scholarly journals Clinical Outcome of Tuberculous Meningitis with Hydrocephalus — A Retrospective Study

2021 ◽  
Vol 28 (5) ◽  
pp. 82-93
Author(s):  
Davendran Kanesen ◽  
◽  
Regunath Kandasamy ◽  
Albert Wong Sii Hieng ◽  
John Tharakan ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Outcome ◽  
Cell Count ◽  
Tuberculous Meningitis ◽  
Surgical Intervention ◽  
Cox Regression ◽  
Survival Function ◽  
Adequate Treatment ◽  
Poor Outcome ◽  
Antituberculosis Treatment

Background: To study the clinical outcome of tuberculous meningitis with hydrocephalus (TBMH) and the factors contributing to its poor clinical outcome. Methods: Clinical data of 143 adult patients diagnosed with TBM over a 6-year period in two tertiary hospitals in Malaysia were retrospectively reviewed. Relevant clinical and radiological data were studied. Patients with TBMH were further analysed based on their clinical grade and rendered treatment to identify associated factors and outcome of this subgroup of patients. The functional outcome of patients was assessed at 12 months from treatment. Results: The mean age of patients was 35.6 (12.4) years old, with a male gender predominance of 67.1%. Forty-four percent had TBMH, of which 42.9% had surgical intervention. In the good modified Vellore grade, 76.5% was managed medically with concurrent antituberculosis treatment (ATT), steroids and osmotic agents. Four patients had surgery early in the disease as they did not respond to medical therapy and reported a good outcome subsequently. Poor outcome (65.2%) was seen in the poor modified Vellore grade despite medical and surgical intervention. Multivariate model multiple Cox regression showed significant results for seizure (adjusted hazard ratio [aHR]: 15.05; 95% CI: 3.73, 60.78), Glasgow coma scale (GCS) (aHR: 0.79; 95% CI: 0.70, 0.89) and cerebrospinal fluid (CSF) cell count (aHR: 1.11; 95% CI: 1.05, 1.17). Conclusion: Hydrocephalus was seen in 44% of patients in this study. GCS score, seizure and high CSF cell count were factors associated with a poor prognosis in TBM. Patients with TBMH treated medically (TBMHM) had better survival function compared to TBMH patients undergoing surgical intervention (TBMHS) (P-value < 0.001). This retrospective study emphasises that TBMH is still a serious illness as 47.6% of the patients had poor outcome despite adequate treatment.

scholarly journals Outcome of Hydrocephalus in Tuberculous Meningitis. A Retrospective Study

2020 ◽  
Author(s):  
Davendran Kanesen ◽  
Regunath Kandasamy ◽  
Albert Wong Sii Hieng ◽  
John Tharakan ◽  
Chien Joo Lim ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Cell Count ◽  
Tuberculous Meningitis ◽  
Surgical Intervention ◽  
Cox Regression ◽  
Survival Function ◽  
Adequate Treatment ◽  
Factors Associated ◽  
Poor Outcome ◽  
Gcs Score

Abstract PurposeTo study outcome of Hydrocephalus in Tuberculous Meningitis (TBMH) and factors associated with poor clinical outcome.MethodsClinical data of 143 adult patients diagnosed with TBM over a 6-year period in 2 tertiary hospitals in Malaysia were retrospectively reviewed. Relevant clinical and radiological data was studied. Patients with Hydrocephalus in TBM (TBMH) were further analysed based on their clinical grade and rendered treatment to identify prognostic factors and outcome of this subgroup of patients. The functional outcome of patients was assessed at 12 months from treatment.Results The mean age of patients was 35.6P12.4 year, with a male gender predominance of 67.1%. Forty four percent had TBMH, of which 42.9% had surgical intervention. In the good Modified Vellore Grade, 76.5% was managed medically with concurrent ATT, steroids and osmotic agents. Four patients had surgery early in the disease as they did not respond to medical therapy and reported a good outcome subsequently. Poor outcome (65.2%) was seen in the poor Modified Vellore Grade despite medical and surgical intervention. Multivariate model Multiple Cox Regression showed significant results for seizure (adjusted HR: 15.05, 95%CI: 3.73, 60.78), GCS (adjusted HR: 0.79, 95%CI: 0.70, 0.89) and CSF cell count (adjusted HR: 1.11, 95%CI: 1.05, 1.17).Conclusion Hydrocephalus was seen in 44% of patients in this study. GCS score, seizure and high CSF cell count were factors associated with a poor prognosis in TBM. Patients with TBMHM had better survival function compared to those with TBMHS (p value <0.001). This retrospective study emphasizes that TBMH is still a serious illness, as 47.6% of these patients had poor outcome despite adequate treatment.

Platform Switching and Bone Platform Switching

2009 ◽  
Vol 35 (5) ◽  
pp. 245-250 ◽  
Author(s):  
Francesco Carinci ◽  
Giorgio Brunelli ◽  
Matteo Danza
Keyword(s):  
Retrospective Study ◽  
Clinical Outcome ◽  
Clinical Outcomes ◽  
Statistical Difference ◽  
Alveolar Bone ◽  
Cox Regression ◽  
Success Rates ◽  
Kaplan Meier ◽  
Implant Abutment ◽  
Platform Switching

Abstract Bone platform switching involves an inward bone ring in the coronal part of the implant that is in continuity with the alveolar bone crest. Bone platform switching is obtained by using a dental fixture with a reverse conical neck. A retrospective study was performed to evaluate the effectiveness of conventional vs reverse conical neck implants. In the period between May 2004 and November 2007, 86 patients (55 females and 31 males; median age, 53 years) were operated and 234 implants were inserted: 40 and 194 were conventional vs reverse conical neck implants, respectively. Kaplan-Meier algorithm and Cox regression were used to detect those variables associated with the clinical outcome. No differences in survival and success rates were detected between conventional vs reverse conical neck implants alone or in combination with any of the studied variables. Although bone platform switching leads to several advantages, no statistical difference in alveolar crest resorption is detected in comparison with reverse conical neck implants. We suppose that the proximity of the implant abutment junction to the alveolar crestal bone gives no protection against the microflora contained in the micrograph. Additional studies on larger series and a combination of platform switching and bone platform switching could lead to improved clinical outcomes.

Salzburg Criteria, A Useful Tool in Non-Convulsive Status Epilepticus Diagnosis: A Retrospective Study

2021 ◽  
pp. 155005942199171
Author(s):  
Adriana Gómez Domínguez ◽  
Raidili C. Mateo Montero ◽  
Alba Díaz Cid ◽  
Antonio J. P. Mazarro ◽  
Ignacio R. Bailly-Bailliere ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Status Epilepticus ◽  
Prospective Studies ◽  
Correct Diagnosis ◽  
Original Description ◽  
Neurological Deficits ◽  
Convulsive Status Epilepticus ◽  
Poor Outcome

Introduction. Non-convulsive status epilepticus (NCSE) has been traditionally a challenging electroencephalographic (EEG) diagnosis. For this reason, Salzburg consensus criteria (SCC) have been proposed to facilitate correct diagnosis. Methods. We retrospectively reanalyzed 41 cases referred to our department (from 2016 to 2018) under the suspicion of NCSE. In this study, we compared the original description (standard criteria) versus the updated description (SCC) of the same EEG. Results. Originally, 15 patients were diagnosed as NCSE (37%) and 26 patients as no NCSE (63%), using the standard criteria. Then, we analyzed EEGs according to the SCC, which led to the following results: 9 patients fulfilled the criteria for definite NCSE (22%), 20 patients were diagnosed as possible NCSE (49%) and 12 patients were diagnosed as no NCSE (29%). Subsequently, when we analyze the outcome of possible NCSE cases, we note that 50% of these patients presented mild-poor outcome (neurological deficits, deceased). Indeed, we observed worse outcomes in patients previously diagnosed as no NCSE and untreated, specifically post-anoxic cases. Conclusions. Salzburg criteria seem to be a useful tool to support NCSE diagnosis, introducing the category of possible NCSE. In our study, we observed that it contributes to improving the prognosis and management of the patients. However, more prospective studies are needed to demonstrate the accuracy of SCC.

scholarly journals ALTERNATIVE TO THE INVERTED “Y” INCISION IN SCOLIOSIS SECONDARY TO MYELOMENINGOCELE

2019 ◽  
Vol 18 (1) ◽  
pp. 14-16
Author(s):  
Diego Veiga Bezerra ◽  
Luis Eduardo Munhoz da Rocha ◽  
Dulce Helena Grimm ◽  
Carlos Abreu de Aguiar ◽  
Luiz Müller Ávila ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Spina Bifida ◽  
Postoperative Period ◽  
Medical Records ◽  
Surgical Intervention ◽  
Case Series ◽  
Material Failure ◽  
Spinal Deformities ◽  
Level Of Evidence ◽  
Skin Conditions

ABSTRACT Objective: To evaluate the healing of the modified inverted “Y” incision in patients with scoliosis due to myelomeningocele. Methods: Retrospective study through medical records review of patients with myelomeningocele surgically treated with a modified inverted “Y” approach between January 2013 and December 2015. Results: We analyzed the medical records of six patients. Two patients progressed with skin complications in the immediate postoperative period and only one of them required surgical intervention for debridement and suturing. In another patient, it was necessary to perform two surgical reviews due to material failure without skin complications in these interventions. Conclusions: The modified inverted “Y” technique is a great alternative to traditional incision and inverted “Y” because it has good results in patients with spina bifida associated with poor skin conditions treated surgically for correction of spinal deformities. Level of Evidence IV; Case series.

scholarly journals Survival Rate of 1008 Short Dental Implants with 21 Months of Average Follow-Up: A Retrospective Study

2020 ◽  
Vol 9 (12) ◽  
pp. 3943
Author(s):  
João Caramês ◽  
Ana Catarina Pinto ◽  
Gonçalo Caramês ◽  
Helena Francisco ◽  
Joana Fialho ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Survival Rate ◽  
Dental Implants ◽  
Cox Regression ◽  
Survival Rates ◽  
High Survival ◽  
Implant Survival ◽  
Posterior Maxilla ◽  
Clinical Records

This retrospective study evaluated the survival rate of short, sandblasted acid-etched surfaced implants with 6 and 8 mm lengths with at least 120 days of follow-up. Data concerning patient, implant and surgery characteristics were retrieved from clinical records. Sandblasted and acid-etched (SLA)-surfaced tissue-level 6 mm (TL6) or 8 mm (TL8) implants or bone-level tapered 8 mm (BLT8) implants were used. Absolute and relative frequency distributions were calculated for qualitative variables and mean values and standard deviations for quantitative variables. A Cox regression model was performed to verify whether type, length and/or width influence the implant survival. The cumulative implant survival rate was assessed by time-to-event analyses (Kaplan–Meier estimator). In all, 513 patients with a mean age of 58.00 ± 12.44 years received 1008 dental implants with a mean follow-up of 21.57 ± 10.77 months. Most implants (78.17%) presented a 4.1 mm diameter, and the most frequent indication was a partially edentulous arch (44.15%). The most frequent locations were the posterior mandible (53.97%) and the posterior maxilla (31.55%). No significant differences were found in survival rates between groups of type, length and width of implant with the cumulative rate being 97.7% ± 0.5%. Within the limitations of this study, the evaluated short implants are a predictable option with high survival rates during the follow-up without statistical differences between the appraised types, lengths and widths.

scholarly journals EP-1239: Clinical outcome of SBRT of central, apical or paracostal tumors in the lung, a retrospective study

2016 ◽  
Vol 119 ◽  
pp. S587
Author(s):  
C. Kristiansen ◽  
S.S. Jeppesen ◽  
M. Nielsen ◽  
T.B. Nielsen ◽  
T. Schytte ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Clinical Outcome

Factors associated with congenital syphilis: A retrospective study in Jiangxi Province, China

2021 ◽  
pp. 095646242110521
Author(s):  
Zhihua Wan ◽  
Yuling Tao ◽  
Huan Zhang ◽  
Yang Hu ◽  
Kuanyong Shu
Keyword(s):  
Regression Analysis ◽  
Retrospective Study ◽  
Pregnant Women ◽  
Congenital Syphilis ◽  
Jiangxi Province ◽  
Multivariable Logistic Regression Analysis ◽  
Syphilis Infection ◽  
Adequate Treatment ◽  
Maternal Characteristics ◽  
Increased Risk

Background There are a lack of studies about factors influencing congenital syphilis (CS) in economically underdeveloped areas, such as Jiangxi Province, China. Methods A retrospective study was conducted based on the information system of prevention of mother-to-child transmission of syphilis management in Jiangxi Province, China. Pregnant women with syphilis infection who delivered ≥28 gestational weeks and registered in this system from 1 January 2013 to 2030 June 2018 were enrolled. Maternal characteristics and treatment regimens associated with CS were evaluated using multivariable regression analysis. Results 1196 syphilis infected mothers and their 1207 infants were included in the analyses, and 116 infants were diagnosed with CS, providing an overall incidence of 9.61% (116/1207). Multivariable logistic regression analysis showed that increasing maternal age was barely associated with the risk of CS (adjusted odds ratio (aOR) = 0.97, 95% CI, 0.93–1.00, p = .047). Women with a high nontreponemal serum test titer (≥1:8) had a 126% increased risk of delivering an infant with CS than those with a low titer (<1:8) (aOR = 2.26, 95% CI, 1.51–3.39, p < .001). The risk for CS decreased significantly in infants born to mothers receiving adequate treatment than those receiving no treatment (aOR = 0.36, 95% CI, 0.21–0.61, p < .001). Conclusions Adequate treatment is critical for the prevention of CS. Further strategies focusing on early diagnosis and adequate treatment among syphilis infected pregnant women, particularly among those with younger age and high nontreponemal titer, should be strengthened to prevent CS.

scholarly journals Predictors of Poor Outcome after Successful Mechanical Thrombectomy in Patients with Acute Anterior Circulation Stroke

2017 ◽  
Vol 01 (03) ◽  
pp. 139-143 ◽  
Author(s):  
Yosuke Tajima ◽  
Michihiro Hayasaka ◽  
Koichi Ebihara ◽  
Masaaki Kubota ◽  
Sumio Suda
Keyword(s):  
Clinical Outcome ◽  
Cerebral Artery ◽  
Mechanical Thrombectomy ◽  
Infarct Volume ◽  
Complete Revascularization ◽  
Anterior Circulation ◽  
Clinical Imaging ◽  
Good Outcome ◽  
Poor Outcome ◽  
Favorable Clinical Outcome

AbstractSuccessful revascularization is one of the main predictors of a favorable clinical outcome after mechanical thrombectomy. However, even if mechanical thrombectomy is successful, some patients have a poor clinical outcome. This study aimed to investigate the clinical, imaging, and procedural factors that are predictive of poor clinical outcomes despite successful revascularization after mechanical thrombectomy in patients with acute anterior circulation stroke. The authors evaluated 69 consecutive patients (mean age, 74.6 years, 29 women) who presented with acute ischemic stroke due to internal cerebral artery or middle cerebral artery occlusions and who were successfully treated with mechanical thrombectomy between July 2014 and November 2016. A good outcome was defined as a modified Rankin Scale score of 0 to 2 at 3 months after treatment. The associations between the clinical, imaging, and procedural factors and poor outcome were evaluated using logistic regression analyses. Using multivariate analyses, the authors found that the preoperative National Institute of Health Stroke Scale (NIHSS) score (odds ratio [OR], 1.152; 95% confidence interval [CI], 1.004–1.325; p = 0.028), the diffusion-weighted imaging Alberta Stroke Program Early Computed Tomography Score (DWI-ASPECTS) (OR, 0.604; 95% CI, 0.412–0.882; p = 0.003), and a Thrombolysis in Cerebral Infarction (TICI) 2b classification (OR, 4.521; 95% CI, 1.140–17.885; p = 0.026) were independent predictors of poor outcome. Complete revascularization to reduce the infarct volume should be performed, especially in patients with a high DWI-ASPECTS, to increase the likelihood of a good outcome.

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