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PubMed1993

[The systematics of acute and chronic radiation sequelae].

A classification system in German language is proposed for scoring of acute and chronic treatment sequelae after radiotherapy. It includes all important organs and organ systems. The proposed grading corresponds to the four-scale-system of the WHO and UICC. The system is also compatible to the RTOG and EORTC acute and late radiation morbidity scoring criteria. This facilitates the data transfer for retrospective and prospective analysis of monomodal and multimodal radiotherapy treatment regimens. We recommend to use this scoring system in all German speaking countries for multicentric prospective studies. It is possible, that organ-specific sophistication of the toxicity grading will be developed in the future. These additions should conform with (inter)national standards and apply the same four-scale grading of this classification system.

Acute Disease↗
PubMedDate not supplied

Congenital muscular torticollis: sequela of intrauterine or perinatal compartment syndrome.

The etiology of congenital muscular torticollis remains a mystery despite intensive investigation. Magnetic resonance imaging (MRI) scans of 10 infants with this condition showed signals in the sternocleidomastoid muscle similar to those observed in the forearm and leg after compartment syndrome. Cadaver dissections and injection studies defined the sternocleidomastoid muscle compartment. Injection studies and pressure measurements performed at the time of bipolar release in three patients with congenital muscular torticollis confirmed the existence of this compartment in vivo. Clinical review of 48 children with congenital muscular torticollis showed a relation between birth position and the side affected by the contracture. Because of the association of congenital muscular torticollis with other intrauterine positioning disorders, we postulate that head positioning in utero can selectively injure the sternocleidomastoid muscle, leading to development of a compartment syndrome. Congenital muscular torticollis may represent the sequela of an intrauterine or perinatal compartment syndrome.

Child, Preschool↗
PubMedDate not supplied

Psychological sequelae of surgical reversal or of IVF after tubal ligation.

This study investigates the psychological concomitants and sequelae of surgical reversal (tubal reanastomosis) or of IVF after tubal ligation. We held semi-structured interviews and used the Giessen test and the Strauss-Appelt body image questionnaire. The sample comprised 25 women; a new partner was the leading reason for reversal in 16 cases ('New Partner'), while in 9 cases experiences of loss (of a child or of ideal values) prevailed ('Loss'). The two groups differed in a number of relevant demographic and psychological data. 'New Partner' patients showed a pattern of factors known to be associated with regret of sterilization. 'Loss' women were less satisfied with reversal than 'New Partner' subjects (P < .01). Satisfaction with reversal was independent of an achieved pregnancy. Patients considered surgical reversal to be preferable to IVF because of the "restoration of the mutilation." In the Giessen test, 'New Partner' women were more depressive (P < .05) and more submissive (P < .05) than 'Loss' subjects. Cluster analysis of the whole sample revealed four well distinguishable profiles. 'Loss' patients experienced less insecurity of their body image than both 'New Partner' women and the general female population. We conclude that reversal of sterilization helps to restore body-image and self-esteem, but it may counteract mourning. Consequences for pre-reversal counseling are discussed.

Adult↗
PubMedDate not supplied

Arthroplasty in the sequelae of congenital hip dysplasia.

The authors report their experience in the surgical treatment of the sequelae of congenital hip dysplasia, more specifically, 125 arthroplasties performed in 116 patients, with specific reference to the technical difficulties encountered and the various surgical methods used. This review suggests that prosthetization yields a high percentage of good results (77%) and constant remission of pain. Nonetheless, joint function, particularly when motion was severely compromised before surgery, or when dislocation was very severe (Crowe grades III and IV), is not always restored.

Aged↗
PubMed1993

Long-term psychosocial sequelae of chronic physical disorders in childhood.

OBJECTIVE: This study was designed to examine the long-term psychosocial sequelae of chronic physical disorders that begin during childhood. DESIGN: We analyzed data from a national birth cohort. 12,537 children were followed until age 23 years--76% of all born in Britain during one week in 1958. Of these, 1667 had a chronic disorder before age 16 and 1279 were included in the 23-year follow-up. MEASURES: Outcome measures included self-reported psychological disturbances between ages 16 and 23, scores on the Malaise Inventory, social class, educational qualifications, unemployment, and social activities. RESULTS: The total cumulative incidence rate before 16 years was 109.5 per 1000. Demographic comparisons showed that the group with chronic physical disorders was similar to those free of chronic disorders in all respects except the sex ratio. Men with chronic physical disorders had significantly higher relative risks for abnormal scores on the Malaise Inventory (1.52, confidence interval [CI] 1.13, 2.05); specialist psychological care (1.43, CI 1.00, 2.03); poor educational qualifications (1.26, CI 1.08, 1.47); periods of unemployment (1.20, CI 1.03, 1.41); and less social drinking (1.36, CI 1.15, 1.60). In contrast, women only had a significantly elevated risk for having seen a mental health specialist (1.32, CI 1.02, 1.71). Among the men some of the risks were further elevated for those in specific diagnostic groups. These findings are examined in the light of postulates about the impact of chronic physical disorders as a whole and in an attempt to explain the striking sex differences. For clinicians they provide further reason to justify concern about the psychosocial aspects of care for children with chronic disorders.

Affective Symptoms↗
PubMed1995

Crossed cerebellar atrophy in children: a neurologic sequela of extreme prematurity.

Unilateral atrophy of a cerebellar hemisphere occurring as a sequela of ischemic or destructive injury of the contralateral cerebral hemisphere is uncommon in children. We reviewed our experience with this phenomenon and found an unexpected association with extreme prematurity and a complicated perinatal course with a poor subsequent neurologic outcome. We retrospectively identified eight children, aged 8 months to 13 years, in whom cerebellar atrophy associated with cerebral injury was diagnosed on MR or CT, and reviewed their past medical history, neurologic findings, and neuroimaging studies. Seven patients were born extremely premature, EGA 25-28 weeks, and had severe perinatal intracranial hemorrhage. Neurologic problems include severe developmental delay in seven, spastic paresis in six, and seizures in five. Neuroimaging showed severe unilateral holohemispheric atrophy in four, bilateral asymmetric holohemispheric atrophy in two, and left temporoparietal atrophy in one. Cerebellar atrophy was unilateral in five and bilateral but asymmetric in two. Gliosis of the atrophic cerebellum occurred in one patient. Sequential neuroimaging in one patient showed evolution of crossed cerebellar atrophy at 8 months of age. The final patient, a term infant, had an idiopathic perinatal left cerebral infarct. In our experience, crossed cerebellar atrophy was an uncommon manifestation of extreme prematurity complicated by severe intracranial hemorrhage and/or ischemic necrosis of white matter. The cerebellar atrophy is most often a secondary degenerative phenomenon rather than a result of direct cerebellar injury.

Atrophy↗
PubMed1977

[Functional rehabilitation of the upper extremity in children with sequelae of birth injuries to the brachial plexus using the method of adaptive bioregulation].

The authors report of their experience in the rehabilitation of active functions in the upper extremities of 22 children with sequelae of birth injuries of the shoulder plexi of the Erb type. In order to accelerate the reconstruction of the function of the transplanted trapezius muscle a method of adaptive bioregulations is suggested which permitted to quantify the doses of developed muscular tension and control the movements. The obtained results give ground to positively evaluate this method, based on the principle of external reverse connection in the rehabilitative period following an operation of myolavsanoplastics in children with spquelae of birth injuries of the shoulder joint of the Erb's type.

Biofeedback, Psychology↗
PubMed1996

[Therapeutic effect of "Ueda" method for a case of spastic paraplegia as a sequela of transverse myelitis].

This paper showed the therapeutic effect of the "Ueda" method (UM) for one case with spastic paraplegia as a sequela of transverse myelitis. The effects of UM was dramatic. Two weeks after the beginning of UM, spastic gait improved moderately and inner rotation of lower extremities on supine posture changed to external rotation. Transitionally the fast stretch ROM by the procedure of straight leg raising improved to the level of the normal range four months after the beginning of UM. Although UM was originally designed for cerebral palsy, it was effective for spasticity due to transverse myelitis. Spasticity showed reversible changes depending on UM. Therapists will be able to reduce and control spasticity by means of UM. This result suggests that spasticity treated by UM does not depend on the maturity of central nervous system (CNS) or recovery of the CNS lesion, but is caused by the lesions of the spinal loop.

Child, Preschool↗
PubMed1996

Neuropathological sequelae of traumatic brain injury: relationship to neurochemical and biomechanical mechanisms.

Brain injury is the leading cause of death among individuals under the age of 45 years in the United States and Europe. Recently, the neuropathologic classification of posttraumatic brain damage has provided insight into the specific mechanisms underlying traumatically induced neuronal damage and death. Studies regarding the biomechanics of brain trauma have also provided great insight into the pathophysiologic mechanisms underlying specific patterns of posttraumatic cellular death. Based upon recent clinical evaluations and biomechanical studies, laboratory models of human brain injury have been developed that faithfully reproduce a number of important features of clinical brain trauma. Biomechanical models have been used to study both the acute sequelae of brain injury and the role of neurochemical alterations in contributing to the development of secondary or delayed cellular death and damage. This report reviews and integrates the laboratory investigations linking experimental models of brain injury to clinical diagnosis and treatment.

Animals↗
PubMed1996

Sequelae of ventral rhinotomy in dogs and cats with inflammatory and neoplastic nasal pathology: a retrospective study.

The medical records of 58 patients that had undergone ventral rhinotomies were reviewed to determine the long-term outcome and sequelae of this procedure. The signalment, history, and postoperative survival of these patients were found to be similar to other reports in the literature. The deaths of 2 cats immediately postoperatively were attributed to the use of carotid artery tourniquets. Postoperative complications included 1 oronasal fistula, and a persistent mucopurulent or serous discharge in 76% of the patients that had a primary rhinitis before surgery. Ventral rhinotomy was useful as a diagnostic modality for the removal of foreign material and the curettage of focal lesions, and it may be useful in the palliation of nasal tumors in cats.

Animals↗
PubMed1996

Late psychological sequelae of abortion: questions from a primary care perspective.

Research strongly supports the view that pregnancy termination is seldom associated with adverse psychological sequelae in the short to medium term, but experience shows that there is a small group of women who experience long and intense suffering. This is a report of the cases of two women who presented with psychological problems associated with a termination 19 and 5 years earlier.

Abortion, Induced↗
PubMed1996

[Psychiatric sequelae of craniocerebral trauma--a review of the literature].

In a brief review psychiatric aspects of head-injured patients are discussed. The topic is put into a historical perspective. Examples of recent developments in head-trauma research are given. Differentiation between focal and diffuse brain injury is suggested to be of clinical relevance. Little is known as yet about the neuropsychologic and psychiatric sequelae of diffuse axonal injury to the brain.

Brain Concussion↗
PubMed1996

[Radiologic examination of patients with head injuries. Late sequelae of minor head injuries, a radiological challenge].

We give a brief summary of the use of computerized tomography and magnetic resonance imaging (MRI) in cases of cranial trauma. The authors advocate more extended use of MRI in this connection; even in less severe cases. The method is much more sensitive than computer tomography, and thus provides a sounder basis for diagnosis and treatment in patients suffering from late sequelae of cranial injuries.

Brain Injuries↗
PubMed1996

[Home oxygen therapy (HOT) in patients with pulmonary tuberculosis sequelae--comparison between patients medically treated and those surgically treated].

In Japan there are about 40,000 patients under home oxygen therapy (HOT), of whom about 30 to 40% are pulmonary tuberculosis sequelae (TBS). These patients can be divided into three groups depending on the treatments they had, Group 1: those who had medical treatments only, Group 2: those who had artificial pneumothorax, and Group 3: those who had thoracoplasties or other surgical treatments. The purpose of this study was to observe the distributions and possible differences in the survival rates among these groups. The study included 1537 patients with TBS under HOT followed at National Hospitals and Sanatoriums nationwide in Japan. In 819 patients the treatments were specified and of those 354 were in Group 1, 29 in Group 2, and 436 in Group 3, so that the proportion of surgically treated patients in PTS was estimated between 28.4% (436/ 1537) to 53.2% (436/819). The ages at the onset of tuberculosis, at the start of HOT and the intervals in between were 36.6, 66.2 and 29.8 in Group 1, and 26.8, 65.5, and 38.1 in Group 3 respectively. Though the ages at the start of HOT were the same, those at the onset of tuberculosis were about ten years younger in Group 3 than in Group 1. Comparing Group 1 and 3, the survival rates after the initiation of HOT (Kaplan-Meier method) was better in Group 2 (surgically treated) than in Group 1 (medically treated). It is speculated that the reason could be a better preservation of the function of the remaining lung in the surgically treated and a higher incidence of obstructive impairments in the medically treated patients.

Adolescent↗
PubMed1979

Neurologic sequelae in the survivors of neonatal intraventricular hemorrhage.

We report our experience with the neurologic sequelae (at a mean follow-up of 24 months) among the 15 surviving infants who have had neonatal intraventricular hemorrhage (IVH) documented by computerized tomographic (CT) brain scan. Neurologically six infants (40%) are normal, six infants (40%) mildly impaired, and three infants (20%) moderate to severely impaired. The neurologic outcome correlated to the degree of hemorrhage seen in the CT scans when IVH was classified into four grades. None of the other neonatal factors examined showed significant correlation with the outcome.

Cerebral Hemorrhage↗
PubMed1996

[Frequency of neurological sequelae secondary to head traumas].

Head injuries are a public health problem and any immediate complications related to primary or secondary injury must be detected. However, in view of the physiopathology involved and the functional results of this, it is essential to make a study of the literature on the detection of neurological sequelae secondary to head injury and compare it with the Mexican literature dealing with this subject. The commonest findings are of post-traumatic epilepsy and of unspecified changes in behaviour and learning capacity.

Brain Injuries↗
PubMed1996

[Hypoxic brain damage after carbon monoxide poisoning. Visual agnosia, reduced initiative and memory and delayed sequelae].

Four patients with hypoxic brain damage caused by carbon monoxide poisoning are described. Three of these had attempted suicide with car exhaust fumes. Two patients had visual agnosia due to lesions in the parieto-occipital cortex. Three patients had temporary Parkinsonian symptoms. In two of these patients CT and MRI showed lesions in the globus pallidus. They also showed reduced initiative, and in one patient this was combined with minor tics and obsessive symptoms. One patient had impaired memory as the only symptom. The patient with the longest lasting exposure developed delayed sequelae; three weeks after the poisoning he became apathetic and confused, with failing memory, Parkinsonian symptoms, and urinary and faecal incontinence. MRI showed demyelination in the periventricular white matter. His condition started to improve two months after the accident.

Adult↗