scholarly journals Can Cranioplasty Be Considered a Tool to Improve Cognitive Recovery Following Traumatic Brain Injury? A 5-Years Retrospective Study

2021 ◽  
Vol 10 (22) ◽  
pp. 5437
Author(s):  
Francesco Corallo ◽  
Viviana Lo Buono ◽  
Rocco Salvatore Calabrò ◽  
Maria Cristina De Cola
Keyword(s):  
Retrospective Study ◽  
Decompressive Craniectomy ◽  
Neuropsychological Test ◽  
Routine Clinical Practice ◽  
Cognitive Changes ◽  
Cognitive Recovery ◽  
Long Period ◽  
The Impact ◽  
Normal Cognition

Cranioplasty (CP) is a neurosurgical intervention of skull repairing following a decompressive craniectomy. Unfortunately, the impact of cranioplasty on cognitive and motor function is still controversial. Fifteen TBI subjects aged 26–54 years with CP after decompressive craniectomy were selected in this observational retrospective study. As per routine clinical practice, a neuropsychological evaluation carried out immediately before the cranioplasty (Pre CP) and one month after the cranioplasty (T0) was used to measure changes due to CP surgery. This assessment was performed each year for 5 years after discharge in order to investigate long-term cognitive changes (T1-T5). Before cranioplasty, about 53.3% of subjects presented a mild to severe cognitive impairment and about 40.0% a normal cognition. After CP, we found a significant improvement in all neuropsychological test scores. The more significant differences in cognitive recovery were detected after four years from CP. Notably, we found significant differences between T4 and T0-T1, as well as between T5 and T0-T1-T2 in all battery tests. This retrospective study further suggests the importance of CP in the complex management of patients with TBI showing how these patients might improve their cognitive function over a long period after the surgical procedure.

Long-term impact of head and neck cancer (HNC) and treatment on financial distress and employment of HNC survivors.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e21575-e21575
Author(s):  
Elizabeth Marie Wulff-Burchfield ◽  
David G Schlundt ◽  
Kemberlee Bonnet ◽  
Emily Castellanos ◽  
Mary S. Dietrich ◽  
...  
Keyword(s):  
Marital Status ◽  
Late Effects ◽  
Financial Distress ◽  
Locally Advanced ◽  
Financial Strain ◽  
Cognitive Changes ◽  
Financial Counseling ◽  
The Impact

e21575 Background: Increasing HNC survival highlights the importance of understanding late biopsychosocial outcomes. Financial and occupational impacts of HNC remain unexplored, thus we undertook a qualitative analysis to identify themes and explore the impact of HNC/treatment on survivors’ financial health. Methods: Eligibility: Locally-advanced HNC who participated in an R0-1, NED, and > 1 year post treatment. Ten of 12 eligible patients were interviewed. Topics queried: financial issues related to HNC/treatment, financial/insurance matters affecting treatment, impact of treatment on fiscal responsibilities, financial counseling, and late impact of HNC/treatment on work. Frequency distributions were used to summarize patient characteristics. Interviews were transcribed verbatim, double-coded, and organized into themes and subthemes. Results: 50% male, 100% Caucasian, 60% married, median age 64 years, and median time since treatment of 64 months. Most denied ongoing financial strain from HNC/treatment, citing mitigating factors of preparedness (e.g. preexisting savings), health/disability insurance, and marital status. Those with financial distress noted an income limited by savings or disability. None reported financially-related delays in care. However, 2 patients used free healthcare. Most denied impact of HNC/treatment on financial obligations, but a minority reported subsequent delays in dental care, paying credit card bills, and travel. Financial counseling was used by 4 patients; benefits included decreased stress, access to financial programs, and education. Healthcare providers were considered an important source of financial counseling. Not all patients returned to work; late effects (fatigue, cognitive changes) impaired work capacity for those who did. Limitations: Population may have been skewed by loss to follow-up of patients with financial toxicity that precluded ongoing medical follow-up. Conclusions: Long-term financial distress was limited in this cohort of HNC survivors. Preparedness, adequate insurance, marital status, and financial counseling attenuated financial impacts of HNC. For those returning to work, late effects may affect capacity.

scholarly journals Rescue Decompressive Craniectomy in Children with Severe Traumatic Brain Injury

2017 ◽  
Vol 07 (01) ◽  
pp. 033-038
Author(s):  
Panagiotis Poulos ◽  
Maria Kazantzi ◽  
Panagiotis Kalampalikis ◽  
Dimitrios Rallis
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Decompressive Craniectomy ◽  
Neurological Outcome ◽  
Rescue Therapy ◽  
Increased Intracranial Pressure ◽  
Poor Neurological Outcome ◽  
Severe Tbi ◽  
The Impact

AbstractDecompressive craniectomy (DC) is considered a rescue therapy in patients with traumatic brain injury (TBI) with increased intracranial pressure (ICP). In this retrospective study, we examined the impact of craniectomy on ICP in children with severe TBI and their neurological outcome. A total of 14 patients were enrolled. Peak ICP was significantly lower (31 ± 2.9 to 19 ± 4.6, p < 0.001) and minimum cerebral perfusion pressure (CPP) higher (41 ± 10.5 to 58 ± 11.4, p < 0.001) postcraniectomy. The survival rate was 71%. However, 57% of our cohort had a poor neurological outcome at 6 months postinjury. In conclusion, although rescue DC was effective in controlling ICP and CPP, the long-term neurological outcome remained poor.

The Long Term Impact of Staying Put

1993 ◽  
Vol 13 (2) ◽  
pp. 193-211 ◽  
Author(s):  
Philip Leather ◽  
Sheila Mackintosh
Keyword(s):  
Older People ◽  
Housing Conditions ◽  
Care Needs ◽  
Long Period ◽  
Factors Influencing ◽  
Health Authorities ◽  
The Future ◽  
Long Term Impact ◽  
The Impact

ABSTRACTStaying Put projects provide practical help to older home owners with the repair and improvement of their homes. A number of studies have examined the immediate impact of this help on the housing conditions experienced by older people and on their ability to remain living independently in the community, but the extent to which these benefits could last for a long period of time was not known. This paper describes the findings of a study which attempted to examine the longer-term impact of the Staying Put service. A sample of clients helped by Staying Put in the early 1980s were traced and interviewed in order to assess the impact of the assistance received and to examine their current and future housing and care needs. Although the study could not conclusively disentangle the impact of the Staying Put service from other factors influencing the ability of clients to live independently, it concluded that the help received was significant in improving housing conditions over a long period. The study made recommendations which aim to increase the effectiveness of Staying Put projects in the future, including the establishment of a target standard for the housing conditions of clients, the development of mechanisms for continuing contact with clients, and the provision of advice on moving on options where appropriate. More generally, however, the study concluded that more resources to fund services like Staying Put were required from government and from local and health authorities if they were to be more effective in helping clients to live independently.

scholarly journals Are parallaxes of long-period variable stars and red supergiants reliable?

2007 ◽  
Vol 3 (S248) ◽  
pp. 486-487
Author(s):  
C. Babusiaux ◽  
A. Jorissen
Keyword(s):  
Surface Brightness ◽  
Variable Stars ◽  
Long Period ◽  
Red Supergiants ◽  
Period Variable ◽  
The Impact

AbstractWe have studied the impact of long-term variability and surface brightness asymmetries on the parallaxes of long-period variable stars and red supergiants.

scholarly journals The Impact of Psychological Factors on Outcomes for Spinal Cord Stimulation: An Analysis with Long-term Follow-up

2013 ◽  
Vol 3;16 (3;5) ◽  
pp. 265-275
Author(s):  
Tilman Wolter
Keyword(s):  
Spinal Cord ◽  
Retrospective Study ◽  
Spinal Cord Stimulation ◽  
Self Efficacy ◽  
Psychological Factors ◽  
Anxiety And Depression ◽  
Pain Scores ◽  
Anxiety Depression ◽  
The Impact

Background: For more than 3 decades, spinal cord stimulation (SCS) has successfully been employed to treat neuropathic pain. Psychological factors are assumed to be important for the efficacy of SCS. However, the impact of psychological factors on the outcome of SCS has only rarely been studied. Objectives: The aim of this study was to determine the influence of psychological factors such as anxiety and depression, perceived disability, and self efficacy on the outcome of SCS in a representative clinical sample. Study design: Retrospective study. Setting: Academic university interdisciplinary pain center. Methods: We reviewed the records of 60 consecutive patients who had been treated at our institution with lumbar, thoracic, or cervical neurostimulators between July 1, 2008, and June 30, 2012. Information with respect to age, gender, diagnosis, age at time of implantation, disease duration, the preoperative Hospital Anxiety and Depression Test, German Version (HADS-D), the Pain Disability Index (PDI) and preoperative pain scores on an 11 point Numeric Rating Scale (NRS) were recorded. In addition, a questionnaire was mailed to participants that contained the following items: pain scores on the NRS with and without stimulation, time intervals of stimulation, paresthesia coverage, treatment satisfaction and medication intake, anxiety/depression (HADS-D and Beck Depression Index II [BDI-II]), PDI, and self efficacy using the Fragebogen zur Erfassung der schmerzspezifischen Selbstwirksamkeit (FESS). Results: Preoperative HADS-D, PDI, and NRS pain scores were not different in those patients with an unsuccessful trial and those who underwent IPG implantation. Long-term outcomes were not affected by pre-implantation HADS-D or PDI scores. FESS scores showed a strong inverse correlation with HADS-D, BDI-II, and PDI scores and showed a tendency towards correlation with the percentage of pain reduction. HADS-D and PDI scores improved after SCS therapy. Limitations: Retrospective study. Conclusion: The outcome of SCS therapy could not be predicted on the basis of tested psychological factors anxiety/depression and pain-related disability. FESS correlated inversely with HADS-D, BDI-II, and PDI scores and showed a tendency towards correlation with the percentage of pain reduction. Further research is needed to define the impact of psychological factors on SCS outcomes. Key words: Spinal cord stimulation, clinical efficacy, paresthesia, psychological factors, anxiety, depression, disability, self-efficacy

scholarly journals The impact of COVID-19 in plastic surgery departments: a comparative retrospective study in a COVID-19 and in a non-COVID-19 hospital

2020 ◽  
Vol 43 (5) ◽  
pp. 645-650
Author(s):  
Francesca Romana Grippaudo ◽  
Emilia Migliano ◽  
Ugo Redi ◽  
Gianmarco Turriziani ◽  
Davide Marino ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Plastic Surgery ◽  
National Health System ◽  
Day Surgery ◽  
World Health ◽  
Long Term Effects ◽  
Level Of Evidence ◽  
Reconstructive Procedures ◽  
The Impact

Abstract Background COVID-19 is a new human-infecting coronavirus for which the World Health Organization declared a global pandemic. The first Italian cases occurred in February 2020: since then, there has been an exponential increase in new cases, hospitalizations and intensive care assistance demand. This new and sudden scenario led to a forced National Health System reorganization and review of welfare priorities. The aim of this study is to evaluate the effects of this pandemic on ordinary activities in two plastic surgery divisions in Rome, hosted in a COVID-19 and a non-COVID-19 hospital. Methods The data of this comparative retrospective study was collected between 9 March and 9 April 2019 and the same period of 2020 from two plastic surgery units, one in a COVID-19 hospital and second in a non-COVID-19 hospital in Rome, Italy. The 2019–2020 data of the two hospitals was compared regarding the number of surgeries, post-operative dressings and first consultations performed. Results Both units sustained a decrease in workload due to lockdown effects. Statistically significant differences for day surgery procedures (p value = 0.0047) and first consultations (p value < 0.0001) were found between the COVID-19 and non-COVID-19 institutes, with a drastic trend limiting non-urgent access to COVID-19 hospitals. Conclusions The long-term effects of healthcare reshuffling in the “COVID-19 era” imply a delay in the diagnosis and treatment of skin cancer and cancellation of many reconstructive procedures. These findings pose a question on the future consequences of a long-term limitation in plastic surgery healthcare. Level of evidence: Level III, risk/prognostic study.

scholarly journals Impact of Outpatient Rehabilitation Service in Preventing the Deterioration of the Care-Needs Level Among Japanese Older Adults Availing Long-Term Care Insurance: A Propensity Score Matched Retrospective Study

2019 ◽  
Vol 16 (7) ◽  
pp. 1292 ◽  
Author(s):  
Michio Maruta ◽  
Takayuki Tabira ◽  
Hyuma Makizako ◽  
Akira Sagari ◽  
Hironori Miyata ◽  
...  
Keyword(s):  
Older Adults ◽  
Retrospective Study ◽  
Propensity Score ◽  
Social Life ◽  
Long Term Care ◽  
Outpatient Rehabilitation ◽  
Care Needs ◽  
Term Care ◽  
The Impact

Outpatient rehabilitation (OR) and outpatient day long-term care (ODLC) services are frequently used by older adult patients in Japan. However, there is a need to clarify that OR service, which has more rehabilitation professionals than ODLC, has the role of providing rehabilitation. This retrospective study examined the impact of OR services by comparing the two services based on City A data from the care-needs certification survey conducted between 2015 to 2017. We performed a propensity score matched analysis to compare the changes in the care level and function of OR and ODLC users after two years. The results showed that OR users showed a lower deterioration in care levels and less decline in the activities of daily living (ADL) in dementia and adaptation to social life. In the analysis of older adults requiring support, OR users had a lower deterioration in care levels and less decline in the ADL in dementia and behavioral and psychological symptoms than ODLC users did. There was no difference between the two services with respect to older adults requiring long-term care. The OR service has had an increasingly preventive effect on the deterioration of care levels compared to the ODLC service, which was particularly evident in older adults requiring support.

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