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At least 991 records · Page 55Linked to original sources
PubMed1994

Hazardous chemicals: psychological dimensions of the health sequelae of a community exposure in Texas.

STUDY OBJECTIVE: A chemical spill from an oil refinery exposed the local community to more than 40,000 lb of highly toxic and corrosive hydrofluoric acid. A community based symptom prevalence study found an association between exposure and physical symptoms: the psychological impact of the disaster and its potential effect on the reporting of physical symptoms is examined here. DESIGN: The study used a population based survey design consisting of two phases: phase I, the exposure phase, and, phase II, the symptom prevalence phase. SUBJECTS: In phase I, information indicative of exposure was collected on 10,811 individuals in a door to door survey of a geographically defined area. In phase II, symptom prevalence information was gathered through in-person interviews with 2509 subjects selected from the phase I census in a sampling scheme that balanced across the exposure categories with regard to age, gender, and predisposition. The refusal rate in both phases was < 5%. MEASUREMENT AND MAIN RESULTS: Stepwise logistic regression analyses were used to assess the relative predictive importance of psychological variables and hydrofluoric acid exposure in explaining the reported physical symptoms two years after the disaster. The findings show a linear relationship between the level of hydrofluoric acid exposure and the degree of psychological stress two years after the accident. High exposure had a long term (more than two years) impact on physical health for some self reported symptoms, even after controlling for the psychological impact. Some physical symptom reports, however, were better explained by psychological status than by exposure to hydrofluoric acid. The physical symptoms for which exposure was the major predictor were those for which the biological plausibility of a relationship with hydrofluoric acid exposure was direct. CONCLUSIONS: Measures of psychological status should be included in symptom studies of health sequelae to man-made disasters so that the physical effects of exposure can be more accurately assessed.

Adolescent↗
PubMed1973

Sequelae to pneumoencephalography.

Fifty patients were examined clinically and neurologically for seven days after pneumoencephalography. Headache was present in 78%, neck stiffness in 34%, pyrexia in 38%, vomiting in 34%, tachycardia in 74%, a change in the level of consciousness in 18%, and abnormal neurological signs in 30%. Of the 13 patients with epilepsy, there was an increased frequency of seizures in four, associated with increased EEG epileptiform activity in three. EEG abnormality either appeared or increased in 74% of cases on the second day after the air study. A mechanism for the production of these sequelae is proposed. It is concluded that these findings indicate that in most cases an organic brain syndrome follows pneumoencephalography.

Adolescent↗
PubMed1986

The effect of isovolaemic haemodilution and intravenous glycerol on the sequelae of middle cerebral artery occlusion in the rat.

The therapeutic potential of isovolaemic haemodilution and osmotherapy on the sequelae of middle cerebral artery occlusion has been studied in an animal model. The territory of the middle cerebral artery that failed to fill with a carbon black intravascular marker after intracranial occlusion for 30 minutes in the anaesthetised rat was reduced by 50% by isovolaemic haemodilution to a haematocrit of 30%. An intravenous infusion of 10% glycerol prevented swelling of the ischaemic hemisphere, though it did not further improve vascular perfusion. These findings support the use of isovolaemic haemodilution and osmotherapy in the acute aftermath of stroke.

Animals↗
PubMed1987

The neurobehavioural rating scale: assessment of the behavioural sequelae of head injury by the clinician.

To investigate the inter-rater reliability and validity of the Neurobehavioural Rating Scale at various stages of recovery after hospitalisation for closed head injury, we studied 101 head trauma patients who had no antecedent neuropsychiatric disorder. The results demonstrated satisfactory inter-rater reliability and showed that the Neurobehavioural Rating Scale reflects both the severity and chronicity of closed head injury. A principal components analysis revealed four factors which were differentially related to severity of head injury and the presence of a frontal lobe mass lesion. Although our findings provide support for utilising clinical ratings of behaviour to investigate sequelae of head injury, extension of this technique to other settings is necessary to evaluate the distinctiveness of the neurobehavioural profile of closed head injury as compared with other aetiologies of brain damage.

Adolescent↗
PubMed1991

The cognitive and psychological sequelae of uncomplicated aneurysm surgery.

Many patients are left with psychological symptoms after surgery for a ruptured intracranial aneurysm. Often the reason for these symptoms is not clear. A prospective study was carried out of 27 patients who were in a good (Grade 1 or 2) condition before operation to identify the origin of such symptoms and discover whether the basic techniques of aneurysm surgery could lead to serious psychological sequelae even in the absence of any specific complication. Each patient was given a modified psychometric assessment just before surgery and at the time of discharge from hospital. One year later a full psychometric and social assessment was carried out. Even a temporary worsening of psychometric performance did not occur unless there had been some specific surgical or post-operative problem. Five patients showed worsening of psychometric performance in the immediate post-operative period but by one year, only two of the 27 patients showed any abnormalities on formal psychometric evaluation; in both, clear reasons were evident. Although the majority of patients reported minor psychological symptoms, these had not hindered full functional recovery, and we doubt whether they had any organic basis. It is concluded that aneurysm surgery does not, itself, threaten higher intellectual function unless some specific complication occurs.

Adult↗
PubMed1991

The neuropsychological sequelae of attempted hanging.

Only one report on the neuropsychological sequelae of attempted hanging exists in the English language. Two cases of attempted hanging with subsequent isolated memory deficits are reported. Possible mechanisms for induction of this amnesia are discussed. In these two cases it is most likely that circulatory disturbance produced by the ligatures caused ischaemic hippocampal damage, which in turn led to amnesia.

Adult↗
PubMed1994

Minor head injury: pathophysiological or iatrogenic sequelae?

This study addresses the possibility that cognitive sequelae--albeit of a transient or minor character--can be associated with mild head injury. Twenty men (aged 16-30 years of age), whose post-traumatic amnesia did not exceed eight hours, were examined within 48 hours of their accident and again one month later. This unselected sample had no previous history of head injury. A control group of 20 men of similar socioeconomic background, was selected from medical wards (where they had been admitted for orthopaedic treatment or a minor operation). They were also retested one month after the first examination. Neuropsychological tests were selected to measure abilities often compromised after significant head injury, namely memory and attention. The experimental component consisted of the fractionation of a complex skill (paced addition) to probe for deficits at different stages of information processing: perception and input into storage; search for and retrieval of information from working memory; and paced and unpaced addition. In general, no significant difference was found between the experimental and control groups, with the possible exception of an initial decrement on two working memory tasks: probe digits and a keeping track task (where the subject has to keep in mind and update a number of variables at the same time). The keeping track paradigm, ostensibly of ecological relevance, may well be worth further exploration in memory research, and in studies of more severely head-injured patients. It is further suggested that the appropriate management and counselling of mildly head-injured patients may help to avert symptoms that are of psychological rather than pathophysiological origin.

Adolescent↗
PubMed2000

Upper limb motor function at 5000 metres: determinants of performance and residual sequelae.

Little is known about the effects of age and symptoms of acute mountain sickness and the potential benefit of short term acclimatisation on fine motor performance at altitude. There is uncertainty about whether time spent at altitude results in permanent neurological sequelae. Nine hole pegboard tests were performed on a group of trekkers at sea level (n=61), after ascending to Kanchenjunga base camp (5100 m; n=46), and 20 weeks after return to sea level (n=43). Comparison of baseline and altitude times showed a mean slowing from 36.2 to 39.0 seconds, a 7. 8% deterioration in performance (p<0.0001), which was greatest in subjects aged 50 years or older (5.04 v 1.93 seconds, p=0.017), those tested within 24 hours of arrival at 5100 m (4.75 seconds, 13. 3% v 0.48 seconds, 1.3% p<0.001), and persons experiencing symptoms of acute mountain sickness (p=0.012), each of which were independent determinants of deterioration. Repeat pegboard testing at sea level after 20 weeks showed no significant change compared with baseline (p=0.68). This confirms the deleterious effects of altitude on fine motor function, emphasises the benefit of acclimatisation, and suggests that older persons and those with symptoms of acute mountain sickness are particularly susceptible. The risk of long term motor dysfunction after exposure to these relatively moderate altitudes seems to be small.

Adaptation, Physiological↗
PubMed1993

Adjustment to the psychological and social sequelae of recurrent genital herpes simplex infection.

OBJECTIVE: To investigate whether adverse psychological consequences and impaired sexual and interpersonal functioning are present in individuals suffering from recurrent genital herpes simplex infection (HSV). DESIGN: A questionnaire-based study completed by subjects defined as having more than one episode of HSV infection. SUBJECTS: Completed questionnaires were returned from 90 subjects; 40 from the department of genitourinary medicine at our hospital and 50 from members of the Herpes Association. RESULTS: Stress and being physically run-down were identified as provoking factors by the majority of individuals (78% and 56% respectively). The frequency of sexual activity was not different when comparing rates before and after infection (p < 0.001) and the majority of subjects had told partners of their infection. Women reported significantly greater disturbances in several psychological variables and reported a greater decrement in their general health. However, overall there were no differences in the psychological sequelae following herpes infection. CONCLUSIONS: The study suggests that, given time, most people are able to adjust psychologically to having recurrent herpes infection. However, for a minority of subjects this is not the case and these individuals may require psychotherapeutic intervention.

Adaptation, Psychological↗
PubMed1981

Late respiratory sequelae of blunt chest injury: a preliminary report.

Eighty-six survivors of blunt chest injury were assessed for pre- and post-injury respiratory symptoms using a standardised questionnaire. A comparison was made between observed and expected symptom prevalence and lung function. Respiratory symptom prevalence after injury was greater than expected, 23 survivors (27%) claiming a persistent productive cough, 18 (21%) persistent wheezing, and 22 (26%) grade 2 dyspnoea. After injury persistent productive cough (p less than 0.05) and occasional wheezing (p less than 0.01) were more common among smokers and ex-smokers when compared with non-smokers. Mean forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were not statistically different from expected values. We concluded that respiratory sequelae of blunt chest injury are common and that smokers and ex-smokers are at particular risk.

Adult↗
PubMed1975

Non-oncogenic sequelae of cancer chemotherapy.

The delayed effects of anticancer drugs and late complications in 334 long-term survivors of childhood cancer were reviewed. Sequelae associated with chemotherapy were uncommon. Two men in the series exhibited disorders in reproductive function, possibly due to chlorambucil. A third male patient had cyclophosphamide-induced hematuria which persisted for two years after cessation of therapy. Other abnormalities were renal, hepatic, skeletal and cardiopulmonary, ascribed chiefly to radiotherapy, although the deleterious effect of drugs on irradiated organs cannot be excluded. The data indicate that the skillful and judicious application of chemotherapeutic agents produces a minimum of delayed consequences.

Adolescent↗
PubMed1977

Uncommon sphenoidal fractures and their sequelae.

Eight cases with fractures of the sphenoid bone are discussed. In four the sella turcica was involved. One showed bilateral fractures of the medial pterygoid plates resulting in an open-bite deformity. Another patient exhibited bilateral carotid-cavernous fistulae. This brings the total of documented, angiographically demonstrated, post-traumatic, bilateral, carotid-cavernous fistulae to seven. Fractures of the planum sphenoidale, the floor of the sphenoid sinus, and bilateral fractures of the lesser wings are also shown. The anatomy of the sphenoid bone and clinical sequelae are briefly discussed.

Adolescent↗
PubMed1999

Febrile convulsions in 220 children--neurological sequelae at 12 years follow-up.

We report a 12-year follow-up study of children with febrile convulsions (FCs). The National General Practice Study of Epilepsy (NGPSE) is a large prospective community-based cohort study of 1,195 patients of all ages from first presentation with an identified seizure. Two hundred and twenty children with a first febrile convulsion were identified from the above study between 1984 and 1987. Children were prospectively followed up to ascertain subsequent seizures, neurological problems and treatment. Two hundred and seven patients were followed for a minimum of 8.4 years (median 11.2 years). In the FC cohort, 6% of the children developed subsequent epilepsy, which compares with a population risk of about 1.4%. Ten percent had neurological sequelae. Eleven percent of the children had received medication to prevent recurrence of FC, and in one third of these cases, this was for simple FCs. Using a time-dependent covariate Cox proportional hazards model, the number of FCs was associated with an increased risk of epilepsy (hazard ratio 2.48; 95% confidence limits, CL 1.68, 3.65) up to a limit of 4. A statistically significant association between occurrence of complex FC and subsequent epilepsy was not found, but a review of other studies quantified the odds ratio for epilepsy after a complex first FC as 3.4 (95% CL 2.1, 5.4). Epilepsy is a significant if infrequent sequel to FCs. Factors associated with subsequent epilepsy are the number of FCs or a complex first FC. Overtreatment of this condition continues.

Child↗
PubMed2004

Sequelae of parenteral drug abuse involving the external genitalia.

UNLABELLED: Intravenous drug abuse continues to be a major social problem in the USA. Many drug abusers eventually run out of usual intravenous sites and begin to utilize more unusual sites. Some of these sites include the cervical veins and the superficial dorsal vein of the penis. Sometimes the vein is missed and there is extravasation of the drug subcutaneously or intracorporeally. Acute cavernositis, priapism, penile subcutaneous hematoma, penile ulcerations and corporal fibrosis as well as Fournier's gangrene are some of the sequelae of these adventures. We describe our experience with these situations and review the management of penile ulcers. MATERIAL AND METHODS: Six patients who were seen in our general urology practice in Washington, D.C., with parenteral drug abuse involving the external genitalia were studied. RESULTS: Complications of acute cavernositis, priapism and penile ulcers were observed in this group. CONCLUSION: It is essential to be aware that these habits occur as well as some of the complications outlined here. We review the management of penile ulcers.

Adolescent↗
PubMed1993

Epidemiology of neuromuscular diseases, including the postpolio sequelae, in a Swedish county.

The epidemiology of neuromuscular diseases was studied in the county of Orebro, Sweden (study population 270,000). Several different sources of data were utilized, compared and validated. On the prevalence of day (January 1, 1988) 474 patients were identified. The rate per 100,000 population was 92 for the postpolio sequelae (PPS) and 84 for the other neuromuscular diseases (motor neuron disease 9, hereditary neuropathies 9, myoneural disorders 16, myotonic disorders 19, muscular dystrophies 20 and myositis 11). Of the patients with the PPS, 80% reported late-onset symptoms. On the basis of an expanded survey including all medical records in one health care district, the prevalence of the PPS was estimated to be 186/100,000 population.

Adolescent↗
PubMed1994

Patient/family preparation and education for complications and late sequelae of craniopharyngiomas.

Craniopharyngiomas are the most common pediatric suprasellar tumor. While they are benign by histology, their location in the brain predisposes craniopharyngiomas to be associated with both acute and chronic neurologic, endocrine, visual, neuropsychologic and psychosocial problems. Because of the complexity of problems it is difficult to really prepare a patient and family for every complication or late effect that may occur with a craniopharyngioma diagnosis. Patient/family preparation for potential complications and late sequelae is an ongoing and labor-intensive process for all members of the multidisciplinary health care team. This paper will discuss this process and identify strategies for effective patient/family education for children with the diagnosis of craniopharyngioma.

Child↗
PubMed1991

Persisting renotubular sequelae after cisplatin in children and adolescents.

UNLABELLED: Information on persisting renal sequelae after cisplatin in children and adolescents is limited. Twelve patients aged 4-20 years had been treated with cisplatin and were healthy 4-43 months after stopping chemotherapy. Plasma creatinine, calcium, albumin and hydrogen ion concentration, plasma and urinary sodium, chloride, phosphate and urate, and urinary magnesium and potassium were comparable in patients and controls. However, mean calciuria, magnesemia and potassemia were significantly reduced and bicarbonatemia increased in the patients. Calciuria, magnesemia, potassemia and bicarbonatemia were normal in 3 patients only, calciuria was below -2 SD control in 9 patients, renal magnesium deficiency was demonstrated in 5 patients (all with hypocalciuria as well), and 4 patients presented with hypokalemic metabolic alkalosis (all with magnesium deficiency and hypocalciuria). CONCLUSIONS: (1) Renotubular dysfunctions persist very often after cisplatin; (2) hypocalciuria is more frequent than hypomagnesemia; (3) the most severe tubulopathy after cisplatin includes hypocalciuria, renal magnesium deficiency and hypokalemic metabolic alkalosis.

Adolescent↗
PubMed1995

Occlusion of the right coronary artery as sequelae of Kawasaki disease: the clinical features of 9 cases.

Among the 302 children with Kawasaki disease (KD) who were evaluated by angiography from 1973 through 1992, 9 (3.0%) had either an occlusion (OC) or segmental stenosis (SS) of the right coronary artery. The interval from the onset of KD to the recognition of OC or SS ranged from 0.5 to 7.7 years (median 4.0 years). Left coronary arterial lesions were also present in 8 of 9 patients. In spite of severe sequelae, children or young adolescents with cardiovascular system-related symptoms were unexpectedly rare. Asymptomatic patients, however, are also at risk of developing myocardial infarction since they have been shown to have a high rate of abnormalities on myocardial scintigraphy. A close observation and careful follow-up are thus considered to be indispensable.

Adolescent↗