Background: Information regarding the incidence and risk factors for deep vein thrombosis (DVT) detected by follow-up computed tomographic (CT) venography after pulmonary embolism (PE) is sparse. The aim of the present study was to identify the predictors of DVT in follow-up CT images, and to elucidate their clinical significance. Methods: Patients with PE were classified into the following three cohorts based on the time of indirect CT venography follow-up: within 1 month, 1 to 3 months, and 3 to 9 months after the initial CT scan. Each cohort was subdivided into patients with or without DVT detected by follow-up CT. Clinical variables were compared between the two groups. Results: Follow-up CT revealed DVT in 61% of patients with PE within 1 month, in 15% of patients with PE at 1 to 3 months, and in 9% of patients with PE at 3 to 9 months after the initial CT scan. Right ventricular (RV) dilation on the initial CT (odds ratio [OR], 8.30; 95% confidence interval [CI], 1.89-36.40; p=0.005) and proximal DVT at the initial presentation (OR, 6.93; 95% CI, 1.90-25.20; p=0.003) were found to independently predict DVT in follow-up CT images within 1 month, proximal DVT at the initial presentation was found to independently predict DVT in follow-up CT images at 1 to 3 months (OR, 6.69; 95% CI, 1.53-29.23; p=0.012), and central PE was found to independently predict DVT in follow-up CT images at 3 to 9 months (OR, 4.25; 95% CI, 1.22-4.83; p=0.023) after the initial CT scan. Furthermore, the detection of DVT by follow-up CT independently predicted the recurrence of venous thromboembolism (VTE) (OR, 4.67; 95% CI, 2.24-9.74; p<0.001). Conclusion: Three months after PE, DVT was not detected by follow-up CT in most patients with PE. RV dilation on the initial CT, central PE, and proximal DVT at the initial presentation were found to predict DVT on follow-up CT, which might predict VTE recurrence.
Background: This study aims to compare the clinical outcomes of steroid injections during the rehabilitation period after arthroscopic rotator cuff repair (ACRC). Methods: Among patients who underwent ARCR, 117 patients who met the inclusion and exclusion criteria were enrolled. Pain and range of motion (ROM) recovery at the 3-, 6-, and 24-month follow-up visits and functional outcome at the 24-month follow-up were compared between 45 patients who received ultrasound-guided subacromial steroid injection at postoperative week 4 or 6 and 72 patients who did not. Functional outcome was assessed using the American Shoulder and Elbow Surgeons (ASES) score and Constant score. Healing of the repaired tendon and retear were observed at the 6-month follow-up via magnetic resonance imaging (MRI) or computed tomography (CT) arthrography. Results: At the 3-month follow-up, the steroid injection group showed lower visual analog scale scores than the control group (p<0.05) and showed faster recovery of forward flexion and internal rotation (p<0.05). From the 6-month follow-up, the two groups did not show differences in pain and ROM, and the ASES score and Constant score also did not significantly differ at the 24-month follow-up. The two groups did not differ in retear rate as determined by MRI or CT arthrography at the 6-month follow-up. Conclusions: This study demonstrated that ultrasound-guided subacromial steroid injection at 4 or 6 weeks after ARCR leads to quick pain reduction and ROM recovery until 3 months after surgery. Therefore, subacromial steroid injection is speculated to be an effective and relatively safe method to assist rehabilitation.
As a basic study for enhancing the sensitivity of the follow-up system of the marine gyrocompass, the geometric characteristics of the deflection sensor were investigated and the theoretical model of it was formulated. The output signal voltage of the deflection sensor was esamined by changing the attitude of gyrosphere against follow-up container. The characteristics of the output are found to be indentical with those of the distance difference versus the relative azimuthal deflection of the gyrosphere against the follow up container. On the base of the theoretical model, some useful points for the design of the deflection sensor are suggested as following : 1. When the difference between semidiamter of gyrophere and that of the follow-up container decreases, the sensitivity of deflection sensor increases. 2. If the semidiameter difference of two spheres is constant, the sensitivity of deflection sensor is proportional to the magnitude of the semidiamter of each sphere. 3. The farther the gyrosphere is deviated from the center of follow-up container, the higher the sensitivity of deflection sensor is. 4. It is recommendable that the value of the datum deflection of the electrodes on the gyrosphere should be within the range between $4^{\circ}$ and $16^{\circ}$deviated from north-south line.
Objectives : The aim of this study is to examine the cognitive function change related to aging, the incidence of cognitive impairment, and the association between apolipoprotein E polymorphism and cognitive impairment through a follow-up of the elderly with normal cognitive ability at baseline. Methods : Two hundred and fifteen subjects aged 65 and over were surveyed in February, 1998 (baseline survey), and their cognitive function was assessed again in 2003 1st follow-up) and the once again in 2006 (2nd follow-up). Ninety one subjects completed all surveys up through the 2nd follow-up and their cognitive function scores using MMSE-K (Korean Version of the Mini-Mental State Examination) and the distribution of apolipoprotein E allele were analyzed. Results : The cognitive function scores decreased with aging and the difference between baseline and the 2nd follow-up scores of the study increased with the age group. The incidence rate of cognitive impairment through an 8-year follow-up was 38.5% and higher in older age groups. Age was the only significant factor for incidence of cognitive impairment, but there was no significant association between apolipoprotein E genotype and incidence of cognitive impairment. Conclusions : The cognition of the elderly decreased with aging and the association of apolipoprotein E genotype with incidence of cognitive impairment was not significant in this study. To confirm the association between apolipoprotein E polymorphism and incidence of cognitive impairment further studies will be needed.
Serrano-Olvera, Alberto;Cetina, Lucely;Coronel, Jaime;Duenas-Gonzalez, Alfonso
Asian Pacific Journal of Cancer Prevention
/
제15권20호
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pp.8749-8752
/
2014
Purpose: This study aimed to determine the patterns of follow-up visits for cervix cancer in a national cancer center in Mexico. Materials and Methods: The National Cancer Institute of Mexico is cancer center with 119 beds that mostly cares for an underserved and socially disadvantaged population. The medical records of cases of cervical cancer that had at least one year of clinical follow-up after being in complete response at the end of primary treatment were analyzed. We recorded the numbers of total and yearly follow-up visits and these were compared with the number of follow-up visits recommended by the National Comprehensive Cancer Network 2013, version 2 for cervical cancer. Results: Between March and June 2007, the medical records of 96 consecutive patients were reviewed. Twenty (21%) of these met inclusion criteria and were selected. In the first year the median number of visits was 11 (4-20). In the ensuing years, $2^{nd}$, $3^{rd}$, $4^{th}$ and $5^{th}$, the number of analyzed patients remaining in follow-up decreased to 17, 14, 13 and 9 respectively. There were 462 follow-up visits to primary treating services (Gynecology Oncology, Radiation Oncology and Medical Oncology) as compared to 220 suggested by the NCCN guidelines ($X^2$ test p<0.0001). There were 150 additional visits to other services. Conclusions: Our results suggest that in our institution there is an overuse of oncological services by cervical cancer patients once treatment is completed.
In order to evaluate thelong-term results of conservative treatment on TMJ closed lock, a follow-up study of thirst-two patients was performed 2 to 7 year after treatment. Evaluating method included the questionnaire, clinical examination, transcranial radiograph and mandibular kinesiography. The results were as follows : Seventy-eight percents of patients reported that symptoms were reduced completely or considerably. Recurrent headache was improved after treatment (72 percents of success rate). There was a significant decrease in VAS after treatment and at follow-up comparing with that of before treatment(p<0.01). Most common variable of Helkimo's clinical dysfunction index at follow-up was impared TMJ function. There was a significant decrease in Fricton's craniomandibular index and dysfunction index(p<0.01) Mean interincisal distance was increased by 14.07mm after treatment and was also increased at follow-up by 2.80mm comparing with that of after treatment(p<0.01). Before treatment, condylar translation measurements of affected and non-affected sides on the transcranial radiograph were 4.89±3.20mm and 9.09±3.73mm respectively and at follow- up examination, those were 14.98±4.77 and 17.05±4.35mm respectively. At follow-up, condylar translation were increased significantly comparing with those of before treatment(p<0.01). In 93.1% of patients, the condylar position of affected side at maximum mouth opening was behind the articular eminence before treatment but the percentage was decreased to 13.8% at follow-up(p<0.01). The pattern and range of mandibular movements at follow-up examination were similar to the typical normal movements. And in 16 cases showing lateral deviation of opening path, the deviation was directed to the affected and non-affected sides with the same frequency.
Background: Breast cancer is the most common type of cancer amongst women throughout the world. Currently, there are various follow-up strategies implemented in Iran, which are usually dependent on clinic policies and agreement among the resident oncologists. Purpose: A cost-effectiveness analysis was performed to assess the cost-effectiveness of intensive follow-up versus standard models for early breast cancer patients in Iran. Materials and methods: This cross sectional study was performed with 382 patients each in the intensive and standard groups. Costs were identified and measured from a payer perspective, including direct medical outlay. To assess the effectiveness of the two follow-up models we used a decision tree along with indicators of detection of recurrence and metastasis, calculating expected costs and effectiveness for both cases; in addition, incremental cost-effectiveness ratios were determined. Results: The results of decision tree showed expected case detection rates of 0.137 and 0.018 and expected costs of US$24,494.62 and US$6,859.27, respectively, for the intensive and standard follow-up models. Tornado diagrams revealed the highest sensitivity to cost increases using the intensive follow-up model with an ICER=US$148,196.2. Conclusion: Overall, the results showed that the intensive follow-up method is not cost-effective when compared to the standard model.
Yoo, Jae Chul;Koh, Kyoung Hwan;Shon, Min Soo;Bae, Kyu Hwan;Lim, Tae Kang
Clinics in Shoulder and Elbow
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제21권3호
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pp.127-133
/
2018
Background: This study was undertaken to evaluate the outcome of the arthroscopic capsular release for adhesive capsulitis of the shoulder. Methods: This study retrospectively investigated thirty shoulders in 29 patients who presented with recalcitrant adhesive capsulitis and underwent arthroscopic treatments. Other than typical findings of adhesive capsulitis, combined pathologies in the glenohumeral joint and subacromial space were evaluated by arthroscopy. Clinical evaluations were performed using the Constant's score and ranges of motion (ROM) at preoperative, 6 months postoperatively and at the final follow-up. Results: Our study included 17 women and 12 men with a mean age of 53.8 years (range, 34-74). Mean follow-up duration was 24 months (range, 12-40 months). Assessment of combined pathologies revealed that partial rotator cuff tear of less than 25% thickness, was most common (overall 83.3%; with bursal 57% and articular 23%). Subacromial synovitis and adhesion were also frequent (53.3%). The Constant score and ranges of motion significantly improved at the final follow-up, compared with preoperative levels. However, clinical results at 6 months postoperatively were found to be significantly inferior to those observed at the final follow-up ($p{\leq}0.001$ for all factors). Functional impairment was the major complaint in 59.3% patients at the 6 months follow-up. Conclusions: Although arthroscopic capsular release yielded favorable outcome at the mean 24 months follow-up, pain and motion limitations at 6-month postoperatively persisted in more than 50% of our patients. While combined pathologies were commonly encountered during arthroscopy, although their effects on surgical outcome in adhesive capsulitis remains unclear in this study.
The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.
Recently, there is growing interest in studying the dietary patterns that affect the risk of circulatory system diseases (CSDs). We investigated the relationship between CSDs and dietary patterns through a follow-up study in Korea (2001-2016). The participants of this study were obtained from the Korean Genome and Epidemiology Study (KoGES). This study was a large community-based cohort study (the Ansan-Ansung areas) conducted to assess the effects of various factors, especially diet, on the onset of chronic diseases among the Korean population aged 40-69 yrs. Baseline data were collected from 2001 to 2002, and follow-up studies were performed every 2 yrs, with over 7 follow-up studies performed (2015-2016). Three dietary patterns were identified using factor analysis: "vegetable and seafood (men)/soup and stew (women)" pattern, "sweet foods and breads-rice cake" pattern, and "multigrain rice and cooked white rice" pattern. None of the dietary patterns were significantly associated with the risk of CSDs in either men or women. Our follow-up study is meaningful as it investigated whether the dietary patterns of individuals according to sex affects the development of CSDs.
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