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PubMed1989

Cardiorespiratory responses to aerobic training by patients with postpoliomyelitis sequelae.

We examined the cardiorespiratory responses of 16 patients with postpoliomyelitis sequelae to a 16-week aerobic exercise program. The patients exercised at 70% of maximal heart rate. Dependent variables were resting and maximal heart rates, systolic and diastolic blood pressures, maximum oxygen consumption, maximum carbon dioxide consumption, respiratory quotient, and maximum expired volume per unit time. The exercise group was superior to the control group in watts, exercise time, maximum expired volume per unit time, and maximum oxygen consumption. No untoward events or loss of leg strength occurred as a result of the exercise regimen. We conclude that the aerobic training program employed in this study is a safe, short-term procedure and that patients with postpolio sequelae respond to training in a manner similar to healthy adults.

Adult↗
PubMed1989

Tendency to serious sequelae of infection with the human immunodeficiency virus in sibships with hemophilia.

Cofactors for the clinical expression of infection due to the human immunodeficiency virus (HIV) are not well understood. We asked if there was a familial tendency to the development of complications of HIV infection. We examined 35 hemophilic sibships in which at least two brothers with classic hemophilia (factor VIII deficiency) were infected with HIV. Twenty-four (34%) of the 70 patients had serious sequelae of infection, and 46 (66%) were asymptomatic or had only lymph node enlargement. Using Fisher's exact test, we found the concordance among siblings for serious sequelae of HIV infection was greater than would be expected by chance. When analysis was restricted to include only siblings known to be infected for more than two years, this concordance was still present. In the study population, birth order and mean yearly usage of factor VIII concentrate were unrelated to the outcome of HIV infection. The data indicate a familial tendency to serious complications of HIV infection. The factor(s) responsible for this familial tendency are currently under investigation.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Long-term sequelae of epilepsy.

The long-term prognosis for epileptics vary from an entirely normal life to early death or complete incapacity. Studies to date have not provided clear answers on the long-term sequelae of epilepsy. This is because there are many epileptic syndromes with different outcomes. Most studies include a heterogeneous group of patients who may not be representative of all the epileptics in the community. The prognosis for permanent remission of seizure varies with the seizure type. In childhood epilepsies, overall there is at least 50% chance of permanent remission. The more seizures the patient has had before anticonvulsants were started, the more difficult it is to control the seizures, the poorer the prospects for remission. Other unfavourable signs include partial seizures, multiple seizure types, mental retardation, neurological deficits and underlying brain lesion. The effect of seizures on intellectual development is controversial. Actual regression in children with epilepsy is rare except where the seizures are caused by a progressive pathology. However, in a significant proportion of children, intellectual development slows down after the onset of seizures. This is more likely to occur in children with severe seizures, and those on multiple anticonvulsants and with frequent toxic levels. Children with epilepsy have an increased likelihood of developing behavioural, emotional and psychiatric problems. The underlying neurological dysfunction, anxiety about losing control of oneself at any time, reaction of parents, friends and teachers to the condition and side effects of anticonvulsants all contribute to the psychopathology. In conclusion, the long-term sequelae of epilepsy are multiple and serious. Some of the causal factors are known and preventable.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗
PubMed1989

[Ambulatory care of patients with sequelae of eye trauma].

On the grounds of results of observations over 1642 patients with eye traumas and their outcomes a system of dispensary observation over patients with this pathology has been worked out. Main groups of patients with outcomes after eye traumas requiring dispensarization are determined: sequelae after trauma of the protective system and eye adnexa, cornea, iris, lens, vitreous body, retina, intraocular foreign bodies, post-traumatic disturbances in intraocular pressure, changes in the retina and optic nerve, traumatic uveitis and sympathetic ophthalmia at the stage of remission. Terms, incidence and tasks of dispensarization of such patients are worked out. The developed system of dispensarization of persons with sequelae after eye traumas allows to conduct their planned treatment, prevents development of complications, progression of the pathologic process, promotes to decide questions on getting a job.

Ambulatory Care↗
PubMed1989

[Life-threatening complications and severe neurologic sequelae in surgery of acoustic neurinoma].

Surgical treatment of acoustic neurinoma carries a high risk of mortality. Recent history of successful management sparing the facial, mixed, and even cochlear nerves, as well as of a substantially lower incidence of postoperative complications or neurological sequelae, should not give grounds for any false sense of security to undermine one's alertness during the pre, peri- and postoperative phases of the intervention. The overall mortality rate for surgical neurinoma cases was 0.7%. Severe, disabling CNS-related neurological sequelae, chiefly affecting the cerebellum, occurred in 0.4% of cases.

Adolescent↗
PubMed1989

[Diagnosis and treatment of sequelae of splenic injury].

Posttraumatic splenolithiasis was diagnosed in 33 patients, late posttraumatic hematoma in 4, posttraumatic splenosis in 4, and posttraumatic thrombophlebitic splenomegaly in 8 patients. The diagnosis of the sequelae of injury to the spleen is based on the case history and results of ultrasonic examination, computerized tomography, scintigraphy, laparoscopy, and angiography. Complicated splenomegaly and hypersplenism are indications for operative treatment of the sequelae of trauma of the spleen. Splenectomy is the operation of choice. The results of puncture methods of treatment and organ-preserving operations are to be studied.

Calcinosis↗
PubMed1985

Severe neurological sequelae of childhood bacterial meningitis.

Bacterial meningitis remains the most common type of central nervous system infection in both developing and developed countries. Despite modern antimicrobial chemotherapy, the incidence of severe neurological sequelae remains high. We review the pathogenesis of these sequelae and correlate them with computed tomography (CT) appearances. Early diagnosis and appropriate chemotherapy remain the cornerstones of management. Early and accurate diagnosis of complicating space-occupying lesions with the aid of CT and appropriate aggressive therapy are suggested if the prognosis is to be improved.

Atrophy↗
PubMed1989

[Late sequelae after arterial injuries].

Of 57 patients with arterial injuries, three died, eight had an amputation and 14 experienced various kinds of late sequelae. Four of the sequelae were due to inadequate primary surgical treatment: 1) A 16 year-old girl developed incapacitating claudicatio intermittens after a traffic accident causing serious contusions to the right leg. Angiography four years later showed occlusion of the popliteal artery, which was successfully reconstructed. 2) A 16 year-old boy had a femoral fracture with injuries to the femoral artery and vein. The vessels were reconstructed and circulation was restored, but fasciotomies were not performed. He developed a flexion contracture of the 1st toe which required resection of the proximal phalanx. This was interpreted as a Volkmanns contracture due to a compartment syndrome in the deep, posterior compartment of the leg. 3) A 18 year-old man had a fracture of the leg. Angiography demonstrated a minimal leak from the posterior tibial artery, but this was not surgically explored. Six weeks later a pseudoaneurysm ruptured and produced a large hematoma. Circulation was restored by arteriotomy and a patch plasty. 4) A 24 year-old man was hit in the groin by a 22 caliber rifleshot. An arteriovenous fistula was diagnosed but not surgically treated. Six years later he experienced cardiac failure and venous insufficiency. The fistula was closed, whereafter the symptoms disappeared. Blood flow in the fistula was 7,500 ml/min and the pressure in the distal femoral vein 37 mm Hg. These complications can be avoided by proper investigation and surgery at the time of initial treatment.

Adolescent↗
PubMed1987

Reiter's syndrome in an adolescent female with systemic sequelae.

Reiter's syndrome (RS) generally affects adult white males. It occurs infrequently in adolescents. This condition is characterized by a triad of symptoms: arthritis, urethritis, and ocular abnormalities, and it usually has a benign course. We report an atypical case of RS in a black adolescent female who developed articular and ocular sequelae. Despite aggressive medical therapy, one year after diagnosis her condition has deteriorated and she is confined to a wheelchair. Although RS is believed to be a brief illness predominantly affecting the joints of the lower extremity, this condition may have severe systemic manifestations with chronic sequelae.

Adolescent↗
PubMed1988

[Facial burns--treatment of sequelae].

The treatment of the sequelae of facial burns is still a controversial subject. The authors present a retrospective study of 1516 cases between 1967 and 1987. They suggest a more conservative approach of the therapy in purely aesthetic lesions. Therefore, they wait for the "softening" of the scars and start an operative treatment after the maturation of the collagen connective tissue. Functional sequelae have to be treated earlier according to their dimension and according to the aesthetic units affected.

Burns↗
PubMed1988

Streptococcal infections and their sequelae in the upper respiratory tract.

Local sequelae of group A beta-hemolytic streptococci (GABHS) are common and can vary from otitis media, sinusitis, cervical adenitis associated with generalized adenopathy, peritonsillitis and persisting symptoms in spite of therapy, GABHS is one of the pathogens isolated in acute or chronic otitis media and in acute maxillary sinusitis. In cervical adenitis associated with generalized adenopathy GABHS is, along with S. aureus, the most commonly recovered bacteria. In peritonsillitis, GABHS can be recovered alone or in combination with anaerobes in 50% of the cases. These sequelae are usually associated with a slow clinical response to therapy and a high percentage of relapses, reinfections, and chronic infections in the presence of a penicillin-sensitive GABHS. One of the possible causes of these so-called failures is the interference that beta-lactamase producing bacteria can have on the activity of penicillin and similar compounds. When to select a beta-lactamase-resistant antibiotic for the treatment of an apparent penicillin-sensitive infection remains an important area for further research.

Adolescent↗
PubMed1988

[Value of psychophysiological studies in the evaluation of the rehabilitation of patients with sequelae of brain injuries].

A clinical, follow-up and psychophysiological (including investigations of the auditory, visual and motor analyzers) study involved 123 patients with psychic sequelae of brain injuries (51 patients with posttraumatic psychopathy-like syndrome and 72 patients with traumatic epilepsy). Criteria of clinical and sociooccupational compensation of patients have been developed. The results have been processed by analysis of correlations and multifactorial analysis of variances. The authors have developed a score scale for the evaluation of analyzer functions to objectively assess the severity of long-term sequelae of head traumas and of the effectiveness of therapeutic rehabilitative and readaptational impacts. The authors have demonstrated the possibility of using some psychophysiological parameters as additional characteristics of rehabilitative potentials of patients suffering from brain trauma aftereffects.

Adolescent↗
PubMed1988

[On the contribution of magnets in sequelae of facial paralysis. Preliminary clinical study].

This trial was designed to evaluate the efficacy of EPOREC 1 500 magnets as an adjuvant to rehabilitation following peripheral facial paralysis. Magnetotherapy is used in many other specialties, and in particular in rheumatology. The properties of repulsion between identical poles were used to decrease the effect of sequelae in the form of contractures on the facial muscles. There were two groups of 20 patients: one group with physiotherapy only and the other with standard rehabilitation together with the use of magnets. These 40 patients had facial paralysis of various origins (trauma, excision of acoustic neuroma, Bell's palsy etc). Obviously all patients had an intact nerve. It was at the time of the development of contractures that magnets could be used in terms of evaluation of their efficacy of action on syncinesiae, contractures and spasticity. Magnets were worn at night for a mean period of six months and results were assessed in terms of disappearance of eye-mouth syncinesiae, and in terms of normality of facial tone. Improvement and total recovery without sequelae were obtained far more frequently in the group which wore magnets, encouraging us to continue along these lines.

Facial Paralysis↗
PubMed1987

Postoperative sequelae and complications of rhinoplasty.

This article has overviewed complications of rhinoplasty. Generally, these complications fall into two categories: aesthetic (that is, cosmetic sequelae that may require a revision rhinoplasty) and nonaesthetic. Of the nonaesthetic complications, infection has the widest span of severity. A localized Staphylococcus aureus abscess or Pseudomonas infection of the nose may occur postoperatively. Owing to the proximity of the nose to the cranium, a cavernous sinus thrombosis or basilar meningitis may result. Postoperative toxic-shock syndrome is a rare occurrence that surgeons should be aware of; most cases have occurred with the presence of nasal packing, but a case using only plastic nasal splints has been reported also. Bacteremia seems to be uncommon during rhinoplasty. Infection after rhinoplasty is generally much less frequent than one would expect from an operation in an unsterile field. Antibiotics are frequently utilized electively. Postoperative nasal-periorbital edema and ecchymosis are regarded as unavoidable but may be lessened significantly by postoperative head elevation and cold packs. The possibility of postoperative bleeding must be evaluated by the surgeon preoperatively. This sequela usually occurs either within 72 hours postoperatively or at around 10 days postoperatively. Many different causes exist for chronic postoperative nasal obstruction, from poorly supported nasal valves closing upon inspiration to an enhanced allergic rhinitis leading to chronic nasal mucosal edema. The latter may be treated by injection of steroid into the turbinates. Among aesthetic complications, supratip prominence, saddle deformity, and persistent hump are among the more commonly reported. Supratip prominence--"polly-beak"--can be caused by inadequate reduction of tip cartilaginous or soft-tissue elements, especially in relation to the reduction of the dorsum. An over-reduced dorsum will leave an otherwise normal nasal tip with a relative prominence. An accumulation of blood or a mucous cyst occurring under the skin of the tip will produce a prominence. Poor tip projection, tip ptosis, and alar collapse are the result of overreduction of tip elements. A dislocated alar cartilage can appear as an asymmetric nasal bossa. Saddle-nose deformity occurs after overaggressive bony and/or cartilaginous hump removal. Infractured nasal bones that subsequently drop into the piriform aperture can create a bony saddle. Persistent hump is due to inadequate reduction of a bony or cartilaginous hump. If the septal cartilage reduction is disproportionate to the bony septum reduction, the appearance of either a hump or a saddle is possible.(ABSTRACT TRUNCATED AT 400 WORDS)

Consumer Behavior↗
PubMed1986

Epileptic morbidity: psychiatric sequelae in the family--a case study.

Psychiatric complications associated with the epileptic patient have often been referred to in the literature; however, psychiatric sequelae occurring in the family of an epileptic patient have received far less attention. In this case study, the author presents such an example and suggests that neuropsychiatrists treating the epileptic patient be aware that significant psychiatric sequelae may exist in the family.

Adaptation, Psychological↗
PubMed1986

Etoposide induced blood-brain barrier disruption in rats: duration of opening and histological sequelae.

The intracarotid infusion of the antineoplastic compound etoposide enhances blood-brain barrier (BBB) permeability. In a rat model system, the functional reversibility and anatomic sequelae of etoposide induced BBB disruption were investigated. Etoposide, in a dose range from 3.0 to 22.5 mg/kg, was infused into the left internal carotid artery of Sprague-Dawley rats. BBB disruption was evaluated by the appearance in the infused hemisphere of systemically administered Evans blue dye and quantitatively by the ratio of counts of the technetium labeled chelate of diethylenetriaminepentaacetic acid in the infused to the noninfused hemisphere. Functional reversibility of altered BBB permeability was investigated at three dose levels of etoposide (3.0, 15.0, and 22.5 mg/kg) by the administration of Evans blue dye at the time of etoposide infusion and the administration of the technetium labeled chelate of diethylenetriamine-pentaacetic acid at varying time intervals after etoposide infusion. Fourteen groups of 12 rats each were studied to define the time course of altered BBB permeability at these three doses. The anatomic sequelae of etoposide induced BBB disruption were investigated at varying time intervals (up to 3 weeks) after intracarotid etoposide infusion. Nineteen rats were examined after sacrifice by intracardiac fixation perfusion with 10% formalin. Each brain was sectioned coronally and examined under light microscopy after hematoxylin and eosin staining. Evidence of BBB disruption was seen at all dose levels of etoposide. The degree of BBB disruption increased with increasing doses of etoposide. The duration of altered BBB permeability increased from less than 1 day at 3.0 mg/kg to between 3 and 4 days at 22.5 mg/kg. Histological studies revealed no evidence of parenchymal damage, although at 4 days postdisruption, a mild perivascular lymphocytic infiltration was noted in the infused hemisphere. Etoposide infusion and subsequent BBB disruption were well tolerated by all test animals. In a rat model system the intracarotid infusion of etoposide is capable of producing prolonged reversible BBB disruption.

Animals↗
PubMed1986

Lack of significant long-term sequelae following traumatic myocardial contusion.

We assessed the possibility of long-term functional cardiac sequelae in patients who had sustained a traumatic myocardial contusion (group 1) by comparing this group with a cohort group of patients with similar traumatic injuries but exclusive of the cardiac component (group 2). More than one year following injury, patients in group 1 were qualitatively indistinguishable from patients in group 2 according to the New York Heart Association classification. Both the left and the right ventricular ejection fractions, less in group 1 than in group 2 immediately following trauma, were similar between groups during follow-up study at rest. During exercise to maximal work load at follow-up, changes in the mean right and left ventricular ejection fractions were also similar between the two patient groups. We therefore concluded that traumatic myocardial contusion to the left and/or right ventricle almost always resolves without significant functional sequelae within one year of injury.

Adolescent↗