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PubMed2005

Success rate of root canal treatment in primary molars.

OBJECTIVES: The purpose of the present retrospective large-scale study is to evaluate rate of success of root canal treatments in primary infected molars using Endoflas F.S as a filling material. METHODS: The study material consisted of 382 records of root canal treated primary molars of which 174 teeth with high quality radiographs and sufficient data comprised the 'study group'. The technique for root canal treatment in one visit is described. Treatment was considered success if clinically the tooth was asymptomatic and radiographs showed decrease or no change in pre-existing pathologic radiolucent defects. RESULTS: In the total pulpectomy group there was a statistically significant difference between mandibular teeth presented with a periapical lesion prior to the treatment compared to maxillary teeth. This difference was not significant in the study group. Decrease in post treatment radicular radiographic defects was statistically significant more in the maxilla compared to the mandible. The success rate of teeth restored with a permanent restoration (stainless steel crown or amalgam filling) was statistically significant higher than those teeth left with a temporary filling. There was no statistically significant difference between success rate and the extent of root canal filling material. Rate of success was not statistically different depending on pre-existing radiolucent area prior to RCT. CONCLUSIONS: Endoflas F.S. can be used as an alternative root canal filling material for primary teeth. One condition for success is the prevention of microleakage. A permanent restoration should be placed as soon as possible after clinical signs and symptoms of inflammation are eliminated.

Adolescent↗
PubMed2005

A phenomenological understanding of successful stuttering management.

UNLABELLED: The purpose of this investigation was to understand, from the perspective of the speaker, how seven adults have been able to successfully manage their stuttering. Individual experiences were obtained across the three temporal stages (past, transitional, and current). Recurring themes were identified across participants in order to develop an essential structure of the phenomena at each stage. The ability to make the transition from unsuccessful to successful management of stuttering was associated with six recurring themes of: (1) support, (2) successful therapy, (3) self therapy and behavioral change, (4) cognitive change, (5) utilization of personal experience, and (6) high levels of motivation/determination. Six recurring themes associated with past experiences, when stuttering was unsuccessfully managed, included: (1) gradual awareness, (2) negative reactions of listeners, (3) negative emotions, (4) restrictive lifestyle, (5) avoidance, and (6) inadequate therapy. The five recurring themes identified for the current situation where stuttering continues to be successfully managed were: (1) continued management, (2) self acceptance and fear reduction, (3) unrestricted interactions, (4) sense of freedom, (5) and optimism. EDUCATIONAL OBJECTIVES: The reader will be able to: (1) describe, from the prospective of a select group of adults who stutter, the recurring themes associated with both unsuccessful and successful management of stuttering, (2) explain the recurring themes associated with how this group of seven adults achieved successful management of their stuttering, and (3) discuss the basic rationale and procedures associated with phenomenological analysis.

Adult↗
PubMedDate not supplied

Predictors of successful pessary fitting and continued use in a nurse-midwifery pessary clinic.

Women with incontinence and/or pelvic organ prolapse presenting to an urogynecology service were offered referral to a dedicated midwifery pessary clinic. Charts of these women were reviewed for demographic information, physical examination, pelvic floor disorders, and details of pessary-fitting sessions. Successful fitting was defined as a comfortable fit and retention of the pessary with valsalva and voiding. Continuation was defined as a successfully fit patient who returned at least once after the initial fitting with the pessary still in use. Spearman's correlations identified variables associated with successful fitting and continuation of use. Logistic regression identified variables that predicted continued use. Eighty-six percent of women were successfully fit, and 89% continued pessary use for a mean of 6 months. Predictors of unsuccessful fitting included a history of a prior prolapse procedure or hysterectomy (P < or = .001). Severe posterior prolapse was associated with pessary discontinuation after adjustment for patient's age (P < .04). Success rates for treatment of stress urinary incontinence, pelvic organ prolapse, or both were not significantly different (success rates of 94%, 89%, and 81%, respectively; P = .50). Predictors of unsuccessful pessary fitting include history of a prior prolapse procedure and hysterectomy. Severe posterior prolapse was the single predictor of pessary discontinuation.

Female↗
PubMed2005

Thoracic outlet syndrome: pattern of clinical success after operative decompression.

OBJECTIVE: To evaluate the pattern of clinical results in patients with neurogenic thoracic outlet syndrome (N-TOS) after operative decompression and longitudinal follow-up. METHODS: From May 1994 to December 2002, 254 operative sides in 185 patients with N-TOS were treated by the same operative protocol: (1) transaxillary first rib resection and the lower part of scalenectomy for the primary procedure with or without (2) the subsequent upper part of scalenectomy with supraclavicular approach for patients with persistent or recurrent symptoms. This retrospective cohort study included 38 men and 147 women with an age range of 19 to 80 years (mean, 40 years). Evaluated were primary success, defined as uninterrupted success with no procedure performed, and secondary success, defined as success maintained by the secondary operation after the primary failure. Success was defined as > or =50% symptomatic improvement judged by the patient using a 10-point scale, returning to preoperational work status, or both. RESULTS: Follow-up was 2 to 76 months (mean, 25 months). Eighty sides underwent a secondary operation for the primary clinical failure. No technical failures and no deaths occurred < o =30 days after the operations. The complication rate was 4% (13/334) and consisted of 7 pneumothoraxes, 3 subclavian vein injuries, 1 nerve injury, 1 internal mammary artery injury, and 1 suture granuloma. Of 254 operative sides, the primary and secondary success was 46% (118/254) and 64% (163/254). Most the primary failures (90%, 122/136) and the secondary failures (66%, 23/35) occurred < or =18 months after the respective operation. CONCLUSIONS: The long-term results of operations for TOS in this study were much worse than those initially achieved, and most of the primary and secondary failures occurred < or =12 months of the respective operations. A minimum of 18-month follow-up on patients and standardized definition of the outcomes are necessary to determine the true effectiveness and outcome of operative treatment of N-TOS.

Algorithms↗
PubMed2004

The hippocampal region is involved in successful recognition of both remote and recent famous faces.

There is currently a debate regarding the precise role of medial temporal regions in memory, in particular regarding the time scale of their involvement in conscious recollection of information stored in long-term memory. Using event-related fMRI, we have attempted to contribute to this debate by identifying brain regions associated with the successful recognition of famous faces from two different periods: "Old" faces of people who became famous in the 1960s-1970s and "Recent" faces of people who became famous in the 1990s. We demonstrate that the hippocampus is involved in the successful recognition of famous faces from both periods and does not appear to distinguish between these two periods. We also highlight a network of brain regions, including the left prefrontal cortex, the retrosplenial cortex, the temporo-parietal junction, the caudate and the right cerebellum, which is activated in association with successful recognition of famous faces. Finally, an analysis of the results obtained during a post hoc episodic recognition task shows the specific involvement of anterior hippocampus in the successful encoding of the unfamiliar faces, which were presented during the fame decision task, suggesting a functional distinction between anterior and posterior parts of the hippocampus, the former being specifically involved in successful episodic encoding and the latter being associated with successful retrieval of semantic information.

Brain↗
PubMed2005

Corticosteroids as potential mechanism regulating variability in reproductive success in monogamous oldfield mice (Peromyscus polionotus).

Male and female mammals undergo profound hormonal changes during pregnancy, some of which are sufficiently dramatic to influence offspring survival. In order to understand the proximate mechanisms regulating the variability in reproductive success within and between individuals, we monitored changes in fecal corticosteroid concentrations over the reproductive cycle in male and female oldfield mice (Peromyscus polionotus subgriseus) to test whether corticosteroid concentrations during pregnancy were associated with offspring survival. In females that successfully raised litters to weaning, fecal corticosteroid concentrations were low until mid-gestation and increased significantly towards term; in females that did not raise their pups to weaning, fecal corticosteroid concentrations were significantly higher at mid-gestation, and remained high until late gestation. The difference in fecal corticosteroid concentrations at mid-gestation between successful and unsuccessful females can be explained by the fact that successful females were lactating. Lactation has been associated with a down-regulation of the hypothalamic-pituitary-adrenal (HPA) axis and, accordingly, a decrease in plasma corticosterone (CORT) in several species, including humans. Males that successfully raised their litters had low fecal corticosteroid concentrations throughout their partner's pregnancy. Unsuccessful males, however, had significantly higher fecal corticosteroid concentrations at term than males that raised their pups to weaning. While these preliminary data require further investigation, we suggest that pre-partum fecal corticosteroid concentrations in males were responsible for the variability in reproductive success.

Adrenal Cortex Hormones↗
PubMed2006

Measuring the success of transbronchial needle aspiration in everyday clinical practice.

BACKGROUND: Trans-bronchial needle aspiration (TBNA) is a simple, safe technique that can be performed without additional resources in any centre with a bronchoscopy service. It provides rapid diagnostic information in malignant and benign conditions and staging information in non-small cell lung cancer (NSCLC) and may avoid the delays, risks, in-patient stay and financial implications associated with surgical exploration of the mediastinum. Despite this, centres have been slow to adopt the technique. This may be due to the lack of clarity about the clinical success of TBNA in everyday clinical practice and the absence of a single valid measurement of clinical utility for TBNA against which to audit. METHODS: We undertook a retrospective analysis of all TBNA carried out at Nottingham City Hospital since the service began. "Success" was carefully and strictly defined. The influences of various factors on the likelihood of a successful outcome were analysed. RESULTS: Fifty percent (71/142) of patients undergoing TBNA received an exact histological diagnosis whilst in 72% (97/134) of patients in whom a final diagnosis was made, TBNA results correctly predicted malignant versus benign conditions. We defined the former, more stringent, outcome measure as "success--exact". This outcome was not significantly affected by patient age or gender, lesion size or position, experience of the bronchoscopist or number of aspiration attempts. Final diagnosis strongly influenced "success--exact" with NSCLC 6.5 times and small cell lung cancer 28.5 times more likely to yield a diagnostic sample than benign conditions. CONCLUSIONS: TBNA should be used as a standard first line invasive investigation for diagnosis of mediastinal lymphadenopathy or submucosal endobronchial disease. The stringent outcome defined in this study as "success--exact" is simple for clinicians and patients to understand and would be a useful definition to standardise audit and future research.

Age Factors↗
PubMed2006

Successful and currently ongoing parasite eradication programs.

The eradication of parasitic diseases is not a new concept. The most successful programs of parasite eradication have occurred with species of veterinary importance. The first such program, the eradication of Texas Cattle Fever from the United States, is one of the great success stories of disease eradication. The American screwworm eradication program is ongoing and is serving as a guiding impetus for many of the ongoing or proposed vector eradication schemes around the world. The success of these programs prompted similar successful operations in human health. Although they once led the way, veterinary parasitologists have taken second place in eradication planning. The only three parasitic diseases of veterinary importance that have been targets of recent eradication programs are Hypoderma species in Great Britain and Europe, Cochliomyia hominivorax after its introduction into Libya from the Americas, and Echinococcus granulosus in Tasmania, Australia. There is also work on the eradication of the tick, Amblyomma variegatum, from the Caribbean Islands. Some animal diseases are targeted under the auspices of the human eradication programs, most notably the eradication of the tsetse fly from parts or all of Africa. This paper reviews some of the past or ongoing successful eradication programs and presents a brief summary of the history of the programs, the methods used or planned, and potential controversies surrounding their success and implementation.

Animals↗
PubMed2000

A simplified lesion classification for predicting success and complications of coronary angioplasty. Registry Committee of the Society for Cardiac Angiography and Intervention.

In 1988, the American College of Cardiology/American Heart Association (ACC/AHA) Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures presented a classification of coronary lesions utilizing 26 lesion features to predict the success and complications of balloon angioplasty. Using data from the Registry of the Society for Cardiac Angiography and Interventions (SCAI) we evaluated the ability of this classification to predict success and complications. Lesion success, death in hospital, emergency cardiac bypass surgery, and major adverse events were evaluated in 41,071 patients who underwent single-vessel angioplasty from January 1993 to June 1996. Logistic models using the ACC/AHA lesion classification, vessel patency, or both, were compared. A new classification based on the interaction of the ACC/AHA classification plus lesion patency was compared with the existing ACC/AHA classification. Vessel patency, added to the ACC/AHA classification, improved prediction of lesion success (p </=0.0001). Class A and patent B lesions had similar success and complication rates, so a simplified classification (SCAI) using only 7 lesion characteristics could be created. This system (I: non-C patent, II: C patent, III: non-C occluded, and IV: C occluded) improved prediction of lesion success compared with the ACC/AHA classification (Bayesian Information Criterion statistic: ACC/AHA 16539, SCAI 15956; and area under the receiver- operating characteristics curve 0.659, 0.693, respectively). The SCAI classification was preferred for predicting major complications and in-hospital death and was similar to the ACC/AHA classification for predicting emergency bypass surgery.

Aged↗
PubMed1996

Value of visual versus central quantitative measurements of angiographic success after percutaneous transluminal coronary angioplasty. NHLBI PTCA Registry Investigators.

This study examined the optimal angiographic definition for long-term success after angioplasty and compared visual and quantitative angiographic measurements in assessing outcome. The National Heart, Lung, and Blood Institutes--Percutaneous Transluminal Coronary Angioplasty Registry prospectively followed 1,768 patients from 15 clinical centers. Symptom-free survival, defined as survival without angina, myocardial infarction, bypass surgery, or death, occurred in 59% of patients. In a subset of 393 patients, quantitative coronary angiography (QCA), done at a core angiographic laboratory, was compared with visual site readings. Although there was considerably more variability for visual readings, a site reading of a change in percent stenosis of >20% correlated highly with symptom-free survival (64.6% for patients who had all lesions successfully dilated, 48% for patients with partial success, and only 21% for patients without angiographic success; p < 0.001). Similar findings were seen for other angiographic definitions, but a change of > 20% was most discriminatory. In contrast, QCA readings had little or no predictive value. This study confirms that visual assessment of the immediate change in percent stenosis is predictive of a successful 1-year outcome. A change of greater than 20% is most discriminatory and should still be used to define angiographic success. QCA does not appear to be superior to visual assessment in predicting 1-year outcome.

Angioplasty, Balloon, Coronary↗
PubMed1992

Obstetric parameters affecting success in a trial of labor: designation of a scoring system.

OBJECTIVES: We sought to characterize risk factors in patients undergoing trial of labor after previous cesarean section and to determine whether a subset of patients at high risk of having an unsuccessful trial of labor consequently suffer greater morbidity. STUDY DESIGN: A 13-month chart review analyzed 264 labors with documented transverse lower uterine segment scars. Historic and physical examination variables were recorded, and a scoring system was constructed to evaluate successful vaginal delivery after cesarean. RESULTS: Successful vaginal delivery occurred in 192 patients, resulting in a rate of vaginal birth after cesarean of 72.7%. Four variables significantly lower the rate of vaginal birth after cesarean. Of patients scoring 0 (no variables present), 91.5% were successfully delivered vaginally. Scores of 1, 2, and 3 to 4 were associated with the success of vaginal birth after cesarean in 73.9%, 66.7%, and 46.1% of patients, respectively. A score of 3 to 4 did not increase maternal or fetal morbidity in trial-of-labor patients. CONCLUSION: We constructed a scoring system to evaluate the success of vaginal birth after cesarean. Trial of labor in the subset of patients with the lowest success rate does not increase morbidity.

Cesarean Section↗
PubMed1996

Effect of patient position upon success in placing central venous catheters.

BACKGROUND: There is little consensus regarding the most efficient or the safest method by which to place a central venous catheter (CVC). METHODS: A single house officer prospectively evaluated 140 patients for whom he was requested to place CVCs. One hundred and eight patients participated in a randomized study of positioning. Of the 140 patients, 7 had emergency line placement; 105 randomized patients undergoing elective CVC placement form the basis for this report (power > 80% to detect change of one needle pass between groups). Patient positions were termed "bump" (head turned to the contralateral side and a rolled towel placed vertically between the scapulas) and "no bump" (head facing forward and no towel placed in the back.) RESULTS: Ninety-three of 105 patients had successful catheter placement. Catheters were more often successfully introduced in the bump group than no bump group (98% versus 83%, P < 0.04). For patients with difficult CVC placement (those > 160 pounds, those with a weight-to-height ratio > 29, those with previous unsuccessful catheterization), the bump position was superior with respect to increased likelihood of venous blood return, decreased likelihood of arterial blood return, and increased likelihood of successful catheterization, although differences did not reach statistical significance (P < 0.05) in individual analyses. Of patients with successful catheterization, 97% had three or fewer needle passes. Those with more than three needle passes were less likely to have successful catheter placement (P < 0.01), were more likely to have arterial blood return (P < 0.01) and pneumothorax (P = 0.12). CONCLUSIONS: The bump position improves the likelihood of successful central venous catheter placement. No more than three needle passes ought to be attempted.

Aged↗
PubMed2003

[External electrical cardioversion of atrial arrhythmia: predictive criteria of success].

AIM: Supraventricular arrhythmia is a major public health problem because of its prevalence and clinical consequences. The first step of the treatment usually consists in restoring sinusal rhythm. The aim of this study is to evaluate results and predictive factors of success of electrical cardioversion. METHODS: We studied a series of 143 consecutive electric cardioversion preformed in 131 French patients. RESULTS: The rate of successful direct current cardioversion was 91.2%. Negative predictive factors are the height body mass index and the age of arrhythmia. Atrial flutter is a predictive factor of success. These results agree with published results. Our study highlights the interest of some nonantiarrhythmic drugs received by the patient during the period before the direct current cardioversion. Thus, a spironolactone treatment appears to be a new predictive factor of the success of electrical cardioversion (success in patients treated with spironolactone: 100% vs 89% without, P = 0.04). CONCLUSIONS: Our results agree with usual predictive factors of the success of cardioversion. Nevertheless, a new approach is that of the positive effect of spironolactone on cardioversion. A prospective randomized study is necessary to confirm this result.

Adult↗
PubMed2003

Medical abortion. defining success and categorizing failures.

Medical abortion was performed in 461 consecutive women with gestational age </= 63 days using a regimen of mifepristone 600 mg followed 2 days later by gemeprost 1 mg vaginally. Success, defined as no surgical intervention, declined from 98.7% after 2 weeks to 94.6% after 15 weeks. The difference in short- and long-term success rates increased with increasing gestational age. The majority of failures (76%) were diagnosed more than 2 weeks after initiation of the abortion. At a 2-week follow-up visit, the women who turned out to be failures had a larger endometrial width, higher beta-hCG values and smaller reductions of beta-hCG than those treated successfully. To optimize comparison of success rates after different medical abortion regimens, we suggest that the criteria for success are stated clearly, that the success rates are stratified according to gestational age and that the indications for secondary intervention are categorized.

Abortifacient Agents, Steroidal↗
PubMed1993

Analysis of factors contributing to success in a program of micromanipulation-assisted fertilization.

OBJECTIVE: To determine factors important to clinical success in micromanipulation-assisted in vitro fertilization (IVF). DESIGN: Procedures invoked in two separate series of micromanipulation-assisted IVF cycles, one unsuccessful (series I) and the other successful (series II), were compared in an effort to identify changes that led to clinical success. SETTING: University-based IVF clinic. PATIENTS: In both IVF series involving micromanipulation, patients consisted of infertile couples who fit any of five categories of male-factor related infertility. The female patients underwent controlled hyperstimulation for oocyte retrieval and the oocytes were inseminated normally or were subjected either to partial zona dissection or subzonal sperm insertion to assist fertilization. Results in all groups were compared between the two patient series. RESULTS: In the successful series II, a noticeable improvement in fertilization rate and embryo quality was observed compared with series I. A significant increase in the percentage of patients reaching embryo transfer, the pregnancy rate per transfer, and the pregnancy rate per retrieval were noted in series II; a 25% ongoing pregnancy rate per retrieval was observed overall in this successful group, with "ongoing" defined as manifestation of at least a fetal sac on ultrasound with no detectable problems. Patients with a mixed transfer of embryos derived from manipulated and normally inseminated oocytes had a 75% rate of pregnancy per transfer in series II. Differences between the two series could not be attributed to patient selection or biases in selection of oocytes relegated to micromanipulation. However, oocyte handling, micromanipulation, and culture protocols differed significantly between the two series in that temperature and pH of oocytes was better controlled, and micromanipulation time was minimized in series II. CONCLUSION: Success in micromanipulation depends on maintenance of the oocyte in a stable and supportive environment throughout the micromanipulation procedure. It is also important to minimize trauma to the eggs by performing micromanipulation rapidly and with minimal distortion of the egg. Patients with a poor fertilization rate in standard IVF may experience a substantial increase in the likelihood of pregnancy when micromanipulation-assisted fertilization is performed on some eggs.

Cleavage Stage, Ovum↗
PubMed1993

Defining and interpreting pregnancy success rates for in vitro fertilization.

OBJECTIVES: To review current practice in describing pregnancy success rates after IVF-ET, to identify issues associated with interpreting these rates, and to suggest useful methods of describing these rates in the future. DESIGN: Review of literature concerning medical, epidemiologic, and statistical aspects of reporting IVF-ET pregnancy success rates. SETTING: The United States. PATIENTS: Infertile couples participating in IVF-ET. MAIN OUTCOME MEASURES: Usefulness and accuracy of IVF-ET pregnancy reporting. RESULTS: Several groups have collected information on the pregnancy success rates of IVF-ET clinics and have discussed appropriate definitions of pregnancy success. The largest of these groups in the United States is The American Fertility Society and its affiliate, the Society for Assisted Reproductive Technology. The number of live deliveries per 100 ET procedures and the number of live deliveries per 100 egg retrieval procedures are among the most commonly used definitions. CONCLUSION: The most commonly used definitions are particularly useful for describing the probability that a live infant will be delivered after IVF-ET is completed. To measure the effectiveness of the IVF-ET procedures and the costs of undergoing IVF-ET, other definitions are also important. Success rates need to be stratified by patient characteristics, such as age, that affect the probability of success.

Data Collection↗
PubMed2002

Successful assisted reproductive technology: the beauty of one.

In 1999, the approximately 90,000 in vitro fertilization procedures accounted for 98% of all types of assisted reproductive technologies in the United States. Since 1992, when Congress recognized a public health interest in reporting accurate and timely information about pregnancy success rates for infertility treatments, success has been defined as a live birth after an assisted reproductive technology cycle, regardless of the number of live-born infants per delivery. Because of pressures to achieve success, often more than one pre-embryo is transferred per cycle, frequently resulting in multifetal pregnancy reduction or multiple births. Twin and higher order births associated with assisted reproductive technology have increased significantly since 1980. Although births resulting from assisted reproductive technology amount to less than 1% of all live births, they now account for about a third of all twin births and more than 40% of triplets and higher number births in the United States. Although multiple births fit the current definition of success, they create much higher risks for maternal and infant morbidity and mortality, contributing to more than $640 million in excess initial hospital costs during the year 2000 alone. With recent improvements in assisted reproductive technology procedures that increase the likelihood of delivery after the transfer of just one pre-embryo per cycle, it is time to re-examine how success is measured. Assisted reproductive technology success should be redefined to be the proportion of cycles resulting in a singleton, live birth.

Female↗
PubMed2002

Long-term follow-up of initially successful trabeculectomy with 5-fluorouracil injections.

PURPOSE: To study the long-term results (1-14 years) of trabeculectomies with 5-fluorouracil injections that were successful at 1 year. DESIGN: A retrospective noncomparative case series. INTERVENTION/PARTICIPANTS: We identified 87 patients (87 eyes) who had trabeculectomies with 5-fluorouracil injections from 1984 to 1989 that were successful at 1 year and had a follow-up range of 1.0 to 14.7 years (mean, 8.1, standard deviation of 4.4 years). All patients had previously failed glaucoma surgery (66.7%), cataract surgery (47.1%), or other diagnoses making them at high risk for failure. MAIN OUTCOME MEASURES: Successful control of intraocular pressure (IOP) was defined as IOP less than 21 mmHg or a reduction of 33% if preoperative pressure was less than 21 mmHg. Statistical analysis was performed using Kaplan-Meier life table analysis. RESULTS: If an eye is considered successful by IOP at 1 year, the probability of successful control is 61% at 5 years, 44% at 10 years, and 41% at 14 years. CONCLUSIONS: Despite successful IOP control at 1 year, trabeculectomies with 5-fluorouracil injections show a continual loss of IOP control over time.

Adolescent↗