RENAL FUNCTION IN HYPERPARATHYROIDISM

1970 ◽  
Vol 63 (1) ◽  
pp. 161-174 ◽  
Author(s):  
Lave Ohlsson

ABSTRACT Clearances of inulin and para-aminohippurate (PAH) were studied before as well as three to nine years (average 5½) after surgery in 35 cases of primary hyperparathyroidism. The preoperative inulin clearance ranged from 18 to 105 (average 67) and the PAH clearance from 61 to 666 (349) ml/min/1.73 m2 BSA. In the follow-up studies clearances of inulin and PAH were, on the whole, well maintained both in subjects with normal as well as in cases showing depressed clearance values before surgery. In fact, a slight but statistically significant increase of inulin clearance was demonstrated in the material as a whole, whereas no significant change occurred in PAH clearance. The renal concentrating capacity was estimated before and after operation in 22 of the patients. An increase was almost regularly observed postoperatively but the concentrating capacity remained subnormal in almost half of the subjects studied. The changes in the concentrating capacity and clearances of inulin and PAH did not always run parallel. The renal clearance of phosphate was studied simultaneously with inulin and PAH clearances. Phosphate clearance decreased after surgery concomitantly with an elevation of serum phosphorus. However, restoration to the normal was not always obtained. Arterial hypertension was present in 40 per cent of the patients before and/or after surgery. Only grade I-II eye ground changes were found. Blood pressure was easily controlled by hypotensive drugs. A spontaneous disappearance or a decrease in the number of kidney stones was demonstrated radiologically at the follow-up studies in almost half of the patients. In only two subjects were additional kidney stones found. It is concluded that, following surgical treatment of hyperparathyroidism, the long-term outcome regarding renal function may be more favourable than has hitherto been thought.

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 525-525
Author(s):  
Robert J. Haggerty

Anorexia nervosa is a serious psychosomatic disorder which most typically begins between 16 and 18 years of age. Clinicians have often held that early onset (eg, ages 11 to 15) is associated with a better outcome. This paper reviews the long-term outcome studies on anorexia nervosa and concludes that this contention is not supported by available data. The methodologies of seven outcome studies that focus on an early onset population are critiqued, and it is concluded that two methodologies are strong. Because of the increasing prevalence of anorexia nervosa, this once rare disorder can now be more easily investigated, and consequently better follow-up studies, which examine potential prognostic factors including age of onset, should be forthcoming.


2020 ◽  
Vol 26 (1) ◽  
pp. 94-106
Author(s):  
S. A. Panarina ◽  
Yu. S. Yudina ◽  
M. V. Ionov ◽  
N. G. Avdonina ◽  
I. V. Emelyanov ◽  
...  

Objective. To investigate the dynamics of renal function in patients with resistant arterial hypertension after renal denervation depending on the degree of central and peripheral blood pressure (BP) reduction and the baseline state of the kidneys.Design and methods. A total of 22 patients (mean age 56,1 ± 10,2 years, 9 males) with treated resistant hypertension undergoing bilateral renal denervation (RDN) (Symplicity RDN System, Medtronic, USA) were included. Office BP measuring, 24-hour ambulatory BP monitoring (ABPM) (SpaceLabs 90207, USA), applanation tonometry (SphygmoCor, AtCor Medical, Australia) with the calculation of central aortic blood pressure (CAP), Doppler ultrasonography (Vivid 7 dimension) were obtained at baseline and at 1, 3, 6, 12, 18 and 24 months after RDN. Urine levels of NGAL (neutrophil gelatinase-associated lipocalin), KIM-1 (kidney injury molecule 1), L-FABP (Liver-type fatty acid binding protein), albuminuria and serum levels of сystatin C (sCysC) and creatinine (sCr) were measured by quantitative enzyme immunoassay at baseline and at 1, 3, 6, 12, 18 and 24 months after RDN. Glomerular filtration rate was estimated by the level of sCr and sCysC by CKD-EPI formula.Results. All patients were divided into 3 groups according BP reduction: 1 — BP increase above 0 mm Hg; 2 — BP reduction from 0 to –30 mm Hg; 3 — BP reduction by > 31 mm Hg. An increased sCysС was registered in a group with decreased 24-hour systolic BP (1,06 ± 0,41; 0,93 ± 0,18 and 1,22 ± 0,23 ng/mL; F = 2,882; р = 0,04) and increased urine KIM-1 level — in a group with decreased office diastolic BP (2,18 ± 1,94; 1,53 ± 1,02 and 4,41 ± 0,97 pg/mL; F = 3,663; р = 0,03) at 3-month follow-up. An increased sCr level was registered in a group with decreased 24-hour systolic BP (78,3 ± 3,7; 88,2 ± 6,8 and 142,00 ± 8,8 μmol/L; F = 61,987; p = 0,004) and diastolic CAP (83,4 ± 8,2; 82,0 ± 8,0 and 142,0 ± 9,4 μmol/L; F = 23,476; p = 0,01), also an increased urine L-FABP level — in a group with decreased office diastolic BP (3531,3 ± 1795,0; 997,5 ± 1096,8 and 7351,7 ± 3297,0 pg/mL; F = 12,103; p = 0,002) at 6-month follow up.Conclusions. Renal function worsening in patients during the period of maximum BP lowering may be associated with an excessive BP reduction. Therefore, we can suggest the occurrence of the J-curve phenomenon in relation to the kidneys.


Author(s):  
Lily Hechtman

The introduction stresses that well-controlled long-term prospective follow-up studies helped establish the validity of ADHD in adulthood. No other publication brings together all these highly respected and well-established studies. The studies provide a comprehensive view of the impact of this condition in educational, occupational, social, emotional, and legal domains. The book also outlines factors that can influence long-term outcome and prognosis. These include treatment, IQ, socioeconomic status, and family functioning among others. This has current treatment implications for seeking more positive outcomes. Professionals can access these relevant factors in one place and use them in treatment planning.


1967 ◽  
Vol 113 (504) ◽  
pp. 1169-1182 ◽  
Author(s):  
Michael Rutter ◽  
Linda Lockyer

The psychoses of infancy have long been a matter for controversy. The nature of the disorders, their aetiology, relationship to adult forms of psychosis, long-term outcome and response to treatment are still areas of disagreement among clinicians. Follow-up studies should provide information relevant to some of these problems. Unfortunately, the findings of published investigations have been contradictory. To a large extent contradictions appear to be related to differences in diagnostic criteria, but the failure of many writers to describe their cases adequately has made it difficult to assess the significance of possible differences.


2016 ◽  
Vol 87 (2) ◽  
pp. 200-208 ◽  
Author(s):  
Ulrike Schütz-Fransson ◽  
Rune Lindsten ◽  
Krister Bjerklin ◽  
Lars Bondemark

ABSTRACT Objective: To compare the long-term outcome 9 years after removal of two different types of fixed retainers used for stabilization of the mandibular anterior segment. Materials and Methods: Sixty-four children who had undergone orthodontic treatment with fixed appliances in both arches were divided into two groups depending on which kind of retainer being used. Twenty-eight of the patients had a canine-to-canine retainer bonded to the canines and 36 had a bonded twistflex retainer 3-3, bonded to each tooth. Measurements were made on study models and lateral head radiographs, before and after treatment, 6 years after treatment, and 12 years after treatment, with a mean of 9.2 years after removal of the retainers. Results: No significant differences were found between the two groups at the long-term follow-up according to Little's Irregularity Index or available space for the mandibular incisors. The overjet and overbite were reduced after treatment in both groups and stayed stable throughout the observation period. Also, no differences in bonding failures between the two retainers were found. Conclusions: Both a canine-to-canine retainer bonded only to the canines and a twistflex retainer 3-3 bonded to each tooth can be recommended. However, neither of the retention types prevented long-term changes of mandibular incisor irregularity or available space for the mandibular incisors after removal of the retainers.


VASA ◽  
2002 ◽  
Vol 31 (1) ◽  
pp. 36-42 ◽  
Author(s):  
. Bucek ◽  
Hudak ◽  
Schnürer ◽  
Ahmadi ◽  
Wolfram ◽  
...  

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.


Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Stephen Curran ◽  
Michael Fitzgerald ◽  
Vincent T Greene

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8½ years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five had died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.


2019 ◽  
Vol 24 (4) ◽  
pp. 415-422 ◽  
Author(s):  
Bianca K. den Ottelander ◽  
Robbin de Goederen ◽  
Marie-Lise C. van Veelen ◽  
Stephanie D. C. van de Beeten ◽  
Maarten H. Lequin ◽  
...  

OBJECTIVEThe authors evaluated the long-term outcome of their treatment protocol for Muenke syndrome, which includes a single craniofacial procedure.METHODSThis was a prospective observational cohort study of Muenke syndrome patients who underwent surgery for craniosynostosis within the first year of life. Symptoms and determinants of intracranial hypertension were evaluated by longitudinal monitoring of the presence of papilledema (fundoscopy), obstructive sleep apnea (OSA; with polysomnography), cerebellar tonsillar herniation (MRI studies), ventricular size (MRI and CT studies), and skull growth (occipital frontal head circumference [OFC]). Other evaluated factors included hearing, speech, and ophthalmological outcomes.RESULTSThe study included 38 patients; 36 patients underwent fronto-supraorbital advancement. The median age at last follow-up was 13.2 years (range 1.3–24.4 years). Three patients had papilledema, which was related to ophthalmological disorders in 2 patients. Three patients had mild OSA. Three patients had a Chiari I malformation, and tonsillar descent < 5 mm was present in 6 patients. Tonsillar position was unrelated to papilledema, ventricular size, or restricted skull growth. Ten patients had ventriculomegaly, and the OFC growth curve deflected in 3 patients. Twenty-two patients had hearing loss. Refraction anomalies were diagnosed in 14/15 patients measured at ≥ 8 years of age.CONCLUSIONSPatients with Muenke syndrome treated with a single fronto-supraorbital advancement in their first year of life rarely develop signs of intracranial hypertension, in accordance with the very low prevalence of its causative factors (OSA, hydrocephalus, and restricted skull growth). This illustrates that there is no need for a routine second craniofacial procedure. Patient follow-up should focus on visual assessment and speech and hearing outcomes.


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