scholarly journals Clinical Characteristics and Long-Term Prognosis of Anti-LGI1 Encephalitis: A Single-Center Cohort Study in Beijing, China

2021 ◽  
Vol 12 ◽  
Author(s):  
Tao-Ran Li ◽  
Yu-Di Zhang ◽  
Qun Wang ◽  
Xiao-Qiu Shao ◽  
Di-Yang Lyu ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Complete Recovery ◽  
Psychiatric Disturbance ◽  
Face To Face ◽  
Long Term Follow Up ◽  
Clonic Seizures ◽  
Long Term Prognosis ◽  
Beijing China

Background: This study aimed to analyze the clinical characteristics of anti-leucine-rich glioma-inactivated protein 1 (LGI1) encephalitis patients and investigate prognostic factors by using a large-sample and long-term follow-up cohort.Methods: The clinical data of 45 patients (29 males; mean age, 57.0 years) from May 2014 to August 2019 were collected. All patients were followed up by face-to-face interviews in the third month after discharge and then by telephone and/or face-to-face interviews every 6 months until November 2020. We evaluated each patient's response to the initial treatments at the first interview and divided them into “responders” and “nonresponders.” Relapses were recorded. At the end of follow-up, each patient was evaluated and reclassified into “complete recovery” or “unhealed” groups. Intergroup differences were assessed.Results: All patients presented with seizures at the initial consultation. Other common manifestations included cognitive dysfunction (82.2%), psychiatric disturbance (66.7%), sleep disorder (54.5%), and hyponatremia (66.7%). During the follow-up period (32.8 ± 13.5 months), six patients experienced relapse within 6–37 months. We observed that the patients who did not respond to the initial treatments and those who relapsed all had a poor long-term prognosis. The patients in the “unhealed” group were older (p = 0.009), had a lower incidence of generalized tonic–clonic seizures (p = 0.041), and had a higher probability of cerebrospinal fluid (CSF) abnormalities (p = 0.024) than those in the “complete recovery” group.Conclusion: Anti-LGI1 encephalitis was characterized by seizures, cognitive impairment, psychiatric disturbance, and sleep disorders and was often accompanied by hyponatremia. Patients who responded poorly to the initial treatments and those patients who relapsed had dismal long-term prognoses. Advanced age and CSF abnormalities may be risk factors for poor prognosis, but these still need to be verified.

Impact of new onset atrial fibrillation on long-term prognosis in patients with acute ST-segment elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.A Baturova ◽  
M.M Demidova ◽  
J Carlson ◽  
D Erlinge ◽  
P.G Platonov
Keyword(s):  
Clinical Characteristics ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
All Cause Mortality ◽  
Long Term Follow Up ◽  
Long Term Prognosis ◽  
New Onset

Abstract Introduction New onset AF is a known complication in patients with acute ST-segment elevation myocardial infarction (STEMI). However, whether new-onset AF affects the long-term prognosis to the same extent as pre-existing AF is not fully clarified and prescription of oral anticoagulants (OAC) in patients with new-onset AF remains a matter of debates. Purpose We aimed to assess the impact of new-onset AF in STEMI patients undergoing primary percutaneous intervention (PCI) on outcome during long-term follow-up in comparison with pre-existing AF and to evaluate effect of OAC therapy in patients with new-onset AF on survival. Methods Study sample comprised of 2277 consecutive patients with STEMI admitted to a tertiary care hospital for primary PCI from 2007 to 2010 (age 66±12 years, 70% male). AF prior to STEMI was documented by record linkage with the Swedish National Patient Register and review of ECGs obtained from the digital archive containing ECGs recorded in the hospital catchment area since 1988. SWEDEHEART registry was used as the source of information regarding clinical characteristics and events during index admission, including new-onset AF and OAC at discharge. All-cause mortality was assessed using the Swedish Cause-of-Death Register 8 years after discharge. Results AF prior to STEMI was documented in 177 patients (8%). Among patients without pre-existing AF (n=2100), new-onset AF was identified in 151 patients (7%). Patients with new-onset AF were older than those without AF history (74±9 vs 65±12 years, p<0.001), but did not differ in regard to other clinical characteristics. Among 2149 STEMI survivors discharged alive, 523 (24%) died during 8 years of follow-up. OAC was prescribed at discharge in 45 (32%) patients with new onset AF and in 49 (31%) patients with pre-existing AF, p=0.901. In a univariate analysis, both new-onset AF (HR 2.18, 95% CI 1.70–2.81, p<0.001) and pre-existing AF (HR 2.80, 95% CI 2.25–3.48, p<0.001) were associated with all-cause mortality, Figure 1. After adjustment for age, gender, cardiac failure, diabetes, BMI and smoking history, new-onset AF remained an independent predictor of all-cause mortality (HR 1.40, 95% CI 1.02–1.92, p=0.037). OAC prescribed at discharge in patients with new-onset AF was not significantly associated with survival (univariate HR 0.86, 95% CI 0.50–1.50, p=0.599). Conclusion New-onset AF developed during hospital admission with STEMI is common and independently predicts all-cause mortality during long-term follow-up after STEMI with risk estimates similar to pre-existing AF. The effect of OAC on survival in patients with new-onset AF is inconclusive as only one third of them received OAC therapy at discharge. Kaplan-Meier survival curve Funding Acknowledgement Type of funding source: None

Psychopathology 8½ Years Post Parasuicide

Crisis ◽  
1999 ◽  
Vol 20 (3) ◽  
pp. 115-120 ◽  
Author(s):  
Stephen Curran ◽  
Michael Fitzgerald ◽  
Vincent T Greene
Keyword(s):  
Rating Scales ◽  
Psychiatric Morbidity ◽  
Parental Bonding ◽  
Social Maladjustment ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Face To Face ◽  
Long Term Follow Up

There are few long-term follow-up studies of parasuicides incorporating face-to-face interviews. To date no study has evaluated the prevalence of psychiatric morbidity at long-term follow-up of parasuicides using diagnostic rating scales, nor has any study examined parental bonding issues in this population. We attempted a prospective follow-up of 85 parasuicide cases an average of 8½ years later. Psychiatric morbidity, social functioning, and recollections of the parenting style of their parents were assessed using the Clinical Interview Schedule, the Social Maladjustment Scale, and the Parental Bonding Instrument, respectively. Thirty-nine persons in total were interviewed, 19 of whom were well and 20 of whom had psychiatric morbidity. Five had died during the follow-up period, 3 by suicide. Migration, refusals, and untraceability were common. Parasuicide was associated with parental overprotection during childhood. Long-term outcome is poor, especially among those who engaged in repeated parasuicides.

Abstract 165: Pial Synangiosis in Patients with Moyamoya less than 2 Years of Age

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Eric M Jackson ◽  
Ning Lin ◽  
Lissa Baird ◽  
R. Michael Scott ◽  
Edward R Smith
Keyword(s):  
Late Complications ◽  
High Risk Population ◽  
Consecutive Series ◽  
Ischemic Change ◽  
Initial Surgery ◽  
Long Term Follow Up ◽  
Progression Of Disease ◽  
Long Term Prognosis

Introduction: Moyamoya patients under two years of age represent a therapeutic challenge because of their frequent neurologic instability and concomitant anesthetic risks. We report our experience with pial synangiosis revascularization in this population. Methods: We reviewed the clinical and radiographic records of all patients with moyamoya syndrome in a consecutive series of patients under 2 years of age, who underwent cerebral revascularization surgery using pial synangiosis at a single institution. Results: During a 12-year period (1994-2005), thirty-four procedures (15 bilateral, 4 unilateral) were performed in 19 patients under two years of age (out of a total of 456 procedures in 240 patients). Eighteen of these patients presented with either stroke or TIA. Average age at first surgery was 1.4 years (range 6 months to 1.9 years). Unanticipated staged operations occurred in three patients, two due to persistent EEG changes during the initial surgery and one due to brain swelling during the procedure requiring ventriculostomy. There were two perioperative strokes; both patients had post-operative seizures but made clinical recoveries. The average follow-up was 7 years (range 1-14). In long term follow-up, 13 patients (68%) were clinically independent for their age, with 8 (42%) having no significant deficit. Late complications included subdural hygroma evacuation (1), additional revascularization procedures years later for frontal lobe ischemia (2), late infarction (1) and asymptomatic ischemic change on routine follow-up MRI studies (1). All patients who had both pre and post-operative angiography demonstrated progression of disease. Conclusions: Despite the challenges inherent to this population, the majority of children with moyamoya under 2 years of age have a good long-term prognosis. Our data support the use of pial synangiosis as a safe, effective and durable method for treatment of moyamoya for most children in this potentially high-risk population.

Abstract 13882: Impact of Ischemic Mitral Regurgitation on Long-Term Prognosis in Patients With Acute Myocardial Infarction After Primary Percutaneous Coronary Intervention

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Kitae Kim ◽  
Shuichiro Kaji ◽  
Takeshi Kitai ◽  
Atsushi Kobori ◽  
Natsuhiko Ehara ◽  
...  
Keyword(s):  
Cardiac Death ◽  
Poor Prognosis ◽  
Coronary Intervention ◽  
Killip Class ◽  
Percutaneous Coronary ◽  
Long Term Follow Up ◽  
The Mean ◽  
Long Term Prognosis

Introduction: Ischemic mitral regurgitation (IMR) portends a poor prognosis during long-term follow-up and has been identified as an independent predictor of heart failure (HF) and reduced long-term survival. Despite the poor prognosis with chronic IMR, few studies report the impact of IMR on long-term prognosis in patients with acute myocardial infarction (AMI) who underwent primary percutaneous coronary intervention (PCI). Methods: We studied 674 consecutive patients with AMI from 2000 to 2006 who underwent emergent coronary angiography and primary PCI, and who were assessed by transthoracic echocardiography during index hospitalization. Primary outcomes were cardiac death and the development of HF during follow-up. Results: The mean age of the study patients was 65±12 years and 534 patients (79%) were men. Sixty patients (9%) had moderate or severe MR before hospital discharge. Patients with moderate or severe MR were older, more frequently non-smoker, and more likely to have Killip class ≥2, lower ejection fraction, larger left ventricular end-diastolic volume, compared with patients with no or mild MR. During the mean follow-up period of 5.7±3.6 years, 35 cardiac deaths and 53 episodes of HF occurred. Kaplan-Meier analysis revealed that patients with moderate or severe MR had significantly increased risk for cardiac death (P<0.001), and HF (P<0.001), compared with patients with no or mild MR. Multivariate analysis revealed that moderate or severe MR was the significant predictor of the development of cardiac death (P<0.001), and the development of HF (P=0.006), independently of age, gender, history of MI, Killip class ≥2, initial TIMI flow≤1, peak CPK level, ejection fraction. Conclusions: Moderate or severe IMR detected early after AMI was independently associated with adverse cardiac events during long-term follow-up in patients with AMI after primary PCI.

scholarly journals Supratentorial Brain AVM Embolization with Onyx-18 and Post-Embolization Management

2009 ◽  
Vol 15 (3) ◽  
pp. 275-282 ◽  
Author(s):  
J. W. Pan ◽  
H.J. Zhou ◽  
R.Y. Zhan ◽  
S. Wan ◽  
M. Yan ◽  
...  
Keyword(s):  
Arteriovenous Malformations ◽  
Subsequent Treatment ◽  
Additional Surgery ◽  
Brain Avm ◽  
Initial Symptoms ◽  
Complete Obliteration ◽  
Long Term Follow Up ◽  
Long Term Prognosis

Onyx is increasingly used in endovascular therapy of intracranial arteriovenous malformations (AVMs). However, the embolic effect and post-embolization management are still under discussion. We report our experience in the treatment of supratentorial brain arteriovenous malformations (SBAVMs) with Onyx and discuss post-embolic management. From June 2006 to July 2008, 20 patients with SBAVM were embolized with Onyx. There were 14 men and six women ranging from 14 to 64 years of age (mean 38.3 years). Initial symptoms included spontaneous hemorrhage (n=12), headaches (n=4), seizure (n=3) and incidentally disclosed after head trauma (n=1). After the endovascular procedure, all had subsequent treatment (follow-up angiogram, stereotactic radiosurgery or microsurgery) according to the obliteration degree. At angiography, seven patients (35%, 7/20) were completely obliterated (over 95% closure) after embolization while one suffered a small subarachnoid hemorrhage without permanent clinical sequelae. Four patients (20%, 4/20) were subtotally obliterated (over 80% closure), one patient who suffered severe cerebral edema after embolization underwent decompressive craniectomy, two patients had additional radiosurgery and one patient had follow-up angiogram. Nine patients (45%, 9/20) were partially obliterated (20–80% closure), five patients had additional surgery, two patients had additional radiosurgery and two patients had follow-up angiogram (one patient had intraventricular hemorrhage three months after embolization). Of all 20 AVMs, an average of 2.2 ml Onyx was used per patient and average volume reduction was 80% (range, 30%–99%). Onyx is suitable for embolization of SBAVMs because of its diffuse controllable properties. We suggest clinical follow-up after complete obliteration, additional radiosurgery or angiographic follow-up after subtotal obliteration and additional surgery after partially obliteration. More cases with long-term follow-up are needed to evaluate the long-term prognosis of our post-embolization management.

Proliferation Index of Nonfunctioning Pituitary Adenomas: Correlations with Clinical Characteristics and Long-term Follow-up Results

Neurosurgery ◽  
2000 ◽  
Vol 47 (6) ◽  
pp. 1313-1319 ◽  
Author(s):  
Marco Losa ◽  
Alberto Franzin ◽  
Francesca Mangili ◽  
Maria Rosa Terreni ◽  
Raffaella Barzaghi ◽  
...  
Keyword(s):  
Pituitary Adenomas ◽  
Clinical Characteristics ◽  
Proliferation Index ◽  
Nonfunctioning Pituitary Adenomas ◽  
Long Term Follow Up

scholarly journals Multiple major morbidities and increased mortality during long-term follow-up after recovery from thrombotic thrombocytopenic purpura

Blood ◽  
2013 ◽  
Vol 122 (12) ◽  
pp. 2023-2029 ◽  
Author(s):  
Cassandra C. Deford ◽  
Jessica A. Reese ◽  
Lauren H. Schwartz ◽  
Jedidiah J. Perdue ◽  
Johanna A. Kremer Hovinga ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Complete Recovery ◽  
Systemic Lupus ◽  
Thrombocytopenic Purpura ◽  
Risk Of Death ◽  
Chronic Disorder ◽  
Key Points ◽  
Long Term Follow Up

Key Points After recovering from TTP, the prevalence of hypertension, depression, and systemic lupus erythematosus and risk of death are increased. TTP may be a more chronic disorder rather than a disorder of acute episodes and complete recovery.

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