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At least 577 records · Page 32Linked to original sources
PubMed2006

[Retrospective analysis of colorectal carcinomas reveals potential for improvement of diagnostic quality].

INTRODUCTION: The histopathological work-up of colorectal cancer is of critical importance for prognosis and therapy. Therefore we retrospectively analyzed all colorectal carcinomas diagnosed at our institution from January 2002 through March 2003. METHODS: 735 of a total of 777 carcinomas could be followed up. These tumors comprised 74 polypectomy specimens, 32 transanal microscopic surgery specimens, 322 surgical resection specimens analyzed at our own institution (subgroup A) and 263 surgical resection specimens that had been worked up at other pathological institutions (subgroup B) after the diagnosis of carcinoma had been established in our own institution in biopsies. 44 tumors were not treated locally until the end of the study. Quantitative quality parameters were analyzed statistically using Fisher's exact test. RESULTS: Between subgroups A and B significant differences were found within 1. the proportion of specimens with less than 12 lymph nodes examined (11 vs. 25 %), 2. for the detection of an R1 situation despite macroscopic R0 resection (9 vs. 1 %), 3. the proportion of early colonic cancers (9 vs. 4 %), 4. of mucinous adenocarcinomas (19 vs. 4 %), 5. of lymphatic (48 vs. 23 %) and venous invasion (25 vs. 8 %), 6. the frequency of a macroscopic description of mesorectum quality (85 vs. 14 %). In 7 of 32 surgically treated patients with a high-risk carcinoma originally found within a polypectomy specimen, residual tumor was detected in the surgical resection specimen (at the polypectomy site and/or in regional lymph nodes). CONCLUSION: Due to retrospective analysis of colorectal cancer specimens we were able to identify potential for improvement of diagnostic quality. Furthermore our data underline the importance of an oncological resection, if a high risk carcinoma has been detected within a polypectomy specimen.

Aged↗
PubMed2006

Free fasciocutaneous flaps in the treatment of chronic osteomyelitis of the tibia: a retrospective study.

The efficacy of free fasciocutaneous flaps for the treatment of chronic osteomyelitis of the tibia was evaluated in a retrospective study. A series of 14 patients is reported who underwent soft-tissue reconstruction using different free fasciocutaneous flaps after radical debridement. Radical debridement and microvascular reconstruction were performed in two operative steps. The mean duration of disease was 14 years (range: 6 months to 37 years). At a mean follow-up of 31.4 (12 to 52) months, there was no evidence of recurrence of osteomyelitis. This retrospective study validates that fasciocutaneous flaps can be used for microsurgical soft-tissue reconstruction after radical debridement in the treatment of chronic osteomyelitis. The introduction of free fasciocutaneous flaps has challenged the dictum of the therapy of chronic osteomyelitis with muscle flaps.

Adult↗
PubMed1986

[Experiences in 2,149 labor inductions using 3 mg prostaglandin E2 vaginal tablets. A retrospective analysis].

This study is a retrospective analysis of induction of labour by means of PGE2 tablets, one group being electively, the other group medically indicated; in all, 2149 primi- and multiparae during a period of 5 years. Application of the vaginal tablets containing 3 mg PGE2 was effected every 6 hours. Low-risk women stayed mobile up to the amniocentesis performed at about 4-5 cm. Patients with specific risks or spontaneous ruptures of the membranes were supervised correspondingly. About 80% of the primiparae, respectively 90% of the multiparae of the elective induction group delivered within 24 hours after the first application of a vaginal tablet. The rate of Caesarian sections was extremely low. As expected in patients in whom induction of labour was necessary usually before term, the percentage of successful inductions was lower and the rate of Caesarian sections higher. The foetal outcome in both groups in respect of Apgar scores, and the blood gases of the umbilical cord as well as length and weight ranged within the normal limits. The cleared perinatal mortality was 0% (1 congenital defect with death). This study shows that the good results of prospective studies with a smaller number of cases can be confirmed by a retrospective analysis of an extensive group of patients, demonstrating the increasing acceptance of induction of labour by means of PGE2 tablets in elective as well as in medical indications.

Administration, Intravaginal↗
PubMed1975

Retrospective evidence favoring use of anticoagulants for myocardial infarctions.

During a state-wide retrospective study of myocardial infarction discharges from Maryland hospitals from July, 1966, through June, 1967, the relation of in-hospital case fatality rates to use of anticoagulants was examined in 1,156 patients. In patients who did not receive anticoagulants, the rate was 2.5 times that of those who did (p less than 0.0001). A large difference in case fatality rates between the anticoagulant and no-anticoagulant groups persisted when the data were analyzed by demographic and medical-care variables. When patients were classified according to clinical characteristics relating to prognosis, including arrhythmia, congestive heart failure and shock, the difference between the groups were also demonstrated. Although such a retrospective study cannot demonstrate conclusively the value of anticoagulant therapy, the data are sufficiently suggestive of a beneficial effect to warrant reopening the anticoagulant question.

Acute Disease↗
PubMed2002

Neonatal outcomes in immediate versus delayed conceptions after spontaneous abortion: a retrospective case series.

OBJECTIVE: This study was undertaken to determine differences in neonatal outcomes between successful pregnancies conceived immediately after a spontaneous abortion (SAB) and successful pregnancies conceived after two menstrual cycles or at least 100 days from the spontaneous abortion. STUDY DESIGN: This study was a retrospective case series. Deliveries were identified from the University of California-San Francisco Perinatal Database among patients with a history of one SAB. Medical records of 268 patients were reviewed. Sixty-four patients fulfilled study criteria, with 19 in the immediate conception group and 45 in the delayed conception group. Categorical variables were analyzed using chi(2) tests and Fisher exact tests for variables with expected values of <5, whereas continuous variables were analyzed using Student t tests. RESULTS: Neonatal outcomes for the 2 groups were similar, although neonates in the delayed conception group were more likely to have at least one of the following: low birth weight, an Apgar score <7 at 5 minutes, or admission to the neonatal intensive care unit. CONCLUSION: In this small retrospective case series, there was no evidence of adverse neonatal outcomes associated with conception immediately after a SAB.

Abortion, Spontaneous↗
PubMed2002

A retrospective study of pulpal response in vital adult teeth prepared for complete coverage restorations at ultrahigh speed using only air coolant.

STATEMENT OF PROBLEM: The dental literature has shown a 3% to 25% pulpal necrosis rate as a result of tooth preparation for complete coverage restorations. PURPOSE: The purpose of this retrospective study was to examine clinical and radiographic records for evidence of pulpal necrosis in teeth prepared for complete coverage restorations at ultrahigh speed when air coolant alone was used. MATERIAL AND METHODS: The 1847 teeth in this study (182 fixed partial denture abutment teeth and 1665 single teeth restored with 21 all-ceramic, 1095 metal-ceramic, and 731 all-metal restorations) were prepared with diamond instruments (burs) in a sweeping or painting motion with the use of light pressure (1-3 oz) at ultrahigh speed with air coolant alone from the handpiece. New burs were used for each patient and then discarded. Each bur was used on no more than 4 teeth. All impressions were made with reversible hydrocolloid. Provisional restorations were fabricated on a stone cast and cemented with zinc oxide and eugenol cement. Provisional restorations were removed at 3 to 4 weeks and definitive restorations placed. Between 1970 and 1989, 6 different luting agents (zinc phosphate, resin, glass ionomer, ortho-ethoxybenzoic acid, carboxylate, and polycarboxylate) were used to place definitive restorations. All patients were questioned about symptoms of tooth sensitivity, tenderness, or pain at their regular (4- to 6-month) hygiene recall appointments. Success was defined as any definitively restored teeth that remained free of radiographic evidence of periapical radiolucency and clinical signs and symptoms of pulpal sensitivity or pain recorded in the clinical record. The results were compared with rates of pulpal necrosis for teeth prepared with water coolant as reported in the dental literature published between 1970 and 1997. RESULTS: Of 638 teeth prepared between 1970 and 1979, the pulpal necrosis rate was 2.19% (14 teeth: 12 single teeth and 2 fixed partial denture abutment teeth) (97.81% success rate). Of 1209 teeth prepared between 1980 and 1989, the pulpal necrosis rate was 0.66% (8 teeth: 7 single crown teeth and 1 partial denture abutment tooth) (99.34% success rate). Of 1825 teeth prepared between 1970 and 1989, radiographic evidence of pulpal necrosis was found in 0% (100% success rate). No clinical symptoms of pain or sensitivity were recorded in the patient records for the surviving teeth during the time period of this study, which was conducted in May 2001. No crowns were repaired or removed as a result of carious lesions. No higher incidence of pulpal necrosis relative to the type of luting agent was observed. CONCLUSION: Within the limitations of this retrospective study, it is suggested that tooth reduction procedures can be completed with minimal damage to the pulp when only air coolant from the dental handpiece is used.

Adult↗
PubMed2004

Early intramedullary nailing of lower extremity fracture and respiratory function in polytraumatized patients with a chest injury: a retrospective study of 61 patients.

BACKGROUND: The optimal treatment of diaphyseal fractures of the lower extremities in patients who also have serious chest injuries is not known. PATIENTS AND METHODS: We retrospectively evaluated the effect of an early intramedullary nailing (IMN) of femur or tibia fractures on respiratory function in 61 consecutive polytraumatized patients with unilateral or bilateral pulmonary contusion (thoracic AIS=3) admitted to our trauma intensive care unit between January 2000 and June 2001. 27 patients had a diaphyseal fracture of at least one long bone of the lower extremity, which was treated with IMN within 24 hours of admission. RESULTS: We found no difference between patients with or without a lower extremity fracture regarding the length of ventilator treatment, oxygenation ratio (PaO2/FiO2) or in the incidence of acute respiratory distress syndrome (ARDS), pneumonia, multi-organ failure or mortality. INTERPRETATION: In this retrospective study, IMN of a long bone fracture in a patient with multiple injuries and with a coexisting pulmonary contusion did not impair pulmonary function or outcome.

Adolescent↗
PubMed1998

Paediatric facial paralysis caused by Lyme borreliosis: a prospective and retrospective analysis.

The incidence of Lyme borreliosis (LB) was studied prospectively in 49 children (< 17 years of age) with 50 episodes of acute FP. In addition, 43 children with a history of FP (average follow-up of 5.2 y) were studied retrospectively for the outcome of FP and for the symptoms and signs of late LB. In the prospective study, 17 (34%) patients with FP proved to have acute LB. They all received antibiotic treatment and their FP had a favourable outcome. In the retrospective study the patients had had FP before the diagnostic tests for LB were available. Thus, none of the 43 patients had been diagnosed to have, or treated for, LB. The outcome of their FP had generally been favourable. None of them had any signs of late LB at the follow-up visit. Our results indicate that LB is a frequent cause of acute paediatric FP in an endemic area. In addition our data suggests that FP caused by LB in children has a favourable prognosis, even when left untreated.

Acute Disease↗
PubMed1999

Retrospective evaluation of exposure to P. falciparum using antibodies to circumsporozoite protein and to cultured P. falciparum antigens.

A Danish school class travelled under primitive circumstances in East Africa for 28 d. Four out of 18 persons had febrile illnesses interpreted as malaria during the journey. Retrospective serological testing for antibodies against the P. falciparum circumsporozoite protein indicated a transmission rate of more than 80% despite extensive protection against mosquito bites. The study demonstrates the use of serological evaluation of malaria transmission risk as well as retrospective immunodiagnosis of clinical malaria. Three of the travellers with febrile illnesses used self-medication with mefloquine, and in 2 of the cases a diagnosis of malaria was supported by a positive immunofluorescence assay for malaria antibodies.

Adolescent↗
PubMed1997

Serotonin reuptake inhibitor-induced sexual dysfunction and its treatment: a large-scale retrospective study of 596 psychiatric outpatients.

In the present study, a large-scale retrospective case review was undertaken to assess the incidence and type of sexual dysfunctions associated with serotonin reuptake inhibitor (SRI) therapy, in addition to the effects of three pharmacological antidotes (yohimbine, amantadine, cyproheptadine) on SRI-induced sexual dysfunctions. A retrospective chart review was conducted on 596 patients treated with SRIs in an outpatient psychiatric practice between July 1991 and September 1994. Patients who reported new-onset sexual dysfunction during this time were categorized as having SRI-induced sexual dysfunctions. Sexual difficulties were characterized by type and duration, and the background characteristics and psychiatric diagnoses of all patients were recorded. Psychiatric outcome and sexual functioning at follow-up were independently assessed by a single psychiatrist by means of a 4-point rating scale. Sexual dysfunction symptoms were clearly associated with SRI administration in 97 (16.3%) cases. The most common problems reported were orgasmic delay or anorgasmia and hypoactive sexual desire. Sexual difficulties were more frequent among men (23.4%) and married patients of both sexes (22.3%), whereas psychiatric diagnosis and type of SRI were unrelated to the occurrence of sexual problems. Of the patients with sexual dysfunction, 45 (46.4%) opted for a trial of antidote therapy with yohimbine, amantadine, or cyproheptadine. All three antidotes were found to be safe and relatively effective, although yohimbine was significantly more effective than amantadine or cyproheptadine in reversing SRI-induced sexual dysfunction.

Adult↗
PubMed2005

Is tamoxifen associated with high-risk endometrial carcinomas? A retrospective case series of 196 women with endometrial cancer.

Tamoxifen therapy is associated with an increased risk of endometrial cancer. There is controversy regarding the incidence of high-grade endometrial malignancies associated with tamoxifen therapy. This retrospective study assesses pathological features of endometrial malignancy in patients with and without a history of tamoxifen therapy. This is a retrospective case analysis from a district general hospital. The cases were identified from the pathology database and the medical notes reviewed. The period of the study was January 1994 to December 2001. One hundred and ninety six women with endometrial cancer were identified. 20 patients had a history of breast cancer being treated with adjuvant tamoxifen therapy and developed subsequently endometrial cancer. The histology in women who had not taken tamoxifen showed: adenocarcinoma (97.1%), 1.7% had mixed mullerian tumour. Women in the tamoxifen-treated group had: adenocarcinoma (85%), sarcoma (5%), mixed mullerian tumour (5%). In this study the tamoxifen-treated group of patients developed endometrial malignancies with a higher incidence of poor prognostic malignancies (p = 0.01). Further research is needed to analyse the precise tumour types and pathophysiology.

Adenocarcinoma↗
PubMed2004

Vaginal prostaglandin E2 gel versus tablet in the induction of labour at term--a retrospective analysis.

Our aim in this retrospective analysis was to compare labour outcomes between 145 consecutive women with unfavourable cervices, who received prostaglandin E2 vaginal gel (1-2 mg) for labour induction over a 3-month period, and 149 women receiving a prostaglandin E2 vaginal tablet (3 mg) over the following 3 months. Our results showed that cervical dilatation in the gel group was significantly more than in the tablet group at transfer to labour ward [4 cm (SD 2.5 cm) versus 3.3 cm (SD 2 cm), mean difference -0.7, 95% CI -1.2 to -0.2, P=0.01), with fewer women requiring oxytocin augmentation, but this was not statistically significant (41.4% versus 50%, RR 0.8, 95% CI 0.7-1.1). There were no significant differences in the mode of delivery in the number delivering vaginally within 24 hours of the induction (60.4% in the gel group versus 56.2% in the tablet group, RR1.1, 95% CI 0.9-1.4), in the number of doses of PGE2 administered, or in the neonatal outcomes between the two groups. In conclusion, there were no significant differences in labour or neonatal outcomes between prostaglandin E2 gel or tablet use in the induction of labour in this retrospective analysis.

Administration, Intravaginal↗
PubMed2004

A retrospective study of multiple interbody grafting and long segment strut grafting following multilevel anterior cervical decompression.

A retrospective study of 201 patients who underwent multilevel anterior cervical decompression and fusion by multiple interbody grafting and long segment strut grafting without plate fixation was conducted from January 1991 to December 2001. Previous studies have reported lower fusion rates for anterior cervical decompressions reconstructed with multiple interbody grafts as opposed to a single long strut graft. Our aim was a retrospective study of two fusion techniques with reference to radiological and clinical outcomes in patients operated by the senior author. Of 132 patients who underwent strut grafting, 124 achieved solid fusion (93.9%), whereas 48 of 69 patients who underwent multiple interbody grafting (69.6%) achieved solid fusion. There were five cases of graft displacement or extrusion among strut-grafted patients and one among patients with interbody grafts. More 'good' and 'excellent' clinical outcomes were found among patients who underwent strut grafting (87.1 v. 81.1%). Patients with pseudoarthrosis had significantly poorer clinical outcomes. Therefore, corpectomy or vertebrectomy and strut grafting should be considered after multilevel anterior cervical decompression to increase the likelihood of successful fusion and to improve clinical outcome.

Adolescent↗
PubMed2006

Occurrence of ocular disease in traumatic brain injury in a selected sample: a retrospective analysis.

PRIMARY OBJECTIVE: To determine retrospectively the relative risk of ocular disease in a selected, visually-symptomatic sample of clinic patients having traumatic brain injury (TBI; n=160) vs. cerebrovascular accident (CVA; n=60), with all initially presenting at the clinic with symptoms and/or signs of vision dysfunction. METHODS AND PROCEDURES: To review retrospectively 220 medical records of individuals with TBI (n=160) vs. CVA (n=60), as determined by a computer-based query spanning the years 2000-2003, to ascertain the frequency of occurrence of ocular disease in the two major sub-groups of acquired brain injury. MAIN OUTCOMES AND RESULTS: Conditions with high relative risk unique to TBI included corneal abrasion, blepharitis, chalazion/hordeolum, dry eye, traumatic cataract, vitreal prolapse and optic atrophy. This is distinct from those ophthalmic conditions unique to CVA, which included sub-conjunctival haemorrhage and ptosis. CONCLUSION: These new findings should alert clinicians to the potential increased frequency of occurrence of specific ocular diseases in a selected, visually-symptomatic population with TBI and their associated rehabilitative and quality-of-life implications.

Adolescent↗
PubMed2002

Early versus late treatment of posthaemorrhagic ventricular dilatation: results of a retrospective study from five neonatal intensive care units in The Netherlands.

UNLABELLED: Posthaemorrhagic ventricular dilatation (PHVD) in very preterm infants carries a poor prognosis. As earlier studies have failed to show a benefit of early intervention, it is recommended that PHVD be first treated when head circumference is rapidly increasing and/or when symptoms of raised intracranial pressure develop. Infants with PHVD, admitted to 5 of the 10 Dutch neonatal intensive care units were studied retrospectively, to investigate whether there was a difference in the time of onset of treatment of PHVD and, if so, whether this was associated with a difference in the requirement of a ventriculo-peritoneal (VP) shunt and/or neurodevelopmental outcome. The surviving infants with a gestational age <34 wk, born between 1992 and 1996, diagnosed as having a grade III haemorrhage according to Papile on cranial ultrasound and who developed PHVD were included in the study. PHVD was defined as a ventricular index (VI) exceeding the 97th percentile according to Levene (1981), and severe PHVD as a VI crossing the p 97 + 4 mm line. Ninety-five infants met the entry criteria. Intervention was not deemed necessary in 22 infants, because of lack of progression. In 31 infants lumbar punctures (LP) were done before the p 97 + 4 mm line was crossed (early intervention). In 20/31 infants, stabilization occurred. In 9 a subcutaneous reservoir was placed, with subsequent stabilization in 6. In 5/31 infants a VP shunt was eventually inserted. In 42 infants treatment was started once the p 97 + 4 mm line was crossed (late intervention). In 30 infants LPs were performed and in 17 of these a VP shunt was eventually inserted. In 11 infants a subcutaneous reservoir was immediately inserted and in 8 of these infants a VP shunt was needed. In one infant a VP shunt was immediately inserted, without any other form of treatment. Infants with late intervention crossed the p 97 + 4 mm earlier (p 0.03) and needed a shunt (26/42; 62%) more often than those with early intervention (5/31; 16%). Early LP was associated with a strongly reduced risk of VP-shunting (odds ratio = 0.22, 95% confidence interval: 0.08-0.62). The number of infants who developed a moderate or severe handicap was also higher (11/42; 26%) in the late intervention group, compared with those not requiring any intervention (3/22; 14%) or treated early (5/31; 16%). CONCLUSION: In this retrospective study, infants receiving late intervention required shunt insertion significantly more often than those treated early. A randomized prospective intervention study, comparing early and late drainage, is required to further assess the role of earlier intervention.

Cerebral Hemorrhage↗
PubMed2000

The craniocervical connection: a retrospective analysis of 300 whiplash patients with cervical and temporomandibular disorders.

Because the concept of whiplash as a causative factor for temporomandibular disorders (TMD) is highly controversial, we decided to do a retrospective analysis of patients treated in our office who had sustained whiplash injuries and were treated for cervical and temporomandibular disorders. The records of 300 patients with TMD preceded by a motor vehicle accident were examined retrospectively. The most common presenting symptoms, in order, were: jaw pain, neck pain, post-traumatic headache, jaw fatigue, and severe temporomandibular joint (TMJ) clicking. The most common TMD diagnoses were: masseter trigger points, closing jaw muscle hyperactivity, TMJ synovitis, opening jaw muscle hyperactivity, and advanced TMJ disk derangement. Based primarily on the physical examination, we concluded that the TMJ and surrounding musculature should be examined similarly to other joints, with no preconceived notion that TMD pathology after whiplash is unlikely.

Accidents, Traffic↗
PubMed2001

Collaborative exercise on the use of FISH chromosome painting for retrospective biodosimetry of Mayak nuclear-industrial personnel.

PURPOSE: To investigate within the framework of a multilaboratory study the suitability of FISH chromosome painting to measure so-called stable translocations in peripheral lymphocytes of Mayak nuclear-industrial workers (from the Southern Urals) and their use for retrospective biodosimetry. MATERIALS AND METHODS: Chromosime analyses were carried out from 69 workers who had received protracted occupational radiation exposures (0.012-6.065 Gy) up to approximately 40 years before blood sampling. Twenty-one unexposed people living in the same area were controls. A multicolour FISH-painting protocol with the target chromosomes 1, 4 and 8 simultaneously with a pancentromeric probe was used to score potentially transmissible chromosome-type aberrations (reciprocal translocations 2B and related 'one-way' patterns I-III according to the S&S classification). RESULTS: Individual biodosimetry estimates were obtained in terms of these potentially long-term surviving aberration types based on the linear component of a low dose-rate gamma-ray calibration curve produced using identical staining and scoring protocols. For comparison, the workers personal and total background doses were converted to red bone marrow doses. The estimated doses were mainly lower than would be predicted by the calibration curve, particularly at accumulated higher dose levels. CONCLUSIONS: Owing to the limited life-time of circulating T-lymphocytes, the long-term persistence of translocations in vivo requires the assumption of a clonal repopulation of these naturally senescing cells from the haemopoietic stem cell compartments. Obviously such a replacement cannot be fully achieved, leading to a temporal decline even of the yield of transmissible aberrations types. Assuming further a highly selective capacity of stem cells against any type of chromosomal damage and the fact that one must rely on partial genome findings, the potential of FISH chromosome painting for retrospective dose reconstruction is probably limited to a decade or so after high-level protracted radiation exposure.

Adult↗
PubMed2005

Retrospective analysis of double-strand break rejoining data collected using warm-lysis PFGE protocols.

Sample preparation procedures for the pulsed-field gel electrophoresis (PFGE) assay usually involve a lysis step at temperatures as high as 50 degrees C. During this warm-lysis procedure, multiply damaged sites containing heat-labile sites (HLS) can be converted into double-strand breaks (DSB). Once formed, these DSB cannot be distinguished from the DSB formed directly by ionizing radiation. This paper develops a method to correct DSB estimates for the effects of HLS in warm-lysis protocols. A first-order repair model is used to predict the number of HLS available for conversion into DSB as a function of the time available for repair before initiating warm-lysis. A mathematical expression is derived to separate prompt DSB from those formed through the artefactual conversion of HLS into DSB. The proposed formalism only requires the specification of two adjustable parameters, both of which can be estimated from measured data. Estimates of prompt DSB yields obtained by correcting warm-lysis data are in good agreement with estimates obtained using cold-lysis protocols, which do not include the effect of HLS. The retrospective analyses of two published datasets suggest that corrections for HLS have a substantial impact on DSB yields within the first 20-30 min after irradiation. Bi-exponential fits to the DSB data for Chinese hamster ovary cells suggest that corrections for HLS reduce the half-time for fast DSB rejoining by about 15%, whereas the half-time for the slow DSB rejoining only decreases by 4%. The total DSB yield and the fraction of fast-rejoining DSB decrease by 24 and 38%, respectively, when the correction is applied. The proposed formalism can be used to characterize trends and uncertainties in DSB rejoining kinetics associated with the artefactual conversion of HLS into DSB. The retrospective application of the methodology to warm-lysis data enhances their relevance and usefulness for studies of DSB rejoining kinetics.

DNA Damage↗