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At least 1,369 records · Page 76Linked to original sources
PubMed1994

[Late sequelae of deep venous thrombosis: a 13-year follow-up of 223 patients].

To investigate late sequelae of deep vein thrombosis, 223 consecutive patients, 148 men, 75 women, aged 61.5 +/- 14.7 years, with phlebographically documented unilateral deep vein thrombosis were reexamined 13 years after the acute event. 29 had an isolated calf vein thrombosis, 45 a 2-level- (calf an popliteal), 72 a 3-level- (calf, popliteal and femoral), 62 a 4-level- (calf, popliteal, femoral and pelvic) thrombosis and 15 had a special location, for example an isolated popliteal or pelvic involvement. In the acute stage all patients were given full dose heparin followed by a six month period of oral anticoagulation. 144 were initially treated by thrombolytic treatment with streptokinase. Control phlebography 5-14 days after the onset of the treatment revealed no clearance in a so called negative group of 123 patients, aged 63.5 +/- 14.9 years, namely the 79 "only" anticoagulated and 44 unsuccessfully thrombolysed. In this negative group natural course of deep vein thrombosis can be studied. The positive group, comprising 100 patients, aged 59.4 +/- 13.9 years (25 with complete and 75 with partial lysis, after streptokinase), is compared with the negative group. The global incidence of postthrombotic syndrome in the natural course, 13 years after deep vein thrombosis, was 39%, 9.8% with and 29.2% without ulcer. Slight changes were noted in 25% and no change in 36%. The incidence of postthrombotic syndrome was correlated with the extent of the original thrombosis: 3.7% after isolated calf vein thrombosis vs. 55.2% after 4-level thrombosis. Moreover, the mortality after deep vein thrombosis and the frequency of recurrence in the interval and of venous symptoms were also correlated to the extent of the thrombosis. The incidence of post phlebitic syndrome in the positive group is significantly lower in patients with 3- and 4-level thrombosis (p = 0.01). Patients with complete and partial lysis also have less venous symptoms (for 3- and 4-level thrombosis p < 0.0001). Thus, the successful thrombolysis seems to be beneficial in long terms for patients with extended thrombosis. Therefore, in our hospital thrombolytic treatment is offered as an additional treatment to anticoagulation to patients with recent, less than 7 days old, 3- and 4-level-thrombosis without contraindications.

Adult↗
PubMed1994

[Intrathoracic goiter. Diagnostic aspects, surgical complications and permanent sequelae].

During the course of 1151 thyroidectomies performed during an 11-year period, 195 patients were found to have intrathoracic goitre. Centre experience of operating this disease and the usefulness of applied diagnostic methods are analysed. The sensitivity of physical examination (palpation), technetium scintigraphy and chest roentgenogram is respectively 52%, 33% and 65%, while specificity is respectively 99%, 98% and 95%. These three methods together ensure the diagnosis in 82% of the patients. Positive predictive values are respectively 95%, 78%, and 72%, while negative predictive values are found to be 91%, 89%, and 93%. Frequency of permanent unilateral vocal cord paresis is 2.5%, no cases of bilateral recurrent nerve damage occurred. The frequency of unilateral vocal cord paresis is found to be 1.4%, if nerves of risk are considered. The incidence of hypocalcemia requiring permanent treatment reaches 2%. Intrathoracic goitre can be treated surgically with an only slightly elevated risk for surgical complications and permanent sequelae, especially when performed in the elective phase and within the frame of centre facilities. Intrathoracic components can nearly always (97%) be reached through cervical incision.

Adult↗
PubMed1994

Infections requiring hospital readmission following face lift surgery: incidence, treatment, and sequelae.

This retrospective study evaluates 11 infections requiring hospital readmission following 6166 consecutive face lifts (0.18 percent). Seven patients had surgical drainage of an abscess, and four patients were treated for severe cellulitis, Staphylococcus was the predominant organism in all abscess cultures. Of three patients admitted 3 weeks after surgery, two cultured gram-negative organisms in addition to Staphylococcus. This suggests that all patients should be treated initially with Staphylococcus coverage. If a patient is readmitted more than 1 week postoperatively, gram-negative coverage should be considered, pending culture results. There was no consistent finding regarding past medical history, the use of perioperative antibiotics, surgical equipment used, complexity of the surgical dissection, drains, or hematoma formation. No patients demonstrated systemic signs or grossly abnormal laboratory results on readmission. Eight patients had no sequelae from the infection. Three patients developed scarring that was considered minor by the affected patients. These data support the conclusion that major infections following a face lift are rare occurrences. Standard medical and surgical care, given in a timely fashion, usually results in a satisfactory outcome with minimal morbidity.

Abscess↗
PubMed1994

Sequelae after esophageal variceal ligation and sclerotherapy: a prospective randomized study.

OBJECTIVES: Esophageal variceal ligation is a new approach to the treatment of esophageal varices that does not result in transmural tissue injury and inflammation, and therefore might produce fewer sequelae and symptoms than sclerotherapy. We conducted a prospective, randomized comparison of sclerotherapy with ligation to study the relative short-term risks of these two procedures with respect to bacteremia, pulmonary and coagulation function, esophageal motility, and gastroesophageal reflux. METHODS: Patients with previously documented high grade esophageal varices were randomized to receive sclerotherapy or ligation. Blood was drawn for culture and coagulation profiles, and patients underwent pulmonary function tests, esophageal manometry, and intraesophageal pH monitoring before and after treatment. RESULTS: Six patients with Childs class B cirrhosis and one patient with pre-sinusoidal portal hypertension underwent 20 courses of therapy. Neither sclerotherapy nor ligation produced significant clinical changes in pulmonary or coagulation parameters, or bacteremia requiring treatment. The majority of ligation treatments were without worsening of motility or reflux scores, and none were associated with symptoms. Sclerotherapy was followed by significantly greater esophageal dysmotility and worsening reflux patterns. CONCLUSIONS: Patient acceptance of ligation was much greater than that for sclerotherapy. Our data define the advantages of ligation over sclerotherapy.

Bacteremia↗
PubMed1993

[Effect of photosensitized oxidation auto-hemotherapy with buyang huanwu tang on sequela of apoplexy].

An effective therapy in treating sequela of apoplexy (SA) was reported, 115 patients were divided semi-randomly into three groups: group T for treatment, both group A and B for control. Patients in group T received Photosensitized Oxidation Auto-Hemotherapy (POAH) with Buyang Huanwu Tang therapy, group A received POAH only, while in group B, conventional treatment were conducted. Clinical data were collected based on pre- and post-treatment qualified procedures according to "The Advice For Clinical Study on Apoplexy", complemented by hemorheologic findings and examination of nail fold microcirculation. The results showed that there was significant difference between group T and group A or B (P < 0.05), among them, the effective rate in group T was 78.5%. Differences in hemorheology findings and examination of nail fold microcirculation were similar (P < 0.01).

Adult↗
PubMed1993

[Partial tracheal rupture in a newborn infant. A rare traumatic birth complication or intubation sequela?].

The neonate was born with the help of vacuum extraction because of difficult delivery of the shoulders. After birth respiratory distress developed and endotracheal intubation and artificial ventilation became necessary. When the tube was changed in the intensive care unit the infant's clinical status suddenly deteriorated. A rupture of the trachea was diagnosed immediately followed by surgery. The child survived without neurological sequelae. The chronological sequence of symptoms after birth suggests that the rupture of the trachea primarily developed during delivery and was secondarily enlarged by repeated endotracheal intubation.

Asphyxia Neonatorum↗
PubMed1993

Adult sequelae of childhood abuse presenting as environmental illness.

Sixty-three patients with polysomatic complaints attributed to sensitivity to environmental chemicals had detailed clinical assessments and diagnostic psychologic evaluations. Objective medical parameters failed to substantiate their beliefs that multiple chemicals were the cause of their problems. A group of 64 patients with chronic medical conditions and defined psychologic disorders not attributed to chemical exposure served as controls. Approximately half the patients in each group underwent long-term psychotherapy, and in these patients, the prevalence of physical and sexual childhood abuse was significantly higher (P < .05) among the cohort of women who attributed their symptoms to environmental or chemically related illness. These data suggest that somatization may reflect sequelae of childhood abuse and may play an important role in the illness experienced by women who believe they are sensitive to environmental chemicals.

Adolescent↗
PubMed1993

[Forum on tissue expansion. Breast reconstruction by expansion in a young woman with sequelae of thoracic amniotic disease. Apropos of a case].

Amniotic disease or congenital skin sulci disease is a clinical entity covering a broad spectrum of malformations, usually involving the limbs, skull and face. This malformation is exceptional in the thorax. The authors report the case of a 22 year old woman with sequelae of thoracic amniotic disease, consisting of unilateral mammary aplasia, atrophy of the pectoralis major and latissimus dorsi muscles and deformity of the homolateral thoracic skeleton. They describe the breast reconstruction performed by tissue expansion in this patient.

Adult↗
PubMed1993

Long-term psychological sequelae of augmentation mammoplasty.

A request for elective surgery for augmentation mammoplasty (AM) is often associated with underlying psychopathology and high expectations of a positive psychological outcome. This study was designed to ascertain the long-term psychological sequelae of AM in a group of patients who were reassessed 3 years or more after surgery. The postoperative study cohort of 20 patients constituted 67% of the original sample that was psychologically assessed pre-operatively. The results show that the majority of patients benefited psychologically from the AM and had experienced an improvement in psychosexual functioning and a reduction of high pre-operative levels of negative body image, anxiety and depression. Although not all expectations had been met and basic personalities remained unchanged, most women had no regrets and would recommend AM to other women in similar circumstances. They had not, however, seriously considered the possibility of unsatisfactory postoperative outcome. The value of close liaison between mental health specialists and plastic surgeons is emphasised.

Adult↗
PubMed1993

[Follow-up and prognosis of neurologic sequelae of pelvic ring fractures with involvement of the sacrum and/or the iliosacral joint].

The extent of neurological lesions following an injury of the pelvic ring is often not initially recognized, as interest is then focused on the treatment of the pelvic ring fracture. Once the fracture has healed, the patient suffers from the sequelae of the neurological injury. Our series of 323 pelvic ring injuries includes 161 sacral fractures and 12 complete disruptions of the sacroiliac joint. Twenty-three patients sustained an injury of the lumbosacral plexus, and 20 patients were examined retrospectively. The different parts of the lumbosacral plexus showed variable recovery potential. An important or complete recovery was noted in 8 of 9 patients suffering from a motor deficit of the lumbar plexus, the obturator nerve, the superior gluteal nerve or the inferior gluteal nerve. Four out of 8 patients with a motor deficit of the sacral plexus had an important or complete improvement. In contrast to these results was the poor recovery of lesions of the lumbosacral trunk. Eight out of 11 patients showed no or only minor recovery, although the pelvic ring was stabilized by operative means in 9 patients. In 2 patients the lumbosacral trunk was directly decompressed by a dorsal approach. In both cases the recovery was complete. In 6 patients the sphincter function was damaged. Recovery was dependent on the localization of the sacral fracture. If the fracture traversed the sacral canal, no neurological improvement was noted.

Adult↗
PubMed1977

Reye's syndrome: relapses and neurological sequelae.

Twenty-two children aged 2 months to 11 years were seen at our institution from January 1970 to March 1975 with clinical, laboratory, and/or histological features consistent with the diagnosis of Reye's syndrome. There were three pairs of siblings. Severity of the illness ranged from relatively benign to rapidly fatal forms. Five received live attenuated vaccines within the three weeks prior to admission. Four relapsed 1 to 21 months after the initial episode, and in one there were multiple recurrences. Six developed major neurological sequelae. All patients graded levels IV and V by EEGs on admission subsequently died in contrast to none from grades 1 and 2. Peritoneal dialysis was carried out in the more severely affected patients. The procedure did not influence final outcome as predicted by the first EEG and is thought to be of limited value.

Alanine Transaminase↗
PubMed1993

Pathologic features associated with decreased longevity of mutant sphha/sphha mice with chronic hemolytic anemia: similarities to sequelae of sickle cell anemia in humans.

A colony of sphha/sphha mice with congenital hemolytic anemia and an abnormality in erythrocyte spectrin assembly was screened to determine the cause of premature death. Sphha/sphha mice have decreased life span, with 50% of animals dying by 6 months of age. The phenotype of these mutant mice includes moderate anemia (hematocrit: 21 to 28%), reticulocytosis, leukocytosis, lymphocytosis, extensive extramedullary hematopoiesis in spleen and liver, lymph node hyperplasia and membranoproliferative glomerulonephritis. With increased surveillance of this mouse colony, 20 clinically sick anemic mice were evaluated (complete blood counts and cultures of blood), euthanized and necropsied. Compared with anemic mice without clinical signs of disease, sick anemic mice had significantly higher white blood cell counts with only 4 (20%) of 20 animals being severely anemic (hematocrit: 4 to 8%). Blood from 11 (45%) of 20 animals was culture-positive for Pasteurella pneumotropica, Enterococcus, and/or Escherichia coli. In addition to the usual lesions in sphha/sphha mice, sick anemic mice had pneumonitis (95%) with thrombosis and infarction (80%) of one or more organs (spleen, myocardium, pancreas, liver, or bone marrow). The thrombotic tendency that accompanies the chronic hemolytic anemia in sphha/sphha mice, as well as the other clinicopathologic changes in these mutant mice, bears a striking resemblance to some poorly understood sequelae in human patients with sickle cell anemia. This mouse model may be useful in studying the pathophysiology of complications associated with sickle cell anemia in humans.

Anemia, Hemolytic↗
PubMed1993

[Relationship between limitation of daily life and prognosis in patients with sequelae of tuberculosis treated with long-term oxygen therapy].

The sequelae of tuberculosis (TBC) sometimes causes severe restrictive lung disorders. In Japan, lung tuberculosis was pandemic up to the 1950s, with TBC being a major underlying disease of chronic respiratory failure and cor pulmonale. Until the end of 1991, we encountered 95 cases of Home Oxygen Therapy (HOT) in Ogaki area, 30 of which were patients with TBC. To clarify factors affecting the prognosis of these patients, we examined background factors, directing special attention to daily activities. In this study, 10 inactive patients (Group A) whose daily activity was limited to indoors and 10 control patients (Group B) whose age, vital capacity and arterial PO2 were equal to inactive patients, from the 30 TBC cases were used. A comparison was made of the prognoses. Among the patients, activity was closely related to dyspnea grade and arterial PCO2. Group A patients showed more marked dyspnea and lower arterial PCO2 than those of group B patients. Percentage home stay and cumulative survival rates of Group A patients (percentage home stay, 59.2 +/- 38.7% and 3 year survival, 26.3%) were significantly less than those of Group B patients (91.0 +/- 16.4% and 87.5%, p < 0.05, respectively). Among chronic pulmonary emphysema patients treated with HOT, no significant relation between activity and prognosis could be found, when factors of age, arterial PO2 and forced expiratory volume in 1 sec were excluded. There would thus appear to be a close relation between activity and prognosis in TBC patients specific for underlying disease.

Activities of Daily Living↗
PubMed1993

[Ilizarov method used for the sequela of growth cartilage lesions].

Ilizarov distraction osteogenesis is a good way to correct sequelae of growth plate injury after completion of the growth. There is often both limb length discrepancy and angular deformation in varus, valgus, flexum, and recurvatum after surgery or trauma in childhood. Such deformations of the distal femoral growth plate, both proximal and distal tibial and distal radial will be presented, treated by a one-step Ilizarov method.

Adolescent↗
PubMed1993

Electrographic seizures in preterm and full-term neonates: clinical correlates, associated brain lesions, and risk for neurologic sequelae.

Electrographically confirmed seizures in preterm and term neonates were compared with respect to clinical correlates, incidence, associated brain lesions, and risk for neurologic sequelae. Over a 4-year period, 92 neonates from a neonatal intensive care unit population of 4020 admissions at a large obstetric hospital with 40,845 livebirths had electrographically confirmed seizures. Sixty-two neonates were preterm and 30 were full-term for gestational age. Chi-square calculations were used to compare the two groups. While the incidence of seizures for all neonates admitted to a neonatal intensive care unit was 2.3%, outborn neonates were more likely to have seizures than inborn neonates. Preterm neonates of < or = 30 weeks gestational age had a seizure frequency of 3.9%, which was significantly higher than that of older preterm neonates and full-term neonates. Clinical criteria contemporaneous with electrographic seizures were noted in only 28 (45%) of 62 preterm, and 16 (53%) of 30 full-term neonates. Subtle seizures coincident with electrographically confirmed seizures were the most predominant clinical type for both term and preterm neonates (71% and 68%, respectively). The distribution of clonic, myoclonic, and tonic seizures was also similar for both groups. Autonomic signs coincident with electrographically confirmed seizures (ie, blood pressure, heart rate, oxygenation, respiration changes) were more frequently observed in preterm than full-term neonates with subtle seizures; 7 (37%) of 19 compared with 1 (6%) of 16. Electrical seizures without clinical correlates were noted more frequently than electroclinical seizures for both populations.(ABSTRACT TRUNCATED AT 250 WORDS)

Anticonvulsants↗
PubMed1993

[Long-term clinical course of sequelae in patients with neonatal anoxic encephalopathy resulting in profound mental retardation and motor disturbance].

A long-term observation has been made in 58 patients (30 males and 28 females) with severe sequelae of neonatal anoxic encephalopathy. They aged from 8 months to 65 years. All of them had motor disturbances and profound mental retardation. Motor function was improved in 4 patients with aging. In contrast, motor activity deteriorated in 11 cases, of which 4 showed a mental regression. Among them, patients who had originally better motor ability than sitting were likely to deteriorate by uncontrollable epilepsy and/or excessive administration of anticonvulsants. Regression of the patients with worse motor ability like bedridden appeared to attributable hypertonia of muscles and bodily deformation. Fifteen cases showed an exacerbation of general condition which originated predominantly to respiratory distress. Twelve patients died including 6 exacerbated cases. Exacerbation or death may have occurred frequently in specific periods of infancy, adolescence and youth with the patients who showed very low motor function such as bedridden and no locomotion.

Adolescent↗
PubMed1993

[Heart arrest in outpatients resuscitated without neurologic sequelae].

BACKGROUND: Around 65% of the deaths by acute myocardial infarction are presented in the first hour of the attack when most patients are outside a hospital and it is almost always caused by ventricular fibrillation. Home defibrillation permits these patients to be saved if an integral emergency system is available. METHODS: The cases of ambulatory cardiac arrest resuscitated with no residual neurologic lesions in the province of Ciudad Real were reviewed. The hospital possesses an integral emergency department with an area of communication with one sole emergency telephone (006) and 7 mobile intensive care medical units. RESULTS: Five male patients with a mean age of 54 years were ambulatory defibrillated (4 at home and 1 at work) following cardiac arrest by ventricular fibrillation of acute myocardial infarction (4 inferior localization and 1 anterior). All the patients called for angina, except one for cardiorespiratory arrest. The mean time of delay between the call for help and the arrival of the doctor was 8.4 +/- 6.3 minutes; ventricular fibrillation was witnessed by a doctor in all the cases except for one. Ventricular fibrillation was recurrent in three patients and all required more than one defibrillation. Two patients required mechanical ventilation and vasoactive drugs due to cardiac failure. The complications secondary to resuscitation manoevers are commented upon but the absence of neurologic sequelae is of note. All the patients were discharged and returned to work with the exception of one patient who died due to rupture of the posteromedian muscle of the mitral valve. CONCLUSIONS: Cardiac arrest by ventricular fibrillation in the acute myocardial infarction may be successfully treated out of the hospital with an integral emergency system.

Ambulatory Care↗