scholarly journals The value of a patient global assessment in management of sarcoidosis

2021 ◽  
Author(s):  
Robert Baughman ◽  
Jeffrey Kotzin ◽  
Elyse E Lower
Keyword(s):  
Global Assessment ◽  
Well Being ◽  
Patient Global Assessment ◽  
Outcome Instrument ◽  
Time Period ◽  
Significant Difference ◽  
Anti Inflammatory ◽  
A Prospective Study ◽  
The University

Abstract The patient global assessment (PGA) is a reported outcome instrument used to gauge the patient’s well-being. We performed a prospective study of patients seen at the University of Cincinnati Sarcoidosis Clinic. Two groups were studied: those at first visit during the time period (Initial) and those seen at least one more time by the same physician (Follow-up). A total of 1006, including 677 Initial visits, occurred during the six month period. Patients who initiated or increased their anti-inflammatory therapy had a significantly lower mean PGA score (ANOVA P<0.001, p<0.05 for increased versus all others). There was no significant difference in initial PGA score based on race, sex, or age. The change in PGA was significantly lower for those who increased medication (ANOVA P<0.001, increased different from all others, p<0.05). The PGA was significantly lower for patients who increased anti-inflammatory therapy initially or at follow-up, however there was overlap between groups.

Conservative treatment of plantar fasciitis. A prospective study

1998 ◽  
Vol 88 (8) ◽  
pp. 375-380 ◽  
Author(s):  
DM Lynch ◽  
WP Goforth ◽  
JE Martin ◽  
RD Odom ◽  
CK Preece ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Prospective Study ◽  
Plantar Fasciitis ◽  
Mechanical Treatment ◽  
Conservative Therapy ◽  
Significant Difference ◽  
Anti Inflammatory ◽  
The Individual ◽  
A Prospective Study

A randomized, prospective study was conducted to compare the individual effectiveness of three types of conservative therapy in the treatment of plantar fasciitis. One hundred three subjects were randomly assigned to one of three treatment categories: anti-inflammatory, accommodative, or mechanical. Subjects were treated for 3 months, with follow-up visits at 2, 4, 6, and 12 weeks. For the 85 patients who completed the study, a statistically significant difference was noted between groups, with mechanical treatment with taping and orthoses proving to be more effective than either anti-inflammatory or accommodative modalities.

scholarly journals A prospective study on outcome of function after proximal row carpectomy

2019 ◽  
Vol 6 (1) ◽  
pp. 44
Author(s):  
Chaitanya Gadi ◽  
S. M. Venugopal ◽  
Bhaskaranand Kumar ◽  
Karthik Gudaru
Keyword(s):  
Prospective Study ◽  
Grip Strength ◽  
Neuromuscular Disorders ◽  
Wrist Flexion ◽  
Proximal Row Carpectomy ◽  
Significant Difference ◽  
Post Traumatic ◽  
A Prospective Study ◽  
Traumatic Arthritis

<p class="abstract"><strong>Background:</strong> Proximal row carpectomy (PRC) is a procedure with varied indications. The purpose of this study was to evaluate functional outcomes with PRC in wrist flexion deformities, neuromuscular disorders and also post-traumatic wrist arthritis.</p><p class="abstract"><strong>Methods:</strong> A prospective study was performed on all patients who underwent PRC between April 2015 and December 2017, in BIRRD (T) hospital, Tirupati, Andhra Pradesh with a minimum follow up of 6 months. Outcome was assessed in terms of range of motion (ROM), grip strength, quick disabilities of the arm, shoulder, and hand (QDASH) score and pain score. Data was analyzed using the Student t-test.<strong></strong></p><p class="abstract"><strong>Results:</strong> Thirty-two patients underwent PRC of which 12 are neuromuscular disorders, 10 are wrist flexion deformities, 10 are post-traumatic wrist arthritis. On the final follow-up, significant improvement in ROM was observed in wrist flexion deformities and neuromuscular disorders, whereas grip strength and QDASH scores showed a significant difference in post-traumatic wrist arthritis. Pain was studied only in post-traumatic wrist arthritis, all were very much pleased with pain reduction.</p><p class="abstract"><strong>Conclusions:</strong> PRC is fairly a reliable procedure for all the indications in our study. We consider that PRC is a promising procedure in correcting wrist flexion deformities. Though there has been significant improvement in all the parameters for all the cases, we consider this procedure is best suited for post-traumatic arthritis group.</p>

Single Centre Experience in Patients with Primary Hyperparathyroidism: Sporadic, Lithium-associated and in Multiple Endocrine Neoplasia

2019 ◽  
Vol 128 (10) ◽  
pp. 693-698
Author(s):  
Sabine Dillenberger ◽  
Detlef K. Bartsch ◽  
Elisabeth Maurer ◽  
Peter Herbert Kann
Keyword(s):  
Primary Hyperparathyroidism ◽  
Multiple Endocrine Neoplasia ◽  
University Hospital ◽  
Primary Surgery ◽  
Endocrine Neoplasia ◽  
Single Centre Experience ◽  
Significant Difference ◽  
History Of ◽  
The University

Abstract Purpose It is assumed that primary hyperparathyroidism (pHPT) in Multiple Endocrine Neoplasia (MEN) and lithium-associated pHPT (LIHPT) are associated with multiple gland disease (MGD), persistence and recurrence. The studies purpose was to determine frequencies, clinical presentation and outcome of sporadic pHPT (spHPT), LIHPT and pHPT in MEN. Additional main outcome measures were the rates of MGD and persistence/recurrence. Methods Retrospective analysis of medical records of 682 patients with pHPT who had attended the University Hospital of Marburg between 01–01–2004 and 30–06–2013. All patients were sent a questionnaire asking about their history of lithium medication. Results Out of 682 patients, 557 underwent primary surgery (532 spHPT, 5 LIHPT, 20 MEN), 38 redo-surgery (31 spHPT, 7 MEN), 55 were in follow-up due to previous surgery (16 spHPT, 1 LIHPT, 38 MEN) and 37 were not operated (33 spHPT, 1 LIHPT, 3 MEN). Primary surgeries were successful in 97.4%, revealed singular adenomas in 92.4%, double adenomas in 2.9% and MGD in 3.4% of the cases. Rates of MGD in MEN1 (82.35%) were significantly higher than in spHPT (3.8%), while there was no significant difference between LIHPT (20%) and spHPT. Rates of persistence/recurrence did not significantly differ due to type of surgery (bilateral/unilateral) or type of HPT (spHPT/LIHPT/MEN). Conclusions History of lithium medication is rare among pHPT patients. While MGD is common in MEN1, rates of MGD, persistence or recurrence in LIHPT were not significantly higher than in spHPT.

Is Intraperitoneal Tobramycin Ototoxic in CAPD Patients?

1991 ◽  
Vol 11 (2) ◽  
pp. 156-161 ◽  
Author(s):  
Paul Nikolaidis ◽  
Stephen Vas ◽  
Victor Lawson ◽  
Lorraine Kennedy-Vosu ◽  
April Bernard ◽  
...  
Keyword(s):  
Concomitant Treatment ◽  
Speech Discrimination ◽  
Duration Of Treatment ◽  
Cochlear Function ◽  
Threshold Test ◽  
Speech Reception ◽  
Significant Difference ◽  
Ototoxic Drugs ◽  
A Prospective Study

In 40 CAPD patients treated for peritonitis, the authors did a prospective study of ototoxic effects of intraperitoneal tobramycin. They evaluated cochlear function in pure-tone threshold audiograms over a range of frequencies from 250–10, 000 Hz, in the speech-reception threshold test and in the speech-discrimination test. These tests were performed within 48 hours of initiation of tobramycin treatment and within 2 or 3 weeks of the drug's discontinuation. With the aminoglycoside doses used in this study, no statistical difference between the mean baseline and mean follow-up hearing levels was seen in these 40 patients. However, according to the standard criteria of ototoxicity, the hearing in 10 of 40 patients (25%) deteriorated after tobramycin, while it improved in seven patients (17.5%). In the remaining 23 (57.5%), hearing remained stable. With respect to the risk factors for ototoxicity such as advanced age, increased duration of treatment, elevated plasma aminoglycoside levels, concomitant treatment with other ototoxic drugs, pre-existing hearing loss, renal dysfunction and hyperthermia, no statistically significant difference was demonstrated between the patients with deteriorated, stable or improved hearing. The results of this study do not confirm that tobramycin given intraperitoneally to CAPD patients produces auditory toxicity. The hearing deterioration observed in 10 patients may be due to synergistic factors. The improvement observed in 7 patients could not be explained.

Plication versus Resection in Horizontal Strabismus Surgery

2019 ◽  
Vol 236 (04) ◽  
pp. 442-445 ◽  
Author(s):  
Jill Kühne ◽  
Anja Palmowski-Wolfe
Keyword(s):  
Strabismus Surgery ◽  
Dose Effect ◽  
P Value ◽  
Separate Analysis ◽  
Resection Group ◽  
Simultaneous Surgery ◽  
Age At Surgery ◽  
Significant Difference ◽  
The University

Abstract Background To compare two commonly used strengthening procedures in strabismus surgery: plication and resection of the extraocular muscle (EOM). Patients and Methods From an anonymous databank of strabismus surgeries, performed at the University Eye Hospital Basel, patients with a horizontal strabismus surgery, consisting of a recession combined with either plication or resection of the antagonist and a follow-up of at least 3 months, were included. Exclusion criteria were previous eye surgeries, binocular surgeries, and simultaneous surgery of oblique or vertical EOM. Pre- and postoperative angles were measured using the alternating prism cover test during fixation at distance. Results Fifty-nine patients met the criteria and were matched according to the angle at baseline in the recession/plication group, resulting in 12 resection/recession and 12 plication/recession patients. There was no significant difference in the number of eso- and exodeviations, age at surgery, or gender between the groups. Mean difference between plication and resection was 1.2 PD at 1 week (p = 0.72) and 1.7 PD at 3 months (p = 0.61). A separate analysis for eso- and exodeviations showed no significant difference between recession/plication and recession/resection at 1 week or 3 months (p value side effect = 0.59; resection vs. plication at 1 week p = 0.68; resection vs. plication at 3 months: p = 0.57). The overall dose effect (SD) was 2.13 PD (0.88)/mm in the recession/plication group and 2.51 PD (0.81)/mm in the recession/resection group after 1 week (p = 0.331). After 3 months, the mean dose effect was 1.85 PD (1.06)/mm in the recession/plication group and 2.09 PD (1.12)/mm in the recession/resection group (p = 0.611). Discussion Our findings show that recession/plication is a valid alternative to recession/resection in horizontal strabismus without the need to cut the muscle, as we saw no difference in surgical effectiveness in either eso- or exodeviations at 1 week or at 3 months.

scholarly journals RADI-24. VENTRICULOMEGALY AFTER STEREOTACTIC RADIOSURGERY (SRS) FOR BRAIN METASTASES (BM): A PILOT ANALYSIS OF TWO INSTITUTIONAL EXPERIENCES

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i26-i26
Author(s):  
Ali Alattar ◽  
Jiri Bartek ◽  
Brian HIrshman ◽  
Clark Chen
Keyword(s):  
Stereotactic Radiosurgery ◽  
Cerebral Atrophy ◽  
White Matter Injury ◽  
Whole Brain Radiation ◽  
History Of ◽  
Radiation Induced ◽  
A Prospective Study ◽  
The University ◽  
Brain Radiation

Abstract INTRODUCTION: Ventriculomegaly, or dilatation of the cerebrospinal fluid (CSF) space, occurs after whole-brain radiation (WBRT) of brain metastasis (BM) patients due to either 1) hydrocephalus or 2) cerebral atrophy from radiation-induced white matter injury. In this study, we examined whether cumulative radiation from repeat stereotactic radiosurgery (SRS) increases the risk of ventriculomegaly. METHODS: Patients were included if they underwent SRS of BM from 2007–2017 and had imaging follow-up. We examined a cohort of 214 patients treated at the University of California San Diego (1,106 BM) and a second cohort of 148 patients (1,760 BM) treated at Karolinska Institutet. Ventriculomegaly was defined according to established morphometric criteria. Patients were grouped according to the development of new ventriculomegaly at last follow-up. Demographic, clinical, and dosimetric factors were compared between groups using univariable and multivariable logistic regressions. RESULTS: In the UCSD cohort, 63 patients (29%) presented with ventriculomegaly before SRS. Of 151 remaining patients with normal ventricular size before first SRS, 30 (20%) developed new ventriculomegaly. The odds of developing ventriculomegaly increased with history of WBRT (OR 5.247, p&lt; 0.001) and trended toward significance with a greater number of SRS treatments (OR 1.296, p=0.075). In the Karolinska cohort, the odds of developing new ventriculomegaly trended towards significance with a greater number of SRS treatments (OR 1.605, p=0.26). To test whether this trend would achieve significance in a larger sample, we repeated the analysis in the combined cohort of 362 patients. The association between number of SRS treatments and developing ventriculomegaly reached significance (OR 1.254, p=0.049). CONCLUSIONS: These pilot findings suggest that cumulative radiation from repeat stereotactic radiosurgery (SRS) potentially increases the risk of ventriculomegaly. Based on our study, a prospective study of &gt;350 patients will be needed to further test this hypothesis.

Survival rate of self-tapping implants for bone-anchored hearing aids

2006 ◽  
Vol 121 (2) ◽  
pp. 101-104 ◽  
Author(s):  
A Tjellström ◽  
G Granström ◽  
M Odersjö
Keyword(s):  
Hearing Aids ◽  
High Frequency ◽  
Operating Time ◽  
The Self ◽  
Heavy Smoker ◽  
Exact Test ◽  
Time Period ◽  
Significant Difference ◽  
Bone Anchored Hearing Aid

Objective: The purpose of this study was to investigate whether a new self-tapping implant for a bone-anchored hearing aid (BAHA) had the same high frequency of osseointegration as previous implants requiring pre-tapping.Method: Over a three-year period, 144 consecutive implants were placed in the mastoid for BAHA and evaluated.Results: Two implants were lost; both were of the self-tapping type. One was in an 11-year-old boy, who lost his implant six weeks after surgery when the BAHA was fitted. The other was in an elderly man, a heavy smoker with diabetes. Using Fisher's exact test, there was no significant difference between the two groups (p>0.30).Conclusion: Self-tapping implants facilitate surgery and shorten operating time. Over a short follow up, we did not find any significant difference; however, it is important to follow these implants over a longer time period.

Changing treatment paradigms in the era of targeted therapies.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 518-518
Author(s):  
Philipp Marius Papavassilis ◽  
Edwin Herrmann ◽  
Laura-Maria Krabbe ◽  
Lothar Hertle ◽  
Martin Boegemann ◽  
...  
Keyword(s):  
Targeted Therapy ◽  
Rank Test ◽  
P Value ◽  
Line Treatment ◽  
New Agents ◽  
Exact Test ◽  
Significant Survival ◽  
Significant Difference ◽  
The University

518 Background: Our goal was to describe the change of treatment paradigms for metastatic renal cell carcinoma (mRCC) since targeted therapy became available in 2006. Methods: In this cohort population study we retrospectively investigated all mRCC patients who were treated with targeted therapy between 06/2006 and 06/2012 in the Department of Urology of the University of Münster. To distinguish nominal variables Fisher's exact test was used, in other respects Pearson's χ² test. For metrical variables the Mann-Whitney-U-Test was used. The log-rank test was chosen to derive differences between two or more groups with regard to survival. A p value <0,05 was considered statistically significant. Results: 50/158 (31.6%) patients with a median follow-up of 362 days were initially treated with immunotherapy. The most often used second line treatment after immunotherapy was sorafenib (29 patients, 58.0%). As first line treatment sunitinib was chosen most frequently (68 patients, 63.0%). There was no statistically significant difference in survival between the patients who were treated with immunotherapy and those who were not (572 vs. 554 days, p=0,745). 134 (84.4%) patients received cytoreductive nephrectomy before systemic treatment start. Comparing the survival curves there was a significant survival benefit in favor of nephrectomized patients (632 vs. 169 days, p<0,0001). Conclusions: After introduction of the new agents treatment paradigms have changed substantially. Immunotherapy is used only rarely. Cytoreductve nephrectomy should continue to be regarded as standard treatment.

scholarly journals Veiledningssamtale for første års studenter: Et innspill til praksisnærhet og studiekvalitet

2020 ◽  
pp. 67-79
Author(s):  
Anne-Lise With
Keyword(s):  
Career Guidance ◽  
Well Being ◽  
First Year ◽  
First Year Students ◽  
Study Programme ◽  
Quality In Higher Education ◽  
University Of Oslo ◽  
The University ◽  
Shed Light

This chapter deals with counselling for first-year students as a way to strengthen motivation and mastery. Based on the model ForVei – preparatory counselling, it is argued for the relevance of the counselling conversation as a part of follow-up and study programme quality in higher education and the time of mass education. ForVei is based on the basic values MSHRL – Met, Seen, Heard, Respected, Equal, which is central to the way the conversation is conducted. It is the student’s motivation, mastery and well-being that are the main focus of ForVei, which is now practiced at several universities in Norway, such as the University of Oslo and Nord University. The chapter contains examples from our own research project on ForVei – counselling at INN University, where career guidance is a theme, as well. In the perspective of the student’s motivation and experience, counselling and learning theory are used, among others, with Vance Peavy’s constructivist Socio-Dynamic Counselling and Mark S. Savicka’s concept of self-efficacy. The latter, for example, helps to shed light on differences in self-perception and belief in one’s own resources and abilities. The chapter deals with these and other topics in light of study programme quality and ForVei – counselling for first-year students.

scholarly journals Effect of persistence of left ventricular hypertrophy and left atrial dilatation after aortic valve replacement on early outcomes and survival: a prospective study

2019 ◽  
Vol 6 (10) ◽  
pp. 3786
Author(s):  
Hari Krishna Murthy P. ◽  
Abha Chandra
Keyword(s):  
Aortic Valve ◽  
Left Ventricular Hypertrophy ◽  
Aortic Stenosis ◽  
Left Atrial ◽  
Ventricular Hypertrophy ◽  
Severe Aortic Stenosis ◽  
Left Ventricular ◽  
Significant Difference ◽  
A Prospective Study

Background: The objective of the study was to evaluate the early outcomes and survival in patients with severe aortic stenosis associated with concentric left ventricular hypertrophy following aortic valve replacement.Methods: This is a prospective study done at SVIMS, Tirupati, from June 2014 to September 2015 evaluating out comes and survival in patients undergoing primary isolated aortic valve replacement (AVR) for severe aortic stenosis, severe aortic stenosis with mild aortic regurgitation and severe aortic stenosis with moderate aortic regurgitation.Results: A total of 40 cases 26 males and 14 females aged 18 to 60 years (mean age, 48.5±13.4 years) underwent elective AVR. Left ventricular end diastolic diameter (p=0.008) at 6 months, a statistically highly significant difference in left ventricular mass  preoperatively, at discharge, at 3rd and 6th month follow up. The difference in mean left ventricular mass index (LVMI) had declined from 244.425 to 141.100 at 6 months, showing a statistically highly significant difference in LVMI preop, at discharge, at 3rd month and at 6th month follow up.Conclusions: Patients with preoperative increase in LVMI, with large left atrial diameter carries a strong predictor of postoperative mortality for patients undergoing aortic valve surgery. We also conclude that there will be significant regression of LVMI following successful AVR. But, the decrease in LVMI is maximum during early three months and it is minimal though significant in the later course of follow up. 

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