Growth of Hyperkinetic Children Taking Methylphenidate, Dextroamphetamine, or Imipramine/Desipramine

PEDIATRICS ◽  
1976 ◽  
Vol 58 (3) ◽  
pp. 423-431 ◽  
Author(s):  
Mortimer D. Gross
Keyword(s):  
Statistical Significance ◽  
Dosage Level ◽  
Significant Degree ◽  
Brain Dysfunction ◽  
Iowa City ◽  
Minimal Brain Dysfunction ◽  
Duration Of Treatment ◽  
Hyperkinetic Syndrome

One hundred children with the hyperkinetic syndrome or minimal brain dysfunction syndrome were treated with medication: 60 with methylphenidate (Ritalin), 24 with dextroamphetamine (Dexedrine), and 16 with either imipramine or desipramine. The duration of treatment was for a minimum of two years, and averaged five years, with an average follow-up of six years from the onset of treatment. Their weight and height had been measured prior to treatment, and these and subsequent measurements were converted to percentiles, using the tables of norms of the Iowa City study. Initially there was a diminution in expected weight, but not height, but after a few years the growth in weight and height was found to be greater than predicted from the norms to a statistically significant degree. Gains in weight and height were greater for those whose medication had been stopped prior to the final measurements than for those still taking medication; but these differences did not reach statistical significance. No correlations were found between dosage level and changes in weight and height percentiles. It is concluded that there is no stunting of growth from the long-term use of methylphenidate, dextroamphetamine, or imipramine/desipramine in children. Any slowing of growth when treatment is first started is compensated for later on, both while the patient is still taking the medication, and after discontinuing it.

scholarly journals Two-component surface replacement implants compared with perichondrium transplantation for restoration of Metacarpophalangeal and proximal Interphalangeal joints: a retrospective cohort study with a mean follow-up time of 6 respectively 26 years

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Daniel Muder ◽  
Nils P. Hailer ◽  
Torbjörn Vedung
Keyword(s):  
Primary Outcome ◽  
Statistical Significance ◽  
Surface Replacement ◽  
Level Of Evidence ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Two Component ◽  
Pip Joint

Abstract Background The aim of our study was to compare the long-term outcome after perichondrium transplantation and two-component surface replacement (SR) implants to the metacarpophalangeal (MCP) and the proximal interphalangeal (PIP) joints. Methods We evaluated 163 joints in 124 patients, divided into 138 SR implants in 102 patients and 25 perichondrium transplantations in 22 patients. Our primary outcome was any revision surgery of the index joint. Results The median follow-up time was 6 years (0–21) for the SR implants and 26 years (1–37) for the perichondrium transplants. Median age at index surgery was 64 years (24–82) for SR implants and 45 years (18–61) for perichondium transplants. MCP joint survival was slightly better in the perichondrium group (86.7%; 95% confidence interval [CI]: 69.4–100.0) than in the SR implant group (75%; CI 53.8–96.1), but not statistically significantly so (p = 0.4). PIP joint survival was also slightly better in the perichondrium group (80%; CI 55–100) than in the SR implant group (74.7%; CI 66.6–82.7), but below the threshold of statistical significance (p = 0.8). Conclusion In conclusion, resurfacing of finger joints using transplanted perichondrium is a technique worth considering since the method has low revision rates in the medium term and compares favorable to SR implants. Level of evidence III (Therapeutic).

Stability in Waking-Sleep States in Neonates as a Predictor of Long-Term Neurologic Outcome

PEDIATRICS ◽  
1985 ◽  
Vol 76 (1) ◽  
pp. 52-63
Author(s):  
Cesare T. Lombroso ◽  
Yoichi Matsumiya
Keyword(s):  
Statistical Significance ◽  
Observation Time ◽  
Long Term Outcomes ◽  
Newborn Period ◽  
Waking And Sleep ◽  
Total Observation Time ◽  
Total Observation ◽  
The Individual

Thirty-three full-term neonates were ranked blindly on a scale ranging from the least to the highest "risk" for future neurologic complications on the basis of available perinatal biographies, tests, and examinations performed during the newborn period. Four prolonged polygraphic-behavioral recordings were obtained one week apart beginning at ten days after birth. Five waking and sleep states were scored in each session as percentages of total observation time, giving a total of 20 scores for each baby to be subjected to analysis of variance. These measures also provided individual profile consistency or variability in maintaining waking-sleep states over the selected period of postnatal time. The whole cohort, except three infants who could not be followed adequately, was then reexamined periodically over a period ranging from 3 to 4 years (±6 months) for neurologic and developmental assessments. Except for two scores that produced a low level of statistical significance (P < .05), the other 18 scores were found to be not associated with long-term outcomes. Even the first two scores were not satisfactory discriminators for the outcome of the individual babies. However, when coefficients of concordance (W) were computed from each individual baby profile, significant statistics (P < .001) emerged to indicate good correlations between high or low W values in the newborn period and long-term outcomes. All 17 newborns who had W scores greater than 0.9 were found to be normal at follow-up regardless of the poor ranking given several of them during the newborn period. Among the 13 newborns who had W scores less than 0.9, 11 had a poor clinical outcome at follow-up, though several had been ranked initially as falling within the least "risk" group.

Is catheter-directed foam sclerotherapy more effective than the usual foam sclerotherapy for treatment of the great saphenous vein?

2018 ◽  
Vol 33 (9) ◽  
pp. 646-652 ◽  
Author(s):  
Orsini Camillo
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Statistical Significance ◽  
Long Term Results ◽  
Complication Rates ◽  
Foam Sclerotherapy ◽  
Occlusion Rate ◽  
Long Term Experience

Objective This retrospective study presents the long-term results of catheter-directed foam sclerotherapy of the great saphenous vein. Method From January 2003 to June 2017, 277 patients with varices and great saphenous vein incompetence were treated with echo-guided foam sclerotherapy. Forty-six patients were treated with long-catheters guided by foam sclerotherapy. Foaming was carried out with sodium-tetra-decyl-sulphate. Results Results were examined in the two groups: A (long-catheters) and B (other procedures). The median overall follow-up was 52.1 months. In the A-group, the complete occlusion rate was 34/46 pts (73.9%) and partial occlusion was 10/46 (21.7%). In the B-group, respectively, 130/231 (56.2%) and 90/231 (38.9%). Comparisons between groups were statistically significant (p = 0.023; p = 0.021). Failures involved, respectively, 2/46 (4.3%) and 11/231 (4.7%) with no statistical significance. The complication rates were similar in the two groups. Conclusions In this long-term experience (median follow-up exceeding four years), foam-guided sclerotherapy of the great saphenous vein with a long-catheter turned out to be more effective than the usual foam-guided sclerotherapy.

Comment on Medication for Hyperkinetic Children

PEDIATRICS ◽  
1976 ◽  
Vol 58 (2) ◽  
pp. 303-303
Author(s):  
Leon Oettinger
Keyword(s):  
Drug Therapy ◽  
Child Health ◽  
Brain Dysfunction ◽  
Minimal Brain Dysfunction ◽  
Long Term Effects ◽  
Stimulant Drug ◽  
Recent Meeting ◽  
Average Intelligence ◽  
Behavior Syndrome

The article of the Council on Child Health referring to medication for hyperactive children1 contains several misleading or confusing statements: (1) The hyperkinetic behavior syndrome (minimal brain dysfunction) appears in children of below-average intelligence as well as in children of average or above-average intelligence. This was generally agreed on at a recent meeting in Alta, Utah, where a number of investigators, including Paul Wender and C. K. Conners, were present. In an article presented for the Workshop on Evaluating Long-Term Effects of Stimulant Drug Therapy, I presented data showing that minimal brain dysfunction occurred at essentially all levels of intellect.2

scholarly journals Long-Term Postoperative Total Knee Arthroplasty Flexion Scores in Relation to Body Mass Index

2020 ◽  
Author(s):  
Matthew A. Siegel ◽  
Michael J. Patetta ◽  
Angie M. Fuentes ◽  
Armaan S. Haleem ◽  
Craig W. Forsthoefel ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Total Knee Arthroplasty ◽  
Body Mass ◽  
Knee Arthroplasty ◽  
Statistical Significance ◽  
P Value ◽  
Preoperative Body Mass Index ◽  
Total Knee

AbstractKnee range of motion (ROM) is an important postoperative measure of total knee arthroplasty (TKA). There is conflicting literature whether patients who are obese have worse absolute ROM outcomes than patients who are not obese. This study analyzed whether preoperative body mass index (BMI) influences knee ROM after patients' primary TKA. A retrospective investigation was performed on patients, who underwent primary TKA at an academic institution, by one of three fellowship-trained adult reconstruction surgeons. Patients were stratified according to their preoperative BMI into nonobese (BMI < 30.0 kg/m2) and obese (BMI ≥ 30.0 kg/m2) classifications. Passive ROM was assessed preoperatively as well as postoperatively at patients' most recent follow-up visit that was greater than 2 years. Mann–Whitney U tests were performed to determine statistical significance at p-value <0.05 for ROM outcomes. No statistically significant differences were observed when ROM in the nonobese group was compared with ROM in the obese group both preoperatively (105.73 ± 11.58 vs. 104.14 ± 13.58 degrees, p-value = 0.417) and postoperatively (105.83 ± 14.19 vs. 104.49 ± 13.52 degrees, p-value = 0.777). Mean follow-up time for all patients was 4.49 ± 1.92 years. In conclusion, long-term postoperative ROM outcomes were similar between patients who were nonobese and patients who were obese.

scholarly journals Longitudinal follow-up with VIM thalamic deep brain stimulation for dystonic or essential tremor

Neurology ◽  
2020 ◽  
Vol 94 (10) ◽  
pp. e1073-e1084 ◽  
Author(s):  
Takashi Tsuboi ◽  
Zakia Jabarkheel ◽  
Pamela R. Zeilman ◽  
Matthew J. Barabas ◽  
Kelly D. Foote ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Essential Tremor ◽  
Brain Stimulation ◽  
Rating Scale ◽  
Statistical Significance ◽  
Ventral Intermediate Nucleus ◽  
Deep Brain

ObjectiveTo assess longitudinal tremor outcomes with ventral intermediate nucleus deep brain stimulation (VIM DBS) in patients with dystonic tremor (DT) and to compare with DBS outcomes in essential tremor (ET).MethodsWe retrospectively investigated VIM DBS outcomes for 163 patients followed at our center diagnosed with either DT or ET. The Fahn-Tolosa-Marin tremor rating scale (TRS) was used to assess change in tremor and activities of daily living (ADL) at 6 months, 1 year, 2–3 years, 4–5 years, and ≥6 years after surgery.ResultsTwenty-six patients with DT and 97 patients with ET were analyzed. Compared to preoperative baseline, there were significant improvements in TRS motor up to 4–5 years (52.2%; p = 0.032) but this did not reach statistical significance at ≥6 years (46.0%, p = 0.063) in DT, which was comparable to the outcomes in ET. While the improvements in the upper extremity tremor, head tremor, and axial tremor were also comparable between DT and ET throughout the follow-up, the ADL improvements in DT were lost at 2–3 years follow-up.ConclusionOverall, tremor control with VIM DBS in DT and ET was comparable and remained sustained at long term likely related to intervention at the final common node in the pathologic tremor network. However, the long-term ADL improvements in DT were not sustained, possibly due to inadequate control of concomitant dystonia symptoms. These findings from a large cohort of DT indicate that VIM targeting is reasonable if the tremor is considerably more disabling than the dystonic features.Classification of evidenceThis study provides Class IV evidence that VIM DBS improves tremor in patients with DT or ET.

Surgical Repair of Ileovesical Fistulas: Long-term Complications, Quality of Life, and Patient Satisfaction

2014 ◽  
Vol 80 (12) ◽  
pp. 1207-1211 ◽  
Author(s):  
Jeffrey W. Hastings ◽  
Malika Garg ◽  
Elizabeth T. Lynn ◽  
Celia M. Divino
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Statistical Significance ◽  
Retrospective Chart Review ◽  
Administrative Database ◽  
Low Incidence ◽  
Assess Quality

Ileovesical fistulas (IVFs) are an uncommon complication of Crohn's disease. The aim of this study is to compare long-term surgical outcomes, assess quality of life, and quantify patient satisfaction after IVF repair. A retrospective chart review followed by a prospective survey was carried out. Survey questions focused on patient satisfaction and quality of life after repair of IVF. Fifty-one patients were identified from an administrative database. Mean follow-up was 4.3 years with a response rate of 51 per cent. At the time of the study, 0 per cent mortality and 16 per cent morbidity were recorded. No recurrence was noted. There was no statistical significance in incidence of complications between laparoscopic and open surgery. Statistically significant differences in single-stage versus multistage operations were found in postoperative day of discharge ( P < 0.001) and patient satisfaction ( P = 0.049). Ninety-eight per cent of patients reported extreme satisfaction with their surgery and an improvement in quality of life. A low incidence of morbidity and recurrence supports early surgical intervention in IVFs.

Long-term effect on outcome of clozapine in chronic therapy-resistant schizophrenic patients

1997 ◽  
Vol 12 (S5) ◽  
pp. 353s-355s ◽  
Author(s):  
LH Lindström ◽  
T Lundberg
Keyword(s):  
Duration Of Treatment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Clozapine Treatment ◽  
Long Term Effect ◽  
Chronic Therapy ◽  
Schizophrenic Patients ◽  
The Mean

SummaryControlled clinical trials have shown that the atypical neuroleptic clozapine is highly effective in schizophrenic patients who are unresponsive to conventional neuroleptic agents. The long-term outcome of clozapine treatment was studied in 122 patients who were treated between 1974 and 1991. The mean duration of treatment was 5.2 years. At follow-up, 74 patients (61%) were still receiving clozapine. Only 11 patients discontinued treatment because of adverse events and eight because of poor compliance. Clinical improvement was seen in 87% of patients; 40% had resumed employment after 2 years' treatment. About one-third of patients who received clozapine for 5–10 years continued to improve during this time; this was probably because of a continuing process of socialisation. Thus, clozapine offers important advantages in schizophrenic patients resistant to conventional neuroleptics in terms of long-term efficacy and lack of extrapyramidal side-effects.

scholarly journals Malondialdehyde can predict survival in hemodialysis patients

2016 ◽  
Vol 89 (2) ◽  
pp. 250-256 ◽  
Author(s):  
Crina Claudia Rusu ◽  
Simona Racasan ◽  
Ina Maria Kacso ◽  
Diana Moldovan ◽  
Alina Potra ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Cox Model ◽  
Statistical Significance ◽  
Morbidity And Mortality ◽  
Protein Carbonyls ◽  
Cross Sectional ◽  
Long Term Follow Up ◽  
Cv Disease

Background and aims. Cardiovascular (CV) disease is the leading cause of morbidity and mortality in hemodialysis (HD) patients. Kidney disease is associated with increased oxidative stress (OS), a nontraditional CV risk factor. Few studies evaluate the effect of OS markers on CV events (CVE) and survival in HD patients. The aim of this study is to examine potential determinants of OS markers and their predictive role on survival and CV morbidity and mortality in HD patients during a long-term follow-up (108 months).  Methods. We conducted an analytical cross-sectional prospective observational study, carried on a cohort of randomly selected HD patients. We registered in 44 HD patients baseline characteristics, OS markers, mortality and CVE over a period of 108 months and we used statistical analysis (descriptive, Kaplan-Meier, univariate and multivariate Cox model) for interpretation.Results. Bound malondialdehyde (bMDA) was positively correlated with serum calcium, protein carbonyls (PC) were inversely correlated with diastolic blood pressure (DBP) and directly correlated with ferritin, NOx was directly correlated with ceruloplasmin) and serum albumin. Of the measured OS markers only bMDA was related to survival (HR=3.29 95% CI (1.28-8.44), p=0.01), and approached statistical significance in the effect on CV mortality (HR=2.85 95% CI (0.88-9.22), p=0.07). None of the measured OS markers was associated with CVE.Conclusions. bMDA has a strong predictive value on survival in HD patients in a long-term follow-up (9 years). Its value is correlated with CV mortality but is not a predictor of CV events. Regular assessment of MDA in HD patients and the development of strategies aimed at reducing oxidative stress in these patients might be beneficial.

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