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Long Term Follow-up (long + term_follow-up)
Selected AbstractsLong term follow-up of allogeneic stem cell transplantation in patients with myelodysplastic syndromes using busulfan, cytosine arabinoside, and cyclophosphamide,AMERICAN JOURNAL OF HEMATOLOGY, Issue 8 2010Ehab Atallah We report here the 10-year follow-up of 86 patients who underwent allogeneic stem cell transplantation (ASCT) for myelodysplastic syndrome (MDS). All patients received the busulfan, cytosine arabinoside, and cyclophosphamide (BAC) preparative regimen which consisted of busulfan 16 mg/kg, cytosine arabinoside 8 g/m2 IV, and cyclophosphamide 120 mg/kg IV. Fifty-nine patients (69%) had de novo MDS; 26 (30%) had secondary MDS (treatment related), and one had a preceding aplastic anemia which progressed to MDS before transplant. Cytogenetics (80 patients) was classified as good (34%), intermediate (17%), or poor (42%). With a median follow-up for survivors of 124 months, the 10-year Kaplan-Meier estimates for overall survival (OS) was 43% (95% confidence interval [CI]: 31,53%). Cumulative nonrelapse mortality (NRM) and relapse was 43% (95% CI: 32,54%) and 19% (95% CI: 11,27%), respectively. No patient relapsed after 2 years. In patients with RAEB-T/AML, 10-year relapse-free survival (RFS), relapse, and NRM was 36%, 36%, and 27%, respectively. Younger age (P = 0.05), human leukocyte antigen (HLA) match (P = 0.002), good risk cytogenetics (P = 0.008), and having a related donor (P = 0.03) significantly improved overall and RFS in the multivariable analysis. The long-term follow-up of patients receiving the BAC regimen with ASCT in this study indicated durable relapse-free and OS with acceptable toxicity in this group of patients with high-risk features. Am. J. Hematol., 2010. © 2010 Wiley-Liss, Inc. [source] Long term follow-up of transcatheter coil embolotherapy for major colonic haemorrhageCOLORECTAL DISEASE, Issue 10 2010T. M. Ahmed Abstract Aim, Therapeutic angiography with embolization is fast becoming the preferred treatment modality for major bleeding in the lower gastrointestinal (LGI) tract. The aim of this study was to determine the long term outcome and complications of percutaneous coil embolization (PCE) and its efficacy as definitive therapy in patients with major LGI bleeding. Methods, All patients presenting to our institution with a haemodynamically significant LGI tract bleed between 1995 and 2001 that were unresponsive to conservative measures were considered for emergency angiography and coil embolization where appropriate. The outcome of these individuals was determined by case note review and telephone interview. Results, There were 20 patients (11 females) with a mean follow-up period 72 months, mean age was 67 years. All underwent PCE following positive angiogram. The most common site of bleeding was the right colon (40%); haemostasis was successfully achieved in 16 (80%) patients. Five of the 20 patients died within 30 days of the intervention, three following PCE and two following surgery. None of the mortality following PCE was considered procedure related. On long term follow-up four patients required readmission to hospital for further LGI bleeds at 1, 2, 12 and 16 months respectively. Ischaemic complications occurred in 23%. Conclusion, Superselective embolization as the primary technique for the treatment of haemodynamically significant LGI bleeding is an effective, feasible and safe technique. Long term follow-up in our series up to 72 months has shown that it should be considered as both a primary and potentially definitive treatment for life threatening LGI bleeds. [source] Angiotensin-converting enzyme gene insertion/deletion polymorphism frequency in normotensive children with a positive family history of essential hypertensionJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 12 2009Lale Camci Aim: To evaluate the possible relationship between blood pressure (BP) and angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in normotensive children with a positive family history of essential hypertension (EHT). Material and Methods: Three hundred seventy-six randomly selected normotensive schoolchildren (147 boys, 229 girls) between the ages of seven and 17 years were enrolled. Children were subdivided into a ,first-degree relative group' and a ,second-degree relative group' according to the presence of EHT in parents or grandparents, respectively. BP was measured twice from the right arm and the systolic BP, diastolic BP and mean BP were recorded. ACE gene I/D polymorphism was performed from all studied children and frequency od DD, ID and ID allele were analysed in each study group. Results: Allelic frequencies of the DD genotype of the ACE gene were higher in children with a positive history in the first- (36.2%) and second-degree (38.3%) relatives for EHT than the controls (30.7%) (P < 0.05 for both). Children with a positive family history of EHT and a DD genotype, had significantly higher SBP, DBP and MBP levels (P < 0.05) than the children with ID or II genotypes. Conclusion: We found that the ACE gene DD genotype was common and that BP levels were higher in Turkish children with a positive family history of EHT and DD genotype. Because the presence of DD allele might be the one of the potential contributor of EHT pathogenesis, further studies needed in large cohort for long term follow-up for EHT in children with DD allele. [source] Implementing a Smoking Cessation Program for Pregnant Women Based on Current Clinical Practice GuidelinesJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 6 2002Lynne Buchanan APRN, PhDArticle first published online: 24 MAY 200 Purpose To describe the U.S. Department of Health and Human Services clinical practice guideline for treating tobacco use and dependence and demonstrate how the guideline was utilized in a pilot program for a small sample of pregnant women (n=20) to help them decrease smoking. Data Sources A convenience sample of 20 pregnant women was recruited from a health maintenance organization at their initial prenatal contact either by telephone or in person. A comparison group of pregnant women (n=28) was used for analysis of outcomes. Conclusions Clinical results showed better outcomes for women in the pilot program when compared to a similar group who did not participate in the program. There was a statistically significant difference between the two groups in average number of cigarettes smoked per day at delivery and two weeks after delivery with pilot program participants reporting less smoking (p<.05). Women in both groups showed a pattern of returning to smoking after delivery of the baby. Implications for Practice Although a few tobacco users achieve permanent abstinence in first or second attempts, the majority continue to use tobacco for many years and typically cycle through many lapse and relapses before permanent abstinence. Ambulatory care systems need to be developed and funded to treat tobacco use and dependence over the life span. Recognition of the chronic nature of the problem and development of long term care delivery systems are needed to assist clients to achieve goals of permanent abstinence and better personal and family health. This cycle of lapse and relapse before permanent abstinence is typical and demonstrates the chronic nature of tobacco use and dependence and the need for long term follow-up. [source] Hemoglobin Kenya composed of ,- and (A,,)-fusion-globin chains, associated with hereditary persistence of fetal hemoglobinAMERICAN JOURNAL OF HEMATOLOGY, Issue 1 2009Ibifiri Wilcox Hb Kenya is made up of two normal ,-globin chains and two A,,-fusion globin chains. The latter are the product of an A,,-hybrid globin gene formed as a result of misalignment during meiosis and nonhomologous crossing over. It is associated with a deletion of 22.7 kb including the ,-globin gene, between the A,- and ,-globin genes. Hb Kenya is found in Kenyans and Ugandans. Heterozygotes have moderately increased Hb F, and this mutation has been known as an (A,,)+ hereditary persistence of fetal hemoglobin (HPFH). Compound heterozygotes for Hb Kenya/Hb S are thought to be asymptomatic, but reports of long term follow-up of these patients are lacking. The correct identification of Hb Kenya is sometimes problematic. In cation exchange high performance liquid chromatography, Hb Kenya elutes in similar position as Hb A2, Hb Lepore, Hb E, and several other variant hemoglobins. Definitive diagnosis that is necessary for proper patient management is best done by DNA-based gap-PCR tests. Am. J. Hematol, 2009. © 2008 Wiley-Liss, Inc. [source] Endovascular treatment of Angio-SealÔ-related limb ischemia,Primary results and long-term follow-up,CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 6 2010Christoph Thalhammer MD Abstract Objectives: To investigate primary success rates and long term follow-up of endovascular treatment of AngioSealÔ-related limb ischemia. Background: Current knowledge on optimal therapy of ischemic complications following application of AngioSealÔ is limited. Methods: A single-center prospectively maintained database was retrospectively interrogated and AngioSealÔ,related complications requiring endovascular treatment over an 8-year-time period was identified. Results: Fifteen patients fulfilling the inclusion criteria were identified, resulting in an approximated incidence of 0.26% of all devices implanted at our institution. In all cases, the complication was managed successfully in the absence of complications. Eleven patients were treated with balloon angioplasty (PTA) and four with stent implantation because of suboptimal PTA results. Twelve patients were available for noninvasive vascular follow-up examination for a median time of 40 months postinterventionally. Only two patients needed a second intervention consisting of balloon angioplasty due to symptomatic restenosis. At final follow-up all patients were asymptomatic with no relevant restenosis. Conclusion: Endovascular treatment for AngioSealÔ-related limb ischemia with or without stent implantation results in an excellent immediate and long-term clinical and hemodynamic outcome. © 2009 Wiley-Liss, Inc. [source] 3413: Treatment options of macular edema in uveitisACTA OPHTHALMOLOGICA, Issue 2010Y GUEX-CROSIER Purpose To summarize current concepts on therapeutic approach in inflammatory cystoid macular edema (ICME). Methods A review of relevant literature concerning treatment options of ICME was performed. Results ICME is a major factor related to poor visual acuity in long term follow-up of uveitis. Topical corticosteroids administration has a minor therapeutic effect on ICME. Local therapies consist mostly of posterior sub-tenon's, intraocular corticosteroids injections or drug delivery systems. The effect of systemic corticosteroids, immunosuppressive agents or biological therapies will be discussed. Conclusion The recent development of drug delivery systems and biological therapies has considerably improved the prognosis of ICME. [source] Pterygium surgery long term follow-upACTA OPHTHALMOLOGICA, Issue 2009T WOOD Purpose To determine if a pterygium surgical procedure consisting of minimal conjunctival removal, excision of the hypertrophic subconjunctival fibrovascular tissue, application of mitomycin 0.25 mg/ml for 1 minute combined with temporary nasal tarsorrhaphy, and postoperative dexamethasone/antibiotic drops achieved the following: safely simplified pterygium removal, controlled the early side effects of mitomycin, reduced the rate of recurrence, and eliminated the need for conjunctival transplantation. Methods Twenty eyes of 19 patients underwent the procedure with mitomycin; fifteen were primary and 5, recurrent. These were compared to a previous group of 28 eyes in 26 patients that underwent pterygium/tarsorrhaphy surgery without mitomycin; twenty had primary and 8 had recurrent pterygia. Postoperatively, all eyes in both groups were treated with dexamethasone/antibiotic drops. Results In the mitomycin group (average follow-up 25 months), 19 of 20 eyes healed uneventfully. At 12 months, there had been no recurrences in the mitomycin group. In the non-mitomycin group (average follow-up 43 months), 9 (32%) recurred within 12 months; four (44%) of these required a second procedure at an average of 9 months. At 23 and 33 months, 2 (10%) eyes treated with mitomycin presented with asymptomatic, one mm recurrences that required no additional treatment. Conjunctival healing, as reflected in the time from surgery until tarsorrhaphy opening, was significantly longer in the mitomycin group, 37 vs. 17 days (P = .001). Conclusion The described technique provided a safe and successful approach to pterygium management. [source] Long term follow-up of transcatheter coil embolotherapy for major colonic haemorrhageCOLORECTAL DISEASE, Issue 10 2010T. M. Ahmed Abstract Aim, Therapeutic angiography with embolization is fast becoming the preferred treatment modality for major bleeding in the lower gastrointestinal (LGI) tract. The aim of this study was to determine the long term outcome and complications of percutaneous coil embolization (PCE) and its efficacy as definitive therapy in patients with major LGI bleeding. Methods, All patients presenting to our institution with a haemodynamically significant LGI tract bleed between 1995 and 2001 that were unresponsive to conservative measures were considered for emergency angiography and coil embolization where appropriate. The outcome of these individuals was determined by case note review and telephone interview. Results, There were 20 patients (11 females) with a mean follow-up period 72 months, mean age was 67 years. All underwent PCE following positive angiogram. The most common site of bleeding was the right colon (40%); haemostasis was successfully achieved in 16 (80%) patients. Five of the 20 patients died within 30 days of the intervention, three following PCE and two following surgery. None of the mortality following PCE was considered procedure related. On long term follow-up four patients required readmission to hospital for further LGI bleeds at 1, 2, 12 and 16 months respectively. Ischaemic complications occurred in 23%. Conclusion, Superselective embolization as the primary technique for the treatment of haemodynamically significant LGI bleeding is an effective, feasible and safe technique. Long term follow-up in our series up to 72 months has shown that it should be considered as both a primary and potentially definitive treatment for life threatening LGI bleeds. 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