Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “sequelae”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 343 records · Page 19Linked to original sources
PubMed1996

A comparison of children with suprasellar germ cell tumors and craniopharyngiomas: final height, weight, endocrine, and visual sequelae after treatment.

BACKGROUND: Although treatment results of craniopharyngiomas and germ cell tumors in children have been reported extensively, the relationship between various posttreatment sequelae and the nature of the tumor is not well understood. METHODS: From 1968-94, 47 children with 23 suprasellar germ cell tumors and 24 craniopharyngiomas were treated at Gunma University Hospital, Japan. Forty survivors were assessed with regard to Karnofsky scores, visual scores, final height, final weight, and other endocrine sequelae as long-term functional prognostic indicators. RESULTS: Kaplan-Meier life-table estimates and Karnofsky scores were not significantly different between the two histologic groups. The visual function of survivors did not differ significantly at diagnosis. However, the final visual function following treatment in the germ cell tumor group was better than in the craniopharyngioma group (p < 0.05). Antidiuretic hormone secretion was significantly impaired at diagnosis in the germ cell tumor group (p < 0.0001). However, there was only a marginally significant difference in posttreatment persistent diabetes insipidus. Craniopharyngioma children were shorter and more obese at diagnosis (p < 0.02), and became much more obese than germinoma children with the same hormone therapy (p < 0.003), although the height difference became insignificant following growth hormone treatment. CONCLUSIONS: Children with craniopharyngiomas tended to have more visual disturbances, increased dwarfism and obesity, and less diabetes insipidus than patients with germ cell tumors despite adequate therapy. The method of quantifying visual function may in itself be useful.

Adrenocorticotropic Hormone↗
PubMed2000

Megalophallus as a sequela of priapism in sickle cell anemia: use of blood oxygen level-dependent magnetic resonance imaging.

Priapism is a common complication of sickle cell anemia. We report a little known sequela of priapism: painless megalophallus, with significant penile enlargement. The patient had had an intense episode of priapism 9 years previously and his penis remained enlarged. Blood oxygen level-dependent magnetic resonance imaging revealed enlarged, hypoxic corpora cavernosa. Megalophallus probably resulted from permanent loss of elasticity of the tunica albuginea due to severe engorgement during the episode of priapism. This sequela needs to be recognized by physicians because no intervention is necessary and sexual function seems to remain intact.

Adult↗
PubMed1994

Sequelae of definitive radiation therapy for prostate cancer localized to the pelvis.

OBJECTIVES: To evaluate sequelae and estimate quality of life utilizing a survey instrument in 133 consecutive patients who have undergone definitive radiation therapy for localized prostate cancer. METHODS: All patients reported on have been followed for 14 to 60 months (median, 31 months) after radiation therapy and only patients with definitive prostate radiation therapy are included. Of the patients still alive at time of follow-up, 115 were mailed the questionnaire. Data regarding tumor grade and stage as well as treatment were extracted from patient files. RESULTS: Of the 91% of patients who returned the questionnaire, 11% used a pad and 13% leaked more than a few drops of urine daily. Of all the respondents, 9% stated that incontinence was a problem, and 31% found urinary leaking significantly worsened after radiation therapy compared with before their diagnosis of prostate cancer. With respect to sexual function, 77% recalled being able to have full or partial erections prior to radiation therapy. At some time after radiation therapy, 22% of previously potent respondents were able to have a full erection and 41% were able to have a partial erection. Twenty-nine percent of all patients who were able to establish an erection prior to radiation therapy reported that impotence was a problem at the time of follow-up. Forty-nine percent of patients had abdominal pain, diarrhea, or abdominal cramping during or after radiation therapy and 31% of all patients still had some intestinal symptoms at the time of follow-up. Eighteen percent of all patients were significantly bothered by one or more of these bowel problems. Overall, 31% of all patients reported a persistent degree of physical discomfort that they believed was secondary to their prostate cancer or the effect of treatment. Eighty-one percent were satisfied with radiation therapy and 97% of the patients said they would have radiation therapy again if faced with the decision. CONCLUSIONS: Utilizing a sensitive questionnaire on patients who had definitive radiation therapy for prostate cancer, we found the incidence of patients bothered by incontinence to be surprisingly frequent and higher than previously reported. The frequency of impotence is similar to previous studies. However, when our incontinence and impotence data were compared to Medicare patients who had undergone radical prostatectomy, the frequencies after radiation therapy were significantly lower. Despite the rates of sequelae, the patients were generally satisfied with the decision to undergo radiation therapy and with the medical treatment received.

Aged↗
PubMedDate not supplied

Sequelae of abuse. Health effects of childhood sexual abuse, domestic battering, and rape.

Violence against women is endemic in the United States. One third to one half of all women will experience one or more types of abuse in their lifetime, most often at the hands of a family member or an intimate or formerly intimate partner. One in 12 women is battered during pregnancy. Abuse survivors are disproportionately frequent users of health care services because of acute and chronic physical, somatic, emotional, and behavioral sequelae of abuse. Health care practitioners are often the first contact abuse survivors have with a potentially helping professional. It is, therefore, essential that health care providers learn to identify and to intervene appropriately with survivors of abuse. This article reviews and compares the health effects of three of the most common types of violence against women: childhood sexual abuse, domestic battering, and rape. Sequelae are divided into six categories: physical/medical, somatic, emotional/ psychological, social/interpersonal, behavioral/sexual, and pregnancy-related effects. The health effects discussed in this article include research findings, as well as effects noted in clinical practice. Recommendations are made for routine screening of all women for past and current abuse, as well as for intervention strategies.

Child↗
PubMed2002

Neurological sequelae in children born after in-vitro fertilisation: a population-based study.

BACKGROUND: There is an absence of population-based long-term studies on the risk of neurological sequelae in children born after in-vitro fertilisation (IVF). Our aim was to compare the frequency of such problems between IVF-born children and controls. METHODS: We did a population-based retrospective cohort study in which we compared development of neurological problems in 5680 children born after IVF, with 11360 matched controls. For 2060 twins born after IVF, a second set of controls (n=4120), all twins, were selected. We obtained data on neurological problems from the records of the Swedish habilitation centres. FINDINGS: Children born after IVF are more likely to need habilitation services than controls (odds ratio 1.7, 95% CI 1.3-2.2). For singletons, the risk was 1.4 (1.0-2.1). The most common neurological diagnosis was cerebral palsy, for which children born after IVF had an increased risk of 3.7(2.0-6.6), and IVF singletons of 2.8 (1.3-5.8). Suspected developmental delay was increased four-fold (1.9-8.3) in children born after IVF. Twins born after IVF did not differ from control twins with respect to risk of neurological sequelae. Low-birthweight and premature infants were more likely to need habilitation than fullterm babies. Maternal age did not affect risk. INTERPRETATION: Our study suggests that children born after IVF have an increased risk of developing neurological problems, especially cerebral palsy. These risks are largely due to the high frequency of twin pregnancies, low birthweight, and prematurity among babies born after IVF. To limit these risks, we recommend that only one embryo should be transferred during IVF.

Adolescent↗
PubMed2001

Anterior capsule opacification: correlation of pathologic findings with clinical sequelae.

OBJECTIVE: To evaluate the degree of anterior capsule opacification (ACO) in human eyes obtained postmortem containing various rigid and foldable posterior chamber intraocular lens (PC-IOL) designs and compare the findings with clinical sequelae of capsular shrinkage. DESIGN: Comparative autopsy tissue study with clinicopathologic correlations. MATERIALS: Three hundred formalin-fixed human eyes containing the following PC-IOL styles were analyzed: (1) one-piece polymethyl methacrylate (PMMA) optic-PMMA haptic (n = 50), one-piece silicone-plate IOL, with large (2) or small (3) fixation holes (n = 35), (4) three-piece PMMA optic-Prolene haptic (n = 50), (5) three-piece acrylic optic-PMMA haptic (n = 55), three-piece silicone optic with PMMA (6) or polyimide (7) haptics (n = 30), and (8) three-piece silicone optic-Prolene haptic (n = 80) lenses. TESTING: The eyes were sectioned in the equatorial plane for gross examination of the capsular bag from a posterior view. The cornea and iris were then excised for evaluation from an anterior view. MAIN OUTCOME MEASURES: ACO was scored in each eye from 0 to IV, according to the degree/area of capsule opacification. Capsulorrhexis size and IOL decentration were measured with calipers. RESULTS: The overall differences among the IOL groups regarding the three parameters were significant (ACO score: P < 0.001; capsulorrhexis diameter: P = 0.036; IOL decentration: P = 0.012). Mean ACO scores were highest with the large- and small-hole one-piece silicone-plate lenses (2.543 +/- 0.950) and lowest with the three-piece acrylic optic-PMMA haptic lenses (0.600 +/- 0.710). Of 10 cases of capsulorrhexis phimosis observed in the study, 7 cases were associated with three-piece silicone optic-Prolene haptic lenses, which also presented the highest mean decentration (0.375 +/- 0.601 mm). CONCLUSIONS: Our results confirm previous histopathologic observations that the rate of ACO is the lowest with acrylic lenses and higher with plate-haptic silicone IOLs. Nevertheless, clinical sequelae of capsular shrinkage are also very important with three-piece silicone optic-Prolene haptic designs. Thus, IOL material and design are significant factors in the development of ACO, but they ultimately also influence the clinical presentation of capsular shrinkage.

Acrylic Resins↗
PubMed1995

Delayed neuropsychologic sequelae after carbon monoxide poisoning: prevention by treatment with hyperbaric oxygen.

STUDY OBJECTIVE: Carbon monoxide (CO) poisoning is a major clinical problem. The risk of morbidity and the most effective treatment have not been clearly established. We measured the incidence of delayed neurologic sequelae (DNS) in a group of patients acutely poisoned with CO and tested the null hypothesis that the incidence would not be affected by treatment with hyperbaric oxygen (HBO). DESIGN: We conducted a prospective, randomized study in patients with mild to moderate CO poisoning who presented within 6 hours. Patients had no history of loss of consciousness or cardiac instability. INTERVENTIONS: The incidence of DNS was compared between groups treated with ambient pressure 100% oxygen or HBO (2.8 ATA for 30 minutes followed by 2.0 ATA oxygen for 90 minutes). DNS were defined as development of new symptoms after oxygen treatment plus deterioration on one or more subtests of a standardized neuropsychologic screening battery. RESULTS: In 7 of 30 patients (23%), DNS developed after treatment with ambient-pressure oxygen, whereas no sequelae developed in 30 patients after HBO treatment (P < .05). DNS occurred 6 +/- 1 (mean +/- SE) days after poisoning and persisted 41 +/- 8 days. At follow-up 4 weeks after poisoning, patients who had been treated with ambient pressure oxygen and had not sustained DNS exhibited a worse mean score on one subtest, Trail Making, compared with the group treated with HBO and with a control group matched according to age and education level. There were no differences in scores between the control group and the hyperbaric oxygen group. CONCLUSION: DNS after CO poisoning cannot be predicted on the basis of a patient's clinical history or CO level. HBO treatment decreased the incidence of DNS after CO poisoning.

Adolescent↗
PubMed1985

Potential permanent respiratory sequela of Stevens-Johnson syndrome in an adolescent.

Respiratory involvement is a frequent complication of the Stevens-Johnson Syndrome (SJS); however, there are no reports of persisting pulmonary sequelae following recovery. We present a case report of an adolescent girl with a history of clinically inactive hyperactive airway disease who developed persistent, severe obstructive pulmonary disease following an episode of SJS. This case may represent a permanent respiratory sequela.

Adolescent↗
PubMedDate not supplied

The elderly patient receiving radiation therapy: treatment sequelae and nursing care.

Preparing the elderly patient for radiation therapy requires knowledge of the major cancers, the role of radiation treatment, sequelae of treatment, and the age-associated factors that exacerbate treatment reactions. Elderly patients often require long treatment courses. Encouragement to express feelings and report symptoms may be necessary in this patient population. Instructions should be written and repeated, especially for patients with memory loss. The nurse caring for the elderly patient receiving radiation must help the patient to anticipate side effects and manage sequelae of treatment. The patient who knows what to expect is better able to tolerate therapy and to maintain an optimal quality of life during treatment.

Aged↗
PubMedDate not supplied

Evidence that amyloid beta-peptide-induced lipid peroxidation and its sequelae in Alzheimer's disease brain contribute to neuronal death.

Amyloid beta-peptide [Abeta(1-42)] is central to the pathogenesis of Alzheimer's disease (AD), and the AD brain is under intense oxidative stress, including membrane lipid peroxidation. Abeta(1-42) causes oxidative stress in and neurotoxicity to neurons in mechanisms that are inhibited by Vitamin E and involve the single methionine residue of this peptide. In particular, Abeta induces lipid peroxidation in ways that are inhibited by free radical antioxidants. Two reactive products of lipid peroxidation are the alkenals, 4-hydroxynonenal (HNE) and 2-propenal (acrolein). These alkenals covalently bind to synaptosomal protein cysteine, histidine, and lysine residues by Michael addition to change protein conformation and function. HNE or acrolein binding to proteins introduces a carbonyl to the protein, making the protein oxidatively modified as a consequence of lipid peroxidation. Immunoprecipitation of proteins from AD and control brain, obtained no longer than 4h PMI, showed selective proteins are oxidatively modified in the AD brain. Creatine kinase (CK) and beta-actin have increased carbonyl groups, and Glt-1, a glutamate transporter, has increased binding of HNE in AD. Abeta(1-42) addition to synaptosomes also results in HNE binding to Glt-1, thereby coupling increased Abeta(1-42) in AD brain to increased lipid peroxidation and its sequelae and possibly explaining the mechanism of glutamate transport inhibition known in AD brain. Abeta also inhibits CK. Implications of these findings relate to decreased energy utilization, altered assembly of cytoskeletal proteins, and increased excitotoxicity to neurons by glutamate, all reported for AD. The epsilon-4 allele of the lipid carrier protein apolipoprotein E (APOE) allele is a risk factor for AD. Synaptosomes from APOE knock-out mice are more vulnerable to Abeta-induced oxidative stress (protein oxidation, lipid peroxidation, and ROS generation) than are those from wild-type mice. Further, synaptosomes from allele-specific APOE knock-in mice have tiered vulnerability to Abeta(1-42)-induced oxidative stress, with APOE4 more vulnerable to Abeta(1-42) than are those from APOE2 or APOE3 mice. These results are consistent with the notion of a coupling of the oxidative environment in AD brain and increased risk of developing this disorder. Taken together, the findings from in-vitro studies of lipid peroxidation induced by Abeta(1-42) and postmortem studies of lipid peroxidation (and its sequelae) in AD brain may help explain the APOE allele-related risk for AD, some of the functional and structural alterations in AD brain, and strongly support a causative role of Abeta(1-42)-induced oxidative stress in AD neurodegeneration.

Aged↗
PubMed1998

Lymphomas: long-term sequelae and survivorship issues.

OBJECTIVES: To provide a review of long-term sequelae of lymphoma and its treatment, with emphasis on second malignancies, survivorship issues, rehabilitation, and quality of life. DATA SOURCES: Review articles, research studies, and book chapters pertaining to late effects of treatment of lymphomas and to rehabilitation and quality of life for survivors of Hodgkin's disease or non-Hodgkin's lymphoma. CONCLUSIONS: Overall, the outlook for survivors of the lymphomas is positive. The risk of developing second malignancies as long-term sequelae, although relatively low, and the need for physical and psychological health maintenance, warrant lifetime follow-up and support. IMPLICATIONS FOR NURSING PRACTICE: Nurses have a key role in preparing patients for survivorship. By fostering a philosophy and program of rehabilitation that begins at the time of diagnosis, nurses can assist survivors of lymphoma to achieve quality of life.

Humans↗
PubMed1992

[Resection of the proximal carpal bones in the sequelae of scaphoid fractures].

Proximal row carpectomy has precise indications in cases of severe sequelae of scaphoid fractures. This procedure may be indicated either as first-line treatment in a case of advanced pseudarthrosis with osteoarthritis, particularly radio-scaphoid, or secondarily after scaphoid pseudarthrosis has been unsuccessfully treated by other methods. It is essential to make sure that the head of the capitatum and the radial surface of the lunate bone have a satisfactory appearance on plain X-rays, MRI and occasionally arthroscopy. The overall results of this operation which retains wrist movements and which also preserves a good grip strength are very encouraging, as demonstrated by the series of 48 cases of sequelae of scAphoid fractures treated by this technique.

Activities of Daily Living↗
PubMed2002

The EQ-5D and the Health Utilities Index for permanent sequelae after meningitis: a head-to-head comparison.

Framed in a study on the cost-effectiveness of different diagnostic strategies regarding children with meningeal signs, this study evaluated the quality weights for permanent sequelae after childhood bacterial meningitis obtained with two different classification instruments: the EQ-5D, and Health Utilities Index (HUI). A panel of 28 pediatricians classified seven standardized descriptions of patients with permanent sequelae after bacterial meningitis according to the EQ-5D and HUI classification system. Quality weights for each classification were calculated using the EQ-5D and HUI standard scoring algorithms. HUI Mark 3 quality weights were substantially lower than the EQ-5D for all descriptions (mean difference 0.11; 95% CI: 0.08-0.14). Mean Kendall W for agreement of the ranking order between EQ-5D and HUI Mark 3 was 0.90. The EQ-5D and HUI resulted in different absolute quality weights, in particular for states associated with "deafness" and "mental retardation." Due to their performance differences, the HUI may be preferable to EQ-5D in studies focussed on "sensation" (hearing, vision, speech) or "cognition." These differences proved not to be relevant in the present cost-utility study of diagnostic strategies to rule out bacterial meningitis, as such consequences were at the distal end of the decision tree. This may be different in a cost-utility analysis of therapeutic strategies. Hence, sensitivity analysis to quality weights is recommended.

Adult↗
PubMed1998

[Medium and long-term sequelae of community-acquired pneumonia in children].

Bacterial (including intracellular pathogens) and mainly viral pneumonia can lead to middle and long term pulmonary sequelae in children with or without underlying disease, namely chronic atelectasis (right middle lobe syndrome), bronchiectasis, obliterative bronchiolitis, unilateral hyperlucent lung syndrome, fibrosis, and peumatoceles. Functional alterations may also be observed, such as bronchial hyperreactivity, chronic cough and asthma. Additionally a relationship between pneumonia in early childhood and the further occurrence of chronic obstructive pulmonary disease in adult life is now admitted. The occurrence of sequelae being usually unpredictable, and a careful assessment of the clinical and radiological outcome is important. The unusual persistence of either respiratory symptoms or radiological alterations justifies investigations such as tomodensitometry and the evaluation of lung function, to look for complications or underlying diseases and, whenever it is possible, to set up an adapted treatment.

Adult↗
PubMed1988

Deep vein thrombosis of the axillary-subclavian veins: epidemiologic data, effects of different types of treatment and late sequelae.

Upper extremity deep venous thrombosis (DVT) is uncommon. In the city of Malmö, Sweden (240,000 inhabitants), 296 cases undergoing phlebography due to a suspicion of upper extremity DVT, during 1971-1986 were analysed. 165 arm phlebograms did not reveal any thrombi (56%). In 11 cases (4%) external compression of the vein was found. Thrombi in the axillary or subclavian vein were found in 120 cases (40%) and were classified as primary in 73 cases and secondary in 47 cases. Only seven cases of effort thrombosis were found. Four cases had neurovascular symptoms mimicking thoracic outlet syndrome and underwent elective first rib resection. None of the patients with primary DVT had a fatal pulmonary embolism (FPE). One patient had clinical signs suspicious of pulmonary embolism (PE), however, scintigraphy of the lungs was negative. Of the cases with secondary thrombi three cases had fatal, and one case had contributory PE at autopsy. Additionally, one patient had a non-fatal PE verified scintigraphically. Post-thrombotic sequelae from the arm were in no case so severe that the patient had to change occupation. Patients with primary DVT had moderate complaints in three and mild in fifteen cases. Those with secondary arm thrombi experienced only moderate symptoms in two cases and mild sequelae in fourteen. There was no correlation between the type of treatment and late post-thrombotic symptoms. From this study it can be concluded that phlebography must be undertaken before treatment can be started in patients with a suspected arm DVT. Primary DVT seems to be a "benign" disease, and in general treatment with anticoagulants is sufficient.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed2000

No, some types of nonconvulsive status epilepticus cause little permanent neurologic sequelae (or: "the cure may be worse than the disease").

Nonconvulsive status epilepticus (NCSE) is characterized by a cognitive or behavioral change which lasts for at least 30 minutes, with EEG evidence of seizures. Although there is little argument that generalized nonconvulsive status epilepticus (GNSE) does not cause lasting deficits, there is still debate regarding the morbidity of complex partial status epilepticus (CPSE). Because the EEG is used for diagnosis, a strong argument can be made that NCSE is significantly under-recognized and diagnosed. Furthermore, since the documented cases of permanent neurologic sequelae are few, the potential permanent morbidity from CPSE may be significantly exaggerated. The literature indicates that comatose patients have a poor prognosis largely as a result of comorbid conditions and coma, whereas lightly obtunded or slightly confused patients with NCSE have little or no sequelae. Patients with NCSE may suffer (hypotension and respiratory suppression) from iatrogenic 'aggressive' treatment with intravenous anti-epileptic drugs (IV-AEDs), and the findings in the literature indicate that subjects treated with benzodiazepines may have a worse prognosis. The clinician must balance the potential but rare neurologic morbidity associated with NCSE against the not infrequent morbidity caused by IV-AEDs. Better stratification of the level of consciousness and comorbid conditions is needed when evaluating outcomes so as to clearly distinguish among the deficits due to: comorbid conditions; the effects of treatment and the effects of status epilepticus (SE) proper.

Anticonvulsants↗
PubMed1989

Malar bone fractures and their sequelae. A statistical study of 1.393 cases covering a period of 20 years.

The authors analyse the results of 1.393 cases of malar fractures treated in the maxillo-facial Departments of Montpellier and Perpignan. A clinical and therapeutic classification is given. Study of the sequelae demonstrated that the most frequent were infra-orbital nerve lesions, residual displacement of the malar bone, diplopia, and enophthalmos. A point is made about the use of Franchebois's inflatable balloon as a means of retention. Its indications as well as its contra-indications are clearly defined. The reduction in the number of bone sequelae, when compared to cases treated without the balloon, demonstrates the efficacy and simplicity of this method.

Adolescent↗
PubMed1999

Functional and mechanical sequelae of colon interposition for benign oesophageal disease.

OBJECTIVE: In an attempt to estimate the incidence and severity of the functional and mechanical problems associated with colon interposition for benign oesophageal disease, a retrospective analysis of a single centre experience was undertaken. METHODS: Between 1961 and 1990, a total of 365 patients who survived the postoperative stay in hospital were followed up over 7-38 years and form the basis for this study. Upper gastro intestinal symptoms in these patients were investigated clinically, radiologically, endoscopically and in the oesophageal laboratory. Mechanical and functional abnormalities requiring surgical intervention for relief of symptoms were documented. RESULTS: There were two late presentations of colo bronchial fistulae, two instances of persistent colo cutaneous fistulae, three cases of diaphragmatic herniation and two adenocarcinomata of the colo gastric junction in the patients with short segment colon interposition. Amongst the long segment colon interposition patients there was one hiatal obstruction, two thoracic inlet delays associated with pseudo diverticulosis and one hiatal obstruction. One other patient presented with an adenocarcinoma of the intrathoracic colon. There were four patients requiring revision of the cervical oesophago colic anastomosis, two of them on recurrent occasions. The remaining sequelae were functional and were associated with increasing redundancy of the colonic segments at different levels. There were 17 such patients, two of whom developed significant redundancy at two different levels. CONCLUSIONS: Although the patients with short segment colon interposition developed predominantly avoidable iatrogenic complications, those undergoing long segment colon interposition developed functional sequelae requiring re-operations in later life.

Adult↗