scholarly journals Feline arterial thromboembolism: prognostic factors and treatment

2018 ◽  
Vol 87 (3) ◽  
pp. 164-175
Author(s):  
L. Locquet ◽  
D. Paepe ◽  
S. Daminet ◽  
P. Smets
Keyword(s):  
Prognostic Factors ◽  
Clinical Presentation ◽  
Term Survival ◽  
Adequate Treatment ◽  
Arterial Thromboembolism ◽  
Key Points ◽  
The Individual

Feline arterial thromboembolism (ATE) is a complete or partial obstruction of a peripheral artery caused by a thrombus that was formed at a distant site. The most common underlying cause in cats is cardiomyopathy. Given the clinical presentation, often without preceding signs, an ATE event is considered one of the most distressing emergency conditions in feline practice. Often, these cats are euthanized at the time of diagnosis. However, recent scientific research has shown that a subpopulation of these patients may have long-term survival. In case of adequate treatment and follow-up, some cats survive over a year with a satisfying quality of life. Key points of ATE are the identification of specific prognostic factors in the individual patient in order to guide owner communication, the decision to treat or not to treat, individually adjusted patient management and regular monitoring, which are discussed in this article.

The Different Impacts on the Long-Term Survival of Tunneled Internal Jugular Hemodialysis Catheters Based on Tip Position and Laterality

2017 ◽  
Vol 43 (4) ◽  
pp. 315-320 ◽  
Author(s):  
Vedran Premuzic ◽  
Drazen Perkov ◽  
Ranko Smiljanic ◽  
Bruna Brunetta Gavranic ◽  
Bojan Jelakovic
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
The Body ◽  
Term Survival ◽  
Catheter Tip ◽  
Tip Position ◽  
The Impact

Background/Aims: The aim of this study was to examine the impact of different catheter tip positions on the life of the catheter, dysfunction, infection, and quality of hemodialysis and possible differences between the access site laterality in jugular-tunneled hemodialysis catheters. Methods: Catheters were evaluated for the following parameters: place of insertion, time of insertion, duration of use, and reason for removal. In all patients, the catheter tip position was checked using an X-ray. Results: The mean duration of implanted catheters with the tip placed in the cavo-atrial junction and right atrium was significantly longer. There were no differences in catheter functionality at follow-up or complications based on catheter laterality for each catheter tip position. Conclusion: According to our results, the localization of the catheter tip in superior vena cava still remains the least preferable method. Our results showed that the main factor responsible for better catheter functionality was not laterality but the depth to which the catheter tip is inserted into the body.

scholarly journals LONG-TERM SURVIVAL AND PROGNOSTIC FACTORS FOR UNFAVORABLE OUTCOME IN PATIENTS WITH SYSTEMIC SCLEROSIS.A PROSPECTIVE SINGLE-CENTER STUDY

2017 ◽  
Vol 26 (2) ◽  
pp. 60-64
Author(s):  
Alexandra Daniela Radu ◽  
◽  
Ana Maria Gheorghiu ◽  
Raida Oneata ◽  
Alina Soare ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prognostic Factors ◽  
Systemic Sclerosis ◽  
Lung Involvement ◽  
Term Survival ◽  
Long Term Survival ◽  
Male Sex ◽  
Cox Analysis

Background. Systemic sclerosis (SSc) is a complex chronic autoimmune disease, with an unpredictable evolution and high morbidity and mortality rates. Objective. Evaluation of long-term survival and identification of prognostic factors in patients with systemic sclerosis. Methods. All patients with SSc of the EUSTAR100 center, having at least one visit between 2004 and 2016, were included. Data were analyzed for survival, cause of death, as well as for the following events defining disease worsening: increase in modified Rodnan score (mRSS) with at least 25% and 5 points (compared to baseline visit), decrease with at least 10% (compared to baseline) of predicted forced vital capacity (FVC) and predicted diffusing capacity of the lungs for carbon monoxide (DLCO), and presence of new digital ulcers (DUs). Logistic regression (LR), Cox proportional hazards regression and Kaplan-Meier survival curves were used in univariate and multivariate analysis to study survival and identify prognostic factors. Results. 137 patients were included in the study (89.1% females, mean age ± SD 56.7 ± 12.6 years, disease duration 9.7 ± 7.1 years), with a follow-up duration of up to 19 years. 96 patients had at least one follow-up visit and 66 (not including patients who died earlier than 2 years after the first presentation) had follow-up data at 2 years (± 6 months) after the first visit in the clinic. There were 19 reported deaths (13.9%), 11 attributed to SSc (of whom 8 were due to lung involvement). Risk factors for death were diffuse cutaneous subset and mRSS>14 at baseline (identified by LR adjusted for age and sex), male sex and proteinuria (Cox analysis). While in over half of the patients FVC and mRSS were stable or improved (86% and 96% respectively), and no new DUs occurred (64%), 52% of the patients presented significant worsening of DLCO during the entire followup. Risk factors for DLCO worsening at 2 years, by LR adjusted for sex and age, were male sex and diffuse cutaneous subset, while Cox analysis identified only male sex. The only risk factor identified for appearance of new DUs was the history of DUs at the first presentation. Conclusions. SSc often presents an unfavorable disease course, particularly due to lung involvement. Risk factors for disease worsening were male sex, diffuse cutaneous subset, and mRSS>14 at baseline. SSc-related deaths were mainly due to lung involvement, thus underlining the necessity of identifying predictive factors for lung function deterioration at the first presentation.

scholarly journals Long-term survival and health-related quality of life in patients with severe acute respiratory distress syndrome and veno-venous extracorporeal membrane oxygenation support

Critical Care ◽  
2021 ◽  
Vol 25 (1) ◽  
Author(s):  
Jonathan Rilinger ◽  
Klara Krötzsch ◽  
Xavier Bemtgen ◽  
Markus Jäckel ◽  
Viviane Zotzmann ◽  
...  
Keyword(s):  
Distress Syndrome ◽  
Term Survival ◽  
Long Term Survival ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related ◽  
Vv Ecmo

Abstract Background There is limited information about the long-term outcome of patients suffering from acute respiratory distress syndrome (ARDS) supported with veno-venous extracorporeal membrane oxygenation (VV ECMO). Most studies focused on short- to mid-term follow-up. We aimed to investigate long-term survival and health-related quality of life (HRQL) in these patients. Methods We report retrospective data from a single-centre registry of patients with severe ARDS treated with VV ECMO at the Interdisciplinary Medical Intensive Care Unit at the Medical Centre, University of Freiburg, Germany, between 10/2010 and 06/2019. Follow-up data of all patients that survived the index hospitalisation were collected by telephone interviews from 02/2020 till 09/2020. Long-term survival, HRQL (Short-Form Health Survey-36 (SF-36), St. Georges Respiratory Questionnaire (SGRQ), Hospital Anxiety and Depression Scale (HADS)) and the return to work rate were documented. Results In total, 289 patients were treated with VV ECMO during the study period (median age 55 years, 67% males, hospital survival 45%). After a median duration of 3.9 years, follow-up assessment was complete in 94 of 129 hospital survivors (73%). Fifty-three patients completed the HRQL assessment. Hospital survivors showed a high 6- and 12-month survival rate (89% and 85%, respectively). Estimated survival rate of those discharged alive from ICU was 68.5% (95%-CI 56.9–80.1%) after 9.7 years. These patients reported high levels of HRQL (median SF-36 total score 73) and only few pulmonary (median SGRQ total score 19) and mental limitations (median HAD-D score 2 and HAD-A score 3). In total, 80% of the patients were able to resume employment. Conclusion This analysis of VV ECMO patients showed favourable long-term survival and high levels of HRQL suggesting promising prospects for VV ECMO survivors. Graphical Abstract

scholarly journals Jeune syndrome with renal failure

2017 ◽  
Vol 145 (3-4) ◽  
pp. 147-152
Author(s):  
Amira Peco-Antic ◽  
Mirjana Kostic ◽  
Brankica Spasojevic ◽  
Gordana Milosevski-Lomic ◽  
Dusan Paripovic ◽  
...  
Keyword(s):  
Renal Failure ◽  
Growth Failure ◽  
Term Survival ◽  
Jeune Syndrome ◽  
Long Term Follow Up ◽  
The University ◽  
Age Range

Introduction/Objective. Jeune syndrome (JS) is a rare hereditary ciliopathy characterized by asphyxiating thoracic dystrophy, shortened limbs and brachydactyly. Extraskeletal anomalies such as chronic renal failure (CRF), hepatic fibrosis, and retinitis pigmentosa may be a part of the JATD phenotype. The aim of this study is to present long-term follow-up of JS patients with early progressive kidney disease. Methods. This is a retrospective study of pediatric patients with JS and CRF who were treated at the University Children?s Hospital between January 1980 and December 2014. The patients? data were retrospectively reviewed from the medical records. Results. There were thirteen patients from 11 families, five girls and eight boys mean aged 4.3 years at the time of diagnosis. All of the patients had characteristic skeletal findings, retinal degeneration and an early onset of CRF at age range from 1.5 to 7 years. Five patients had neonatal respiratory distress and congenital liver fibrosis was diagnosed in five patients. One patient died due to complications of CRF, while others survived during follow-up of mean 11 years. IFT140 mutations were found in four genetically tested patients. Conclusion. The average incidence rate of JS with renal phenotype in Serbia was about 0.2 per one million of child population. Long-term survival of JS patients depends on renal replacement therapy, while skeletal dysplasia, growth failure, respiratory and eyes problems have impact on the patients? quality of life.

Genetic and Clinical Spectrum of Osteopetrosis.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1087-1087
Author(s):  
Ansgar S Schulz ◽  
Despina Moshous ◽  
Klaus-Michael Debatin ◽  
Anna Villa
Keyword(s):  
Quality Of Life ◽  
Genetic Background ◽  
Clinical Presentation ◽  
Hematopoietic Stem ◽  
Long Term Outcome ◽  
Significant Difference ◽  
Unrelated Donors

Abstract Abstract 1087 Poster Board I-109 Background Osteopetrosis (OP) is a multi-systemic inborn disorder characterized by heterogeneous clinical presentations on the basis of a variety of mutated genes. We performed a retrospective analysis in patients with OP from 28 European centers on behalf of the ESID and the EBMT. Main objectives of this analysis were survival and quality of life with respect to genetic background, initial clinical presentation, and treatment modality. Methods A set of clinical parameters, genetic findings, transplant information and follow up data were collected using specific questionnaires. Questionnaires were sent at several time points to European centers treating patients with OP and the collected data were stored in a central OP database. DNA sequencing of candidate genes involved in human OP was done predominantly at laboratories in Milan, Paris and Ulm. Results Data of 173 patients and of 134 hematopoietic stem cell transplantations (HSCT) were obtained during a time frame between 1983 and 2008. In the whole cohort, mutations in the following genes were detected: 47% biallelic TCIRG1, 9% biallelic CLCN7, 6% monoallelic CLCN7, 5% OSTM1, 2% RANK, 1% RANKL; 30% of patients have no mutations in these genes or could not be tested completely. In 23% of patients HSCT was not considered because of severe neurological problems or other complications mostly in the context of OSTM1 or CLCN7 mutations, or because of less severe phenotypes mainly due to monoallelic CLCN7 mutations (autosomal dominant OP, ADO). Follow up data of 103 transplanted patients were available. With respect to donor type, the probability of survival at 2 years was 88% for matched family donors, 80% for matched unrelated donors, 68% for HLA-haploidentical donors and 54% for mismatched unrelated donors. There was no significant difference in survival of patients with different gene mutations but a trend to a worse long term outcome in CLCN7 patients. Most notably, several major sequelae were present in the majority of surviving patients. Visual impairment or dwarfism were found in about 2/3 of children showing no significant influence of the affected genes. About 10% of patients are suffering from significant persistent neurological problems after HSCT, which were found in patients with TCIRG and CLCN7 mutations. The quality of life were judged as normal by the parents in about 2/3 of surviving patients. Conclusion HSCT in infantile OP results in acceptable survival rates even after HLA-nonidentical transplants. However, outcome is influenced by a set of specific disease related problems and long term sequelae. The heterogeneity of OP necessitates an individualised therapeutic strategy respecting the genetic background, the clinical presentation and the type of the available donor. Disclosures No relevant conflicts of interest to declare.

A Population-Based 5-Year Cohort Study Including All Cases of Epithelial Ovarian Cancer in Western Sweden: 10-Year Survival and Prognostic Factors

2009 ◽  
Vol 19 (1) ◽  
pp. 116-123 ◽  
Author(s):  
Margaretha Åkeson ◽  
Anne-Marie Jakobsen ◽  
Britt-Marie Zetterqvist ◽  
Erik Holmberg ◽  
Mats Brännström ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Cohort Study ◽  
Prognostic Factors ◽  
Residual Tumor ◽  
Population Based ◽  
Ca 125 ◽  
Term Survival ◽  
Ploidy Status

Epithelial ovarian cancer (EOC) is the major gynecologic cancer mortality cause in Sweden. The aim of the present study was to investigate the long-term survival and prognostic factors of a complete population-based 5-year cohort of 682 patients with invasive EOC in western Sweden (population around 1.6 million). Data relating to residual tumor after surgery, FIGO stage, grade, histopathologic subtype, ploidy status, adjuvant chemotherapy (the prepaclitaxel period), and disease state (recurrence and death) were reported to a quality register in a prospectively kept database and were controlled against the Swedish National Cancer Registry for completeness. The median follow-up durations for the prospectively collected data in the Cox analysis and for the survival analysis that was made for all patients were 81 months (range, 52-109 months) and 11.7 years (range, 8.7-14.1 years), respectively. No patient was lost to follow-up. The relative 10-year survival rate was 38.4% (95% confidence interval, 34.5%-42.8%). The median relative survival time was 4.3 years (95% confidence interval, 3.6%-5.2%). In the univariate Cox regression analysis, prognostic significances for age, stage, residual tumor, histopathologic subtype of serous cystadenocarcinoma, grade, CA-125, and ploidy status were seen. In the multivariate analysis, age, stage, residual tumor after surgery, and postoperative CA-125 were of prognostic significance. In conclusion, 4 major prognostic factors were found for EOC in this population-based cohort study that also presents nearly accurate long-term survival owing to the nonselective nature and completeness regarding patients and follow-up of the study.

scholarly journals A teljes nagyér-transzpozíción átesett betegek Senning- és Mustard-féle műtéti megoldásának hosszú távú utánkövetése. Eredmények a CSONGRAD Regiszterből

2016 ◽  
Vol 157 (3) ◽  
pp. 104-110 ◽  
Author(s):  
Kálmán Havasi ◽  
Anita Kalapos ◽  
Krisztina Berek ◽  
Péter Domsik ◽  
Mária Kohári ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Functional Capacity ◽  
Heart Diseases ◽  
Term Survival ◽  
Mortality And Morbidity ◽  
Significant Difference ◽  
Long Term Follow Up

Introduction: Transposition of the great arteries is one of the most common cyanotic congenital heart diseases. Aim: The present study aimed to examine and compare long-term survival, functional grading, arrhytmologic and quality of life control in patients with transposition of the great arteries following Senning- and Mustard-operations. Methods: The present study comprised 85 patients with transposition of the great arteries, of whom Senning-operation was performed in 37 cases and Mustard-operation in 48 subjects. Follow-up study was performed in all cases. Results: The success rate of long-term follow-up proved to be 74%. Twelve out of the 31 Senning-operated and 16 out of 32 Mustard-operated patients died during the follow-up (39% vs. 50%, p = 0.45). Neither features of heart failure, nor those of arrhythmias showed differences between the groups, but parameters of quality of life and functional capacity proved to be favourable in Senning-operated patients. Conclusions: There is no significant difference in mortality and morbidity of patients with transposition of the great arteries following Mustard- and Senning-operations. Regarding to long-term follow-up quality of life and functional capacity of Senning-operated patients were more favourable. Orv. Hetil., 2016, 157(3), 104–110.

scholarly journals Metastatic melanoma of the stomach

2008 ◽  
Vol 21 (4) ◽  
pp. 205-207 ◽  
Author(s):  
Marcelo Eustáquio Rocha ◽  
Gilberto Pedro Rodrigues ◽  
Samir Almeida Borges ◽  
Fernando Gusmão Santiago
Keyword(s):  
Metastatic Melanoma ◽  
Dark Spot ◽  
Rare Entity ◽  
Term Survival ◽  
Long Term Survival ◽  
Full Relief ◽  
Survival Case

BACKGROUND: Metastatic melanoma of the stomach is a relatively rare entity with an unusual diagnosis during life. Surgery is the treatment of choice once it alleviates the symptoms in over 90% of the cases and increases the long-term survival. CASE REPORT: A 50y woman had presented a dark spot in the ungual bed of her right-hand thumb for two years, evolving into ulceration and bleeding. The biopsy diagnosed ungual malanocytic neoplasia compatible with lentiginous melanoma confirmed by immunohistochemistry, which presented positive pigmented HMB-45 cells. After an year and a half, the patient developed metastasis of the melanoma on her left thigh and extensive ulcerated lesion in the small gastric curvature, whose biopsy was compatible with metastatic melanoma of the stomach. The hemogram found discrete anemia (Hb: 11.1 and Ht: 33%) and LDH: 333 U/L. The patient underwent total gastrectomy with reconstruction in Roux-en-Y. There was a good evolution and on the 6th post-operative day, she was discharged home. At present, in the 12th month of follow up, the patient remains without complaints, with full relief of symptoms and all normal control exams. CONCLUSION: Surgical management should always be considered for the metastatic melanoma of the gastrointestinal tract, since the procedure shows low morbidity and mortality, besides providing relief of symptoms with the improvement of the quality of life and increase in the long-term survival.

Six Cycles of BEACOPP Tailored Based on Interim Scintigraphy Provide Favorable Outcome for Patients with Standard and Advanced Risk Hodgkin Lymphoma and Female Fertility Is Preserved: Results of a 10-Year Follow-up

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 1564-1564
Author(s):  
Eldad J Dann ◽  
Zeev Blumenfeld ◽  
Rachel Bar-Shalom ◽  
Irit Avivi ◽  
Menachem Ben-Shachar ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Hodgkin Lymphoma ◽  
Gnrh Agonist ◽  
Ovarian Function ◽  
Prognostic Score ◽  
Individual Risk ◽  
Term Survival ◽  
Pet Ct

Abstract Abstract 1564 Background: Therapy of Hodgkin lymphoma (HL) is designed to prolong survival and minimize toxicity; however, an intense debate is ongoing over whether ABVD or BEACOPP should be used upfront and whether a long-term survival benefit is obtained with the BEACOPP regimen. The current study was aimed to personalize therapy based on individual risk factors and interim scintigraphy. Design and Methods: 124 patients with newly diagnosed HL and adverse prognostic factors were prospectively studied between 7/1999 and 8/2005. Patients with early unfavorable and advanced disease were eligible for the study. Study participants were assigned to therapy based on their International Prognostic Score (IPS). Those with an IPS of ≥3 were assigned to 2 cycles of escalated BEACOPP (EB). All others received 2 cycles of standard BEACOPP (SB). Subsequent therapy was prospectively allocated according to the results of early interim GA67 or PET/CT. Four cycles of EB or SB were administered following a positive or negative scan, respectively. Results: Complete remission (CR) rate, 10-year progression free (PFS) and overall survival (OS) were 97%, 87% and 88%, respectively, at a median follow-up of 89 months (5–144). Only 38% of patients, mostly with a bulky mediastinal mass, received radiation therapy. PFS and OS were similar in both groups. Predictive value of negative interim Ga67 or PET/CT was 87% and 93%, respectively. Fertility status was assessed in 38 females aged <40 years (Table). Twenty four of these patients received 6 cycles of SB, 8 patients had 2 cycles of EB and 4 cycles of SB, 3 patients were treated with 2 cycles of SB and 4 cycles of EB and one patient received 6 cycles of EB. Thirty six females did not have disease progression and 34 of them were found to preserve their cyclic ovarian function (COF). Twenty six females were co-treated with 6 cycles of GNRH agonist triptorelin (Decapeptyl 3.75 mg) for 6 months. 19 patients conceived during the follow-up (30 pregnancies), delivering 23 babies. Deliveries were reported for up to seven years from diagnosis. Notably, the female receiving 6 cycles of EB, co-administered with the GNRH agonist, was among those who conceived and delivered a healthy baby. Conclusion: Six cycles of tailored BEACOPP administered to HL patients with adverse prognostic factors provide encouraging long-term PFS and OS, and fertility is preserved in most females following reduction in the number of chemotherapy cycles and GNRH agonist co-administration. Disclosures: Off Label Use: GNRH agonist triptorelin was simultaneously administered for fertility preservation.

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