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At least 1,405 records · Page 78Linked to original sources
PubMed1996

Neurologic sequelae in high risk infants--a three year follow up.

OBJECTIVE: To determine the neurologic sequelae in high risk infants. DESIGN: A three year longitudinal follow up. SETTING: Inborn and outborn infants discharged from the Neonatal Special Care Unit (NSCU) of a referral hospital. METHODS: High risk infants were identified for follow up using predetermined risk criteria. A detailed neurodevelopmental examination was done 3 monthly in the first year and 6 monthly subsequently. The Amiel-Tison Method, Bayley Scales of Infant Development and Raval's Scale for social maturity were used. EEG was done in children with seizures. Hearing and ophthalmic assessments were done at 6 months. RESULTS: Three hundred and thirty six high risk infants and 70 normal control infants came for regular follow up. Out of these, 16 (4.8%) had cerebral palsy and 11 had associated mental retardation. Six other children had mental retardation without motor problems. None of the children in the control group had any neurological problems. Sensorineural hearing loss was present in 5 (1.5%) children while 1 subject had corfical blindness. Three children with cerebral palsy had infantile myoclonus, nine had generalized seizures and one child had a focal seizure. The incidence of seizure disorders was 3.9%. CONCLUSIONS: The incidence of major handicap in our study was low. Many of the risk factors which caused adverse outcome, could have been prevented by good antenatal and perinatal care.

Child Development↗
PubMedDate not supplied

[Alkaline blood serum proteins in patients with the initial manifestations of cerebral arteriosclerosis and the late sequelae of mild closed craniocerebral trauma (comparative data)].

Alkaline proteins play their pathogenetic part in the course of cerebral atherosclerosis the development of which is accompanied by decline in their content. It has been ascertained that in patients with early cerebral atherosclerosis and remote sequelae of mild closed craniocerebral injury (RS MCCCI) the content of alkaline proteins is below the established norm. The absence of significant differences between the patients presenting with early manifestation of cerebral circulatory insufficiency and those with RS MCCCI may suggest similarity of mechanisms of development of vascular disorders of traumatic and atherosclerotic genesis.

Adult↗
PubMed1977

[Forms and method of rehabilitation therapy and social-occupational rehabilitation of patients with the sequelae of cerebrovascular diseases].

The authors give some data on restitutional therapy of 516 patients (400 with sequelae following strokes and 116 with transient disorders of cerebral circulation). Treatment of the first group was made in a neurological ward, the second--in a cardiological sanatorium. The programme of restitutional therapy provided the use of psychosocial and biological methods, an appeal to the personality and stage-by-stage accomplishment of rehabilitative measures. Comprehensive restitutional therapy included psychotherapy, medical-activizing regimes, medical gymnastics, massage, occupational therapy, medicinal therapy, etc. The authors elaborated differentiated complexes of rehabilitative treatment for patients with spastic hemiparesis, normal or decreased tone, as well as for patients with transient disorders of cerebral circulation in conditions of a cardiological sanatorium. The indices of effectiveness were the following: an improvement of the condition in patients after brain strokes--97.8%, in patients with transient disorders of cerebral circulation--94%.

Cerebrovascular Disorders↗
PubMed1996

Liver transplantation for hepatitis B cirrhosis: clinical sequela of passive immunization.

UNLABELLED: Aggressive administration of hepatitis B immune globulin (HBIg) has been shown to prevent hepatitis B viral (HBV) infection of the allograft; however, the clinical sequela of such therapy has not been previously described. We reviewed our experience with high dose, intravenous infusion of an intramuscular HBIg preparation to assess the effectiveness and complications of such therapy. Thirty three orthotopic liver transplants (OLTx) were performed in 32 patients with chronic HBV cirrhosis at the University of Virginia between March 1990 and June 1995. Twenty-nine of 32 (91%) patients remain free of HBV recurrence (defined by undetectable serum HBsAg and HBV-DNA) after a mean of 21 months (2-54 months), with one patient requiring retransplantation. Three (10%) patients died of non-HBV causes (two vascular events, one infectious event). Twenty episodes of acute cellular rejection were treated in 18 patients (two had two episodes). Sixteen rejections occurred within 18 d of transplant, 19 by day 120, and one late rejection occurred at 18 months owing to medication non-compliance. Eighteen patients had at least one documented infection. Six patients were treated for CMV infection (five empirically). Eight patients were treated for HSV infections (seven mild herpetic labialis and one herpetic keratitis). Four patients had documented fungal infection (one mucormycosis pneumonia and three minor superficial mucosal infections). With the exception of one necrotizing pneumonia, 11 bacterial infections were successfully treated with conventional antimicrobial agents. No patient developed post-transplant lymphoproliferative disorder. Symptoms associated with HBIg infusion were intermittent but frequent and consisted of myalgias, predominantly back pain (90%), headache (20%) and flushing (5%). No patient experienced anaphylaxis, fever, rash, arthritis or hypotension. Despite the potential for mercury toxicity and HCV transmission in the HBIg formulations currently available in the United States, serum mercury levels remained below standards for industrial exposure (60 micrograms/ml), and only one individual developed post-transplant HCV infection after receiving multiple units of unscreened blood prior to 1991. SUMMARY: High-dose HBIg prevented HBV infection of the allograft in 29 of 32 patients transplanted for HBV cirrhosis with three non-HBV associated deaths. The intravenous infusion of HBIg was frequently associated with minor side effects that were safely tolerated by patients. The risk of HCV transmission and mercury toxicity are minimal, but support the need for a new intravenous formulation of HBIg. HBIg therapy successfully decreased post-OLTx HBV recurrence with no clinical events associated with immunosuppression. Patients did non experience allergic or infusion-related complications that altered or terminated therapy. Manufacturing modifications of HBIg may allow for improved patient tolerance and decreased risks.

Adult↗
PubMed1996

[Minor head injuries in sport. Occurrence, management, sequelae and prevention].

Approximately 10% of all head injuries are caused during sport and about 10% of all sport-related injuries are head injuries. Most of these are minor head injuries. Many sports involve risk of repeated head injury. The classic punch-drunk syndrome in boxers reflects severe chronic traumatic encephalopathy. Recent research shows that repeated head injury can entail encephalopathy also in other types of athletes. They may experience symptoms such as headache, dizziness, irritability, memory deficit and concentration deficit. Neuropsychological testing reveals such cognitive deficits as impaired memory and attention, and reduced speed of information processing. Persistent sequelae can be prevented by correct management in the acute stage, appropriate follow-up, and prevention of repeated head injuries.

Athletic Injuries↗
PubMed1997

Long-term pulmonary sequelae after treatment of childhood Hodgkin's disease.

BACKGROUND: Pulmonary sequelae have been reported in patients treated for Hodgkin's disease (HD). Few data are available about patients treated for childhood HD followed over several years. PATIENTS AND METHODS: In a cross-sectional study carried out for 76 months (median time) after treatment completion, we evaluated the lung function abnormalities and respiratory symptoms in 27 patients (16 males and 11 females) with HD diagnosed between 1983 and 1994 (median age at diagnosis 11 years, range 2-16 years). They had been treated with chemotherapy and radiotherapy according to current protocol AIEOP-MH 83 (n = 14) or AIEOP-MH 89 (n = 13). At the time of the study, 26 patients were in first complete remission and one in second remission. Of the 27 patients, 19 had had mediastinal irradiation at a dose of 20 Gy (n = 5) or 20.8-44 Gy (n = 14). Forced vital capacity (FVC), functional residual capacity (FRC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio, and maximal expiratory flow at 25% of FVC were registered; diffusion capacity for carbon monoxide (DLCO) was determined. Data were expressed as standard deviation (SD) score. Four patterns of respiratory function abnormalities were defined: restrictive, obstructive, isolated bronchiolar impairment, isolated diffusing impairment. RESULTS: Twelve patients (44%) were asymptomatic and showed completely normal pulmonary function tests. Three patients reported dyspnea on exertion, and one of them also cough and phelgm: out of these symptomatic subjects, only 1 had functional abnormality (isolated DLCO impairment). A restrictive pattern was found in 5 patients (18%), including 2 who also had a pathological DLCO SD score. Eight additional patients (30%) had isolated diffusing impairment. Oxygen saturation was normal in all patients. Forty-seven percent of patients with normal DLCO had had lower dose irradiation (20 Gy) compared to 10% of patients with impaired DLCO (P = 0.054). Similarly, patients with normal DLCO had had significantly less chemotherapy as compared to patients with abnormal DLCO (P = 0.003). Occurrence of lung abnormalities was not significantly associated with sex, age at treatment, mediastinal irradiation, and time elapsed from treatment completion. CONCLUSION: Adolescents and young adults treated for childhood HD are at risk for lung function abnormalities, significantly more frequent in patients who received more intense treatment, as mediastinal irradiation at a higher dose (> 20 Gy) and more chemotherapy blocks. Long-term follow-up should be offered to these patients because of their possible limited potential for pulmonary function and possible lesser resistance to adverse agents such as smoke, pollution, infections and aging.

Adolescent↗
PubMed1996

Incidence and outcome of neurological sequelae in survivors of cerebral malaria.

This hospital based study was carried out on 185 adult patients of cerebral malaria. Out of 185 patients, 62 (33.5%) died and 123 (66.5%) survived. Neurological sequelae were present in 13 (10.5%) of 123 survivors at the time of discharge (i.e. 10-15 days after recovery from coma) from the hospital. These were in form of psychosis in 5 patients (4%), cerebellar ataxia in 4 patients (3.2%), extrapyramidal rigidity in 2 patients (1.62%) and hemiplegia in 2 patients (1.62%).

Adult↗
PubMed1997

[Late sequelae of comprehensive antineoplastic therapy in children and adolescents with solid extracranial tumors. Effect on growth, pubertal development and gonadal function].

BACKGROUND: Modern treatment of oncological diseases increases markedly the chance of long-term survival and permanent recovery. Due to frequently highly aggressive treatment it is however associated with the risk of late sequelae in the surviving patients. Comprehensive care of patients includes therefore not only control of the neoplastic disease but also efforts of maximal improvement of the quality of life of the patients. In young subjects, in view of their long-term perspective, this problem is particularly important. METHODS AND RESULTS: In 32 patients (25 boys and 7 girls) with extracranial solid tumours without primary endocrinological symptomatology (m. Hodgkin, neuroblastoma, ganglioneuroblastoma, nephroblastoma, Ewings sarcoma and others) a single examination was made assessing height, body weight, grade of sexual maturation according to Tanner, in boys testicular volume by means of a orchidometer and 20 other anthropometric dimensions. The mean age at the time of examination was 16.5 +/- 4.1 years, the mean age at the onset of treatment 6.1 +/- 4.8 years. The patients height, -0.4 +/- 0.9 SD, differs from the Czech national standard (p = 0.025). Impaired growth was recorded in 12.5% patients and had heterogenous causes. The authors proved a negative effect of radiotherapy on the growth of the spine, most markedly in children subjected to irradiation of the abdomen and chest and a highly significant reduction of the testicular volume in boys after cytostatic treatment of m. Hodgkin. CONCLUSIONS: The results are consistent with studies made abroad and indicate the necessity of comprehensive long-term follow-up of somatic growth and development of the gonads in oncological child patients.

Adolescent↗
PubMed1997

[Cortical status marmoratus in a patient with a sequela of postnatal anoxic encephalopathy].

Status marmoratus (ST) of the basal ganglia and thalamus has been observed in cases of perinatal hypoxic ischemic encephalopathy and rarely of postnatal encephalopathy. In occasional cases, the cerebral cortex is also involved. Here, we reported a 22-year-old male with a sequela of postnatal anoxic encephalopathy. He had been bedridden with severe mental retardation since he suffered anoxic encephalopathy at 3 months of age. ST was found in the cerebral cortex as well as basal ganglia and thalamus. In addition to ST, the cerebral cortex and white matter were remarkably devastated. We also performed a preliminary immunohistochemical study to investigate the process of ST formation, using antibodies against glial fibrillary acidic protein (GFAP), myelin basic protein (MBP) and synaptophysin. MBP-positive abnormal myelinated fibers were identified in the ST areas, which were not colocalized with GFAP-immunopositivity. Synaptophysin was positive in the areas of ST, which were not stained with Holzer method. These results suggest that the myelination in the early infancy damage of basal ganglia and cerebral cortex could be implicated in the formation of ST.

Adult↗
PubMedDate not supplied

[One decade after Chernobyl: sequelae of the accident and urgent problems of radiation pathology].

Medico-biological sequelae of irradiation of humans as a result of the Chernobyl accident are considered. Acute radiation sickness, thyroid carcinoma in children, chromosomal aberrations in the peripheral blood lymphocytes have an etiological link with radiation. Three problems are important for future studies: 1) collection of reliable information about the radiation, 2) assessment of dose-effect relations, 3) organization of supervision.

Child↗
PubMed1997

Post polio syndrome. The late sequelae of poliomyelitis.

Patients who in earlier life suffered from acute poliomyelitis are reporting new and disabling symptoms that have been variously labelled the 'late sequelae' or 'post polio syndrome'. Systematic review of such patients has identified specific categories of disability. A practical investigation and management plan for such patients presenting to a general practitioner is proposed.

Australia↗
PubMedDate not supplied

Comparison of postanesthetic sequelae after clinical use of 27-gauge cutting and noncutting spinal needles.

BACKGROUND AND OBJECTIVES: The tips of the bevels of thin spinal needles may be easily damaged by bony contact during puncture attempts. In this respect and also because they are less traumatic by design, noncutting, pencil-point-tip needles may be beneficial. A prospective clinical comparison of postanesthetic effects of the use of 27G Quincke-type and pencil-point spinal needles was therefore performed. METHODS: The study included 400 spinal anesthesia patients, in 200 of whom the initial needle was a 27-gauge Quincke type, a 27-gauge pencil-point needle being used in the other 200. Altogether, 464 needles had to be used; in 30 cases the pencil-point needle was replaced by a 27- or 25-gauge Quincke-type needle. A block performance form was filled in, and the patients were interviewed personally on the first postoperative day and by means of a mailed questionnaire on the 14th day. RESULTS: The tips of the Quincke-type needles were distorted in a blunt, bent or hooked manner in 13% of the initial and 14% of the final needles. The severity of the damage was related to the count category of bony contacts during puncture (0, 1-4, or 5 or more). The occurrence of postdural puncture headache was not, however, related either to damage of the needles or to the number of puncture attempts. Diffuse (not posture-dependent) headache occurred more often after the use of the Quincke-type needle than after use of the pencil-point needles, the tips of which remained intact in each case. CONCLUSION: Postanesthetic sequelae, including postdural puncture headache (overall incidence 2.5%), were not related to the shape of the spinal needles or to the damage of the Quincke-type needles.

Adult↗
PubMedDate not supplied

Radiotherapy and oral sequelae: preventive and management protocols.

The purpose of this paper is to provide background information on radiotherapy, and to present dental hygiene protocols for the treatment of head and neck radiation patients. These patients experience specific oral complications or sequelae that require specialized care. To assist the treating dental hygienist in understanding the genesis of these complications, a brief history of the use of radiotherapy and its effects on mammalian tissue is included. Complications may include mucositis, candidiasis, xerostomia, loss of taste, trismus, severe caries, nutritional deficit, and osteoradionecrosis. Management protocols are presented for the prevention and treatment of these complications. Maximum protocol effectiveness and long-term success may only be attained by education of and communication with the patient. As the number of head and neck radiation patients increases daily, a thorough understanding of the disease and treatment process is becoming more necessary for all oral healthcare providers.

Clinical Protocols↗
PubMed1997

[Closure of anterior oro-nasal communications, sequelae of cleft palate, using a retro-incisal flap].

The persistence of a residual communication between mouth and nose, is an important sequela a after primary closing of cleft palate. This retrospective study reports twenty-one cases of a new technique (retro-incisive flap) used for closing this residual communication. This flap is an easy and reliable method with an 85% success rate, so we recommend it as the first choice in this indication.

Child↗
PubMed1976

Neutrophil and rheumatoid factor-Immunoglobulin G insoluble complex interactions: phagocytosis and sequelae.

Studies utilizing 51CrCl3 labelled human immunoglobulin G have demonstrated a quantitative, time-related increase in the uptake of insoluble rheumatoid factor-immunoglobulin G complexes by human neutrophils. A burst of hexose monophosphate shunt activity occurs when these complexes are phagocytized by neutrophils as evidenced by the increased oxidation of glucose-l-14C to 14CO2. Metabolic and electron micrographic studies suggest that a heat stable serum factor is needed for maximum complex uptake and shunt activity. Phagocytosis of complexes did not affect the adherence of neutrophils to nylon fiber columns, but did not produce selective release of lysosomal enzymes. This study has delineated in an in vitro system, functional and metabolic sequelae of neutrophil phagocytosis of insoluble rheumatoid factor-immunoglobulin G complexes, which may be important components of the inflammation occurring in the joints of patients with rheumatoid arthritis.

Glucuronidase↗
PubMed1998

Volutrauma, PaCO2 levels, and neurodevelopmental sequelae following assisted ventilation.

Today it is essential that we define care practices in neonatology that not only increase survival but also produce optimal pulmonary and neurodevelopmental outcomes for our patients. Assisted ventilatory care continues to be influential at all three levels. In this article, the authors discuss current understanding of the possible mechanisms for pulmonary and neurologic injury, or benefits associated with ventilation at both low and high PaCO2 levels, as well as evidence for neurodevelopmental sequelae with various ventilator strategies.

Barotrauma↗
PubMed1998

[The determination in the blood of the enzyme neuron-specific enolase in children with acute encephalopathies: the prognostic value in neurological sequelae].

OBJECTIVE: The objective of this study was to evaluate if there is a correlation between blood levels of the enzyme neuron-specific enolase in children with non-traumatic acute encephalopathies with severe alterations in consciousness and the neurological sequellae. PATIENTS AND METHODS: Neuron-specific enolase (EC 4.2.1.11) activity in plasma was measured by radioimmunoassay in 9 children aged 7 months to 5 years, who suffered acute encephalopathy and coma of non-traumatic origin. The etiology was acute viral encephalitis (n = 4), near drowning (n = 2), shock (n = 2) and cardiac arrest (n = 1). Blood samples were obtained between 24 and 72 hours after the onset of encephalopathy. The neurological status was evaluated 18 months after the onset of encephalopathy in the 8 surviving patients (1 patient with brain death criteria died in the acute stage). RESULTS: Enzyme activities were significantly higher in the children who showed neurological sequelae (median 68.9 ng/ml, range 35.0-95.6, n = 4) than in those who did not present neurological abnormalities (median 15.8 ng/ml, range 9.7-18.7, n = 5), with p < 0.05. No differences were found between the latter and the control group (median 7.7 ng/ml, range 4.1-12.7, n = 10). CONCLUSIONS: It appears that the presence of elevated neuron-specific enolase in blood is predictive of neurological outcome in children with acute encephalopathies of non-traumatic origin.

Acute Disease↗
PubMed1998

[Serial and multiple tissue expansion in burn sequela].

The authors present the case of a 16 year old female with 3rd degree burn sequelae. They describe the surgical steps during the three years of treatment with serial and multiple tissue expansion. From the 9 tissue expanders used with reference capacities of 3350cc, 10350 were achieved. The conclusions point out the utility of this technique, using re-expansion and supraexpansion as one, should be associated with careful surgical planning and constant rapport with the patient.

Adolescent↗