Poor Functional Outcomes (poor + functional_outcome)

Distribution by Scientific Domains


Selected Abstracts


Severe Vascular Lesions and Poor Functional Outcome in Kidney Transplant Recipients with Lupus Anticoagulant Antibodies

AMERICAN JOURNAL OF TRANSPLANTATION, Issue 9 2010
G. Canaud
The impact of antiphospholipid antibodies (APA) on clinical outcome and graft histology following renal transplantation remains poorly known and controversial. We retrospectively explored the functional and histological significance of APA, primarily lupus anticoagulant (LA), in kidney transplant recipients using a systematic evaluation of 3- and 12-month posttransplant screening biopsies and glomerular filtration rate measurements (mGFR). During the study period, 37 patients had APA (2.7%), primarily LA, and 12 fulfiled antiphospholipid syndrome (APS) diagnostic criteria (0.8%) at the time of transplantation. Early after transplantion, 4 of the 12 APS patients died. Early thrombosis of graft vessels and deep venous thrombosis occurred more frequently in APA+ patients than in controls (27% vs. 7%, p < 0.05 and 35% vs. 14%, p < 0.05, respectively). The survival rate was significantly lower in patients with APS. Strikingly, the hallmark lesions of APS-associated nephropathy (APSN) were found in most of screening graft biopsies in APA+ patients but not in the controls. Accordingly, APA+ patients had a dramatic increase in chronic vascular scores and a faster decline in mGFR at 1 year. In conclusion, renal transplantation may be life-threatening in APS patients, and the presence of LA at the time of transplantation is associated with a high rate of allograft APSN and poor transplantation outcomes. [source]


Outcome of craniopharyngioma in children: long-term complications and quality of life

DEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 4 2004
Andrea Poretti MB BS
Childhood craniopharyngiomas are histologically benign tumours arising from remnants of Rathke's pouch in the hypothalamic,pituitary region. The two common treatment approaches are primary total resection or limited resection followed by radiotherapy. To study the outcome after a primary surgical approach, we followed 25 consecutive patients (10 females, 15 males) under 16 years of age who were treated in a single institution with a management policy of radical tumour excision (mean age at diagnosis 9 years 2 months, SD 4 years 3 months; range 2 years 9 months to 15 years 11 months). Mean follow-up after primary surgery was 11 years 3 months (SD 7 years 7 months). Tumour control, and neurological, endocrine, and hypothalamic complications and their impact on health-related quality of life were assessed (medical follow-up, semi-structured interview, and questionnaires). Results of tumour control were generally good, however, local failure was observed in 6 of 25 patients, and severe late-treatment complications decreased quality of life for many long-time survivors. Endocrine deficiency occurred in 24/25, visual complications in 16/24, neurological complications in 8/24, obesity in 14/23, increased daytime sleepiness in 6/21, and significant school problems in 10/20. Patients with craniopharyngioma rated their health-related quality of life as considerably lower than healthy controls; the domains of social and emotional functioning were particularly affected. Parents'ratings were considerably lower than those of the patients. Poor functional outcome was associated with large tumours infiltrating or displacing the hypothalamus, the occurrence of hydrocephalus, and young age at diagnosis, but also with multiple operations due to tumour recurrence. Alternative treatment strategies should be considered, especially in very young patients with large tumours. [source]


Interpersonal problems and emotional intelligence in compulsive hoarding

DEPRESSION AND ANXIETY, Issue 9 2008
Jessica R. Grisham Ph.D.
Abstract There is some evidence that compulsive hoarding is associated with social impairment, which may contribute to poor functional outcomes among hoarding patients. In this study, individuals with compulsive hoarding (n = 30) were compared to nonhoarding anxious or depressed patients (n = 30) and nonclinical community participants (n = 30) with respect to clinical characteristics, interpersonal difficulties, and emotional intelligence. All participants were diagnosed using a semi-structured interview and completed self-report measures. Participants with compulsive hoarding endorsed more depression and schizotypal personality disorder symptoms than participants in both comparison groups. Hoarding participants also reported more interpersonal difficulties than community volunteers, but they did not differ significantly from nonhoarding participants with an anxiety or mood disorder. Multiple regression analyses demonstrated that hoarding-related beliefs were marginally related to increased interpersonal problems over and above the effect of depression and anxiety. The groups did not differ significantly with respect to emotional intelligence. Depression and Anxiety. © 2007 Wiley-Liss, Inc. [source]


Occupational status and social adjustment six months after hospitalization early in the course of bipolar disorder: a prospective study

BIPOLAR DISORDERS, Issue 1 2010
Faith Dickerson
Dickerson F, Origoni A, Stallings C, Khushalani S, Dickinson D, Medoff D. Occupational status and social adjustment six months after hospitalization early in the course of bipolar disorder: a prospective study. Bipolar Disord 2010: 12: 10,20. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S. Objectives:, Bipolar disorder is often accompanied by poor functional outcomes, the determinants of which are not fully understood. We assessed patients with bipolar disorder undergoing a hospital admission early in the illness course and identified predictors of occupational status, overall social adjustment, and work adjustment six months later. Methods:, This was a prospective longitudinal cohort study. During hospitalization patients were evaluated with a cognitive battery; symptoms, occupational history, and other clinical factors were also assessed. At six-month follow-up, patients' symptom remission status was assessed; they were also evaluated as to their occupational status, overall social adjustment, and work adjustment. Multivariate analyses were used to identify predictors of these outcomes. Results:, Among the 52 participants, the average rating of overall social adjustment at follow-up was between mild and moderate maladjustment. While 51 had a history of working full time, only 28 (54%) worked full time at follow-up. A total of 24 (46%) had symptoms that met criteria for a full depression or mania syndrome. In multivariate analyses, full-time occupational status at follow-up was predicted by the absence of baseline substance abuse. Better overall social adjustment was predicted by better performance on cognitive tasks of processing speed and by symptom remission; the latter variable also predicted work adjustment. Conclusions:, Persons with bipolar disorder have limited occupational recovery and overall social adjustment six months after a hospital admission early in the illness course. Predictors vary among outcomes; performance on tasks of processing speed and the extent of symptom remission are independently associated with functional outcomes. [source]