Subject(s)
Coronary Occlusion/therapy , Patient Discharge , Percutaneous Coronary Intervention , Aged , Arizona , Chronic Disease , Coronary Occlusion/diagnostic imaging , Coronary Occlusion/mortality , Feasibility Studies , Female , Humans , Length of Stay , Male , Middle Aged , Percutaneous Coronary Intervention/adverse effects , Percutaneous Coronary Intervention/mortality , Retrospective Studies , Risk Factors , Time Factors , Treatment OutcomeABSTRACT
INTRODUCTION: Acute decompensated heart failure is a known complication following orthotopic liver transplant. Among those, there are some cases of takostubo type cardiomyopathy (TC), commonly referred to as "broken heart syndrome". While the exact mechanism of TC is unknown, it frequently proceeds a physical or emotional stressor. Here we present a series of seven cases of TC following orthotopic liver transplant. METHODS: A retrospective chart review was conducted on 454 patients were identified as having post-operative cardiac dysfunction in the setting of orthotopic liver transplantation. Of those, seven were identified as having TC based on apical ballooning, acute heart failure without evidence of coronary artery disease. All seven underwent pre-operative cardiac evaluation per protocol. Extensive chart review was performed on the seven patients to identify pre and post-operative qualities. RESULTS: At this single institution, TC affected 7/454 patients, reflecting an incidence of 1.5% over the eight year study period. Of the seven patients affected, one expired. Patients represented a mix of emergent and scheduled transplantation in the setting of end stage liver disease (ESLD). Patients had a mix of etiologies related to their ELSD including hepatitis C, alcoholic cirrhosis, and non-alcoholic steatohepatitis. DISCUSSION: It is important to recognize TC as a potential complication following liver transplantation so as to detect cases earlier in the disease course and begin early goal-directed care.
Subject(s)
Liver Transplantation/adverse effects , Postoperative Complications/etiology , Takotsubo Cardiomyopathy/etiology , Aged , End Stage Liver Disease/surgery , Fatal Outcome , Female , Humans , Incidence , Male , Middle Aged , Postoperative Complications/epidemiology , Retrospective Studies , Takotsubo Cardiomyopathy/epidemiologyABSTRACT
BACKGROUND: Preformed metal crowns, also known as stainless steel crowns (SSC), are utilized for providing full coverage to young permanent teeth and have been used extensively as restorations of primary teeth for approximately 65 years. AIM: Evaluate permanent tooth SSC longevity as an interim restoration for teeth requiring full coverage restoration in pediatric patients. DESIGN: Retrospective chart review from 2006 through 2014 in a hospital-based dental clinic for permanent tooth pre-fabricated crown longevity. One hundred and fifty-five SSCs were evaluated with regard to: age of patient at restoration placement, diagnoses, and duration of crown service. Duration service was further categorized as successful or failed. RESULTS: Of 155 SSCs, 137 were considered successfully functioning. Total failures were 18. The overall combined success rate for the study group was observed to be 88% with an average service period of 45.18 months. Significant success was noted in patients less than 9 years of age, and significant failure was observed in patients 12 years and older. CONCLUSIONS: Stainless steel crowns are a viable option for interim restoration needs, with an 88% overall success rate during an average service period of 45.18 months.
Subject(s)
Crowns , Dental Restoration, Temporary/instrumentation , Adolescent , Child , Dental Restoration Failure , Female , Humans , Male , Retrospective Studies , Stainless Steel , Time Factors , Young AdultABSTRACT
PURPOSE: The purposes of this study were to determine the previously unreported prevalence of antral pseudocysts in an exclusively pediatric dental population, characterize their presentation, and investigate potential correlates to the presence of these lesions. METHODS: A tripartite chart review was conducted of 2,000 five- to 21-year-old pediatric dental patients at Yale-New Haven Hospital for the presence of antral pseudocysts identifiable on panoramic radiographs. Demographic, medical, and dental variables potentially influencing their pathogenesis were analyzed via descriptive statistics, odds ratios, and Fisher's exact test. RESULTS: Thirty-six antral pseudocysts were identified in the study sample (1.8 percent). They presented as asymptomatic solitary lesions with a slight male predominance and occurring with greater frequency in individuals with reported allergies. No significant relationship was found between maxillary extractions, orthodontics, obstructive sleep apnea, or history of orofacial trauma and the presence of antral pseudocysts. CONCLUSION: The prevalence of antral pseudocysts in the pediatric dental population falls among the lower end of ranges previously reported in the literature and may reflect their development over time in response to environmental exposures.
