Long-term outcomes of laser coagulation of feto-fetal anastomoses in monochorionic twins

2020 ◽  
Vol 15 (5) ◽  
pp. 52-56
Author(s):  
A.E. Bugerenko ◽  
◽  
Zh.Yu. Kunyakh ◽  
O.B. Panina ◽  
Yu.S. Mirakyan ◽  
...  
Keyword(s):  
Gestational Age ◽  
Laser Coagulation ◽  
Control Group ◽  
Healthy Children ◽  
Long Term Outcomes ◽  
Monochorionic Twins ◽  
Gestational Age At Delivery ◽  
One Year ◽  
Experimental Group

Objective. To evaluate long-term outcomes of fetoscopic laser coagulation (FLC) of placental anastomoses in monochorionic twins with feto-fetal transfusion syndrome (FFTS). Patients and methods. The experimental group included live infants after FLC born to 76 women between 2012 and 2017. The control group comprised monochorionic, diamniotic (MCDA) twins with no complications born to 109 women. The following criteria were used in the analysis: gestational age at FLC, FFTS stage (Quintero staging system), gestational age at delivery, and delivery method. During follow-up, we analyzed children’s data at birth and at the age of one and three years. Results. The number of healthy children and children with minimal health problems in the experimental group was 106 (84.8%) by the age of one year and 112 (89.6%) by the age of 3 years. Nineteen children (15.2%) were disabled at the age of one year; by 3 years of age, their number decreased to 13 (10.4%). In the control group, 2 participants (1.8%) had neurological disabilities. Conclusion. The majority of children born after FLC were healthy and socially adapted. The most common disorders after FLC were neurological disorders (8.8%), cardiovascular disorders (14.8%), retinopathy of prematurity (15.7%), and bronchopulmonary dysplasia (10%). The main factor affecting the development of complications in these children was gestational age at delivery. The optimal gestational age was 33–35 weeks, when the risk of disability was similar to that in MCDA twins without complications. Key words: monochorionic twins, feto-fetal transfusion syndrome, fetoscopy

Long-term outcomes of twins based on gestational age at delivery

2017 ◽  
Vol 31 (23) ◽  
pp. 3102-3107 ◽  
Author(s):  
Erica Stern ◽  
Natalie Cohen ◽  
Elizabeth Odom ◽  
Annemarie Stroustrup ◽  
Simi Gupta ◽  
...  
Keyword(s):  
Gestational Age ◽  
Long Term Outcomes ◽  
Gestational Age At Delivery

scholarly journals Short- and long-term effects of using shooting straps on free-throw accuracy of young female basketball players

Kinesiology ◽  
2017 ◽  
Vol 49 (2) ◽  
pp. 225-234 ◽  
Author(s):  
Miguel-Ángel Gómez ◽  
Jaime Sampaio
Keyword(s):  
Basketball Player ◽  
Control Group ◽  
Long Term Effects ◽  
Basketball Players ◽  
Intervention Training ◽  
Free Throw ◽  
Short And Long Term ◽  
One Year ◽  
Experimental Group

This study identified the short- and long-term effects of using a shooting strap on the accuracy of freethrows performed by U15 female basketball players during training and competition. Thirty six female<br>basketball player volunteers (aged 14.3±0.5 years) from the Lithuanian Schoolchildren Basketball League were randomly assigned to either an experimental or control group. The experimental group used a shooting strap that immobilized movements of the supporting hand while shooting. The control group performed freethrows without any training aid. Learning and transfer of performance was assessed before and after the intervention training sessions (4-week intervention program applied 4 times per week), and on a retention test after one year. Results showed that: (a) free-throw accuracy was higher after one month and after one year of intervention than before the intervention training program in both practice and competition; (b) the experimental group scored better in practice and competition than the control group after one month and one year of the intervention; and (c) free-throw accuracy was higher during training sessions than during&nbsp;competition. The identified short-term and long-term improvements in free-throw shooting accuracy support the usage of shooting straps. The use of shooting straps and external assisting devices might allow adjusting programs of training to provide fluent free-throw accuracy progresses from youth to senior categories.

Short-Term Postnatal Renal Function in Twin Anemia-Polycythemia Sequence

2015 ◽  
Vol 39 (3) ◽  
pp. 192-197 ◽  
Author(s):  
Lianne Verbeek ◽  
Femke Slaghekke ◽  
Romain Favre ◽  
Marine Vieujoz ◽  
Francesco Cavigioli ◽  
...  
Keyword(s):  
Renal Function ◽  
Renal Dysfunction ◽  
Gestational Age ◽  
Twin Pair ◽  
Control Group ◽  
Short Term ◽  
Monochorionic Twins ◽  
Gestational Age At Birth ◽  
Age At Birth

Objective: To evaluate the short-term renal function in neonates with twin anemia-polycythemia sequence (TAPS). Methods: All consecutive monochorionic twins with TAPS with double survivors admitted to three European centers were included in this retrospective study. Each twin pair was matched for gestational age at birth with a control twin pair unaffected by TAPS or twin-twin transfusion syndrome. Creatinine and urea levels in the first week after birth were recorded. Short-term postnatal renal dysfunction was defined as creatinine >100 μmol/l during the first week after birth. Results: A total of 52 TAPS twin pairs and 52 control twin pairs with a median gestational age of 31 weeks at birth were included in the study. In the TAPS group, donors had higher mean creatinine levels compared to recipients, 85 versus 71 μmol/l, respectively (p = 0.001). Short-term renal dysfunction was detected in 26.0% (13/50) of the donors versus 6.3% (3/48) of the recipients (p = 0.022). In the control group, no inter-twin differences in creatinine levels were found. Conclusions: Donor twins with TAPS have higher creatinine levels than recipient twins, suggesting that chronic inter-twin transfusion in TAPS may also cause short-term renal dysfunction. Long-term renal consequences in TAPS donors require further investigation.

scholarly journals Outcomes of extensive surgeries in combination treatment of stage III–IV ovarian cancer

2020 ◽  
Vol 10 (1) ◽  
pp. 43-49
Author(s):  
Kh. I. Mamazhonov ◽  
S. O. Nikogosyan ◽  
A. S. Shevchuk ◽  
V. V. Kuznetsov
Keyword(s):  
Ovarian Cancer ◽  
Lymph Node ◽  
Lymph Node Dissection ◽  
Intraoperative Complications ◽  
Stage Iii ◽  
Control Group ◽  
Node Dissection ◽  
Long Term Outcomes ◽  
Experimental Group

Objective: to evaluate short-term and long-term outcomes of lymph node dissection in patients with stage III–IV ovarian cancer.Materials and methods. This retrospective study included patients with stage III–IV ovarian cancer who have undergone either complete or optimal cytoreduction. Patients in the experimental group additionally had lymph node dissection, whereas patients in the control group had surgery without lymph node dissection. We evaluated 3‑year relapse-free survival (primary outcome measure), 3‑year overall survival, incidence of intraoperative and postoperative complications, and frequency of lymph node lesions.Results. The study included 272 patients: 43 women in the experimental group and 229 women in the control group. Intraoperative complications were significantly more common in patients who had lymph node dissection compared to those who had cytoreductive surgery alone (37.2 % vs 16.6 % respectively; р = 0.0001). The incidence of postoperative complications did not vary significantly between the groups (27.9 % in the experimental group vs 16.2 % in the control group; р = 0.128). Thirty-three patients (76.7 %) were found to have metastasis in the lymph nodes excised. The three-year overall survival rate was 82.6 % among patients who had lymph node dissection and 75.7 % among patients who had no lymph node dissection (р = 0.306). The three-year relapse-free survival rate was 26.2 % in the experimental group and 38.4 % in the control group (р = 0.858).Conclusions. Systemic lymph node dissection does not improve long-term outcomes and increases the incidence of intraoperative complications in patients with stage III–IV ovarian cancer undergoing complete or optimal cytoreduction.

Twin Anemia-Polycythemia Sequence: Perinatal Management and Outcome

2015 ◽  
Vol 40 (1) ◽  
pp. 28-34 ◽  
Author(s):  
Eran Ashwal ◽  
Yoav Yinon ◽  
Michal Fishel-Bartal ◽  
Abraham Tsur ◽  
Benjamin Chayen ◽  
...  
Keyword(s):  
Gestational Age ◽  
Neonatal Morbidity ◽  
Control Group ◽  
Monochorionic Twins ◽  
Monochorionic Twin ◽  
Gestational Age At Delivery ◽  
Perinatal Management ◽  
Intrauterine Blood Transfusion ◽  
And Control ◽  
Twin Pregnancies

Objective: To determine the perinatal outcome of monochorionic twin pregnancies complicated by twin anemia-polycythemia sequence (TAPS). Methods: All monochorionic twins diagnosed with TAPS between 2011 and 2014 were included. Each twin pair with TAPS (study group) was compared with 2 uncomplicated monochorionic twin pairs who were matched for gestational age at delivery (control group). Neonatal morbidity and mortality were evaluated. Results: During the study period, 179 monochorionic twins were followed at our center, of whom 46 underwent laser ablation due to twin-to-twin transfusion syndrome. TAPS was diagnosed in 10 cases; 8 of them were spontaneous, and 2 occurred following laser surgery. Out of 7 patients diagnosed prenatally with TAPS, 5 cases were managed expectantly, and 2 cases were treated with intrauterine blood transfusion. The rates of severe and mild central nervous system lesions on postnatal ultrasound were similar in the TAPS group and control group (5.0 vs. 2.5%, p = 0.61, and 5.0 vs. 12.5%, p = 0.25, respectively). Additionally, severe neonatal morbidity was comparable between the groups. All neonates were alive at 1 month of age. Conclusion: The neonatal outcome of monocohorionic twins affected by TAPS is favorable and comparable to gestational age-matched uncomplicated monochorionic twins.

Evaluation of an Experimental Treatment for Problem Drivers

1978 ◽  
Vol 20 (4) ◽  
pp. 489-493 ◽  
Author(s):  
Jon C. Prothero
Keyword(s):  
Experimental Treatment ◽  
Control Group ◽  
Record Data ◽  
Preliminary Study ◽  
New Treatment ◽  
One Year ◽  
Hearing Officers ◽  
Experimental Group

This preliminary study compared the effectiveness of a new treatment for problem drivers with the National Safety Council's Defensive Driving Course (DDC) and a control group. Hearing officers from four large Florida cities randomly assigned 432 problem drivers, whose licenses had been suspended, to three groups. Safety officers from each of the four locations taught both the experimental course and the DDC. Pretests and posttests on driving knowlege and attitudes were administered to the three groups. Driving record data of the 358 subjects who completed treatment were used to help identify long-term effectiveness of the treatments. Although there was no significant improvements between the groups in driving knowledge or in attitudes after treatment, the experimental group had a greater reduction than the DDC group and a significantly greater reduction than the control group in traffic law violations and collisions during a one year follow-up period. A larger investigation of the effectiveness of the experimental course is recommended.

A Controlled Clinical Trial for Stuttering in Persons Aged 9 to 14 Years

1996 ◽  
Vol 39 (4) ◽  
pp. 808-826 ◽  
Author(s):  
Ashley Craig ◽  
Karen Hancock ◽  
Esther Chang ◽  
Chris McCready ◽  
Alison Shepley ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Controlled Trial ◽  
Control Group ◽  
Controlled Clinical Trial ◽  
Long Term Outcomes ◽  
Adolescent Treatment ◽  
Treatment Groups ◽  
Home Based ◽  
One Year

This paper presents the results of a controlled trial of child stuttering treatment. The aim of the study was, first, to compare the effectiveness of three viable treatments, and, second, to compare these three treatments to a no-treatment control composed of children who stuttered of a similar age and sex ratio who were on treatment waiting lists. The three treatments investigated included intensive smooth speech, intensive electromyography feedback, and home-based smooth speech. The children/adolescents were assessed across three speaking contexts on measures of percentage syllables stuttered (%SS) and syllables spoken per minute (SPM) and outcomes were assessed 12 months later. Repeated measures analyses of variance demonstrated significant differences between the control group and all three treatment groups across time on conversations in the clinic, on the telephone, and at home (although home measures were not taken for the intensive smooth speech group). Although the controls' stuttering did not change across time, the treatment groups' stuttering was decreased to very low levels posttreatment (less than 1% syllables stuttered on average), with mean improvement in stuttering frequency of at least 85% to 90% across all assessment contexts. Stuttering did not increase significantly up to 3 months and one year posttreatment in the experimental groups, although levels did rise across time (less than 3% syllables stuttered on average). Speech naturalness results showed increasing naturalness across time as rated by the clinician and parent. This was not the case for the controls. The children were also less anxious across time following treatment. The results suggest that all three treatments for children aged 9–14 who stutter were very successful in the long term for over 70% of the group, though the EMG feedback and home-based treatments were superior when percentages falling below a cutoff point (2%SS) were used to discriminate between groups. Implications for child/adolescent treatment in the community are discussed. Long-term outcomes will be assessed up to 5 years after the treatment.

Short- and long-term outcomes of preterm spontaneous twin anemia-polycythemia sequence

2020 ◽  
Vol 48 (4) ◽  
pp. 329-334
Author(s):  
Soo Jin Han ◽  
Seung Mi Lee ◽  
Sohee Oh ◽  
Subeen Hong ◽  
Jeong Won Oh ◽  
...  
Keyword(s):  
Cord Blood ◽  
Neonatal Morbidity ◽  
Adverse Outcomes ◽  
Control Group ◽  
Long Term Outcomes ◽  
Neurodevelopmental Outcomes ◽  
Monochorionic Twin ◽  
Increased Risk ◽  
Study Population

AbstractBackgroundIn monochorionic twin pregnancy, placental anastomosis and inter-twin blood transfusion can result in specific complications, such as twin-twin transfusion syndrome (TTTS) and twin anemia-polycythemia sequence (TAPS). It is well established that adverse outcomes are increased in TTTS, but reports on the neonatal and long-term outcomes of TAPS are lacking. The objective of this study was to evaluate the neonatal and neurodevelopmental outcomes in spontaneous TAPS.MethodsThe study population consisted of monochorionic twin pregnancies with preterm birth (24–37 weeks of gestation) between November 2003 and December 2016 and in which cord blood was taken at the time of delivery. According to the result of hemoglobin in cord blood, the study population was divided into two groups: a spontaneous TAPS group and a control group. Neonatal and neurodevelopmental outcomes were compared between the two groups.ResultsDuring the study period, 11 cases were diagnosed as spontaneous TAPS (6.4%). The TAPS group had lower gestational age at delivery and had a higher risk for cesarean delivery. However, neonates with TAPS were not at an increased risk for neonatal mortality and significant neonatal morbidity. In addition, the frequency of severe cerebral lesion during the neonatal period and the risk of cerebral palsy at 2 years of age were not different between the two groups.ConclusionThe spontaneous TAPS diagnosed by postnatal diagnostic criteria was not associated with the increased risk of adverse neonatal and neurodevelopmental outcomes. Further studies are needed to evaluate the morbidity of antenatally diagnosed TAPS.

scholarly journals Impact of atrial fibrillation pattern on outcomes after left atrial appendage closure: lessons from the prospective LAARGE registry

2021 ◽  
Author(s):  
Shinwan Kany ◽  
Johannes Brachmann ◽  
Thorsten Lewalter ◽  
Ibrahim Akin ◽  
Horst Sievert ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Left Atrial Appendage ◽  
Systemic Embolism ◽  
Long Term Outcomes ◽  
Increased Risk ◽  
History Of ◽  
One Year ◽  
The One

Abstract Background Non-paroxysmal (NPAF) forms of atrial fibrillation (AF) have been reported to be associated with an increased risk for systemic embolism or death. Methods Comparison of procedural details and long-term outcomes in patients (pts) with paroxysmal AF (PAF) against controls with NPAF in the prospective, multicentre observational registry of patients undergoing LAAC (LAARGE). Results A total of 638 pts (PAF 274 pts, NPAF 364 pts) were enrolled. In both groups, a history of PVI was rare (4.0% vs 1.6%, p = 0.066). The total CHA2DS2-VASc score was lower in the PAF group (4.4 ± 1.5 vs 4.6 ± 1.5, p = 0.033), while HAS-BLED score (3.8 ± 1.1 vs 3.9 ± 1.1, p = 0.40) was comparable. The rate of successful implantation was equally high (97.4% vs 97.8%, p = 0.77). In the three-month echo follow-up, LA thrombi (2.1% vs 7.3%, p = 0.12) and peridevice leak > 5 mm (0.0% vs 7.1%, p = 0.53) were numerically higher in the NPAF group. Overall, in-hospital complications occurred in 15.0% of the PAF cohort and 10.7% of the NPAF cohort (p = 0.12). In the one-year follow-up, unadjusted mortality (8.4% vs 14.0%, p = 0.039) and combined outcome of death, stroke and systemic embolism (8.8% vs 15.1%, p = 0.022) were significantly higher in the NPAF cohort. After adjusting for CHA2DS2-VASc and previous bleeding, NPAF was associated with increased death/stroke/systemic embolism (HR 1.67, 95% CI 1.02–2.72, p = 0.041). Conclusion Atrial fibrillation type did not impair periprocedural safety or in-hospital MACE patients undergoing LAAC. However, after one year, NPAF was associated with higher mortality. Graphic abstract

scholarly journals Combined low-dose everolimus and low-dose tacrolimus after Alemtuzumab induction therapy: a randomized prospective trial in lung transplantation

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Alberto Benazzo ◽  
Ara Cho ◽  
Anna Nechay ◽  
Stefan Schwarz ◽  
Florian Frommlet ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Lung Transplantation ◽  
Kidney Function ◽  
Induction Therapy ◽  
Low Dose ◽  
Prospective Trial ◽  
Control Group ◽  
Long Term Outcomes ◽  
Maintenance Immunosuppression

Abstract Background Long-term outcomes of lung transplantation are severely affected by comorbidities and development of chronic rejection. Among the comorbidities, kidney insufficiency is one of the most frequent and it is mainly caused by the cumulative effect of calcineurin inhibitors (CNIs). Currently, the most used immunosuppression protocols worldwide include induction therapy and a triple-drug maintenance immunosuppression, with one calcineurin inhibitor, one anti-proliferative drug, and steroids. Our center has pioneered the use of alemtuzumab as induction therapy, showing promising results in terms of short- and long-term outcomes. The use of alemtuzumab followed by a low-dose double drug maintenance immunosuppression, in fact, led to better kidney function along with excellent results in terms of acute rejection, chronic lung allograft dysfunction, and survival (Benazzo et al., PLoS One 14(1):e0210443, 2019). The hypothesis driving the proposed clinical trial is that de novo introduction of low-dose everolimus early after transplantation could further improve kidney function via a further reduction of tacrolimus. Based on evidences from kidney transplantation, moreover, alemtuzumab induction therapy followed by a low-dose everolimus and low-dose tacrolimus may have a permissive action on regulatory immune cells thus stimulating allograft acceptance. Methods A randomized prospective clinical trial has been set up to answer the research hypothesis. One hundred ten patients will be randomized in two groups. Treatment group will receive the new maintenance immunosuppression protocol based on low-dose tacrolimus and low-dose everolimus and the control group will receive our standard immunosuppression protocol. Both groups will receive alemtuzumab induction therapy. The primary endpoint of the study is to analyze the effect of the new low-dose immunosuppression protocol on kidney function in terms of eGFR change. The study will have a duration of 24 months from the time of randomization. Immunomodulatory status of the patients will be assessed with flow cytometry and gene expression analysis. Discussion For the first time in the field of lung transplantation, this trial proposes the combined use of significantly reduced tacrolimus and everolimus after alemtuzumab induction. The new protocol may have a twofold advantage: (1) further reduction of nephrotoxic tacrolimus and (2) permissive influence on regulatory cells development with further reduction of rejection episodes. Trial registration EUDRACT Nr 2018-001680-24. Registered on 15 May 2018

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