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PubMedDate not supplied

[Somatic sequelae induced by radiotherapy in bone segments in adults].

The authors, on the basis of reports found in literature and of a personal series, discuss the radiological aspects, the differential diagnosis, the main factors that lead to bone sequelae, and the possible contributory causes and complications. The radiological aspects is characterized by the association of sclerotic and atrophic changes, with a prevalence of the latter in the involvement of the mandible and the cranial bones. Among the main factors there are the radiation dose and its chronological distribution. In fact, the higher the values of the nominal standard dose (NSD), the higher the incidence of such alterations and the more difficult to carry out the efficacy of their treatment. These alterations are found almost exclusively after treatment with administration, in terms of NSD, of more than 1352 rets. Among the contributory causes there are all the factors that may change the physiological condition of the bony tissue. The most common complications are fractures and septic osteitis, the last particularly frequent in the mandible. These alterations and mainly fractures may be solved even spontaneously, even if rather late, so that conservative treatments are indicated. After osteitis it is usually possible to avoid pseudoarthrosis. In cases irradiated with higher doses, osteotomy is often necessary sometime followed by poor results.

Femur↗
PubMed1986

Late sequelae following laparoscopic sterilization employing electrocoagulation and tubal ring techniques: a comparative study.

Data on 211 consecutive laparoscopic sterilized women were compared. Half the patients were sterilized using unipolar electrocoagulation and the rest had tubal rings. The period of observation was 21-50 months, median 36.5 months. Four failures were observed, median 15 months after the operation. Pregnancy rates were 0.32 per 100 woman years using electrocoagulation and 1.02 using tubal rings. A total of 11% had experienced low abdominal pain and 4% dyspareunia. Menstrual pattern changes were reported by 31% in the electrocoagulation group and 43% in the tubal ring group. The rates of late sequelae were statistically significant independent of the technique employed.

Dyspareunia↗
PubMedDate not supplied

Neuropsychological sequelae after head injury with mesencephalic coma in childhood.

Eleven children aging between 4 years 11 months and 12 years 6 months were examined periodically over five years following closed head injury with mesencephalic coma (Plum and Posner's definition). It was found that although transient sequelae (neurological and cognitive) on coma resolution were severe, long-term recovery was generally good. The subjects had drug, neurological and psychological treatment during the 2-5-years period and showed apparently better recovery than reported in literature for trauma in adults. This suggests that the mildly controversial "age" variable is highly important in long-term prognosis of impairments following head injury. Further studies will be necessary; with the systematic use of the same standardised testing procedures in all studies, we suggest to obviate the problems in collation arising from discrepancies in methodological, neurological and psychological techniques.

Age Factors↗
PubMed1985

Propofol in emulsion form: induction characteristics and venous sequelae.

Propofol in a 1% emulsion was used to induce anaesthesia in 20 female patients premedicated with diazepam (10 mg). A dose of 2.5 mg kg-1 produced a rapid loss of consciousness and only minor excitatory effects. Discomfort during the injection was not severe. Cardiovascular changes included a fall in blood pressure similar to that which occurs with other induction agents, and a decrease in pulse rate. Apnoea occurred after each induction and in some patients (13) was prolonged (greater than 60 s). There were no venous sequelae, and patient acceptance was high. Propofol given in an emulsion to induce anaesthesia merits further study.

Adult↗
PubMed1985

[Ocular sequelae and sicca syndrome following Lyell's syndrome].

The mucous lesions are customary in toxic epidermal necrolysis. The acute ocular lesions have led to definitive sequelae. 22 out of 32 patients surviving to a Lyell's syndrome lend themselves to an ophthalmological supervision. 13 of these 22 patients (59 p. 100) presented a sicca syndrome with a decrease of the lacrimal secretion (12 cases) and/or salivary secretion (8 cases). The sicca syndrome appeared sometimes from the beginning of the acute phase of the Lyell's syndrome or more often a few weeks later. This decrease of the lacrimal flux went along with objective corneal lesions among 11 patients, and 6 of them had a change of the visual function. A biopsy of the accessory salivary glands was performed on 7 of these patients having a reduction of the salivary flux. 5 of these 7 biopsies showed lymphocytic infiltrates giving in 2 cases a nodular aspect, grade III of Chisholm's classification, held to be pathognomonic of Sjögren syndrome. The 13 patients having presented a sicca syndrome differed from the other 9 patients (without sicca syndrome) by a higher severity of their Lyell's syndrome and by a higher age. None of our patients with dry syndrome had antinuclear antibody detected by immunofluorescence on sections of rat's livers. Sicca syndromes with sometimes lymphocytic infiltrate similar to those of Sjögren's syndrome were occasionally imputed to drug reactions. The occurrence of "Sjögren like's syndrome" after a toxic epidermal necrolysis suggests the intervening of autoimmune phenomena in the pathogenesis of this toxic epidermal necrolysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1985

[Radiographic diagnosis in the early recognition and evaluation of incapacitating sequelae of advanced rheumatoid arthritis].

Two observed cases of rheumatoid arthritis, one at an initial, the other at a very advanced stage, form the basis for a detailed report on the radiographic signs of the disease. Particular emphasis is placed on the possibilities offered by the various radiographic techniques for the evaluation of the sequelae of rheumatoid arthritis and for the early diagnosis of the disease.

Arthritis↗
PubMed1985

[Outcome of children operated on for congenital cardiopathy before 2 years of age. Foreseeable sequelae at adulthood].

A brief description is presented of the long-term follow-up of four commonly encountered cardiopathies undergoing early surgical correction. Sequelae are not increased and probably even less frequent when compared to children undergoing surgery after two years of age. It is still too early, however, to establish whether or not certain manifestations, such as rhythm or conduction disturbances and ventricular dysfunction will develop at a later date. The prognosis of coarctation of the aorta depends to a great extent on other associated lesions which can become serious over time and require additional surgical procedures. In the past, early surgery for large ventricular septal defects was poorly tolerated, but now the prognosis is particularly favorable. Persistent hemodynamic abnormalities such as stenoses of the pulmonary outflow tract can worsen the prognosis in tetralogy of Fallot. In addition, it is especially important to recognize subsequent ventricular dysrhythmias due to their potentially serious nature. The most common procedures for transposition of the great arteries consist of auricular transposition of the venous returns which may later cause rhythm disturbances or venous stenoses. The long-term functional capacity of the right ventricle as a pump for the systemic circulation is not known. A general outline of follow-up care is presented.

Adult↗
PubMed1985

[Evolution and radiologic sequelae of pulmonary tuberculosis].

During the treatment of pulmonary tuberculosis, the radiologist is often asked the following questions: 1) is it really TB?; 2) is there any improvement?; 3) when is the X-ray check-up required?. In our opinion, the radiologist is in a position: 1) to confirm the diagnosis of TB; 2) to give a radiological diagnosis of "abnormality" but without a prognostic opinion; 3) to suggest, case by case, when the X-ray check-up is required. After some month or years, when radiological-clinical sequelae are present, the radiologist is often asked equally difficult questions: 1) is it still TB?; 2) is it still active?; 3) could it have caused the hemoptysis?. Again, in our opinion, the radiologist must bear in mind: 1) the not infrequent possibility of reinfections; 2) that the fine, smooth contour of the cavity, whose shape remains unchanged, does not necessarily signify absence of activity; 3) that, at the present time, other illnesses (bronchitis, bronchiectasis, lung cancer) are more frequently the cause of hemoptysis.

Adult↗
PubMed1985

[Diagnosis of esophageal wall perforation and its sequelae].

Based on the symptoms of oesophageal wall perforation and its sequelae the significance of immediate examination and clinical observation are emphasised. This disease is difficult to diagnose by modern technology in the early stages. Advice is given on the main diagnostic symptoms and the appropriate sequence of examination.

Diagnosis, Differential↗
PubMed1985

Surgical sequelae of abnormal eustachian tube function.

Mechanical, neural, and immunologic factors controlling eustachian tube function are discussed in detail. Relationships of normal tubal function to the development of otitis media with effusion and its pathologic sequelae are reviewed.

Chemoreceptor Cells↗
PubMed1985

[Changes in bone conduction in the surgery of chronic otitis and its sequelae (evaluation of 800 operations)].

The authors undertook a study of changes in bone conduction (BC) during 800 operations carried out over a 5 years period (1979-1984) for chronic otitis or sequelae of chronic otitis. After elimination of ears with deafness (47) and cases unsuitable for evaluation (39), they finally included 714 records in the study. Only comparison of free and post-operative BC was made and using 4 conversational frequencies, not taking into account a deviation of 5 DB for each of these 4 frequencies. The study involved 317 myringoplasties: In 271 (i.e. 85,5%) there was no change in BC. Amongst them, 37 patients nevertheless showed a transient fall in BC. Of particular importance is the fact that almost 1/3 (11 to be exact) recovered only during the 2nd semester following surgery, a period which was even exceeded in the other 5 cases. 46 (i.e. 14.5%) were classified as "permanent" falls in BC. Amongst these in only 17 (i.e. 5%) were there "only" the three standard aggression factors for the I.O.: aspiration--scraping--manipulation of the tympano-ossicular system, without it being possible to attribute a predominant role to one more than the other. With regard to reaming of the E.A.M., those cases in which this could be considered responsible appeared to be infinitesimal. Furthermore, there was no statistically significant difference (reduced deviation test--"chi"2 test) between the number of falls in BC seen following myringoplasty with or without reaming. 83 tympanoplasties by Piston-Malleus, study of which led to the same conclusions as for myringoplasties. 118 masto-atticotomies, including 23 with posterior tympanotomy. Despite peri-labyrinthine and peri-ossicular scraping, results were essentially identical. 196 evacuation cavities (227-31 deafness) of which somewhat less than half only (46%) were ears undergoing surgery for the first time. Percentage of unchanged BC was here much more unfavourable, with 49 "permanent" falls in BC, i.e. 25%, of which, it must be said, 5 were minimal falls, and with, in 25 cases, a follow-up of less than 3 months.

Bone Conduction↗
PubMed1978

[Resections of the left ventricle in the surgical treatment of parietal sequelae of myocardial infarct].

Resection of left ventricular tissue seems to be playing an increasing part in the treatment of the sequelae of myocardial infarction. In a total of 700 patients who underwent surgery for some aspect of coronary atherosclerosis, 40 underwent resection of left ventricular tissue. In the majority of cases, diagnosis rested on left ventricular cine-angiography and in 3 cases this had to be carried out as an urgent procedure with circulatory assistance using diastolic counter-pressure (DCP) from an intra-aortic balloon. A selective contrast technique for the two coronary arteries was used whenever possible. The surgical anatomy of the lesions indicates a difference between a localised dyskinesia and diffuse dyskinesia, the latter having a severe effect on left ventricular function. In a group of localised dyskinesias, the territory supplied by the anterior descending artery was by far the most frequently affected. Resection of left ventricular tissue was associated with a myocardial bypass revascularisation procedure in 9 cases, valve repair in 7 cases, and closure of a septal perforation in 3 cases. The total inpatient mortality rate is still quite high (23.1%) because of the severity and widespread nature of the coronary disease. However, the mid-and long-term results are good, the criteria being functional improvement and the actuarial 4-year survival rate.

Adult↗
PubMed1979

[Late sequelae of tuberculous meningitis].

The paper contains a clinico-morphological description of a case with late sequelae of treated tubercular meningitis. The patient at 7 years of age had tuberculous meningitis which was treated by suboccipital and endolumbar administration of streptomycin. Following 12 years, epileptical seizures ensued with an eventual gradual weakness in the extremities leading to profound spastic tetraparesis. During the last years of life contractures and stem symptoms developed. The morphological picture was characterized by posttuberculous fibrous leptomeningitis with an extensive internal hydrocephalus, universal sclerosis of the cerebral and spinal vessels, disseminated demyelinization in the spinal cord and brain, a distinct improverishment of the grey matter by ganglionic cells. The result of liquorohemodynamical disorders was a syringolike cavity in the spinal cord. Under the ependima of the laral ventricle calcified cholesteatomas were found, which are considered as complications of suboccipital punctures in administering streptomycin.

Adult↗
PubMed1979

[Effect of small doses of alcohol on emotional stress in patients with late sequelae of cranio-cerebral injuries].

An experimental study of individuals with late sequelae of closed cerebrocranial trauma, demonstrated that diverse signs of CNS activity to a different extent may be under the influence of small doses of alcohol. For instance, the sensorial process does not change significantly, which may indicate a relative independence of specific sensorial pathways (including the cortical area) from small doses of alcohol. Changes in cortical electro-activity and the threshold of the orientation reflex, the mechanisms of which are connected with the function of the brain stem reticular formation, points to an inhibitory action of alcohol on it. Against the background of alcoholic influence the socially significant emotionally negative stimula intensify emotional stress, the action of which is related to the activity of the limbic system structures and a weakening of the function of associative cortical fields. The results of this study permit to assume that different functional-structural mechanisms may lie at the basis of an emotional background (mood) and emotional stress.

Adult↗
PubMed1979

[Unusual sequelae of a cranial injury].

A 13 year old child who had an apparently mild head injury presented with psychiatric sequelae. The main feature was a variable level of consciousness. The only explanation for the symptoms lay within the family environment. A hysterical converion symptom was possible but the start of a psychosis could not be excluded.

Adolescent↗
PubMed1968

Some problems concerning psychiatric sequelae in brain-injured children.

The report concerns 100 children (64 boys, 36 girls, 2-15 years old) with psychiatric disorders due to mechanical injuries of the brain. The symptoms occurred for the most part within 1-3 years after the injury. They were: encephalopathy (35 cases), characteropathy (5), neurosis (16), epilepsy (44). Epilepsy was the most important posttraumatic problem, particularly the focal form of epilepsy. There was conformity between focal changes in the EEG curves and the clinical character of seizures. The age of the child at the moment of the injury, the gravity of the injury, and previous organic disorders caused by abnormal delivery seem to be the main factors determinant of the severity of the psychiatric sequelae of a trauma. Mechanical trauma seems to activate former latent lesions of the brain due to abnormal delivery.

Brain Concussion↗
PubMed1968

[Psychologic sequelae of early childhood brain damage in puberty and adolescence].

In the authors opinion a multidimensional attitude is the most expedient in analyzing the late sequelae of early childhood cerebral damage. In agreement with published views, she believes that no direct correlations can be traced between early childhood cerebral impairment and psychic changes presenting in adolescence. She ascribes the causes of this to the differences in heredobiologic factors; the differences in the time of the onset of nervous lesions, in their quality, and in the localization of the affected structures; the great variety of environmental influences.

Adolescent↗