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Delayed Presentation (delayed + presentation)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Delayed Presentation of Low Molecular Weight Heparin Treatment Failure in a Patient With Mitral Valve Prosthesis

JOURNAL OF CARDIAC SURGERY, Issue 1 2007
Sotiris C. Stamou M.D.
The patient did not develop the embolic complication from the thrombosis until almost 4 months after the bridging sequence with low molecular weight heparin. The patient underwent thrombectomy of the mitral valve. At least 16 similar cases with mechanical valve prostheses and treatment failure of low molecular weight heparin have been reported. [source]

Delayed Presentation of Injury to the Sinus of Valsalva with Aortic Regurgitation Resulting from Penetrating Cardiac Wounds

JOURNAL OF CARDIAC SURGERY, Issue 3 2003
Narutoshi Hibino M.D.
An emergency operation was performed successfully to repair the penetrating cardiac injury of the right ventricular outflow tract without using cardiopulmonary bypass. Two years after the operation, he was complained of dyspnea and a continuous murmur was detected. Echocardiography and cardiac catheterization revealed aorto-right ventricular fistula in the sinus of valsalva with aortic regurgitation. In operation, the healed laceration of the right coronary cusp and the fistula between aorta and right ventricle were identified. The fistula was closed using a Dacron patch and the aortic valve was replaced with a mechanical valve. Long-term follow-up of penetrating thoracic injuries is important for detecting underlying intracardiac lesions. (J Card Surg 2003;18:236-239) [source]

Bladder wall injury consequent to total hip replacement: Delayed presentation

INTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2006
ULRICH KALDENBACH
Abstract, Bladder injury, although rare, may be traumatic or iatrogenic. We report a patient with greatly delayed presentation of bladder injury after a total hip replacement. [source]

Delayed presentation of tracheo-oesophageal fistula following percutaneous dilatational tracheostomy

ANAESTHESIA, Issue 9 2002
S. M. Drage
No abstract is available for this article. [source]

Presentation of intraocular foreign body 25 years after the event

CLINICAL & EXPERIMENTAL OPHTHALMOLOGY, Issue 6 2005
Stuart J McGimpsey MB MRCOphth
Abstract Delayed presentation of retained intraocular foreign body is a diagnostic and therapeutic challenge to the ophthalmologist. Herein a case of a man presenting 25 five years after initial injury with a retained metallic foreign body adjacent to the optic disc is described. [source]

Bladder wall injury consequent to total hip replacement: Delayed presentation

A Comparative Study of Community- and Nursing Home-Acquired Empyema Thoracis

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2007
Ali A. El Solh MD
OBJECTIVES: To compare the clinical presentation, microbiological features, and outcomes of patients with community-acquired empyema (CAE) with those of patients with nursing home-acquired empyema (NHAE). DESIGN: A retrospective observational study. SETTING: Three tertiary care centers. PARTICIPANTS: One hundred fourteen patients admitted from the community and 55 patients transferred from nursing homes. MEASUREMENTS: Baseline sociodemographic information, activities of daily living, Charlson Comorbidity Index score, and clinica, and microbiologic data were obtained. Outcome was assessed at hospital discharge and 6 months postdischarge. RESULTS: Patients admitted from nursing homes had a delayed presentation, with dyspnea, weight loss, and anemia as the predominant manifestation. Patients with CAE presented more acutely, with fever, cough, and chest pain. Anaerobic organisms were more commonly isolated from patients with NHAE. The success rate of nonsurgical intervention was significantly lower for the NHAE patients than for the CAE group (39% vs 63; P=.01). In-hospital mortality was not significantly different between the two groups (NHAE, 18%; CAE, 8%; P=.09). In a Cox regression analysis, preadmission functional status (hazard ratio (HR)=1.26, 95% confidence interval (CI)=1.19,1.4; P<.001) and surgical intervention (HR=0.47, 95% CI=0.24,0.92; P=.03) were the only variables highly correlated with long-term outcome. CONCLUSION: Patients admitted with NHAE have distinctly different clinical and microbiological presentation from that of patients with CAE. Because of the delayed presentation in patients with NHAE, medical treatment alone may be associated with higher rate of failure. Surgical therapy should be considered for selected cases, with the aim of improving long-term survival. [source]

Delayed Rupture of the Left Ventricle Inferior Wall: A Diagnostic and Surgical Challenge

JOURNAL OF CARDIAC SURGERY, Issue 2 2009
Minoo N. Kavarana M.D.
The etiology, factors contributing to the delayed presentation, diagnosis, and management are discussed. [source]

Late free-flap salvage with catheter-directed thrombolysis

MICROSURGERY, Issue 4 2008
Andrew P. Trussler M.D.
Introduction: Despite high success rates with free-tissue transfer, flap loss continues to be a devastating event. Flap salvage is often successful if vascular complications are recognized and treated early. However, delayed presentation of flap compromise is an ominous predictor of flap loss. Late free-flap salvage has been described with poor long-term results. Catheter-directed thrombolysis (CDT) has only been described in context with free-tissue transfer in a case of distal bypass salvage. Objectives: The authors examined the efficacy of highly selective CDT in late salvage of free-flaps with vascular compromise. Methods: Two patients underwent highly selective CDT after delayed presentation (>5 days) of flap compromise. Patient 1 is a 59-year-old woman who underwent delayed breast reconstruction with a free TRAM flap and presented with arterial thrombosis 12 days postoperatively. Patient 2 is a 53-year-old man who underwent fibular osteocutaneous free-flap reconstruction of a floor of mouth defect who developed venous thrombosis 6 days postoperatively. Patient 2 underwent two attempted operative anastamotic revisions with thrombectomies and local thrombolysis prior to CDT. Results: The average time of presentation was 9 days, with the average time to CDT being 9.5 days. Patient 1 had an arterial thrombosis, whereas Patient 2 had a venous thrombosis. Both patients underwent successful thrombolysis after super-selective angiograms. Continuous infusions of thrombolytic agents were used in both patients for ,24 h. Average length of stay postCDT was 7 days with no perioperative complications. Long-term follow-up demonstrated complete flap salvage with no soft tissue loss. Conclusion: Despite extremely delayed presentation, aggressive CDT was successful in both breast, and head and neck reconstructions with excellent long-term flap results. CDT appears to be a useful modality in managing difficult cases of free-flap salvage. © 2008 Wiley-Liss, Inc. Microsurgery, 2008. [source]

Delayed penile replantation after prolonged warm ischemia

MICROSURGERY, Issue 2 2001
Afshin Mosahebi
We report a case of microsurgical replantation of traumatic self-amputation of penis after prolonged warm ischemia as a result of delayed presentation. At 12 weeks postoperative follow-up evaluation, the patient exhibited good urinary flow, spontaneous erection, and a normal response to pharmacological stimulation. © 2001 Wiley-Liss, Inc. MICROSURGERY 21:52,54 2001 [source]

Why do older women delay presentation with breast cancer symptoms?

PSYCHO-ONCOLOGY, Issue 11 2006
C. C. Burgess
Abstract Women who delay their presentation with breast cancer for three months or longer are more likely to be diagnosed with later stage disease and have poorer survival. Older women, who are at greater risk of developing breast cancer, are also more likely to delay their presentation. Factors associated with delayed presentation were assessed in 69 women (>65 years) with breast cancer. Previous factors identified for women of all ages were confirmed (having a non-lump symptom p=0.003) or strengthened (non-disclosure of symptom discovery to a relative or close friend p=0.001). Additional factors for delay in this older group included reservations about seeing their GP (p=0.02) and fear of the consequences of cancer (p=0.04). These factors should inform the design of interventions to reduce delays. Copyright © 2006 John Wiley & Sons, Ltd. [source]

ORIGINAL RESEARCH,PEYRONIE'S DISEASE: Predicting Delay in Presentation in Men with Peyronie's Disease

THE JOURNAL OF SEXUAL MEDICINE, Issue 6 2010
John P. Mulhall MD
ABSTRACT Introduction., Many men with Peyronie's disease (PD) delay presentation to a urologist. The reasons for this are unclear. Aim., To define the differences in men who present early compared to those presenting in a delayed fashion and to determine predictors of delayed presentation. Methods., A retrospective analysis of all patients presenting for the first medical evaluation of PD. All patients underwent a standard history and physical examination and had a standardized deformity assessment. Demographic and PD parameters were recorded. Main Outcome Measures., Statistical comparison was used to define factors that were different between early and delayed presenters and multivariable analysis was used to define predictors of presentation >12 months. Results., 482 patients were analyzed, 61% presenting ,12 months, 39% >12 months. Mean patient age was 52 ± 13 years and mean duration of PD was 17 ± 30 months. Mean measured curvature was 42° ± 19°. Multivariable analysis revealed that delayed presentation patients were significantly more likely to be older (odds ratio [OR] = 4.0), to be in long-term relationships (OR = 3.6), to have dorsal curvature (OR = 2.5), to have curvature <45° (OR = 3.3), to be heterosexual (OR = 2.0), and to have simple deformity (OR = 1.5). Conclusions., One-third of men with PD presented in a delayed fashion and they tended to be older, to be in long-term relationships, to have dorsal curvature, or to have simple deformity. Mulhall JP, Alex B, and Choi JM. Predicting delay in presentation in men with Peyronie's disease. J Sex Med 2010;7:2226,2230. [source]

Island flap perineoplasty for coverage of perineal skin defects after repair of cloacal deformity

ANZ JOURNAL OF SURGERY, Issue 8 2001
Brian Draganic
Background: Traumatic cloacal defect is an injury sustained during childbirth in which the anovaginal septum is completely disrupted and the anus and vagina open as a common channel. Such injuries result in complete faecal incontinence and are difficult to repair both in terms of improving function and obtaining skin closure. Methods: Four cases of traumatic cloacal defect with a delayed presentation are illustrated here. All were treated with an overlapping anterior sphincter repair in combination with island flap perineoplasty to achieve skin closure. Anorectal function before and after surgery and the success of achieving primary wound healing were evaluated. Results: In all four cases profound incontinence was found preoperatively; all patients returned to normal or near normal continence following overlapping anterior sphincter repair. Island flap perineoplasty was successful in achieving primary healing in all cases and no flaps were lost to necrosis. Conclusions: Island flap perineoplasty is an effective method of achieving skin closure after anterior sphincter repair of traumatic cloacal defects. [source]

Sling distress: A subanalysis of the IVS tapes from the SUSPEND trial

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2007
Siva BALAKRISHNAN
Abstract Aim:, To study the incidence of erosions and tape infections following the use of intravaginal slingplasty (IVS) treatment for stress urinary incontinence after the SUSPEND trial period of 30 months. This subanalysis was carried out because of concerns regarding high percentage of delayed sling erosions and infections during follow up of the patients who participated in the trial. Materials and methods:, The subanalysis patient group consisted of all IVS patients drawn from the SUSPEND randomised control trial that compared the safety and efficacy of three types of suburethral slings, TVT, SPARC and IVS, for the treatment of urodynamic stress incontinence. Results:, A total of 62 patients were reviewed during this study conducted from April 2002 to May 2003. Continence was achieved in 88% the patients. A total of eight (13%) sling erosions were found requiring sling removal. Forty-eight (77.4%) patients were followed up at 12 months with one case of erosion (1.7%). Twenty-nine (46.8%) of the 62 patients were followed up between 12 and 34 months, and seven cases of sling erosions were diagnosed. One patient had purulent suprapubic sinus, five patients had foul-smelling discharge, and one had recurrent urinary tract infection associated with pain and discharge. After the slings were removed the patients had no further symptoms. However, three of them had recurrent stress urinary incontinence. Discussion/conclusion:, The delayed presentation of the sling erosion from this subanalysis is a concern, and pelvic reconstructive surgeons using IVS need to be aware of the delayed presentations we found in our cohort of patients. [source]