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PubMed1994

Sexual sequelae of antihypertensive drugs: treatment effects on self-report and physiological measures in middle-aged male hypertensives.

Antihypertensive drugs are commonly associated with adverse side effects in both clinical and laboratory studies. We investigated the sexual sequelae of several major classes of antihypertensive drugs (e.g., beta blockers, central alpha agonists, diuretics) in normal males and in hypertensive patients. We compared the effects of four widely used agents (methyldopa, propranolol, atenolol, hydrochlorothiazide-triamterene) and placebo, in a selected sample of 21 sexually dysfunctional male hypertensives, 13 of whom completed all five phases of the study. Each study drug was administered for a 1-month treatment period, followed by a 2-week, single-blind washout phase, according to a randomized, Latin square crossover design. Dependent variables for the study included a broad range of hormonal, NPT, and self-report measures of sexual response. Results indicated a lack of consistent drug effects on measures of sexual response, although more frequent sexual and nonsexual side effects were observed with methyldopa and propranolol. As in our previous studies, age was negatively correlated with both hormonal and NPT measures, whereas changes in blood pressure were not significantly related to sexual function scores. Results do not support the hypothesis that sexually dysfunctional males are at greater risk for adverse sexual sequelae when treated with centrally active agents or diuretics.

Adult↗
PubMed1983

Evaluation of the different methods used in the treatment of rhinoplastic sequelae.

Reports on rhinoplastic sequelae are infrequent. Reported incidence rates vary from 5% to 12%. The authors have an overall rate of 8%, with 6.5% of cases involving slight sequelae and 1.5% moderate ones. Various techniques for correction are used, depending on the sequel. Silastic implants have been unsatisfactory over the long term, so generally autogenous implants are used.

Humans↗
PubMed1993

Chronological changes of MRI findings on striatal damage after acute cyanide intoxication: pathogenesis of the damage and its selectivity, and prevention for neurological sequelae: a case report.

A 31-year-old male technician in an electroplating factory, who had been suffering from the temporal lobe epilepsy for 24 years and from hypertension for 2 years, took an unknown amount of potassium cyanide apparently over the lethal dose, in an attempt to commit suicide. He was treated successfully and survived without any neurological sequelae. The electroencephalograms and the nature of the seizures were not different before and after the poisoning. The T2-weighted magnetic resonance images at 9 and 51 days after the poisoning showed bilateral elevation of signals in the caudate nuclei and the putamina. At the 143th and 286th days. T2-weighted high-resonance areas were restricted to the lateral portion of the putamina. The T1-weighted images at the 51st day showed abnormal signal elevations in both putamina, while those of 9th, 143th and 286th days were mainly normal. Selective vulnerability of the putamen and the caudate nucleus may be due to their specific structural properties of high oxygen and glucose utilization, and enzyme distribution. Both chronological changes of striatal damage and the absence of neurological sequelae in this patient suggest the possibility that anti-epileptics and a calcium antagonist played a neuroprotective role in the acute cyanide intoxication.

Adult↗
PubMedDate not supplied

Immediate complications and late sequelae of arterial catheterization in children with congenital heart disease.

Early vascular complications and late sequelae are reported in relation to 195 left heart catheterizations, 125 performed by brachial arteriotomy (BA), and 70 by percutaneous femoral artery puncture (FAP) with the Seldinger technique. Vascular complications occurred in 25 patients, 11 requiring surgical intervention, which was successful in restoring normal circulation in all. The rate of complications was higher after FAP in children 6 years old or less, while after BA the rate was significantly higher in patients of 2 years or older. In patients under 2 years, brachial artery suture repair resulted in more complications than ligation, but the cases were not randomized. Late follow-up of 101 catheterizations (35 FAP, and 66 BA, of which 38 were ligated and 28 sutured) included clinical evaluation, Doppler pressure measurements, and a comparison of the length and bone development of the catheterized and non-catheterized limbs. All these have indicated an absence of any serious late sequelae in this group 6 months to 9 years (average 4 years) after catheterization.

Arteries↗
PubMed2006

[Chronic eustachian tube dysfunction and its sequelae in adult patients with cleft lip and palate].

BACKGROUND: While almost all children with cleft palate develop eustachian tube dysfunction, this tends to normalize with age although it remains impaired in a number of patients. METHODS: Eustachian tube function was evaluated by tympanometry in 40 patients with an average age of 19.9 years. The number of patients with chronic otitis media, a sequelae of chronic eustachian tube dysfunction, was determined microscopically and from the patient's history. Hearing was assessed by pure tone RESULTS: Eustachian tube dysfunction was found bilaterally in 25% of the patients and unilaterally in 6%, while chronic otitis media was found in 32.5% and 12.5%, respectively. The hearing level did not differ between the side of the cleft and the opposite side (P=0.562). CONCLUSION: Nearly a third of the adult patients still suffered from eustachian tube dysfunction. Pathological tympanograms and chronic otitis media usually occurred bilaterally. A relationship between the side of the cleft and the side on which the eustachian tube dysfunction or its sequelae occurred was not apparent. The main reason seems to be the continuing bilateral muscular insufficiency in opening the eustachian tube.

Adolescent↗
PubMed2002

Psychiatric sequelae in atomic bomb survivors in Hiroshima and Nagasaki two decades after the explosions.

BACKGROUND: Atomic bomb exposure was an extraordinarily stressful event. Although little epidemiological research has been performed on the psychiatric effects of the bombings, many medical descriptions of the survivors suggest that there was an increase of various symptoms that implied autonomic ataxia or neurosis-like disorders. The psychiatric effects of exposure to the atomic bomb explosions in Hiroshima and Nagasaki were assessed in this study. METHOD: From a self-administered medical questionnaire completed between 1962 and 1965 by 9421 informed and consenting Adult Health Study subjects, some questions congruent with the DSM-IV diagnostic criteria for generalized anxiety disorder and somatization disorder were selected and used as indicators of anxiety symptoms and somatization symptoms. The prevalence of psychiatric symptoms in relation to age, sex, city (Hiroshima vs. Nagasaki), acute radiation symptoms, exposure status (in city or not in city), ground distance from hypocenter, disease history, and death of family members were analyzed. RESULTS: A higher prevalence of anxiety symptoms (odds ratio, 1.73) and somatization symptoms (odds ratio, 1.99) was observed in those with acute radiation symptoms than in those without them. The prevalence of anxiety symptoms and somatization symptoms among people who were in the city at the time of the explosion was significantly higher than among those who were not in the city. Among the former, prevalence was lower among proximally exposed people than among distally exposed people. Symptom prevalences were also affected by age, sex, and city. Although disease history such as neurotic disorder and ulcer were risk factors for anxiety symptoms and somatization symptoms, the increased prevalence of anxiety symptoms and somatization symptoms in association with atomic bomb exposure was independent of disease history and the death of family members. CONCLUSION: The prevalence of anxiety symptoms and somatization symptoms was elevated in atomic bomb survivors even 17-20 years after the bombings had occurred, indicating the long-term nature of the psychiatric effects of the experience. Psychiatric sequelae were independent of physical sequelae.

Adult↗
PubMed2003

Magnetic resonance imaging of sequelae of central pontine myelinolysis in chronic alcohol abusers.

Central pontine myelinolysis (CPM) is one of the serious neurological complications of alcoholism. This study evaluated magnetic resonance images of sequelae of CPM. Approximately 600 alcoholic patients were examined by a 1.0-T magnetic resonance imaging device, and 11 patients were retrospectively found to have a central pontine lesion, a presumed sequela of CPM. The lesions had various shapes and most were cavitary. In 3 of the 11 patients bilateral symmetrical oval lesions were faintly visible in the middle cerebellar peduncles. These middle cerebellar peduncular lesions were diagnosed as having Wallerian degeneration of the pontocerebellar tract secondary to CPM.

Adult↗
PubMed2005

Neonatal meningitis in England and Wales: sequelae at 5 years of age.

UNLABELLED: This study determined the prevalence of serious sequelae among a national cohort of 5-year old children, born in England and Wales in 1996-7, who had had neonatal meningitis. The results were compared with those from two matched control groups. In addition the results from this study were compared with those from a previous 5-year follow-up of children who had had neonatal meningitis in 1985-7. Follow-up questionnaires requesting information about the children's health and development were sent to the general practitioners (GPs) and parents of the index children and controls. Information was collected on 166 of 232 (72%) children who had had meningitis as neonates, 109 general practice controls and 191 hospital controls. At 5 years, 39/166 (23%) index children had a serious disability compared to 2% of GP controls and 7% of hospital controls. There was a 16-fold increase in risk of serious disability compared to GP-matched controls and a 4-fold increase in risk compared to hospital controls. The isolation of bacteria from the CSF was the best single predictor of serious long-term disability. Although there was a 70% fall in acute phase mortality between 1985 (22%) and 1996 (6.6%), the overall incidence of serious disability remained alarmingly high, 25.5% in 1985 compared to 23.5% in 1996. In the present study, however, fewer children had cerebral palsy or seizure disorders. CONCLUSION: Despite the dramatic improvement in acute phase survival following neonatal meningitis, the prevalence of serious sequelae remains alarmingly high.

Child↗
PubMed2000

Oral sequelae of chemotherapy: an important teaching opportunity for oncology health care providers and their patients.

The object of this work was to conduct a rapid assessment of a teaching hospital's promotion of optimal oral health among its chemotherapy patients. A pilot study was undertaken, which included focus interviews with oncology clinic staff, a review of the fellowship training curriculum, and unobtrusive observations in the clinic setting. Charts were also audited for oncology patients who were probable chemotherapy candidates. A review of the data offered no evidence that oral health care was routinely addressed in a preventive context prior to the initiation of chemotherapy. Promotion of oral health care will help reduce the risk of oral sequelae of chemotherapy for patients and the subsequent impact of the oral sequelae on patients' chemotherapeutic regimen, thereby improving patients' chances of survival and improving their quality of life. Other teaching hospitals may wish to conduct a similar rapid assessment to determine whether they too could improve patient care and professional education in this area by incorporating pre-chemotherapy oral health evaluation and treatment into routine care for cancer patients.

Antineoplastic Agents↗
PubMed2003

Sequelae of endoscopic sympathetic block.

Endoscopic sympathetic block as a treatment for primary hyperhidrosis is associated with certain sequelae. The reported occurrence of side effects still varies in the literature. As the majority of patients describe sequelae after sympathetic surgery, the frequency and importance of these persisting changes are still underestimated. Patient's informed consent should include and define side effects like gustatory sweating, olfactory sweating and bradycardia as likely, and compensatory sweating as obligatory.

Adaptation, Physiological↗
PubMed2007

Chernobyl disaster sequelae in recent immigrants to the United States from the former Soviet Union (FSU).

Long-term mental health sequelae of the 1986 Chernobyl disaster have been documented for exposed populations who remained in the former Soviet Union (FSU) (Havenaar et al., 1997), and in a cohort migrated to Israel (Cwikel et al., 1997). This paper reports on Chernobyl disaster sequelae in émigrés (n = 321) to the United States. Demographic characteristics, migration factors, and self-reported physical health were considered. Both geographical proximity to the 1986 disaster, and perception of radiation risk stood as long-term indicators of current psychological distress. Proximity was related to poor self-perceived physical health, as well as current symptoms of depression (p<.05), anxiety (p<.01), and Chernobyl-related trauma distress (p<.001) on standardized measures. Environmental contamination as a reason for migration was also associated with greater mental health symptomatology.

Adult↗
PubMed2005

Nitrite/nitrate (NOx) and zinc concentrations in influenza-associated encephalopathy in children with different sequela.

NOx (NO2 and NO3) in CSF obtained from 22 patients with influenza-associated encephalopathy were higher than those of a control group. Within the different prognosis, there were no significant differences in NOx levels. By analyzing the serum obtained from patients infected with influenza, including encephalopathy, with others, the serum zinc levels did show marked differences between them. Four out of eleven patients with influenza-associated encephalopathy showed low zinc levels below the normal range. However, there were no significant differences in the zinc levels between the group with sequela and without sequela. These results indicate that the increase of NOx levels detected in influenza-associated encephalopathy relates to the low zinc levels, and both low molecules might play an important role for the cause of encephalopathy.

Brain Damage, Chronic↗
PubMed1975

Late sequelae of radiation therapy in cancer of the head and neck with particular reference to the nasopharynx.

Sequlae of radiation therapy may be late in occurring and varied in their manifestations. Although some are untreatable and progressive, the risk of development of some other sequelae can be minimized by careful application of radiotherapy or by ancillary measures, such as dental decay prophylaxis. Some of the serious sequelae secondary to radiation therapy of the nasopharynx have been summarized. These include radiation myelitis, paralysis of the cranial nerves, stricture of the pharynx, radiation-induced cancer, and necrosis with fatal hemorrhage.

Adult↗
PubMed1984

Late sequelae of deep venous thrombosis. Diagnostic and therapeutic considerations.

The efficacy of heparin, sodium warfarin, and elastic stockings in preventing the late leg sequelae of deep venous thrombosis was evaluated by reexamining 15 patients with previous acute deep venous thrombosis so treated. All 5 patients with iliocommon femoral disease and only 5 of 10 patients with distal disease had evidence of postphlebitic syndrome. Venous Doppler and strain gauge plethysmography confirmed these clinical findings. The most striking and consistent laboratory abnormalities were in the patients with proximal disease. Treatment of acute deep venous thrombosis by traditional means does not prevent the clinical and laboratory late leg sequelae. In light of these findings, serious investigation of new therapeutic modalities is strongly suggested.

Clothing↗
PubMed1991

Effect of the LTD4 receptor antagonist LY203647 on endotoxic shock sequelae in the rat.

This study investigated the effect of a novel LTD4 receptor antagonist LY203647 on Salmonella enteritidis endotoxin-induced shock sequelae in anesthetized rats. LY203647 (30 mg/kg i.v.) or vehicle was given 10 min prior to endotoxin (10 mg/kg i.v.) or its vehicle, and the hematocrit, mean arterial pressure and circulating leukocyte counts were determined. LY203647 significantly inhibited endotoxin-induced hemoconcentration up to 90 min post-endotoxin (46.7 +/- 1.3 vs. 51.9 +/- 2.4% at 30 min post-endotoxin, 45.9 +/- 1.1 vs. 53.1 +/- 1.4% at 90 min post-endotoxin, N = 8-9, P less than 0.05). The endotoxin-induced decreases in mean arterial pressure were also attenuated by LY203647, -29 +/- 5 vs. -56 +/- 9 mm Hg at 60 min post-endotoxin and -42 +/- 4 vs. -60 +/- 9 mm Hg at 90 min post-endotoxin (N = 9-10, P less than 0.05). LY203647 also attenuated endotoxin-induced decreases in leukocyte count in arterial blood. A study of differential counts in circulating leukocytes (N = 3) showed that endotoxin induced complete disappearance in circulating neutrophils. The circulating lymphocyte count was decreased by 30 +/- 10 and 41 +/- 1% at 15 and 30 min post-endotoxin, respectively. LY203647 inhibited endotoxin-induced lymphopenia (P less than 0.05) but failed to alter endotoxin-induced neutropenia. These data suggest that LTD4 may play an important role in mediating hemoconcentration, hypotensive and lymphocytopenic sequelae of endotoxin shock.

Acetophenones↗
PubMed1987

Infectious flare-ups and serious sequelae following endodontic treatment: a prospective randomized trial on efficacy of antibiotic prophylaxis in cases of asymptomatic pulpal-periapical lesions.

Without peritreatment antibiotics, infectious flare-ups (about 15% incidence) and serious sequelae follow endodontic treatment of asymptomatic teeth with necrotic pulps and associated periapical lesions. Antibiotics administered after endodontic treatment (4-day regimen) reduce the flare-up incidence to about 2%, but hypersensitivity responses, sensitization, resistant microbes, and drug-taking compliance are potential problems. To ascertain whether a specific prophylactic antibiotic (high-dose, 1-day regimen) would preferentially maintain this low flare-up incidence while overcoming antibiotic-related problems, 315 patients with quiescent pulpal necrosis and an associated periapical lesion were randomly given either penicillin V or erythromycin (base or stearate). Evaluations of flare-up after endodontic treatment were done at 1 day, 1 week, and 2 months. A 2.2% flare-up incidence was found, with no statistically significant differences for penicillin (0.0%), base (2.9%), and stearate (3.8%). No hypersensitivity responses occurred. Gastrointestinal side effects were found primarily with the erythromycins (12.4%). A comparative analysis of the data from our first study (no peritreatment antibiotics) and the pooled data from our last two investigations (including the current trial) showed that peritreatment antibiotic coverage significantly reduced flare-ups and serious sequelae after endodontic treatment (p less than 0.001).

Adolescent↗
PubMed1990

Neurological sequelae of cerebral malaria in children.

Out of 604 Gambian children admitted with falciparum malaria to one hospital between September and December, 1988, 308 had cerebral malaria and 203 were severely anaemic (haemoglobin less than 60 g/l). 14% of those with cerebral malaria died, as did 7.8% of those with severe anaemia. 32 (12%) of children surviving cerebral malaria had residual neurological deficit. 69 other children were admitted with clinical features strongly suggestive of cerebral malaria but with negative blood films; 16 of these died and 3 had residual neurological deficits. The commonest sequelae of cerebral malaria were hemiplegia (23 cases), cortical blindness (11), aphasia (9), and ataxia (6). Factors predisposing to sequelae included prolonged coma, protracted convulsions, severe anaemia, and a biphasic clinical course characterised by recovery of consciousness followed by recurrent convulsions and coma. At follow up 1-6 months later over half these children had made a full recovery, but a quarter were left with a major residual neurological deficit. Cerebral malaria in childhood may be an important cause of neurological handicap in the tropics.

Adolescent↗
PubMed1980

Delayed sequelae of head injury.

The evaluation of delayed sequelae of head injury is greatly facilitated by CT. This non-invasive technique provides us with the opportunity to evaluate the head trauma patients sequentially to detect the development and clinical significance of post-traumatic sequelae like delayed intracerebral hemorrhage, hydrocephalus, and post-traumatic atrophy.

Adult↗