In resected pancreatic adenocarcinoma, increased pancreatic steatosis and increased visceral fat stores are associated with lymphatic metastases. Furthermore, increased visceral fat is associated with abbreviated survival in patients with lymphatic metastases. Hence, increased visceral fat may be a causative factor of abbreviated survival and serves a prognostic role in patients with pancreatic malignancies.
The thickness of the PVST is important in the detection of underlying injuries to the cervical spine. MDCT is playing an increasingly important role in the evaluation of pediatric trauma patients. We propose the obtained values as the upper limits of normal for PVST thickness on MDCT images in the pediatric population from 0 to 15 years old.
Background: Multiple randomized clinical trials have shown the benefits of thrombectomy in the treatment of acute stroke after 90 days; a recent study showed extended benefit in the functional outcomes of the original cohort of randomized patients. However, data on real-world experience on long-term outcomes, including recurrent vascular events and risk factor controls, is lacking. Aim: To study long-term clinical outcomes, risk factor modification, medication compliance, and recurrent events in patients undergoing thrombectomy in a community-based setting. Methods: Retrospective data was collected on 143 cases performed between 2013 and 2017 in a non-academic medical center. Long-term follow-up was performed by reviewing hospital and clinic records of available patients. Results: At the time of discharge, 79% of the 143 thrombectomy patients survived, 11% had died, and 10% went to hospice. Post-hospitalization data, ranging from 30-days to 3 years, was available in 83 patients. A majority of the survivors (81%) were living with family at home. Within that time frame, cardiovascular events occurred in 39% of patients, with 5 deaths (6%). Only 7% (6/83) of patients had a recurrent stroke; most of them were lacunar. Two patients had repeat thrombectomies, and one was treated with IV tpa. Seventy-nine percent (66/83) continued to be on anti-platelet agents. A surprising number (34/83) of long-term survivors continued to smoke and drink heavily (20/83). Only 78% of patients had regular medical care. Twenty-percent of survivors were depressed and 20% were demented. Conclusions: Although thrombectomy helps reduce disability and benefits stroke survival, there is a high incidence of cardiovascular and cerebrovascular events afterwards, due to poor control of risk factors, inadequate medical follow-up, and lack of lifestyle changes. Thrombectomy is a costly procedure; to be cost-effective in the long-term, it is imperative that the survivors are not left without proper medical surveillance and secondary prevention strategies.
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