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PubMed1985

[Long-term course of the cerebral circulatory function after brain irradiation in rats].

Long-term evolution of radioisotope indices, evaluating respectively the cerebral blood flow (CBF), the cerebral blood volume (CBV) and the cephalic specific distribution space of iodoantipyrine (delta IAP) of rat, was studied after brain irradiation at 20 Gy. Radioinduced hemodynamic alterations evidenced by this approach are biphasic and support the prominent role of circulation impairment in the genesis of delayed brain radionecrosis.

Animals↗
PubMed1981

[Long-term course of patients with Smeloff-Cutter aortic valve prosthesis].

The long-term results (5 to 12 years) of 77 patients with Smeloff-Cutter aortic valve prostheses are reported. These patients were comparable in age, preoperative clinical condition and type of aortic valve replacement. The postoperative follow-up period of this series was however significantly longer. The 5 year survival rate was of 87%. The causes of death included thromboembolism, infectious endocarditis and cardiac failure. Mortality was higher in the first 5 postoperative years : 2,4% patient-years compared to 1,5% patient-years in the following years. Thromboembolism and neurological complications were particularly rare, representing a risk of 1,04% patient-years but these complications were lethal in half the cases in which they occurred. No haemolytic complications were observed. Infective endocarditis always occurred in patients with a history of infection, the complication usually being late (after 3 years). The life expectancy of patients seen after 5 years is at least 5 additional years in 80% of cases. The haemodynamic profile of the prosthesis did not degrade with time. After 5 years, 58,6% of patients in functional Class IV at operation were in Class I or II afterwards. 84,4% of patients operated in functional Class III were in Class I or II, and 93% operated in functional Class II were in Class I or III. A control of 3 prostheses carried out by the Cutter laboratory after 10 and 11 years' function shows practically no deterioration of the prosthesis. The low incidence of thromboembolism, the absence of haemolysis and long-term deterioration of the prosthesis are particularly valuable characteristics of this prosthesis in the aortic position.

Adult↗
PubMed1998

Long-term course of West syndrome associated with tuberous sclerosis.

We retrospectively analyzed the long-term clinical profiles of 47 patients with West syndrome (WS) associated with tuberous sclerosis (TS) the follow-up study for >10 years showed that WS developed into epilepsies of various types in all patients. Their final diagnoses were symptomatic generalized epilepsy (SGE: 29 patients, 62%), symptomatic partial epilepsy (PE: 14 patients, 30%), and undetermined epilepsy (UE: 4 patients, 8%). Eighty-five percent of all patients continued to show the same types of epilepsy that they had at their first examination, but in 15% the diagnosis had to be revised at the end of the follow-up period. The outcome of seizures was unfavorable for the SGE group. In the PE group, however, seizures were controlled in 9 (64%) of the 14 patients, and disturbances of daily activity were mild. In patients with WS associated with TS, the seizure outcome and social activity varied depending on the type of epilepsy or epileptic syndrome that developed from WS. The complicated clinical developments from WS with TS multiple cortical tubers related to epileptogenesis in addition to impairment of brain development.

Adolescent↗
PubMed2001

Long-term course in collagenous colitis and the impact of bile acid malabsorption and bile acid sequestrants on histopathology and clinical features.

BACKGROUND: Bile acid malabsorption is common in collagenous colitis, although long-term follow-up data on the impact of bile acids are limited. The aim was to study whether bile acid malabsorption is a permanent finding, with an impact on histopathology and clinical features in collagenous colitis. METHODS: The objective was to reinvestigate 27 patients with collagenous colitis > or = 3 years after index investigation. The clinical course was evaluated by means of an interview, a review of the hospital records and registration of symptoms over a period of 7 days. The patients were invited to undergo a repeat colonoscopy and 75SeHCAT measurement. Initial and follow-up data and 75SeHCAT values from 29 controls were compared. RESULTS: The median follow-up time was 4.2 (range 3-5.3) years. Twenty-two patients underwent a repeat 75SeHCAT test, 23 patients a colonoscopy and in 25 patients the clinical course could be evaluated. The 75SeHCAT values were abnormal in 32% at follow-up versus 44% at index, and the median retention value was 19% (range 2-69) versus 12% (range 0.5-41) (P = 0.024) although lower than in the control groups figure of 38% (range 8-91) (P < 0.005). Histopathology had improved independently of bile acid malabsorption, gender, smoking and autoimmune disease at follow-up. Four were normalized. Patients on bile acid binders had no significant change of histopathology. Four patients had recovered, seven displayed an intermittent course and 14 had continuous diarrhoea. CONCLUSIONS: Collagenous colitis and bile acid malabsorption seem to be associated yet independent disorders. The histopathology improves during the long-term course although only a few patients resolve.

Bile Acids and Salts↗
PubMed1988

Coronary artery aneurysms and congestive heart failure--possible long-term course of Kawasaki disease in an adult--a case report.

Multiple coronary artery aneurysms, rarely seen in patients with atherosclerotic heart disease, can be frequently observed in children with Kawasaki disease. However, their long-term clinical courses still remain obscure. A thirty-nine-year-old male came to our clinic because of congestive heart failure. A left ventriculogram revealed highly reduced wall motion. A coronary angiogram showed left main trunk aneurysm with complete occlusion of the left anterior descending artery and ramification of the right coronary artery close to the ostium. Six months after discharge, he died suddenly. On autopsy, aneurysms were observed in the left main trunk and right coronary artery, together with an old anteroseptal myocardial infarction. Although he did not have a clear history of febrile disease in childhood, he was highly suspected to be a long-term survivor of Kawasaki disease because of the unique form and distribution of the coronary artery aneurysms.

Adult↗
PubMed1988

[The long-term course of 60 patients with alveolar echinococcosis in continuous therapy with mebendazole (1976-85)].

Since 1976 60 patients with inoperable alveolar echinococcosis caused by Echinococcus multilocularis were treated with high doses of mebendazole and examined at regular intervals prospectively according to our protocol regarding clinical course, liver function, morphology, immunologically and plasma mebendazole levels. The average duration of disease was 8(1-19) years, the average duration of chemotherapy was 4.25 (0.75-9) years. The long term results showed a correlation of the clinical course with the mean plasma mebendazole levels and the duration of chemotherapy, respectively. Death (n = 5) or transient progression of the disease process (n = 14) was observed primarily in patients with low plasma mebendazole levels in the early course and within the first two years of chemotherapy. Only 9 patients showed a decrease of the parasite mass. Immundiagnosis (total serum IgE and serum antibodies against Echinococcus antigen) gave some information with regard to therapy results, but only in the long-term course. The cumulative survival of the patients under study was 96% at 5 years and 84% at 10 years, respectively which is markedly higher compared to historical control series with a letality of greater than 90% within 10 years.

Adult↗
PubMedDate not supplied

[Long term course of insulin secretion in treated noninsulin dependent diabetics (author's transl)].

The long-term effects of sulfonamides were studied by means of hyperinsulinemia tests in 82 diabetics over a period of 12 months (24 months for 30 of them). Whereas for those obese diabetics whose only treatment was dieting--alone or combined with biguanides--hyperinsulinemia attenuates itself as do also variations in glycemia, although some asynchronism remains, in those diabetics treated with sulfonamides--alone or in combination with other treatments--the insulinemia curve is hardly modified.

Biguanides↗
PubMed2004

[Long-term courses in children with attention deficit hyperactivity disorder (ADHD)].

ADHD was long considered to be the attention deficit disorder of childhood. Observations over the long-term have, however, shown that some one-third of victims also continue to meet the criteria for ADHD in adulthood too. In many cases, such additional psychiatric conditions as depression or an addictive illness are also to be seen. Today, ADHD is believed to be a mainly heritable disorder with deviations in the dopaminergic system. Re-evaluation of the condition now focuses attention on the attention-related, rather than the hyperactivity-related aspects of the problem. Currently, the best therapeutic results are achieved through the use of stimulants coupled with intensive paediatric psychiatric care.

Adolescent↗
PubMed1999

The long-term course of chronic hepatitis B.

The aim of this study was to assess the long-term outcome in hepatitis B virus (HBV)-infected patients according to HBV, hepatitis C virus (HCV), and hepatitis D virus (HDV) replication, focusing on survival, liver failure, and hepatocellular carcinoma (HCC). A cohort of 302 hepatitis B surface antigen (HBsAg)-positive subjects (mean age, 34 +/- 15.3 years; male/female 214/88; 39 subjects under 14 years) with biopsy-proven chronic hepatitis (86 with cirrhosis) was prospectively assessed, with a median follow-up of 94 +/- 37.6 months. One hundred nine patients received interferon alfa (IFN). At baseline, 86 subjects (28.5%) were hepatitis B e antigen (HBeAg)-positive (wild-type HBV), 80 (26.5%) were HBeAg-negative, HBV-DNA-positive, 76 (25.2%) had HDV infection, 43 (14.2%) had dual HBV/HCV infection, and 17 (5.6%) were negative for HBV-DNA, anti-HCV, and anti-HDV. During follow-up, decompensation of disease occurred in 46 subjects: 8 developed HCC, 36 developed ascites, and 2 developed jaundice. Five patients underwent transplantation. Thirty-five subjects died: 33 of hepatic and 2 of nonhepatic causes. Overall mortality was 5.2-fold that of the general population (95% CI: 3.6-7.3; 35 deaths observed, 6.7 expected; P <.0001). By Cox regression analysis, survival was independently predicted by young age, absence of cirrhosis at baseline, and sustained normalization of aminotransferases during follow-up. Survival without decompensation was independently predicted by the same factors and by IFN treatment. Chronic hepatitis B infection increases mortality in comparison with the general population in our area regardless of specific virological profiles at presentation. Presence of cirrhosis and persistent necroinflammation markedly increase the risk of death.

Adolescent↗
PubMed2005

The long-term course of alcoholism, 5, 10 and 16 years after treatment.

AIMS: To discover the long-term stability of drinking behaviour following an in-patient treatment episode. DESIGN: Three follow-up periods were used at 5, 10 and 16 years. The patients were classified as being abstinent, improved or unimproved on the basis of self-reported drinking behaviour. Patients who could not be interviewed at follow-up were classified as unimproved. SETTING: An alcohol dependence treatment programme at the University Hospital Tuebingen, Germany. PARTICIPANTS: We were able to locate all 96 patients at the 16-year follow-up. Seventy were alive and 26 had died. We collected information from 59 of the 70 surviving patients. The remaining 11 patients could be located and were definitely alive. FINDINGS: Thirty-eight of the 70 patients were abstinent, 10 were improved and 22 (including the 11 living patients without further information) were classified as unimproved. Our main finding indicates that the so-called 'improved drinking' is very inconsistent over time. In contrast, the abstinent and unimproved patients were much more stable in their drinking behaviour. CONCLUSIONS: This study extends our knowledge of the drinking trajectory and outcome from only a few years of follow-up to 16 years. Complete abstinence and unimproved drinking behaviour were the most stable drinking patterns observed over the long term, confirming study results obtained primarily from English-speaking countries.

Adult↗
PubMed1988

[Long-term course of hepatic glycogenosis. A retrospective study of 76 cases].

In order to study the long term outcome of hepatic glycogen storage diseases, a national retrospective inquiry gathered 76 patients older than 12 years. In adolescents and adults, hypoglycemia, failure to thrive, pubertal delay, hepatomegaly and metabolic disturbances are major in type I, intermediary in type III and mild in type "VI+IX". Spontaneous improvement of these symptoms is noted in older patients. Beside these classical signs, anemia, high blood pressure, renal failure and persistent hypercholesterolemia were reported in some type I glycogen storage disease and bad school and professional results in type III. The knowledge of these complications should lead to a better management of these patients.

Adolescent↗
PubMed1983

[Long-term course of psychoses in continuously hospitalized patients].

Thorough reexamination of 70 patients in a long-term psychiatric ward led to partial revision of the diagnoses. Classified on the basis of Leohards's differential diagnostics, the large proportion of schizophrenics has dropped by over a third from 78% to 47%. Half of the 22 psychosis originally considered to be schizophrenia proved to be curable phasic and cycloid psychoses which had previously been overlooked and the other half were mental disturbances caused by brain-organic damage. A third of the chronic mental illnesses were found to be rooted in somatic brain lesions.

Adult↗
PubMed1994

Differences in diagnosis and long-term course and outcome between monosymptomatic and other delusional disorders.

A presentation is given of a long-term personal follow-up investigation of patients with paranoid psychoses consecutively admitted at the University Psychiatric Department in Oslo. The patients were followed-up for the first time after a period of 5-18 years, and again after 22-39 years. On the basis of the findings, it is suggested that the diagnostic category will best indicate the course and outcome for cases with delusional misidentification syndromes.

Adult↗
PubMed2000

Duration of untreated psychosis and the long-term course of schizophrenia.

This study examines the relationship between duration of untreated psychosis (DUP) and long-term symptomatic and social outcome in 205 patients with schizophrenia, whose parents are member of a consumer organisation. We found only a tendency that longer DUP was related to negative symptoms, but no relation to other outcome domains. The results of this study do not support antipsychotic intervention at the earliest sign of psychosis in order to 'protect the brain'.

Adult↗
PubMed1990

[How to evaluate the long-term course of osteoarthritis. Tests for trials of fundamental treatments (spine excluded)].

The best assessment tests for long term trials on osteoarthritis (OA) of the hip and knee are the following, in order of relevance value (consensus of french experts): 1) the loss of joint space thickness on successive radiographies; 2, 3) the indices of the severity for OA of the hip and knee; the investigator's overall opinion; 4) the patient's overall opinion (visual analogue scale of handicap); 5, 6, 7) the pain level (visual analogue scale); the time for going up and down a standard flight of stairs and the time of pain in this distance; the limitation of two articular movements; 8) the increase of either analgesics or NSAIDs consumption; 9) concerning OA of fingers, the number of joints newly involved on successive radiographies. At present, only the radiological tests 1 and 9 are validated. The clinical tests 2 to 8, valuable for short term trials, have yet to be validated for long term follow-up. Recommended duration of trials is three years. A rigorous organisation is necessary to avoid erroneous inclusions: all data recorded in the pre-inclusion visit have to be checked by the principal investigator. Since we have not yet a validated chondroprotective agent as a reference drug, the trial must be randomised, double blind, placebo controlled, parallel group study.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

[Long term course of insulin secretion in treated non-insulin dependent diabetics (author's transl)].

The long-term effects of sulfonamides were studied by means of hyperinsulinemia tests in 82 diabetics over a period of 12 months (24 months for 30 of them). Whereas for those (obese) diabetes whose only treatment was dieting--alone or combined with biguanides--hyperinsulinemia attenuates itself as do also variations in glycemia, although some asynchronism remains, in those diabetics treated with sulfonamides--alone or in combination with other treatments--the insulinemia curve is hardly modified.

Biguanides↗
PubMed1985

[Long-term course of lumbar curvature following Harrington instrumentation for thoracic or double major idiopathic scoliosis].

A long-term follow-up study has been made of 276 patients with thoracic or double major idiopathic curves treated by Harrington rodding between 1963 and 1971. 82 patients were able to be followed up to the present date, including 24 double major idiopathic curves and 58 thoracic or thoracolumbar curves. The average follow-up was 15 years with a maximum of 20 years. There were 71 female and 11 male patients. It was concluded that the lumbar curve associated with a thoracic or thoraco-lumbar curve lost about 9.9 degrees when the lower point of insertion of the rod was higher than L3. When it was at L3 or L4 loss of correction was only 3.6 degrees. During the same period the loss of correction of the main grafted curve was 13.6 degrees. In double major curves, the best results were obtained when the lumbar curve was completely or almost completely fused, with an average correction of 17.2 degrees. The results were good when the fixation extended to the apex of the lumbar curve, with an average correction of 11.6 degrees and was moderate when it extended to a higher level with an average correction of 10.9 degrees. It is concluded that in almost all cases, instrumentation needs to be extended to a low level at L3 or L4 to provide greater stability. A study on all 276 cases showed that the morphological adaptation beneath the grafts was satisfactory and long lasting. When the instrumentation stopped at the level of T12, L1 or L2 there was a danger of the development of secondary lumbar kyphosis. Low back pain was not made worse in any cases of low lumbar fixation.

Adolescent↗
PubMed1983

[Long-term course of primary vascular pulmonary hypertension with and without intake of appetite depressants].

1. The long-term follow-up of 22 patients with anorectic drug intake (aminorex fumarate) (AS) and PVPH is compared to 38 patients with PVPH of unknown etiology. 2. The 10-year cumulative survival rate is significantly higher for the AF-positive group (54 +/- 11%) than for the AF-negative patients (15 +/- 6%). 3. In terms of the hemodynamic parameters at the time of diagnosis, there were no differences between the two patient groups. 4. Hemodynamic serial controls in the AF-positive group often show a decrease in pulmonary pressure at rest, in contrast to the AF-negative group. However, in all but one of the patients with a pressure drop at rest there is a considerable increase in pulmonary pressure during exercise. 5. In neither group any correlation is to be found between pulmonary pressure and survival time.

Adolescent↗