PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “complication”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 163 records · Page 9Linked to original sources
PubMed2003

Do plasminogen activator inhibitor (PAI-1) or tissue plasminogen activator PAI-1 complexes predict complications in Type 1 diabetes: the Pittsburgh Epidemiology of Diabetes Complications Study.

AIMS: To examine the predictive power of plasminogen activator inhibitor-1 (PAI-1) and the complexes it forms with tissue plasminogen activator (tPA-PAI-1) for the two major Type 1 diabetes (T1D) complications (coronary artery disease (CAD) and overt nephropathy) in the context of standard risk factors. METHODS: Observational prospective study of 454 participants with childhood onset (< 17 years) T1D, aged 18+ years at baseline. PAI-1 and tPA-PAI-1 were determined using ELISA methodology. Follow-up (6 years) was limited to 382 individuals for CAD and 294 individuals for overt nephropathy, after excluding baseline cases. Total, HDL and LDL-cholesterol, triglycerides, HbA1, blood pressure, body mass index (BMI), waist-hip ratio (WHR), leucocyte count, Beck depression score and fibrinogen were also examined. RESULTS: The 56 incident cases of CAD had marginally lower PAI-1 and higher tPA-PAI-1 levels compared with those free of CAD. However, marginally higher PAI-1 and significantly higher tPA-PAI-1 (P = 0.04) levels were seen in those who developed nephropathy. After controlling for age, both PAI-1 and tPA-PAI-1 showed significant negative correlations with HDL-cholesterol, and positive correlations with triglycerides, WHR, HbA1 and fibrinogen. tPA-PAI-1 was also positively correlated with total and LDL-cholesterol. In multivariate analyses, neither PAI-1 nor tPA-PAI-1 was an independent predictor of CAD or overt nephropathy. CONCLUSIONS: These results suggest little association between PAI-1 and later CAD in patients with T1D. However, tPA-PAI-1 complexes may be involved in the pathogenesis of overt nephropathy.

Adult↗
PubMed1992

[External fixator in complicated tibial fracture. Effect of various fixation systems on fracture healing and rate of complications].

In a retrospective analysis 93 external fixations with different rigidity after open tibial shaft fractures have been reviewed and compared concerning complications and healing time. Fracture consolidation was attained in fixation with unilateral frame after 14 weeks, with bilateral v-shaped fixator after 19 weeks and with triangular configuration in about 28 weeks. Subsequent internal fixation or extension to v-shaped fixation was necessary in about 33% after initial unilateral half-pin frame, whereas 90% of the two rigid systems could be left in situ until fracture consolidation was achieved. Cancellous bone grafts were performed in 58% after triangular, in 40% after v-shaped, and 28% after unilateral fixation. Pin infections were observed in 36% after triangular, 25% after bilateral v-shaped, and in 15% after unilateral fixation.

Adult↗
PubMed1987

Color photography vs fluorescein angiography in the detection of diabetic retinopathy in the diabetes control and complications trial. The Diabetes Control and Complications Trial Research Group.

During eligibility screening for the Diabetes Control and Complications Trial, we compared stereoscopic color fundus photography and stereoscopic fluorescein angiography in the detection of diabetic retinopathy in 320 patients (mean age, 24 years [SD, eight years]) with insulin-dependent diabetes (mean duration, 7.0 years [SD, 4.0 years]) and no or mild diabetic retinopathy. Of 153 patients classified as having no retinopathy according to color photographs of seven standard 30 degrees fields of both eyes, 21% of the patients had evidence of retinopathy (mostly one or two microaneurysms in one eye) on review of fluorescein angiograms, including two standard 30 degrees fields in each eye. Of those patients with no retinopathy detected on angiograms, 19% had retinopathy on review of color photographs. When used in conjunction with color photography, angiography allows a modest increase in sensitivity to the earliest signs of retinopathy, a gain potentially useful in some research applications, although not of demonstrated value in patient management.

Adolescent↗
PubMed1993

Design of a prospective study of the pulmonary complications of human immunodeficiency virus infection. The Pulmonary Complications of HIV Infection Study Group.

Because no studies have systematically described the pulmonary complications associated with early stages of infection with the human immunodeficiency virus (HIV), the National Heart, Lung and Blood Institute and the National Institute of Allergy and Infectious Diseases jointly initiated a prospective cohort study in 1987 to describe the incidence and course of lung diseases at all stages of HIV infection. This paper describes the ongoing study and highlights some of its unusual features. Six clinical centers from different geographic areas in the U.S. began enrolling participants in 1988, and the resulting cohort comprises 1353 members. HIV seropositive participants were randomized to "intensive" (pulmonary disease screening and follow-up at 3-month intervals) or "routine" (6-month follow-up intervals with annual screening) follow-up to assess the impact of these strategies on patient outcomes. New information from this complex study will lead to a broader understanding of the pulmonary diseases associated with HIV infection and will have relevance to clinical as well as epidemiologic aspects of HIV disease.

AIDS-Related Opportunistic Infections↗
PubMed1995

Progression of retinopathy with intensive versus conventional treatment in the Diabetes Control and Complications Trial. Diabetes Control and Complications Trial Research Group.

PURPOSE: To answer the following questions regarding the effect of intensive diabetes management on retinopathy in insulin-dependent diabetes mellitus (IDDM): (1) Does intensive therapy completely prevent the development of retinopathy? (2) Are some states of retinopathy too advanced to benefit from intensive therapy? (3) Are the retinopathy endpoints in the Diabetes Control and Complications Trial (DCCT) clinically important? and (4) What other factors influence the effectiveness of therapy? METHODS: A total of 1441 patients, ranging in age from 13 and 39 years and with IDDM of 1 to 5 years' duration and no retinopathy at baseline (primary prevention cohort) or with 1 to 15 years' duration and minimal to moderate nonproliferative retinopathy (secondary intervention cohort), were assigned randomly to either intensive or conventional diabetes therapy. Intensive therapy, aimed at achieving glycemic levels as close to the normal range as possible, included three or more daily insulin injections or a continuous subcutaneous insulin infusion, guided by four or more glucose tests daily. Conventional therapy included one or two daily injections. Seven-field stereo-scopic fundus photography was performed every 6 months, for a mean follow-up of 6.5 years (range, 4-9 years). RESULTS: Intensive therapy reduced the risk of any retinopathy (> or = 1 microaneurysm) developing in the primary prevention cohort (70% of intensive versus 90% of conventional treatment group; P = 0.002) by 27%. It reduced the risk of retinopathy developing or progressing to clinically significant degrees by 34% to 76%. Intensive therapy was most effective when initiated early in the course of IDDM. It had a substantial beneficial effect over the entire spectrum of retinopathy studied in the DCCT and, with rare exceptions, in all patient subgroups. CONCLUSION: Although intensive therapy does not prevent retinopathy completely, it has a beneficial effect that begins after 3 years of therapy on all levels of retinopathy studied in the DCCT. The reduction in risk observed in the study is translatable directly into reduced need for laser treatment and saved sight. Intensive therapy should form the backbone of any healthcare strategy aimed at reducing the risk of visual loss from diabetic retinopathy.

Adolescent↗
PubMed1993

Baseline analysis of renal function in the Diabetes Control and Complications Trial. The Diabetes Control and Complications Trial Research Group [corrected].

To determine whether there are relationships between nephropathy, retinopathy and putative risk factors at points very early in the development of long-term complications of IDDM, we have analyzed baseline data pertinent to nephropathy in the 726 subjects in the primary prevention cohort and the 715 subjects in the secondary intervention cohort of the DCCT. AER correlated positively with CCr and HbA1c in both cohorts and with degree of retinopathy and duration of IDDM in the secondary cohort. Within the secondary cohort only mean BP and HbA1c levels were significantly increased (P < 0.005) in the 73 subjects with AER > or = 28 micrograms/24 hr compared to the 642 subjects with AER < 28 micrograms/24 hr. Stratification of all subjects in the secondary cohort showed significant associations (P < 0.001) between retinopathy level, AER, duration of diabetes at entry and entry HbA1c. Even very early in the development of retinopathy and nephropathy, there is a relationship between them and with level of metabolic control. The prospective studies of the DCCT are designed to answer the question of whether intensive diabetes treatment will affect the development and/or progression of retinopathy, and, possibly, of nephropathy.

Adolescent↗
PubMed2006

Pain attacks in non-complicated and complicated gallstone disease have a characteristic pattern and are accompanied by dyspepsia in most patients: the results of a prospective study.

OBJECTIVE: The cardinal indication for surgical treatment of gallstones is pain attacks. However, following cholecystectomy, 20% of patients remain symptomatic. It is unclear to what extent post-cholecystectomy symptoms can be ascribed to persistence of preoperative symptoms or to new pathology. The pain and digestive pattern in gallstone patients has not been defined in a recent setting with ultrasonography as the diagnostic method. The aim of this study was to characterize a pain pattern that is typical for gallstone disease and to describe the extent of associated dyspepsia. MATERIAL AND METHODS: A total of 220 patients with symptomatic gallstone disease including complicated disease (acute cholecystitis and common bile duct stones) were interviewed using detailed questionnaires to disclose pain patterns and symptoms of indigestion. RESULTS: All patients had pain in the right upper quadrant (RUQ) including the upper midline epigastrium. The pain was localized to the right subcostal area in 20% and to the upper epigastrium in 14%, and in the rest (66%) it was more evenly distributed. An area of maximal pain could be defined in 90%. Maximal pain was located under the costal arch in 51% of patients and in the epigastrium in 41%, but in 3% behind the sternum and in 5% in the back. The pain was referred to the back in 63% of the patients. The mean visual analogue scale (VAS) score was very high: 90 mm on a 0-100 scale. A pattern of incipient or low-grade warning pain with a subsequent relatively steady state until subsiding in the same fashion was present in 90% of the patients. An urge to walk around was experienced by 71%. Pain attacks usually occurred in the late evening or at night (77%), with 85% of the attacks lasting for more than one hour and almost never less than half an hour. Sixty-six percent of the patients were intolerant to at least one kind of food, but only 48% to fatty foods. Symptoms of functional indigestion (gastroesophageal reflux, dyspepsia or irritable bowel symptoms) were seen in the vast majority in association with attacks. CONCLUSIONS: Gallstone-associated pain follows a certain pattern in the majority of patients. The pain is located in a defined area with a point of maximum intensity, is usually referred, and occurs mainly at night with duration of more than one hour. The majority of patients experience functional indigestion, mainly of the reflux type or dyspepsia.

Acute Disease↗
PubMed1989

Prevention of atherosclerotic complications: controlled trial of ketanserin. Prevention of Atherosclerotic Complications with Ketanserin Trial Group.

STUDY OBJECTIVE: To determine whether ketanserin, an antagonist at the serotonin receptor, prevents important vascular events such as death, myocardial infarction, major stroke, and amputation of a leg in patients with claudication. DESIGN: Double blind, randomised, placebo controlled trial after a single blind run in period of placebo treatment for one month. SETTING: One hundred and forty seven outpatient clinics in 14 countries. PATIENTS: Total of 3899 patients over 40 years old who had had documented intermittent claudication for at least two months and in whom the ratio of systolic blood pressure in the ankle to that in the arm was less than or equal to 0.85 in both arteries of at least one foot. INTERVENTION: After the one month placebo run in period patients were randomly allocated to take 20 mg ketanserin three times daily for the first month and 40 mg three times daily thereafter or to take the same number of placebo tablets. Five months after the onset of the trial, on the recommendation of the ethical and safety committee, four patients stopped taking ketanserin and two stopped taking placebo because they had a corrected QT interval greater than 500 ms. Four months later the committee recommended that all patients taking diuretics should stop receiving trial treatment (167 of those taking ketanserin and 144 of those taking placebo). END POINT: The first primary event after randomisation. Primary events were definite myocardial infarction, major stroke, amputation above the ankle, excision of ischaemic viscera, and death due to other vascular causes. MEASUREMENTS AND MAIN RESULTS: There were 136 study end points in the 1930 patients treated with ketanserin, who were followed up for 2063 patient years, and 132 study end points in the 1969 patients treated with placebo, who were followed up for 2129 patient years. A harmful interaction of ketanserin and potassium losing diuretics resulted in an increase in the number of deaths. After patients taking potassium losing diuretics or antiarrhythmic agents were excluded [corrected] a secondary analysis showed that there were 65 end points in 1514 patients taking ketanserin and 87 in 1557 patients taking placebo, a reduction of 23% in the number of study end points in those taking ketanserin. CONCLUSIONS: Ketanserin can prolong the corrected QT interval, and the combined use of ketanserin and potassium losing diuretics can be harmful. A secondary analysis suggested a protective effect of ketanserin against cardiovascular complications in patients with claudication.

Adult↗
PubMedDate not supplied

Cardiac catheterization complicated by iliacus abscess: a rare complication of transfemoral approach--a case report.

Iliacus abscess is an extremely rare complication of percutaneous transfemoral artery catheterization. This is a report of a case of iliacus abscess and Acinetobacter baumanii sepsis following percutaneous transfemoral artery catheterization. After a 43-day course of intravenous antibiotics treatment and repeated drainage, clinical recovery was achieved, though without complete radiologic resolution.

Abscess↗
PubMed1996

A comparison of renal disease across two continents; the epidemiology of diabetes complications study and the EURODIAB IDDM Complications Study.

OBJECTIVE: To compare prevalence rates of increased albumin excretion in the Epidemiology of Diabetes Complications Study (EDC) (in the U.S.) to similar rates in the EURODIAB study (in Europe) and determine if any differences relate to hypertension, glycemic control, or smoking status. RESEARCH DESIGN AND METHODS: The study population is made up of two epidemiological clinic-based IDDM populations with comparable ages (chi = 28 years, both studies), sex distribution (50% male, EURODIAB; 49% male, EDC), and duration characteristics. Comparison of two cross-sectional (prevalence) studies was made. Despite different laboratory assays, comparability was established for urinary albumin (r = 0.98) and GHb measures (r = 0.95). Hypertension was measured with an identical protocol. Renal status was determined by 24-h urine albumin excretion (< 20 micrograms/min normal, 20-200 micrograms/min microalbuminuria, > 200 micrograms/min macroalbuminuria) in EURODIAB. Identical cutoffs were used for EDC, though two of three samples (24-h, 4-h clinic, and/or overnight sample) had to be positive in one range. (Main findings are confirmed using only 24-h results from EDC.) RESULTS: The prevalence of macroalbuminuria was higher in EDC (27%) than in EURODIAB (12%). Rates of microalbuminuria were similar (22 vs. 25%, respectively). These patterns were seen at all durations and ages and in both sexes. Controlling for glycemic control, hypertension, or smoking did not account for the higher rate in EDC, nor did exclusion of subjects with raised serum creatinine. CONCLUSIONS: Advanced renal disease is more prevalent in IDDM in EDC (Pittsburgh, PA) than in Europe. This is not explained by hypertension, glycemic control, or smoking.

Adolescent↗
PubMedDate not supplied

[Motor and mental complications in the long-term treatment of complicated Parkinson's disease with levodopa].

INTRODUCTION: The progression of Parkinson's disease and levodopa therapy leads to development of motor and psychic complications that cause serious limitations to the management of the advanced disease. DEVELOPMENT: This article reviews the current literature regarding the pathophysiology and the therapeutic approaches to the management of motor and psychic fluctuations in Parkinson's disease. CONCLUSIONS: 1. The most important risk factors for the development of motor fluctuations are the young age at onset and severity of Parkinson's disease, and duration and maximum dose of levodopa. 2. Pathophysiological data include the denervation of substantia nigra compacta and postsynaptic pharmacodynamic mechanisms, with a lesser contribution of pharmacokinetic factors. 3. The main therapeutic approaches include changes in the form of administration of levodopa, inhibitors of levodopa catabolism, and dopamine agonists. 4. A number of psychiatric symptoms, including depression, panic attacks, mania and cognitive impairment, can have a fluctuating course, coinciding with the motor fluctuations.

Antiparkinson Agents↗
PubMed2001

[Prevention of complications: a forgotten aspect of therapy? arrhythmia complication in heart failure].

Heart failure has a high prevalence in the western world: 1-1.5% in the general population and 2-5% in patients above 65 years old. The association with cardiac dysarrhythmia is very common: 20-30% of patients have atrial fibrillation and significant ventricular arrhythmias occur in 50%. The pathophysiology of cardiac arrhythmias is multifactorial, including reentry, increased automaticity and triggered activity. Several prognostic factors have been described in patients with coronary artery disease, however, the two more important are the functional class and the severity of left ventricular dysfunction. In order to prevent disarrhythmic complications, the appropriate treatment of heart failure and of the underlying cardiac disease are very important. Class III antiarrhythmic drugs and the implantable cardioverter-defibrillator are increasingly used as primary (in high risk patients) or secondary prophylactic agents.

Anti-Arrhythmia Agents↗
PubMed2000

[Modern aspects of treatment of colonic cancer, complicated by ileus. Part II. Treatment of colonic cancer, complicated by ileus].

The results of treatment of 364 patients with colonic cancer, complicated by ileus. In 165 patients with partial ileus the radical operative interventions were performed, palliative--in 61 and symptomatic--in 83; with complete ileus--in 30.9 and 16 patients accordingly. Application of the interintestinal anastomoses formation methods, elaborated in the clinic, had permitted to perform primarily-restorational operations in 81.9% of patients with partial ileus and in 61.5%--with complete one, obtaining satisfactory immediate results. Insufficiency of the duplicature anastomosis sutures had occurred in 5 (2.2%) of colonic cancer patients, suffering partial ileus.

Colonic Neoplasms↗
PubMed2001

[Complicated cataract. Part I: complicated cataract in uveitic patients].

The paper shows pathognomonique cases of complicated cataracts concerning the prognostic aspects of surgical treatment. The article presents methods of treatment in cases with uveitic cataract. Modern diagnostic methods are discussed, how to choose the safest surgical technique and to reach the desired postoperative refraction. More effective ways of cataract surgery in uveitis patients are proposed.

Cataract↗
PubMed2001

[Bone complications in diabetic subjects with good metabolic control and without any long-term complications--certain problems. Part III: The influence of hypertension and type 2 diabetes mellitus co-incidence of calcium, phosphorus and magnesium metabolism].

Both high morbidity and potentiation of systemic complications emphasise significance of diabetes mellitus and hypertension co-incidence. The aim of the study was to analyse the influence of hypertension accompanied with type 2 diabetes mellitus on calcium phosphorus and magnesium metabolism. The study was performed in standard low-calcium diet conditions on the group of 49 patients with type 2 diabetes mellitus (among them 27 had hypertension), 14 patients with essential hypertension and 20 healthy persons. Both serum and urine concentration of creatinine, calcium, phosphorus, hydroxyproline, hydroxylysine and uric acid were analysed. Oral calcium load test was done. Serum alkaline phosphatase activity and oxalic acid urine excretion were also estimated. There were no significant differences between diabetic patients with and without hypertension as far as calcium, phosphorus or magnesium metabolism were concerned.

Adult↗
PubMed2001

[Bone complication in diabetes subjects with good metabolic control and without longterm complications: certain problems. Part II. Basal parameters of bone turnover].

The resorption and osteogenesis equilibrium is commonly known basal condition of bone tissue homeostasis. For the purpose of bone turnover analysis in the group of good controlled diabetic patients without any diabetic complications basal biochemical parameters of osteogenesis and resorption were estimated. During low-calcium diet conditions both serum concentration and urine excretion of creatinine, hydroxyproline, hydroxylysine and uric acid were investigated. Serum alkaline phosphatase activity and oxalic acid urine excretion were also measured. As the result of the study the higher serum alkaline phosphatase activity and hydroksyproline urine excretion in type 1 diabetic patients as well as higher hydroxyproline and hydroxylysine urine excretion in type 2 diabetic patients were found.

Alkaline Phosphatase↗