(s):  
Observational Studies ◽  
Systemic Circulation ◽  
Controlled Trials ◽  
Foam Sclerotherapy ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Randomised Controlled ◽  
Meta Analyses ◽  
Long Term Studies

Objectives The aim was to evaluate the published literature to assess what is conclusively known about optimal technique and outcome for foam sclerotherapy. Methods A literature search was performed for randomised controlled trials, meta-analyses and observational studies using appropriate statistical techniques with survival analysis for long-term outcome. Results Foam is more effective than liquid for ultrasound-guided sclerotherapy. Both sclerosants commonly used are equally effective for sclerotherapy for small veins. Ultrasound signals appear in the systemic circulation in most patients after foam sclerotherapy but do not appear to be associated with serious complications. Conclusion Little else is known about the optimal preparation of foamed sclerosants and the best technique for administering foam for sclerotherapy. Long-term studies are required to determine outcome for various techniques. There is an opportunity for many controlled trials to assess results.

scholarly journals INTRAUTERINE UNDERNUTRITION AND HYPERTENSION AND CARDIOVASCULAR RISK

2013 ◽  
Vol 19 (4) ◽  
pp. 299-304
Author(s):  
E. V. Moguchaya ◽  
O. P. Rotar ◽  
A. O. Konradi
Keyword(s):  
Cardiovascular Risk ◽  
Observational Studies ◽  
Historical Events ◽  
Term Outcome ◽  
Long Term Outcome

The paper reviews the data of observational studies concerning effects of famine during untrauterine development and long-term outcome and cardiovascular risk. The overview and results of the major cohorts of subjects born during famine due to wars and other historical events are described. 

Computerised Life Chart Methods to Map Domains of Function and Illustrate Patterns of Interactions in the Long-Term Course Trajectories of Patients Who Once Met the Criteria for DSM-III Schizophrenia

1989 ◽  
Vol 155 (S5) ◽  
pp. 100-106 ◽  
Author(s):  
Courtenay M. Harding ◽  
Rodney V. McCormick ◽  
John S. Strauss ◽  
Takamaru Ashikaga ◽  
George W. Brooks
Keyword(s):  
American Psychiatric Association ◽  
Research Question ◽  
Severe Illness ◽  
Clinical Knowledge ◽  
Term Outcome ◽  
Long Term Outcome ◽  
The Past ◽  
Mediating Factors ◽  
The Usa

The research question of which mediating factors influence the long-term course of schizophrenia was not asked until recently because the expectation has been of uniformly poor outcome (Kraepelin, 1902; American Psychiatric Association, 1980). However, anecdotal clinical knowledge about heterogeneity in the long-term course of this severe illness has been firmly supported in the last 15 years by six recent longitudinal studies in Europe, Asia, and the USA (Blueler, 1972; Ciompi & Müller, 1976; Huber et al, 1979; Tsuang et al, 1979; Harding et al, 19876; Ogawa et al, 1987). Each of these studies, more methodologically rigorous than those of the past, has found multiple indices of wide heterogeneity in the long-term outcome of schizophrenia with trends toward significant improvement or recovery demonstrated in over half of each cohort.

scholarly journals Long-Term Outcome of Mechanical and Biological Prostheses in Patients with Left-Side Infective Endocarditis: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (19) ◽  
pp. 4356
Author(s):  
Francesco Formica ◽  
Francesco Maestri ◽  
Florida Gripshi ◽  
Alan Gallingani ◽  
Silvia Grossi ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Observational Studies ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Reported Data

Background. Long-term outcomes of patients with infective endocarditis (IE) who received either a mechanical (MP) or biological prosthesis (BP) are conflicting. A meta-analysis of observational studies comparing the long-term outcomes of left-side IE with the use of MP versus BP was performed. Methods. Electronic databases from January 2000 to June 2021 were screened. Studies reporting long-term mortality were analyzed. The primary endpoint was long-term overall mortality. Secondary endpoints were in-hospital/.30-day mortality and freedom from both prosthesis reinfection and reintervention. The pooled hazard ratio (HR) with 95% confidence interval (CI) was calculated for survival according to the random effect model. Results. Thirteen retrospective observational studies reporting on 8645 patients (MP: 4688; BP: 4137) were included for comparison. Twelve studies reported data of long-term survival for a total of 8285 patients (MP: 4517; BP: 3768). The pooled analysis revealed that the use of MP was statistically associated with longer benefits compared to BP (HR 0.74; 95% CI 0.63–0.86; p < 0.0001). The median follow-up time ranged from 1 to 15.3 years. The pooled analysis of five studies reporting data on prosthesis reinfection in 4491 patients (MP: 2433; BP: 2058) did not reveal significant differences (HR 0.60; 95% CI 0.30–1.21; p = 0.15). Five studies reported data on prosthesis reintervention in 4401 patients (MP: 2307; BP: 2094). The meta-analysis revealed a significant difference in favor of MP (HR 0.40; 95% CI 0.29–0.55; p < 0.0001). Meta-regression reported no effect of male gender (p = 0.09) and age (p = 0.77) on long-term survival. Conclusions. In a meta-analysis of retrospective observational studies comparing the long-term outcome of patients who underwent surgery for left-sided IE, the use of MP compared to BP is associated with a significant longer-term survival and with a reduced incidence of late reoperation. The incidence of late reinfection is comparable between the two prostheses.

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