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Long-term Functional Outcome (long-term + functional_outcome)

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Medical Sciences	100%

Selected Abstracts

Long-term functional outcomes in patients with various types of orthotopic intestinal neobladder

INTERNATIONAL JOURNAL OF UROLOGY, Issue 7 2008
Hideaki Miyake
Objectives: To evaluate the long-term functional outcomes of various types of orthotopic neobladder (NB). Methods: Eighty-nine patients who underwent orthotopic NB reconstruction after radical cystectomy and were followed for at least 60 months after surgery were included in this retrospective study. The types of NB in this series were: modified Studer type, Hautmann type, Mainz type, Goldwasser type and modified Reddy type in 36, 9, 15, 10 and 19 patients, respectively. Results: Sixty-seven (75.3%) patients could void spontaneously, 15 (16.8%) voided with clean intermittent catheterization (CIC) assistance and seven (7.9%) with CIC alone. After excluding the seven voiding with CIC alone, daytime and night-time continence was achieved in 63 and 50 of the remaining 82 patients, respectively. In addition, the proportion of daytime continence in the modified Studer group was significantly greater than that in the Mainz group, whereas there was no significant difference in the proportion of night-time continence among these groups. Uroflow examination indicated that despite the lack of significant differences in the maximal flow rates and the voided volumes, the post-void residual in the modified Reddy group was significantly smaller than that in the modified Studer group. Blood gas analysis in the 82 patients showed that there were no significant differences in the pH, bicarbonate, chloride and base excess among these groups. Conclusions: Orthotopic NB created with intestinal segments generally has acceptable functional outcomes on long term follow up. These outcomes differ according to the type of NB. To define the optimal procedure for NB reconstruction, it is necessary to understand the long-term functional prospects, on which the subjective success of NB creation is based. [source]

Long-term results of transarticular pinning for surgical stabilisation of coxofemoral luxation in 20 cats

JOURNAL OF SMALL ANIMAL PRACTICE, Issue 3 2009
T. R. Sissener
Objectives: The objective of this study was to describe initial and long-term results of open reduction and transarticular pinning for treatment of coxofemoral luxations in cats. Methods: Cats were treated by open reduction and transarticular pinning for coxofemoral luxation over a five year period at two institutions. Follow-up assessment included orthopaedic examination, radiography and owner questionnaires. Results: Twenty cats were included in the study (14 males and six females). One cat was affected bilaterally. Mean time to follow-up was 21 months. Seventeen joints were stabilised with a 1·6 mm pin, three with 2·0 mm pins and a 1·2 mm pin was used in the remaining joint. An Ehmer sling was not utilised in any case. All transarticular pins except one were removed (mean 3·5 weeks), with all hips still in reduction The overall success rate was 77 per cent, with two reluxations and one resorbed femoral head noted on radiographs of 13 joints followed long term. All 20 owners reported good to excellent long-term functional outcome for their cats. Clinical Significance: Results from this study indicate that transarticular pinning for stabilisation of coxofemoral luxation in cats can provide a good long-term outcome without sacrificing the integrity of the coxofemoral joint. [source]

Quality of life after liver transplantation for alcoholic liver disease

LIVER TRANSPLANTATION, Issue 6 2000
Stephen P. Pereira
There are few data on predictive factors for alcohol relapse or long-term functional outcome after liver transplantation for alcoholic liver disease (ALD). In all 56 surviving UK patients (47 men, 9 women; mean age: 51 years; range: 33 to 69 years) who underwent transplantation for ALD at King's College Hospital over a 10-year period, alcohol relapse and outcome were assessed by outpatient and case-note review and by postal questionnaire containing (1) the Nottingham Health Profile (NHP), (2) the Short-Form-36 (SF-36) Health Survey, and (3) a drug and alcohol questionnaire. At a median of 2.5 years (range: 0.5 to 10 years), 13 of the 47 respondents (28%) and 2 of the 9 nonrespondents (22%) had evidence of potentially harmful drinking (>3 units daily) at some time posttransplantation. An additional 13 patients admitted to drinking some alcohol at least once, corresponding to an overall relapse rate of 50%. The patients with harmful drinking (1) had started drinking regularly at a younger age (18 v 25 years; P = .01), (2) began drinking heavily at a younger age (30 v 40 years; P = .01), (3) had shorter pretransplantation abstinence periods (10 v 23 months; P = .02), and (4) had a longer time since transplantation (median, 5.7 v 1.5 years; P = .0004) than those with no or mild alcohol relapse. They were also more likely to report sleep disturbance (NHP sleep problem score, 45 v 16; P = .01) and use benzodiazepines regularly (7 of 13 v 3 of 34 patients; P = .002). Despite these differences, health dimension scores in the SF-36 and NHP posttransplantation were similar between the groups and to those of UK community controls. In the long term, at least 50% of the patients will drink again at some time posttransplantation, although at lower levels of alcohol intake than previously. Those patients with multiple predictive factors for alcohol relapse may be at greatest risk for harmful drinking and be the group that would benefit most from professional counseling. Overall, the quality of life after liver transplantation for ALD is high and broadly similar to the levels expected in the normal population. [source]

Depression predicts unfavourable functional outcome and higher mortality in stroke patients: The Bergen Stroke Study

ACTA NEUROLOGICA SCANDINAVICA, Issue 2010
H. Naess
Naess H, Lunde L, Brogger J, Waje-Andreassen U. Depression predicts unfavourable functional outcome and higher mortality in stroke patients: The Bergen Stroke Study. Acta Neurol Scand: 2010: 122 (Suppl. 190): 34,38. © 2010 John Wiley & Sons A/S. Objective,,, To assess the influence of depression prior to stroke (PD) on stroke severity on admittance, functional outcome (short- and long-term), mortality, and long-term depression (PSD). Methods,,, Consecutive acute stroke patients were screened for PD. The National Institute of Health Stroke Scale score was obtained on admission. Short-term functional state was registered by the modified Rankin scale and on long-term functional outcome by the Barthel Index. PSD was defined as depression subscale of the hospital anxiety and depression scale (HADSD) ,11. HADSD and Barthel Index were obtained by postal questionnaire. Survival analyses were performed. Results,,, Among 771 patients 21.7% had PD. Among 376 patients returning the questionnaire, 8.8% were depressed. On logistic regression analyses severity of stroke on admission, short-term, and long-term functional outcome were independently associated with PD. Logistic regression showed PSD to be independently associated with PD and being unmarried. Cox regression analyses showed that both PD and PSD were associated with high long-term mortality. Conclusions,,, This study has identified several factors associated with PSD. PD predicts more severe stroke on admittance and less functional improvement both in the short- and the long-term. Both PD and PSD predict higher long-term mortality. [source]

Outcome after treatment of congenital bilateral cataract

ACTA OPHTHALMOLOGICA, Issue 6 2002
Anna Lundvall
ABSTRACT. Purpose:, To evaluate long-term functional outcome after treatment of dense congenital bilateral cataract. Methods:, The records of 22 consecutive children operated on before the age of 12 months at St. Erik's Eye Hospital over a 5-year period (1991,96) were reviewed retrospectively. Linear Snellen visual acuity (VA) at last check, presence of stereoacuity, nystagmus, strabismus and other complications are accounted for. Subject age at last check ranged from 4 to 9 years. Results:, Visual acuity could be estimated in 19 children: the median VA of the better eye was 0.4 (range: counting fingers , 0.8) and of the fellow eye 0.15 (range: amaurosis , 0.8). In nine otherwise healthy children who were operated on early (by 1 month of age), VA varied from 0.4 to 0.8 in the better eye. Four of these children achieved stereopsis. Pupillary block glaucoma developed in five eyes (in three children). Chronic glaucoma developed in eight eyes (in five children). Glaucoma occurred predominantly in children who underwent cataract extraction during the first week of life. Two of the latter had marked microphthalmos. Conclusion:, Good postoperative VA was achieved in most healthy children with dense bilateral congenital cataract when surgery was performed early (before 6,8 weeks of age). Chronic glaucoma developed predominantly when cataract extraction was performed during the first week of life. [source]

Delays in the diagnosis of anorectal malformations are common and significantly increase serious early complications

ACTA PAEDIATRICA, Issue 3 2006
Richard M Lindley
Abstract Aim: To clarify the extent of delayed diagnosis of anorectal malformations and the consequences of delaying this diagnosis. Methods: We performed a retrospective case review of all neonatal admissions with an anorectal malformation to a tertiary paediatric surgery unit. A delayed diagnosis was considered to be one made 24 h or more after birth. Results: 75 patients were included in the study group: 31 (42%) had a delay in the diagnosis; 44 (58%) had no delay in the diagnosis. The time of diagnosis where a delay had occurred ranged from 2,16 (median 2) d. A delay in diagnosis could not be accounted for by differences in age, sex, birthweight, gestational age, the severity or visibility of the lesion, the need for neonatal special or intensive care, or the presence of other anomalies. There were significantly more complications (including one death) amongst the group of children who had a delay in the diagnosis of an anorectal malformation. There was no significant difference in long-term functional outcome. Conclusion: Delays in the diagnosis of anorectal malformations are much more common than previously thought. A delay in diagnosis significantly increases the risk of serious early complications and death. [source]