Browsing by Subject "recurrence"

The aims of this study are to determine the prevalence of clinically apparent orolabial herpes and the rate of recrudescence in the Finnish population. As a secondary aim we evaluate the significance of sociodemographic, health-related and other factors previously associated with the disease. The study sample was collected from the Finnish population register office using simple random sampling. A mailed questionnaire was sent to 3200 adults and 1000 children in 1989-1990. Response rate was excellent. In the adult study sample (15-65 years old) the lifetime prevalence of recurrent herpes labialis is 19.4%. Over 60% of cases have 1-3 relapses per year. Family background and health factors are found to be independent predictive factors for recurrent herpes labialis: mother (OR 3.38; 95% CI 2.35 – 4.86), chapped lips (OR 3.28; 95% CI 2.39 - 4.49). A larger proportion of women than men have the disease (OR 2.17; 95% CI 1.70 – 2.77). In order to develop the management of the disease further studies on the role of factors affecting the clinical manifestation, symptomatic and asymptomatic latency reactivation are needed.

Background A number of randomized controlled trials have shown the benefit of drain placement in the operative treatment of chronic subdural hematoma (CSDH); however, few reports have described real-life results after adoption of drain placement into clinical practice. We report the results following a change in practice at Helsinki University Hospital from no drain to subdural drain (SD) placement after burr hole craniostomy for CSDH. Methods We conducted a retrospective observational study of consecutive patients undergoing burr hole craniostomy for CSDH. We compared outcomes between a 6- month period when SD placement was arbitrary (July-December 2015) and a period when SD placement for 48 hours was routine (July-December 2017). Our primary outcome of interest was recurrence of CSDH necessitating reoperation within 6 months. Patient outcomes, infections, and other complications were assessed as well. Results A total of 161 patients were included, comprising 71 (44%) in the drain group and 90 (56%) in the non-drain group. There were no significant differences in age, comorbidities, history of trauma, or use of antithrombotic agents between the 2 groups (P>0.05 for all). Recurrence within 6 months occurred in 18% of patients in the non-drain group, compared with 6% in the drain group (odds ratio, 0.28; 95% confidence interval, 0.09-0.87; P=0.028). There were no differences in neurologic outcomes (P=0.72), mortality (P=0.55), infection rate (P=0.96), or other complications (P=0.20). Conclusions The change in practice from no drain to use of an SD after burr hole craniostomy for CSDH effectively reduced the 6-month recurrence rate with no effect on patient outcomes, infections, or other complications.