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PubMed1996

Month of birth and schizophrenia in Taiwan: effect of gender, family history and age at onset.

Schizophrenic patients have been shown to have a moderate excess of winter births in the areas where seasonal variations in weather are large. In this report, we examined the seasonality of schizophrenic births in Taiwan, which has a subtropical climate. Using nationwide hospitalization data (2429 male and 1320 female schizophrenic patients), we applied the life table method to compare the risk of schizophrenia among 12 cohorts of month-of-birth for males and females, respectively. Differences among the risks of the 12 cohorts were tested using the logrank test. The samples were further stratified by family history and age at onset. There was a significant association between the risk of being admitted as a schizophrenic and month of birth for both males and females. The cohorts born in November and January had the highest risks. After stratification, the association was significant only for non-familial, male, and early onset schizophrenic patients. The results indicate that seasonally varying factors might increase the risk of schizophrenia, especially in those without a family history of the disease. Men are more vulnerable to such factors than women, and the schizophrenics resulting from such insults tend to be early onset.

Adolescent↗

PubMed2005

Outcomes of total elbow arthroplasty for rheumatoid arthritis: comparative study of three implants.

BACKGROUND: As the English-language literature on prosthetic elbow arthroplasty contains only two comparative studies of implants in contemporary use, to our knowledge, comparisons of prosthetic performance is difficult. An improved knowledge of comparative outcomes would be valuable in guiding implant selection. METHODS: We identified three groups of consecutive patients who had undergone prosthetic elbow arthroplasty with the Souter-Strathclyde, Kudo, or Coonrad-Morrey implant for the treatment of rheumatoid arthritis. There were thirty-three elbows in each group. All procedures were done by or under the supervision of one surgeon. Surviving patients in whom the elbow had not been revised were followed for a mean of sixty-one months after treatment with the Souter-Strathclyde implant, sixty-seven months after treatment with the Kudo implant, and sixty-eight months after treatment with the Coonrad-Morrey implant. Clinical function was assessed on the basis of pain relief and the range of flexion. Survivorship was assessed with use of a life-table method, with revision surgery and radiographic signs of loosening as the end points. RESULTS: The groups were comparable in terms of age, sex, and mean duration of follow-up. All three implant procedures relieved pain. Sustained improvement in the range of flexion was comparable among the three groups, with no implant procedure dramatically changing the fixed flexion deformity and all three improving maximum flexion. Revision surgery was needed because of infection, dislocation, and aseptic loosening. Survival of the Coonrad-Morrey implant was better than that of the other two implants. The five-year survival rates, with revision and radiographic signs of loosening as the end points, were 85% and 81% for the Souter-Strathclyde implant, 93% and 82% for the Kudo implant, and 90% and 86% for the Coonrad-Morrey implant. While radiographic evidence of loosening of the Coonrad-Morrey implants was less common, we noted focal osteolysis adjacent to 16% of these ulnar components and half of these cases progressed to frank loosening. CONCLUSIONS: The clinical function of these implants was similar in terms of pain relief and range of motion. We believe that component linkage with the Coonrad-Morrey implant prevents dislocation without increasing the risk of loosening.

Aged↗

PubMed2000

Long-term survival of renal transplant recipients in the United States after acute myocardial infarction.

Cardiac disease is a major cause of death in renal transplant recipients. One third of the cardiac deaths are attributed to acute myocardial infarction (AMI). Few data exist on predictors of long-term survival of renal transplant recipients after AMI. The purpose of this study is to determine predictors of survival (including treatment era) for renal transplant recipients in the United States after AMI. The US Renal Data System database of 783, 171 patients was used to retrospectively examine outcomes of renal transplant recipients hospitalized during 1977 to 1996 for a first AMI after initiation of renal replacement therapy. Long-term survival was estimated by life-table method, and independent predictors of survival were examined in a comorbidity-adjusted Cox model. There were 4,250 renal transplant recipients with AMI. The in-hospital death rate was 12.8%. Overall 2-year cardiac and all-cause mortality rates were 11.8% +/- 0.6% (SE) and 33.6% +/- 0. 8%, respectively. The poorest survival after AMI occurred in patients with diabetic end-stage renal disease (ESRD), with 2-year cardiac and all-cause mortality rates of 14.9% +/- 1.1% and 40.5% +/- 1.4%, respectively. In the Cox model, the risks for cardiac and all-cause death from AMI were 51% (P = 0.0003) and 45% less (P < 0. 0001) in 1990 to 1996 compared with 1977 to 1984, respectively. The long-term survival of renal transplant recipients in the United States after AMI has markedly improved in the modern treatment era. Patients with diabetic ESRD experience the worst outcome.

Adult↗

PubMed1975

Dairy calf mortality rate: characteristics of calf mortality rates in Tulare County, California.

Sixteen dairy farm owners in Tulare County, California, provided data on heifer calf births and deaths. Eleven of these dairymen had maintained records on the calves before this study was done, and 5 agreed to maintain them for 6 months. Basic statistical techniques, including time series analyses and life-table methods, were used to examine the data for temporal and demographic characteristics. Overall, the calf mortality rate on the 16 farms averaged 17.3 to 20.2%. The interfarm variation in mortality rate was large, ranging from 3.7 to 32.1%. Time series studies indicated that the extent of death losses increased during midsummer (June, July, August) and midwinter (November, December, January), with mortality rates in winter months being 20% greater than those in summer. Death losses in October and March were highly variable; however, losses in October usually exceeded the yearly average; those in March did not. Also, 80% of the dairymen recorded the same relative change in mortality rate during each of 2 consecutive winters and 2 consecutive summers. The risk of death for calves was greatest in their 1st week of life on most of the farms; of all deaths in calves less than 5 weeks old, 55% occurred during the 1st week of life, and 27% occurred during the 2nd. In general, the death loss in calves between 5 weeks and 3 months old was less than 2%.

Animals↗

PubMed2004

Durability of carotid endarterectomy for treatment of symptomatic and asymptomatic stenoses.

PURPOSE: Although many studies have well established that carotid endarterectomy (CEA) is beneficial in selected patients with severe carotid disease, only a few large studies have focused on the durability of the surgical procedure. Carotid artery angioplasty and stenting (CAS) has recently been proposed as a potential alternative to CEA. We analyzed the incidence of late occlusion and recurrent stenosis after CEA. METHODS: Over 13 years 1000 patients underwent 1150 CEA procedures to treat symptomatic and asymptomatic high-grade carotid stenosis. CEA procedures involving either traditional CEA with patching (n = 302) or eversion CEA (n = 848) were all performed by the same surgeon, with patients under deep general anesthesia and cerebral protection involving continuous electroencephalographic monitoring for selective shunting. All patients underwent postoperative duplex ultrasound scanning and clinical follow-up at 1, 6, and 12 months, and yearly thereafter. New neurologic events, late occlusions, and recurrent stenoses 50% or greater were recorded. Complete follow-up (mean, 6.2 years; range, 6-156 months) was obtained in 95% of patients (949 of 1000), for an overall average of 95% of procedures (1092 of 1150). Survival analysis was performed with the Kaplan-Meier life table method. RESULTS: Perioperative (30-day) mortality rate was 0.3% (3 of 1000), and stroke rate was 0.9% (11 of 1150), with a combined mortality and stroke rate of 1.2%. The incidence of late occlusion and recurrent stenosis 70% or greater was 0.6% and 0.5%, respectively, with a combined occlusion and restenosis rate of 1.1%. Kaplan-Meier analysis showed that the rate of freedom from occlusion, restenosis 70% or greater, and combined occlusion and restenosis 70% or greater at 12 years was 99,4%, 99.5%, and 98.8%, respectively. Occlusion and restenosis developed asymptomatically. CONCLUSIONS: CEA is a low-risk procedure for treating severe symptomatic and asymptomatic carotid disease, with excellent long-term durability. Proponents of CAS should bear this in mind before considering CAS as a routine alternative to CEA.

Adult↗

PubMed1994

Recurrence of acute otitis media at preschool age in Sweden.

STUDY OBJECTIVE: The probability of recurrence of acute otitis media during the preschool years was investigated. SETTING: All children born in a semirural Swedish municipality were followed up from birth to their 7th birthday. DESIGN: Information about visits to physicians for acute otitis media was collected retrospectively at all primary health care centres and at paediatric and ear, nose, and throat departments. Check up visits after acute otitis media were excluded. Life table methods were used for analyses. PARTICIPANTS: All 1306 children born in the study municipality between 1977 and 1981 were included. Children who moved from the study area during the follow up years (24%) were included in the analyses from the date of birth to the date they left the area. MAIN RESULTS: At age 3 years, 38%, 10%, and 4% of the children had made at least one, three, and five visits respectively to a physician because of acute otitis media. By their 7th birthday, 61%, 24%, 12%, and 2% of the children had made at least one, three, five, and 10 visits respectively to a physician because of this disorder. CONCLUSIONS: A strong association was found between the number of visits made for acute otitis media during the first year of life and the probability of visiting a physician because of this disorder over the next 12 months.

Acute Disease↗

PubMed1998

Comorbid survival among elderly male participants of the Canada health survey: relevance to prostate cancer screening and treatment.

This study assessed the survival of a nationally representative sample of older Canadian men, taking into account common comorbid conditions. Mortality follow-up between 1978 and 1989 was conducted for male participants of the Canada Health Survey who were at least 60 years of age at baseline. The proportional hazards model and life table methods were used to examine survival by comorbidity status. Comorbid conditions examined included history of stroke and/or heart disease, high blood pressure, chronic bronchitis or emphysema, diabetes and smoking status, but excluded cancer because of small numbers. For those subjects aged 80 and older, comorbidity was not a significant predictor of survival. A large portion of men between the ages of 60 and 79, even those with pre-existing comorbid conditions, survived at least 10 years after interview. In a clinical setting, more detailed information on comorbid conditions can be obtained to better estimate long-term survival. Notwithstanding, our findings may have implications for the administration of population-based health interventions (e.g. the use of prostate-specific antigen [PSA] blood tests for the early detection of prostate cancer). In particular, our results suggest that there may be little benefit in restricting access to PSA screening based on survival probability in men under age 80.

Aged↗

PubMed1989

The benefits of treating mild to moderate hypertension. A quantitative estimation of the life expectancy gains from pharmacological reduction of blood pressure.

A quantitative assessment of the benefits of pharmacological treatment of mild to moderate hypertension (diastolic blood pressure 90-114 mmHg) in patients aged 30-60 years was performed, based on the pooled results of nine major clinical trials. The benefits were expressed as added "quality-adjusted life-years" (QALYs), using life-table methods and utility valuations of health states. The expected gains in QALYs were found to be quite small, ranging from 2.3-11.4 months in males, and 1.4-7.6 months in females. Previous attempts to estimate the nature and magnitude of the benefits of antihypertensive therapy have all been based on extrapolations from epidemiological data, instead of on the actual achieved reductions in mortality and morbidity demonstrated in clinical trials. The former method considerably overestimates the potential direct benefits from drug treatment of mild to moderate hypertension.

Adult↗

PubMed1990

The prognosis in Alzheimer's disease. 'How far' rather than 'how fast' best predicts the course.

Clinical features at the initial examination of 42 patients with probable Alzheimer's disease were tested for prognostic value at subsequent follow-up of 54 +/- 25 months. These potential prognostic features were of three types: degree of severity features (eg, IQ scores); variable clinical features (eg, extrapyramidal signs); and individual distinguishing features (eg, gender, education, and age). The power of these potential prognostic features to predict prognosis was assessed using the Kaplan-Meier life-tables method and the Cox proportional hazards model. Three clinical end points were considered: total dependence in activities of daily living; incontinence; and institutionalization at follow-up. Degree of severity features (subtests of the Wechsler Adult Intelligence Scale-Revised and the Wechsler Memory Scale, and the Clinical Severity Score) predicted subsequent dependence in activities of daily living, incontinence, and institutionalization. Historical disease duration, age, gender, family history of dementia, retrospective rate of progression, anxiety, psychosis, depression, and extrapyramidal signs did not influence prognosis. These results suggest that initial degree of severity ("how far") rather than variation in the rate of progression ("how fast") best predicts prognosis in the early to intermediate stages of Alzheimer's disease. The relationship of disease severity to prognosis should be taken into account before concluding that there are subtypes of Alzheimer's disease that have different rates of progression.

Activities of Daily Living↗

PubMed2003

Incremental net benefit in randomized clinical trials with quality-adjusted survival.

Owing to induced dependent censoring, estimating mean costs and quality-adjusted survival in a cost-effectiveness comparison of two groups using standard life-table methods leads to biased results. In this paper we propose methods for estimating the difference in mean costs and the difference in mean effectiveness, together with their respective variances and covariance in the presence of dependent censoring. We consider the situation in which the measure of effectiveness is either the probability of surviving a duration of interest or mean quality-adjusted survival time over a duration of interest. The methods are illustrated in an example using an incremental net benefit analysis.

Amiodarone↗

PubMedDate not supplied

Femoropopliteal artery recanalization: factors affecting clinical outcome of conventional and laser-assisted balloon angioplasty.

PURPOSE: The clinical efficacy of 44 successful conventional and laser-assisted recanalizations of the femoropopliteal artery was assessed in a noncomparative study by the life-table method. METHODS: Laser-assisted angioplasty using continuous laser and a sapphire probe was performed to achieve primary recanalization in femoral artery occlusions when conventional guidewire recanalization had already failed. Nineteen of the patients underwent a conventional recanalization (PTA; mean length of occlusion 4.4 +/- 4.1 cm), and 25 underwent percutaneous laser-assisted angioplasty (PLA; mean length of occlusion 10.1 +/- 6.7 cm). RESULTS: There was no statistical relation between the preprocedure Fontaine classification and the success rate in the PTA cases (p = 0.25), whereas there was a statistical relation in the PLA cases: The success rate in patients preprocedurally classified as Fontaine II was better than in those classified as Fontaine III/IV (p = 0.05). After a 3-year follow-up the patency rate in the patients with the PTA recanalizations was 37% and that in those with the PLA procedure was 53%. This difference was not statistically significant (p = 0.47). CONCLUSION: It is concluded that the laser should remain an investigational device.

Angioplasty, Balloon↗

PubMed2004

[Comparison of efficacy between ceftriaxone and cefoperazone plus sulbactam in peri-operative treatment of acute suppurative cholangitis].

OBJECTIVE: To compare the efficacy of ceftriaxone and that of cefoperazone plus sulbactam (sulperazon) in controlling infection, in scavenging bacteria from bile, and in their costs when treating acute suppurative cholangitis with choledochostomy. METHODS: Patients were randomly assigned to two groups: the ceftriaxone group (R-group, n=95) and sulperazon group (S-group, n=95). Before choledochostomy, both groups received one intravenous dose of the corresponding antibiotics: and 2 g ceftriaxnoe for the R-group, 2 g sulperazon, containing 1 g cefoperazone and 1 g sulbactam, for the S-group. After the operation, the patients in the R-group received ceftriaxone 2 g i.v. q.d.; the patients in the S-group received sulperazon 2 g i.v. b.i.d.. In addition, all patients in both groups received metronidazole 0.5 g daily before and after the operation. The efficacy was evaluated by efficiency in controlling infection and the persisting days of symptoms due to infection, fever and leukocytosis; the persisting days was compared using the life table method to calculate the "cumulative probability of persistence of symptoms (CPPS)". The two groups were also compared in regards to their biliary bacterial clearance rates and the costs directly attributable to the antibiotics. RESULTS: The efficiency in controlling infection was 98.9% (94/95) in both groups. However, the CPPS of the R-group decreased more rapidly than that of the S-group, Log-Rankchi2=6.7901, P=0.0092. Biliary bacterial clearance rate on post-operative day 3 was 72.0% (36/50) for the R-group, 41.3% (19/46) for the S-group, P=0.0037. Cost directly attributable to the antibiotics were (1788.29 +/- 518.46) yuan (RMB) for the R-group, and (3768.74 +/- 820.55) yuan for the S-group, F=395.51, P=0.0000. CONCLUSION: Both ceftriaxone and sulperazon are effective in treating acute suppurative cholangitis when used before and after choledochostomy. Ceftriaxone is superior in expediting symptom relief and bacterial clearance from bile, and is more cost-effective.

Acute Disease↗

PubMed2003

Evaluations of bronchoplasty and pulmonary artery reconstruction for bronchogenic carcinoma.

OBJECTIVE: To evaluate the surgical results of bronchovascular reconstruction and the prognostic factors for lung cancer. METHODS: From 1976 to 1995, 78 patients with a mean age of 55.1 years (range 26-69 years) underwent bronchoplasty for non-small-cell lung cancer (NSCLC) including pulmonary artery (PA) reconstruction in 21 patients. There were 47 right upper lobectomies (60.3%), 24 left upper lobectomies (30.8%), and seven other atypical types of operations (8.9%). The bronchoplasty was a full sleeve in 71 patients, and a bronchial wedge resection in seven. Thirteen PA tangential resections and eight PA sleeve resections were performed. Tissue diagnosis was squamous cell carcinoma in 56 patients, adenocarcinoma in six, adenosquamous carcinoma in ten, neuroendocrine carcinoma in two and others in four. No patient had a microscopically positive bronchial resection margin. The follow up is complete for all patients. Seventy-five patients were statistically analyzed using STATA software. The survival rate was calculated with life table method. Comparisons of the difference of survival rates between groups were made according to the log-rank test. RESULTS: The operative mortality rate (30 days) was 3.8% (3/78). The prolonged atelectasis necessitating repeated bronchoscopy was the most common major complication which occurred in 12 patients (16%). Tumor recurrence around the anastomotic site confirmed by bronchoscopic biopsy was observed in four patients. The overall survival at 5 and 10 years was 48.9 and 38.8%, respectively. The 5- and 10-year survival for patients with stage I disease were 66.1 and 57.5%, and for patients with stage II were 62.8 and 44.2%, respectively. The 3- and 5-year survivals for patients with stage III were 11.1 and 0%, respectively (P = 0.0000). The 5-year survival rates for those with N0 tumor (n = 36) were 63.3%, 53.6% for those with N1 (n = 26), and with no survivors for N2 (n = 13), respectively (P = 0.0000). The 5- and 10- year survival rates with bronchoplasty (n = 54) were 55.0 and 47.8%, and 33.3 and 16.7% with bronchovascular reconstruction (n = 21), respectively (P = 0.0033). Multivariate analysis showed that long-term results were influenced chiefly by nodal stage among five factors of pT, pN, bronchoplasty with or without PA reconstruction, cell types, and postoperative adjuvants (P = 0.004). CONCLUSIONS: Any type of lobectomy with bronchial reconstruction is an adequate cancer operation for both compromised and uncompromised patients especially in patients with stages I and II lung cancer with reasonably good results. Sleeve lobectomy with PA reconstruction may finally be indicated in patients considered compromised because of cardiac or respiratory impairment contraindicating pneumonectomy.

Adenocarcinoma↗

PubMed1977

Fifteen year experience with subcutaneous bypass grafts for lower extremity ischemia.

A 15-year experience with 92 subcutaneous arterial bypass grafts for lower extremity revascularization has been reviewed. Fifty-nine AF and 33 FF bypass operations were performed on 89 patients whose average age was 66 years. The overall five-year survival was 33% compared to an expected survival of 80%. 88% of the AF, and 76% of the FF operations were performed for limb salvage, bypass of an aortic aneurysm, or replacement of an infected aortic graft. The remainder were performed for intermittent claudication on patients who were too ill to withstand an intra-abdominal operation. 75% of the patients with AF grafts and 64% of those with FF grafts experienced complete relief of lower extremity ischemia, including all of the patients with claudication. Graft patency was analyzed by the life table method. In the FF series, 74% of the grafts remained patent for one year; 73% for two years; 66% for three years; and 53% for four years. A 50% incidence of thrombosis occurred at the end of two years in the AF group. The patency rate of the AF grafts was also studied with regard to the type of graft material employed: a 50% incidence of thrombosis was reached at 36 months with knitted Dacron; at 18 months with weave-knit Dacron; and at 9 months with woven Dacron. THESE DATA INDICATE THAT: (1) contrary to our previous report, weave-grafts provide adequate blood flow to the lower extremities but do not remain patent as long as more conventional types of reconstruction; (2) subcutaneous grafts should be performed only when an intra-abdominal procedure is contraindicated or life expectancy is limited.

Aged↗

PubMed2005

Influence of time on risk of bowel resection in complete small bowel obstruction.

BACKGROUND: Little is known about the effect of passing time on risk of resection among patients with complete small bowel obstruction. We sought to provide a benchmark of the relationship of time from symptom onset to surgical treatment on the need for resection in patients with complete small bowel obstruction. STUDY DESIGN: We performed an observational study of patients with surgically treated complete small bowel obstruction at an inner-city urban tertiary referral center and a municipal hospital. Patients were sampled randomly retrospectively (n=60), and prospectively (n=81), for a final sample of 141. Detailed clinical and time data were abstracted from medical records including out-of-hospital examinations. Risk of resection was calculated using actuarial life table methods. Linear regression was used to determine factors affecting time to treatment. RESULTS: All patients were treated surgically for obstruction; 45% underwent resection. Resected patients had longer (11 days versus 8 days; p=0.01) and more complicated (31% versus 14% in ICU; p=0.01) hospital stays. The risk of resection was 4% among patients with 24 hours of unresponsive symptoms; it increased to 10% to 14% through 96 hours, then dropped slightly but did not disappear. Patients treated first with a tube had longer times between first examination and operation, system-time (40.6 hours versus 10.2 hours; p=0.0007), but this was not associated with an increased resection risk. System-times were shorter among patients seen first in the emergency department (median: 25.7 hours versus 59.7 hours; p=0.0001). CONCLUSIONS: Physicians should be cautious in postponing surgery beyond 24 hours in patients with unresponsive symptoms from complete obstruction. The risk of resection rises dramatically, remains elevated through 96 hours of unresolved symptoms, then declines but does not disappear.

Adolescent↗

PubMed2003

Tibial osteotomy for the treatment of varus gonarthrosis. Survival and failure analysis to twenty-two years.

BACKGROUND: The purpose of this retrospective study was to assess the long-term results after the treatment of medial compartment gonarthrosis with a proximal tibial osteotomy to determine whether various clinical and radiographic factors relate to the outcome. METHODS: From 1972 to 1990, seventy-six valgus-producing high tibial osteotomies were performed in sixty-six patients with medial compartment gonarthrosis. Stabilization was achieved with use of a plate on the lateral side of the proximal part of the tibia and a figure-of-eight wire on the medial side. The mean age of the patients at the time of surgery was sixty-nine years, and the mean duration of follow-up was 10.8 years. The factors that were analyzed included postoperative valgus alignment; the age, gender, and weight of the patient; preoperative Ahlbäck radiographic grade; adverse events; Workers' Compensation status; and public liability. Survivorship outcome end points were conversion to arthroplasty, a Hospital for Special Surgery knee score of <70 points, and patient dissatisfaction with the procedure. RESULTS: Ten-year survival, according to the life-table method, was 74%, 70%, and 65% with conversion to arthroplasty, a Hospital for Special Surgery knee score of <70 points, and patient dissatisfaction, respectively, as the end points. Radiographic valgus alignment that ranged between 8 degrees and 16 degrees at one year after the osteotomy had the most significant positive effect on survivorship for all end points (p < 0.01) compared with the other parameters. Complications occurred in sixteen (21%) of the seventy-six procedures, and they had a significant effect on survival, with all three end points (p < 0.05). CONCLUSIONS: We found that survival at ten years was 90% (95% confidence interval, 80% to 99%) when the radiographic valgus angle at one year was between 8 degrees and 16 degrees with arthroplasty as the end point. We believe that there is a role for tibial osteotomy, as an alternative to total knee arthroplasty, in patients who are less than sixty years old. LEVEL OF EVIDENCE: Therapeutic study, Level III-2 (retrospective cohort study). See Instructions to Authors for a complete description of levels of evidence.

Aged↗

PubMed2002

Long-term clinical effectiveness of oral implants in the treatment of partial edentulism. Seven-year life table analysis of a prospective study with ITI dental implants system used for single-tooth restorations.

One hundred and eight-seven ITI implants were prospectively followed from November 1992 to July 2000, in order to evaluate the clinical efficiency and the long-term prognosis in 109 partially edentulous patients (69 women and 40 men; average age 41.3 years). Of these 187 implants, 69.5% were placed in the mandible and 30.5% in the maxilla. After a healing period that ranged from three to six months, the osseointegrated implants (n = 184) were restored with single crowns. Three implants were extracted prior to loading the fixture and were considered early failures. Each implant was reassessed on a yearly basis, both clinically and radiographically. The results of the investigation, which were evaluated according to predefined success criteria, were reviewed in accordance with a life table method. During the follow-up, six cases were deemed to be late failures. In each of these cases, a suppurative infection of the peri-implant tissue was diagnosed: in one implant, the infection could not be eradicated and the implant was removed. When 11 drop-outs were included in the analysis, the cumulative survival and success rates for the whole sample group were 96.77% and 93.6%, respectively. When only prosthetically loaded implants were considered, the results increased to 99.35% for the cumulative survival rate and 96.18% for the cumulative success rate. The analysis on disaggregated data showed better results for maxillary restorations (survival rate 100%) in comparison to mandible restorations (survival rate 95.11%). It was concluded that, under standard anatomic conditions (bone site height > 8 mm, thickness > 6 mm), prosthetic restoration of partially edentulous patients with the ITI system can be described as a reliable and efficient therapy in the long term.

Adult↗

PubMedDate not supplied

Percutaneous transluminal angioplasty of the subclavian artery in nonspecific aortoarteritis: results of long-term follow-up.

PURPOSE: The results of percutaneous transluminal angioplasty (PTA) of the subclavian artery in nonspecific aortoarteritis (Takayasu disease) are analyzed. PATIENTS AND METHODS: Twenty-four patients (15 men, nine women; age range, 18-47 years; mean, 37.1 years) with occlusive disease in 26 subclavian arteries, had symptoms due to vertebrobasilar insufficiency, upper limb claudication, or both. Aortography revealed stenosis in 19 arteries and occlusion in seven. The lesions were focal in 14 arteries (< 3 cm) and extensive in 12. Associated lesions involved the brachiocephalic artery in three patients, carotid arteries in five patients, and renal arteries in five patients. RESULTS: Initial technical and clinical success was achieved in 21 of 26 arteries (81%, 17 of 19 stenoses and four of seven occlusions). The maximum follow-up was 82 months (mean, 26 months), during which time restenosis occurred in six arteries, all of which had extensive lesions. The cumulative primary, secondary, and overall patencies were 64%, 82%, and 65%, respectively, as analyzed by means of the life-table method. The cumulative patencies for short- and long-segment lesions were 100% and 50%, respectively (P = .0113). Minor complications were observed in four of 26 procedures (15%) and included vasospasm (three patients) and transient loss of consciousness (one patient). There were no major complications. CONCLUSIONS: PTA is useful for treatment of occlusive disease of the subclavian artery in nonspecific aortoarteritis. The procedure is simple and associated with minimal morbidity. Long-term results are excellent in focal lesions but are less durable in the presence of more extensive disease.

Adolescent↗