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PubMed1980

[Late sequelae of preventive radiation and chemotherapy of the cerebral cranium in children with acute leukemia (author's transl)].

In 15 children, combined treatment of the cerebral crane (irradiation + cytostatics) was done for acute leukemia, using Pinkel's or Riehm's method. In order to judge of late sequelae on the brain tissue, the cerebral crane was explored by means of computed tomography, generally more than a year later. Of 15 children 10 revealed slight or important parenchymal alterations being imputable to the former therapy. A possible augmentation of the sensitivity to radiation due to combined chemotherapy is discussed, and a revisal of therapeutic schedules, therefore, is recommended.

Adolescent↗
PubMed1980

[Certain features of the delayed sequelae of craniocerebral injuries and questions involving medico-vocational expertise].

Some vegetovascular parameters were examined in 155 persons with late sequelae of open and closed craniocerebral injuries. A certain pathology pointing to vegetovascular dystonia and poor adaptation of the vessels was revealed, this pathology being especially marked and persistent in persons with closed cerebral injuries. These findings, when taken together with the clinical picture, are of importance for evaluating the victims' working capacity, and can serve as a criterion for placing the victim into this or that disability group, or as indications for rational working engagement.

Adult↗
PubMed1980

Development of adverse sequelae in children born with subclinical congenital Toxoplasma infection.

Most infants born with congenital Toxoplasma infection are asymptomatic in the newborn period, and therefore their infection is not recognized. We performed follow-up evaluations on 24 such children. The mean age of these children at least examination was 8.5 years. In group I (13 children), the diagnosis was made prospectively. In group II (11 children), no symptoms or signs were noted in the newborn period and the diagnosis was made only after the first sign developed. Eighty-five percent of the children in group I and all of the children in group II have developed chorioretinitis. In group I, three children (23%) have unilateral blindness; in group II, three children (27%) and five children (45%) have unilateral and bilateral blindness, respectively. One child (8%) in group I and two children (18%) in group II developed severe, permanent neurologic sequelae after they initially presented with eye disease. Two of the children in each group are now retarded (IQ score range, 36 to 62). Six of the children in group I who were tested sequentially have had lower IQ scores (mean change from 97 to 74) on repeat tests performed an average of 5.5 years later. Less severe neurologic, intellectual, and audiologic deficits were observed in other children in each group. Treatment of some children may have had a beneficial effect on their outcome.

Adolescent↗
PubMed1995

[Clinical aspects and neurologic expert assessment in sequelae of whiplash injury to the cervical spine].

Whiplash injury to the cervical spine and its possible long-term sequelae, the late (or chronic) whiplash syndrome, are analysed based on a clearly defined accident mechanism and an initial battery of investigations to exclude lesions other than those affecting the soft tissue of the neck region (i.e. the consequences of strain and sprain). Predictors are discussed that may point to a delayed and complicated recovery, with development of a complex array of symptoms. The pattern of this symptomatology, as reviewed on the basis of different neuropsychological investigations, appears inhomogeneous. Comparison with other non-traumatic conditions, such as the chronic fatigue syndrome, the fibromyalgia syndrome and chronic daily headache, as well as with chronic disturbances of cervical origin, reveals striking similarities. In cases of litigation, these circumstances require careful assessment of the patient's previous history and an extensive differential diagnosis. Whiplash injury to the cervical spine rarely results in disability and, if so, is only minor.

Cervical Vertebrae↗
PubMedDate not supplied

Anterior tooth trauma in the primary dentition: incidence, classification, treatment methods, and sequelae: a review of the literature.

A review of the literature is presented to discuss anterior tooth trauma in the primary dentition. Studies show that the incidence ranges from 4 percent to 30 percent and varies depending upon the sex and age of the child. Classification of the type of trauma is subdivided into trauma to the tooth and trauma to the periodontium. Treatment modalities depend upon various factors and range from nontreatment to splinting to extraction. Possible sequelae of primary tooth trauma may include tooth discoloration, loss of vitality, root resorption and/or abscess formation. Careful follow-up is recommended following any type of trauma, because the ultimate goal in treatment is to prevent damage to the permanent successor.

Aftercare↗
PubMed1975

Early complications and late sequelae of induced abortion: a review of the literature.

An attempt to evaluate the recent literature on somatic complications of induced abortion shows that a great amount of data of widely varying quality has been collected. Many areas of research are still not covered in a way that permits valid conclusions to be drawn. Two important points emerge from the review: first, there is a need for uniform definitions of complications and some uniformity in the analysis of data collected; secondly, carefully selected control groups are needed in this kind of research. The areas most urgently requiring further study differ from country to country. From a global point of view, the existence or inexistence of significant late sequelae and the influence of the patient's health status on the complication rate seem to be of the highest priority.

Abortion, Induced↗
PubMedDate not supplied

Sepsis syndrome and associated sequelae in patients at high risk for gram-negative sepsis.

We conducted a prospective surveillance study of 80 hospitals across the United States to determine the incidence of sepsis syndrome and its associated sequelae in hospitalized patients over age 18 years who were administered antibiotics for suspected or documented gram-negative infection. A sample of 1754 hospitalized patients were followed from onset of antimicrobial therapy to discharge or death. Mortality rates (MR) varied depending on the suspected source of sepsis syndrome. For patients in whom the syndrome was associated with community-acquired urinary tract infections, mortality was 20% (relative risk [RR] = 0.51, p < 0.05), for those with trauma 20.6% (RR = 0.51, p < 0.05), and patients with nosocomial respiratory tract infections 57.1% (RR = 1.66, p < 0.05). More than two complications occurred in 65.2% of patients under age 60 years (MR 31%), 40.8% of those age 60-80 (MR 42%), and 35.6% of patients older than 80 years (MR 33.3%, p > 0.05). Various patient populations had significant differences in both the incidence of the syndrome and its complications, and consequent mortality. Perhaps morbidity as well as mortality should be used as outcomes when testing the efficacy of innovative therapies for sepsis.

Adolescent↗
PubMed1994

[Lipid metabolism and blood coagulation system function in patients with the late sequelae of closed craniocerebral trauma].

Long-term follow-up of the subjects who have suffered closed brain injury showed that in comparison to matched controls the injured young subjects demonstrated abnormalities in lipid metabolism and coagulation tending to atherosclerosis. The limits of the values by which the patients significantly differed from the controls as well as 7 specific for the patients signs of lipid metabolism and coagulation impairment have been determined. From 1 to 5 specific indications registered in 67 +/- 5% patients allowed the diagnosis in them of the injury sequelae. The mechanisms of the above atherosclerotic shifts may work through neuroregulatory derangements common for brain injury and atherosclerotic encephalopathy and enhancement of atherosclerosis course by the craniocerebral damage.

Blood Coagulation↗
PubMed1994

[Clinical study on the sequelae of cerebral vascular accident treated with temporal-point acupuncture].

One hundred and eight cases of sequelae of cerebro-vascular accident were randomly divided into two groups temporal point group (TG, 58 cases) and body acupuncture group (BG, 50 cases). It was shown that after 30 treatments the therapeutic effects were significantly different statistically (P < 0.01) between the two groups. The effect in TG was better than that in BG. It indicates that the two acupuncture therapies can improve blood rheology in patients. The ameliorative function in TG was better than that in BG.

Acupuncture Points↗
PubMed1995

Dangerous sequelae of epidural anesthesia in geriatrics.

These three cases demonstrate: (1) an epidural hematoma (case three); (2) a probable anterior spinal artery occlusion (case two); and (3) a low cord damage of obscure nature (case one). Three serious neurological sequelae after epidural anesthesia among the operated patients of one physician seems alarming. The three occurred within two years. These are published to direct attention to potential risks from epidural anesthesia in older patients.

Aged↗
PubMed1994

Changes in muscle morphology, strength and enzymes in a 4-5-year follow-up of subjects with poliomyelitis sequelae.

Twenty subjects with polio sequelae were studied on two occasions 4-5 years apart by means of dynamometer measurements of knee-extension and flexion strength and muscle biopsy for histochemical and enzymatic analyses. The subjects were divided into those who reported (unstable, n = 12) and did not report (stable, n = 8) new or increased muscle weakness in the tested leg between the two examinations. Muscle strength decreased significantly in the unstable subjects, but only for knee-flexion in the stable subjects. However, the endurance test comprising 50 consecutive knee-extensions at 180 degrees/sec showed increased fatigability at the second examination only in the stable subjects. Most subjects had markedly increased muscle fiber areas, which in some subjects increased further, but in those already with very extreme hypertrophy the fiber size decreased. Capillarization and activity of citrate-synthase were decreased at the initial examination, but no significant further reduction was observed at the second examination. The results demonstrate individual patterns in the compensatory process for the presumed loss of motor units.

Adult↗
PubMed1994

Psychosocial sequelae of bone marrow transplantation.

Bone marrow transplantation is a particularly arduous treatment and a source of considerable stress for patients and their families. Psychological sequelae include psychological distress, concern about loss of control, physical complications, sexual dysfunction, difficulties in social relationships, occupational disability, and financial consequences. Patient education that can help BMT recipients and their families know what to expect at the different stages of treatment may help alleviate anxiety and fear of the unknown. Communication should be individualized according to the needs of the particular patient and family. The patient's ability to use information should be considered in deciding what to convey to him or her. To be most effective, patient education should take place throughout the BMT process and should be multidisciplinary.

Anxiety↗
PubMed1995

[Does nocturnal hypoxia relate to acute exacerbation of chronic respiratory failure with right heart failure in late sequelae of pulmonary tuberculosis?].

Thirty-eight patients with late sequelae of pulmonary tuberculosis (TB seq.) were studied to clarify whether or not nocturnal oxyhemoglobin desaturation (NOD) could relate to acute exacerbation of chronic respiratory failure (AE). All patients had been untreated with home oxygen therapy, because they were not severely hypoxic. We performed sleep studies, pulmonary function tests and arterial blood gas analysis and investigated past history about AE in each patient. Twelve patients had experienced AE with right heart failure and they were classified as CHF (congestive heart failure) group. The rest was classified as Non-CHF group. These two groups were compared as for each variables examined. There was no difference between the two groups in age, body weight, %VC, FEV1.0%, and awake PaO2. Awake PaCO2 was significantly higher in CHF group. Although no difference was observed in baseline SaO2, the degree of NOD was significantly greater in CHF group when evaluated by lowest SaO2 during sleep and 85% desaturation time (total time spent with SaO2 less than 85%). Moreover, 21 of Non-CHF and 6 of CHF were studied for cardiac parameters using right side cardiac catherization. While the differences of mean pulmonary arterial pressure and cardiac output between the two groups were not significant, pulmonary arteriolar resistance was higher in CHF group. We concluded that NOD in TB seq. had a major role in AE with right heart failure. We speculated that AE might be caused, at least partly, by pulmonary vasopressor response to recurrent NOD.

Acute Disease↗
PubMed1976

Critical sequelae in biliary tract disease.

The high incidence of calculous biliary tract disease accounts for surgical operation upon the biliary tract disease accounts for surgical operation upon the biliary tract being the most frequently performed within the abdomen. Untreated surgically critical sequelae tend to occur with advancing age and duration of the disease. The more common of these are: acute cholecystitis, choledocholithiasis, acute obstructive suppurative cholangitis, biliary enteric fistulas, liver abscess, related pancreatitis, and biliary cirrhosis. The greater the pathological changes in the biliary tract and the more debilitated the individual, the greater is the risk of surgery. However, the risk is even greater without operation.

Acute Disease↗
PubMed1994

Acute renal failure: a sequelae of sepsis.

Acute renal failure in the critically ill patient may have a wide range of clinical presentations and necessitate numerous nursing interventions. This article reviews the etiologies, pathophysiology, and diagnoses related to acute kidney dysfunction with a particular emphasis on sequelae related to sepsis. Additionally, the nursing care for managing patients with acute renal failure with the available renal replacement modalities is discussed.

Acute Kidney Injury↗
PubMed1994

Sequelae of massive fluid resuscitation in trauma patients.

The severely injured trauma patient presents to the critical care unit with multiple physiologic derangements. The sequelae of massive volume infusion necessary to restore tissue oxygenation in hemorrhagic shock include hypothermia, coagulopathies, electrolyte abnormalities, acidosis, and organ dysfunction. Therapeutic interventions are directed toward minimizing and reversing these derangements, rapid restitution of oxygen transport, and tissue oxygen uptake.

Clinical Protocols↗
PubMed1994

Transient worsening of optic neuropathy as a sequela of the Jarisch-Herxheimer reaction in the treatment of Lyme disease.

A 58-year-old woman developed neurologic and neuroophthalmologic manifestations of Lyme disease, including a radiculomyelitis, cranial neuritis and mild right optic neuropathy. Upon treatment with intravenous ceftriaxone a Jarisch-Herxheimer reaction occurred with encephalopathy, mild fever, worsening radiculomyelitis, and deterioration of her visual acuity. Intravenous methylprednisolone was given, and the visual acuity recovered over 72 hours. This case suggests that transient worsening of optic neuropathy can develop as a sequela of the Jarisch-Herxheimer reaction in the treatment of Lyme disease.

Ceftriaxone↗
PubMed1994

[A doctrinaire approach to evaluation of sequelae of craniocerebral injuries].

The consequences of the severe head injuries should be estimated 1-2 years following the injury. The evaluation must be based upon certain postulates which are to be obligatory for the team of experts (neuropsychiatrist, otologist, ophthalmologist, neuro-radiologist, clinical psychologist). They must work simultaneously as a team for it is the only way to establish the precise qualification of the damage in question. The clinical work up to now has shown many weak points. The first postulate is the information on the state of health prior to the injury: previous injuries and their sequelae, psychopathological manifestations, alcohol abuse, disturbances of the consciousness, vertigo, disturbances of the sight and hearing etc. The second postulate is the review of the case history regarding the acute period of the injury: the qualification of the injury, the duration of the state of unconsciousness and post-traumatic amnesia, focal neurological signs, psychological disturbances, EEG, CT etc. The third postulate is a detailed clinical examination including paraclinical parameters neurological examination (focal neurological signs, hemicerebral syndrome and very seldom-parkinsonism) with consultation of otologist (vestibularis, audiogram) and ophthalmologist (visus, fundus, campus, intraocular pressure), EEG (longitudinal follow-up), possible evoked cerebral potentials. The epilepsy syndrome must be based upon clinical and EEG criteria, while the selection must be very strict. In there are structural brain changes the collaboration with the neuroradiologist is important. Psychological disorders: neurasthenic neurosis, personality disorders, and rarely dementia. It should be clinically confirmed accompanied by psychological tests.(ABSTRACT TRUNCATED AT 250 WORDS)

Craniocerebral Trauma↗