Intracranial Procedures and Expected Frequency of Creutzfeldt-Jakob Disease

2015 ◽  
Vol 46 (1) ◽  
pp. 1-8
Author(s):  
Joseph Y. Abrams ◽  
Ryan A. Maddox ◽  
Lawrence B. Schonberger ◽  
Ermias D. Belay
Keyword(s):  
The United States ◽  
Annual Number ◽  
Considerable Proportion ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
History Of ◽  
Jakob Disease ◽  
Sporadic Cjd

Background/Aims: To assess the frequency and characteristics of intracranial procedures (ICPs) performed and the number of US residents living with a history of ICP. These data are used to calculate the expected annual number of sporadic Creutzfeldt-Jakob disease (CJD) cases among US residents with a history of ICP. Methods: The Nationwide Inpatient Sample provided data on the frequency and types of ICPs, and data from the National Center for Health Statistics was used to produce age-adjusted mortality rates. A model was constructed, which estimated long-term survival and sporadic CJD rates among ICP patients based on procedure type and age. Results: There were an estimated 2,070,488 ICPs in the United States from 1998 to 2007, an average of over 200,000 per year. There were an estimated 2,023,726 US residents in 2013 with a history of ICP in the previous 30 years. In 2013, there was expected to be 4.1 sporadic CJD cases (95% CI 1-8) among people with a history of ICP in the past 30 years. Conclusions: The considerable proportion of US residents living with a history of ICP is important information for retrospective assessments of CJD or any other suspected long-term outcome of ICPs.

Benign paroxysmal vertigo of childhood: Long-term outcome

Cephalalgia ◽  
2010 ◽  
Vol 31 (4) ◽  
pp. 439-443 ◽  
Author(s):  
Benjamin Krams ◽  
Bernard Echenne ◽  
Julie Leydet ◽  
François Rivier ◽  
Agathe Roubertie
Keyword(s):  
Patient Outcome ◽  
Complete Recovery ◽  
Homogeneous Condition ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Family Medical History ◽  
History Of ◽  
Attacks Of Vertigo ◽  
Epidemiological Link

Introduction Benign paroxysmal vertigo (BPV) is characterized by recurrent attacks of dizziness in a healthy child. Complete recovery typically takes place during childhood, and an epidemiological link with migraine has been pointed out. Nevertheless, data concerning long-term patient outcome are scarce. Subjects and methods We analyzed the clinical data of 17 patients diagnosed with BPV between 1991 and 2008 in our neuropediatric department; we particularly focused on family medical history and long-term patient outcome by reviewing their medical files and by interviewing the families with a standardized questionnaire administered by phone. Results Thirteen families responded to the questionnaire, performed 1.1 to 24.5 years after onset. Among 10 patients older than 11 years of age, five continue to suffer attacks of vertigo. Median age at recovery was six years. Nine subjects exhibited migraine, including all six aged 15 years or older. There was a first-degree history of migraine in eight out of 13 children. Conclusion BPV may not be a homogeneous condition, as some children have a poorer prognosis than others. The strong link with migraine, already noticed by previous authors, led us to discuss the pathophysiology of this condition.

The natural history of glycogen storage disease types VI and IX: Long-term outcome from the largest metabolic center in Canada

2014 ◽  
Vol 113 (3) ◽  
pp. 171-176 ◽  
Author(s):  
Anne Roscher ◽  
Jaina Patel ◽  
Stacy Hewson ◽  
Laura Nagy ◽  
Annette Feigenbaum ◽  
...  
Keyword(s):  
Natural History ◽  
Glycogen Storage Disease ◽  
Storage Disease ◽  
Glycogen Storage ◽  
Term Outcome ◽  
Long Term Outcome ◽  
History Of

Impact of age on early outcomes and long-term survival of patients undergoing aortic repair with Stanford A dissection

Perfusion ◽  
2018 ◽  
Vol 33 (8) ◽  
pp. 687-695 ◽  
Author(s):  
Julia Merkle ◽  
Anton Sabashnikov ◽  
Carolyn Weber ◽  
Georg Schlachtenberger ◽  
Johanna Maier ◽  
...  
Keyword(s):  
Surgical Repair ◽  
Age Groups ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Long Term Survival ◽  
Cerebrovascular Events ◽  
Short And Long Term ◽  
Male Patients

Objectives: Stanford A acute aortic dissection (AAD) is a life-threatening emergency, typically occurring in older patients and requiring immediate surgical repair. The aim of this study was to evaluate early outcome and short- and long-term survival of patients under and above 65 years of age. Methods: Two hundred and forty patients with Stanford A AAD underwent aortic surgical repair from January 2006 to April 2015 in our center. After statistical analysis and logistic regression analysis, Kaplan-Meier survival estimation was performed, with up to 9-year follow-up, comprising patients under and above 65 years of age. Results: The proportion of patients above 65 years of age suffering from Stanford A AAD was 50% (n=120). The group of patients above 65 years of age compared to the group under 65 years of age showed statistically significant differences in terms of higher odds ratios (OR) for hypertension (p=0.012), peripheral vascular disease (p=0.026) and tachyarrhythmia absoluta (p=0.004). Patients over 65 years of age also showed significantly poorer short- and long-term survival. Our subgroup analysis revealed that male patients (Breslow p=0.001, Log-Rank p=0.001) and patients suffering with hypertension (Breslow p=0.003, Log-Rank p=0.001) were reasonable for these results whereas younger and older female patients showed similar short- and long-term outcome (Breslow p=0.926, Log-Rank p=0.724). After stratifying all patients into 4 age groups (<45; 55-65; 65-75; >75years), short-term survival of the patients appeared to be significantly poorer with increasing age (Breslow p=0.026, Log-Rank p=0.008) whereas long-term survival of patients free from cerebrovascular events (Breslow p=0.0494, Log-Rank p=0.489) remained similar. Conclusions: All patients referred to our hospital for repair of Stanford A AAD with higher age had poorer short- and long-term survival, caused by male patients and patients suffering from hypertension, whereas survival of women and survival free from cerebrovascular events of the entire patient cohort was similar, irrespective of age.

Abstract TP366: National Institutes of Health Stroke Scale (NIHSS) is a Potent Predictor of Outcome in Acute Intracerebral Hemorrhage

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Suzie Kazaryan ◽  
Nerses Sanossian ◽  
David S Liebeskind ◽  
Sidney Starkman ◽  
Marc Eckstein ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Strong Predictor ◽  
Final Diagnosis ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Acute Cerebral Ischemia ◽  
History Of ◽  
Acute Intracerebral Hemorrhage ◽  
Ich Score

Background: Although the NIHSS is a well-validated tool in assessing neurological deficit and predicting long-term outcome in acute cerebral ischemia, its utility in ICH has not been extensively studied. As NIHSS is routinely obtained in cases of stroke prior to imaging, it is often available in ICH patients to potentially assist physicians in triage, prognostication, and risk-adjustment. Methods: We analyzed consecutive patients enrolled in the NIH Field Administration of Stroke Therapy-Magnesium (FAST-MAG) phase 3 trial whose final diagnosis was ICH. Trained study nurses performed the NIHSS in the Emergency Department (ED) shortly after arrival and the modified Rankin Scale (mRS) at 90 days. Primary outcomes were disability or death (mRS 3-6) and mortality. Candidate potential predictor variables, including NIHSS, ICH Score, and GCS, those with threshold of p<0.10 were candidate parameters for backward selection logistic regression to determine independent predictors of disability or death and of mortality. Results: Among the 384 ICH patients, age was mean 65 (±13); female 34%; race white 78%, black 10%, Asian 10%; Hispanic ethnicity 33%; and history of hypertension 78%. The ED NIHSS and GCS was performed a median 148 minutes (IQR 121-180) after last known well. Initial NIHSS was median 16 (IQR 9-16), GCS 15 (IQR 10-15), and ICH Score 1(IQR 0-2). NIHSS correlated with ICH Score (r=0.780) and GCS (r=0.860). At 90 days, median mRS was 4 (IQR 2-6), disability or death (mRS 3-6) was present in 70%, and mortality occurred in 26%. In predicting disability or death at 90 days, c statistics were: NIHSS 0.81, ICH Score 0.81, and GCS 0.72. NIHSS≥14 showed 72% sensitivity and 75% specificity. For mortality by 90 days, c statistics were: NIHSS 0.78, ICH Score 0.80, and GCS 0.73. NIHSS≥19 had 80% sensitivity and 70% specificity. On multivariate analysis age (OR 1.07, 95%CI 1.04-2.0) and NIHSS (OR 1.18, 95%CI 1.13-1.23) were independent predictors of disability and death. Conclusions: The initial NIHSS is a strong predictor of disability and death and good predictor of mortality after intracerebral hemorrhage, performing as well as the ICH Score and better than the GCS. Consideration should be given to routine performance and documentation of the NIHSS in ICH patients.

scholarly journals 1026 Prognostic implications of global and regional RV strain in patients with heart failure and conduction delays

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
A Janicijevic ◽  
I Stankovic ◽  
A Zivanic ◽  
M Stefanovic ◽  
B Putnikovic ◽  
...  
Keyword(s):  
Heart Failure ◽  
Nyha Class ◽  
Cardiac Resynchronization ◽  
Cardiac Mortality ◽  
Term Outcome ◽  
Term Survival ◽  
Long Term Outcome ◽  
Patients With Heart Failure ◽  
Rv Function

Abstract Background Right ventricular (RV) dysfunction is present in a substantial proportion of candidates for cardiac resynchronization therapy (CRT) but its prognostic implication has not been fully determined. We investigated the association of different echocardiographic indices of RV function and survival in patients with heart failure (HF) and conduction delays. Methods A total of 122 HF patients with bundle branch blocks (BBB), not treated with device therapy, were included in this retrospective observational study. RV function was assessed by measuring the tricuspid annular plane systolic excursion (TAPSE) and RV free wall longitudinal strain (RVFWSL). Patients were followed for cardiac mortality during a median period of 33 months. Results Both TAPSE ≤ 18 mm and RVFWSL≥-25% were associated with unfavorable long-term survival (log rank p &lt; 0.05 for both, Figure A and B). Importantly, in patients with normal TAPSE, RVFWSL remained predictive of long-term outcome (HR 1.15, 95% CI 1.003-1.327; p = 0.045). In the multivariate regression analysis, only NYHA class (HR 2.21, 95%CI (1.122 – 4.357; p = 0.022) and RVFWSL (HR 1.11, 95%CI 1.029 – 1.204; p = 0.008) were independently associated with cardiac mortality. Significant differences among segmental RVFWLS values were observed, including a basal-to-apical gradient with the highest strain values in the base and the lowest in the apex (Figure C). Conclusions RV dysfunction is associated with unfavorable survival in HF patients with BBB. RVFWSL appears to be stronger predictor of mortality than TAPSE. Different segments of the RV may contribute differently to RV dysfunction in patients with conduction delays. Abstract 1026 Figure.

scholarly journals Chemotherapy-Free Initial Treatment of Advanced Indolent Lymphoma Has Durable Effect With Low Toxicity: Results From Two Nordic Lymphoma Group Trials With More Than 10 Years of Follow-Up

2018 ◽  
Vol 36 (33) ◽  
pp. 3315-3323 ◽  
Author(s):  
Sandra Lockmer ◽  
Bjørn Østenstad ◽  
Hans Hagberg ◽  
Harald Holte ◽  
Ann-Sofie Johansson ◽  
...  
Keyword(s):  
Optimal Timing ◽  
Indolent Lymphoma ◽  
First Line ◽  
Term Outcome ◽  
Cross Sectional ◽  
Term Survival ◽  
Long Term Outcome ◽  
New Therapy

Purpose For indolent lymphoma, the optimal timing, sequence, and choice of therapeutic regimens remain a matter of debate. In two Nordic Lymphoma Group randomized trials, symptomatic or clearly progressing patients were treated first line with a rituximab-containing regimen without chemotherapy. The purpose of this study was to assess long-term survival, risk of transformation, and need of new therapies. Methods Data were collected at cross-sectional follow-up for 321 patients with indolent lymphoma (84% with follicular lymphomas [FL]) included in one of two Nordic Lymphoma Group trials (accrual 1998 to 1999 and 2002 to 2008). All patients received first-line therapy with one or two cycles of four weekly infusions of rituximab 375 mg/m2, and 148 were randomly allocated to the addition of interferon alfa-2a. Follow-up data were retrieved from initial trial databases and medical records on repeated clinical evaluations. Results At the end of follow-up, 73% of patients were alive, with a median follow-up after random assignment of 10.6 years. Among all, 36% (38% with FL) had never needed chemotherapy. For patients with FL who required new therapy within 24 months because of early disease progression, the 10-year survival rate was 59% versus 81% for those with longer remission. Interferon was not shown to improve long-term outcome. Transformation was diagnosed in 20% of all patients (2.4% per person-year) and in 18% with FL. An additional malignancy was found in 12%. Conclusion Approximately one third of patients with symptomatic indolent lymphoma (30% with FL, 23% without FL) did not need new therapy in the long term after first-line rituximab without chemotherapy. In the entire cohort, 10-year survival was excellent with no major safety issues, which suggests that chemotherapy can be delayed safely in the majority of patients.

scholarly journals Long-Term Outcomes After Reversible Cerebral Vasoconstriction Syndrome

Stroke ◽  
2020 ◽  
Vol 51 (2) ◽  
pp. 670-673 ◽  
Author(s):  
Rosalie Boitet ◽  
Solène de Gaalon ◽  
Claire Duflos ◽  
Grégory Marin ◽  
Jérôme Mawet ◽  
...  
Keyword(s):  
Thunderclap Headache ◽  
Reversible Cerebral Vasoconstriction Syndrome ◽  
Long Term Outcomes ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Follow Up Study ◽  
Cerebral Vasoconstriction ◽  
History Of

Background and Purpose— We aimed to further investigate the long-term outcomes after reversible cerebral vasoconstriction syndrome (RCVS). Methods— A longitudinal follow-up study was conducted in 173 RCVS patients. Results— Of the 172 patients who completed a mean follow-up of 9.2±3.3 years, 10 had a recurrent RCVS that was benign in all. Independent predictors of relapse were having a history of migraine and having exercise as a trigger for thunderclap headache during initial RCVS. After new delivery, the rate of postpartum RCVS was 9%. Conclusions— Overall, long-term outcome after RCVS is excellent.

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