Traumatic dislocation of the atlanto-occipital articulation (AOA) with short-term survival

1980 ◽  
Vol 52 (4) ◽  
pp. 541-546 ◽  
Author(s):  
Arthur B. Dublin ◽  
William M. Marks ◽  
David Weinstock ◽  
Thomas H. Newton
Keyword(s):  
Systemic Hypertension ◽  
Nerve Injuries ◽  
Short Term ◽  
Term Survival ◽  
Content Type ◽  
Traumatic Dislocation ◽  
Cranial Nerve Injuries ◽  
Angiographic Evidence ◽  
Fine Print ◽  
Short Term Survival

✓ Three patients with traumatic atlanto-occipital articulation (AOA) dislocation are presented, and an additional 10 well documented cases are reviewed from the literature. Medulla oblongata and/or spinal cord deficits, and evidence of cranial nerve injuries were noted in eight patients. Angiographic evidence of vertebral occlusion or narrowing was demonstrated in four patients. One patient had systemic hypertension, presumably from bilateral traumatic ninth nerve injuries. Five patients ultimately died. A new method for measuring the AOA is introduced.

Traumatic atlantooccipital dislocation

1977 ◽  
Vol 46 (5) ◽  
pp. 663-666 ◽  
Author(s):  
Alan H. Fruin ◽  
Thomas P. Pirotte
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Upper Cervical Spine ◽  
Nerve Injuries ◽  
Content Type ◽  
Traumatic Dislocation ◽  
Upper Cervical ◽  
Cranial Nerve Injuries ◽  
Atlantooccipital Dislocation ◽  
Fine Print

✓ A case of traumatic atlantooccipital dislocation is presented and the literature reviewed. This type of traumatic dislocation is probably produced by violent hyperextension of the upper cervical spine. Cranial nerve injuries and spinal cord injuries are common. Early fusion is recommended.

Risk of persistent cranial nerve injury after carotid endarterectomy

2004 ◽  
Vol 101 (3) ◽  
pp. 445-448 ◽  
Author(s):  
Edwin J. Cunningham ◽  
Rick Bond ◽  
Marc R. Mayberg ◽  
Charles P. Warlow ◽  
Peter M. Rothwell
Keyword(s):  
Carotid Endarterectomy ◽  
Nerve Injury ◽  
Cranial Nerve ◽  
Nerve Injuries ◽  
Content Type ◽  
Before And After ◽  
Cranial Nerve Injury ◽  
Cranial Nerve Injuries ◽  
Fine Print

Object. Cranial nerve injuries, particularly motor nerve injuries, following carotid endarterectomy (CEA) can be disabling and therefore patients should be given reliable information about the risks of sustaining such injuries. The reported frequency of cranial nerve injury in the published literature ranges from 3 to 23%, and there have been few series in which patients were routinely examined before and after surgery by a neurologist. Methods. The authors investigated the risk of cranial nerve injuries in patients who underwent CEA in the European Carotid Surgery Trial (ECST), the largest series of patients undergoing CEA in which neurological assessment was performed before and after surgery. Cranial nerve injury was assessed and recorded in every patient and persisting deficits were identified on follow-up examination at 4 months and 1 year after randomization. Risk factors for cranial nerve injury were examined by performing univariate and multivariate analyses. There were 88 motor cranial nerve injuries among the 1739 patients undergoing CEA (5.1% of patients; 95% confidence interval [CI] 4.1–6.2). In 23 patients, the deficit had resolved by hospital discharge, leaving 3.7% of patients (95% CI 2.9–4.7) with a residual cranial nerve injury: 27 hypoglossal, 17 marginal mandibular, 17 recurrent laryngeal, one accessory nerve, and three Horner syndrome. In only nine patients (0.5%; 95% CI 0.24–0.98) the deficit was still present at the 4-month follow-up examination; however, none of the persisting deficits resolved during the subsequent follow up. Only duration of operation longer than 2 hours was independently associated with an increased risk of cranial nerve injury (hazard ratio 1.56, p < 0.0001). Conclusions. The risk of motor cranial nerve injury persisting beyond hospital discharge after CEA is approximately 4%. The vast majority of neurological deficits resolve over the next few months, however, and permanent deficits are rare. Nevertheless, the risk of cranial nerve injury should be communicated to patients before they undergo surgery.

Surgical treatment of bronchogenic carcinoma with a brain metastasis

1978 ◽  
Vol 48 (3) ◽  
pp. 350-354 ◽  
Author(s):  
Tomas A. Salerno ◽  
Darrell D. Munro ◽  
John R. Little
Keyword(s):  
Brain Metastasis ◽  
Cell Carcinoma ◽  
Bronchogenic Carcinoma ◽  
Small Cell ◽  
Short Term ◽  
Term Survival ◽  
Content Type ◽  
Secondary Tumors ◽  
Common Histological Type ◽  
Short Term Survival

✓ Twenty-three patients with bronchogenic carcinoma and a brain metastasis had their primary and secondary tumors treated surgically. The 10 men and 13 women had an average age of 52 years. Fifteen patients presented with a lesion of the lung and eight patients presented initially with neurological findings of an intracranial mass lesion. The most common histological type of tumor was adenocarcinoma (48%), followed by squamous cell carcinoma, undifferentiated small cell carcinoma, and bronchoalveolar carcinoma. Twelve patients (52%) had a poor result and died during the first 6 months. Surgery appeared to improve short-term survival in six patients (26%). Five patients (22%) had a good result and lived longer than 2 years without significant neurological deficit. Three patients (13%) are alive 10 or more years following surgery.

Examining the impact of firm-specific and environmental-specific factors on short and long-term firm survival during an economic crisis

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Dimitrios Chatzoudes ◽  
Prodromos Chatzoglou ◽  
Anastasios Diamantidis
Keyword(s):  
Business Performance ◽  
Firm Survival ◽  
Current Situation ◽  
Short Term ◽  
Term Survival ◽  
Long Term Survival ◽  
Content Type ◽  
Future Situation ◽  
Short Term Survival

PurposeLooking back on the last 12 years, the whole planet went through two major economic crises (2008 and 2019), which both had a profound impact on the survival of businesses. The present study aims to develop and empirically test a conceptual framework that investigates the factors that have an influence on firm survival. More specifically, the study proposes a three-dimensional framework that includes performance drivers (utilizing resource-based view [RBV] factors), performance measures and the measurement of firm survival. Such a multi-dimensional approach has very rarely been explored in the existing literature.Design/methodology/approachA thorough literature review revealed gaps in the literature and offered the basis for developing the proposed conceptual framework of the study. Its empirical examination (hypothesis testing) was conducted with the use of a newly developed structured questionnaire that was distributed to a group of Greek manufacturing organizations (the final sample consists of 364 manufacturing companies). Empirical data were analyzed using the “structural equation modeling” (SEM) technique (multivariate analysis) and other similar techniques (i.e. exploratory factor analysis and analysis of variance). The study is empirical (based on primary data), explanatory (examines cause and effect relationships), deductive (tests research hypotheses) and quantitative (includes the analysis of quantitative data collected with the use of a structured questionnaire).FindingsOn the one hand, empirical results point out that “manufacturing-marketing alignment,” “manufacturing capabilities,” “structural configuration” and “business performance under crisis” have the most significant impact and on short-term survival (current situation). On the other hand, “competitive advantage” and “business performance under crisis” have the most significant impact on long-term survival (future situation). Focusing on RBV factors, only “structural configuration” and “manufacturing capabilities” directly affect short-term survival, while “manufacturing–marketing alignment” has an indirect effect on the same factor. Then again, all RBV factors indirectly affect long-term survival. Also, it is confirmed that short-term survival strongly affects long-term survival.Originality/valueThe present study contributes to the debate concerning the antecedents of firm survival, since current empirical findings are quite inconsistent. Specifically, crucial performance drivers and other measures are incorporated into an original model, which reveals their synergies and their impact on the dynamic dimensions of firm survival. Additionally, it enhances the stream of research that investigates firm survival under crisis since very few similar empirical studies have been conducted. Finally, firm survival is not measured as a static concept but rather as a dynamic one (firm survival – current situation and firm survival – future situation). Overall, the final model can explain 35.2% of the variance in “firm survival – current situation” and 46.3% of the variance in “firm survival – future situation.”

Dual-isotope single-photon emission computerized tomography scanning in patients with glioblastoma multiforme: association with patient survival and histopathological characteristics of tumor after high-dose radiotherapy

1998 ◽  
Vol 89 (1) ◽  
pp. 60-68 ◽  
Author(s):  
Richard B. Schwartz ◽  
B. Leonard Holman ◽  
Joseph F. Polak ◽  
Basem M. Garada ◽  
Marc S. Schwartz ◽  
...  
Keyword(s):  
Survival Rate ◽  
Glioblastoma Multiforme ◽  
Single Photon ◽  
Photon Emission ◽  
High Dose ◽  
Term Survival ◽  
Content Type ◽  
Dual Isotope ◽  
Fine Print

Object. The study was conducted to determine the association between dual-isotope single-photon emission computerized tomography (SPECT) scanning and histopathological findings of tumor recurrence and survival in patients treated with high-dose radiotherapy for glioblastoma multiforme. Methods. Studies in which SPECT with 201Tl and 99mTc-hexamethypropyleneamine oxime (HMPAO) were used were performed 1 day before reoperation in 47 patients with glioblastoma multiforme who had previously been treated by surgery and high-dose radiotherapy. Maximum uptake of 201Tl in the lesion was expressed as a ratio to that in the contralateral scalp, and uptake of 99mTc-HMPAO was expressed as a ratio to that in the cerebellar cortex. Patients were stratified into groups based on the maximum radioisotope uptake values in their tumor beds. The significance of differences in patient gender, histological characteristics of tissue at reoperation, and SPECT uptake group with respect to 1-year survival was elucidated by using the chi-square statistic. Comparisons of patient ages and time to tumor recurrence as functions of 1-year survival were made using the t-test. Survival data at 1 year were presented according to the Kaplan—Meier method, and the significance of potential differences was evaluated using the log-rank method. The effects of different variables (tumor type, time to recurrence, and SPECT grouping) on long-term survival were evaluated using Cox proportional models that controlled for age and gender. All patients in Group I (201Tl ratio < 2 and 99mTc-HMPAO ratio < 0.5) showed radiation changes in their biopsy specimens: they had an 83.3% 1-year survival rate. Group II patients (201T1 ratio < 2 and 99mTc-HMPAO ratio of ≥ 0.5 or 201Tl ratio between 2 and 3.5 regardless of 99mTc-HMPAO ratio) had predominantly infiltrating tumor (66.6%); they had a 29.2% 1-year survival rate. Almost all of the patients in Group III (201Tl ratio > 3.5 and 99mTc-HMPAO ratio ≥ 0.5) had solid tumor (88.2%) and they had a 6.7% 1-year survival rate. Histological data were associated with 1-year survival (p < 0.01); however, SPECT grouping was more closely associated with 1-year survival (p < 0.001) and was the only variable significantly associated with long-term survival (p < 0.005). Conclusions. Dual-isotope SPECT data correlate with histopathological findings made at reoperation and with survival in patients with malignant gliomas after surgical and high-dose radiation therapy.

Tumor recurrence and survival following gamma knife surgery for brain metastases

2005 ◽  
Vol 102 (Special_Supplement) ◽  
pp. 287-288 ◽  
Author(s):  
Thomas Mindermann
Keyword(s):  
Brain Metastasis ◽  
Brain Metastases ◽  
Gamma Knife ◽  
Tumor Recurrence ◽  
Patient Survival ◽  
Gamma Knife Surgery ◽  
Recurrence Rates ◽  
Term Survival ◽  
Content Type ◽  
Fine Print

Object. The authors evaluated prognostic factors for tumor recurrence and patient survival following gamma knife surgery (GKS) for brain metastasis. Methods. A retrospective review of 101 patient charts was undertaken for those patients treated with GKS for brain metastases from 1994 to 2001. Recurrence rates of brain metastasis following GKS depended on the duration of patient survival. Long-term survival was associated with a higher risk of tumor recurrence and shorter-term survival was associated with a lower risk. The duration of survival following GKS for brain metastases seems to be characteristic of the primary disease rather than the cerebral disease. Conclusions. Recurrence rates of brain metastasis following GKS are related to duration of survival, which is in turn mostly dependent on the nature and course of the primary tumor.

Influence of age and shock severity on short-term survival in patients with cardiogenic shock

2021 ◽  
Author(s):  
Jacob C Jentzer ◽  
Benedikt Schrage ◽  
David R Holmes ◽  
Salim Dabboura ◽  
Nandan S Anavekar ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Mayo Clinic ◽  
Older Patients ◽  
Cox Proportional Hazards ◽  
Circulatory Support ◽  
Short Term ◽  
Term Survival ◽  
Risk Of Death ◽  
Coronary Syndrome ◽  
Short Term Survival

Abstract Aims Cardiogenic shock (CS) is associated with poor outcomes in older patients, but it remains unclear if this is due to higher shock severity. We sought to determine the associations between age and shock severity on mortality among patients with CS. Methods and results Patients with a diagnosis of CS from Mayo Clinic (2007–15) and University Clinic Hamburg (2009–17) were subdivided by age. Shock severity was graded using the Society for Cardiovascular Angiography and Intervention (SCAI) shock stages. Predictors of 30-day survival were determined using Cox proportional-hazards analysis. We included 1749 patients (934 from Mayo Clinic and 815 from University Clinic Hamburg), with a mean age of 67.6 ± 14.6 years, including 33.6% females. Acute coronary syndrome was the cause of CS in 54.0%. The distribution of SCAI shock stages was 24.1%; C, 28.0%; D, 33.2%; and E, 14.8%. Older patients had similar overall shock severity, more co-morbidities, worse kidney function, and decreased use of mechanical circulatory support compared to younger patients. Overall 30-day survival was 53.3% and progressively decreased as age or SCAI shock stage increased, with a clear gradient towards lower 30-day survival as a function of increasing age and SCAI shock stage. Progressively older age groups had incrementally lower adjusted 30-day survival than patients aged &lt;50 years. Conclusion Older patients with CS have lower short-term survival, despite similar shock severity, with a high risk of death in older patients with more severe shock. Further research is needed to determine the optimal treatment strategies for older CS patients.

scholarly journals Parenteral Nutrition and Oxidant Load in Neonates

Nutrients ◽  
2021 ◽  
Vol 13 (8) ◽  
pp. 2631
Author(s):  
Kandeepan Karthigesu ◽  
Robert F. Bertolo ◽  
Robert J. Brown
Keyword(s):  
Parenteral Nutrition ◽  
Storage Temperature ◽  
Oral Feeding ◽  
Published Data ◽  
Short Term ◽  
Antioxidant Defences ◽  
Term Survival ◽  
Nutrient Sources ◽  
Short Term Survival

Neonates with preterm, gastrointestinal dysfunction and very low birth weights are often intolerant to oral feeding. In such infants, the provision of nutrients via parenteral nutrition (PN) becomes necessary for short-term survival, as well as long-term health. However, the elemental nutrients in PN can be a major source of oxidants due to interactions between nutrients, imbalances of anti- and pro-oxidants, and environmental conditions. Moreover, neonates fed PN are at greater risk of oxidative stress, not only from dietary sources, but also because of immature antioxidant defences. Various interventions can lower the oxidant load in PN, including the supplementation of PN with antioxidant vitamins, glutathione, additional arginine and additional cysteine; reduced levels of pro-oxidant nutrients such as iron; protection from light and oxygen; and proper storage temperature. This narrative review of published data provides insight to oxidant molecules generated in PN, nutrient sources of oxidants, and measures to minimize oxidant levels.

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