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See detailLong-term fluvastatin reduces the hazardous effect of renal impairment on four-year atherosclerotic outcomes (a LIPS substudy)
Lemos, P. A.; Serruys, P. W.; de Feyter, P. et al

in American Journal of Cardiology (2005), 95(4), 445-451

Mild renal impairment is an important risk factor for late cardiovascular complications. This substudy of the Lescol Intervention Prevention Study (LIPS) assessed the effect of fluvastatin on outcome of ... [more ▼]

Mild renal impairment is an important risk factor for late cardiovascular complications. This substudy of the Lescol Intervention Prevention Study (LIPS) assessed the effect of fluvastatin on outcome of patients who had renal dysfunction and those who did not. Complete data for creatinine clearance calculation. (Cockcroft=Gault formula) were available for 1,558 patients (92.9% of the LIPS population). Patients were randomized to fluvastatin or placebo after successful completion of a first percutaneous coronary intervention. Follow-up time was, 3 to 4 years. The effect of baseline creatinine clearance on coronary atherosclerotic events (cardiac death, non-fatal myocardial infarction, and coronary reinterventions not related to restenosis) was evaluated. Baseline creatinine clearance (logarithmic transformation) was inversely associated with an incidence of adverse events among patients who received, placebo. (hazard ratio 0.99, 95% confidence interval 0.982 to 0.998, p = 0.01). However, no association was noted between creatinine clearance and the incidence of adverse events among patients who received fluvastatin (hazard ratio 1.0, 95% confidence interval 0.99 to 1.0, p = 0.63). No further deterioration in creatinine clearance was observed during follow-up; regardless of baseline renal function or allocated treatment. Occurrence of adverse events was not related to changes in renal function during follow-up. Fluvastatin therapy markedly decreased the risk of coronary atherosclerotic events after percutaneous intervention in: patients who had lower values of creatinine clearance at baseline: The benefit of fluvastatin was unrelated to any effect on renal function. (C) 2005 by Excerpta Medica Inc. [less ▲]

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See detailLong-term follow-up from the STRIDE (anti-restenosis with the biodivysio dexamethasone-eluting stent) clinical study
Liu, X.; Hanet, C.; Legrand, Victor ULg et al

in European Heart Journal (2003), 24(Suppl. S), 268

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See detailLong-Term Follow-up of Elderly Patients with Severe Aortic Stenosis Treated by Balloon Aortic Valvuloplasty. Importance of Haemodynamic Parameters before and after Dilatation
Legrand, Victor ULg; Maes, Josiane ULg; Fastrez, Maurice ULg et al

in European Heart Journal (1991), 12(3), 451-7

Early and late prognosis after percutaneous balloon aortic valvuloplasty (PBAV) was assessed in 38 consecutive elderly patients (mean age, 78.5 +/- 6.1 years). Significant valve opening was achieved in 35 ... [more ▼]

Early and late prognosis after percutaneous balloon aortic valvuloplasty (PBAV) was assessed in 38 consecutive elderly patients (mean age, 78.5 +/- 6.1 years). Significant valve opening was achieved in 35 patients. The hospital mortality was 8% (three patients); two other patients died within the first month and three underwent aortic valve replacement. At 2 years follow-up, there were 10 additional deaths (seven cardiac deaths) and five patients had symptom recurrence managed by aortic valve replacement (3) or repeat PBAV (2). Overall, six patients underwent surgery without untoward events and six had repeat PBAV. Only two out of six patients with repeat PBAV had sustained improvement; one was referred to surgery and the remaining three died soon after the second PBAV. One- and 2-year survival were respectively 72 and 62% and percentage of survivors with persistent improvement 68 and 41%. Although aortic valve area after PBAV was associated with outcome, predictors of poor long-term prognosis were primarily related to the pre-operative haemodynamic status. Patients with pulmonary resistances greater than 400 dynes cm-1 s-5 had the poorest outcome (chi 2 = 18.4-P less than 0.0001). Overall, signs of heart failure were predictors of poor long term follow-up. These data indicate that long-term success of PBAV is mainly related to the left ventricular dysfunction noted prior to intervention. [less ▲]

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See detailLong-term follow-up reveals low toxicity of radiosurgery for vestibular schwannoma
Rutten, Isabelle; Baumert, B. G.; Seidel, Laurence ULg et al

in Radiotherapy & Oncology (2007), 82(1), 83-89

AIM: The long-term effects of radiosurgery of vestibular schwannomas were investigated in a group of consecutively treated patients. METHODS AND MATERIALS: Between 1995 and 2001, 26 patients (median age ... [more ▼]

AIM: The long-term effects of radiosurgery of vestibular schwannomas were investigated in a group of consecutively treated patients. METHODS AND MATERIALS: Between 1995 and 2001, 26 patients (median age: 67, range: 30-82) with a vestibular schwannoma were treated by Linac-based stereotactic radiosurgery (SRS). The median follow-up was 49 months (16-85 months). Only progressive tumours were treated. The median size of tumours was 18 mm (range 9-30 mm). Before SRS, 11 patients had a useful hearing (Gardner-Robertson classes 1 and 2). Single doses of 10-14 Gy were prescribed at the 80% isodose at the tumour margin. The follow-up consisted of regular imaging with MRI the first 3-6 months after the intervention, followed by additional yearly MRIs, a hearing test and a neurological examination. RESULT: The 5-year-probability of tumour control (defined as stabilization or decrease in size) was 95%. Five-year-probability of preservation of hearing and facial nerve function was 96% and 100%, respectively. Hearing was preserved in 10 out of 11 patients who had a normal or useful hearing at the time of treatment. Mild and transient trigeminal toxicity occurred in 2 (8%) patients. It appeared to be significantly correlated to the dose used (p=0.044). However, only a tendency to significance could be demonstrated in the relationship between the two factors when using the Cox analysis (hazard ratio=1.7; 95% CI: 0.7-3.9; p=0.23). CONCLUSIONS: With the doses used, our study demonstrates that SRS provides an equivalent tumour control rate when compared to surgery, as well as on a long-term basis, an excellent preservation of the facial and the acoustic nerves. Although no permanent trigeminal toxicity was observed, our data confirm that doses below 14 Gy can avoid transient dysesthesias. [less ▲]

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See detailLong-term fracture rates seen with continued ibandronate treatment : pooled analysis of DIVA and MOBILE long-term extension studies
Miller, PD; Recker, RR; Harris, S et al

in Osteoporosis International (2014), 25(1), 349-357

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See detailLong-term glycaemic control with metformin– sulphonylurea–pioglitazone triple therapy in PROactive (PROactive 17)
Scheen, André ULg; Tan, M. H.; Betteridge, D. J. et al

in Diabetic Medicine : A Journal of the British Diabetic Association (2009), 26(10), 1033-1039

Aims We assessed the long-term glycaemic effects and the safety profile of triple therapy with the addition of pioglitazone vs. placebo in patients with Type 2 diabetes treated with combined ... [more ▼]

Aims We assessed the long-term glycaemic effects and the safety profile of triple therapy with the addition of pioglitazone vs. placebo in patients with Type 2 diabetes treated with combined metformin–sulphonylurea therapy in the PROspective pioglitAzone Clinical Trial In macroVascular Events (PROactive). Methods In a post-hoc analysis, we identified patients treated with metformin plus sulphonylurea combination therapy and not receiving insulin at baseline (n = 1314). In those patients, we compared the effects of pioglitazone (force-titrated to 45 mg⁄ day, n = 654) vs. placebo (n = 660) on glycated haemoglobin (HbA1c) reduction, concomitant changes in medications and initiation of permanent insulin use (defined as daily insulin use for a period of ‡ 90 days or ongoing use at death ⁄ final visit). Results Significantly greater reductions in HbA1c and greater proportions of patients with HbA1c at target were noted with pioglitazone vs, placebo, despite a decrease in the use of other oral glucose-lowering agents. Therewas an approximate twofold increase in progression to permanent insulin use in the placebo group vs. the pioglitazone group: 31.1 vs. 16.1%, respectively, when added to combination therapy. The overall safety of themetformin–sulphonylurea–pioglitazone triple therapy was good. Conclusions Intensifying an existing dual oral therapy regimen to a triple oral regimen by adding pioglitazone to the classical metformin–sulphonylurea combination resulted in sustained improvements in glycaemic control and reduced progression to insulin therapy. The advantages and disadvantages of adding pioglitazone instead of adding basal insulin should be assessed further. [less ▲]

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See detailLong-term glycaemic effects of pioglitazone compared with placebo as add-on treatment to metformin or sulphonylurea monotherapy in PROactive (PROactive 18)
Scheen, André ULg; Tan, M. H.; Betteridge, D. J. et al

in Diabetic Medicine : A Journal of the British Diabetic Association (2009)

Abstract Aims To assess the long-term glycaemic effects, concomitant changes in medications, and initiation of permanent insulin use (defined as daily insulin use for a period of ≥90 days, or ongoing use ... [more ▼]

Abstract Aims To assess the long-term glycaemic effects, concomitant changes in medications, and initiation of permanent insulin use (defined as daily insulin use for a period of ≥90 days, or ongoing use at death/final visit) with pioglitazone vs. placebo in diabetic patients receiving metformin or sulphonylurea monotherapy at baseline in the PROspective pioglitAzone Clinical Trial in macroVascular Events (PROactive). Methods In PROactive, patients with Type 2 diabetes and macrovascular disease were randomized to pioglitazone (force-titrated to 45 mg/day) or placebo, in addition to other existing glucose-lowering therapies. In a post-hoc analysis, we categorized patients not receiving insulin at baseline and treated by oral monotherapy into two main cohorts: addon to metformin alone (n = 514) and sulphonylurea alone (n = 1001). The follow-up averaged 34.5 months. Results There were significantly greater reductions in glycated haemoglobin (HbA1c) with pioglitazone than with placebo and more pioglitazone-treated patients achieved HbA1c targets, irrespective of the baseline oral glucose-lowering regimen and despite a decrease in the use of other glucose-lowering agents. Approximately twice as many in the placebo groups progressed to permanent insulin use than in the pioglitazone groups across the two cohorts: 3.4% for pioglitazone and 6.5% for placebo when added to metformin monotherapy and 6.3% and 14.8%, respectively, when added to sulphonylurea monotherapy. The overall safety of both dual therapies was good. Conclusions Intensifying an existing oral monotherapy regimen to a dual oral regimen by adding pioglitazone resulted in sustained improvements in glycaemic control and reduced progression to insulin therapy. The efficacy and safety of adding pioglitazone to either metformin monotherapy or sulphonylurea monotherapy were good. [less ▲]

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See detailLong-term glycaemic effects of pioglitazone in triple oral therapy: Results from PROactive
Charbonnel, B.; Scheen, André ULg

in Diabetologia (2006, September), 49(Suppl. 1), 488-489

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See detailLong-term magnetic field monitoring of the Sun-like star \xi Bootis A
Morgenthaler, A.; Petit, P.; Saar, S. et al

in Astronomy and Astrophysics (2012), 540

Aims: We aim to investigate the long-term temporal evolution of the magnetic field of the solar-type star ξ Bootis A, both from direct magnetic field measurements and from the simultaneous estimate of ... [more ▼]

Aims: We aim to investigate the long-term temporal evolution of the magnetic field of the solar-type star ξ Bootis A, both from direct magnetic field measurements and from the simultaneous estimate of indirect activity indicators. Methods: We obtained seven epochs of high-resolution, circularly-polarized spectra from the NARVAL spectropolarimeter between 2007 and 2011, for a total of 76 spectra. Using approximately 6100 photospheric spectral lines covering the visible domain, we employed a cross-correlation procedure to compute a mean polarized line profile from each spectrum. The large-scale photospheric magnetic field of the star was then modelled by means of Zeeman-Doppler Imaging, allowing us to follow the year-to-year evolution of the reconstructed magnetic topology. Simultaneously, we monitored the width of several magnetically sensitive spectral lines, the radial velocity, the line asymmetry of intensity line profiles, and the chromospheric emission in the cores of the Ca II H and Hα lines. Results: During the highest observed activity states, in 2007 and 2011, the large-scale field of ξ Bootis A is almost completely axisymmetric and is dominated by its toroidal component. The toroidal component persists with a constant polarity, containing a significant fraction of the magnetic energy of the large-scale surface field through all observing epochs. The magnetic topologies reconstructed for these activity maxima are very similar, suggesting a form of short cyclicity in the large-scale field distribution. The mean unsigned large-scale magnetic flux derived from the magnetic maps varies by a factor of about 2 between the lowest and highest observed magnetic states. The chromospheric flux is less affected and varies by a factor of 1.2. Correlated temporal evolution, due to both rotational modulation and seasonal variability, is observed between the Ca II emission, the Hα emission and the width of magnetically sensitive lines. The rotational dependence of polarimetric magnetic measurements displays a weak correlation with other activity proxies, presumably due to the different spatial scales and centre-to-limb darkening associated with polarimetric signatures, as compared to non-polarized activity indicators. Better agreement is observed on the longer term. When measurable, the differential rotation reveals a strong latitudinal shear in excess of 0.2 rad d-1. [less ▲]

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See detailLong-term magnetic field monitoring of the sun-like star ξ Bootis A
Morgenthaler, A.; Petit, P.; Aurière, M. et al

in Boissier, S.; Heydari-Malayeri, M.; Samadi, R. (Eds.) et al SF2A-2010: Proceedings of the Annual meeting of the French Society of Astronomy and Astrophysics (2010, December 01)

Phase-resolved observations of the solar-type star ξ Bootis A were obtained using the Narval spectropolarimeter at Telescope Bernard Lyot (Pic du Midi, France) during years 2007, 2008, 2009 and 2010. The ... [more ▼]

Phase-resolved observations of the solar-type star ξ Bootis A were obtained using the Narval spectropolarimeter at Telescope Bernard Lyot (Pic du Midi, France) during years 2007, 2008, 2009 and 2010. The data sets enable us to study both the rotational and the long-term evolution of various activity tracers. Here, we focus on the large-scale photospheric magnetic field (reconstructed by Zeeman-Doppler Imaging), the Zeeman broadening of the FeI 846.84 nm magnetic line, and the chromospheric CaII H and Hα emission. [less ▲]

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See detailLong-term memory effects on verbal short-term memory : a replication study
Majerus, Steve ULg; Van der Linden, Martial ULg

in British Journal of Developmental Psychology (2003), 21(Part 2), 303-310

The influence of lexico-semantic language representations stored in long-term memory (LTM) on short-term memory (STM) performance has been studied extensively in adults. However, there are relatively few ... [more ▼]

The influence of lexico-semantic language representations stored in long-term memory (LTM) on short-term memory (STM) performance has been studied extensively in adults. However, there are relatively few data on lexico-semantic LTM effects on STM in children. On the other hand, the influence of phonological LTM effects on STM has been studied more extensively in children than in adults. In this study, we explored whether these different LTM effects on verbal STM could be replicated in both adults and children by administering immediate serial recall tasks (ISR) for high- and low-frequency words, for high- and low-imageability words, for words and non-words, and for high and low phonotactic frequency non-words to 6-, 8-, and 10-year-old children, to adolescents and to adults. Significant word frequency, lexicality and phonotactic frequency effects were observed in all age groups, as well as a word imageability effect which was, however, weaker than the other three effects. Our data suggest that LTM effects on STM are equivalent in both children and adults. [less ▲]

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See detailLong-term multicolour photometry and high-resolution spectroscopy of the two gamma Doradus stars HD 12901 and HD 48501
Aerts, C.; Cuypers, J.; De Cat, P. et al

in Astronomy and Astrophysics (2004), 415

We gathered long-term multicolour Geneva UB[SUB]1[/SUB]BB[SUB]2[/SUB]V[SUB]1[/SUB]VG photometric and high-resolution (R=40 000) spectroscopic data of the two gamma Doradus stars HD 12901 and HD 48501. The ... [more ▼]

We gathered long-term multicolour Geneva UB[SUB]1[/SUB]BB[SUB]2[/SUB]V[SUB]1[/SUB]VG photometric and high-resolution (R=40 000) spectroscopic data of the two gamma Doradus stars HD 12901 and HD 48501. The photometry reveals three frequencies for each of the two stars: f[SUB]1[/SUB]=1.21563 c d[SUP]-1[/SUP], f[SUB]2[/SUB]=1.39594 c d[SUP]-1[/SUP] and f[SUB]3[/SUB]=2.18636 c d[SUP]-1[/SUP] for HD 12901 and f[SUB]1[/SUB]=1.09408 c d[SUP]-1[/SUP], f[SUB]2[/SUB]=1.29054 c d[SUP]-1[/SUP] and f[SUB]3[/SUB]=1.19924 c d[SUP]-1[/SUP] for HD 48501. The photometric amplitude is each time largest in the Geneva B[SUB]1[/SUB] filter and the variations in all the different filters are perfectly in phase within the measurement errors. Mode identification points out that the six modes are all l=1 modes and that the non-adiabatic temperature variations are extremely small, in contradiction to current theoretical predictions. Our spectra show that all the observed frequencies are intrinsic to the stars and cannot be due to binarity. We detect clear line-profile variations at low amplitude (<1 km s[SUP]-1[/SUP]) due to the oscillations of both targets. The estimated v sin i from the spectra are Ë 53 km s[SUP]-1[/SUP] for HD 12901 and Ë 29 km s[SUP]-1[/SUP] for HD 48501. It is at present unclear if the triplet-like structure for HD 48501 is the consequence of rotational splitting or of the large separation expected for high-order gravity modes in the asymptotic regime. Based on observations gathered with the Swiss 0.7 m telescope equipped with the photometer P 7 and with the Swiss 1.2 m Euler telescope equipped with the spectrograph CORALIE, both situated at La Silla, Chile. Reduced data available upon request from the first author. [less ▲]

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See detailLong-term neurodevelopmental outcome and exercise capacity after corrective surgery for tetralogy of Fallot or ventricular septal defect in infancy.
Hovels-Gurich, Hedwig H; Konrad, Kerstin; Skorzenski, Daniela et al

in Annals of Thoracic Surgery (2006), 81(3), 958-66

BACKGROUND: The purpose of this prospective study was to assess whether neurodevelopmental status and exercise capacity of children 5 to 10 years after corrective surgery for tetralogy of Fallot or ... [more ▼]

BACKGROUND: The purpose of this prospective study was to assess whether neurodevelopmental status and exercise capacity of children 5 to 10 years after corrective surgery for tetralogy of Fallot or ventricular septal defect in infancy was different compared with normal children and influenced by the preoperative condition of hypoxemia or cardiac insufficiency. METHODS: Forty unselected children, 20 with tetralogy of Fallot and hypoxemia and 20 with ventricular septal defect and cardiac insufficiency, operated on with combined deep hypothermic circulatory arrest and low flow cardiopulmonary bypass at a mean age of 0.7 +/- 0.3 years (mean +/- SD), underwent, at mean age 7.4 +/- 1.6 years, standardized evaluation of neurologic status, gross motor function, intelligence, academic achievement, language, and exercise capacity. Results were compared between the groups and related to preoperative, perioperative, and postoperative status and management. RESULTS: Rate of mild neurologic dysfunction was increased compared with normal children, but not different between the groups. Exercise capacity and socioeconomic status were not different compared with normal children and between the groups. Compared with the normal population, motor function, formal intelligence, academic achievement, and expressive and receptive language were significantly reduced (p < 0.01 to p < 0.001) in the whole group and in the subgroups, except for normal intelligence in ventricular septal defect patients. Motor dysfunction was significantly higher in the Fallot group compared with the ventricular septal defect group (p < 0.01) and correlated with neurologic dysfunction, lower intelligence, and reduced expressive language (p < 0.05 each). Reduced New York Heart Association functional class was correlated with lower exercise capacity and longer duration of cardiopulmonary bypass (p < 0.05 each). Reduced socioeconomic status significantly influenced dysfunction in formal intelligence (p < 0.01) and academic achievement (p < 0.05). Preoperative risk factors such as prenatal hypoxia, perinatal asphyxia, and preterm birth, factors of perioperative management such as cardiac arrest, lowest nasopharyngeal temperature, and age at surgery, and postoperative risk factors as postoperative cardiocirculatory insufficiency and duration of mechanical ventilation were not different between the groups and had no influence on outcome. Degree of hypoxemia in Fallot patients and degree of cardiac insufficiency in ventricular septal defect patients did not influence the outcome within the subgroups. CONCLUSIONS: Children with preoperative hypoxemia in infancy are at higher risk for motor dysfunction than children with cardiac insufficiency. Corrective surgery in infancy for tetralogy of Fallot or ventricular septal defect with combined circulatory arrest and low flow bypass is associated with reduced neurodevelopmental outcome, but not with reduced exercise capacity in childhood. In our experience, the general risk of long-term neurodevelopmental impairment is related to unfavorable effects of the global perioperative management. Socioeconomic status influences cognitive capabilities. [less ▲]

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See detailLong-term neurodevelopmental outcomes in school-aged children after neonatal arterial switch operation.
Hovels-Gurich, Hedwig H; SEGHAYE, Marie-Christine ULg; Schnitker, Ralph et al

in Journal of Thoracic and Cardiovascular Surgery (The) (2002), 124(3), 448-58

OBJECTIVE: Neurodevelopmental status of children between 8 and 14 years of age after neonatal arterial switch operation for transposition of the great arteries has not previously been systematically ... [more ▼]

OBJECTIVE: Neurodevelopmental status of children between 8 and 14 years of age after neonatal arterial switch operation for transposition of the great arteries has not previously been systematically evaluated. METHODS: Within a longitudinal study, 60 unselected children operated on as neonates with combined deep hypothermic circulatory arrest and low-flow cardiopulmonary bypass were reevaluated at the age of 7.9 to 14.3 years (mean +/- SD 10.5 +/- 1.6 years). Clinical neurologic status and standardized tests to assess gross motor function, intelligence, acquired abilities, language, and speech were carried out, and the results were related to preoperative, perioperative, and postoperative status, to management, and to neurodevelopmental status at a mean age of 5.4 years. RESULTS: Neurologic and speech impairments were evidently more frequent (27% and 40%, respectively) than in the general population. Intelligence and socioeconomic status were not different (P =.29 and P =.11), whereas motor function, acquired abilities, and language were reduced (P < or =.04 for each). Overall rate of developmental impairment in one or more domains was 55%, compared with 26% at age 5.4 years. Multivariable analysis showed that severe preoperative acidosis and hypoxia predicted reduced motor function (mean deficit 52.7 points, P <.001), whereas longer bypass duration predicted both neurologic (odds ratio per 10 minutes of bypass duration 1.8, P =.04) and speech (odds ratio per 10 minutes of bypass duration 1.9, P =.02) dysfunction, and perioperative and postoperative cardiocirculatory insufficiency predicted neurologic (odds ratio 6.5, P =.04) and motor (mean deficit 6.8 points, P =.03) dysfunction. CONCLUSIONS: The neonatal arterial switch operation with combined circulatory arrest and low-flow bypass is associated increasingly with age, with reduced neurodevelopmental outcome but not with cognitive dysfunction. In our experience, the risk of long-term neurodevelopmental impairment after neonatal corrective cardiac surgery is related to deleterious effects of the global perioperative management and to special adverse effects of prolonged bypass duration. Severe preoperative acidosis and hypoxia and postoperative hemodynamic instability must be considered as important additional risk factors. [less ▲]

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See detailLong-term optical spectrophotometric monitoring of comet C/1995 O1 (Hale-Bopp)
Rauer, H.; Helbert, J.; Arpigny, Claude ULg et al

in Astronomy and Astrophysics (2003), 397

We observed comet C/1995 O1 (Hale-Bopp) at 4.6-2.9 AU pre-perihelion and 2.8-12.8 AU post-perihelion with optical long-slit spectroscopy. Emission bands of CN, C[SUB]3[/SUB], C[SUB]2[/SUB] and NH[SUB]2 ... [more ▼]

We observed comet C/1995 O1 (Hale-Bopp) at 4.6-2.9 AU pre-perihelion and 2.8-12.8 AU post-perihelion with optical long-slit spectroscopy. Emission bands of CN, C[SUB]3[/SUB], C[SUB]2[/SUB] and NH[SUB]2[/SUB] have been covered. Emission of C[SUB]3[/SUB] was detected up to 7.0 AU, and CN could be followed up to 9.8 AU post-perihelion. Spatial column density profiles of the radicals have been used to derive effective parent Haser scale lengths for heliocentric distances beyond 3 AU. Production rates were derived based on these Haser scale lengths. The observations of CN are in agreement with HCN as the major parent molecule of this radical at large distances from the Sun (i.e. beyond ~ 3 AU). We compare the measured CN production rate to sublimation rates of HCN from a simple nucleus sublimation model. The variation of CN production rates with changing heliocentric distance gives no indication for sublimation from the interior and is consistent with very little thermal lag of the nucleus. Based on observations collected at the European Southern Observatory, Chile, and the Observatoire de Haute Provence, France. [less ▲]

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See detailLong-term outcome after infliximab for refractory ulcerative colitis
Ferrante, M.; Vermeire, S.; Fidder, H. et al

in Journal of Crohn’s and Colitis [=JCC] (2008), 2(3), 219-225

Background and aims: Infliximab (IFX) has been shown efficacious for moderate-to-severe ulcerative colitis (UC), but data on long-term efficacy are tacking. We investigated long-term outcome including ... [more ▼]

Background and aims: Infliximab (IFX) has been shown efficacious for moderate-to-severe ulcerative colitis (UC), but data on long-term efficacy are tacking. We investigated long-term outcome including colectomy rates in outpatients treated with IFX for refractory UC in a single referral centre, and evaluated if predictors could be identified. Methods: The first 121 outpatients (median age 38.0 years) with refractory UC treated with IFX were included. The primary outcome was colectomy-free survival. Secondary measures were sustained clinical response and serious adverse events. Results: From the 81 patients (67%) with an initial clinical response to IFX, 68% had a sustained clinical response. No independent predictors of sustained clinical response could be identified. Over a median (IQR) follow-up period of 33.0 (17.0-49.8) months, 21 patients (17%) came to colectomy. Independent predictors of colectomy were absence of short-term clinical response [Hazard ratio 10.8 (95% Cl 3.5-32.8), p < 0.001], a baseline CRP level >= 5 mg/L [Hazard ratio 14.5 (95% Cl 2.0-108.6), p=0.006] and previous IV treatment with corticosteroids and/or cyctosporine [Hazard ratio 2.4 (95% Cl 1.1-5.9), p=0.033]. Six patients developed a serious infection, three a malignancy, two a post-operative complication and one patient died (suicide). Conclusions: With a median follow-upof 33.0 months after start of IFX, 17% of patients with refractory UC needed colectomy, while sustained clinical response was present in 68% of initial responders. (c) 2008 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved. [less ▲]

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See detailLong-term outcome and clinical spectrum of 73 pediatric patients with mitochondrial diseases.
DEBRAY, François-Guillaume ULg; Lambert, Marie; Chevalier, Isabelle et al

in Pediatrics (2007), 119(4), 722-733

OBJECTIVES: We sought to determine the clinical spectrum, survival, and long-term functional outcome of a cohort of pediatric patients with mitochondrial diseases and to identify prognostic factors ... [more ▼]

OBJECTIVES: We sought to determine the clinical spectrum, survival, and long-term functional outcome of a cohort of pediatric patients with mitochondrial diseases and to identify prognostic factors. METHODS: Medical charts were reviewed for 73 children diagnosed between 1985 and 2005. The functional status of living patients was assessed prospectively by using the standardized Functional Independence Measure scales. RESULTS: Patients fell into 7 phenotypic categories: neonatal-onset lactic acidosis (10%), Leigh syndrome (18%), nonspecific encephalopathy (32%), mitochondrial (encephalo)myopathy (19%), intermittent neurologic (5%), visceral (11%), and Leber hereditary optic neuropathy (5%). Age at first symptoms ranged from prenatal to 16 years (median: 7 months). Neurologic symptoms were the most common (90%). Visceral involvement was observed in 29% of the patients. A biochemical or molecular diagnosis was identified for 81% of the patients as follows: deficiency of complex IV (27%), of pyruvate dehydrogenase or complex I (25% each), of multiple complexes (13%), and of pyruvate carboxylase (5%) or complexes II+III (5%). A mitochondrial DNA mutation was found in 20% of patients. At present, 46% of patients have died (median age: 13 months), 80% of whom were <3 years of age. Multivariate analysis showed that age at first symptoms was a major independent predictor of mortality: patients with first symptoms before 6 months had a highly increased risk of mortality. Cardiac or visceral involvement and neurologic crises were not independent prognostic factors. Living patients showed a wide range of independence levels that correlated positively with age at first symptoms. Among patients aged >5 years (n = 32), 62% had Functional Independence Measure quotients of >0.75. CONCLUSIONS: Mitochondrial diseases in children span a wide range of symptoms and severities. Age at first symptoms is the strongest predictor mortality. Despite a high mortality rate in the cohort, 62% of patients aged >5 years have only mild impairment or normal functional outcome. [less ▲]

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See detailLong-term outcome and use of 6-Minute Walk test in West Highland white Terriers with idiopathic pulmonary fibrosis
Lilja-Maula, LIO; Laurila, HP; Syrjä, P et al

in Journal of Veterinary Internal Medicine (2014), 28(2), 379-385

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