scholarly journals Long-Term Evaluation of the Use of the Transdermal Contraceptive Patch in Adolescents

2004 ◽  
Vol 4 ◽  
pp. 512-516 ◽  
Author(s):  
Stephanie Logsdon ◽  
Jessica Richards ◽  
Hatim A. Omar
Keyword(s):  
Young Women ◽  
Skin Irritation ◽  
Adolescent Medicine ◽  
Outpatient Center ◽  
Term Evaluation ◽  
Complete Detachment ◽  
Lost To Follow Up ◽  
Contraceptive Patch

The transdermal contraceptive patch, Ortho Evra™, was approved in December 2001 and released on the market in June 2002. In this study, we reviewed clinical data of young women who started the patch between June 2002 and December 2003 in the adolescent medicine clinic at a university-based outpatient center. A total of 62 patients started the patch in that period and two of them were lost to follow-up. Mean age of patients was 17.9 years and mean length of use was 10 cycles. Only 10 patients (16.7%) discontinued use. Reasons for discontinuation were moderate to severe skin irritation (3 patients, 5%), complete detachment (3 patients, 5%), and economic reasons (4 patients, 6.7%). Compliance was excellent overall and the side-effects profile was good. No pregnancies occurred during this period. These results confirmed that the transdermal contraceptive patch is easy to use and an effective method of birth control that may be better tolerated by young women. It also seemed to improve contraceptive compliance in this population.

scholarly journals Posterior lumbar interbody fusion with bioabsorbable spacers and local autograft in a series of 27 patients

2004 ◽  
Vol 16 (3) ◽  
pp. 1-6 ◽  
Author(s):  
Daniel E. Couture ◽  
Charles L. Branch
Keyword(s):  
Interbody Fusion ◽  
Surgical Complication ◽  
Posterior Lumbar Interbody Fusion ◽  
Lumbar Interbody Fusion ◽  
Radiographic Evidence ◽  
Pedicle Fixation ◽  
Term Evaluation ◽  
Lost To Follow Up

Object The goal of this prospective study was to review a series of 27 patients who underwent bilateral posterior lumbar interbody fusion with instrumented pedicle fixation and two HYDROSORB (known generically as 70:30 poly[L-lactide-co-D,L-lactide]) rectangular cages packed with locally harvested autograft at a total of 48 levels, and to assess the safety and efficacy of this novel technique. This analysis, conducted at a mean of 26 months of follow up, is the first report of a long-term evaluation of this technique. Fusion rates and clinical outcomes are presented. Methods A prospective clinical and radiographic review of findings in 27 consecutive patients was performed. Fusion rates and clinical outcome were assessed at 6-month intervals up to the 32-month follow-up end point. Two patients with four corresponding fusion levels were lost to follow up. Radiographic evidence of satisfactory fusion was achieved in 42 (95.5%) of 44 levels fused. Satisfactory fusion at all levels was achieved in 23 (92%) of 25 patients. Two patients required repeated operations for treatment of symptomatic pseudarthrosis during the study period. The likelihood of all levels attaining fusion in a given patient decreased as the number of levels treated increased, which is consistent with previously published studies. Nonetheless, fusion rates per treated level were similar for patients in whom one to three levels were treated. No significant surgical complication occurred. Conclusions Posterior lumbar interbody fusion in which the HYDROSORB bioabsorbable implant packed with locally harvested autograft and segmental internal fixation are used appears to be an interbody fusion alternative whose efficacy is comparable with previously reported procedures.

scholarly journals A 16-year prospective cohort study to evaluate effects of long-term fluctuations in obesity indices of prediabetics on the incidence of future diabetes

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Shahla Safari ◽  
Maryam Abdoli ◽  
Masoud Amini ◽  
Ashraf Aminorroaya ◽  
Awat Feizi
Keyword(s):  
High Risk ◽  
Transition Probabilities ◽  
Clinical Settings ◽  
High Tendency ◽  
Mean Values ◽  
Latent Markov Model ◽  
Term Evaluation ◽  
Obesity Indices

AbstractThis study aimed to evaluate the patterns of changes in obesity indices over time in prediabetic subjects and to classify these subjects as either having a low, moderate, and high risk for developing diabetes in the future. This study was conducted among 1228 prediabetics. The patterns of changes in obesity indices based on three measurements including first, mean values during the follow-up period, and last visit from these indices were evaluated by using the latent Markov model (LMM). The mean (standard deviation) age of subjects was 44.0 (6.8) years and 73.6% of them were female. LMM identified three latent states of subjects in terms of change in all anthropometric indices: a low, moderate, and high tendency to progress diabetes with the state sizes (29%, 45%, and 26%), respectively. LMM showed that the probability of transitioning from a low to a moderate tendency to progress diabetes was higher than the other transition probabilities. Based on a long-term evaluation of patterns of changes in obesity indices, our results reemphasized the values of all five obesity indices in clinical settings for identifying high-risk prediabetic subjects for developing diabetes in future and the need for more effective obesity prevention strategies.

Long-Term Evaluation of the Roux-Elmslie-Trillat Procedure for Patellar Instability

2005 ◽  
Vol 33 (8) ◽  
pp. 1220-1223 ◽  
Author(s):  
Joseph R. Carney ◽  
Timothy S. Mologne ◽  
Michael Muldoon ◽  
Jay S. Cox
Keyword(s):  
Confidence Interval ◽  
Case Series ◽  
Level Of Evidence ◽  
Long Term Effect ◽  
Functional Scores ◽  
Study Population ◽  
Term Evaluation ◽  
Subluxation Of The Patella

Background Few published articles exist reporting the long-term evaluation of the Roux-Elmslie-Trillat procedure. Purpose To assess the long-term effect of the Roux-Elmslie-Trillat procedure in preventing recurrent subluxation and dislocation of the patella. Study Design Case series; Level of evidence, 4. Methods Eighteen patients who underwent the Roux-Elmslie-Trillat procedure for dislocation or subluxation of the patella were identified from a group previously evaluated at a mean follow-up of 3 years. The prevalence of recurrent subluxation or dislocation at a mean follow-up of 26 years was compared with the prevalence reported at the mean follow-up of 3 years. Although not the focus of this study, Cox functional scores were obtained from the smaller group and compared with the results at the 3-year follow-up. Results Seven percent (95% confidence interval, 0.00-0.32) of the patients had recurrent subluxation at 26 years compared with 7% (95% confidence interval, 0.03-0.13) of the study population reported at 3 years (P = 1.00). Fifty-four percent (95% confidence interval, 0.27-0.79) rated their affected knee as good or excellent at 26 years compared with 73% (95% confidence interval, 0.64-0.81) of the larger study population reported at 3 years (P = .14). Conclusion The prevalence of recurrent subluxation and dislocation in patients with patellofemoral malalignment who underwent the Roux-Elmslie-Trillat procedure for dislocation or subluxation of the patella is similar at 3 and 26 years after the procedure. The long-term functional status of the affected knee in patients who underwent the Roux-Elmslie-Trillat procedure declined.

Long-Term Evaluation of Ifosfamide-Related Nephrotoxicity in Children

2009 ◽  
Vol 27 (32) ◽  
pp. 5350-5355 ◽  
Author(s):  
Odile Oberlin ◽  
Oumaya Fawaz ◽  
Annie Rey ◽  
Patrick Niaudet ◽  
Vita Ridola ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Renal Toxicity ◽  
Moderate Dose ◽  
Median Dose ◽  
Glomerular Function ◽  
Term Evaluation ◽  
Grade 3 ◽  
Length Of Interval

PurposeIfosfamide is widely used in pediatric oncology but its nephrotoxicity may become a significant issue in survivors. This study is aimed at evaluating the incidence of late renal toxicity of ifosfamide and its risk factors.Patients and MethodsOf the 183 patients prospectively investigated for renal function, 77 treated for rhabdomyosarcoma, 39 for other soft tissue sarcoma, 39 for Ewing's sarcoma, and 28 for osteosarcoma were investigated at least 5 years after treatment. No patients had received cisplatin and/or carboplatin. Glomerular and tubular functions were graded according to the Skinner system.ResultsThe median dose of ifosfamide was 54 g/m2(range, 18 to 117 g/m2). After a median follow-up of 10 years, 89.5% of patients had normal tubular function, and 78.5% had normal glomerular function rate (GFR). Serum bicarbonate and calcium were normal in all patients. Hypomagnesemia was observed in 1.2% and hypophosphatemia in 1%. The tubular threshold for phosphate was reduced in 24% of the patients (grade 1 in 15%, grade 2 in 8%, and grade 3 in 0.5%). Glycosuria was detected in 37% of the patients but was more than 0.5 g/24 hours in only 5%. Proteinuria was observed in 12%. Ifosfamide dose and interval from therapy to investigations were predictors of tubulopathy in univariate and multivariate analysis. In a multivariate analysis, an older age at diagnosis and the length of interval since treatment had independent impacts on the risk of abnormal GFR.ConclusionRenal toxicity is moderate with a moderate dose of ifosfamide. However, since it can be permanent and can get worse with time, repeated long-term evaluations are important, and this risk should be balanced against efficacy.

scholarly journals Efficacy of Combined Laparoscopic and Hysteroscopic Repair of Post-Cesarean Section Uterine Diverticulum: A Retrospective Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Cuilan Li ◽  
Shiyan Tang ◽  
Xingcheng Gao ◽  
Wanping Lin ◽  
Dong Han ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Combined Treatment ◽  
Clinical Manifestations ◽  
Abnormal Uterine Bleeding ◽  
Lower Uterine Segment ◽  
Improvement Rate ◽  
Uterine Scar ◽  
Lost To Follow Up

Background. Diverticulum, one of the long-term sequelae of cesarean section, can cause abnormal uterine bleeding and increase the risk of uterine scar rupture. In this study, we aimed to evaluate the efficacy of combined laparoscopic and hysteroscopic repair, a newly occurring method, treating post-cesarean section uterine scar diverticulum.Methods. Data relating to 40 patients with post-cesarean section uterine diverticulum who underwent combined laparoscopic and hysteroscopic repair were retrospectively analyzed. Preoperative clinical manifestations, size of uterine defects, thickness of the lower uterine segment (LUS), and duration of menstruation were compared with follow-up findings at 1, 3, and 6 months after surgery.Results. The average preoperative length and width of uterine diverticula and thickness of the lower uterine segment were recorded and analyzed. The average durations of menstruations at 1, 3, and 6 months after surgery were significantly shorter than the preoperative one (p<0.05), respectively. At 6 months after surgery, the overall success improvement rate of surgery was 90% (36/40). Three patients (3/40 = 7.5%) developed partial improvement, and 1/40 (2.5%) was lost to follow-up.Conclusions. Our findings showed that combined treatment with laparoscopy and hysteroscopy was an effective method for the repair of post-cesarean section uterine diverticulum.

How to Find Patients Who are 'Lost to Follow-up'

2010 ◽  
Vol 92 (3) ◽  
pp. 98-101 ◽  
Author(s):  
LC Biant ◽  
VK Eswaramoorthy ◽  
RE Field
Keyword(s):  
Surgical Interventions ◽  
Loss To Follow Up ◽  
Medical Interventions ◽  
Follow Up Studies ◽  
Long Term Follow Up ◽  
Lost To Follow Up

Long-term surveillance of patients is necessary to ascertain the outcome of medical interventions. The rate of 'loss to follow-up' is the largest controllable variable in long-term follow-up studies. Such surveillance programmes are of particular importance to surgical interventions as differences between techniques or implants may take years to become apparent.

Electrocautery Adenoidectomy Outcomes: A Metaanalysis

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P33-P34
Author(s):  
Jeremy T. Reed ◽  
Shankar K. Sridhara ◽  
Scott E Brietzke
Keyword(s):  
Sample Size ◽  
Random Effects ◽  
English Language ◽  
Operative Time ◽  
Inclusion Criteria ◽  
Subjective Success ◽  
Random Effects Modeling ◽  
Lost To Follow Up

Objective Review and assess the current published literature regarding clinical outcomes of suction electrocautery adenoidectomy (ECA) in pediatric patients. Methods The MEDLINE database was systematically reviewed for articles reporting on the use of ECA. Inclusion criteria included English language, sample size greater than 5, and presentation of extractable data regarding pediatric outcomes with ECA. Random effects modeling was used to estimate summary outcomes. Results 9 studies met the inclusion criteria. There were 2 level 1b studies, 2 level 3b studies, and 5 level 4 studies. The mean sample size was 276 patients with a grand mean age of 6.0 years. Random effects modeling of summary estimates of intra-operative hemorrhage (4.1 cc vs. 24.0 cc 95% CI of difference = 16.5–23.1, p<0.001) and operative time (10.0 minutes vs. 11.9 minutes 95% CI of difference=0.82–2.90, p<0.001) favored ECA vs. traditional curette adenoidectomy. Subjective success was reported in 95.0% (95% CI=92.7–97.3%, p<0.001) of ECA patients with a grand mean of 5.8 months of postoperative follow-up and a grand mean lost to follow-up rate of 23.2%. Adenoid regrowth was evaluated objectively (endoscopy or X-ray) in only 116 of 2,132 (5.4%) total patients with an observed regrowth rate of 2.8% (95% CI=0–5.5%, p=0.052) with 846 total person years of follow-up. Conclusions The preponderance of evidence favors ECA versus curette adenoidectomy in terms of decreased intraoperative hemorrhage and decreased operative time. Long-term outcomes data for ECA are scarce, despite the fact that the procedure is likely performed hundreds of times each day, but suggest a low regrowth rate.

Clinical Course of Different Types of Immune Reactions following Keratoplasty

2021 ◽  
Author(s):  
Philip Keye ◽  
Thabo Lapp ◽  
Daniel Böhringer ◽  
Sonja Heinzelmann ◽  
Philip Maier ◽  
...  
Keyword(s):  
Clinical Course ◽  
Corneal Graft ◽  
Long Term Outcomes ◽  
Immune Mediated ◽  
Corneal Graft Rejection ◽  
Different Types ◽  
Lost To Follow Up

Abstract Background Immune-mediated corneal graft rejection (IR) is a leading cause of corneal graft failure. The endothelium, stroma, epithelium, or a combination can be affected. Little is known about the long-term outcomes of different types of IR. Methods We reviewed the medical records of all keratoplasties that had been performed at our eye centre between 2003 and 2016 (n = 3934) for any kind of IR that occurred between the surgery and 2019. All patients with a definite diagnosis of IR and sufficient clinical data were included in the analysis. IRs were grouped according to the affected part of the graft (endothelial, stromal, epithelial, and mixed). We analysed the dynamics of recovery and the clinical outcomes. Results We identified a total of 319 patients with IR. Twenty-seven of those were lost to follow-up and were excluded from further analysis. Of the IRs, 89% affected the endothelium. Endothelial IR resulted more frequently in a considerable loss of endothelial cell density than other forms of IR. Stromal IR showed a lower relapse rate and a better visual recovery than other types of IR and resulted less often in a failure of the graft. Conclusions We herein report comprehensive data about the prognosis regarding functional recovery after different types of IR following keratoplasty. Our data underline that timely recognition and correct classification of IR are important because they determine the clinical course and prognosis.

scholarly journals Long-term evaluation of autologous lamellar corneal grafts for the treatment of deep corneal ulcer in four dogs: a case report

2019 ◽  
Vol 64 (No. 02) ◽  
pp. 84-91
Author(s):  
SY Kim ◽  
JY Kim ◽  
SW Jeong
Keyword(s):  
Case Report ◽  
Corneal Ulcer ◽  
Donor Site ◽  
Ultrasound Biomicroscopy ◽  
Corneal Graft ◽  
Corneal Ulcers ◽  
Term Evaluation ◽  
The Aesthetic

Autologous lamellar corneal grafts were performed on four dogs with two deep corneal ulcers and two corneal perforations to achieve better visual and aesthetic outcomes. The donor corneal graft was harvested from the relatively normal corneal region of the affected eye and used to cover the corneal defect. At the two-year follow-up examination, ultrasound biomicroscopy was performed to confirm the thickness and endothelial continuity of the transplanted grafts and donor site of the cornea. The evaluations revealed that the dogs had healed without incident and that their vision had been maintained. Furthermore, the owners were satisfied with the aesthetic outcomes in all cases. Our findings show that autologous lamellar corneal grafts are useful and effective in treating canine corneal ulcers and perforations.

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