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Results for “Prospective Studies”

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At least 37 records · Page 2Linked to original sources

PubMed1979

Iron deficiency anaemia--a prospective study.

A prospective study was performed over 15 months to determine the cause of iron deficiency in adult males and postmenopausal females attending a general hospital. The laboratory computer identified all subjects with a haemoglobin less than 10.6 g/dl and a mean corpuscular volume less than 86 fl. Patients becoming anaemic after trauma or recent surgery were excluded. The iron status of each patient was assessed by serum iron studies, serum ferritin or sternal marrow aspiration. Reduced red cell indices and blood film morphology were not diagnostic of iron deficiency. Of 215 patients assessed, about half (103) were found to be iron replete. This group had a variety of disorders--malignancy, chronic inflammation, chronic renal and non-malignant haematological diseases. The other group of 104 patients satisfied criteria for iron deficiency, and 100 of these were investigated further. The cause of iron deficiency was found in all but three subjects. Inadequate dietary intake was a contributing factor in over half of the patients and 40 regularly took salicylates. Investigation defined a source of chronic gastrointestinal blood loss in most instances.

Adult↗

PubMed1975

Appendicitis and mimicking conditions. A prospective study.

A prospective study of 444 consecutive patients diagnosed as having acute appendicitis was carried out in a district general hospital. The appendix was acutely inflamed, gangrenous, or perforated in 346 patients. Diagnostic error, 22% overall, was twice as common in females as in males. Organisms were isolated from the outer appendix wall in 117 patients, isolation increasing with the severity of inflammation. 12% of children under 11 had mesentric adenitis, 10% of all females had gynaecological lesions, and 14% of patients over 50 had acute diverticulitis. In only 6% of patients was no abnormality found at operation, and in every case the disorder was dealt with through the gridiron incision.

Abdomen, Acute↗

PubMed1978

[Diagnosis and outcome of cerebral distress in newborn infants who presented signs of fetal hypoxia. Prospective study].

The prospective study covered 60 full-term newborns, who presented exclusively signs of acute fetal distress. It had two major aims: --the analysis of the clinical and EEG symptomatologies, allowing the assessment of the cerebral damage in the neonatal period; --the evaluation as to whether the post-asphyxia cerebral damage may remain undiagnosed in the neonatal period, sequellae revealing it secondarily. Clinical and EEG supervision was undertaken during the first week; it was continued till 3 years of age in 45 of the 56 survivors. During the first week of life, 50 infants had at least once, an abnormal neurologic manifestation. The signs for a poor outcome are "unexpected" fetal distress, Apgar score below 2 at 1 min., seizures occurring or persisting after 48 hours, severe clinical and/or EEG changes occurring more than once. Prognosis is considered as favorable if EEG or clinical examination are consistently normal, or if EEG and clinical examination are normalized at 6 days of life.

Apgar Score↗

PubMed1978

The effect of normalization of serum complement and anti-DNA antibody on the course of lupus nephritis: a two year prospective study.

A prospective study was carried out in 25 patients with systemic lupus erythematosis (SLE) on the effect of normalizing serum complement (CH50) and anti-DNA antibodies on the course of lupus nephritis. In 16 of the 25 patients, CH50 was maintained within the normal range for two years. Urinary protein excretion increased or remained low in all 16. Repeat renal biopsies were performed in 10 of these 16, and disclosed either stabilization of glomerular disease or diminution. In the nine patients in whom CH50 could not be normalized with tolerated doses of drugs, urinary protein excretion increased or remained increased. Repeat renal biopsies in six of these nine patients were carried out and showed worsening of glomerular disease in five. No clear-cut correlation was found between urinary protein excretion or renal disease and the serum levels of anti-DNA antibody. We conclude from these observations that continuous normalization of CH50 by drug therapy in patients with SLE is associated with stabilization or diminution of lupus nephritis.

Antibodies↗

PubMed1977

Natural history of acute hepatitis B in previously healthy patients: A prospective study.

A prospective study of the natural history of acute hepatitis B was performed in 38 patients. Fatigue started median 4 weeks, abdominal symptoms median 3 weeks and signs of cholestasis median 2.5 weeks before peak SGPT values were reached. Extrahepatic manifestations occurred throughout the prodromal stage, the presence of arthropathy, urticaria or skin rashes was not related to the biochemical severity of liver disease. The higher the the maximal values of serum bilirubin and/or the older the patient, the longer the period of bilirubin elevation; a maximal bilirubin elevation less than 20 X the upper limit of normal was associated with normalisation of serum bilirubin within 6 weeks. No such correlations were found between the height of serum glutamic pyruvic transaminase, alkaline phosphatase, thymol turbidity and cholesterol levels and the subsequent duration of their abnormality. The elevation of alkaline phosphatase as well as the abdominal complaints might partly be caused by gastro-intestinal involvement. Immobilisation before peak SGPT was attained was associated with normalisation of serum glutamic pyruvic transaminase levels within 8 weeks after peak levels. 37 patients recovered completely. In one HBs-antigenemia and slight SGPT elevation persisted. Long term follow up was possible in 33 patients for 4 to 7 years, median 5 years.

Acute Disease↗

PubMed1978

A prospective study of glucose tolerance, insulin, C-peptide, and glucagon responses in patients with pancreatic carcinoma.

Ninety-nine patients suspected of having pancreatic carcinoma were studied prospectively for carbohydrate tolerance. Thirty-two patients were proven subsequently to have pancreatic carcinoma; the remainder served as a control group. There was an increased incidence of carbohydrate intolerance in patients with pancreatic carcinoma compared to the control group. Insulin and C-peptide measurements during glucose tolerance tests suggest abnormal beta cell function and possibly insulin resistance as causes for this abnormality. Although factors related to malignancy in general could partly account for the results, a specific factor occurring in patients with pancreatic carcinoma must also be considered as it could serve as a marker for the early detection of this disease.

Body Weight↗

PubMedDate not supplied

[Prevention of post appendectomy incision abscess with the use of polyvinilpyrrolidone iodine (prospective study)].

365 appendicectomy cases performed from 1972 to 1976 were studied prospectively. In 135 control cases the wound was not lavaged. In 102 cases the wound was lavaged with normal saline solution. En 108 cases the wound was lavaged with PVP-I. Wound abscess formation rate in the first group was 28.8%, in the second group was 21.35% and in the third group was 18.5%. Patients operated after 1974 and treated with PVP-I showed a 4.2% abscess formation. Morbility and mortality in appendicitis are best reduced if early diagnosis and surgical treatment are backed by a faultless technic.

Adolescent↗

PubMed1976

Ischemic colitis incidence following abdominal aortic reconstruction: a prospective study.

With few exceptions, the incidence of left colon ischemia following abdominal aortic reconstruction has been reported to be one to 2 percent. All reports of such ischemic events are retrospective analyses of clinically manifest or autopsy. Fifty patients were studied prospectively to determine more accurately the incidence of this complication. Aortic reconstruction was performed in 23 patients for occlusive disease (OD) and in 27 for aneurysm disease (AD). No emergency operations were performed. All patients underwent colonoscopy within 4 days of operation. Three instances of colon ischemia were noted, an incidence of 6 percent (OD 4.3 percent, AD 7.4 percent). Each patient recovered uneventfully. Two patients had diarrhea, but only after colon ischemia was recognized. Arteriographic opacification of the inferior mesenteric artery by the superior mesenteric artery collateral (meandering mesenteric artery) was documented in 35 percent of patients with OD and in 27 percent of patients with AD. Colon ischemia did not develop when this collateral was identified. The inferior mesenteric artery was patent at the aorta in all who developed colon ischema. Although clinically significant colitis following aortic reconstruction is rare, colonoscopy after operation may prove to be valuable for early recognition of ischemic changes before clinical manifestations preclude effective management.

Adult↗

PubMed1979

Calcitonin as a marker for bronchogenic cancer: a prospective study.

A prospective study was done of serum calcitonin (HCT) levels in 61 patients with bronchogenic cancer. Initially, 52% of patients had hypercalcitonemia. Hypercalcitonemia was not confined to patients with any particular histologic type. Seventy-eight percent of those with high calcitonin remained normocalcemic. There was no correlation between high calcitonin levels and osseous metastases. Selective thyroid venous sampling delineated two types of hypercalcitonemia: thyroidal and ectopic. To date, the ectopic type has been associated with the small cell bronchogenic carcinoma. High initial calcitonin levels decreased significantly in 75% of patients on antitumor therapy. In 13 evaluable patients calcitonin levels mirrored clinical status changes 67% of the time. Calcitonin may be a useful marker to assess the results of therapy in patients with bronchogenic cancer.

Bone Neoplasms↗

PubMed1976

Adequacy of vitamin B6 supplementation during pregnancy: a prospective study.

This prospective study assesses the effect of 2.5, 4, and 10 mg of pyridoxine supplementation during pregnancy on maternal and fetal plasma levels of pyridoxal 5'-phosphate (PLP) and on the degree of coenzyme saturation (activation factor) of aspartate aminotransferase and alanine aminotransferase (alphaEGOT and alphaEGPT) in maternal erythrocytes. More than 4 mg of pyridoxine supplementation daily was required for most pregnancies to maintain maternal plasma PLP levels within the range observed during the first trimester and in the nonpregnant state. The plasma PLP concentrations in maternal and cord blood were highly correlated and indicated a dependence of fetal vitamin B6 nutrition on maternal circulating PLP. Measurements of alphaEGOT and alphaEGPT were not as reproducible as plasma PLP assays and were less sensitive and quantitative indicators. In the majority of subjects, the changes in alphaEGOT and alphaEGPT with time correlated poorly with the changes in plasma PLP. However, when the data were analyzed without regard for their dependence on time, they demonstrated a negative, linear correlation between alphaEGOT and log plasma PLP and between alphaEGPT and log plasma PLP for the group on 2.5 mg of pyridoxine and for all the subjects combined. Finally, the dietary records showed that most of the subjects consumed less than 2 mg of vitamin B6 daily from their food. The results indicate that the current Recommended Dietary Allowance for vitamin B6 during pregnancy (2.5 mg) is too low and that supplementation of this vitamin in an amount more than 4 mg daily is recommended.

Alanine Transaminase↗

PubMed1979

Hemostatic abnormalities in malignancy, a prospective study of one hundred eight patients. Part I. Coagulation studies.

A prospective study of hemostatic abnormalities in 108 cancer patients was undertken at an oncology clinic in a university teaching hospital. Tests included Quick prothrombin time, activated partial thromboplastin time, thrombin time, platelet count, modified Ivy bleeding time, fibrinogen, fibrin degradation products (FDP), euglobulin lysis time, protamine sulfate test, and factor V, VII, VIII and X assays. Ninety-eight per cent of the patients had one or more abnormal coagulation tests. The commonest abnormalities were elevated fibrin degradation products and prolonged thrombin time. Thrombocytosis occurred in 57% of patients, hyperfibrinogenemia in 46%, thrombocytopenia in 11%, and non had hypofibrinogenmia. It is suggested that platelet count, fibrinogen concentration, and serum FDP assay are the most useful tests in assessing the hemostatic abnormalities in cancer patients, although thrombin time, factor V assay, and bleeding time may also be helpful. The peripheral blood smears of 53 patients were reviewed, and only one showed microangiopathic hemolytic anemia. The data illustrate that subclinical coagulopathy is relatively frequent in patients with malignancy.

Adolescent↗

PubMed1978

[III. Continued education in surgery. A. Prospective studies, methods for determination of therapy results. Topics on and results of prospective studies in surgery].

Since the first clinical prospective trial of J. Lind in 1753, the controlled study has proved to be an essential instrument in clinical research. Possible topics include: pharmacologic prophylaxis of complications such as stress ulcer, thrombosis, etc., indications for operation, preoperative preparation, choice of surgical procedure, and techniques or postoperative treatment. Examples for each topic are given.

Clinical Trials as Topic↗

PubMed1978

Calcium pyrophosphate crystal deposition disease and hyperparathyroidism: a controlled, prospective study.

A prospective, controlled study of patients with primary hyperparathyroidism has been carried out to establish the relation of this endocrinopathy to calcium pyrophosphate dihydrate crystal deposition disease. Eight of 26 patients with documented hyperparathyroidism were found to have chondrocalcinosis compared to four of 104 individuals in the control group (p less than 0.01). Two of these eight patients had confirmed pseudogout attacks shortly after parathyroidectomy. Four other patients, including two without chondrocalcinosis, gave a history of typical pseudogout. Patients with hyperparathyroidism and chondrocalcinosis were significantly older than those without the articular lesion (p = 0.006). We could not delineate specific metabolic abnormalities of hyperparathyroidism which contributed to the development of chondrocalcinosis.

Adult↗

PubMed1979

Mortality in patients with haematemesis and melaena: a prospective study.

In a prospective study of death in 817 patients with haematemesis and melaena admitted on 894 occasions, the protocol included admission of all patients to a defined unit, early endoscopy and resuscitation, and planned management. Over the three consecutive two-year periods of the study mortality significantly decreased from 9% to 2.4%. Although the operative rate remained the same, the operative mortality fell from 16% to 1.6%. The fall in mortality was greatest in patients with bleeding gastric ulcers. These results suggest that prospective studies with a defined policy can influence the mortality in patients with upper gastrointestinal bleeding.

Adolescent↗

PubMed1978

Clinical and neurobehavioral effects of repeated intrauterine exposure to oxytocin: a prospective study.

A prospective investigation of 114 pregnant women compared 54 with consistently negative oxytocin challenge tests to 60 women who did not have oxytocin challenge tests but did have fetal monitoring during labor. Despite more high risk factors in the OCT group, there were no significant differences noted in the offspring. Specifically, extensive behavioral testing during the first 12 hours of life and at 3 days of age did not show any abnormalities. Furthermore, jaundice and respiratory distress were not seen more often after oxytocin exposure. These data argue that the OCT itself is without demonstrable adverse effects on the otherwise healthy fetus.

Adult↗

PubMed1977

Results of treatment of 269 patients with primary cutaneous melanoma: a five-year prospective study.

A prospective protocol for the management of primary cutaneous melanoma was initiated at the University of Illinois in October 1968 and continued through June 1974. Over this period 269 cases were treated: 42 of the head and neck region, 75 of the trunk, 94 of the lower extremities and 58 of the upper exremities. The levels of invasion ranged from II to V, according to Clark's classification; level I melanomas were excluded. The status of the regional nodes was correlated with the level of invasion. Preliminary exploratory celiotomies were performed on all patients with lower extremity melanomas and on all those with level IV or V melanoma with clinically positive regional nodes. All patients were treated with wide excision and elective regional node dissection except those in whom celiotomy showed disseminated disease. Of the 150 patients now eligible for five-year analysis, 33 had level II disease, three with positive nodes. None had local recurrence or intra-abdominal metastasis. All 33 (100%) were cancer-free at five years. Of 56 with level III, 23 had positive regional nodes, two had local recurrence within two years, and two with melanoma of the lower extremities had intra-abdominal metastases. At five years 53 (95%) of the 56 were cancer-free. Of the 42 with level IV, 31 had positive regional nodes, five had local recurrence and five had intra-abdominal metastases; 21 (50%) survived for five years. Of the 19 with level V, 17 had positive nodes, three had local recurrence and five intra-abdominal metastases; 7 (37%) were five-year survivors. Of the 150, 114 (76%) were cancer-free at five years. On the basis of these findings, it was concluded that wide local excision is adequate for level II and probably for thin level III. But for thick level III and levels IV and V the best salvage rate is obtained by an aggressive surgical approach.

Adult↗

PubMed1978

Urinary diagnostic indices in acute renal failure: a prospective study.

A prospective analysis of the value of urinary diagnostic indices in ascertaining the cause of acute renal failure was undertaken. Our results show that in the setting of acute oliguria a diagnosis of potentially reversible prerenal azotemia is likely with urine osmolality greater than 500 mosm/kg H2O, urine sodium concentration less than 20 meq/litre, urine/plasma urea nitrogen ratio greater than 8, and urine/plasma creatinine ratio greater than 40. Conversely, a urine osmolality less than 350 mosm/kg, urine sodium concentration greater than 40 meq/liter, urine/plasma urea nitrogen ratio less than 3, and urine/plasma creatinine ratio less than 20 suggest acute tubular necrosis. A significant number of oliguric patients will not have urinary indices that fall within these guidelines. In this setting, urine sodium concentration divided by the urine-to-plasma creatinine ratio (the renal failure index) and the fractional excretion of filtered sodium provide a reliable means of differentiating reversible prerenal azotemia from acute tubular necrosis.

Acute Kidney Injury↗

PubMed1978

[Granulocyte substitution in febrile leukemia patients with bone marrow aplasia. 1. Results of a prospective study].

A prospective, randomized study was performed in aplastic, granulocytopenic, infected patients with acute leukemia during induction therapy. 12 patients received antibiotics alone, and 13 received antibiotics plus 1.7-14.7 X 10(10) (MEAN 6.6 X 10(10) granulocytes by 1-5 (mean 2.7) daily transfusions. In 10 of 12 controls the infection resolved and remission was achieved with granulocyte counts greater than 500/mm3 15 +/- 9 days after randomization. In the transfused patients, infection was brought under control in 10 out of 13 and remission was achieved with granulocyte counts greater than 500/mm3 25+/- 11 days after randomization. Only one death due to infection was observed (6 days after randomization, control).

Anemia, Aplastic↗