ABSTRACT
Objectives. Developments in medication and coronary interventions have improved coronary artery disease (CAD) treatment. We studied long-term outcomes in an observational, real-life population of CAD patients undergoing percutaneous coronary intervention (PCI) depending on the presentation and the stent type used. Design and results. Register included 789 consecutive patients undergoing PCI. Follow up period was three years with primary composite outcome (MACE) of all cause -mortality, myocardial infarction and target lesion revascularization. Mean age was 65 ± 11 and 69% were male. New-generation drug-eluting stents (DES-2) were associated with lower adjusted rates of MACE (HR 0.47; 95% CI 0.29-0.77) but not mortality (HR 0.50; 95% CI 0.22-1.14) in comparison to bare-metal stents. Patients with STEMI (14.4%) or NSTEMI (13.7%) had higher crude mortality rates than those with unstable (4.5%) or stable CAD (3.1%; p < .001). The association diminished after adjustments in NSTEMI (HR 2.01; 95% CI 0.88-4.58). Among smokers 45% quitted and 36% achieved recommended cholesterol levels. Conclusions. The overall prognosis was good. Irrespective of comorbidities, NSTEMI was not associated with worse outcome than stable CAD. DES-2 was associated with lower rates of MACE than BMS without affecting mortality rate. Patients succeeded better in smoking cessation than reaching recommended cholesterol levels.
Subject(s)
Angina, Unstable/therapy , Coronary Artery Disease/therapy , Non-ST Elevated Myocardial Infarction/therapy , Percutaneous Coronary Intervention/instrumentation , ST Elevation Myocardial Infarction/therapy , Stents , Aged , Angina, Unstable/diagnostic imaging , Angina, Unstable/mortality , Anticholesteremic Agents/therapeutic use , Coronary Artery Disease/diagnostic imaging , Coronary Artery Disease/mortality , Drug-Eluting Stents , Dyslipidemias/drug therapy , Dyslipidemias/mortality , Female , Humans , Male , Metals , Middle Aged , Non-ST Elevated Myocardial Infarction/diagnostic imaging , Non-ST Elevated Myocardial Infarction/mortality , Percutaneous Coronary Intervention/adverse effects , Percutaneous Coronary Intervention/mortality , Prosthesis Design , Registries , Risk Assessment , Risk Factors , ST Elevation Myocardial Infarction/diagnostic imaging , ST Elevation Myocardial Infarction/mortality , Smoking/adverse effects , Smoking/mortality , Smoking Cessation , Time Factors , Treatment OutcomeABSTRACT
PURPOSE: To investigate the incidence of hypothyroidism after radiotherapy of laryngeal cancer, including the possible factors that could predict the onset of hypothyroidism. MATERIALS AND METHODS: We report this study on patients treated by radiotherapy as part of the treatment for laryngeal cancer in the Department of Oncology in Eastern Finland. Sixty-five males and seven females were treated with radiotherapy between 1974-1995.Thyroid function was determined by measuring serum thyroid stimulating hormone, and serum free thyroxine (FT4). The studied risk factors for hypothyroidism included age, treatment modalities, radiation dose and energy, height of the radiation field, and follow-up time. RESULTS: Hypothyroidism was detected in 17 (24%) of the 72 patients. Hypothyroidism was clinically unsuspected in all but one patient. Hypothyroidism was more common, if the height of the radiation field was >/=7 cm, or the patient had been operated. Hypothyroidism was less common if less than a half of the thyroid bed was irradiated. CONCLUSION: The detection of hypothyroidism clinically is difficult, and the rate of hypothyroidism warrants routine assessment of thyroid function after irradiation of laryngeal cancer.
Subject(s)
Hypothyroidism/etiology , Laryngeal Neoplasms/radiotherapy , Radiotherapy/adverse effects , Thyroid Gland/radiation effects , Adult , Aged , Aged, 80 and over , Cohort Studies , Dose Fractionation, Radiation , Dose-Response Relationship, Radiation , Female , Humans , Hypothyroidism/diagnosis , Hypothyroidism/epidemiology , Incidence , Laryngeal Neoplasms/drug therapy , Laryngeal Neoplasms/surgery , Male , Middle Aged , Prognosis , Radiation Tolerance , Radiotherapy Dosage , Risk Factors , Thyroid Function TestsABSTRACT
According to reports in the literature, the incidence of occult acoustic neuroma is about 1%. This figure is relatively high compared with clinically encountered neuromas. Our material consisted of 298 temporal bones from 168 cases (129 paired specimens). No occult neuromas were discovered in our material. On the basis of earlier studies, we expected to find one or two occult neuromas, but there was only one case of a large cerebellopontine acoustic neuroma, and the patient died after a neurosurgical operation.
