scholarly journals Predictive factors for recurrent haemorrhagies in patients with brain cavernoma

2005 ◽  
Vol 52 (3) ◽  
pp. 83-86
Author(s):  
V. Jovanovic ◽  
G. Tasic ◽  
B. Djurovic ◽  
M. Janicijevic ◽  
V. Antunovic
Keyword(s):  
Surgical Treatment ◽  
Prospective Study ◽  
Predictive Factors ◽  
Neurological Deficit ◽  
Clinical Presentation ◽  
Statistical Significance ◽  
Recurrent Bleeding ◽  
Focal Neurological Deficit ◽  
Male Patients ◽  
Factors Of Influence

Haemorrhage is most important sequelae of brain cavernoma, so the surgical treatment is very important for treatment that complication. There are two types of bleeding - chronic subclinical microhaemorrhage and acute real hemorrhage. Patophisiologycal factors which are reasponsible for bleeding are not still understanding. The reason for this study is understanding of clinical curse of cavernomas and identification of factors of influence. This is retrospective and prospective study. We analyzed 36 patients with symptomatic brain cavernoma, surgically treated in Institute of neurosurgery KCS in 10 years period (1987-1997). Female were dominant but without statistical significance (p>0,05). Male patients were older (32,1:29,8), but without statistical significance (p>0,05). Almost 75% lesions were supratentorial, 25% infratentorial (p<0,05). Focal neurological deficit (FND) was dominant clinical presentation in 52,8%. FND was dominant in 52,6% female, but without statistical singnificans (p>0,05). Clinical presentation according the age was not statistically significant (p>0,05). Clinical presentation was very different according the size of lesion (p<0,001). FND as a sign of bleeding was in 57,9% supratentorial cavernomas and in 42,1% infratentorial (p<0,005). More than 1/3 patients have recurrent bleeding with 21 attack of haemorrhage or almost 2 attack per patient. We find that dominant predictive factors for recurrent haemorrhages are localization and size of lesion.

scholarly journals Retrospective analysis underestimates neurological deficits in complex spinal deformity surgery: a Scoli-RISK-1 Study

2017 ◽  
Vol 27 (1) ◽  
pp. 68-73 ◽  
Author(s):  
Michael P. Kelly ◽  
Lawrence G. Lenke ◽  
Jakub Godzik ◽  
Ferran Pellise ◽  
Christopher I. Shaffrey ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Cohort Studies ◽  
Prospective Study ◽  
Spinal Deformity ◽  
Neurological Deficit ◽  
Prospective Studies ◽  
Adult Spinal Deformity ◽  
Statistical Significance ◽  
Neurological Deficits ◽  
Inclusion Criteria

OBJECTIVEThe authors conducted a study to compare neurological deficit rates associated with complex adult spinal deformity (ASD) surgery when recorded in retrospective and prospective studies. Retrospective studies may underreport neurological deficits due to selection, detection, and recall biases. Prospective studies are expensive and more difficult to perform, but they likely provide more accurate estimates of new neurological deficit rates.METHODSNew neurological deficits were recorded in a prospective study of complex ASD surgeries (pSR1) with a defined outcomes measure (decrement in American Spinal Injury Association lower-extremity motor score) for neurological deficits. Using identical inclusion criteria and a subset of participating surgeons, a retrospective study was created (rSR1) and neurological deficit rates were collected. Continuous variables were compared with the Student t-test, with correction for multiple comparisons. Neurological deficit rates were compared using the Mantel-Haenszel method for standardized risks. Statistical significance for the primary outcome measure was p < 0.05.RESULTSOverall, 272 patients were enrolled in pSR1 and 207 patients were enrolled in rSR1. Inclusion criteria, defining complex spinal deformities, and exclusion criteria were identical. Sagittal Cobb measurements were higher in pSR1, although sagittal alignment was similar. Preoperative neurological deficit rates were similar in the groups. Three-column osteotomies were more common in pSR1, particularly vertebral column resection. New neurological deficits were more common in pSR1 (pSR1 17.3% [95% CI 12.6–22.2] and rSR1 9.0% [95% CI 5.0–13.0]; p = 0.01). The majority of deficits in both studies were at the nerve root level, and the distribution of level of injury was similar.CONCLUSIONSNew neurological deficit rates were nearly twice as high in the prospective study than the retrospective study with identical inclusion criteria. These findings validate concerns regarding retrospective cohort studies and confirm the need for and value of carefully designed prospective, observational cohort studies in ASD.

scholarly journals Factors Influencing Success Rate of Intracytoplasmic Sperm Injection with Azoospermic Male Patients

2020 ◽  
Vol 80 (07) ◽  
pp. 713-722
Author(s):  
Julia Rehnitz ◽  
Sabine Rösner ◽  
Juliane Harsch ◽  
Jens Dietrich ◽  
Thomas Bruckner ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Predictive Factors ◽  
Intracytoplasmic Sperm Injection ◽  
Smoking Status ◽  
Statistical Significance ◽  
Testicular Sperm Extraction ◽  
Tubular Atrophy ◽  
Male Patients ◽  
Clinical Records

Abstract Introduction Azoospermia affects about 1% of men, of whom up to 15% inquire about infertility treatment. Information about predictive factors for these couples is very limited. Patients, Materials and Methods We performed a retrospective analysis of the clinical records of 118 cycles of intracytoplasmic sperm injection treatment after testicular sperm extraction for male azoospermia carried out between January 2008 and October 2015. Of those, 66 were first, 35 second, and 17 third cycles. Statistical significance was set at p < 0.05. Predictive factors for successful pregnancy were evaluated and included male/female age, male/female body mass index, male/female nicotine use, and histological results of testes biopsies. Results Embryo quality and the number of embryos transferred were positively associated with pregnancy success (p = 0.003). Males whose partners conceived had a significantly lower body mass index than those whose partners did not conceive (p = 0.023). Neither female weight nor age nor smoking status of the male or female were significant factors. In cases with tubular atrophy ≥ SIGG grade 4 the chance of pregnancy was poor, irrespective of the existence of mature sperm and the number of cycles performed. Conclusion Overweight male patients should be advised about weight reduction prior to treatment, and counseling about success rates should include histological and sperm-positive biopsy results.

scholarly journals Angioarchitecture and clinical presentation of brain arteriovenous malformations

2009 ◽  
Vol 67 (2a) ◽  
pp. 316-321 ◽  
Author(s):  
Marcio Luiz Tostes dos Santos ◽  
Zeferino Demartini Júnior ◽  
Luiz Afonso Dias Matos ◽  
Antonio Ronaldo Spotti ◽  
Waldir Antônio Tognola ◽  
...  
Keyword(s):  
Neurological Deficit ◽  
Arteriovenous Malformations ◽  
Clinical Presentation ◽  
Multivariate Analyses ◽  
Morphological Features ◽  
Feeding Artery ◽  
Focal Neurological Deficit ◽  
Brain Arteriovenous Malformations ◽  
Clinical Presentations ◽  
Martin Grade

The purpose of this study was to correlate the angioarchitecture of brain arteriovenous malformations (AVM) with their clinical presentation. A total of 170 patients with AVM 78 males and 92 females, were studied. Univariate and multivariate analyses were conducted in order to test the associations between morphological features and clinical presentation. The most frequent clinical presentations at diagnosis were hemorrhage in 89 (52%) patients, headache in 79 (46%), focal neurological deficit in 54 (32%), and seizure in 52 (31%). According to the Spetzler-Martin classification, grade I was found in 15 patients, II in 49, III in 55, IV in 41, and grade V in 10 patients. AVM with small nidus size, single feeding artery and single draining vein were associated with hemorrhage. Hemorrhage was positively associated with Spetzler-Martin grade I and negatively with grade V. The association between seizure and large nidus size was positive, however negative with small nidus size.

scholarly journals Prognosis of fasting in patients with cerebral venous thrombosis using oral contraceptives

2019 ◽  
Author(s):  
Masoud Ghiasian ◽  
Maryam Mansour ◽  
Nasrin Moradian
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Venous Thrombosis ◽  
Oral Contraceptives ◽  
Neurological Deficit ◽  
Cerebral Venous Thrombosis ◽  
Clinical Presentation ◽  
Modified Rankin Scale ◽  
Focal Neurological Deficit ◽  
Muslim Countries

Background: There have been studies that showed a higher incidence of cerebral venous thrombosis (CVT) in Ramadan, a month in which people fast in Muslim countries, which was associated with increasing use of oral contraceptives (OCPs) in women. We aimed to evaluate the effect and prognosis of fasting in patients with CVT using OCPs. Methods: Consecutive patients with diagnosis of CVT in Sina hospital, Hamadan, West of Iran, from May of 2009 to June of 2016 were evaluated, and women using OCPs were included. Other risk factors except fasting were excluded. Clinical presentation and outcomes of CVT was assessed. Patients were followed up for 12 months. Results: 58 patients were included in this study. 31 of these patients had fasting simultaneously. Fasting in patients using OCPs caused significantly higher focal neurological deficit (64.5%, P = 0.018), and higher hemorrhage (66.7%, P = 0.042). At discharge, 51.6% and after three months, 25.8% of patients with fasting had disability [6 > modified Rankin Scale (mRS) >1]. In patients who used OCPs as sole risk factor, 25.9% at discharge and 11.1% after three months had disability. Conclusion: Fasting in patients with CVT using OCPs causes significant increase in focal neurological deficit and hemorrhage, which also increases the hospital stay and lengthens recovery. However, longterm prognosis and mortality of CVT is similar between the two groups. 

PREDICTIVE FACTORS IN THE CHOICE OF SURGICAL TREATMENT FOR COLORECTAL CANCER WITH LAPAROSCOPIC OR "OPEN" ACCESS

2017 ◽  
Vol 63 (3) ◽  
pp. 470-474
Author(s):  
Rustem Topuzov ◽  
Georgiy Manikhas ◽  
Eskender Topuzov ◽  
Mikhail Khanevich ◽  
Magomed Abdulaev ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Open Access ◽  
Comparative Study ◽  
Retrospective Analysis ◽  
Predictive Factors

There are presented results of surgical treatment of 347 patients with colorectal cancer. Based on the retrospective analysis a comparative study of results of surgical treatment for colorectal cancer using laparoscopic technologies and “open” access was carried out. Predictive factors that correlate with the risk of postoperative complications with laparoscopic and “open” access at the surgical stage of treatment for colorectal cancer were determined.

Hypoglycemic Hemiparesis Masquerading As Ischemic Stroke: When Guideline Fails

2020 ◽  
Vol 15 (4) ◽  
pp. 420-422
Author(s):  
Dhruvkumar M. Patel ◽  
Mukundkumar V. Patel ◽  
Jayanti K. Gurumukhani ◽  
Maitri M. Patel ◽  
Himal J. Mahadevia ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Neurological Deficit ◽  
Clinical Case ◽  
Complete Recovery ◽  
Acute Onset ◽  
Diabetic Patients ◽  
Focal Neurological Deficit ◽  
Random Blood Sugar ◽  
Resident Doctor

Background: Hypoglycemia may rarely present as hemiparesis and sometimes it is difficult to differentiate from ischemic stroke. When random blood sugar (RBS) value is between 50 and 80 mg % in patients presenting with focal neurological deficit, no guideline exists to consider the possibility of hypoglycemia before initiating thrombolytic therapy. Clinical Case: A 58-year-old male, who was a known case of diabetes and hypertension, was brought to the emergency room with acute onset of right hemiparesis and dysarthria of 90 minutes duration. His NIHSS Score was 9, blood pressure was 150/90 mm of Hg and RBS was 79 mg% on admission. His CT scan brain was normal and was considered for thrombolysis. Resident doctor not aware of previous sugar repeated RBS before thrombolysis which was surprisingly 60 mg% 60 minutes after the first RBS. Even though he was a candidate for thrombolysis, intravenous 25 % dextrose was administered considering the possibility of hypoglycemia. He made a complete recovery within 20 minutes and thrombolytic therapy was withheld. : In Diabetic patients with focal neurological deficit and RBS less than 80 mg% on admission, RBS should be rechecked and in appropriate cases should be challenged with IV dextrose considering the possibility of hypoglycemia before commencing thrombolytic therapy.

scholarly journals Neuropathic Pain in Children with Sickle Cell Disease: The Hidden Side of the Vaso-Occlusive Crisis

Children ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. 84
Author(s):  
Jeanne Sigalla ◽  
Nathalie Duparc Alegria ◽  
Enora Le Roux ◽  
Artemis Toumazi ◽  
Anne-Françoise Thiollier ◽  
...  
Keyword(s):  
Risk Factors ◽  
Neuropathic Pain ◽  
Sickle Cell Disease ◽  
Sex Ratio ◽  
Prospective Study ◽  
Sickle Cell ◽  
Clinical Presentation ◽  
Early Stage ◽  
Cell Disease ◽  
A Prospective Study

The majority of hospitalizations of patients with sickle cell disease (SCD) are related to painful vaso-occlusive crises (VOCs). Although the pain of VOC is classically nociceptive, neuropathic pain (NP) has also been demonstrated in SCD patients. The aim of our study is to specify the prevalence of NP during VOCs in SCD children using a dedicated scale and to measure its characteristics. We performed a prospective study that included SCD children hospitalized for an acute VOC. The presence of NP was sought with the DN4 scale on the second and fourth days of hospitalization. A total of 54 SCD children were included in the study. Overall, 41% of the patients (n = 22) experienced neuropathic pain during the VOC, mostly at an early stage (Day 2). The median age, the sex ratio, the location of the pain, and the morphine consumption were similar for patients with and without NP. Our study shows that neuropathic pain is very common during VOCs in SCD children. The absence of identified risk factors should prompt us to be vigilant regardless of the patient’s age, sex, and clinical presentation.

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