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At least 1,243 records · Page 69Linked to original sources
PubMed1986

Epilepsy in the elderly: prognosis.

251 patients were admitted with seizures after the age of 60 years to the county hospital of Frederiksberg during the period 1979-1983, 163 had not received anti-epileptic treatment prior to admission, of these 151 had been admitted with their first seizure, 88 had established epilepsy at the time of admission. Of patients not previously treated and observed for at least 12 months, 62% remained seizure-free throughout the study, while 47% with established epilepsy were seizure-free. Of those not previously treated, 72% entered remission within the first year with a slight increase during the subsequent years. The first year was crucial in determining the long-term prognosis. Compared to previous studies on the prognosis of epilepsy it seems that prognosis in the elderly is as good or even better. Measurement of S-drug-levels at the time of seizure recurrence suggests that suboptimal treatment and poor compliance are important factors, thus indicating the need for regular control and monitoring of S-drug-levels. The presence of paroxysmal activity in the EEG was significantly correlated to seizure recurrence. Thirty-three patients entered nursing homes during the study period. Deterioration in residence status was correlated to degree of dementia and to the presence of focal neurological signs but not to age or to the severity of epilepsy.

Age Factors↗
PubMed2005

Prognosis of epilepsy in a community-based study: 8 years of follow-up in an Argentine community.

OBJECTIVE: To assess the prognosis of epilepsy, the possibility of achieving remission of seizures, in patients who were identified in a population-based study carried out in Junín, a city of about 70,000 inhabitants in Buenos Aires Province, Argentina. On January 1, 1991 (prevalence day), 106 people had epilepsy, including 64 (60%) with the condition active. METHODS: Eight years later, we revisited the patients identified in the prevalence study. We analyzed risk factors in relation to remission of seizures. We also confirmed the specific cause of death. RESULTS: Ninety-six patients were revisited (10 were completely lost to follow-up). We divided them into two groups: the group in terminal remission (defined as a seizure-free period that extended from prevalence day until the visit day in 1998) which included 64 people (66.7%), and the group of those who continued to have seizures which included 32 (33.3%) patients, of whom eight (25%) died. The overall standardized mortality ratio was 2.45; the rate was two and a half times that of the general national population. CONCLUSION: The better prognosis was observed in the group with generalized idiopathic epilepsy syndrome. Patients with epilepsy secondary to underlying structural causes had the worst prognosis, with higher mortality.

Adolescent↗
PubMed1980

Psychogenic psychoses. A retrospective study with special reference to clinical course and prognosis.

The study comprises a retrospective evaluation of case records of 220 patients admitted for the first time with psychogenic psychosis with special reference to clinical course and prognosis within a period of 13--14 years. The reliability of the diagnosis at the time of the first admission is about 60% when the evaluation is based on positive criteria for psychosis. If the psychogenic psychoses are divided into subgroups, the reliability of the diagnosis of psychogenic affective psychoses is about 30%, whereas it is over 90% for psychogenic confusional psychoses and psychogenic paranoid psychoses. If subsequent cases of other functional psychoses (manic-depressive psychosis and schizophrenia) are subtracted, the diagnostic reliability is 50% (111 of 220 cases), which represents the number of retrospectively verified psychogenic psychoses. The frequency of recurrence of psychogenic psychosis was 18% (40), corresponding to 36% of psychogenic psychoses verified by retrospective evaluation (111 of 220 cases). The recurrences were mainly homologous, as heterologous recurrences developed only among the psychogenic affective psychoses (slightly less than half of the recurrences in question). Schizophrenia developed in only 10% (23), and subsequent episodes of manic-depressive psychosis occurred in 8% (18). The stability of psychogenic psychosis on recurrence of functional psychosis was 49% expressed in relation to all subsequent cases of functional psychosis. The over-all prognosis for the psychogenic/reactive psychosis is thus good as regards subsequent mental disease. Chronic functional psychosis (schizophrenia) developed in only 10% (and in less than 20% if the prognosis is assessed on the basis of the reliability of the diagnosis at the time of the first admission (about 60%)). However, in the group of psychogenic/reactive psychoses as a whole an overmortality of 100% was observed in the course of the 14 years, highest in the younger age groups.

Adult↗
PubMed1982

Prognosis in nickel allergy and hand eczema.

63 female patients with nickel allergy and hand eczema were reinvestigated 6 years after the primary investigation. 30% of the patients were healed. Patients with the pompholyx-type eczema had the worst prognosis. The start of hand eczema was not correlated to any particular occupation. There was a strong correlation between a history of metal sensitivity and a positive patch test reaction. High frequencies of personal and family atopy were found, and atopy made the prognosis worse. Determination of serum IgE was not found to be of any use in predicting the prognosis in patients with nickel allergy and hand eczema.

Cobalt↗
PubMed1996

Prognosis of occupational hand dermatitis in metalworkers.

Hand dermatitis is common in workers employed in the cutting and grinding of metals. Previous studies have given conflicting results on the prognosis of this common occupational disease. This study was designed to determine the prognosis of hand dermatitis in metalworkers and the responsible allergens. A questionnaire survey was conducted on 64 patients seen between 1 and 5 years previously in the contact dermatitis clinic. Of the 51 patients responding, 82% still had hand dermatitis. There was no difference in outcome between those who continued to work with metals and oils, and those who had changed their occupation. Hand dermatitis in metalworkers carries a poor prognosis, with most workers remaining symptomatic even if they no longer had occupational exposure to metals or oils. This study also demonstrates that biocides are the most important allergen group in the aetiology of hand dermatitis in metalworkers.

Adult↗
PubMed2004

Type of treatment, prognosis, and estimation of time spent to manage dental trauma in late presentation cases at a dental teaching hospital: a longitudinal and retrospective study.

Traumatic dental injuries are emergencies that must be treated promptly and properly in order to reduce the suffering, costs, and time for patients, parents, and health care providers. The aim of this study was to investigate the treatment, long-term prognosis, and number of visits needed to manage cases resulting from complications of late presentation of traumatic dental injuries. The sample consisted of 195 children, all presented with complications of dental trauma at the Pediatric Dentistry Clinics in the Dental Teaching Hospital of Jordan University of Science and Technology in Irbid city, Jordan. Retrospective data relied on trauma forms as well the clinical notes and radiographs in the patients' records. Prospective data was collected by examining patients at recall appointments. The treatment of traumatized teeth in this sample ranged from no active treatment to extraction and prosthetic replacement. It was estimated that the number of visits needed to carry out the planned treatment for these patients ranged between 3 and 17.2 visits according to the type of treatment. Apexification procedure was the most time consuming. Thirty-two per cent of teeth with apexification ended up with root fracture mainly subsequent to another minor trauma episode (in 85%), the rest were reported to be spontaneous fractures. Almost half of the teeth with luxation injuries became necrotic after 3 years. Teeth with avulsion actually kept on deteriorating even at the 36-month follow-up appointment. The long-term prognosis of teeth with middle root fracture was favorable in (80%) of the teeth in the sample, despite the fact that they were splinted late. Luxation injuries led to more necrotic teeth (50%) than uncomplicated crown fractures. Multiple dental trauma episodes (MDTE) were reported in about 30% of the patients in the sample and were responsible for some of the complications noticed in this report. As all cases followed up in this report are late presentation of dental trauma, the findings may emphasize and highlight predictors for healing and favorable long-term prognosis for such injuries. This will help selecting the treatment option that would lead to better outcomes with less expense and less time consumption for dentists and patients alike. The findings of this report also stress the importance of prevention of dental trauma and minimize its complications through proper treatment, educational programs, supervision of children during play, use of mouth guards, and orthodontic treatment of proclined incisors.

Child↗
PubMed1995

Diagnosis and prognosis of chronic hepatitis and cirrhosis in dogs.

The purpose of this investigation was to evaluate the significance of enzymatic and biochemical analyses in the classification of chronic inflammatory liver disease and to evaluate the prognosis of these diseases. Chronic hepatitis and cirrhosis were diagnosed by histopathological examination in 79 dogs. Decreased appetite and lethargy were the most common owner complaints (46/79). Vomiting and, or, diarrhoea were reported in 27/79 dogs. Ascites was the most common clinical sign (43/79), whereas icterus was a more unusual finding demonstrated in 16/79 dogs. Liver cirrhosis was diagnosed most frequently, in 33/79 dogs, followed by chronic progressive hepatitis (22/79), chronic cholangiohepatitis (13/79), and chronic non-specific hepatitis (11/79). Hypoalbuminaemia was the most consistent biochemical aberration in liver cirrhosis (25/26) and in chronic progressive hepatitis (13/18). These diseases also showed normal to mildly increased concentrations of serum alanine aminotransferase (ALT) and serum gamma-glutamyl transferase (GGT) and a moderate to marked increase of serum alkaline phosphatase (ALP) and fasting serum bile acid (SBA) concentrations. As expected, icterus and markedly elevated ALT, ALP, GGT and SBA levels were demonstrated in chronic cholangiohepatitis. In this disease hypoalbuminaemia was shown in 6/12 dogs, whereas in dogs with chronic non-specific hepatitis, mean SBA and albumin concentrations were normal. In liver cirrhosis the prognosis was poor, with 94 per cent of the dogs dead within one week of established diagnosis. For dogs with the other types of chronic hepatitis the prognosis was more favourable with the mean survival time ranging from 21.1 to 36.4 months.

Alanine Transaminase↗
PubMed1996

Influence of ovariectomy at the time of mastectomy on the prognosis for canine malignant mammary tumours.

The two-year prognosis for malignant mammary tumours seen in 175 bitches in the Tokyo metropolitan area was assessed based on the extent of mastectomy and on whether an ovariectomy was carried out at the time of mastectomy. The prognosis for the bitches was not influenced by the excision size of the affected mammary glands. Ovariectomy had no effect on the two-year survival rate of the dogs that underwent the tumour excision. There was no significant difference in the two-year survival rate between the dogs ovariectomised prior to mastectomy and those ovariectomised at the time of mastectomy. These results suggest that ovariectomy at the time of mastectomy has no effect on the prognosis in dogs with established neoplasms of the mammary gland.

Animals↗
PubMed1996

The prognosis of oral mucosal squamous cell carcinomas: a comparison of clinical and histopathological grading and of laminin and type IV collagen staining.

Changes in the distribution of basement membrane components have been described in dysplastic lesions and in oral mucosal squamous cell carcinomas (OMSCC). The purpose of this study was to determine if these changes were related to pathological grade and if so, whether this had prognostic implications. Fifty formalin-fixed, paraffin-embedded specimens of OMSCC, with five or more years clinical follow-up, were studied using an immunoperoxidase technique for the detection of the basement membrane components, laminin and type IV collagen. The immunoreactivity of each component was evaluated and semiquantitatively scored as minimal, moderate or extensive and the results compared with the tumour size, node involvement and metastasis (TNM) clinical staging system and histopathological features. OMSCC were characterized by minimal or moderate staining with small islands of neoplastic cells frequently lacking staining for laminin and type IV collagen. Deposition of these components decreased with increased histopathological grade and absence of staining was more commonly associated with a poor prognosis. In particular the pattern of type IV collagen staining frequently differed from laminin staining. Neither of these parameters offered an advantage over TNM clinical staging with regard to prognosis. It was concluded that variations in laminin and type IV collagen immunoreactivity occurred in OMSCC and that high histopathological grade tumours with considerably diminished staining with anti-laminin and anti-type IV collagen carried a poor prognosis.

Basement Membrane↗
PubMed1991

Assessment of the breeding prognosis of mares using paired endometrial biopsy techniques.

Paired endometrial biopsy samples were taken from 530 subfertile mares, before and after treatment (where indicated) and a period of sexual rest. Prognoses were made after each biopsy (Categories 1A-4A before treatment and Categories 1B-4B after treatment), using histopathological criteria similar to those described by Kenney and Doig (1986). Eighty-seven per cent of the mares were assigned to first biopsy prognosis Category 3A. The second biopsy prognosis produced a more even population distribution (10, 47, 40 and 3 per cent respectively for Category 1B, 2B, 3B and 4B mares). First biopsy Category 3A and 4A mares produced mean foaling rates of 51 and 40 per cent respectively. None of the 14 second biopsy Category 4B mares delivered a live foal (12 were barren, one aborted and one suffered early foetal death). This study supports the hypothesis that a breeding prognosis assigned on the basis of two endometrial biopsy samples, taken before and after specific uterine treatment, where indicated, which takes into consideration the mare's ability to respond to treatment, is likely to be more accurate than one assigned after a single biopsy sample.

Animals↗
PubMed1997

[Analysis of prognosis of bronchopulmonary infectious disease with lung cancer].

Bronchopulmonary infection affects the prognosis of lung cancer patients. Thus, we investigated the relationship between the prognosis of bronchopulmonary infectious diseases and their causative bacteria isolated by transtracheal aspiration (TTA) in lung cancer patients. In the present study, we determined which factor is more predisposing for the outcome of bronchopulmonary infections, the type of causative bacteria or the host nutritional status. A total of 107 lung cancer patients, which consisted of 105 males and 5 females (mean age 67.3 +/- 8.0), were included in this study. The study was conducted from 1981 to 1994. They were classified into the survival group and the deceased group. Causative agents of infection were compared between these 2 groups. S. pneumoniae, alpha-Streptococcus sp., M. catarrhalis, and Neisseria sp. were predominant in organisms isolated from TTA-specimens of lung cancer patients with bronchopulmonary infections, regardless of prognosis. Nutritional status, as determined by serum levels of cholinesterase, albumin, and cholesterol, was poor in the deceased group than in the survival group. These results indicate that the outcome of bronchopulmonary infections in lung cancer patients are affected mainly by the nutritional status of the host.

Aged↗
PubMed1977

Prognosis of babies with neonatal hepatitis.

105 babies with neonatal hepatitis were studied carefully and followed for up to 11 1/2 years. Ascertainment was complete for those with severe and persistent jaundice, but less complete for mild or anicteric cases. Prognosis was found to be poor (40% death or cirrhosis) in babies with perisitently acholic stools, but relatively good (less than 15% death or cirrhosis) in those with jaundice which was less persistent and less obstructive. The presence of second diseases (including alpha1-antitrypsin deficiency or a family history of other affected children) seemed to play a part in determining poor prognosis. A distinctive group of babies (22 cases) presented with acute fulminant illness (with or without jaundice) in the neonatal period. Cytomegalovirus infection carried a relatively good prognosis. Guidelines for selection of patients for therapeutic trials are suggested.

Child↗
PubMed1988

Prognosis of partial epilepsy.

The prognosis of partial epilepsy in childhood (excluding cases of benign partial epilepsy) was studied; the average follow up period was 7.4 years. Improvement rate of seizure status was 82.3%. We studied favourable prognostic factors and found that those most often associated with seizure improvement were familial convulsions and idiopathic forms, no generalised seizures before partial onset, low frequency of seizures after 12 months of treatment, short duration of epilepsy, and no background activity abnormalities on electroencephalography. We also observed such factors as mental retardation, neurological abnormalities, and behaviour and cognitive disorders. Factors that determined the prognosis for social adjustment were similar to those for seizure improvement. We discuss the favourable prognosis of partial seizures in childhood and the predictive factors.

Adolescent↗
PubMed2000

Idiopathic pulmonary fibrosis in infants: good prognosis with conservative management.

BACKGROUND: Pulmonary interstitial fibrosis in children is a disease of unknown aetiology, usually associated with a poor prognosis. METHODS: In this case series we describe 11 children presenting over a 10 year period, managed conservatively and associated with a good prognosis. RESULTS: In six, symptoms were present from birth and 10 had symptoms at or before 3 months. Diagnosis was made using chest computed tomography and percutaneous lung biopsy. All patients were treated with oral prednisolone. In five no steroid response was noted. One patient responded to hydroxychloroquine. Home oxygen was required in five patients. At follow up all patients are alive at a median age of 6 years (range 1 to 12 years). The two recently diagnosed children have significant symptoms, seven have dyspnoea on exercise, and two are symptom free. CONCLUSION: The good prognosis seen in these patients is different to previous case reports, indicating a greater than 50% mortality.

Anti-Inflammatory Agents↗
PubMed1997

Long-term prognosis of reactive salmonella arthritis.

OBJECTIVES: Reactive joint complications triggered by salmonella gastroenteritis are increasingly reported, but the outcome and long term prognosis of the patients is incompletely known. This study looked at the prognosis of salmonella arthritis in patients hospitalised in 1970-1986. METHODS: Hospital records from two hospitals in southern Finland were screened for patients with the discharge diagnosis of salmonellosis or reactive, postinfectious arthritis or Reiter's disease. For the patients with confirmed diagnosis of reactive salmonella arthritis, data about the acute disease were collected from the hospital records. A follow up study was performed. RESULTS: There were 63 patients (28 women, 35 men, mean age 36.5 years) with salmonella arthritis. Urethritis occurred in 27%, eye inflammation in 13%, and low back pain in 44% of the patients. HLA-B27 was present in 88%. More men than women were HLA-B27 positive. HLA-B27 positive patients had higher erythrocyte sedimentation rate (mean 80.9 v 46.5 mm 1st h, p = 0.0180). Also, extra-articular features and radiological sacroiliitis were seen only in HLA-B27 positive patients. A follow up study was performed on 50 patients mean 11.0 (range 5-22 years) later. Twenty patients had recovered completely. Ten patients had mild joint symptoms, 11 patients had had a new acute transient arthritis, and five acute iritis. Eight patients had developed chronic spondyloarthropathy. Radiological sacroiliitis was seen in six of 44 patients, more frequently in male than in female patients (32% v 0%; p = 0.0289). Recurrent or chronic arthritis, iritis or radiological sacroiliitis developed only in HLA-B27 positive patients. CONCLUSION: Joint symptoms are common after reactive salmonella arthritis. HLA-B27 contributes to the severity of acute disease and to the late prognosis.

Acute Disease↗
PubMed1977

Photoreceptor differentiation in retinoblastomas and its significance in prognosis.

Fleurette is an expression of photoreceptor differentiation and its presence is said to indicate a good prognosis. Twenty-four eyes from 22 cases of retinoblastoma sent to the Mitrani Foundation laboratory between the years 1964 and 1976 were reviewed histologically and clinically. The presence of differentiation in the tumour was not always associated with a good prognosis. The most important prognostic factor seemed to be the length of time the tumour is allowed to remain in the eye. The longer it remains the more undifferentiated the tumour cells become and the greater the probability that it will spread into the choroid and the optic nerve and out of the eye through the sclera and metastasise throughout the body. The presence of gliosis seems to improve the prognosis.

Cell Differentiation↗
PubMed1979

Retinoblastoma: correlation of invasion of the optic nerve and choroid with prognosis and metastases.

The histological sections of 74 retinoblastoma patients were reviewed. The extent of optic nerve invasion was correlated with choroidal/scleral extension. Choroidal invasion carries 100% survival provided that the sclera, iris, and whole optic nerve are not also involved. Invasion of the optic nerve beyond the lamina cribrosa also carries 100% survival provided that the resection line is free and that invasion does not involve the sclera or iris. Plentiful rosettes were usually found in those tumours that had not extended beyond the choroid or as far as the resection line of the optic nerve and were therefore associated with a good prognosis. The absence of rosettes did not necessarily indicate a poor prognosis. The site of metastases was related to optic nerve and scleral/extrascleral extension. The various systems of staging retinoblastoma are compared, and a new system is proposed to cover the whole spectrum of the disease and to offer a reliable guide to prognosis and treatment.

Choroid↗
PubMed1986

Reasons for poor prognosis in British patients with cutaneous malignant melanoma.

One hundred and twenty five patients presenting in the west of Scotland with primary cutaneous malignant melanoma answered a detailed questionnaire to establish whether there was any evidence of inappropriate delay in receiving surgical treatment for a new or changing pigmented lesion. The survey was carried out because of the relatively high proportion of patients in Scotland with melanoma presenting with primary lesions categorised as "thick, poor prognosis" and the poor five year survival figures as compared with many other countries. Of the 125 patients questioned, only 20 (16%) had received appropriate surgical treatment within three months of becoming aware of a suspicious cutaneous pigmented lesion; 63 (50%) had received surgical treatment three to 12 months after first noticing such a change, and in 42 cases (34%) this interval was over one year. In 102 of 105 patients in whom the interval exceeded three months the patient alone was responsible for the delay; in only three cases was the family doctor partially at fault. No evidence of delay by the hospital service was identified. Because of these findings a public education campaign was launched in the west of Scotland in June 1985 with the aim of improving recognition of early malignant melanoma. In the next six months the proportion of patients in the west of Scotland with primary melanomas categorised as "thin, good prognosis" had risen from 38% to 62%, and the proportion with tumours categorised as "thick, poor prognosis" had fallen from 34% to 15%.

Adult↗