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PubMedDate not supplied

French survey of postpolio sequelae. Risk factors study and medical social outcome.

For 10 yr, numerous studies have been conducted to try to explain the further deterioration of the sequelae from a previous, acute poliomyelitis. The different etiologic hypotheses, which have been put forward, have not been confirmed yet. A retrospective study has been completed by mailed questionnaires sent to 360 patients previously affected by acute polio; 248 polio survivors replied. Deterioration, as functional loss especially during walking and exertion, was reported by 77% of our respondents. Among the newly affected cases, 60% have given up or slowed down their socio-professional activities because of these new problems with their health. These functional losses, reported by patients, have been statistically related to several factors: the aging process, weight gain, female predominance and the involvement of abdominal muscles at a previously acute polio stage. The recently affected population has the same degree of disability (measured through the "Functional Independence Measure" (translated in French and self-administered)) as the nonaffected one. This fact suggests that the problems that are being experienced may be partly subjective.

Abdominal Muscles↗
PubMed1996

Assessment of disease activity and its sequelae in children and adults with myositis.

Validated, comprehensive measures for assessing disease activity and its irreversible sequelae, known as disease damage, have not been developed for the idiopathic inflammatory myopathies (IIM), thus limiting our capacity to assess individual patients and responses to therapies. This review summarizes current approaches for assessing disease activity and damage in the idiopathic inflammatory myopathies and speculates on possibly useful novel approaches for the future. Disease activity and damage indices that combine a number of these assessments are proposed for use in all therapeutic trials. Methods for assessing target organs of the idiopathic inflammatory myopathies will likely evolve as more sensitive and specific measures are developed that can distinguish active inflammation from the irreversible effects of disease.

Adult↗
PubMed1982

Intellectual and emotional sequelae of Reye's Syndrome.

Previous reports on survivors of Reye's syndrome have indicated a high proportion of significant neurological and intellectual sequelae. However, increasingly sophisticated monitoring and therapeutic techniques have diminished both the mortality and morbidity of this disease. Our present study documented the relatively good intellectual and neurological prognosis for recent survivors of Reye's at our institution and explored the emotional impact of this illness on survivor's families. The significant emotional problems of the children and their families were in striking contrast to the relatively good intellectual and academic recovery. Nine of the 16 survivors showed emotional disruption (primarily somatic complaints, anxiety, and depression). Fourteen of 16 mothers interviewed continued to suffer from anxiety, depression, and overprotective behavior as long as 5 years after their child's illness. In many respects, the parents endured more prolonged and profound suffering than did the children. These findings have implications for the delivery of follow-up care to families of survivors.

Adolescent↗
PubMed1999

When the earth stops shaking: earthquake sequelae among children diagnosed for pre-earthquake psychopathology.

OBJECTIVE: To examine risk and protective processes for posttraumatic stress reactions and negative sequelae following the Northridge earthquake (EQ) among youths diagnosed for pre-EQ psychopathology. METHOD: Symptoms of posttraumatic stress disorder (PTSD), depression, general anxiety, and social impairment were evaluated using telephone interviews among 66 children participating in a family-genetic study of childhood-onset depression at the time of the EQ. RESULTS: Significant predictors of PTSD symptoms 1 year after the EQ included perceived stress and resource loss associated with the EQ, a pre-EQ anxiety disorder, and more frequent use of cognitive and avoidance coping strategies. PTSD symptoms were associated with high rates of concurrent general anxiety symptoms, depressive symptoms, and social adjustment problems with friends. The only significant correlation between sibling scores was on measures of sibling reports of objective exposure. CONCLUSIONS: Preexisting anxiety disorders represent a risk factor for postdisaster PTSD reactions. Postdisaster services need to attend to the needs of these youths as well as those of youths experiencing high levels of subjective stress, resource loss, and/or high exposure. That children within families show significant variation in postdisaster reactions underscores the need for attention to individual child characteristics and unshared environmental attributes.

Adolescent↗
PubMed1996

Long-term persisting cognitive sequelae of traumatic brain injury and the effect of age.

This study examined the notion that mild to moderate traumatic brain injury (TBI) may have persistent effects that become evident upon neurocognitive testing in a phase in which the effects of physiological aging become manifest. Neurocognitive performance was tested in 25 middle-aged and 20 old subjects who had sustained mild to moderate TBI, on average, several decades earlier. The TBI subjects regarded themselves as normal and healthy. The performance of the TBI subjects was inferior to that of matched healthy controls on all aspects of primary and secondary memory and on the majority of tests used to measure speed of performance. There was no interaction between the effects of TBI and those of age, and the performance of middle-aged TBI subjects was similar to that of old controls. The results are taken to indicate that TBI sustained earlier in life may cause permanent sequelae in specific domains of cognitive functioning and that it might attenuate the age-related decline in cognitive functioning. Most striking, however, was that these deficits were not perceived as a limiting factor in everyday life, which suggests that coping strategies may be important.

Adaptation, Psychological↗
PubMed1995

Layoff survivor sickness. Minimizing the sequelae of organizational transformation.

In 1991, our University Hospital initiated a series of strategic changes designed to increase organizational effectiveness and efficiency, foster a culture of commitment to customer-driven service, and flatten the organizational structure, pushing decision making closer to the point of service. These events, although proactive and positive in their intent, triggered a significant, debilitating response among many members of the nursing staff. The authors discuss the experience of this organization, examines the process of transition and the responses of staff members to change, and provides recommendations for minimizing the sequelae of organizational transformation.

Employment↗
PubMed1994

Cystic degeneration and calcification of muscle: late sequelae of compartment syndrome.

Cystic degeneration and calcification of the leg are uncommon late sequelae of compartment syndrome. Previously reported cases have all involved the anterior compartment of the leg. We present a 68-year-old man with a mass in the superficial posterior compartment of the leg who presented 37 years after the initial trauma and ischemic myonecrosis. MRI was useful in establishing the diagnosis and early surgical intervention. The mass was excised and closed primarily over a drain. Patient was followed up for 29 months, and there were no secondary infections, chronic sinus formation, or recurrences. Based on our experience and the available literature review, we recommend considering either excision and primary closure, or repeated needle aspiration of the mass. Packing the wound and delayed closure may lead to secondary infection, chronic sinus formation, and lower limb amputation as potential complications.

Aged↗
PubMed1994

Treatment of compartmental liquefaction as a late sequelae of a lower limb compartment syndrome.

Symptomatic liquefaction and calcification of muscle tissue as a late sequela of compartment syndrome of the lower leg is rare. The literature shows a high complication rate involved with simple debridement of these compartments. In our limited experience, complete compartmental debridement and immediate introduction of functional viable muscle may prevent the documented complications of chronic drainage and infection.

Adult↗
PubMed1986

Cardiac and vascular sequelae of sternal fractures.

A 5-year experience with 12 sternal fractures treated at the Los Angeles County Harbor/UCLA Medical Center is presented. Our data indicate that sternal fractures with roentgenographic mediastinal widening commonly have associated aortic injuries. There is an almost uniform depression of right ventricular or anterior left ventricular function associated with sternal fractures and these cardiac sequelae are documentable by first-pass biventricular radionuclide angiography including left ventricular segmental wall motion analysis. These data facilitate the management of patients with complex hemodynamic problems. In contrast, the incidence of displaced or unstable fractures is very low. Only one patient in this series had a depressed manubriosternal fracture, and no injury necessitated surgical stabilization. The outcome of isolated sternal fractures is benign, and they should be viewed as harbingers of the discovery of other injuries.

Accidents, Traffic↗
PubMed1998

Missed diaphragmatic injuries and their long-term sequelae.

BACKGROUND: Blunt or penetrating truncal traumas can result in diaphragmatic rupture or injury. Because diaphragmatic defects are difficult to diagnose, those that are missed may present with latent symptoms of obstruction of herniated viscera. METHODS: A chart review of all patients admitted with late presentations of posttraumatic diaphragmatic hernias from 1980 to 1996 was undertaken. RESULTS: Ten patients with posttraumatic diaphragmatic hernias were treated in this specified period. There were six males and four females with a mean age of 65 years. Eight patients sustained blunt truncal traumas and two patients sustained penetrating truncal traumas. The hernias occurred in two patients on the right and in eight patients on the left side and contained the liver (n = 2), bowel (n = 10), stomach (n = 4), omentum (n = 5), or spleen (n = 1). The time until the hernias became clinically symptomatic ranged from 20 days to 28 years. In all but one patient, either routine chest roentgenograms or upper gastrointestinal contrast studies were diagnostic. All 10 patients underwent laparotomy (n = 9) or thoracotomy (n = 2) with direct repair of the diaphragmatic defect. One patient died 3 days after the operation, representing a mortality of 10%; the morbidity was 30%. CONCLUSION: Initial recognition and treatment of diaphragmatic rupture or injury is important in avoiding long-term sequelae.

Adult↗
PubMed2001

Chronic otitis media sequelae in skeletal material from medieval Denmark.

OBJECTIVES: Chronic otitis media sequelae (COMS) have been identified in archaeological skeletal materials from various ages. COMS reflecting episodes of upper respiratory tract infection may be used as a paleopathological indicator of general health. Estimation of the frequency of COMS may be useful in the gross evaluation of general standard of living. MATERIALS AND METHODS: Temporal bones and auditory ossicles from 659 individuals from two Danish medieval rural parish cemeteries, dated to 1050-1200 and 1150-1350, respectively, were examined otomicroscopically. RESULTS: Osseous fistulae from mastoid abscesses, remodelling of the hypotympanon, and erosion of the incus were among the convincing indications of COMS. A minimum frequency of COMS of 1% to 7% was found. The youngest material displayed the highest frequency of pathological changes. CONCLUSION: Indications of a rising incidence of infectious middle ear disease in early medieval Denmark were found. This may reflect a deterioration of living conditions from the 11th through the 14th centuries.

Bone Diseases↗
PubMed1982

Population-based study of herpes zoster and its sequelae.

The epidemiology of herpes zoster and its sequelae have been investigated in a community-based study. The incidence rates observed in Rochester, Minnesota, are lower than those determined in practice-based series; and this may reflect some selectivity in practice-based series compared to population-based studies. No significant sex difference or seasonal variation was observed but the incidence did increase markedly with age. An increase in incidence was also observed over the 15-year period studied. The dermatomal distribution of herpes zoster observed in Rochester was quite similar to previous studies, despite their inherent biases in case ascertainment, except for a lower proportion with cranial nerve zoster. Herpes ophthalmicus (V1) appears to affect a slightly different population than zoster of the other dermatomes, with elderly males being more at risk. Also, herpes ophthalmicus is associated with a higher complication rate compared to the other dermatomes primarily due to the fragility of the involved organ. The elderly are also at greatest risk for the most common complication, post-herpetic neuralgia. The rate of PHN is not significantly increased in any particular dermatome but is significantly decreased in lumbar herpes zoster.

Adolescent↗
PubMed1991

Syringomyelia as a postoperative sequela of the resection of a chordoma of the clivus: case report.

Syringomyelia has been described frequently in association with various abnormalities of the skull base but rarely with tumors of the skull base. Syringomyelia as a postoperative sequela of surgery of the skull base has not been reported. The authors describe a case of cervical syringomyelia developing after the partial resection of a chordoma and combined conventional and proton beam irradiation. The possible mechanisms causing this abnormality are discussed.

Adult↗
PubMedDate not supplied

Polio and postpolio sequelae: the lived experience.

Many polio survivors who have been asymptomatic for a number of years are now experiencing problems with fatigue, weakness, pain, and cold intolerance. Treatment is possible, and support groups are available to deal with postpolio sequelae.

Fatigue↗
PubMedDate not supplied

Behavioral and cognitive sequelae of head trauma.

Traumatic brain injury accounts for many deaths each year. Those who survive stand a high chance of sustaining permanent cognitive and behavioral sequelae that will impact not only their own lives, but those of family and friends. The most frequently observed cognitive manifestations include memory loss, decreased rates of information processing, and cognitive rigidity. The most common behavioral manifestations are lack of impulse control, increased agitation, and mood lability. While these deficits are often permanent, cognitive retraining and behavioral management can modulate responses. The focus of care is on reorganization of existing abilities rather than modification of abnormal responses.

Adult↗
PubMedDate not supplied

Skeletal and cutaneous sequelae to meningococcal purpura.

Meningococcal infection can produce symptoms that have severe morbid or even fatal effects. The survival rate has increased over the last 20 years and health care workers are now faced with managing the sequelae of cutaneous and skeletal necroses. It is important for nurses to recognize symptoms of the disease as well as associated complications. A multidisciplinary approach is needed to manage all phases of the illness. This phenomenon occurs most commonly in children but may be seen in adolescents and young adults as well. Despite extensive alteration in body image and the need for long-term rehabilitation, with proper management, a full recovery may be expected.

Adolescent↗
PubMedDate not supplied

Long-term sequelae following blunt thoracic trauma.

People experiencing blunt thoracic trauma may sustain multiple rib fractures, flail chest, cardiac or pulmonary contusions, injury to the great vessels, sternal fractures, clavicular fractures, neck injuries, and lacerations of the liver and/or spleen. Long-term sequelae from blunt chest trauma include chest wall deformities, persistent dyspnea, and cardiac, neurologic, or esophageal complications. Chronic pain, depression, and loss of functional status are also frequent components of recovery from trauma.

Humans↗
PubMedDate not supplied

Association between preadmission oral antibiotic therapy and cerebrospinal fluid findings and sequelae caused by Haemophilus influenzae type b meningitis.

The association between the administration of oral antibiotics and cerebrospinal fluid (CSF) findings and sequelae was investigated in 281 children with Haemophilus influenzae type b meningitis from two prospective studies. Ninety-four (33%) children were pretreated; 59% of pretreated children received ampicillin or amoxicillin. Compared with untreated children, in pretreated children significant decreases were noted in the percentage of polymorphonuclear leukocytes in the CSF (P less than 0.03), CSF protein concentration (P less than 0.001) and percentage with a positive CSF Gram stain or culture (P less than 0.05). When adjusted for duration of illness prior to admission, only the CSF protein concentration remained different (P less than 0.01). Children who were pretreated were more likely (P less than 0.05) to have paresis at one or more follow-up visits and sensorineural hearing loss (P less than 0.05), but these differences were diminished when adjusted for duration of illness before admission. The duration of illness prior to admission was significantly (P less than 0.0001) longer for pretreated (median, 3.0 days) than for untreated children (median, 1.0 day). The incidence of deafness did not correlate with duration of illness before admission by multiple logistic regression analysis (P = 0.132), but deafness was significantly (P less than 0.02; relative risk, 5.9) more common when all children who were ill for more than 1 day prior to admission were compared to those children who were ill for 1 day or less.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Bacterial Agents↗