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At least 649 records · Page 36Linked to original sources
PubMed2003

[Symptomatic vesicoureteral reflux in kidney transplantation: results of endoscopic injections of teflon and predictive factors for success].

OBJECTIVES: Evaluation of the results of endoscopic Teflon injections for the treatment of symptomatic vesicoureteric reflux in renal transplant recipients and identification of prognostic factors. POPULATION AND METHODS: Between June 1997 and January 2002, out of a series of 408 renal transplant recipients, 15 patients (8 males, 7 females) with a mean age of 41.9 years were treated for symptomatic vesicoureteric reflux on the transplanted kidney by endoscopic Teflon injection. This treatment was indicated due to the presence of febrile or afebrile infections, possibly associated with deterioration of renal function. Reflux was demonstrated by retrograde cystography. The results of endoscopic treatment were evaluated by cystography at 3 months, and by clinical and laboratory examinations thereafter. RESULTS: The mean interval between renal transplantation and endoscopic treatment was 64.2 +/- 64.7 months. With a mean follow-up of 25 +/- 16.7 months, we observed a 53.3% success rate (8 patients), 13.3% of patients (2 patients) were improved and 33.3% of procedures were considered to be failures (5 patients). A lower number of preoperative infections, reflux < or = grade III and the absence of impaired renal function are predictive factors for the success of endoscopic treatment. The only complication was one case of renal colic due to meatal stenosis at 3 months, which responded favourably to endoscopic treatment alone. CONCLUSION: Endoscopic treatment of symptomatic vesicoureteric reflux on a transplanted kidney by Teflon injection is effective in two-thirds of cases. Due to the low morbidity of this minimally invasive procedure, this treatment should be proposed as first-line management for all cases of symptomatic vesicoureteric reflux on a transplanted kidney.

Adult↗
PubMed2003

In vitro comparative kinetics of adhesive and haemolytic potential of T. vaginalis isolates from symptomatic and asymptomatic females.

The host parasite relationship and pathogenic mechanisms of the commonly reported sexually transmitted urogenital disease, trichomoniasis, are poorly understood. This study was planned to correlate the adhesion properties of Trichomonas vaginalis isolates from symptomatic and asymptomatic women to vaginal epithelial cells in vitro (in presence and absence of L. acidophilus) and to ascertain the haemolytic activity of the isolates, in order to assess these properties as possible markers of pathogenicity. Cytoadherence assay study shows the significant difference in adhesion only up to first 15 minutes of incubation in symptomatic versus asymptomatic isolates. The presence of L. acidophilus was found to be more effective in enhancing the attachment of T. vaginalis in a time dependent manner mostly operative through its pH lowering effect, whereas the excretory secretory products of L. acidophilus reduced the attachment in case of both symptomatic and asymptomatic isolates. Amount of haemoglobin released by isolates from symptomatic patients was significantly higher than by the isolates from asymptomatic women. This investigation forms the basis for future studies to explore the role of other known virulence factors of T. vaginalis in initiation and persistence of vaginal infection by the parasite.

Animals↗
PubMed2004

Rifaximin plus mesalazine followed by mesalazine alone is highly effective in obtaining remission of symptomatic uncomplicated diverticular disease.

BACKGROUND: Rifaximin plus mesalazine has been showed to be more effective than rifaximin alone in the treatment of recurrent and complicated diverticulitis of the colon. We investigated the effectiveness of the combination rifaximin/mesalazine followed by mesalazine alone to evaluate tolerability and effectiveness in symptomatic remission in uncomplicated diverticular disease. MATERIAL/METHODS: We studied 90 consecutive patients (39 M, 51 F, mean age 67.2 yrs, range 32-91 yrs) with symptomatic uncomplicated diverticular disease. We assessed the following symptoms, scoring them on a quantitative scale: 1) constipation, 2) diarrhea, 3) abdominal pain, 4) rectal bleeding, and 5) mucus with stools. All were treated with 800 mg/day rifaximin plus 2.4 gr/day mesalazine for 10 days, followed by 1.6 gr/day mesalazine for 8 weeks. They were re-evaluated at the end of mesalazine-alone treatment. RESULTS: Eighty-six patients completed the study (95.56%): the total score decreased from 1439 to 44 (p<0.001). 70 patients (per-protocol: 81.40% (C.I.: 67-94%); on intention-to-treat: 77.78% (C.I.: 60-85%)) were completely asymptomatic after the 8th week of treatment with mesalazine alone (total symptomatic score: 0), while 16 (per-protocol: 18.60%; on intention-to-treat: 17.77%) showed only slight symptoms (total score: 44). Two (2.22%) showed recurrence of diverticulitis after 4 and 6 weeks of treatment with mesalazine alone. Two patients (2.22%) were withdrawn from the study for diarrhea after starting mesalazine. Two others (2.22%) showed transitory pruritus (one) and epigastric pain (one). CONCLUSIONS: The results show that rifaximin/mesalazine followed by mesalazine alone is extremely effective in resolving symptoms in patients with symptomatic uncomplicated diverticular disease.

Adult↗
PubMed2004

Organ-specific immunity in canine visceral leishmaniasis: analysis of symptomatic and asymptomatic dogs naturally infected with Leishmania chagasi.

We characterized key leukocyte immunophenotypes in the liver and spleen of naturally infected dogs from an area in Venezuela endemic for leishmaniasis. Dogs were classified as symptomatic or asymptomatic after serologic and physical analysis. Symptomatic dogs showed a higher parasite burden in the liver and spleen than asymptomatic dogs. The livers of asymptomatic dogs showed an effective immunity with well-organized granulomas walling off parasites in an environment of central memory CD44(lo), CD45RO(hi), activated effector CD44(hi), and CD45RO(hi) T cells. These granulomas also had many major histocompatibility class II+ cells and CD11c+ dendritic cells, and cells expressing CD18 and CD44. In contrast, symptomatic livers showed a non-organized and non-effective infiltrate composed of T cells and heavily parasitized Kupffer cells and a diminished expression of activation molecules. In the spleen, the immune responses of symptomatic and asymptomatic dogs were very similar. The results showed a distinct immune response against Leishmania chagasi in target organs.

Animals↗
PubMed2005

Uterine artery embolisation for symptomatic fibroids in a tertiary hospital in Singapore.

INTRODUCTION: Transcatheter uterine artery embolisation (UAE) for the treatment of symptomatic uterine enlargement due to fibroids has been performed in several overseas centres with promising results. We report our experience with UAE in Singapore General Hospital. MATERIALS AND METHODS: Twenty women with symptomatic uterine fibroids who declined surgery were treated by transcatheter UAE. The uterine arteries were selectively catheterised and embolised with polyvinyl alcohol particles. Post-procedure analgesia was administered via a patient-controlled analgesia pump. The patients were followed up at regular intervals clinically and with transabdominal ultrasonography. RESULTS: Transcatheter UAE was performed on all patients with no major complications. Nineteen patients had both uterine arteries embolised while 1 patient had only the right uterine artery embolised on account of hypoplasia of the left uterine artery. The mean hospital stay was 3.5 days (range, 2 to 9). At a mean follow-up of 56 weeks (range, 6 to 168), all patients reported improvements in their presenting symptoms. Objective improvement in terms of reduction of uterine and fibroid sizes was determined on ultrasonography. The median size of the uterine volume decreased from 308 to 187 mL while the median diameter of the largest fibroid reduced from 6.2 to 4.6 cm. The median haemoglobin level increased to 12.7 g/dL from the pre-procedural median of 9.9 g/dL. One patient, who initially responded with a decrease in uterine and dominant fibroid size, became symptomatic (menorrhagia) at 6 months post-embolisation. She underwent a repeat procedure with complete resolution of symptoms. A second patient had recurrence of symptoms at 12 months, but was subsequently lost to follow-up. CONCLUSION: Mid-term results of UAE for the treatment of symptomatic fibroids in our hospital indicate this to be a safe and effective therapeutic option.

Adult↗
PubMedDate not supplied

Laparoscopic fenestration of symptomatic non-parasitic cysts of the liver.

BACKGROUND/AIMS: The use of laparoscopic technique for management of symptomatic liver cysts is documented to be a feasible and safe procedure with proved symptomatic relief. In the present study, we reviewed the results of this approach in the management of symptomatic liver cysts. METHODOLOGY: Retrospective review of all patients with symptomatic liver cysts that were treated by laparoscopic fenestration in our department over a 3-year period from 1999 to 2001. RESULTS: Ten patients were treated using a laparoscopic approach. All patients achieved short-term alleviation of symptoms and an uneventful postoperative course. The mean hospital stay was 3 days. Long-term follow-up (24 months) was available for all the patients. In all the patients, there was no clinical and radiographical recurrence. CONCLUSIONS: The present study confirms that relief of symptoms can be achieved with the laparoscopic approach for non-parasitic liver cysts. Omental packing is not necessary to prevent recurrence of simple hepatic cysts.

Aged↗
PubMedDate not supplied

[Association between symptomatic gastroesophageal reflux and Barrett's esophagus].

BACKGROUND DATA: Barrett esophagus is a proximal displacement of the squamocolumnar junction relative to the gastroesophageal junction with intestinal metaplasia, it has been linked to gastroesophageal reflux disease. However, it has been observed in individuals without gastroesophageal reflux symptoms, with prevalence up to 25% in 50 years older men. OBJECTIVE: Assess the association between symptomatic gastroesophageal reflux and Barrett's esophagus. METHODS: Consecutive patients undergoing endoscopy at our center were studied. Before endoscopy, through a direct interview all subjects were asked to complete the Carlsson-Dent questionnaire for determining 2 groups (patients with and without gastroesophageal reflux symptoms). Those subjects with suggestive image of Barrett's esophagus, biopsy specimens were obtained from the distal esophageal mucosa with the intention of find intestinal metaplasia. We compared prevalence of Barrett's esophagus between groups. RESULTS: One hundred and nine patients were studied. Prevalence of symptomatic gastroesophageal reflux disease was 37.6%. Barrett's esophagus was found in 9.7% of symptomatic gastroesophageal reflux disease patients and in 9.6% of subjects without symptoms of gastroesophageal reflux disease (p = 0.87). Gender and age were similar between groups. Prevalence of hernia hiatal was bigger in patients with Barrett's esophagus (90 vs. 42%) (p = 0.004). CONCLUSION: Our study didn't show association between symptomatic gastroesophageal reflux detected by a questionnaire and Barrett's esophagus.

Adult↗
PubMed2005

[Analysis of pooled data from the randomized controlled trials of endarterectomy for symptomatic carotid stenosis].

It is important to establish clear definitions concerning carotid artery disease, a topic that recently regained widespread interest in medical literature. Therefore, we summarize a paper of Rothwell and Barnett, recently published in the Lancet 2003 (1). In their analysis, the data of three randomized trials, comparing carotid endarterectomy to optimal medical therapy alone for a symptomatic internal carotid artery stenosis, were pooled after standardization of the measurement of the degree of stenosis and redefinition of the outcome events, to achieve comparability of the results of each trial. This analysis concerns 6092 patients with 35,000 patient-years of follow-up. Surgery offers a marginal benefit for patients with a moderate (50-69%) symptomatic carotid artery stenosis (absolute risk reduction of 4.6% for subsequent ipsilateral stroke at 5 years). Surgery is highly beneficial for patients with a symptomatic 70-99% stenosis (absolute risk reduction of 16% for ipsilateral stroke at 5 years). The benefit is uncertain for a symptomatic "near occlusion" (99% with retarded opacification of the distal internal carotid artery): absolute risk reduction of -1.7% for ipsilateral stroke at 5 years).

Carotid Artery, Internal↗
PubMed1991

[Symptomatic cytomegalovirus infection in patients with acquired immunodeficiency syndrome].

During a seven-year period, symptomatic cytomegalovirus (CMV)-infection was diagnosed in 21.5% (n = 10) of all AIDS patients at the National Hospital of Norway (retinitis n = 8, colitis n = 3, pneumonitis n = 2, gastritis n = 1). Symptomatic cytomegalovirus-infection was associated with a poor long-term prognosis (median survival 174 days, range 10-415). Median CD4+ lymphocyte counts at onset of symptomatic cytomegalovirus-infection was 24 x 10(6)/l (range 6-68). Regular ophthalmological examination of HIV-infected patients with severe immunodeficiency, and endoscopy with multiple mucosal biopsies in patients with suspected cytomegalovirus-infection of the gastrointestinal tract, were of major importance in diagnosing symptomatic cytomegalovirus-infection. Six patients received an induction course of ganciclovir, and foscarnet was administered in two patients due to leukopenia. Problems of toxicity to the available anti-CMV agents make the development of additional therapeutic approaches desirable.

Acquired Immunodeficiency Syndrome↗
PubMed2005

Efficacy of terazosin and finasteride in symptomatic benign prostatic hyperplasia: A comparative study.

Medical treatment for symptomatic Benign Prostatic Hyperplasia (BPH) has become popular for the last few years. This study was designed to find out and compare the efficacy of terazosin, a alpha1 adrenoceptor blocker and finasteride, a 5alpha-reductase inhibitor in symptomatic BPH. A total of 60 patients (30 in terazosin group and 30 finasteride group) of symptomatic BPH were selected. Terazosin group received 1 mg daily at bedtime for 3 days, 2 mg at bedtime for 7 days, thereafter 5 mg at bedtime daily for 6 months. Finasteride group received 5 mg once daily. In terazosin treated patients, improvement after 3 months were as follows, IPSS 3.93 +/- .74 points reduction, Qmax 2.13 +/- .68 ml/s increase, post-voided residual urine volume (PVR) 20.67 +/- 10.56 ml reduction (significant, p<0.001) and prostate volume 0.57 +/- 1.54 ml reduction (not significant). Similar statistical differences were observed at 6 months follow up. In finasteride treated patients, improvements after 3 months were as follows, International Prostate Symptom Score (IPSS) 1.38 +/- .63 points reduction, Qmax 0.55 +/- 0.78 ml/s increase, PVR 5.93 +/- 7.64 ml reduction (significant, p<0.001) and prostate volume 0.17 +/- 5.6 ml reduction (non-significant). At 6 month follow up statistical differences were significant in all parameters including prostate volume 4.57 +/- 5.30 ml reduction (p<0.001). In comparison, statistically significant superiority of terazosin over finasteride was found in improving IPSS, Qmax and PVR in both follow up visits. But terazosin had nonsignificant effect in reducing prostate volume; in contrast, finasteride had significant effect in second visit. It can be concluded from this study that terazosin 5mg once daily is effective in mild to moderate cases of symptomatic BPH. On the other hand, finasteride 5mg once daily may be useful in large prostate and to be given for at least 6 months.

Adrenergic alpha-Antagonists↗
PubMed2006

Should symptomatic menopausal women be offered hormone therapy?

UNLABELLED: Many physicians remain uncertain about prescribing hormone therapy for symptomatic women at the onset of menopause. The American Society for Reproductive Medicine (ASRM) convened a multidisciplinary group of healthcare providers to discuss the efficacy and risks of hormone therapy for symptomatic women, and to determine whether it would be appropriate to treat women at the onset of menopause who were complaining of menopausal symptoms. MAJOR FINDINGS: Numerous controlled clinical trials consistently demonstrate that hormone therapy, administered via oral, transdermal, or vaginal routes, is the most effective treatment for vasomotor symptoms. Topical vaginal formulations of hormone therapy should be preferred when prescribing solely for the treatment of symptoms of vulvar and vaginal atrophy. Data from the Women's Health Initiative indicate that the overall attributable risk of invasive breast cancer in women receiving estrogen plus progestin was 8 more cases per 10,000 women-years. No increased risk for invasive breast cancer was detected for women who never used hormone therapy in the past or for those receiving estrogen only. Hormone therapy is not effective for the treatment of cardiovascular disease and that the risk of cardiovascular disease with hormone therapy is principally in older women who are considerably postmenopause. CONCLUSIONS: Healthy symptomatic women should be offered the option of hormone therapy for menopausal symptoms. Symptom relief with hormone therapy for many younger women (at the onset of menopause) with menopausal symptoms outweighs the risks and may provide an overall improvement in quality of life. Hormone therapy should be individualized for symptomatic women. This involves tailoring the regimen and dose to individual needs.

Aged↗
PubMed2006

Radiofrequency catheter ablation in patients with symptomatic atrial flutter/tachycardia after orthotopic heart transplantation.

BACKGROUND: Atrial tachycardia or flutter is common in patients after orthotopic heart transplantation. Radiofrequency catheter ablation to treat this arrhythmia has not been well defined in this setting. This study was conducted to assess the incidence of various symptomatic atrial arrhythmias and the efficacy and safety of radiofrequency catheter ablation in these patients. METHODS: Electrophysiological study and catheter ablation were performed in patients with symptomatic tachyarrhythmia. One Halo catheter with 20 poles was positioned around the tricuspid annulus of the donor right atrium, or positioned around the surgical anastomosis when it is necessary. Three quadripolar electrode catheters were inserted via the right or left femoral vein and positioned in the recipient atrium, the bundle of His position, the coronary sinus. Programmed atrial stimulation and burst pacing were performed to prove electrical conduction between the recipient and the donor atria and to induce atrial arrhythmias. RESULTS: Out of 55 consecutive heart transplantation patients, 6 males [(58 +/- 12) years] developed symptomatic tachycardias at a mean of (5 +/- 4) years after heart transplantation. Electrical propagation through the suture line between the recipient and the donor atrium was demonstrated during atrial flutter or during recipient atrium and donor atrium pacing in 2 patients. By mapping around the suture line, the earliest fragmented electrogram of donor atrium was assessed. This electrical connection was successfully ablated in the anterior lateral atrium in both patients. There was no electrical propagation through the suture line in the other 4 patients. Two had typical atrial flutter in the donor atrium which was successfully ablated by completing a linear ablation between the tricuspid annulus and the inferior vena cava. Two patients had atrial tachycardia which was ablated in the anterior septal and lateral donor atrium. There were no procedure-related complications. Patients were free of recurrent atrial tachyarrhythmias after a follow-up of (8 +/- 7) months. CONCLUSIONS: Four electrophysiological mechanisms have been found to contribute to the occurrence of symptomatic supraventricular arrhythmias following heart transplantation. Radiofrequency catheter ablation in patients with atrial flutter/tachycardia is feasible and safe after heart transplantation.

Adult↗
PubMed2007

Prevalence of knee symptoms and radiographic and symptomatic knee osteoarthritis in African Americans and Caucasians: the Johnston County Osteoarthritis Project.

OBJECTIVE: To report contemporary estimates of the prevalence of knee-related osteoarthritis (OA) outcomes in African Americans and Caucasians aged > or = 45 years. METHODS: Weighted prevalence estimates for knee symptoms, radiographic knee OA, symptomatic knee OA, and severe radiographic knee OA were calculated for age, ethnic, and sex subgroups, in 3018 participants (33% African Americans, 38% men) in the baseline examination (1991-97) of The Johnston County Osteoarthritis Project, a population-based study of OA in North Carolina. Radiographic knee OA was defined as Kellgren-Lawrence radiographic grade > or = 2, severe radiographic knee OA as grades 3 and 4, and symptomatic knee OA as knee symptoms in a knee with radiographic OA. RESULTS: Knee symptoms were present in 43%, 28% had radiographic knee OA, 16% had symptomatic knee OA, and 8% had severe radiographic knee OA. Prevalence was higher in older individuals and women. African Americans had slightly higher prevalence of knee symptoms, radiographic knee OA, and symptomatic knee OA, but significantly higher prevalence of severe radiographic knee OA compared to Caucasians. CONCLUSION: Policy should be directed to increasing education of the public and the medical community about the high prevalence of these conditions, especially in these subgroups, to decrease their impact and ultimately prevent them.

Black or African American↗
PubMedDate not supplied

[Pharmacological closure of symptomatic PDA in premature infants using indomethacin].

When left to right shunting through the ductus arteriosus is of a degree contributing to the cardiopulmonary problems in a premature infant, the condition is clinically termed symptomatic PDA. It is also generally agreed that symptomatic PDA if left untreated is a significant cause of increased morbidity and mortality. Studies have also concluded that all infants with symptomatic PDA who are prematurely born and/or ventilator dependent should be considered candidates for ductal closure by either pharmacological or surgical mean. Over a period of approximately 2 1/2 years, 22 premature infants with symptomatic PDA have been treated here with powder form indomethacin. The one course success rate was 68%. Thereafter, in another 2 1/2 years, 33 cases were selected for whom a liquid form was used instead. The success rate was 70%. Indomethacin is better given by an intravenous route. However, if the intravenous form is not available, using the liquid form by mouth or via the naso-gastric tube is a good substitute.

Ductus Arteriosus, Patent↗
PubMedDate not supplied

Indomethacin for the prevention of symptomatic patent ductus arteriosus in very low birth weight infants.

To assess the efficacy of prophylactic indomethacin in reducing the incidence of symptomatic patent ductus arteriosus, thirty two preterm infants weighing 750-1500 gm at birth were randomized to receive oral indomethacin or placebo. Fifteen infants received oral indomethacin with a dosage of 0.2 mg/kg at the 24th, 36th and 60th hour of age as the study group. The other 17 infants received 1 ml 0.33% saline in 5% G/W solution at the same schedule. Birth weight, gestational age, male/female ratio and severity of respiratory distress syndrome were similar for both groups. Nine of the 16 survivors of control group developed symptomatic patent ductus arteriosus. On the contrary, only two of the 14 survivors who received prophylactic indomethacin developed symptomatic PDA (P less than 0.05). There were no significant difference in the development of bronchopulmonary dysplasia, duration of oxygen therapy, duration of endotracheal intubation, days required to regain birth weight or complication between these two groups. The results indicated that the use of prophylactic oral indomethacin is beneficial in the prevention of symptomatic PDA in very low birth weight infant.

Ductus Arteriosus, Patent↗
PubMed1989

Critical carotid stenoses: morphologic and chemical similarity between symptomatic and asymptomatic plaques.

To identify microanatomic and chemical features that may mark the transition from asymptomatic to symptomatic atherosclerotic carotid lesions, we evaluated 62 carotid artery bifurcation plaques including 45 high-grade stenoses removed at endarterectomy and 17 nonstenotic plaques recovered at autopsy. Morphologic features were evaluated on multiple-interval histologic sections and were graded for the presence of hemorrhage, ulceration, thrombosis, lumen surface irregularity, and calcification. Plaque hemorrhage, recent and remote, was found in most of the specimens, and did not discriminate between symptomatic and asymptomatic stenotic plaques. High-grade carotid stenotic plaques were associated with a significantly higher incidence of ulceration (53%), thrombosis (49%), and lumen irregularity (78%) when compared to nonstenotic asymptomatic plaques (6%, 0%, and 17%, respectively; p less than 0.01). Although these features were more prominent in lesions that produced symptoms, they were present in 80% of the stenotic bifurcations, and did not distinguish between symptomatic and asymptomatic endarterectomy plaques. No significant differences were found between symptomatic and asymptomatic high-grade lesions with respect to collagen, DNA, total cholesterol, fibrinogen, lipase, elastase, or collagenase content. We conclude that intraplaque hemorrhage is commonly seen in carotid plaques even without severe stenosis, and it does not appear to be a dominant determinant of symptoms. Ulceration and surface thrombi that may lead to cerebral embolization are prominent features in markedly stenotic plaques even when symptoms are absent. The disruptive processes that underlie plaque instability appear to be closely associated with plaque size and stenosis rather than plaque composition.

Adult↗
PubMed1986

Spectrum of human T-cell lymphotropic virus type III infection in children. Recognition of symptomatic, asymptomatic, and seronegative patients.

This study was done to gain insight into the clinical spectrum and immunologic disturbances resulting from infection with the human T-cell lymphotropic virus type III/lymphadenopathy-associated virus (HTLV-III/LAV) in children. Serum antibody to p41 antigen of HTLV-III and/or direct evidence of HTLV-III in lymphocytes was considered indicative of HTLV-III/LAV infection. In 36 children with HTLV-III/LAV infection, a wide clinical spectrum was noted, ranging from asymptomatic (seven children) to symptomatic, the latter including 14 children with the acquired immunodeficiency syndrome. Microcephaly was noted in five symptomatic infants. Immunologic dysfunction was noted in all symptomatic and in two asymptomatic children. Panhypogammaglobulinemia was noted in one child. Two asymptomatic children who were HTLV-III antibody negative had virologic evidence of HTLV-III infection. All of 20 mothers who were studied were HTLV-III antibody positive and had immunologic abnormalities but only nine were symptomatic, indicating that apparently healthy women may transmit HTLV-III/LAV infection to their offspring.

Acquired Immunodeficiency Syndrome↗
PubMed1988

[The effects of ticlopidine and nicardipine on the prevention of symptomatic vasospasm after aneurysmal rupture].

From the previous reports that the pathogenesis of cerebral vasospasm is most likely multifactorial process and that early removal of the clot may decrease the incidence or severity of the ischemic deficits and also that antifibrinolytic therapy increases the incidence and the severity of the symptomatic vasospasm, we attempted at prevention of the symptomatic vasospasm in aneurysmal patients with our own protocol. One hundred twenty-one consecutive patients with a ruptured aneurysm were operated upon within 48 hours after subarachnoid hemorrhage. Seventy-seven patients in group (A) were treated with a regimen of postoperative Ticlopidine and Nicardipine without antifibrinolytic therapy. Fifty-four patients in group (B) were not treated with the above regimen. Symptomatic vasospasm occurred only in four patients (5%) in group (A), but in 18 patients (33%) in group (B). In total series, 82% in group (A) and 63% in group (B) had an excellent to good outcome. Nine % in group (A) and 20% in group (B) had a poor outcome. The results indicate that our protocol with Ticlopidine and Nicardipine can reduce the incidence of symptomatic vasospasm following the aneurysmal rupture.

Adult↗