Characteristics and Management of Vertical Deviations in an Urban Academic Clinic: A Retrospective Analysis

2016 ◽  
pp. 123-131
Keyword(s):  
Treatment Recommendations ◽  
Referral Source ◽  
Effective Treatment Option ◽  
Small Magnitude ◽  
Vertical Deviation ◽  
State College ◽  
Vision Rehabilitation ◽  
One Year ◽  
The University

Background: The purpose of this retrospective study was to determine the characteristics of patients with vertical oculomotor deviations, and furthermore to examine the efficacy of optometric vision rehabilitation (OVR) as a treatment for vertical deviations. Methods: Medical records were reviewed for 512 patients who were diagnosed with a vertical deviation at the University Eye Centerm (UEC) at the SUNY State College of Optometry from the years 2005-2010. Presenting complaints, referral source, and descriptions of the deviations were analyzed. Previous interventions were noted, and treatment recommendations were reviewed. Of those patients for whom OVR was recommended, the initial therapeutic results and follow-up were evaluated. Results: The most common presenting complaint was diplopia (“double vision”) (42%), and the most common referral source was a self-referral (59%). The most prevalent vertical deviation was a constant, comitant, hypertropia of small magnitude (1-5Δ). Concurrent horizontal strabismus was present in 52% of the patients. Previous interventions included extraocular muscle surgery, prism, and OVR. Treatment recommendations included prism (37%), OVR only (22%), or OVR and prism (14%). For those patients who were recommended for OVR only, 37% completed the OVR. Of those who were recommended OVR and prism, 39% completed the OVR. Symptoms were reduced in 78% of those who either completed OVR only or received OVR and prism treatment. More of the patients who completed the OVR showed maintenance of their improvements (38% of OVR only and 44% of OVR and prism) at greater than one year follow-up. Conclusions: The present findings provide critical information that can be used for optimal referral and treatment. Optometric vision rehabilitation provided an effective treatment option.

Prospective evaluation for gastrointestinal bleedings at the University Hospital St. Pölten – one year of follow-up

2019 ◽  
Author(s):  
M Stättermayer ◽  
F Riedl ◽  
S Bernhofer ◽  
A Stättermayer ◽  
A Mayer ◽  
...  
Keyword(s):  
University Hospital ◽  
Prospective Evaluation ◽  
One Year ◽  
The University

Predictors of Job-Seeking Behavior among Persons with Visual Impairments

2002 ◽  
Vol 96 (9) ◽  
pp. 635-644 ◽  
Author(s):  
Robin Leonard
Keyword(s):  
Visual Impairments ◽  
Job Seeking ◽  
Physical Conditions ◽  
Follow Up Study ◽  
Seeking Behavior ◽  
Rehabilitation Agency ◽  
Placement Services ◽  
Vision Rehabilitation ◽  
One Year

This follow-up study of 60 nonworking persons with visual impairments who contacted a vision rehabilitation agency for vocational placement services over a five-year period found that the absence of other health or physical conditions and being unemployed one year or less were significant predictors of job-seeking behavior.

Changes in management and survival outcomes for patients receiving gene-expression-based tissue-of-origin test results for difficult-to-diagnose primary cancers.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 397-397 ◽  
Author(s):  
John C. Hornberger ◽  
Gauri R. Varadhachary ◽  
Hialy R Gutierrez ◽  
William David Henner ◽  
Shawn Becker ◽  
...  
Keyword(s):  
Gene Expression ◽  
Median Survival ◽  
Treatment Recommendations ◽  
Subsequent Treatment ◽  
Survival Outcomes ◽  
Test Results ◽  
Extensive Evaluation ◽  
Tissue Of Origin ◽  
One Year

397 Background: An important step for a novel test is assessing its clinical utility and real-world effect on diagnosis and patient management. This report describes completed results of a cohort of physicians who have ordered a gene expression profile assay for identification of tumor tissue of origin (Pathwork Tissue of Origin Test) for patients with difficult-to-diagnose primary cancers and their subsequent treatment and survival. Methods: The IRB-approved registry collected data from participating physicians who have ordered the Tissue of Origin test. A detailed interview was conducted using both a web-based questionnaire and a confirmatory telephone interview with the physicians. Chart survey included collection of data on patient demographics, diagnostic procedures including imaging and immunohistochemistry as well as therapy. The physicians were queried regarding their working diagnoses and treatment recommendations prior to and after Tissue of Origin Test result availability. Date of death was also obtained with a minimum of one year follow-up from date of biopsy. Results: One hundred seven patients (61 women) have been studied and 65 participating physicians have completed the interview. Results indicate that most patients underwent extensive evaluation (≥ 10 IHC) prior to gene expression analysis. After receiving test results, physicians changed the primary site diagnosis for 53 patients (50%, CI [43,58%]; p<.001) and changed the treatment management for 72 patients (65%, CI [58%,73%]; p<.0001). At last follow-up, 69 patients had died with a median survival of 426 days. More than 30% of patients were alive at 1000 days. Conclusions: This registry study confirms that in patients with difficult-to-diagnose primary cancers, extensive baseline diagnostics are common and less than half of the patients have an established working diagnosis. Results indicate that the Tissue of Origin Test led to a change in working diagnosis and changed treatment recommendations in over half the patients. Survival outcomes compare favorably to historical controls in treatment trials where median survival is generally less than one year.

scholarly journals A Triage Approach to Managing a Two Year Wait-List in a Chronic Pain Program

2005 ◽  
Vol 10 (3) ◽  
pp. 155-157 ◽  
Author(s):  
Alexander J Clark ◽  
Ian Beauprie ◽  
Lynne B Clark ◽  
Mary E Lynch
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Fast Track ◽  
Treatment Plan ◽  
Treatment Recommendations ◽  
Management Unit ◽  
Waiting List ◽  
One Year ◽  
Referring Physicians

OBJECTIVE: Individuals with chronic pain referred to specialist chronic pain management programs frequently wait months to years for assessment and care. In the authors' pain management program, approximately 600 patients are on the waiting list. An innovative recommendation program to encourage and educate referring physicians to continue active care of pain during this waiting period was developed.METHODS: All referrals to the Queen Elizabeth II Health Sciences Centre's Pain Management Unit for a one-year period were reviewed and triaged as either 'regular waiting list' or 'fast track'. Patients in the fast track group were seen within four months and required limited interventions or were urgent in nature. The regular waiting list group waited up to 27 months for assessment and development of a treatment plan. Treatment recommendations were faxed to the referring physician. A follow-up questionnaire was sent to each physician to assess whether these treatment recommendations were useful.RESULTS: Recommendations were faxed for 297 patients. One hundred forty-nine physicians returned the follow-up questionnaire. Ninety-five physicians used the recommendations and 68 patients followed the recommendations. Seventy-nine physicians felt that the recommendations were helpful to them in their care of the patient. For 39 patients, the recommendations were helpful. The most frequently used recommendations were those on medications (eg, tricylic antidepressants, anticonvulsants, nonsteroidal anti-inflammatory drugs and controlled-release opioids). Other modalities included participation in an interdisciplinary group program and physiotherapy.CONCLUSIONS: A triage review process with recommendations faxed to referring physicians was developed and put into action for one year. The recommendations were used by 32% of the physicians (64% of responding physicians). Fifty-three per cent of responding physicians felt that the recommendations were helpful in the care of their patient. This process led to a benefit in care, as perceived by the physician, in 26% of patients (of physicians who returned the questionnaire [13% of all patients]) on the waiting list for a tertiary care pain management unit.

scholarly journals Better treatment option in chronic superficial femoral artery occlusive disease: comparison of methods (meta-analysis)

2019 ◽  
Vol 11 (3) ◽  
pp. 224-229
Author(s):  
Vladimir Starodubtsev ◽  
Andrey Karpenko ◽  
Evgeniy Lenko ◽  
Pavel Ignatenko
Keyword(s):  
Treatment Option ◽  
Femoral Artery ◽  
Superficial Femoral Artery ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Occlusive Disease ◽  
Qualitative Synthesis ◽  
Effective Treatment Option ◽  
One Year

Introduction: The objective is to evaluate the frequency of primary obstruction events (PrO) during one-year follow-up after performing excisional atherectomy with the SilverHawk/TurboHawk atherectomy device (S/TH) or remote superficial femoral artery endarterectomy (RSFAE) in patients with the chronic superficial femoral artery occlusive disease (СSFAOD). Methods: We included all randomized clinical trials (RCTs) and not-RCTs concerning the treatment of patients with СSFAOD after S/TH and RSFAE without duration. Results: Twenty-nine items (1990-2017) were discovered; 27 articles on the levels of evidence were included in qualitative synthesis; 9 studies (meta-analysis) were included in quantitative synthesis. The results of 2762 patients’ treatment were summed up in our analysis (1422 patients S/TH; 1340 patients RSFAE). All included reports were at low risk of bias. According to the criterion "frequency of PrO" during one-year follow-up, the pooled Hazard Ratios indicate significant favours of S/TH if compared it with RSFAE (HR= 0.66 (0.57 to 0.76, P < 0.00001), I2 = 9%). Conclusion: Our study showed that S/TH with the SpiderFX device (distal embolic protection) are safe and effective treatment option for short lesion (<15 cm) in patients with СSFAOD. The usage of S/TH methods significantly reduced number of PrO if compared it with RSFAE. In long-segment lesion (>15 cm) in patients with СSFAOD, RSFAE may be considered better than an endovascular procedure. But still it is necessary to conduct well-planned randomized studies to determine effectiveness and safety of the compared methods (S/TH and RSFAE) in patients with long-segment lesion (>15 cm).

scholarly journals RADI-12. LEPTOMENINGEAL FAILURE AFTER PREOPERATIVE VERSUS POSTOPERATIVE RADIOSURGERY

2019 ◽  
Vol 1 (Supplement_1) ◽  
pp. i24-i24
Author(s):  
John Fiveash ◽  
Kristen Riley ◽  
James Markert ◽  
Bart Guthrie ◽  
Paul Foreman ◽  
...  
Keyword(s):  
Cranial Nerves ◽  
Cauda Equina ◽  
Target Volume ◽  
University Of Alabama ◽  
Leptomeningeal Seeding ◽  
Dural Enhancement ◽  
One Year ◽  
The University ◽  
The Brain

Abstract INTRODUCTION: Postoperative stereotactic radiosurgery (postop SRS) is potentially complicated by difficulty defining the target volume and the risk of leptomeningeal seeding at the time of surgery. It is hypothesized that preop SRS may render cells less viable to disseminate in the leptomeningeal space. This retrospective study compares the leptomeningeal dissemination (LMD) rate for preop versus postop radiosurgery METHODS: We identified 140 patients with brain metastases who underwent resection and radiosurgery at the University of Alabama at Birmingham including 91 postop patients (2005–2015) and 49 preop patients (2011–2018). The preop group included 19 patients enrolled in a phase I trial of preoperative radiosurgery (12–15 Gy) for tumors 2–6 cm in greatest diameter. In that study 15 Gy was found to be safe in the preop setting but further escalation was not attempted. An additional 30 patients received preop SRS off-study (median dose 15 Gy). The median postop dose was 16 Gy. LMD recurrence was defined as focal pachymeningeal or diffuse leptomeningeal enhancement of the brain, spinal cord, or cauda equina, dural enhancement beyond 5 mm from the index metastasis, subependymal enhancement, or enhancement of cranial nerves. This definition is not limited to carcinomatosis. All events were categorized and confirmed by at least two physicians. RESULTS: 40/140 (29%) patients developed new focal or diffuse LMD. Preop SRS was associated with a higher freedom from leptomeningeal recurrence (84% vs 60% at one year, p=0.021 Breslow, p=0.128 log-rank). Since later LMD may not be related to surgery, a second analysis censoring follow-up at one year was performed and confirmed this trend (p=0.008 Breslow, p=0.014 log-rank). CONCLUSIONS: Preoperative SRS is associated with a reduction in the risk of LMD compared to postop SRS. Focal pachymeningeal dissemination may not always be recognized as related to surgery. A randomized trial of preop vs postop SRS is warranted.

Salvage with Radiotherapy of Postsurgical Relapses of Endometrial Cancer

1980 ◽  
Vol 66 (4) ◽  
pp. 475-480 ◽  
Author(s):  
Luigi Pirtoli ◽  
Stefano Ciatto ◽  
Luca Cionini ◽  
Gianluigi Taddei ◽  
Maurizio Colafranceschi
Keyword(s):  
Therapeutic Response ◽  
Endometrial Adenocarcinoma ◽  
Late Recurrence ◽  
Complete Regression ◽  
Initial Surgery ◽  
One Year ◽  
University Of Florence ◽  
The University ◽  
Lost To Follow Up

From January 1960 to June 1974, 71 patients with a postsurgical relapse of endometrial adenocarcinoma have been referred to the Radiology Institute of the University of Florence. Eleven patients showed hematogenous metastases; the remaining 60 cases showed locoregional relapses and were treated with radiotherapy. Forty-eight patients, whose relapse was localized to the pelvis, vagina, inguinal nodes or perineal scar, were treated with a radical aim (4,500-6,000 rad in 5-6 weeks); the treatment was palliative in 12 cases with abdominal extrapelvic relapse. The therapeutic response was not evaluated in 8 patients lost to follow-up shortly after the treatment. In the cases treated with a radical scope, a complete regression was attained in 22 of 43 (51 %); a survival rate of 16 of 43 (37 %) was attained at 5 years. In 9 cases treated with a palliative aim, only subjective remission was attained, and no patient was alive one year after the therapy. The most favorable therapeutic response was attained in the vaginal relapses (50 % survivors at 5 years) and the cases with a late recurrence (more than 3 years) after the initial surgery. No definite correlation was found between the prognosis of the relapse and the histological grading of the primary tumor.

Psychiatric consequences of temporal lobectomy for intractable seizures: a 20–30-year follow-up of 14 cases

1990 ◽  
Vol 20 (3) ◽  
pp. 529-545 ◽  
Author(s):  
Janice R. Stevens
Keyword(s):  
Age Of Onset ◽  
Careful Analysis ◽  
Temporal Lobectomy ◽  
Psychiatric Status ◽  
Intractable Seizures ◽  
Paranoid Personality Disorder ◽  
One Year ◽  
The University ◽  
Psychiatric Problems

SynopsisBetween 1958 and 1968, 14 patients from the epilepsy clinic at the University of Oregon Hospitals and Clinics with a diagnosis of temporal lobe epilepsy (TLE) had a temporal lobectomy for medically intractable seizures. Nine of the 14 patients operated on remained seizure-free over the 20–30-year period of follow-up. Between 6 months and one year following temporal lobectomy, two women, previously healthy from a psychiatric standpoint, developed psychoses, and the previous psychiatric problems of four other patients worsened. Two patients, one with incapacitating paranoid personality disorder and the other with explosive rage attacks preoperatively, had marked improvement in their psychiatric status following temporal lobectomy. The remaining six patients, all psychiatrically healthy prior to surgery, have had no change in psychiatric status following surgery. Development of psychosis or deterioration in psychiatric status after surgery was more common in patients with later age of onset, unreality or déjà vu rather than epigastric aura, pre-operative evidence of bilateral brain damage, and persistence of EEG or clinical seizure activity. Development of a chronic psychosis in psychiatrically healthy individuals many months after temporal lobectomy, even when seizures are arrested or ameliorated, suggests that anomalous synaptic regeneration may follow the surgery in these cases. Careful analysis of histories and outcomes may contribute to better understanding of the pathophysiology and anatomical substrates of psychoses.

scholarly journals Better adherence to treatment recommendations in heart failure predicts improved cognitive function at a one-year follow-up

2014 ◽  
Vol 36 (9) ◽  
pp. 956-966 ◽  
Author(s):  
Michael L. Alosco ◽  
Mary Beth Spitznagel ◽  
Ronald Cohen ◽  
Lawrence H. Sweet ◽  
Richard Josephson ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cognitive Function ◽  
Treatment Recommendations ◽  
Adherence To Treatment ◽  
One Year

Some Biological Applications of High Voltage Electron Microscopy

1974 ◽  
Vol 32 ◽  
pp. 298-299
Author(s):  
Hans Ris
Keyword(s):  
High Voltage ◽  
Chromosome Structure ◽  
Nerve Fibers ◽  
Good Resolution ◽  
High Voltage Electron Microscopy ◽  
Voltage Electron ◽  
University Of Wisconsin ◽  
High Voltage Electron ◽  
One Year ◽  
The University

The High Voltage Electron Microscope Laboratory at the University of Wisconsin has been in operation a little over one year. I would like to give a progress report about our experience with this new technique. The achievement of good resolution with thick specimens has been mainly exploited so far. A cold stage which will allow us to look at frozen specimens and a hydration stage are now being installed in our microscope. This will soon make it possible to study undehydrated specimens, a particularly exciting application of the high voltage microscope.Some of the problems studied at the Madison facility are: Structure of kinetoplast and flagella in trypanosomes (J. Paulin, U. of Georgia); growth cones of nerve fibers (R. Hannah, U. of Georgia Medical School); spiny dendrites in cerebellum of mouse (Scott and Guillery, Anatomy, U. of Wis.); spindle of baker's yeast (Joan Peterson, Madison) spindle of Haemanthus (A. Bajer, U. of Oregon, Eugene) chromosome structure (Hans Ris, U. of Wisconsin, Madison). Dr. Paulin and Dr. Hanna are reporting their work separately at this meeting and I shall therefore not discuss it here.

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