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Sample records for follow-up association studies

  1. Factors Associated with Remission of Eczema in Children: a Population-based Follow-up Study.

    von Kobyletzki, Laura; Bornehag, Carl-Gustaf; Breeze, Elizabeth; Larsson, Malin; Boman Lindström, Cecilia; Svensson, Åke

    2014-01-01

    The aim of this study was to analyse factors associated with remission of atopic dermatitis (AD) in childhood. A population-based AD cohort of 894 children aged 1-3 years from a cross-sectional baseline study in 2000 was followed up in 2005. The association between remission, background, health, lifestyle, and environmental variables was estimated with crude and multivariable logistic regression. At follow-up, 52% of the children had remission. Independent factors at baseline predicting remis...

  2. Factors associated with remission of eczema in children: a population-based follow-up study.

    von Kobyletzki, Laura B; Bornehag, Carl-Gustaf; Breeze, Elizabeth; Larsson, Malin; Lindström, Cecilia Boman; Svensson, Åke

    2014-03-01

    The aim of this study was to analyse factors associated with remission of atopic dermatitis (AD) in childhood. A population-based AD cohort of 894 children aged 1-3 years from a cross-sectional baseline study in 2000 was followed up in 2005. The association between remission, background, health, lifestyle, and environmental variables was estimated with crude and multivariable logistic regression. At follow-up, 52% of the children had remission. Independent factors at baseline predicting remission were: milder eczema (adjusted odds ratio (aOR), 1.43; 95% confidence interval (95% CI) 1.16-1.77); later onset of eczema (aOR 1.40; 95% CI 1.08-1.80); non-flexural eczema (aOR 2.57; 95% CI 1.62-4.09); no food allergy (aOR 1.51; 95% CI 1.11-2.04), and rural living (aOR 1.48; 95% CI 1.07-2.05). Certain aspects of AD and rural living were important for remission, but despite the initial hypotheses to the contrary, the environmental factors examined in this paper were not substantial predictors of remission.

  3. A Study on Adherence to Follow-up, Quality of Life, and Associated Factors Among Renal Transplant Recipients in China.

    Zhao, L; Yan, J; Yang, G-L; Liu, Y

    Adherence to follow-up is vital for the medical surveillance of the postoperative blood concentration, but relatively little research has examined it, and there is less study on relationships between adherence to follow-up and quality of life (QoL). We investigated the status of adherence to follow-up and QoL and associated factors among kidney transplantation recipients in China. A cross-sectional study with the use of a Kidney Transplantation Recipient's Adherence to Follow-Up Questionnaire and a Quality of Life of Kidney Transplantation Recipients Questionnaire was conducted among 250 kidney transplantation recipients in Changsha, China, from January to March in 2015. The mean score for adherence to follow-up was 54.71 ± 6.46. Time after transplantation was the only factor affecting adherence to follow-up scores (β = -0.210; P adherence to follow-up, economic level, job status, donor source, and original disease affected with QoL. Adherence to follow-up decreases with time after transplantation, and better compliance is associated with better QoL in all areas. Improvements in adherence to follow-up, income and reimbursement, psychologic guidance, and social support may increase QoL of kidney transplantat recipients. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Long term follow up study of survival associated with cleft lip and palate at birth

    Christensen, Kaare; Juel, K.; Herskind, Anne Maria

    2004-01-01

    OBJECTIVE: To assess the overall and cause specific mortality of people from birth to 55 years with cleft lip and palate. DESIGN: Long term follow up study. SETTING: Danish register of deaths. PARTICIPANTS: People born with cleft lip and palate between 1943 and 1987, followed to 1998. MAIN OUTCOME...... MEASURES: Observed and expected numbers of deaths, summarised as overall and cause specific standardised mortality ratios. RESULTS: 5331 people with cleft lip and palate were followed for 170 421 person years. The expected number of deaths was 259, but 402 occurred, corresponding to a standardised...... of death. CONCLUSIONS: People with cleft lip and palate have increased mortality up to age 55. Children born with cleft lip and palate and possibly other congenital malformations may benefit from specific preventive health measures into and throughout adulthood....

  5. Characteristics associated with intervention and follow-up attendance in a secondhand smoke exposure study for families of NICU infants.

    Northrup, Thomas F; Green, Charles; Evans, Patricia W; Stotts, Angela L

    2015-07-01

    The neonatal intensive care unit (NICU) is an ideal setting to intervene with an under served population on secondhand smoke exposure (SHSe). Unfortunately, attrition may compromise outcomes. Baseline characteristics associated with intervention and follow-up attendance were investigated in mothers who participated in a novel SHSe prevention study designed for households with a smoker and a NICU-admitted infant. Intervention participants received two motivational, NICU-based counseling sessions; usual care participants received pamphlets. Home-based follow-up assessments occurred at 1, 3 and 6 months. Sociodemographic, smoking history, and psychosocial factors were analyzed. Mothers from households with greater numbers of cigarettes smoked and fewer children had higher odds of both intervention and follow-up attendance. Maternal smoking abstinence (lifetime), more adults in the home and higher perceived interpersonal support were also associated with higher odds of follow-up visit completion. Innovative strategies are needed to engage mothers in secondhand smoke interventions, especially mothers who smoke, have lower levels of social support and have greater childcare responsibilities.

  6. Psoriasis and associated variables in classification and outcome of juvenile idiopathic arthritis - an eight-year follow-up study

    Ekelund, Maria; Aalto, Kristiina; Fasth, Anders

    2017-01-01

    BACKGROUND: To study the impact of psoriasis and features associated with psoriasis on classification and outcome in a population-based follow-up cohort of children with juvenile idiopathic arthritis (JIA). METHODS: In all, 440 children with JIA were followed for a median of 8 years...... in a prospective Nordic population-based cohort study. Data for remission was available for 427 of these children. The presence of psoriasis, psoriasis-like rash, dactylitis, nail pitting, enthesitis, tenosynovitis and heredity was assessed in relation to ILAR classification and remission. RESULTS: Clinical...... findings associated with psoriasis developed consecutively during the 8-year period. Six of 14 children with psoriasis were not classified as juvenile psoriatic arthritis according to the ILAR criteria at 8 year follow-up. Dactylitis was more common in children with early onset of JIA. After 8 years we...

  7. Factors associated with desistence and persistence of childhood gender dysphoria: a quantitative follow-up study.

    Steensma, Thomas D; McGuire, Jenifer K; Kreukels, Baudewijntje P C; Beekman, Anneke J; Cohen-Kettenis, Peggy T

    2013-06-01

    To examine the factors associated with the persistence of childhood gender dysphoria (GD), and to assess the feelings of GD, body image, and sexual orientation in adolescence. The sample consisted of 127 adolescents (79 boys, 48 girls), who were referred for GD in childhood (orientation. We examined contributions of childhood factors on the probability of persistence of GD into adolescence. We found a link between the intensity of GD in childhood and persistence of GD, as well as a higher probability of persistence among natal girls. Psychological functioning and the quality of peer relations did not predict the persistence of childhood GD. Formerly nonsignificant (age at childhood assessment) and unstudied factors (a cognitive and/or affective cross-gender identification and a social role transition) were associated with the persistence of childhood GD, and varied among natal boys and girls. Intensity of early GD appears to be an important predictor of persistence of GD. Clinical recommendations for the support of children with GD may need to be developed independently for natal boys and for girls, as the presentation of boys and girls with GD is different, and different factors are predictive for the persistence of GD. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

  8. Cognitive Deficits Associated with Acquired Amusia after Stroke: A Neuropsychological Follow-Up Study

    Sarkamo, Teppo; Tervaniemi, Mari; Soinila, Seppo; Autti, Taina; Silvennoinen, Heli M.; Laine, Matti; Hietanen, Marja

    2009-01-01

    Recent evidence on amusia suggests that our ability to perceive music might be based on the same neural resources that underlie other higher cognitive functions, such as speech perception and spatial processing. We studied the neural correlates of acquired amusia by performing extensive neuropsychological assessments on 53 stroke patients with a…

  9. Characteristics Associated With Antihypertensive Treatment and Blood Pressure Control: A Population-Based Follow-Up Study in Peru.

    Zavala-Loayza, J Alfredo; Benziger, Catherine Pastorius; Cárdenas, María Kathia; Carrillo-Larco, Rodrigo M; Bernabé-Ortiz, Antonio; Gilman, Robert H; Checkley, William; Miranda, J Jaime

    2016-03-01

    Over one-quarter of the world's adult population has hypertension, yet achieving adequate treatment or control targets remains a challenge. This study sought to identify, longitudinally, characteristics associated with antihypertensive treatment and blood pressure (BP) control among individuals with hypertension. Data from individuals enrolled in the population-based CRONICAS Cohort Study (adults ≥35 years, living in 4 different rural/urban and coastal/high-altitude Peruvian settings) with hypertension at baseline were used. Antihypertensive treatment and BP control were assessed at baseline and at 15 months. Multinomial logistic regressions were used to estimate relative risk ratios (RRR) and 95% confidence intervals (95% CI) of factors associated with antihypertensive treatment and BP control at follow-up. At baseline, among 717 individuals with hypertension (53% women, mean age 61.5 ± 12.4 years), 28% were unaware of their hypertension status, 30% were aware but untreated, 16% were treated but uncontrolled, and 26% were treated and controlled. At follow-up, 89% of unaware and 82% of untreated individuals persisted untreated, and only 58% of controlled individuals remained controlled. Positive predictors of receiving treatment and being controlled at follow-up included age (RRR: 0.81; 95% CI: 0.73 to 0.91 for every 5 years) and family history of a chronic disease (RRR: 0.53; 95% CI: 0.31 to 0.92 vs. no history); whereas Puno rural site (RRR: 16.51; 95% CI: 1.90 to 143.56 vs. Lima) and male sex (RRR: 2.59; 95% CI: 1.54 to 4.36) were risk factors. Systolic BP at baseline (RRR: 1.27; 95% CI: 1.16 to 1.39 for every 5 mm Hg) and male sex (RRR: 1.75, 95% CI: 1.02 to 2.98) were risk factors for being treated but uncontrolled at follow-up. Large gaps in treatment of hypertension were observed. Targeting specific populations such as men, younger individuals, or those without family history of disease may increase coverage of antihypertensive treatment. Also, targeting

  10. Associations of Physical Activity and Sedentary Behavior with Academic Skills – A Follow-Up Study among Primary School Children

    Haapala, Eero A.; Poikkeus, Anna-Maija; Kukkonen-Harjula, Katriina; Tompuri, Tuomo; Lintu, Niina; Väistö, Juuso; Leppänen, Paavo H. T.; Laaksonen, David E.; Lindi, Virpi; Lakka, Timo A.

    2014-01-01

    Background There are no prospective studies that would have compared the relationships of different types of physical activity (PA) and sedentary behavior (SB) with academic skills among children. We therefore investigated the associations of different types of PA and SB with reading and arithmetic skills in a follow-up study among children. Methods The participants were 186 children (107 boys, 79 girls, 6–8 yr) who were followed-up in Grades 1–3. PA and SB were assessed using a questionnaire in Grade 1. Reading fluency, reading comprehension and arithmetic skills were assessed using standardized tests at the end of Grades 1–3. Results Among all children more recess PA and more time spent in SB related to academic skills were associated with a better reading fluency across Grades 1–3. In boys, higher levels of total PA, physically active school transportation and more time spent in SB related to academic skills were associated with a better reading fluency across the Grades 1–3. Among girls, higher levels of total PA were related to worse arithmetic skills across Grades 1–3. Moreover, total PA was directly associated with reading fluency and arithmetic skills in Grades 1–3 among girls whose parents had a university degree, whereas these relationships were inverse in girls of less educated parents. Conclusions Total PA, physically active school transportation and SB related to academic skills may be beneficial for the development of reading skills in boys, whereas factors that are independent of PA or SB may be more important for academic skills in girls. Trial Registration ClinicalTrials.gov: NCT01803776 PMID:25207813

  11. Associations of physical activity and sedentary behavior with academic skills--a follow-up study among primary school children.

    Eero A Haapala

    Full Text Available There are no prospective studies that would have compared the relationships of different types of physical activity (PA and sedentary behavior (SB with academic skills among children. We therefore investigated the associations of different types of PA and SB with reading and arithmetic skills in a follow-up study among children.The participants were 186 children (107 boys, 79 girls, 6-8 yr who were followed-up in Grades 1-3. PA and SB were assessed using a questionnaire in Grade 1. Reading fluency, reading comprehension and arithmetic skills were assessed using standardized tests at the end of Grades 1-3.Among all children more recess PA and more time spent in SB related to academic skills were associated with a better reading fluency across Grades 1-3. In boys, higher levels of total PA, physically active school transportation and more time spent in SB related to academic skills were associated with a better reading fluency across the Grades 1-3. Among girls, higher levels of total PA were related to worse arithmetic skills across Grades 1-3. Moreover, total PA was directly associated with reading fluency and arithmetic skills in Grades 1-3 among girls whose parents had a university degree, whereas these relationships were inverse in girls of less educated parents.Total PA, physically active school transportation and SB related to academic skills may be beneficial for the development of reading skills in boys, whereas factors that are independent of PA or SB may be more important for academic skills in girls.ClinicalTrials.gov: NCT01803776.

  12. The associations between psychosocial working conditions and changes in common mental disorders: a follow-up study.

    Laine, Hanna; Saastamoinen, Peppiina; Lahti, Jouni; Rahkonen, Ossi; Lahelma, Eero

    2014-06-11

    Common mental disorders (CMD) are prevalent in working populations and have adverse consequences for employee well-being and work ability, even leading to early retirement. Several studies report associations between psychosocial working conditions and CMD. However, there is a lack of longitudinal research within a broad framework of psychosocial working conditions and improvement in CMD. The aim of this study was to examine the associations between several psychosocial working conditions and deteriorating and improving CMD among ageing employees over a five-to-six-year follow-up period. The study is based on the Helsinki Health Study baseline survey in 2001-2002 and a follow-up in 2007 (N = 4340, response rate 83%) conducted among 40-60-year-old female and male employees. The General Health Questionnaire (GHQ-12) was used to measure common mental disorders. Psychosocial working conditions were measured in terms of job strain, organisational justice, work-family interface, social support and workplace bullying. The covariates included sociodemographic and health factors. Following adjustment for all the covariates, family-to-work (OR 1.41, 95% Cl 1.04-1.91) and work-to-family conflicts (OR 1.99, 95% Cl 1.42-2.78) and workplace bullying (OR 1.40, 95% Cl 1.09-1.79) were associated with deterioration, and family-to-work conflicts (OR 1.65, 95% Cl 1.66-2.34) and social support (OR 1.47, 95% Cl 1.07-2.00) with improvement in CMD. Adverse psychosocial working conditions contribute to poor mental health among employees. Preventing workplace bullying, promoting social support and achieving a better balance between work and family may help employees to maintain their mental health.

  13. Risk factors associated with loss to follow-up from tuberculosis treatment in Tajikistan: A case-control study

    J. Wohlleben (Jessica); M. Makhmudova (Mavluda); F. Saidova (Firuza); S. Azamova (Shahnoza); C. Mergenthaler (Christina); S. Verver (Suzanne)

    2017-01-01

    markdownabstract_Background:_ There are very few studies on reasons for loss to follow-up from TB treatment in Central Asia. This study assessed risk factors for LTFU and compared their occurrence with successfully treated (ST) patients in Tajikistan. _Methods:_ This study took place in all TB

  14. Association Between Manual Loading and Newly Developed Carpal Tunnel Syndrome in Subjects With Physical Disabilities: A Follow-Up Study.

    Lin, Yen-Nung; Chiu, Chun-Chieh; Huang, Shih-Wei; Hsu, Wen-Yen; Liou, Tsan-Hon; Chen, Yi-Wen; Chang, Kwang-Hwa

    2017-10-01

    To identify the association between body composition and newly developed carpal tunnel syndrome (CTS) and to search for the best probabilistic cutoff value of associated factors to predict subjects with physical disabilities developing new CTS. Longitudinal. University-affiliated medical center. Subjects with physical disabilities (N=47; mean age ± SD, 42.1±7.7y). Not applicable. Median and ulnar sensory nerve conduction velocity (SNCV) were measured at the initial and follow-up tests (interval >2y). Total and regional body composition were measured with dual-energy x-ray absorptiometry at the initial test. Leg lean tissue percentage was calculated to delineate each participant's manual loading degree during locomotion. Leg lean tissue percentage is the lean tissue mass of both legs divided by body weight. Based on median SNCV changes, we divided all participants into 3 groups: subjects with bilateral CTS (median SNCV value normative ulnar SNCV value >37.8m/s) in the initial test (n=10), subjects with newly developed CTS in the follow-up test (n=8), and subjects without additional CTS in the follow-up test (n=27). Eight of 35 subjects not having bilateral CTS initially developed new CTS (8.8% per year; mean follow-up period, 2.6y). Leg lean tissue percentage was associated with the probability of newly developed CTS (adjusted odds ratio, .64; P12% were less likely to have developed new CTS at the follow-up test (sensitivity, .75; specificity, .85; area under the curve, .88; Pphysical disabilities. Therefore, a preventive program for those subjects at risk can start early. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Workplace bullying and sickness presenteeism: cross-sectional and prospective associations in a 2-year follow-up study.

    Conway, Paul Maurice; Clausen, Thomas; Hansen, Åse Marie; Hogh, Annie

    2016-01-01

    The aim of this study was to investigate exposure to workplace bullying as a potential risk factor for sickness presenteeism (SP), i.e. working while ill. This study is based on data collected through self-reported questionnaires in a 2-year prospective study on employees in Denmark. At baseline, 3363 employees (45.7 % response rate) answered to a questionnaire on their psychosocial work environment and health status. After 2 years, 1664 of the respondents also completed a follow-up questionnaire (49.5 % of the total baseline respondents). After excluding participants with missing values, the final samples were composed of 2865 and 1331 participants in the cross-sectional and prospective analyses, respectively. Modified poisson regression analyses showed that frequent (i.e. daily or weekly) exposure to workplace bullying was associated with reporting 8 or more days of SP in the preceding year in both the cross-sectional and the prospective analysis, also when controlling for several confounders including health-related variables. However, the prospective relationship became non-significant after adjustment for baseline SP. This study provides indications of a significant relationship between exposure to frequent workplace bullying and SP, although causal connections could not be established. Methodological and theoretical considerations about study findings are provided, which could be of benefit to future studies examining the impact of being a target of workplace bullying on SP.

  16. Associations between Reoperations and Psychological Factors after Contralateral Risk-Reducing Mastectomy: A Two-Year Follow-Up Study

    Dmytro Unukovych

    2016-01-01

    Full Text Available Introduction. The aim of the study was to investigate associations between reoperations after contralateral risk-reducing mastectomies (CRRM and emotional problems, body image, sexuality, and health related quality of life (HRQoL in women with breast cancer and hereditary high risk. Patients and Methods. Patients scheduled for CRRM with breast reconstruction between 1998 and 2010 completed questionnaires, comprised of SF-36, the Hospital Anxiety and Depression Scale, the Body Image Scale, and the Sexual Activity Questionnaire, preoperatively and two years after CRRM. Data on reoperations was collected from medical charts. Results. A total of 80 women participated, with a response rate of 61 (76% preoperatively and 57 (71% at the two-year follow-up. At the two-year assessment, 44 (55% patients had undergone ≥1 reoperation (reoperation group, whereas 36 (45% had not (no reoperation group. No statistically significant differences between the groups were found for HRQoL, sexuality, anxiety, or depression. A higher proportion of patients in the “reoperation group” reported being dissatisfied with their bodies (81% versus 48%, p=0.01. Conclusion. The results suggest associations between reoperation following CRRM with breast reconstruction and body image problems. Special attention should be paid to body image problems among women who are subject to reoperations after CRRM.

  17. Surgical Satisfaction, Quality of Life, and Their Association After Gender-Affirming Surgery: A Follow-up Study.

    van de Grift, Tim C; Elaut, Els; Cerwenka, Susanne C; Cohen-Kettenis, Peggy T; Kreukels, Baudewijntje P C

    2018-02-17

    We assessed the outcomes of gender-affirming surgery (GAS, or sex-reassignment surgery) 4 to 6 years after first clinical contact, and the associations between postoperative (dis)satisfaction and quality of life (QoL). Our multicenter, cross-sectional follow-up study involved persons diagnosed with gender dysphoria (DSM-IV-TR) who applied for medical interventions from 2007 until 2009. Of 546 eligible persons, 201 (37%) responded, of whom 136 had undergone GAS (genital, chest, facial, vocal cord and/or thyroid cartilage surgery). Main outcome measures were procedure performed, self-reported complications, and satisfaction with surgical outcomes (standardized questionnaires), QoL (Satisfaction With Life Scale, Subjective Happiness Scale, Cantril Ladder), gender dysphoria (Utrecht Gender Dysphoria Scale), and psychological symptoms (Symptom Checklist-90). Postoperative satisfaction was 94% to 100%, depending on the type of surgery performed. Eight (6%) of the participants reported dissatisfaction and/or regret, which was associated with preoperative psychological symptoms or self-reported surgical complications (OR = 6.07). Satisfied respondents' QoL scores were similar to reference values; dissatisfied or regretful respondents' scores were lower. Therefore, dissatisfaction after GAS may be viewed as indicator of unfavorable psychological and QoL outcomes.

  18. A follow-up study of the association between mobile phone use and symptoms of ill health

    Yong Min Cho

    2016-12-01

    Full Text Available The duration and frequency of mobile phone calls, and their relationship with various health effects, have been investigated in our previous cross-sectional study. This 2-year period follow-up study aimed to assess the changes in these variables of same subjects. The study population comprised 532 non-patient adult subjects sampled from the Korean Genome Epidemiology Study. The subjects underwent a medical examination at a hospital in 2012/2013 and revisited the same hospital in 2014/2015 to have the same examination for the characteristics of mobile phone use performed. In addition, to evaluate the effects on health, the Headache Impact Test-6 (HIT-6, Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale, Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey were analyzed. For all these tests, the higher the score, the greater the effect on health. Variances between scores in all the indices in the baseline and follow-up surveys were calculated, and correlations of each index were analyzed. The average duration per call and HIT-6 score of the subjects decreased significantly compared with those recorded two years ago. The results showed a slight but significant correlation between call duration changes and HIT-6 score changes for female subjects, but not for males. HIT-6 scores in the follow-up survey significantly decreased compared to those in the baseline survey, but long-time call users (subjects whose call duration was ≥5 minutes in both the baseline and follow-up surveys had no statistically significant reduction in HIT-6 scores. This study suggests that increased call duration is a greater risk factor for increases in headache than any other type of adverse health effect, and that this effect can be chronic.

  19. A follow-up study of the association between mobile phone use and symptoms of ill health.

    Cho, Yong Min; Lim, Hee Jin; Jang, Hoon; Kim, Kyunghee; Choi, Jae Wook; Shin, Chol; Lee, Seung Ku; Kwon, Jong Hwa; Kim, Nam

    2016-01-01

    The duration and frequency of mobile phone calls, and their relationship with various health effects, have been investigated in our previous cross-sectional study. This 2-year period follow-up study aimed to assess the changes in these variables of same subjects. The study population comprised 532 non-patient adult subjects sampled from the Korean Genome Epidemiology Study. The subjects underwent a medical examination at a hospital in 2012/2013 and revisited the same hospital in 2014/2015 to have the same examination for the characteristics of mobile phone use performed. In addition, to evaluate the effects on health, the Headache Impact Test-6 (HIT-6), Psychosocial Well-being Index-Short Form, Beck Depression Inventory, Korean-Instrumental Activities of Daily Living, Perceived Stress Scale, Pittsburgh Sleep Quality Index, and 12-item Short Form Health Survey were analyzed. For all these tests, the higher the score, the greater the effect on health. Variances between scores in all the indices in the baseline and follow-up surveys were calculated, and correlations of each index were analyzed. The average duration per call and HIT-6 score of the subjects decreased significantly compared with those recorded two years ago. The results showed a slight but significant correlation between call duration changes and HIT-6 score changes for female subjects, but not for males. HIT-6 scores in the follow-up survey significantly decreased compared to those in the baseline survey, but long-time call users (subjects whose call duration was ≥5 minutes in both the baseline and follow-up surveys) had no statistically significant reduction in HIT-6 scores. This study suggests that increased call duration is a greater risk factor for increases in headache than any other type of adverse health effect, and that this effect can be chronic.

  20. The influence of duration of follow-up on the association between alcohol and cause-specific mortality in a prospective cohort study

    Nielsen, Naja Rod; Thygesen, Lau Caspar; Johansen, Ditte

    2005-01-01

    PURPOSE: To investigate whether duration of follow-up influences the association between alcohol and cause-specific mortality in a prospective cohort study with only baseline assessment of alcohol intake. METHODS: In a cohort of 14,223 men and women participating in the first investigation...... of the Copenhagen City Heart Study between 1976 and 1978 and followed until 2001, we assessed whether the association between alcohol and mortality was modified by duration of follow-up. The 24 years of follow-up were divided into four intervals, and Cox survival analyses were conducted separately for these four...... succeeding 6-year periods of follow-up. RESULTS: The authors found differences in the predictive values of alcohol and beverage-specific types of alcohol depending on duration of follow-up both in terms of all-cause mortality and death from coronary heart disease and cancer. The apparent protective effect...

  1. A follow-up study of the association between mobile phone use and symptoms of ill health

    Yong Min Cho; Hee Jin Lim; Hoon Jang; Kyunghee Kim; Jae Wook Choi; Chol Shin; Seung Ku Lee; Jong Hwa Kwon; Nam Kim

    2016-01-01

    The duration and frequency of mobile phone calls, and their relationship with various health effects, have been investigated in our previous cross-sectional study. This 2-year period follow-up study aimed to assess the changes in these variables of same subjects. The study population comprised 532 non-patient adult subjects sampled from the Korean Genome Epidemiology Study. The subjects underwent a medical examination at a hospital in 2012/2013 and revisited the same hospital in 2014/2015 to ...

  2. Auditory and cognitive deficits associated with acquired amusia after stroke: a magnetoencephalography and neuropsychological follow-up study.

    Teppo Särkämö

    2010-12-01

    Full Text Available Acquired amusia is a common disorder after damage to the middle cerebral artery (MCA territory. However, its neurocognitive mechanisms, especially the relative contribution of perceptual and cognitive factors, are still unclear. We studied cognitive and auditory processing in the amusic brain by performing neuropsychological testing as well as magnetoencephalography (MEG measurements of frequency and duration discrimination using magnetic mismatch negativity (MMNm recordings. Fifty-three patients with a left (n = 24 or right (n = 29 hemisphere MCA stroke (MRI verified were investigated 1 week, 3 months, and 6 months after the stroke. Amusia was evaluated using the Montreal Battery of Evaluation of Amusia (MBEA. We found that amusia caused by right hemisphere damage (RHD, especially to temporal and frontal areas, was more severe than amusia caused by left hemisphere damage (LHD. Furthermore, the severity of amusia was found to correlate with weaker frequency MMNm responses only in amusic RHD patients. Additionally, within the RHD subgroup, the amusic patients who had damage to the auditory cortex (AC showed worse recovery on the MBEA as well as weaker MMNm responses throughout the 6-month follow-up than the non-amusic patients or the amusic patients without AC damage. Furthermore, the amusic patients both with and without AC damage performed worse than the non-amusic patients on tests of working memory, attention, and cognitive flexibility. These findings suggest domain-general cognitive deficits to be the primary mechanism underlying amusia without AC damage whereas amusia with AC damage is associated with both auditory and cognitive deficits.

  3. Auditory and cognitive deficits associated with acquired amusia after stroke: a magnetoencephalography and neuropsychological follow-up study.

    Särkämö, Teppo; Tervaniemi, Mari; Soinila, Seppo; Autti, Taina; Silvennoinen, Heli M; Laine, Matti; Hietanen, Marja; Pihko, Elina

    2010-12-02

    Acquired amusia is a common disorder after damage to the middle cerebral artery (MCA) territory. However, its neurocognitive mechanisms, especially the relative contribution of perceptual and cognitive factors, are still unclear. We studied cognitive and auditory processing in the amusic brain by performing neuropsychological testing as well as magnetoencephalography (MEG) measurements of frequency and duration discrimination using magnetic mismatch negativity (MMNm) recordings. Fifty-three patients with a left (n = 24) or right (n = 29) hemisphere MCA stroke (MRI verified) were investigated 1 week, 3 months, and 6 months after the stroke. Amusia was evaluated using the Montreal Battery of Evaluation of Amusia (MBEA). We found that amusia caused by right hemisphere damage (RHD), especially to temporal and frontal areas, was more severe than amusia caused by left hemisphere damage (LHD). Furthermore, the severity of amusia was found to correlate with weaker frequency MMNm responses only in amusic RHD patients. Additionally, within the RHD subgroup, the amusic patients who had damage to the auditory cortex (AC) showed worse recovery on the MBEA as well as weaker MMNm responses throughout the 6-month follow-up than the non-amusic patients or the amusic patients without AC damage. Furthermore, the amusic patients both with and without AC damage performed worse than the non-amusic patients on tests of working memory, attention, and cognitive flexibility. These findings suggest domain-general cognitive deficits to be the primary mechanism underlying amusia without AC damage whereas amusia with AC damage is associated with both auditory and cognitive deficits.

  4. Morbidity follow-up feasibility study

    Carpenter, M.

    1988-02-01

    The report reviews the available sources of data within Canada for undertaking morbidity follow-up studies to both supplement and complement studies using Canadian mortality data. Such studies would permit earlier detection and more sensitive measures of differences in risk for exposures to radiation and allow timely measures to be taken to minimize any occupational and environmental health risk to radiation workers. The technical feasibility of using these sources was reviewed using the criteria of adequate personal identifying information, automation of data records, file size and the accuracy of the morbidity diagnosis information. At the present time certain of the provincial cancer registry files meet these criteria best. A work plan was prepared suggesting a morbidity pilot study to clarify the role of occupational factors in the incidence of cancer among radiation workers using the Alberta Cancer Registry file and the National Dose Registry (NDR) file of radiation workers. For the longer term a full cohort study using the National Cancer Incidence Reporting System (NCIRS) and the NDR workers as the study population would provide information on all radiation workers on a national basis. A work plan was prepared and some initial format conversion of historical data was undertaken to begin developing the NCIRS into a data base suitable for long-term health studies

  5. Therapeutic abortion follow-up study.

    Margolis, A J; Davison, L A; Hanson, K H; Loos, S A; Mikkelsen, C M

    1971-05-15

    To determine the long-range psychological effects of therapeutic abortion, 50 women (aged from 13-44 years), who were granted abortions between 1967 and 1968 Because of possible impairment of mental and/or physical health, were analyzed by use of demographic questionnaires, psychological tests, and interviews. Testing revealed that 44 women had psychiatric problems at time of abortion. 43 patients were followed for 3-6 months. The follow-up interviews revealed that 29 patients reacted positively after abortion, 10 reported no significant change and 4 reacted negatively. 37 would definitely repeat the abortion. Women under 21 years of age felt substantially more ambivalent and guilty than older patients. A study of 36 paired pre- and post-abortion profiles showed that 15 initially abnormal tests had become normal. There was a significant increase in contraceptive use among the patients after the abortion, but 4 again became pregnant and 8 were apparently without consistent contraception. It is concluded that the abortions were therapeutic, but physicians are encouraged to be aware of psychological problems in abortion cases. Strong psychological and contraceptive counselling should be exercised.

  6. Associations of work-related factors and work engagement with mental and physical health: a 1-year follow-up study among older workers.

    Leijten, Fenna R M; van den Heuvel, Swenne G; van der Beek, Allard J; Ybema, Jan Fekke; Robroek, Suzan J W; Burdorf, Alex

    2015-03-01

    The goals of this study were to determine whether, among older employees, unfavourable physical and psychosocial work-related factors were associated with poorer mental and physical health and whether high work engagement buffered the associations between unfavourable work-related factors and poorer health. A 1-year longitudinal study with employed persons aged 45-64 was conducted within the Study on Transitions in Employment, Ability and Motivation (n = 8,837). Using an online questionnaire, work-related factors (physical: physical load; psychosocial: psychological job demands, autonomy, and support) and work engagement were measured at baseline and health at baseline and 1-year follow-up. General linear models were used to assess associations of work-related factors and work engagement with health. Tests of interaction terms assessed whether work engagement buffered the work-related factor-health associations. Unfavourable psychosocial work-related factors at baseline were associated with poorer mental health at follow-up. Higher physical load, higher psychological job demands, and lower autonomy at baseline were associated with poorer physical health at follow-up. Higher work engagement at baseline was related to better physical and especially better mental health during the 1-year follow-up. Work engagement had a small effect on the associations between work-related factors and health. Among older employees, especially the promotion of a high work engagement and, to a lesser extent, favourable work-related factors can be beneficial for mental health in particular.

  7. The long-term association of OCD and depression and its moderators: A four-year follow up study in a large clinical sample.

    Tibi, L; van Oppen, P; van Balkom, A J L M; Eikelenboom, M; Rickelt, J; Schruers, K R J; Anholt, G E

    2017-07-01

    Depression is the most common comorbidity in obsessive-compulsive disorder (OCD). However, the mechanisms of depressive comorbidity in OCD are poorly understood. We assessed the directionality and moderators of the OCD-depression association over time in a large, prospective clinical sample of OCD patients. Data were drawn from 382 OCD patients participating at the Netherlands Obsessive-Compulsive Disorder Association (NOCDA) study. Cross-lagged, structural equation modeling analyses were used to assess the temporal association between OCD and depressive symptoms. Assessments were conducted at baseline, two-year and four-year follow up. Cognitive and interpersonal moderators of the prospective association between OCD and depressive symptoms were tested. Cross-lagged analyses demonstrated that OCD predicts depressive symptoms at two-year follow up and not vice a versa. This relationship disappeared at four-year follow up. Secure attachment style moderated the prospective association between OCD and depression. Depressive comorbidity in OCD might constitute a functional consequence of the incapacitating OCD symptoms. Both OCD and depression symptoms demonstrated strong stability effects between two-year and four-year follow up, which may explain the lack of association between them in that period. Among OCD patients, secure attachment represents a buffer against future depressive symptoms. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Association between lithium serum level, mood state, and patient-reported adverse drug reactions during long-term lithium treatment : a naturalistic follow-up study

    Wilting, Ingeborg; Heerdink, Eibert R.; Mersch, Peter-Paul A.; den Boer, Johannes A.; Egberts, Antoine C. G.; Nolen, Willem A.

    To assess the association between mood state and the prevalence and the severity of lithium adverse drug reactions (ADRs). A 26-year follow-up study was conducted among patients >= 18 years treated at the outpatient lithium clinic of the University Medical Center Groningen, The Netherlands, between

  9. Association between Dairy Intake and Caries among Children and Adolescents. Results from the Danish EYHS Follow-Up Study

    Lempert, Susanne; Christensen, Lisa Bøge; Froberg, Karsten 

    2015-01-01

    below the mean (72.8 vs. 65.8% at age 9 and 41.1 vs. 30.7% at age 15). The results from the generalized estimation equation showed that dairy and milk intake, as well as intakes of components of dairy such as dairy calcium, whey and casein, was generally inversely associated with childhood...... incidence. This study found that previous dairy intake, as well as milk intake or intake of dairy components, may be a predictor of future risk of caries measured by the DMFS count level. This relationship was inverse, meaning that a high intake of dairy products was associated with less future caries...

  10. A Follow-up Association Study of Genetic Variants for Bone Mineral Density in a Korean Population

    Seokjin Ham

    2014-09-01

    Full Text Available Bone mineral density (BMD is one of the quantitative traits that are genetically inherited and affected by various factors. Over the past years, genome-wide association studies (GWASs have searched for many genetic loci that influence BMD. A recent meta-analysis of 17 GWASs for BMD of the femoral neck and lumbar spine is the largest GWAS for BMD to date and offers 64 single-nucleotide polymorphisms (SNPs in 56 associated loci. We investigated these BMD loci in a Korean population called Korea Association REsource (KARE to identify their validity in an independent study. The KARE population contains genotypes from 8,842 individuals, and their BMD levels were measured at the distal radius (BMD-RT and midshaft tibia (BMD-TT. Thirteen genomic loci among 56 loci were significantly associated with BMD variations, and 3 loci were involved in known biological pathways related to BMD. In order to find putative functional variants, nearby SNPs in relation to linkage equilibrium were annotated, and their possible functional effects were predicted. These findings reveal that tens of variants, not a single factor, may contribute to the genetic architecture of BMD; have an important role regardless of ethnic group; and may highlight the importance of a replication study in GWASs to validate genuine loci for BMD variation.

  11. Association between Childhood Obesity and Neighbourhood Accessibility to Fast-Food Outlets: A Nationwide 6-Year Follow-Up Study of 944,487 Children.

    Hamano, Tsuyoshi; Li, Xinjun; Sundquist, Jan; Sundquist, Kristina

    2017-01-01

    The aim of this 6-year follow-up study was to examine whether neighbourhood accessibility to fast-food outlets was associated with diagnosed childhood obesity, after adjustment for neighbourhood- and individual-level socio-demographic factors. This 6-year follow-up study comprised 484,677 boys and 459,810 girls aged 0-14 years in Sweden. The follow-up period ran from January 1, 2005, until hospitalisation/out-patient treatment for obesity, death, emigration or the end of the study period on December 31, 2010. Multilevel logistic regression models (individual-level factors at the first level and neighbourhood-level factors at the second level) were used to calculate odds ratios (ORs) with 95% confidence intervals (95% CIs). We identified 6,968 obesity cases (3,878 boys and 3,090 girls) during the follow-up period. Higher odds of childhood obesity for those living in neighbourhoods with accessibility to fast-food outlets was observed (OR = 1.14, 95% CI = 1.07-1.22) that remained significant after adjustments (OR = 1.06, 95% CI = 1.00-1.13). This prospective nationwide study showed that the neighbourhood accessibility to fast-food outlets was independently associated with increased odds of diagnosed childhood obesity. This finding implicates that residential environments should be considered when developing health promotion programmes. © 2017 The Author(s) Published by S. Karger GmbH, Freiburg.

  12. Moderate wine consumption is associated with better cognitive test results: a 7 year follow up of 5033 subjects in the Tromsø Study.

    Arntzen, K A; Schirmer, H; Wilsgaard, T; Mathiesen, E B

    2010-01-01

    The impact of moderate alcohol consumption on cognitive function and dementia is unclear. We examined the relationship between consumption of different alcoholic beverages and cognitive function in a large population-based study. Subjects were 5033 stroke-free men and women who participated in a longitudinal population-based study in Tromsø, Norway. Alcohol consumption and other cardiovascular risk factors were measured at baseline and cognitive function was assessed after 7 years follow up with verbal memory test, digit-symbol coding test and tapping test. Moderate wine consumption was independently associated with better performance on all cognitive tests in both men and women. There was no consistent association between consumption of beer and spirits and cognitive test results. Alcohol abstention was associated with lower cognitive performance in women. Light-to-moderate wine consumption was associated with better performance on cognitive tests after 7 years follow up.

  13. A GWAS follow-up study reveals the association of the IL12RB2 gene with systemic sclerosis in Caucasian populations

    Bossini-Castillo, Lara; Martin, Jose-Ezequiel; Broen, Jasper; Gorlova, Olga; Simeón, Carmen P.; Beretta, Lorenzo; Vonk, Madelon C.; Luis Callejas, Jose; Castellví, Ivan; Carreira, Patricia; José García-Hernández, Francisco; Fernández Castro, Mónica; Coenen, Marieke J.H.; Riemekasten, Gabriela; Witte, Torsten; Hunzelmann, Nicolas; Kreuter, Alexander; Distler, Jörg H.W.; Koeleman, Bobby P.; Voskuyl, Alexandre E.; Schuerwegh, Annemie J.; Palm, Øyvind; Hesselstrand, Roger; Nordin, Annika; Airó, Paolo; Lunardi, Claudio; Scorza, Raffaella; Shiels, Paul; van Laar, Jacob M.; Herrick, Ariane; Worthington, Jane; Denton, Christopher; Tan, Filemon K.; Arnett, Frank C.; Agarwal, Sandeep K.; Assassi, Shervin; Fonseca, Carmen; Mayes, Maureen D.; Radstake, Timothy R.D.J.; Martin, Javier

    2012-01-01

    A single-nucleotide polymorphism (SNP) at the IL12RB2 locus showed a suggestive association signal in a previously published genome-wide association study (GWAS) in systemic sclerosis (SSc). Aiming to reveal the possible implication of the IL12RB2 gene in SSc, we conducted a follow-up study of this locus in different Caucasian cohorts. We analyzed 10 GWAS-genotyped SNPs in the IL12RB2 region (2309 SSc patients and 5161 controls). We then selected three SNPs (rs3790567, rs3790566 and rs924080) based on their significance level in the GWAS, for follow-up in an independent European cohort comprising 3344 SSc and 3848 controls. The most-associated SNP (rs3790567) was further tested in an independent cohort comprising 597 SSc patients and 1139 controls from the USA. After conditional logistic regression analysis of the GWAS data, we selected rs3790567 [PMH= 1.92 × 10−5 odds ratio (OR) = 1.19] as the genetic variant with the firmest independent association observed in the analyzed GWAS peak of association. After the first follow-up phase, only the association of rs3790567 was consistent (PMH= 4.84 × 10−3 OR = 1.12). The second follow-up phase confirmed this finding (Pχ2 = 2.82 × 10−4 OR = 1.34). After performing overall pooled-analysis of all the cohorts included in the present study, the association found for the rs3790567 SNP in the IL12RB2 gene region reached GWAS-level significant association (PMH= 2.82 × 10−9 OR = 1.17). Our data clearly support the IL12RB2 genetic association with SSc, and suggest a relevant role of the interleukin 12 signaling pathway in SSc pathogenesis. PMID:22076442

  14. Transition in health status from childhood to adulthood and associated risk factors: A 13 year interval follow-up study in South Africa

    Oosthuizen, MA

    2005-09-01

    Full Text Available IN HEALTH STATUS FROM CHILDHOOD TO ADULTHOOD AND ASSOCIATED RISK FACTORS: A 13 YEAR INTERVAL FOLLOW-UP STUDY IN SOUTH AFRICA [Program and Abstracts: The Seventeenth Conference of the International Society for Environmental Epidemiology (ISEE): Abstracts...- communicable diseases of which the risk factors are largely associated with lifestyle. Emerging infections such as HIV/AIDS and re-emerging infections (polio) together with existing diseases (TB and malaria) and the exposure to occupational and environmental...

  15. The association between exposure to psychosocial work factors and mental health in older employees: A 3-year follow-up study

    Havermans, B.M.; Boot, C.R.L.; Hoekstra, T.; Houtman, I.L.D.; Brouwers, E.P.M.; Anema, J.R.; Van Der Beek, A.J.

    2018-01-01

    Purpose Unfavourable exposure to psychosocial work factors threatens older employees’ mental health, and their sustained employment. This study assesses whether an improved compared to stable unfavourable and stable favourable exposure to psychosocial work factors is associated with a change in mental health in older employees at 3-year follow-up. Methods The current study used data from the Study on Transitions in Employment, Ability and Motivation (STREAM), in workers aged 45–65 years (n = ...

  16. Depressive symptoms and associated psychosocial factors among adolescent survivors 30 months after 2008 Wenchuan earthquake: A follow-up study

    Xuliang eShi

    2016-03-01

    Full Text Available AbstractPurpose: This study longitudinally investigated the changes of depressive symptoms among adolescent survivors over two years and a half after the 2008 Wenchuan earthquake in China, as well as the predictive effects of demographic characteristics, earthquake exposure, negative life events, social support and dispositional resilience on the risk of depressive symptoms at two time points after the earthquake.Methods: Participants were 1573 adolescent survivors (720 males and 853 females, mean age at initial survey =15 ± 1.26, whose depressive symptoms were assessed at 6 months (T6m and 30 months (T30m post-earthquake. Data on demographics, earthquake exposure and dispositional resilience were collected at T6m. Negative life events and social support were measured at T6m and 24 months (T24m post-earthquake.Results: The prevalence rates of probable depression, 27.5% at T6m and 27.2% at T30m, maintained relatively stable over time. Female gender was related with higher risk of depressive symptoms at both T6m and T30m, while being only-child could only predict higher risk of depressive symptoms at T30m. Negative life events and social support at T6m, as well as earthquake exposure, were concurrently associated with increased risk of depressive symptoms at T6m, but not associated with the risk of depressive symptoms at T30m, while negative life events and social support at T24m could predict depressive symptoms at T30m, all of which suggested that these variables may have strong but short-term effect on adolescents’ depressive symptoms post-earthquake. Besides, dispositional resilience was evidenced as a relatively stable negative predictor for depressive symptoms.Conclusions: These findings could inform mental health professionals regarding how to screen adolescent survivors at high risk for depression, so as to provide them with timely and appropriate mental health services based on the identified risk and protective factors for depressive

  17. Prolonged fatigue is associated with sickness absence in men but not in women: prospective study with 1-year follow-up of white-collar employees.

    Roelen, Corné A M; van Rhenen, Willem; Groothoff, Johan W; van der Klink, Jac J L; Bültmann, Ute

    2014-04-01

    Prolonged fatigue adversely affects an individual's performance and functioning. The present study investigated the prospective associations between prolonged fatigue and sickness absence (SA) during 1-year follow-up. At baseline, a convenience sample of white-collar employees received the 20-item Checklist Individual Strength (CIS), which measures prolonged fatigue by covering the dimensions fatigue severity, reduced concentration, reduced motivation, and reduced physical activity. SA episodes were registered during the 1-year follow-up distinguishing between short-term (1-7 days) and long-term ( 7 days) SA episodes. Baseline CIS scores were linked to SA during follow-up by negative binomial regression models in which age, gender, job grade, and prior SA were controlled for. Six hundred and thirty-three (56 %) employees participated in the study of which 598 had complete data and were eligible for analysis. Gender was a significant effect modifier of the relationship between prolonged fatigue and SA. Therefore, the results were stratified for men (N = 365) and women (N = 233). In white-collar men, fatigue severity and reduced concentration were positively associated with the number of long-term SA episodes, while other fatigue dimensions were not significantly related to SA. In white-collar women, prolonged fatigue was not associated with SA during 1-year follow-up. The results of this study warrant more attention for prolonged fatigue in occupational healthcare practice and research. Early identification of and treatment for prolonged fatigue might prevent future health problems and SA, especially in white-collar men.

  18. Determining the variables associated to clean intermittent self-catheterization adherence rate: one-year follow-up study

    Marcia Eli Girotti

    2011-12-01

    Full Text Available PURPOSE: To determine adherence rate and variables associate with patients' adherence to Clean Intermittent Self Catheterization (CISC. MATERIALS AND METHODS: Patients refereed to CISC training program between July 2006 and May 2008, were prospectively evaluated with urodynamic, 3 days bladder diary (BD and WHOQoL-bref questionnaire. After training to perform CISC, patients were evaluated at 2 weeks, monthly for 6 months and at 12 months with clinical visits and BD. Patients were considered adherent if they were performing at least 80% of the initial recommendation. RESULTS: Sixty patients (50.4 ± 19.9 years old were trained to perform CISC (21 female and 39 male. Out of them, 30 (50% had neurogenic and 30 (50% had a non-neurogenic voiding dysfunction. The adherence rate at 6 and 12 months was 61.7%, 58%, respectively. Patients < 40 years old had adherence rate of 86%. Women and neurogenic patients had higher adherence rate than their counterparts (p = 0.024 and p = 0.016, respectively. In the WHOQoL-bref, patients that adhere to the program had a significant higher score on psychological and social relationships domains. There was not difference in pre and post training WHOQoL-bref scores. Educational background, marriage status, detrusor leak point pressure, Bladder Capacity, number of leakage episodes did not play a role on the adherence rate. CONCLUSION: Patients in CISC program present a reasonable adherence after one year. Women, neurogenic voiding dysfunction and patients under 40 years old were significantly more adherents. The psychological and social relationship status seems to positively interfere on adherence. CISC did not affect patient's QoL evaluated by WHOQoL-bref.

  19. Association between Cognition and Serum Insulin-Like Growth Factor-1 in Middle-Aged & Older Men: An 8 Year Follow-Up Study.

    Shankar Tumati

    Full Text Available Low levels of insulin-like growth factor-1 (IGF-1, an essential neurotrophic factor, have been associated with worse cognitive function in older adults. However, few studies have assessed the prospective association of serum IGF-1 with cognitive function. We aimed to determine the association between serum IGF-1 on concurrent and prospective cognitive function in a population sample of men aged 40-80 years. Blood samples were assessed for IGF-1 levels at baseline and neuropsychological assessments were performed at baseline (n = 400 and at follow-up after a mean duration of 8.3 years (n = 286. Linear regression analyses were carried out to determine the associations between quintiles of IGF-1 and cognitive function at the baseline and follow-up visits. Results showed that those in the top quintile of IGF-1 had lower processing capacity and global cognition scores at follow-up after controlling for cognitive function at baseline and other confounding factors. Additional analyses exploring associations with IGF-1 separately in middle-aged and older participants, and with quartiles of IGF-1 produced similar results. In those older than 60 years, high IGF-1 levels were also associated with lower baseline processing capacity. These results suggest that high IGF-1 levels are associated with worse long-term cognition in men. Together with past studies, we suggest that both, high and low levels of IGF-1 may be associated with poor cognitive function and that optimum levels of IGF-1 (quintile 2 and 3 in current study may be associated with better cognitive function.

  20. Associations of workplace bullying and harassment with stress reactions: a two-year follow-up study

    TANIGUCHI, Toshiyo; TAKAKI, Jiro; HIROKAWA, Kumi; FUJII, Yasuhito; HARANO, Kaori

    2015-01-01

    The purpose of this prospective study was to investigate the effect of the patterning of workplace bullying and harassment over two time points (chronic, remission, onset, and never) on psychological and physical stress reactions. The subjects were 543 workers at welfare facilities for the elderly in Japan who completed a self-administered questionnaire at Time 1 (from August to September, 2009) and at Time 2 (from September to October, 2011). Workplace bullying and harassment were assessed using the Negative Acts Questionnaire (NAQ). Stress reactions were assessed using the Brief Job Stress Questionnaire. In the multiple logistic regression analyses, onset of person-related bullying was significantly (ppsychological and physical stress reactions at Time 2. Chronic form of person-related bullying was significantly (ppsychological stress reaction at Time 2. Onset of sexual harassment was significantly (psexual harassment was significantly (psexual harassment can cause stress reactions. Remission of sexual harassment can terminate physical stress reaction. PMID:26537998

  1. Associations of workplace bullying and harassment with stress reactions: a two-year follow-up study.

    Taniguchi, Toshiyo; Takaki, Jiro; Hirokawa, Kumi; Fujii, Yasuhito; Harano, Kaori

    2016-01-01

    The purpose of this prospective study was to investigate the effect of the patterning of workplace bullying and harassment over two time points (chronic, remission, onset, and never) on psychological and physical stress reactions. The subjects were 543 workers at welfare facilities for the elderly in Japan who completed a self-administered questionnaire at Time 1 (from August to September, 2009) and at Time 2 (from September to October, 2011). Workplace bullying and harassment were assessed using the Negative Acts Questionnaire (NAQ). Stress reactions were assessed using the Brief Job Stress Questionnaire. In the multiple logistic regression analyses, onset of person-related bullying was significantly (psexual harassment was significantly (psexual harassment was significantly (psexual harassment can cause stress reactions. Remission of sexual harassment can terminate physical stress reaction.

  2. Dynamics of resilience in forced migration: a 1-year follow-up study of longitudinal associations with mental health in a conflict-affected, ethnic Muslim population.

    Siriwardhana, Chesmal; Abas, Melanie; Siribaddana, Sisira; Sumathipala, Athula; Stewart, Robert

    2015-02-16

    The concept of 'resilience' is of increasing interest in studies of mental health in populations facing adversity. However, lack of longitudinal data on the dynamics of resilience and non-usage of resilience-specific measurements have prevented a better understanding of resilience-mental health interactions. Hence, the present study was conducted to investigate the stability of levels of resilience and its associations with sociodemographic and mental health exposures in a conflict-affected internal-migrant population in Sri Lanka. A prospective follow-up study of 1 year. Puttalam district of North Western province in postconflict Sri Lanka (baseline in 2011, follow-up in 2012). An ethnic Muslim population internally displaced 20 years ago (in 1990) from Northern Sri Lanka, aged 18 or above and currently in the process of return migration. It was hypothesised that levels of resilience would be associated with mental health outcomes. Resilience was measured on both occasions using the 14-item Resilience Scale (RS-14), social support by the Multidimensional Social Support Scale and Lubben Social Network Scale and common mental disorders by the Patient Health Questionnaire (PHQ). Of 450 participants interviewed at baseline in 2011, 338 (75.1%) were re-interviewed in 2012 after a 1-year follow-up. The mean resilience scores measured by RS-14 were 80.2 (95% CI 78.6 to 81.9) at baseline and 84.9 (83.5 to 86.3) at follow-up. At both time points, lower resilience was independently associated with food insecurity, lower social support availability and social isolation. At both time points, there were significant associations with common mental disorders (CMDs) in unadjusted analyses, but they only showed independence at baseline. The CMD prevalence, maintenance and incidence at follow-up was 8.3%, 28.2% and 2.2%, respectively. In this displaced population facing a potential reduction in adversity, resilience was more strongly and robustly associated with economic and

  3. Incidence of Ceramic Liner Malseating After Ceramic-on-Ceramic Total Hip Arthroplasty Associated With Osteolysis: A 5- to 15-Year Follow-Up Study.

    Higuchi, Yoshitoshi; Hasegawa, Yukiharu; Komatsu, Daigo; Seki, Taisuke; Ishiguro, Naoki

    2017-05-01

    The aim of our study was to evaluate the clinical and radiographic outcomes of malseating of the acetabular liner in ceramic-on-ceramic total hip arthroplasty (THA). Outcomes for 160 ceramic-on-ceramic THAs, contributed by 116 women and 39 men, were evaluated. Clinical and radiographic measurements were obtained over a 5- to 15-year follow-up for analysis. Liner malseating was identified in 20% of cases. Outcomes for 32 cases with liner malseating (group A) were compared to outcomes for 128 joints with correct liner seating (group B). The Harris hip score at the last follow-up was 90.1 for group A and 89.6 for group B. Osteolysis was identified in 5 cases in group A (15.6%), compared to 3 cases in group B (P ceramic fracture, audible squeaking, loosening of components, and revision THA. The mean annual liner wear rate was comparable between groups, 0.0045 mm/y for group A and 0.0039 mm/y for group B. The 10-year Kaplan-Meier survivorship, based on an end point of revision THA, was 100% for group A and 99.0% for group B. Over a moderate-length follow-up of 5-15 years, malseating of the acetabular liner was not associated with negative clinical outcomes or THA survivorship. Malseating did increase the incidence of osteolysis, a risk factor for adverse effects. Long-term follow-up studies are needed to fully quantify the effects of malseating of the acetabular liner. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Regional brain activation supporting cognitive control in the context of reward is associated with treated adolescents’ marijuana problem severity at follow-up: A preliminary study

    Tammy Chung

    2015-12-01

    Full Text Available This preliminary study examined the extent to which regional brain activation during a reward cue antisaccade (AS task was associated with 6-month treatment outcome in adolescent substance users. Antisaccade performance provides a sensitive measure of executive function and cognitive control, and generally improves with reward cues. We hypothesized that when preparing to execute an AS, greater activation in regions associated with cognitive and oculomotor control supporting AS, particularly during reward cue trials, would be associated with lower substance use severity at 6-month follow-up. Adolescents (n = 14, ages 14–18 recruited from community-based outpatient treatment completed an fMRI reward cue AS task (reward and neutral conditions, and provided follow-up data. Results indicated that AS errors decreased in reward, compared to neutral, trials. AS behavioral performance, however, was not associated with treatment outcome. As hypothesized, activation in regions of interest (ROIs associated with cognitive (e.g., ventrolateral prefrontal cortex and oculomotor control (e.g., supplementary eye field during reward trials were inversely correlated with marijuana problem severity at 6-months. ROI activation during neutral trials was not associated with outcomes. Results support the role of motivational (reward cue factors to enhance cognitive control processes, and suggest a potential brain-based correlate of youth treatment outcome.

  5. Factors associated with attrition, mortality, and loss to follow up after antiretroviral therapy initiation: data from an HIV cohort study in India

    Gerardo Alvarez-Uria

    2013-09-01

    Full Text Available Background: Studies from sub-Saharan Africa have shown high incidence of attrition due to mortality or loss to follow-up (LTFU after initiating antiretroviral therapy (ART. India is the third largest country in the world in terms of HIV infected people, but predictors of attrition after ART initiation are not well known. Design: We describe factors associated with attrition, mortality, and LTFU in 3,159 HIV infected patients who initiated ART between 1 January 2007 and 4 November 2011 in an HIV cohort study in India. The study included 6,852 person-years with a mean follow-up of 2.17 years. Results: After 5 years of follow-up, the estimated cumulative incidence of attrition was 37.7%. There was no significant difference between attrition due to mortality and attrition due to LTFU. Having CD4 counts <100 cells/µl and being homeless [adjusted hazard ratio (aHR 3.1, 95% confidence interval (CI 2.6–3.8] were associated with a higher risk of attrition, and female gender (aHR 0.64, 95% CI 0.6–0.8 was associated with a reduced risk of attrition. Living near a town (aHR 0.82, 95% CI 0.7–0.999 was associated with a reduced risk of mortality. Being single (aHR 1.6, 95% CI 1.2–2.3, illiteracy (aHR 1.3, 95% CI 1.1–1.6, and age <25 years (aHR 1.3, 95% CI 1–1.8 were associated with an increased risk of LTFU. Although the cumulative incidence of attrition in patients diagnosed with tuberculosis after ART initiation was 47.4%, patients who started anti-tuberculous treatment before ART had similar attrition to patients without tuberculosis (36 vs. 35.2%, P=0.19 after four years of follow-up. Conclusions: In this cohort study, the attrition was similar to the one found in sub-Saharan Africa. Earlier initiation of ART, improving the diagnosis of tuberculosis before initiating ART, and giving more support to those patients at higher risk of attrition could potentially reduce the mortality and LTFU after ART initiation.

  6. Factors Associated with Adherence to Follow-up Colposcopy

    Fish, Laura J.; Moorman, Patricia G.; Wordlaw-Stintson, Lashawn; Vidal, Adriana; Smith, Jennifer S.; Hoyo, Cathrine

    2013-01-01

    Background: Understanding the gaps in knowledge about human papilloma virus (HPV) infection, transmission, and health consequences and factors associated with the knowledge gap is an essential first step for the development of interventions to improve adherence to follow-up among women with abnormal Pap smears. Purpose: To examine the relationship…

  7. Nonfasting cholesterol and triglycerides and association with risk of myocardial infarction and total mortality: the Copenhagen City Heart Study with 31 years of follow-up

    Langsted, A; Freiberg, J J; Tybjaerg-Hansen, A

    2011-01-01

    Abstract. Langsted A, Freiberg JJ, Tybjaerg-Hansen A, Schnohr P, Jensen GB, Nordestgaard BG (Herlev Hospital, Herlev; University of Copenhagen; Bispebjerg Hospital; and Rigshospitalet, Copenhagen Ø, Denmark) Nonfasting cholesterol and triglycerides and association with risk of myocardial infarction...... and total mortality: the Copenhagen City Heart Study with 31 years of follow-up. J Intern Med 2010; doi: 10.1111/j.1365-2796.2010.02333.x. Objectives. We compared the ability of very high levels of nonfasting cholesterol and triglycerides to predict risk of myocardial infarction and total mortality. Design...

  8. Association between education and future leisure-time physical inactivity: a study of Finnish twins over a 35-year follow-up

    Maarit Piirtola

    2016-08-01

    Full Text Available Abstract Background Education is associated with health related lifestyle choices including leisure-time physical inactivity. However, the longitudinal associations between education and inactivity merit further studies. We investigated the association between education and leisure-time physical inactivity over a 35-year follow-up with four time points controlling for multiple covariates including familial confounding. Methods This study of the population-based Finnish Twin Cohort consisted of 5254 twin individuals born in 1945–1957 (59 % women, of which 1604 were complete same-sexed twin pairs. Data on leisure-time physical activity and multiple covariates was available from four surveys conducted in 1975, 1981, 1990 and 2011 (response rates 72 to 89 %. The association between years of education and leisure-time physical inactivity (<1.5 metabolic equivalent hours/day was first analysed for each survey. Then, the role of education was investigated for 15-year and 35-year inactivity periods in the longitudinal analyses. The co-twin control design was used to analyse the potential familial confounding of the effects. All analyses were conducted with and without multiple covariates. Odds Ratios (OR with 95 % Confidence Intervals (CI were calculated using logistic and conditional (fixed-effects regression models. Results Each additional year of education was associated with less inactivity (OR 0.94 to 0.95, 95 % CI 0.92, 0.99 in the cross-sectional age- and sex-adjusted analyses. The associations of education with inactivity in the 15- and 35-year follow-ups showed a similar trend: OR 0.97 (95 % CI 0.93, 1.00 and OR 0.94 (95 % CI 0.91, 0.98, respectively. In all co-twin control analyses, each year of higher education was associated with a reduced likelihood of inactivity suggesting direct effect (i.e. independent from familial confounding of education on inactivity. However, the point estimates were lower than in the individual

  9. Association between education and future leisure-time physical inactivity: a study of Finnish twins over a 35-year follow-up.

    Piirtola, Maarit; Kaprio, Jaakko; Kujala, Urho M; Heikkilä, Kauko; Koskenvuo, Markku; Svedberg, Pia; Silventoinen, Karri; Ropponen, Annina

    2016-08-04

    Education is associated with health related lifestyle choices including leisure-time physical inactivity. However, the longitudinal associations between education and inactivity merit further studies. We investigated the association between education and leisure-time physical inactivity over a 35-year follow-up with four time points controlling for multiple covariates including familial confounding. This study of the population-based Finnish Twin Cohort consisted of 5254 twin individuals born in 1945-1957 (59 % women), of which 1604 were complete same-sexed twin pairs. Data on leisure-time physical activity and multiple covariates was available from four surveys conducted in 1975, 1981, 1990 and 2011 (response rates 72 to 89 %). The association between years of education and leisure-time physical inactivity (inactivity periods in the longitudinal analyses. The co-twin control design was used to analyse the potential familial confounding of the effects. All analyses were conducted with and without multiple covariates. Odds Ratios (OR) with 95 % Confidence Intervals (CI) were calculated using logistic and conditional (fixed-effects) regression models. Each additional year of education was associated with less inactivity (OR 0.94 to 0.95, 95 % CI 0.92, 0.99) in the cross-sectional age- and sex-adjusted analyses. The associations of education with inactivity in the 15- and 35-year follow-ups showed a similar trend: OR 0.97 (95 % CI 0.93, 1.00) and OR 0.94 (95 % CI 0.91, 0.98), respectively. In all co-twin control analyses, each year of higher education was associated with a reduced likelihood of inactivity suggesting direct effect (i.e. independent from familial confounding) of education on inactivity. However, the point estimates were lower than in the individual-level analyses. Adjustment for multiple covariates did not change these associations. Higher education is associated with lower odds of leisure-time physical inactivity during the three-decade follow-up

  10. The association between exposure to psychosocial work factors and mental health in older employees, a 3-year follow-up study.

    Havermans, Bo M; Boot, Cécile R L; Hoekstra, Trynke; Houtman, Irene L D; Brouwers, Evelien P M; Anema, Johannes R; van der Beek, Allard J

    2018-01-01

    Unfavourable exposure to psychosocial work factors threatens older employees' mental health, and their sustained employment. This study assesses whether an improved compared to stable unfavourable and stable favourable exposure to psychosocial work factors is associated with a change in mental health in older employees at 3-year follow-up. The current study used data from the Study on Transitions in Employment, Ability and Motivation (STREAM), in workers aged 45-65 years (n = 5249). Two-year (2010-2012) exposure was assessed for psychological demands, autonomy, support, mental load, and distributive justice. Linear regression analyses were performed to compare improved exposure to unfavourable psychosocial work factors with stable unfavourable and stable favourable exposure and mental health at follow-up (2013), corrected for confounders. Analyses were stratified for age groups (45-54 and 55-65 years) and gender. In certain subgroups, stable unfavourable exposure to psychological demands, autonomy, support, and distributive justice was associated with a significantly lower mental health score than improved exposure. Stable favourable exposure to support was associated with a higher mental health score than improved support, whereas stable favourable exposure to autonomy was associated with a lower mental health score compared to improved exposure. There is a longitudinal association between changes in exposure to psychosocial work factors and mental health. Improvement in unfavourable exposure to psychosocial work factors was associated with improved mental health. This is important information for organisations that consider deploying measures to improve the psychosocial work environment of older workers.

  11. Associations of dietary intake and metabolic syndrome risk parameters in Vietnamese female marriage immigrants in South Korea: The KoGES follow-up study

    Yang, Hyesu; Kim, Hyesook; Kim, Ji-Myung; Chung, Hye Won

    2016-01-01

    BACKGROUND/OBJECTIVES This study was conducted to compare the overall changes in dietary intake and metabolic syndrome risk parameters in Vietnamese marriage-based female immigrants over time. SUBJECTS/METHODS The subjects of this study were 581 Vietnamese marriage-based female immigrants, who were recruited from local clinical centers in Korea. Baseline data were collected from 2006-2011 and the follow-up data were collected from 2012-2014. Dietary food intake was assessed by a 1-day 24-hour recall method. RESULTS Compared to the baseline, the mean body weight, body mass index, waist circumference, high density lipoprotein (HDL)-cholesterol, systolic blood pressure and diastolic blood pressure increased while the fasting blood sugar, triglycerides and low density lipoprotein-cholesterol decreased at follow-up. The total consumption of foods such as vegetables/fruits/seaweeds/mushrooms, oil and fat, and eggs decreased during the follow-up period, whereas the consumption of sugars, beverages and meats increased. Partial correlation between the rate of change [(Follow-up - Baseline) / Baseline × 100] in metabolic syndrome risk parameters and food intake after controlling for confounding factors showed that the waist circumference was positively correlated with either the total plant food intake (r = 0.1042, P = 0.0129) or the total food intake (r = 0.0880, P = 0.0359). The plasma levels of total cholesterol (r = -0.1918, P = 0.0289) and HDL-cholesterol (r = -0.1424, P = 0.0007) were negatively correlated with the percentage of total intake from plant food, and HDL-cholesterol levels were positively correlated with the intake of total animal food (r = 0.0980, P = 0.0217). The serum C-reactive protein levels were positively correlated with the total intake of animal food (r = 0.2374, P < 0.0001) or the percentage of total intake from animal food (r = 0.1346, P = 0.0016). CONCLUSIONS These results suggest that the change rate of dietary intake such as total plant food

  12. Handgrip strength is associated with, but poorly predicts, disability in older women with acute low back pain: A 12-month follow-up study.

    Felício, Diogo Carvalho; Diz, Juliano Bergamaschine Mata; Pereira, Daniele Sirineu; Queiroz, Bárbara Zille de; Silva, Juscélio Pereira de; Moreira, Bruno de Souza; Oliveira, Vinícius Cunha; Pereira, Leani Souza Máximo

    2017-10-01

    Older women with low back pain (LBP) constitute a special subpopulation at risk of severe and permanent disability. It is important to identify factors limiting functionality in this population in order to reduce costs and improve both prevention and intervention. Handgrip strength (HGS) is a biomarker of aging associated with several adverse health outcomes, but long-term associations with disability in older patients with LBP are not known. To examine whether HGS predicts disability in older women with acute low back pain (LBP). Longitudinal analyses were conducted with a sample of 135 older women from the international multicenter study Back Complaints in the Elders (BACE-Brazil). Women aged 60 years and over with a new episode of acute LBP were included. HGS was assessed with Jamar ® dynamometer, and disability was assessed using the Roland Morris questionnaire and gait speed test. Variables were assessed at baseline and at 12-month follow-up. Linear regression models explored associations between HGS and disability measures. Significant association was found between HGS at baseline and gait speed at 12-month follow-up (r=-0.24; p=0.004). A multivariable-adjusted model showed that this association was independent of age, body mass index, and pain intensity (adjusted R 2 =0.13; pinclusion of HGS as an independent variable. No association was found between HGS and score on the Roland Morris questionnaire. Caution is needed regarding the use of HGS as a predictive measure of disability in older women with acute LBP. Changes in gait speed were very small and unlikely to be of clinical relevance. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Weight Gain and Somatization are Associated With the Onset of Gastroesophageal Reflux Diseases: Results of Two 5-year Follow-up Studies.

    Barcelo, Marta; Alvarez Sanchez, Angel; Garcia Sanchez, Raquel; Diaz-Rubio, Manuel; Rey, Enrique

    2016-03-01

    Although 2% to 4% of the population develop gastroesophageal reflux disease (GERD) annually, factors associated with the onset of GERD are scarcely known. To assess whether such factors include weight gain and psychological distress. Two cohorts (first: N=222; second N=754) drawn from 2 case-control studies were followed up for around 5 years. In 2004, all participants were directly interviewed using a validated questionnaire to collect data on body weight, height, GERD symptoms, and psychological distress. In 2009 to 2010, these same participants were again interviewed using the same methodology. The response rate was 83.3% in cohort 1 and 39.1% in cohort 2, after a follow-up of 4.3±0.7 and 5.6±0.3 years, respectively. The multivariate analysis showed only weight gain and psychological distress as being independently associated with the onset of GERD in both cohorts. Weight gain per kilogram showed an adjusted odds ratio (OR) of 1.21 (1.01-1.44) in the first cohort, and a gain of 5 kg or more showed an adjusted OR of 4.65 (1.72-12.53) in the second. Somatization scores showed an adjusted OR of 1.09 (1.04-1.15) in the first cohort (measured as Minnesota Multiphasic Personality Inventory 2 hypochondriasis score) and 2.88 (1.04-8.02) in the second (measured as psychosomatic symptoms score). Body mass index on attaining overweight or obese status was associated with the onset of GERD in the unadjusted but not in the adjusted analysis. Weight gain and somatization are the main factors associated with the onset of GERD. The association between GERD and obesity is just the ultimate consequence of gaining weight.

  14. Longitudinal associations of burnout with heart rate variability in patients following acute coronary syndrome: A one-year follow-up study.

    Zhang, Min; Liu, Ling; Shi, Yunke; Yang, Yanfei; Yu, Xiaoju; Angerer, Peter; Kristensen, Tage S; Li, Jian

    2018-05-25

    To investigate longitudinal associations of burnout with heart rate variability (HRV) in patients after their first acute coronary syndrome (ACS). Two hundred eight patients participated in this one-year follow-up study. On the day before discharge, their personal burnout level was assessed by the Copenhagen Burnout Inventory. HRV signals were collected at four time points: the day before discharge, one month, six month and one year after discharge. HRV was measured by 24-h ambulatory electrocardiography and analyzed in time and frequency domains. Generalized estimating equations were applied to analyze the associations of burnout at baseline with longitudinal tracking of HRV during follow-up. After adjusting for relevant confounding factors, high burnout at baseline was significantly associated with low SDNN, a time domain measure of HRV [regression coefficient = -0.087, 95% CI = (-0.136, -0.038) by an increase per SD in burnout score, p = 0.001]. Also, baseline burnout was inversely associated with five frequency domain measures, i.e., HF [coefficient = -0.179, 95% CI = (-0.352, -0.006), p = 0.043], LF [coefficient = -0.171, 95% CI = (-0.319, -0.023), p = 0.024], VLF [coefficient = -0.367, 95% CI = (-0.483, -0.250), p burnout is longitudinally associated with decreased HRV during one-year period among patients after first ACS. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. Association of cytomegalovirus and Epstein-Barr virus with cognitive functioning and risk of dementia in the general population: 11-year follow-up study.

    Torniainen-Holm, Minna; Suvisaari, Jaana; Lindgren, Maija; Härkänen, Tommi; Dickerson, Faith; Yolken, Robert H

    2018-03-01

    Earlier studies have documented an association between cytomegalovirus and cognitive impairment, but results have been inconsistent. Few studies have investigated the association of cytomegalovirus and Epstein-Barr virus with cognitive decline longitudinally. Our aim was to examine whether cytomegalovirus and Epstein-Barr virus are associated with cognitive decline in adults. The study sample is from the Finnish Health 2000 Survey (BRIF8901, n = 7112), which is representative of the Finnish adult population. The sample was followed up after 11 years in the Health 2011 Survey. In addition, persons with dementia were identified from healthcare registers. In the Finnish population aged 30 and over, the seroprevalence of cytomegalovirus was estimated to be 84% and the seroprevalence of Epstein-Barr virus 98%. Seropositivity of the viruses and antibody levels were mostly not associated with cognitive performance. In the middle-aged adult group, cytomegalovirus serointensity was associated with impaired performance in verbal learning. However, the association disappeared when corrected for multiple testing. No interactions between infection and time or between the two infections were significant when corrected for multiple testing. Seropositivity did not predict dementia diagnosis. The results suggest that adult levels of antibodies to cytomegalovirus and Epstein-Barr virus may not be associated with a significant decline in cognitive function or with dementia at population level. Copyright © 2018. Published by Elsevier Inc.

  16. Postoperative follow-up studies in biliary atresia using radioisotope

    Kanto, Kei; Ishida, Haruo; Hayashi, Akira; Kamagata, Shoichiro; Sanbonmatsu, Toru; Matsufuji, Hiroshi; Ishii, Katsumi

    1988-09-01

    With increasing numbers of long survival patients in biliary atresia, associated diseases such as liver cirrhosis and portal hypertension seem to be more important in their course. We use liver scintigraphy, hepatobiliary scintigraphy and transrectal portal scintigraphy as the follow-up study. Three studies generally correlate the present state of the patients, but there seems to be dissociation in the group of cirrhosis without icterus which are encountered most often in biliary atresia. That can be seen in hepatobiliary scintigraphy especially. So we emphasis that to choose several isotope studies are essential in determination of the postoperative state in biliary atresia.

  17. Association of Self-Perceived Physical Competence and Leisure-Time Physical Activity in Childhood-A Follow-Up Study.

    Hamari, Lotta; Heinonen, Olli J; Aromaa, Minna; Asanti, Riitta; Koivusilta, Leena; Koski, Pasi; Laaksonen, Camilla; Matomäki, Jaakko; Pahkala, Katja; Pakarinen, Anni; Suominen, Sakari; Salanterä, Sanna

    2017-04-01

    The basis of self-perceived physical competence is built in childhood and school personnel have an important role in this developmental process. We investigated the association between initial self-perceived physical competence and reported leisure-time physical activity (LTPA) longitudinally in 10-, 12-, and 15-year-old children. This longitudinal follow-up study comprises pupils from an elementary school cohort (N = 1346) in the city of Turku, Finland (175,000 inhabitants). The self-perceived physical competence (fitness and appearance) and LTPA data were collected with questionnaires. The full longitudinal data were available from 571 pupils based on repeated studies at the ages of 10, 12, and 15 years in 2004, 2006, and 2010. We analyzed the association of self-perceived physical competence and LTPA using regression models. Self-perceived physical competence was positively associated with LTPA at all ages (10 years p fitness scores was likely to associate with higher LTPA at each age point (10 years [odds ratio, OR] = 1.18, 95% confidence interval, CI: 1.09-1.27; 12 years [OR] = 1.27, 95% CI: 1.18-1.37; and 15 years [OR] = 1.28, 95% CI: 1.19-1.38). Self-perceived physical competence is associated with LTPA in children and adolescents, and the association is strengthened with age. © 2017, American School Health Association.

  18. A follow-up study on the association of working conditions and lifestyles with the development of (perceived) mental symptoms in workers of a telecommunication enterprise.

    Suwazono, Y; Okubo, Y; Kobayashi, E; Kido, T; Nogawa, K

    2003-10-01

    This study investigated the association of working conditions and lifestyle with mental health in Japanese workers. A follow-up study was carried out in the Kanto district of Japan of workers in a telecommunications enterprise who received their first annual health check-up between 1992 and 1996 and were between 20 and 54 years old. Workers who reported mental symptoms, had a past history of disease, or current illness at their first check-up were excluded from the analysis. In total, the study included 23 837 workers. The association between working conditions and lifestyle and the development of mental symptoms was investigated by pooled logistic regression analyses. Working long hours and part-time work, as opposed to normal daytime hours of work, were factors associated with the development of mental symptoms in males, as were smoking, short sleeping hours, little physical exercise, rarely taking three meals a day, frequently eating within 1 h before sleep, much preference for salty meals and little preference for vegetables. Consumption of alcohol was negatively associated with the development of mental symptoms in males. Overall, the results suggested that the lower the Healthy Work and Lifestyle Score, the higher the risk of developing mental symptoms. Working conditions and lifestyle, especially food preferences, have an apparent influence on the mental health of Japanese workers. Moreover, the Healthy Work and Lifestyle Score indicates that working conditions and lifestyle appear to have a cumulative influence upon the mental health of Japanese workers.

  19. The joint association of eating frequency and diet quality with colorectal cancer risk in the Health Professionals Follow-up Study.

    Mekary, Rania A; Hu, Frank B; Willett, Walter C; Chiuve, Stephanie; Wu, Kana; Fuchs, Charles; Fung, Teresa T; Giovannucci, Edward

    2012-04-01

    The results of most case-control studies have suggested a positive association between eating frequency and colorectal cancer risk. Because no prospective cohort studies have done so to date, the authors prospectively examined this association. In 1992, eating frequency was assessed in a cohort of 34,968 US men in the Health Professionals Follow-up Study. Cox proportional hazards regression models were used to estimate relative risks and 95% confidence intervals for various levels of eating frequency. Effect modifications by overall dietary quality (assessed using the Diet Approaches to Stop Hypertension score) and by factors that influence insulin resistance were further assessed. Between 1992 and 2006, a total of 583 cases of colorectal cancer were diagnosed. When comparing the highest eating frequency category (5-8 times/day) with the reference category (3 times/day), the authors found no evidence of an increased risk of colorectal cancer (multivariate relative risk = 0.88, 95% confidence interval: 0.62, 1.26) or colon cancer (multivariate relative risk = 0.78, 95% confidence interval: 0.49, 1.25). There was an implied inverse association with eating frequency among participants who had healthier diets (high Diet Approaches to Stop Hypertension score; P for interaction = 0.01), especially among men in the high-insulin-sensitivity group (body mass index (weight (kg)/height (m)(2)) frequency of healthy meals and colorectal cancer risk and in men with factors associated with higher insulin sensitivity.

  20. Consumer satisfaction with the Child and Adolescent Mental Health Service and its association with treatment outcome: a 3-4-year follow-up study.

    Solberg, Cathrine; Larsson, Bo; Jozefiak, Thomas

    2015-04-01

    Consumer satisfaction studies with the Child and Adolescent Mental Health Service (CAMHS) have mainly assessed evaluations in a short-term follow-up perspective. Adolescent reports with CAMHS have not been included nationally. The purposes of this study were to explore adolescent and parental satisfaction with the CAMHS in a 3-4-year follow-up perspective, and to examine the relationships between reported consumer satisfaction and clinical parameters such as reason for adolescent referral, emotional/behavioral symptoms and treatment outcome. Of 190 adolescent-parent pairs in a sample of CAMHS outpatients, 120 completed a Consumer Satisfaction Questionnaire. Parents assessed adolescent emotional/behavior problems both at baseline and at follow-up by completing the Child Behavior Checklist (CBCL). Correlations were examined between adolescent and parental evaluations. The relationships between service satisfaction and symptom load at baseline and follow-up and treatment outcome at follow-up were explored. Overall, adolescents and parents were satisfied with the services received from the CAMHS. The correlations between adolescent and parent consumer satisfaction ratings were low to moderate. Consumer satisfaction was significantly and negatively correlated with symptom load on the CBCL Total Problems scores at baseline, but not at follow-up. There was no difference in satisfaction levels between those who improved after treatment and those who did not. Given the differences in informant ratings of consumer satisfaction, it is important to include both adolescent and parental perceptions in evaluations of CAMHS services and treatment outcomes. Consumer satisfaction should serve as a supplement to established standardized outcome measures.

  1. Variables associated with change in quality of life among persons with dementia in nursing homes: a 10 months follow-up study.

    Marit Mjørud

    Full Text Available To investigate variables associated with change in quality of life (QOL, measured by QUALID scale and three subscales; tension, sadness and wellbeing, among dementia patients in nursing homes.A 10 months follow-up study including 198 (female 156, 79% nursing home patients, mean age 87 (s.d 7.7 years. Scales applied; quality of life in late stage dementia (QUALID scale and three subscales (wellbeing, sadness and tension, neuropsychiatric inventory questionnaire 10 items (NPI-10-Q, clinical dementia rating (CDR scale, physical self-maintenance (PSMS scale and a scale of general medical health. Use of psychotropic medication, gender and age was collected from the patient's records.Mean baseline QUALID score: 20.6 (s.d.7.0, follow-up score: 22.9 (s.d.7.4, mean change 2.8 (s.d.7.4. QOL improved in 30.8%, were unchanged in 14.7%, deteriorated in 54.6% of patients. A regression analysis revealed that change in QUALID score was significantly associated with: QUALID baseline score (beta -.381, p-value.000, change in NPI score (beta.421, p-value.000, explained variance 38.1%. Change in score on wellbeing subscale associated with: change in PSMS score (beta.185, p-value.019, wellbeing baseline score (beta -.370, p-value.000, change in NPI score (beta.186, p-value.017, explained variance 25.3%. Change in score on tension subscale associated with: change in CDR sum-of-boxes (beta.214, p-value.003, change in NPI score (beta.270, p-value.000, tension baseline score (beta -.423, p-value.000, explained variance 34.6%. Change in score on sadness subscale associated with: change in NPI score (beta.404, p-value.000, sadness baseline score (beta -.438, p-value.000, explained variance 38.8%.The results imply that a lower baseline score (better QOL results in a larger change in QOL (towards worse QOL. Change in QOL is mostly associated with change in neuropsychiatric symptoms. In almost 50% of patients QOL did not deteriorate.

  2. A 1-year follow-up study exploring the associations between perception of illness and health-related quality of life in persons with chronic obstructive pulmonary disease.

    Bonsaksen, Tore; Haukeland-Parker, Stacey; Lerdal, Anners; Fagermoen, May Solveig

    2014-01-01

    Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disease with an increasing prevalence worldwide. Its potential consequences, including reduced function and reduced social participation, are likely to be associated with decreased health-related quality of life (HRQoL). However, illness perceptions and self-efficacy beliefs may also play a part in determining HRQoL in persons with COPD. The aim of this study was to explore the relationships between illness perceptions, self-efficacy, and HRQoL in a sample of persons with COPD in a longitudinal perspective. The context of the study was a patient education course from which the participants were recruited. Data concerning sociodemographic variables, social support, physical activity, illness perceptions, general self-efficacy, and HRQoL were collected before the course started and 1 year after completion. Linear regression was used in the analyses. The results showed that less consequences and less symptoms (identity) were associated with higher physical HRQoL (PCS) at baseline and at 1-year follow-up. Less emotional response was similarly associated with higher mental HRQoL (MCS) at both time points. Lower self-efficacy showed a borderline significant association with higher PCS at baseline, but was unrelated to MCS at both time points. Self-efficacy showed no influence on the associations between illness perceptions and HRQoL. In conclusion, the study showed that specific illness perceptions had a stable ability to predict HRQoL in persons with COPD, whereas self-efficacy did not. The associations between illness perceptions and HRQoL were not mediated by self-efficacy.

  3. Association of the Aspartate Aminotransferase to Alanine Aminotransferase Ratio with BNP Level and Cardiovascular Mortality in the General Population: The Yamagata Study 10-Year Follow-Up

    Miyuki Yokoyama

    2016-01-01

    Full Text Available Background. Early identification of high risk subjects for cardiovascular disease in health check-up is still unmet medical need. Cardiovascular disease is characterized by the superior increase in aspartate aminotransferase (AST to alanine aminotransferase (ALT. However, the association of AST/ALT ratio with brain natriuretic peptide (BNP levels and cardiovascular mortality remains unclear in the general population. Methods and Results. This longitudinal cohort study included 3,494 Japanese subjects who participated in a community-based health check-up, with a 10-year follow-up. The AST/ALT ratio increased with increasing BNP levels. And multivariate logistic analysis showed that the AST/ALT ratio was significantly associated with a high BNP (≥100 pg/mL. There were 250 all-cause deaths including 79 cardiovascular deaths. Multivariate Cox proportional hazard regression analysis revealed that a high AST/ALT ratio (>90 percentile was an independent predictor of all-cause and cardiovascular mortality after adjustment for confounding factors. Kaplan-Meier analysis demonstrated that cardiovascular mortality was higher in subjects with a high AST/ALT ratio than in those without. Conclusions. The AST/ALT ratio was associated with an increase in BNP and was predictive of cardiovascular mortality in a general population. Measuring the AST/ALT ratio during routine health check-ups may be a simple and cost-effective marker for cardiovascular mortality.

  4. Association of diabetes mellitus with decline in ankle-brachial index among patients on hemodialysis: A 6-year follow-up study.

    Szu-Chia Chen

    Full Text Available Peripheral artery occlusive disease is common among diabetes mellitus (DM and end-stage renal disease patients, and tends to progress faster and lead to worse outcomes. This study compared the association of DM with the decline in ankle-brachial index (ABI among patients on hemodialysis (HD. This was a longitudinal analysis of ABI in HD patients from 2009 to 2015. Medical records and yearly ABI values were obtained. A longitudinal mixed-model analysis was used to evaluate ABI changing trends while accounting for within-patients correlation. There were 296 patients on HD in the period of 2009-2015. In a 6-year follow-up, those with DM had a more rapid ABI decline compared to non-DM patients (slopes: -0.014 vs. 0.010 per year, interaction p < 0.001. In DM patients, female sex, high pulse pressure, high triglyceride, low creatinine, and high uric acid were associated with a decrease in ABI. In non-DM patients, old age, high pulse pressure, high low-density lipoprotein cholesterol, and high uric acid were associated with a decreased in ABI. There were 49.6% of patients with a normal ABI experienced a decrease at least 0.1 of ABI from baseline, and 35.3% had a final ABI < 0.9 in patients with a baseline ABI ≥ 0.9 (n = 232. In this study, DM patients on HD tend to develop a more rapid decline in ABI than non-DM patients on HD. Age, sex, pulse pressure, lipid profile, creatinine, and uric acid are associated with a decreased in ABI.

  5. Association of Cognitive Function With Cause-Specific Mortality in Middle and Older Age: Follow-up of Participants in the English Longitudinal Study of Ageing.

    Batty, G David; Deary, Ian J; Zaninotto, Paola

    2016-02-01

    We examined the little-tested associations between general cognitive function in middle and older age and later risk of death from chronic diseases. In the English Longitudinal Study of Ageing (2002-2012), 11,391 study participants who were 50-100 years of age at study induction underwent a battery of cognitive tests and provided a range of collateral data. In an analytical sample of 9,204 people (4,982 women), there were 1,488 deaths during follow-up (mean duration, 9.0 years). When we combined scores from 4 cognition tests that represented 3 acknowledged key domains of cognitive functioning (memory, executive function, and processing speed), cognition was inversely associated with deaths from cancer (per each 1-standard-deviation decrease in general cognitive function score, hazard ratio = 1.21, 95% CI: 1.10, 1.33), cardiovascular disease (hazard ratio = 1.71, 95% CI: 1.55, 1.89), other causes (hazard ratio = 2.07, 95% CI: 1.79, 2.40), and respiratory illness (hazard ratio = 2.48, 95% CI: 2.12, 2.90). Controlling for a range of covariates, such as health behaviors and socioeconomic status, and left-censoring to explore reverse causality had very little impact on the strength of these relationships. These findings indicate that cognitive test scores can provide relatively simple indicators of the risk of death from an array of chronic diseases and that these associations appear to be independent of other commonly assessed risk factors. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  6. Associations of exercise, sedentary time and insomnia with metabolic syndrome in Taiwanese older adults: A 1-year follow-up study.

    Chen, Li-Jung; Lai, Yun-Ju; Sun, Wen-Jung; Fox, Kenneth R; Chu, Dachen; Ku, Po-Wen

    2015-01-01

    Understanding the risk factors of metabolic syndrome (MetS) is important to public health, since individuals with MetS have an increased risk of health problems. This study examined the associations of exercise, sedentary time and insomnia with incident MetS among older adults 1 year later. A total of 1,359 older adults receiving hospital health examinations in 2012 were studied, and 779 subjects had a follow-up after 1 year. The components of MetS (waist, blood pressure, high-density lipoprotein cholesterol, fasting glucose and triglyceride) were defined by the Program's Adult Treatment Panel III report. Exercise, sedentary time and insomnia data were obtained through self-report questionnaires. Physical fitness (body fatness, balance and hand grip strength) was measured. Two logistic regressions were computed to examine the associations of exercise/physical fitness, sedentary time and insomnia at baseline with incident MetS 1 year later. The first regression included age, sex, smoking and alcohol as covariates. The second regression was further adjusted with the components of MetS. Sex, exercise/balance, sedentary time and insomnia were significant predictors of MetS. The risk of MetS incidence was 3.36 (95% CI 1.96-5.77) for women, 1.92 (95% CI 1.01-3.63) for those who did not exercise, 2.52 (95% CI 1.37-4.63) for those who sat more than 5 h/day, and 2.17 (95% CI 1.13-4.15) for those with insomnia. Poor balance was significantly associated with greater risk of MetS (AOR = 1.07, 95% CI 1.02-1.12). Sex, sedentary time, insomnia and balance remained significant after adjusting with the components of MetS. Cultivating exercise habits, reducing sedentary time and improving sleep quality may be important strategies for MetS prevention among older adults.

  7. Leisure-time physical inactivity and association with body mass index: a Finnish Twin Study with a 35-year follow-up.

    Piirtola, Maarit; Kaprio, Jaakko; Waller, Katja; Heikkilä, Kauko; Koskenvuo, Markku; Svedberg, Pia; Silventoinen, Karri; Kujala, Urho M; Ropponen, Annina

    2017-02-01

    We investigated the stability and change of leisure-time physical inactivity in adult men and women during a 35-year follow-up. We also analysed the impact of long-term physical inactivity on the development of body mass index (BMI). : In this population-based cohort study, 5254 Finnish twin individuals (59% women) participated in four surveys in 1975, 1981, 1990 and 2011. Mean age at baseline was 23.9 years. Individual long-term leisure-time physical activity (LTPA) was categorized into seven classes varying from 'persistently inactive' to 'persistently active'. We used the multivariate multilevel mixed-effects linear regression model and paired-sample t-test in the analyses. Co-twin control design was used for examining within-pair associations. : Of men 11%, and of women 8%, were persistently inactive. Among both sexes, the mean BMI slope trajectories were steeper among the persistently inactive and those who became inactive than among those who were persistently active. Overall, the inactive participants gained 1.4 kg/m 2 [95% confidence interval (CI) 1.2 to 1.7] more in weight than did the active participants from 1975 to 2011. Among twin pairs discordant for LTPA, the corresponding difference was 1.4 kg/m 2 (95% CI 0.83 to 2.0) in dizygotic pairs and 0.68 kg/m 2 (95% CI 0.05 to1.3) in monozygotic pairs. Over a 35-year time span from young adulthood, persistently inactive participants and those who had become inactive had greater weight increases than those who were persistently active. This association was also found in twin-pair analyses, although attenuated in monozygotic pairs. This may support the importance of LTPA in weight management, although further causal inference is required. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association

  8. A 1-year follow-up study exploring the associations between perception of illness and health-related quality of life in persons with chronic obstructive pulmonary disease

    Bonsaksen T

    2013-12-01

    Full Text Available Tore Bonsaksen,1 Stacey Haukeland-Parker,2 Anners Lerdal,3,4 May Solveig Fagermoen4,5 1Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway; 2Department of Physiotherapy, Østfold Hospital Trust, Fredrikstad, Norway; 3Research Department, Lovisenberg Diakonale Hospital, Oslo, Norway; 4Department of Nursing Science, Institute of Health and Society, University of Oslo, Oslo, Norway; 5Department of Gastroenterology, Division of Medicine, Oslo University Hospital, Oslo, Norway Abstract: Chronic obstructive pulmonary disease (COPD is a progressive respiratory disease with an increasing prevalence worldwide. Its potential consequences, including reduced function and reduced social participation, are likely to be associated with decreased health-related quality of life (HRQoL. However, illness perceptions and self-efficacy beliefs may also play a part in determining HRQoL in persons with COPD. The aim of this study was to explore the relationships between illness perceptions, self-efficacy, and HRQoL in a sample of persons with COPD in a longitudinal perspective. The context of the study was a patient education course from which the participants were recruited. Data concerning sociodemographic variables, social support, physical activity, illness perceptions, general self-efficacy, and HRQoL were collected before the course started and 1 year after completion. Linear regression was used in the analyses. The results showed that less consequences and less symptoms (identity were associated with higher physical HRQoL (PCS at baseline and at 1-year follow-up. Less emotional response was similarly associated with higher mental HRQoL (MCS at both time points. Lower self-efficacy showed a borderline significant association with higher PCS at baseline, but was unrelated to MCS at both time points. Self-efficacy showed no influence on the associations

  9. Initial healthcare and coping preferences are associated with outcome 1 year after whiplash trauma: a multicentre 1-year follow-up study.

    Myrtveit, Solbjørg Makalani; Carstensen, Tina; Kasch, Helge; Ørnbøl, Eva; Frostholm, Lisbeth

    2015-03-20

    Individuals exposed to whiplash collisions have to cope with the stressful event as well as early physical symptoms. As in other chronic pain conditions, coping has been associated with outcome after whiplash. In this study, our aim was to examine whether initial coping preferences were associated with the development of chronic whiplash. Prospective study. Primary care. 740 acute whiplash patients were recruited from emergency units and general practitioners after car collisions in Denmark. Within 10 days postinjury, participants were asked what they believed could help them get better. At 12-month follow-up, the level of neck pain and capability to work was obtained. Whether coping preferences (baseline) were associated with outcome was investigated using multiple regression analyses. Persistent neck pain was most strongly associated with preferring medications (mean difference=1.24 (95% CI 0.67 to 1.82)) and sickness absence (mean difference=1.18 (95% CI 0.53 to 1.82)). Reduced work capability was most strongly associated with preferring medications (OR=3.53 (95% CI 2.13 to 5.86)), sickness absence (OR=3.05 (95% CI 1.80 to 5.17)) and being referred to a physiotherapist/chiropractor (OR=3.03 (95% CI 1.33 to 6.91)). Active coping was associated with better outcomes: Participants preferring to change their lifestyle were protected against reduced work capability (OR=0.11 (95% CI 0.01 to 0.78)). Individuals who wanted to keep living as usual only (no other preference reported) were protected against neck pain (mean difference -1.62 (95% CI -2.39 to -0.84)) and reduced work capability (OR=0.09 (95% CI 0.01 to 0.64)). A simple nine-item measure of coping preferences is associated with the development of chronic neck pain and reduced capability to work following whiplash trauma and may be used to identify individuals at risk of poor recovery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  10. Dietary pattern transitions, and the associations with BMI, waist circumference, weight and hypertension in a 7-year follow-up among the older Chinese population: a longitudinal study

    Xiaoyue Xu

    2016-08-01

    Full Text Available Abstract Background Few studies explored the effects of nutritional changes on body mass index (BMI, weight (Wt, waist circumference (WC and hypertension, especially for the older Chinese population. Methods By using China Health and Nutrition Survey 2004-2011 waves, a total of 6348 observations aged ≥ 60 were involved in the study. The number of participants dropped from 2197 in 2004, to 1763 in 2006, 1303 in 2009, and 1085 in 2011. Dietary information was obtained from participants using 24 hour-recall over three consecutive days. Height, Wt, WC, systolic and diastolic blood pressure were also measured in each survey year. The dietary pattern was derived by exploratory factor analysis using principal component analysis methods. Linear Mixed Models were used to investigate associations of dietary patterns with BMI, Wt and WC. Generalized Estimating Equation models were used to assess the associations between dietary patterns and hypertension. Results Over time, older people’s diets were shifting towards a modern dietary pattern (high intake of dairy, fruit, cakes and fast food. Traditional and modern dietary patterns had distinct associations with BMI, Wt and WC. Participants with a diet in the highest quartile for traditional composition had a β (difference in mean of −0.23 (95 % CI: −0.44; −0.02 for BMI decrease, β of −0.90 (95 % CI: −1.42; −0.37 for Wt decrease; and β of −1.57 (95 % CI: −2.32; −0.83 for WC decrease. However, participants with a diet in the highest quartile for modern diet had a β of 0.29 (95 % CI: 0.12; 0.47 for BMI increase; β of 1.02 (95 % CI: 0.58; 1.46 for Wt increase; and β of 1.44 (95 % CI: 0.78; 2.10 for Wt increase. No significant associations were found between dietary patterns and hypertension. Conclusions We elucidate the associations between dietary pattern and change in BMI, Wt, WC and hypertension in a 7-year follow-up study. The strong association between favourable body

  11. Dietary pattern transitions, and the associations with BMI, waist circumference, weight and hypertension in a 7-year follow-up among the older Chinese population: a longitudinal study.

    Xu, Xiaoyue; Byles, Julie; Shi, Zumin; McElduff, Patrick; Hall, John

    2016-08-08

    Few studies explored the effects of nutritional changes on body mass index (BMI), weight (Wt), waist circumference (WC) and hypertension, especially for the older Chinese population. By using China Health and Nutrition Survey 2004-2011 waves, a total of 6348 observations aged ≥ 60 were involved in the study. The number of participants dropped from 2197 in 2004, to 1763 in 2006, 1303 in 2009, and 1085 in 2011. Dietary information was obtained from participants using 24 hour-recall over three consecutive days. Height, Wt, WC, systolic and diastolic blood pressure were also measured in each survey year. The dietary pattern was derived by exploratory factor analysis using principal component analysis methods. Linear Mixed Models were used to investigate associations of dietary patterns with BMI, Wt and WC. Generalized Estimating Equation models were used to assess the associations between dietary patterns and hypertension. Over time, older people's diets were shifting towards a modern dietary pattern (high intake of dairy, fruit, cakes and fast food). Traditional and modern dietary patterns had distinct associations with BMI, Wt and WC. Participants with a diet in the highest quartile for traditional composition had a β (difference in mean) of -0.23 (95 % CI: -0.44; -0.02) for BMI decrease, β of -0.90 (95 % CI: -1.42; -0.37) for Wt decrease; and β of -1.57 (95 % CI: -2.32; -0.83) for WC decrease. However, participants with a diet in the highest quartile for modern diet had a β of 0.29 (95 % CI: 0.12; 0.47) for BMI increase; β of 1.02 (95 % CI: 0.58; 1.46) for Wt increase; and β of 1.44 (95 % CI: 0.78; 2.10) for Wt increase. No significant associations were found between dietary patterns and hypertension. We elucidate the associations between dietary pattern and change in BMI, Wt, WC and hypertension in a 7-year follow-up study. The strong association between favourable body composition and traditional diet, compared with an increase in BMI, WC and Wt

  12. Associations of socioeconomic position in childhood and young adulthood with cardiometabolic risk factors: the Jerusalem Perinatal Family Follow-Up Study.

    Savitsky, B; Manor, O; Friedlander, Y; Burger, A; Lawrence, G; Calderon-Margalit, R; Siscovick, D S; Enquobahrie, D A; Williams, M A; Hochner, H

    2017-01-01

    Several stages in the life course have been identified as important to the development of cardiovascular disease. This study aimed to assess the associations of childhood and adulthood socioeconomic position (SEP) and social mobility with cardiometabolic risk factors (CMRs) later in life. We conducted follow-up examinations of 1132 offspring, aged 32, within a population-based cohort of all births in Jerusalem from 1974 to 1976. SEP was indicated by parents' occupation and education, and adulthood SEP was based on offspring's occupation and education recorded at age 32. Linear regression models were used to investigate the associations of SEP and social mobility with CMRs. Childhood-occupational SEP was negatively associated with body mass index (BMI; β=-0.29, p=0.031), fat percentage (fat%; β=-0.58, p=0.005), insulin (β=-0.01, p=0.031), triglycerides (β=-0.02, p=0.024) and low-density lipoprotein cholesterol (LDL-C; β=-1.91, p=0.015), independent of adulthood SEP. Adulthood-occupational SEP was negatively associated with waist-to-hip ratio (WHR; β=-0.01, p=0.002), and positively with high-density lipoprotein cholesterol (HDL-C; β=0.87, p=0.030). Results remained similar after adjustment for smoking and inactivity. Childhood-educational SEP was associated with decreased WHR and LDL-C level (p=0.0002), and adulthood-educational SEP was inversely associated with BMI (p=0.001), waist circumference (p=0.008), WHR (p=0.001) and fat% (p=0.0002) and positively associated with HDL-C (p=0.030). Additionally, social mobility (mainly upward) was shown to have adverse cardiometabolic outcomes. Both childhood and adulthood SEP contribute independently to CMR. The match-mismatch hypothesis may explain the elevated CMRs among participants experiencing social mobility. Identification of life-course SEP-related aspects that translate into social inequality in cardiovascular risk may facilitate efforts for improving health and for reducing disparities in cardiovascular

  13. [Follow-up study on the association between problematic cell phone use and cognitive function of college students in Chizhou City in 2014-2015].

    He, Qiong; Cheng, Hualing; Zhang, Shichen; Zhu, Peng

    2017-09-01

    To estimate the association between problematic cell phone use and reasoning ability in adolescent. In a stratified cluster sampling design, problematic cell phone use and reasoning ability were evaluated in 929 college students from three universities for twice in one year's follow-up investigation from June 2014 to May 2015. The cross-sectional analysis showed that the score of problematic cell phone use was significantly associated with the score of reasoning ability( the baseline β =-0. 101, 95% CI-0. 168--0. 034; the follow-up in one year's β =-0. 161, 95% CI-0. 255--0. 067). However, the score of problematic cell phone use on the baseline was not associated with the score of reasoning ability in one year late. Interestingly, after controlling of multiple confounding factors and the score of problematic cell phone use on the baseline, the scores of reasoning ability in one year late decreased 0. 40 points( 95%CI-0. 60--0. 20), by the score of problematic cell phone use in one year lateincreased ten percent compared to that on the baseline. Higher problematic cell phone use is significantly associated with poorer reasoning ability in college students.

  14. Associations of social environment, socioeconomic position and social mobility with immune response in young adults: the Jerusalem Perinatal Family Follow-Up Study.

    Lawrence, Gabriella M; Friedlander, Yehiel; Calderon-Margalit, Ronit; Enquobahrie, Daniel A; Huang, Jonathan Yinhao; Tracy, Russell P; Manor, Orly; Siscovick, David S; Hochner, Hagit

    2017-12-21

    Immune response to cytomegalovirus (CMV) impacts adult chronic disease. This study investigates associations of childhood and adulthood social environment, socioeconomic position (SEP) and social mobility with CMV response in young adults. Historical prospective study design. Subcohort of all 17 003 births to residents of Jerusalem between 1974 and 1976. Participants included 1319 young adults born in Jerusalem with extensive archival and follow-up data, including childhood and adulthood SEP-related factors and anti-CMV IgG titre levels and seroprevalence measured at age 32. Principal component analysis was used to transform correlated social environment and SEP-related variables at two time points (childhood and adulthood) into two major scores reflecting household (eg, number of siblings/children, religiosity) and socioeconomic (eg, occupation, education) components. Based on these components, social mobility variables were created. Linear and Poisson regression models were used to investigate associations of components and mobility with anti-CMV IgG titre level and seroprevalence, adjusted for confounders. Lower levels of household and socioeconomic components in either childhood or adulthood were associated with higher anti-CMV IgG titre level and seropositivity at age 32. Compared with individuals with stable favourable components, anti-CMV IgG titre level and risk for seropositivity were higher in stable unfavourable household and socioeconomic components (household: β=3.23, P<0.001; relative risk (RR)=1.21, P<0.001; socioeconomic: β=2.20, P=0.001; RR=1.14, P=0.01), downward household mobility (β=4.32, P<0.001; RR=1.26, P<0.001) and upward socioeconomic mobility (β=1.37, P=0.04; RR=1.19, P<0.001). Among seropositive individuals, associations between household components and mobility with anti-CMV IgG titre level were maintained and associations between socioeconomic components and mobility with anti-CMV IgG titre level were attenuated. Our study

  15. Borderline personality disorder associates with violent criminality in women: A population based follow-up study of adolescent psychiatric inpatients in Northern Finland.

    Arola, Riikka; Antila, Henna; Riipinen, Pirkko; Hakko, Helinä; Riala, Kaisa; Kantojärvi, Liisa

    2016-09-01

    Various psychiatric problems in adolescence and early adulthood have been shown to associate with criminal behaviour. In this study the association of personality disorders (PDs) with criminal behaviour was examined in adolescents treated in psychiatric hospitals. The study sample consisted of 508 adolescents (age 13-17) admitted to acute psychiatric impatient care between April 2001 and March 2006. Crime data was obtained from the Finnish Legal Register Centre on September 2013. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) was used to assess psychiatric diagnoses in adolescence. The information on PDs in early adulthood was based on follow-up information on psychiatric treatments in either out- or inpatient settings until the end of 2012, and was extracted from the National Care Register for Health Care provided by the Finnish National Institute for Health and Welfare. A total of 22 (39%) of the 57 subjects with PD had committed a crime. In women, the likelihood for violent criminality was significantly increased in those with Borderline PD (OR 6.09, CI 1.24-29.84, p=0.009) and was also associated with conduct disorder (OR 4.26, CI 1.38-13.19, p=0.012), child welfare placement (OR 11.82, CI 3.61-38.76, pdisorder (OR 7.74, CI 2.30-26.10, p=0.001). In men, no association was observed between PD and any kind of criminal behaviour. Significant predictors for violent criminality in males were conduct disorder (OR 4.05, CI 1.75-9.38, p=0.001), substance use disorder (OR 2.51, CI 1.22-5.17, p=0.012) and special services at school (OR 2.58, CI 1.16-5.76, p=0.021). Females with Borderline PD showed an increased risk for violent offending. This suggests Borderline PD as a potential explanatory factor for violent assaults by females and highlights the importance of recognizing the risk for violence in young women with a Borderline PD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. [A prospective follow-up study on the association between serum level of C-reactive protein and risk of digestive system cancers in Chinese women].

    Wang, G; Cao, L Y; Chen, S H; Xie, S H; Feng, X S; Lyu, Z Y; Guo, L W; Li, F; Su, K; Chang, S; Ren, J S; Dai, M; Li, N; Wu, S L; He, J

    2016-11-23

    Objective: It has been reported by some prospective studies that C-reactive protein (CRP) is associated with cancer risk. However, the correlation between CRP and digestive system cancers has not been evaluated in Chinese females. We conducted a large population-based cohort study to investigate whether elevated level of CRP in serum is associated with an increased risk of digestive system cancers in Chinese women. Methods: From the Chinese Kailuan Female Cohort, 19, 437 women were enrolled in this study in July 2006, and all of the subjects were followed up through 2014. At the baseline investigation, the serum levels of high-sensitivity CRP (hsCRP) were tested for all subjects, and demographic information and risk factor data were collected. Multivariable Cox proportional hazards regression model was used to calculate the hazard ratios ( HR ) and 95% confidence intervals (95% CI ) for the baseline levels of hsCRP after adjusting for age, marital status, smoking, drinking, body mass index (BMI), diabetes and physical activity, and risk of digestive system tumors (including colorectal cancer, stomach cancer, pancreas cancer, liver and gallbladder cancer, and other cancers). Results: By Dec 31, 2014, a total of 100 incident cancer cases were observed, including 47 colorectal cancers, 17 stomach cancers, and altogether 29 pancreas, liver and gallbladder cancers. All the subjects investigated were divided into three groups according to the level of hsCRP (3 mg/L). The 8-year cumulative incidence of digestive system cancers were 405/100 000, 520/100 000 and 787/100 000 in these 3 groups, respectively (Log rank test χ 2 = 8.37, P =0.015). Compared to those with lower hsCRP levels (3 mg/L) had a significantly increased risk of pancreas, liver and gallbladder cancers ( HR = 2.70, 95% CI = 1.06-6.91; P trend = 0.036). Conclusions: Elevated levels of hsCRP at baseline may be associated with increased risk of certain digestive system cancers.

  17. Nimh Treatment Study of ADHD Follow-Up

    J Gordon Millichap

    2004-04-01

    Full Text Available The effects of changes in medication use between 14 and 24 months follow-up on effectiveness (symptom ratings and growth (height and weight measures were analyzed, comparing 4 groups of patients, in the Multimodal Treatment Study of ADHD (MTA reported by the MTA Cooperative Group.

  18. Association between knee alignment and knee pain in patients surgically treated for medial knee osteoarthritis by high tibial osteotomy. A one year follow-up study

    W-Dahl, Annette; Toksvig-Larsen, Sören; Roos, Ewa

    2009-01-01

    on for knee OA by high tibial osteotomy. METHODS: 182 patients (68% men) mean age 53 years (34 - 69) with varus alignment having tibial osteotomy by the hemicallotasis technique for medial knee OA were consecutively included. Knee alignment was assessed by the Hip-Knee-Ankle (HKA) angle from radiographs...... including the hip and ankle joints. Knee pain was measured by the subscale pain (0 - 100, worst to best scale) of the Knee injury and Osteoarthritis Outcome Score (KOOS) preoperatively and at one year follow-up. To estimate the association between knee alignment and knee pain multivariate regression...... with every degree of HKA angle, adjusted analysis 0.3 points (95% CI -1.3 - 0.6).The mean postoperative knee alignment was 184 degrees (171 - 185). The mean change in knee alignment was 13 degrees (0 - 30). The mean change in KOOS pain was 32 (-16 - 83). There was neither any association between change...

  19. Follow-up study on energy entrepreneurs; Laempoeyrittaejaet seurannassa

    Solmio, H

    1995-11-01

    Energy supplying (i.e. wood and peat fuels) is a new form of entrepreneurship in which one or more entrepreneurs attend to the supply of energy to local buildings. At present there are about ten localities where this is practised. TTS Institute is engaged in a follow-up study of a chipfired heating system with energy entrepreneurs supplying the chipped wood. The study is part of the nationwide Bioenergy research programme. The targets of the study, three in number during the 1993-94 heating season, are rural schools located in southern and eastern Finland. The primary fuel used to heat these premises is chipped wood made from small-diameter timber with light fuel oil as the supplementary fuel. The entrepreneurs supplying the chip fuel are local farmers, and they both delivered the fuel and attended to the actual heating. The time consumed in transporting the chipped wood to the heating plant and to attend to the actual heating was 0,1-1,1 h/MWh with the work associated with heating representing 0,2-0,5 h/MWh. The productivity of fuelwood harvesting in the study sites was 0,4-0,8 m{sup 3}/h and the productivity of chipping was 3,8-7,5 loose m{sup 3}/h. TTS Institute expanded the study in 1994 to also include a few premises larger in their energy requirement than those mentioned in the above

  20. Association of serum hs-CRP and lipids with obesity in school children in a 12-month follow-up study in Japan.

    Nishide, Ritsuko; Ando, Michiko; Funabashi, Hidemitsu; Yoda, Yoshiko; Nakano, Masataka; Shima, Masayuki

    2015-03-01

    To investigate the association of serum lipids and high-sensitivity C-reactive protein (hs-CRP) with obesity in school children and to explore whether hs-CRP levels could be used to predict the presence or absence of obesity 12 months later. The subjects were school children (6-11 years old) in Japan. Blood sampling and physical measurements were performed in school (2001); low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, and hs-CRP levels were measured. Data from children who could be followed 12 months later were analyzed. Subjects weighing 20% or more over his/her standard weight were regarded as obese, and the association of obesity with serum parameters was analyzed. Data from 612 subjects were analyzed (follow-up rate, 75.4%). The mean of each serum parameter was significantly higher (inverse for HDL-C; lower) in obese than that in non-obese children. Logistic regression analysis for obesity at baseline showed that the odds ratio (OR) of hs-CRP was the highest [OR, 2.15; 95% confidence interval (CI), 1.65-2.78 for an interquartile rage (IQR) increase]; the association with triglycerides and LDL-C/HDL-C was significant. At the 12-month follow-up, the OR of high hs-CRP remained the highest of all serum parameters (2.09; 95% CI, 1.63-2.69 for an IQR increase). High levels of triglycerides, LDL-C/HDL-C, and hs-CRP increased the risk of obesity in school children. Hs-CRP is considered to be a better predictor of obesity 12 months later than is LDL-C/HDL-C.

  1. Internet of things and bariatric surgery follow-up: Comparative study of standard and IoT follow-up.

    Vilallonga, Ramon; Lecube, Albert; Fort, José Manuel; Boleko, Maria Angeles; Hidalgo, Marta; Armengol, Manel

    2013-09-01

    Follow-up of obese patient is difficult. There is no literature related to patient follow-up that incorporates the concept of Internet of Things (IoT), use of WiFi, Internet, or portable devices for this purpose. This prospective observational study commenced in June 2011. Patients were prospectively offered to participate in the IoT study group, in which they received a WiFi scale (Withing®, Paris) that provides instant WiFi data to the patient and surgeon. Other patients were admitted to the standard follow-up group at the outpatient clinic. A total of 33 patients were included in our study (ten in the IoT group). Twelve patients did not have WiFi at home, ten lacked of computer knowledge, and seven preferred standard for follow-up. All patients underwent different surgical procedures. There were no complications. Excess weight loss (EWL) was similar in both groups. More than 90% of patients were satisfied. In the IoT group, patients considered it valuable in saving time, and considered seeing their evolution graphics extremely motivating. IoT technology can monitor medical parameters remotely and collect data. A WiFi scale can facilitate preoperative and follow-up. Standard follow-up in a classical outpatient clinic setting with the surgeon was preferred globally.

  2. Urinary Neutrophil Gelatinase-Associated Lipocalin and Progression of Diabetic Nephropathy in Type 1 Diabetic Patients in a Four-Year Follow-Up Study

    Nielsen, Stine Elkjaer; Hansen, Henrik Post; Jensen, Berit Ruud

    2010-01-01

    -year randomized, intervention study evaluating low-protein diet in T1D patients with diabetic nephropathy, 78 patients were studied with yearly measurements of u-NGAL (ELISA, BioPorto). Outcome: Decline in glomerular filtration rate (GFR) ((51)Cr-EDTA), and end-stage renal disease (ESRD) or death....... Results: Mean age 40.7 (8.2) years and 50 men. 13 patients developed ESRD or died. Baseline GFR (mean, SD): 68 (31) ml/min/1.73 m(2). Baseline u-NGAL [geometric mean (95% CI)] and GFR were 15.6 ng/24 h (11.8-20.7) and 68 (31) ml/min/1.73 m(2). During follow-up, an increase in u-NGAL [geometric mean (95...

  3. Pregnant women's preference and factors associated with institutional delivery service utilization in Debra Markos Town, North West Ethiopia: a community based follow up study.

    Bayu, Hinsermu; Adefris, Mulatu; Amano, Abdella; Abuhay, Mulunesh

    2015-02-05

    Majority of deaths from obstetric complications are preventable. But every pregnant woman face risks which may not always be detected through the risk assessment approach during antenatal care (ANC). Therefore, the presence of a skilled birth attendant in every delivery is the most critical intervention in reducing maternal mortality and morbidity. In Ethiopia the proportion of births attended by skilled personnel, is very low, even for women who have access to the services. A community-based follow up study was conducted from January 17, 2012 to July 30, 2012, among 2(nd) and 3(rd) trimester's pregnant women in Debre-Markos town, east Gojam Zone, Amhara Region, North West Ethiopia. Simple random sampling technique was used to get a total sample size of 422 participants. A total of 393 pregnant women were included in the study. The study revealed that 292(74.3%) of the pregnant women planned to deliver in a health institution. Of these 292 pregnant women 234 (80.14%) actually delivered in a health facility. Age range from 15-19 year (AOR = 4.83, 95% CI = 1.562-12.641), college and above education of the pregnant women (AOR = 12.508, 95% CI = 1.082-14.557), ANC visit during the current pregnancy (AOR = 1.975, 95% CI = 1.021-3.392),perceived susceptibility and severity of pregnancy and delivery complication (AOR = 3.208, 95% CI = 1.262-8.155) and intention (preference) of pregnant women for place of delivery (AOR = 7.032, 95% CI = 3.045-10.234) are predictors of institutional delivery service utilization. Preference for institutional delivery is low in the study area. Sociodemographic factors, perception about delivery complication, ANC follow up and their intentions for institutional delivery are among important predictors of institutional delivery.

  4. Radiological follow-up of uncemented knee prostheses. Preliminary study

    Martin Hervas, C.; Gomez Barrena, E.; Marquez Moreno, I.; Calle Yuste, F.; Ordonez Parra, J.M.

    1993-01-01

    The preliminary results of a prospective study of 40 uncemented total knee prostheses (TKP) are presented following a radiological protocol with fluoroscopic control and follow-up of over 2 years. The prosthesis-bone interface and the components alignment were assessed. Several radiological signs were studied to assess this interface with respect to the fixing of the component, but they showed little clinical correlation. Statistical significance (p<0.05, chisquare) was found only in the observation of sclerosis in areas of support for the tibital tray as a reaction of the bone. This radiological follow-up is of interest to determine the evolution of the interface and position of the implant to prevent complications (especially loosening) in patients, particularly those under 60 years old, who represent the group that can most benefit from prosthetic systems with uncemented anchorage because of their life expectation and level of activity. Author

  5. Ute Unit: Study Guide and Follow Up Activities.

    North Conejos School District, Capulin, CO.

    The study guide and follow-up activities were designed primarily to give students a feeling of Ute life in the San Luis Valley in Colorado. The unit begins with six Southern Ute stories about the wolf and coyote, the race between the skunk and the coyote, the frog and the eagle, why the frog croaks, the bear (Que Ye Qat), and the two Indian…

  6. Factors Associated with Relapse among Heroin Addicts: Evidence from a Two-Year Community-Based Follow-Up Study in China

    Chao Rong

    2016-01-01

    Full Text Available Background: Many countries including China are facing a serious opiate dependence problem. Anti-drug work effectiveness was affected by the high relapse rate all over the world. This study aims to analyze the factors influencing heroin addict relapse, and to provide evidence for generating relapse prevention strategies. Methods: A community-based follow-up study was conducted in China between October 2010 and September 2012. A total of 554 heroin addicts in accordance with the inclusion criteria from 81 streets in 12 districts of Shanghai, China were divided into 4 groups: group 1—daily dosage taken orally of 60 mL of methadone or under combined with psychological counseling and social supports (n = 130; group 2—daily dosage taken orally of over 60 mL of methadone combined with psychological counseling and social supports (n = 50; group 3—JTT (Jitai tablets combined with psychological counseling and social supports (n = 206; group 4—JTT combined with social supports (n = 168. Results: Log-rank test results showed that the cumulative relapse rate differences among four groups during the two-year follow-up period were not statistically significant (χ2 = 5.889, p = 0.117. Multivariate Cox regression analysis results showed that only three independent variables were still statistically significant, including compliance with participation in psychological counseling (OR = 3.563, p = 0.000, the years of drug use (OR = 1.078, p = 0.001and intervention model. Conclusions: Using the detoxification medications combined with appropriate psychological counseling and social support measures will help improve the effectiveness of relapse prevention, which is a kind of alternative community detoxification pattern. Appropriate and standard psychological counseling is very important for anti-drug treatment. The longer the drug addiction lasts, the longer the anti-drug treatment takes.

  7. Factors associated with intentions to adhere to colorectal cancer screening follow-up exams

    Ishibashi Teruo

    2006-11-01

    Full Text Available Abstract Background To increase adherence rate to recommendations for follow-up after abnormal colorectal cancer (CRC screening results, factors that inhibit and facilitate follow-up must be identified. The purpose of this study was to identify the factors associated with intention to adhere to CRC screening follow-up exams. Methods During a 4-week period in October 2003, this survey was conducted with 426 subjects participating in a community-based CRC screening program in Nagano, Japan. Study measures included intention to adhere to recommendation for clinical follow-up in the event of an abnormal fecal occult blood test (FOBT result, perceived susceptibility and severity of CRC, perceived benefits and barriers related to undergoing follow-up examination, social support, knowledge of CRC risk factors, health status, previous CRC screening, personality and social demographic characteristics. Univariate and multivariate logistic regression analyses on intention to adhere to recommendations for follow-up were performed. Results Among the 288 individuals analyzed, approximately 74.7% indicated that they would definitely adhere to recommendations for follow-up. After controlling for age, gender, marital status, education, economic status, trait anxiety, bowel symptoms, family history of CRC, and previous screening FOBT, analyses revealed that lower levels of perceived barriers, higher levers of perceived benefits and knowledge of CRC risk factors were significantly associated with high intention respectively. Conclusion The results of this study suggest that future interventions should focus on reducing modifiable barriers by clarifying misperceptions about follow-up, promoting the acceptance of complete diagnostic evaluations, addressing psychological distress, and making follow-up testing more convenient and accessible. Moreover, educating the public regarding the risk factors of CRC and increasing understanding of the benefits of follow-up is

  8. Uncontrolled hypertension and associated factors among adult hypertensive patients on follow-up at Jimma University Teaching and Specialized Hospital: cross-sectional study

    Tesfaye B

    2017-03-01

    Full Text Available Bekele Tesfaye,1 Dessalegn Haile,1 Benalfew Lake,1 Tefera Belachew,2 Temamen Tesfaye,3 Habtamu Abera4 1Department of Nursing, College of Health Science, Debre Markos University, Debre Markos, 2Department of Population and Family Health, 3Department of Nursing and Midwifery, College of Health Science, Jimma University, Jimma, 4Department of Nursing and Midwifery, College of Health Sciences, School of Allied Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia Introduction: Hypertension, including poorly controlled blood pressure, is the major global health problem that affects one billion people worldwide. Limited studies have been conducted on prevalence of uncontrolled hypertension and associated factors among adult hypertensive patients in Ethiopia.Objective: The aim of this study was to determine the prevalence of uncontrolled hypertension and associated factors among adult hypertensive patients at Jimma University Teaching and Specialized Hospital.Methods: Institution-based cross-sectional study was conducted at the chronic illness clinic of Jimma University Specialized and Teaching hospital from March 09 to April 13, 2016. A total of 345 hypertensive patients were selected using systematic sampling technique. Data were collected using structured questionnaire through face-to-face exit interview and chart review. Data were analyzed using Statistical Package for the Social Sciences (SPSS version 20.0 software. The bivariate and multivariable analysis was done to identify factors of uncontrolled hypertension.Results: More than half, 52.7%, of the patients had uncontrolled hypertension. Lack of awareness of hypertension-related complications (adjusted odds ratio [AOR]=2.140, 95% confidence interval [CI]=1.272–3.600, p=0.004, nonadherent to smoking abstinence (AOR=3.935, 95% CI=1.065–14.535, p=0.004, nonadherent to alcohol abstinence (AOR=2.477, 95% CI=1.074–5.711, p=033, Khat (Catha edulis chewing (AOR=2.518, 95% CI=1.250–5

  9. Radiographic follow-up study of Little Leaguer's shoulder

    Kanematsu, Yoshiji; Iwase, Takenobu; Matsuura, Tetsuya; Suzue, Naoto; Sairyo, Koichi; Kashiwaguchi, Shinji; Iwame, Toshiyuki

    2015-01-01

    Little Leaguer's shoulder is a syndrome involving the proximal humeral epiphyseal plate. Conservative treatment usually resolves the symptoms. However, there are no reports of a radiographic follow-up study of this disease. The purpose of this study was to show the radiographic healing process of Little Leaguer's shoulder. A total of 19 male baseball players diagnosed as having Little Leaguer's shoulder were retrospectively evaluated. The mean age at first presentation was 12.7 years. External rotation anteroposterior radiographs of the shoulder were taken. All patients were treated with rest from throwing, and no throwing was recommended until remodeling was confirmed. Follow-up radiographs were taken at 1-month intervals to assess healing. All patients were observed until healing was confirmed radiographically, after which they returned to baseball. The mean follow-up period was 8.5 months. In addition to radiography, patients were asked whether they had any symptoms and whether they had been able to return to baseball. At the first examination, radiographs showed a wider epiphyseal plate of the throwing side compared with the asymptomatic contralateral shoulder. Healing was observed in all cases. Healing occurred first along the medial side and was then extended laterally. The mean time required for healing was 4.7 months. All patients were able to return to playing baseball at their pre-injury level of play and were asymptomatic when examined at the final follow-up. The healing process of Little Leaguer's shoulder advanced from medial to lateral, and healing was achieved about 5 months after initial examination. (orig.)

  10. Mortality in acromegaly: a 20-year follow-up study.

    Ritvonen, Elina; Löyttyniemi, Eliisa; Jaatinen, Pia; Ebeling, Tapani; Moilanen, Leena; Nuutila, Pirjo; Kauppinen-Mäkelin, Ritva; Schalin-Jäntti, Camilla

    2016-06-01

    It is unclear whether mortality still is increased in acromegaly and whether there are gender-related differences. We dynamically assessed outcome during long-term follow-up in our nationwide cohort. We studied standardized mortality ratios (SMRs) relative to the general population and causes of death in acromegaly (n=333) compared with age- and gender-matched controls (n=4995). During 20 (0-33) years follow-up, 113 (34%) patients (n=333, 52% women) and 1334 (27%) controls (n=4995) died (P=0.004). SMR (1.9, 95% CI: 1.53-2.34, Pacromegaly. Overall distribution of causes of death (Pacromegaly, but not in controls, causes of deaths shifted from 44% cardiovascular and 28% cancer deaths during the first decade, to 23% cardiovascular and 35% cancer deaths during the next two decades. In acromegaly, cancer deaths were mostly attributed to pancreatic adenocarcinoma (n=5), breast (n=4), lung (n=3) and colon (n=3) carcinoma. In acromegaly, men were younger than women at diagnosis (median 44.5 vs 50 years, Pacromegaly, men are younger at diagnosis and death than women. Compared with controls, mortality is increased during 20 years of follow-up, especially in women. Causes of deaths shift from predominantly cardiovascular to cancer deaths. © 2016 Society for Endocrinology.

  11. Barriers to follow-up for pediatric cataract surgery in Maharashtra, India: How regular follow-up is important for good outcome. The Miraj Pediatric Cataract Study II

    Parikshit Gogate

    2014-01-01

    Full Text Available Background: Regular follow up and amblyopia treatment are essential for good outcomes after pediatric cataract surgery. Aim: To study the regularity of follow-up after cataract surgery in children and to gauge the causes of poor compliance to follow up. Subjects: 262 children (393 cataracts who underwent cataract surgery in 2004-8. Materials and Methods: The children were identified and examined in their homes and a "barriers to follow-up" questionnaire completed. Demographic data collected, visual acuity estimated, and ocular examination performed. Statistical Analysis: SPSS version 19. Results: Of the 262 children, only 53 (20.6% had been regularly following up with any hospital, 209 (79.4% had not. A total of 150 (57.3% were boys and the average age was 13.23 years (Std Dev 5 yrs. Poor follow up was associated with the older age group ( P 1 line with regular follow-up. Conclusion: Regular follow-up is important and improves vision; eye care practitioners need to take special efforts to ensure better follow-up.

  12. Influence of Anti-TNF and Disease Modifying Antirheumatic Drugs Therapy on Pulmonary Forced Vital Capacity Associated to Ankylosing Spondylitis: A 2-Year Follow-Up Observational Study

    Alberto Daniel Rocha-Muñoz

    2015-01-01

    Full Text Available Objective. To evaluate the effect of anti-TNF agents plus synthetic disease modifying antirheumatic drugs (DMARDs versus DMARDs alone for ankylosing spondylitis (AS with reduced pulmonary function vital capacity (FVC%. Methods. In an observational study, we included AS who had FVC% <80% at baseline. Twenty patients were taking DMARDs and 16 received anti-TNF + DMARDs. Outcome measures: changes in FVC%, BASDAI, BASFI, 6-minute walk test (6MWT, Borg scale after 6MWT, and St. George’s Respiratory Questionnaire at 24 months. Results. Both DMARDs and anti-TNF + DMARDs groups had similar baseline values in FVC%. Significant improvement was achieved with anti-TNF + DMARDs in FVC%, at 24 months, when compared to DMARDs alone (P=0.04. Similarly, patients in anti-TNF + DMARDs group had greater improvement in BASDAI, BASFI, Borg scale, and 6MWT when compared to DMARDs alone. After 2 years of follow-up, 14/16 (87.5% in the anti-TNF + DMARDs group achieved the primary outcome: FVC% ≥80%, compared with 11/20 (55% in the DMARDs group (P=0.04. Conclusions. Patients with anti-TNF + DMARDs had a greater improvement in FVC% and cardiopulmonary scales at 24 months compared with DMARDs. This preliminary study supports the fact that anti-TNF agents may offer additional benefits compared to DMARDs in patients with AS who have reduced FVC%.

  13. Follow up study of Alzheimer's type dementia with computed tomography

    Hirata, Nobuhide

    1987-01-01

    In 54 patients who were diagnosed as having Alzheimer's type dementia based on the Diagnostic and Statistical Manual of Mental Disorders, III, cranial computed tomography (CT) scans were obtained before and after their follow-up study ranging from 6 to 24 months (mean 15.4 +- 4.7 months). Cerebrospinal percentage and CT density in various regions of interest were examined. Six patients died during the study. Comparison of the group of the deceased (Group I) with the group of survivors (Group II) revealed: (1) there was no difference in average age and the degree of mental disorder at first presentation; (2) Group I had decreased activities of daily living; and (3) CT density was significantly decreased in the bilateral lateral and frontal lobes in Group I. As for Group II, decreased CT numbers were noticeable during the follow-up period in the frontal lobe, parietal lobe, and caudate nucleus in the group evaluated as aggravated, as compared with the group evaluated as unchanged. (Namekawa, K.)

  14. Missed opportunities for institutional delivery and associated factors among urban resident pregnant women in South Tigray Zone, Ethiopia: a community-based follow-up study.

    Bayu, Hinsermu; Fisseha, Girmastion; Mulat, Amlaku; Yitayih, Gebre; Wolday, Mengistu

    2015-01-01

    Every pregnant woman is considered to be at risk and some risks may not always be foreseeable or detectable. Therefore, the presence of a skilled birth attendant at every delivery is considered to be the most critical intervention in reducing maternal mortality and morbidity. In Ethiopia, the proportion of births attended by skilled personnel in urban settings can be as low as 10%. Therefore, the main purpose of this research was to identify factors affecting unplanned home delivery in urban settings, where there is relatively good access in principle to modern healthcare institutions. A community-based follow-up study was conducted from 17 January 2014 to 30 August 2014, among second- and third-trimester pregnant women who had planned for institutional delivery in South Tigray Zone. A systematic sampling technique was used to get a total of 522 study participants. A pre-tested and structured questionnaire was used to collect relevant data. Bivariate and multivariate data analyses were performed using SPSS version 16.0. The study revealed that among 465 pregnant women who planned for institutional delivery, 134 (28.8%) opted out and delivered at their home (missed opportunity). Single women (AOR 2.34, 95% CI 1.17-4.68), illiterate mothers (AOR 6.14, 95% CI 2.20-17.2), absence of antenatal clinic visit for indexed pregnancy (AOR 3.11, 95% CI 1.72-5.61), absence of obstetric complications during the index pregnancy (AOR 2.96, 95% CI 1.47-5.97), poor autonomy (AOR 2.11, 95% CI 1.27-3.49), and absence of birth preparedness and complication readiness (AOR 3.83, 95% CI 2.19-6.70) were significant predictors of unplanned home delivery. A significant proportion of pregnant women missed the opportunity of modern delivery assistance. Educational status, antenatal care status, lack of obstetric complications, poor autonomy, and lack of birth preparedness and complication readiness were among the important predictors of unplanned home delivery.

  15. Missed opportunities for institutional delivery and associated factors among urban resident pregnant women in South Tigray Zone, Ethiopia: a community-based follow-up study

    Hinsermu Bayu

    2015-09-01

    Full Text Available Background: Every pregnant woman is considered to be at risk and some risks may not always be foreseeable or detectable. Therefore, the presence of a skilled birth attendant at every delivery is considered to be the most critical intervention in reducing maternal mortality and morbidity. In Ethiopia, the proportion of births attended by skilled personnel in urban settings can be as low as 10%. Therefore, the main purpose of this research was to identify factors affecting unplanned home delivery in urban settings, where there is relatively good access in principle to modern healthcare institutions. Design: A community-based follow-up study was conducted from 17 January 2014 to 30 August 2014, among second- and third-trimester pregnant women who had planned for institutional delivery in South Tigray Zone. A systematic sampling technique was used to get a total of 522 study participants. A pre-tested and structured questionnaire was used to collect relevant data. Bivariate and multivariate data analyses were performed using SPSS version 16.0. Results: The study revealed that among 465 pregnant women who planned for institutional delivery, 134 (28.8% opted out and delivered at their home (missed opportunity. Single women (AOR 2.34, 95% CI 1.17–4.68, illiterate mothers (AOR 6.14, 95% CI 2.20–17.2, absence of antenatal clinic visit for indexed pregnancy (AOR 3.11, 95% CI 1.72–5.61, absence of obstetric complications during the index pregnancy (AOR 2.96, 95% CI 1.47–5.97, poor autonomy (AOR 2.11, 95% CI 1.27–3.49, and absence of birth preparedness and complication readiness (AOR 3.83, 95% CI 2.19–6.70 were significant predictors of unplanned home delivery. Conclusions: A significant proportion of pregnant women missed the opportunity of modern delivery assistance. Educational status, antenatal care status, lack of obstetric complications, poor autonomy, and lack of birth preparedness and complication readiness were among the important

  16. Association between Cognition and Serum Insulin-Like Growth Factor-1 in Middle-Aged & Older Men : An 8 Year Follow-Up Study

    Tumati, Shankar; Burger, Huibert; Martens, Sander; van der Schouw, Yvonne T; Aleman, André

    2016-01-01

    Low levels of insulin-like growth factor-1 (IGF-1), an essential neurotrophic factor, have been associated with worse cognitive function in older adults. However, few studies have assessed the prospective association of serum IGF-1 with cognitive function. We aimed to determine the association

  17. Incidence of cardiovascular diseases and associated risk factors among subjects with type 2 diabetes – An 11-year follow up study

    K. Umamahesh

    2014-01-01

    Conclusions: Smoking and heavy alcohol consumption were significantly associated with CVD, and increased BMI was significantly associated with hypertension and dyslipidemia among subjects with type 2 diabetes in this study population. These findings emphasize the need for early identification and modification of risk factors associated with CVD events in patients with diabetes.

  18. Epidemiological follow-up study of Japanese Thorotrast cases

    Mori, T.; Maruyama, T.; Kato, Y.; Takahashi, S.

    1979-01-01

    The authors conducted a follow-up study on 243 Thorotrast-administered war-wounded ex-servicemen in 1975, after a lapse of 30 to 38 years from Thorotrast injections, and found 18 cases of malignant hepatic tumor, 15 cases of other malignant tumors, 2 cases of blood diseases, and 9 cases of liver cirrhosis in 224 cases who had been given Thorotrast intravascularly. The incidence of hepatic and other malignant tumors, blood diseases, and liver cirrhosis was significantly higher than in the controls. The total number of deaths in the Thorotrast-administered cases was also significantly higher than in the controls. In the remaining 19 cases who had been given Thorotrast by a route other than intravascularly, no fatal case related to Thorotrast administration was discovered. In the living cases, however, one sarcoma was observed to have developed at the site of the Thorotrast injection

  19. Hydrotherapy after total knee arthroplasty. A follow-up study.

    Giaquinto, S; Ciotola, E; Dall'Armi, V; Margutti, F

    2010-01-01

    The study evaluated the subjective functional outcome following total knee arthroplasty (TKA) in participants who underwent hydrotherapy (HT) six months after discharge from a rehabilitation unit. A total of 70 subjects, 12 of which were lost at follow-up, were randomly assigned to either a conventional gym treatment (N=30) or HT (N=28). A prospective design was performed. Participants were interviewed with Western-Ontario McMasters Universities Osteoarthritis Index (WOMAC) at admission, at discharge and six months later. Kruskal-Wallis and Wilcoxon tests were applied for statistical analysis. Both groups improved. The WOMAC subscales, namely pain, stiffness and function, were all positively affected. Statistical analysis indicates that scores on all subscales were significantly lower for the HT group. The benefits gained by the time of discharge were still found after six months. HT is recommended after TKA in a geriatric population. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  20. Associations of Work-Related Factors and Work Engagement with Mental and Physical Health: A 1-Year Follow-up Study Among Older Workers

    Leijten, F.R.M.; van den Heuvel, S.G.; van der Beek, A.J.; Ybema, J.F.; Robroek, S.J.W.; Burdorf, A.

    2015-01-01

    Purpose The goals of this study were to determine whether, among older employees, unfavourable physical and psychosocial work-related factors were associated with poorer mental and physical health and whether high work engagement buffered the associations between unfavourable work-related factors

  1. Associations of Work-Related Factors and Work Engagement with Mental and Physical Health : A 1-Year Follow-up Study Among Older Workers

    Leijten, Fenna R M; van den Heuvel, Swenne G.; van der Beek, Allard J.; Ybema, Jan Fekke; Robroek, Suzan J W; Burdorf, Alex

    2015-01-01

    Purpose The goals of this study were to determine whether, among older employees, unfavourable physical and psychosocial work-related factors were associated with poorer mental and physical health and whether high work engagement buffered the associations between unfavourable work-related factors

  2. The association between exposure to psychosocial work factors and mental health in older employees, a 3-year follow-up study

    Havermans, B.M.; Boot, C.R.L.; Hoekstra, T.; Houtman, I.L.D.; Brouwers, E.P.M.; Anema, J.R.; Beek, A.J. van der

    2018-01-01

    Purpose Unfavourable exposure to psychosocial work factors threatens older employees’ mental health, and their sustained employment. This study assesses whether an improved compared to stable unfavourable and stable favourable exposure to psychosocial work factors is associated with a change in

  3. The association between exposure to psychosocial work factors and mental health in older employees : A 3-year follow-up study

    Havermans, B.M.; Boot, C.R.L.; Hoekstra, T.; Houtman, I.L.D.; Brouwers, E.P.M.; Anema, J.R.; Van Der Beek, A.J.

    2018-01-01

    Purpose Unfavourable exposure to psychosocial work factors threatens older employees' mental health, and their sustained employment. This study assesses whether an improved compared to stable unfavourable and stable favourable exposure to psychosocial work factors is associated with a change in

  4. Association between alcohol consumption pattern and the incidence risk of type 2 diabetes in Korean men: A 12-years follow-up study

    Lee, Dae-Yeon; Yoo, Min-Gyu; Kim, Hyo-Jin; Jang, Han Byul; Kim, Jae-Hong; Lee, Hye-Ja; Park, Sang Ick

    2017-01-01

    Moderate alcohol consumption is generally associated with reduced risk of type 2 diabetes. However, this beneficial effects of alcohol intake remains controversial due to inconsistent results across studies. The analysis was performed using data from the Ansung-Ansan cohort study. We categorized the participants into four groups?based on the baseline (one-point measure; non-drinking,

  5. Bradykinesia in Huntington's disease. A prospective, follow-up study.

    García Ruiz, Pedro J; Hernández, Jaime; Cantarero, Susana; Bartolomé, Manuel; Sánchez Bernardos, Vicenta; García de Yébenez, Justo

    2002-04-01

    Bradykinesia is a frequent finding in Huntington's disease (HD), but some aspects are presently unknown; including the natural evolution of bradykinesia over time and the correlation between bradykinesia and functional capacity. We studied the motor performance of 20 genetically confirmed patients with HD (age: 40+/-10.8 years; age at onset 33.6+/-11 years; total functional capacity (TFC): 9.57+/-3; UHDRS total motor scale: 31.4+/-13, triplet length (CAG)n: 46.7+/-4 triplets). These patients were studied in baseline conditions and after 18.7+/-6 months of follow-up. In addition, HD patients were compared with 20 age-matched normal controls. Motor study included the four CAPIT timed tests commonly used for Parkinson's disease: pronation-supination (PS), finger dexterity (FD), movement between two points (MTP) and walking test (WT). HD patients were significantly slower than controls in all motor tasks. A significant deterioration occurred over time in three of the four motor tasks (especially FD and WT). A significant correlation between timed tests and TFC score was found (for MTP, r: -0.845; p < 0,0001). In addition a significant correlation between timed tests and the UHDRDS total motor scale was also found (for MTP, r: 0.864; p < 0.0001). In conclusion, simple timed motor tests can detect a deterioration of motor activity over time in HD. Timed tests might be useful to follow the natural evolution of HD and to assess the efficacy of new therapies.

  6. Association between childhood health, socioeconomic and school-related factors and effort-reward imbalance at work: a 25-year follow-up study.

    Wang, Shuo; Sanderson, Kristy; Venn, Alison; Dwyer, Terence; Gall, Seana

    2018-01-01

    Stress pathways can have origins in childhood, but few early predictors have been explored in relation to adult job stress. This study examined whether childhood school, health or socioeconomic factors were associated with adult job stress. Data came from the Childhood Determinants of Adult Health study that began in 1985 with children aged 7-15 years who reported effortreward imbalance (ERI) scales at ages 31-41 years. Linear regression assessed the association between childhood factors and adult ERI adjusted for age and socioeconomic position (SEP) in childhood and adulthood. There were between 999 and 1390 participants in each analysis. Lower adulthood ERI, indicating less job stress, was predicted by several school-related factors in men. For example, each higher category of learner self-concept was associated with a 19% (95% CI - 32% to 6%) reduction in adult ERI, and each unit increase in academic attainment was associated with a 15% (95% CI -28% to 3%) reduction in adult ERI. Childhood health was associated with adult ERI. For example, in women, overweight children had 14% (95% CI 5% to 22%) higher adult ERI scores compared with healthy weight children, and each unit of negative affect was associated with 2% (95% CI 1% to 4%) increase in adult ERI. Adult SEP had no effect on these associations for men but explained some of the effect in women. Childhood SEP had inconsistent associations with adult ERI. Our findings suggest that a range of childhood socioeconomic, school- and health-related factors might contribute to the development of job stress in adulthood. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Multimorbidity and Polypharmacy Are Independently Associated with Mortality in Older People with Intellectual Disabilities: A 5-Year Follow-Up from the HA-ID Study

    Schoufour, Josje D.; Oppewal, Alyt; van der Maarl, Hanne J. K.; Hermans, Heidi; Evenhuis, Heleen M.; Hilgenkamp, Thessa I. M.; Festen, Dederieke A.

    2018-01-01

    We studied the association between multimorbidity, polypharmacy, and mortality in 1,050 older adults (50+) with intellectual disability (ID). Multimorbidity (presence of = 4 chronic health conditions) and polypharmacy (presence = 5 chronic medication prescriptions) were collected at baseline. Multimorbidity included a wide range of disorders,…

  8. Associations between the home environment and children's sweet beverage consumption at 2-year follow-up: the 'Be active, eat right' study.

    van Grieken, A; Renders, C M; van de Gaar, V M; Hirasing, R A; Raat, H

    2015-04-01

    This study evaluates the association between home environmental characteristics and sweet beverage consumption (i.e. beverages that contain sugar) of 7-year-old children. The population for analysis consisted of n = 2047 parents and their children from the population-based 'Be active, eat right' study. Data on sociodemographic characteristics, parental beliefs, parenting practices and child's sweet beverage consumption were obtained by parental report with questionnaires. We performed linear and multinomial regression analyses evaluating associations between characteristics at age 5 years and (i) consumption at 7 years and (ii) consumption patterns between age 5 and 7 years with reference category 'low consumption'. Based on the report from their parents, 5-year-old children drank on average 3.0 (SD:1.4) sweet beverage per day. Children consumed less sweet beverages at age 7 years (beta -0.16, 95% confidence interval [CI] -0.24 to -0.09) when there were less sweet beverages available at home. The multinomial regression model showed that children with parents who discouraged sweet beverage consumption were more likely to decrease their sweet beverage consumption over the study period (odds ratio: 1.24, 95% CI 1.07 to 1.43). Moreover, when there were less sweet beverages available at home, children were less likely to increase their consumption or have a high consumption over the study period (odds ratio: 0.70, 95% CI 0.59 to 0.83 and 0.61, 95% CI 0.54 to 0.70, respectively). The results showed that characteristics of the home environment are associated with the consumption of sweet beverages among children. Specifically, the availability of sweet beverages at home is associated with the child's sweet beverage consumption. © 2014 The Authors. Pediatric Obesity © 2014 World Obesity.

  9. Association of lean body mass with nutritional parameters and mortality in hemodialysis patients: A long-term follow-up clinical study.

    Zhou, Dong Chi; Yang, Xiu Hong; Zhan, Xiao Li; Gu, Yan Hong; Guo, Li Li; Jin, Hui Min

    2018-06-01

    This study aimed to evaluate the correlation between lean body mass (LBM) and nutritional status in hemodialysis (HD) patients to better predict their long-term prognosis. Anthropometric body measurements and biochemical parameters were recorded from 222 patients on maintenance hemodialysis (MHD) at the Shanghai Pudong Hospital Hemodialysis Center. LBM was calculated using the serum creatinine index (LBM-SCR), mid-arm muscle circumference (LBM-MAMC), and dominant-arm hand-grip strength (LBM-HGS). Patient mortality and hospitalization were observed after 24 months. LBMs measured from LBM-SCR and LBM-MAMC were associated with sex, body mass index (BMI), serum albumin, and serum creatinine (SCR) ( p LBM evaluation, low LBM was shown to be associated with a higher mortality in patients undergoing HD ( p LBM-SCR and LBM-HGS are strongly associated with hospitalization and mortality in HD patients, indicating LBM is an important factor in prediction of outcomes in those patients. LBM is associated with nutritional parameters in HD patients, and LBM-SCR, HGS, and MAMC are simple approaches for accurately predicting the patient's risk of hospitalization and/or death.

  10. Urinary Neutrophil Gelatinase-Associated Lipocalin and Progression of Diabetic Nephropathy in Type 1 Diabetic Patients in a Four-Year Follow-Up Study

    Nielsen, Stine Elkjaer; Hansen, Henrik Post; Jensen, Berit Ruud

    2010-01-01

    Background: Neutrophil gelatinase-associated lipocalin (NGAL), a marker of renal tubular damage, predicts progression in non-diabetic chronic kidney. We evaluated urinary (u)-NGAL as a predictor of progression in diabetic nephropathy in type 1 diabetic (T1D) patients. Methods: As a substudy of a 4......-year randomized, intervention study evaluating low-protein diet in T1D patients with diabetic nephropathy, 78 patients were studied with yearly measurements of u-NGAL (ELISA, BioPorto). Outcome: Decline in glomerular filtration rate (GFR) ((51)Cr-EDTA), and end-stage renal disease (ESRD) or death...

  11. Loss to follow up did not bias associations between early life factors and adult depression

    Osler, Merete; Kriegbaum, Margit; Christensen, Ulla

    2008-01-01

    a single mother at birth, low educational attainment at age 18, and low cognitive function at ages 12 and 18. Hospitalizations for depression and having claimed a prescription for an antidepressive drug were also most frequent among men who did not respond in the follow up. However, the effect......OBJECTIVE: This study examines the consequences of nonresponse in a follow-up survey for the associations of early life factors with adult depression. STUDY DESIGN AND SETTING: A cohort of 11,532 Danish men born in 1953 had nearly complete follow up for outcomes retrieved from the Danish...... characteristics and four measures of depression were described by odd ratios (OR), estimated by logistic regression. For the register-based measures the effect of nonresponse was described by a relative OR(OR(responders)/OR(entire cohort)=ROR). RESULTS: Nonresponse at 50 years of age was related to having...

  12. Long-term association of food and nutrient intakes with cognitive and functional decline: a 13-year follow-up study of elderly French women

    Vercambre, Marie-Noël; Boutron-Ruault, Marie-Christine; Ritchie, Karen; Clavel-Chapelon, Françoise; Berr, Claudine

    2009-01-01

    The objective of this study was to determine the potential long-term impact of dietary habits on age-related decline among 4,809 elderly women (born between 1925 and 1930) in the E3N study, a French longitudinal cohort. In 1993, an extensive diet history self-administered questionnaire was sent to all participants, and in 2006 another questionnaire on instrumental activities of daily living (IADL) and recent cognitive change was sent to a close relative/friend of each woman. Logistic models adjusted for sociodemographic, lifestyle and health factors were performed to evaluate associations between habitual dietary intakes and two outcomes of interest based on the informant response: recent cognitive decline and IADL impairment. Recent cognitive decline was associated with lower intakes of poultry, fish, and animal fats, as well as higher intakes of dairy dessert and ice-cream. IADL impairment was associated with lower intake of vegetables. The odds of recent cognitive decline increased significantly with decreasing intake of soluble dietary fibre and n-3 fatty acids but with increasing intake of retinol. The odds of IADL impairment increased significantly with decreasing intake of vitamins B2, B6, and B12. These results are consistent with a possible long-term neuroprotective effect of dietary fibre, n-3 polyunsaturated fats, and B-group vitamins, and support dietary intervention to prevent cognitive decline. PMID:19203415

  13. A Follow-Up Study of the Deaf.

    Reich, P. A.; Reich, C. M.

    Followed up through interviews and questionnaires were 278 former students, average age 28 years, of two residential schools and one day school for the deaf in Ontario. Data was collected on the degree of hearing loss, use of a hearing aid, educational and occupational history, social integration, methods of communication, and attitudes toward…

  14. Long-term adverse effects associated with isolated below-knee deep-vein thrombosis: a 10-year follow-up study

    Cowell, G.W.; King, S.C.; Reid, J.H.; Beek, E.J.R. van; Murchison, J.T.

    2016-01-01

    Aim: To assess the effect of the presence and locality of symptomatic lower-limb deep vein thrombosis (DVT) on mortality and morbidity following contrast venography (CV), the reference standard for diagnosing below-knee DVT, with a view to determining the prevalence of recurrent episodes of DVT and post-thrombotic syndrome (PTS). Materials and methods: Patients with clinical DVT undergoing investigation using CV were prospectively recorded. By retrospective case note examination and mortality data evaluation, 347 patients with DVT were matched with negative controls for mortality follow-up. Long-term complications were recorded. Results: Fifty-one (14.7%) of the DVT patients were diagnosed with PTS and 43 (12.4%) with possible PTS in the 10 years following presentation. The relative risk for developing definite PTS was 0.544 for below- versus above-knee DVT; 9.9% with below-knee DVT had PTS, and 9% had probable PTS. Recurrent DVT occurred in 23.3% of patients with proximal DVT as opposed to 12.6% of patients with isolated below-knee DVT. Conclusions: Morbidity is greater in patients with proximal DVT; however, a significant, albeit smaller, proportion of patients with isolated below-knee DVT develop recurrent DVT and PTS. Below-knee DVT carries sufficient morbidity and mortality to warrant vigilance in diagnosis and management of this condition. - Highlights: • We assessed the effect of symptomatic lower limb DVT on mortality and morbidity. • Morbidity is greater in patients with proximal DVT. • A small percentage of patients with distal DVT develop post thrombotic syndrome. • Distal DVT warrants vigilance in diagnosis and management of this condition.

  15. Attitudes to Medication after Kidney Transplantation and Their Association with Medication Adherence and Graft Survival: A 2-Year Follow-Up Study

    Mirjam Tielen

    2014-01-01

    Full Text Available Background. Nonadherence to medication is a common problem after kidney transplantation. The aim of this study was to explore attitudes towards medication, adherence, and the relationship with clinical outcomes. Method. Kidney recipients participated in a Q-methodological study 6 weeks after transplantation. As a measure of medication adherence, respondents completed the Basel Assessment of Adherence to Immunosuppressive Medications Scale (BAASIS©-interview. Moreover, the intrapatient variability in the pharmacokinetics of tacrolimus was calculated, which measures stability of drug intake. Data on graft survival was retrieved from patient records up to 2 years after transplantation. Results. 113 renal transplant recipients (19–75 years old participated in the study. Results revealed three attitudes towards medication adherence—attitude 1: “confident and accurate,” attitude 2: “concerned and vigilant,” and attitude 3: “appearance oriented and assertive.” We found association of attitudes with intrapatient variability in pharmacokinetics of tacrolimus, but not with self-reported nonadherence or graft survival. However, self-reported nonadherence immediately after transplantation was associated with lower two-year graft survival. Conclusion. These preliminary findings suggest that nonadherence shortly after kidney transplantation may be a risk factor for lower graft survival in the years to follow. The attitudes to medication were not a risk factor.

  16. Different factors associate with body image in adolescence than in emerging adulthood: A gender comparison in a follow-up study

    Sunna Gestsdottir

    2017-11-01

    Full Text Available Background Body image dissatisfaction has been linked with a range of adverse psychosocial outcomes in both genders and has become an important public health issue. Across all ages, women have reported being more dissatisfied with their bodies than men. The aim of the current study was to examine if fitness and physical activity associate with body image satisfaction differently across gender and age, measured in the same participants. Participants and procedure Participants were measured initially at age 15 years (N = 385 and again at age 23 years (N = 201. Structural equation modelling was used to examine the association between body image satisfaction, fitness, and physical activity. Covariates included skinfold thickness, body mass index, socioeconomic status, anxiety, and depression. Results Fitness and physical activity declined during the study period, body mass index increased, but no changes were found in body image satisfaction, depression, anxiety, or skinfold thickness. For women at ages 15 and 23 years, self-reported fitness and depression were found to be related to body image satisfaction, including body mass index at the age of 23 years. For 15-year-old men, skinfold thickness and aerobic fitness related to body image satisfaction, whereas skinfold thickness, depression, body mass index, and self-reported fitness did so at age 23 years. Conclusions Results suggest that different approaches are needed across gender to improve body image in adolescence whereas more similar ones can be used in emerging adulthood.

  17. Clinical and ultrasonographic features associated to response to intraarticular corticosteroid injection. A one year follow up prospective cohort study in knee osteoarthritis patient with joint effusion

    Galisteo, Carlos; García-Manrique, María; Navarro, Noemí; Caixàs, Assumpta; Larrosa, Marta; Gratacós, Jordi

    2018-01-01

    Objectives Intraarticular injection is used for pain relief in knee osteoarthritis (OA), but there is not a well defined profile of patient who could get more benefit from it. The purpose of this study was to evaluate the frequency of pain relief at one year after corticosteroids intraarticular injection and to identify clinical factors associated to response in patients with knee osteoarthritis with joint effusion. Methods One-year prospective cohort study of patients with knee OA with joint effusion confirmed by ultrasound. An intraarticular injection was performed following a clinical protocol. Anthropometric measurements, laboratory parameters, clinical severity, ultrasound parameters and radiological severity were collected. Response regarding pain and presence of synovial fluid on ultrasound at one month and at one year were evaluated. Clinical responder were consider in subjects with enough improvement to carry out normal daily activities with pain VASeffusion. PMID:29351562

  18. Joint association of physical activity and overweight with subsequent psychotropic medication: a register-linked follow-up study among employees.

    Loponen, Tiina; Lallukka, Tea; Holstila, Ansku; Lahti, Jouni

    2015-10-03

    Physical activity level and overweight have shown associations with mental health problems but it is not known whether the risk of mental health problems due to overweight varies by physical activity. We examined joint association of physical activity and overweight with subsequent psychotropic medication among 40-60-year-old employees. The questionnaire survey data were derived from Helsinki Health Study baseline postal questionnaires in 2000-02 among employees of the City of Helsinki aged 40-60 years (n = 8960, response rate 67%). Baseline survey data were linked with prospective register data on prescribed psychotropic medication (ATC-codes N05 and N06, except N06D) among those with written consent (74%) for such linkage. The analyses included 6169 responders (78% women, corresponding to the target population). We divided participants into six groups according to their baseline self-reported body mass index and leisure-time physical activity using physically highly active normal-weight participants as a reference group. We used Cox regression analysis adjusted for age, gender, psychotropic medication prior to baseline, and socioeconomic position, marital status, working conditions, limiting long-standing illness, alcohol use, and smoking. At baseline, 49% were overweight and 23% were physically inactive. After adjusting for age and gender, inactive normal-weight (hazard ratio (HR) 1.3, 95% CI 1.1-1.5), moderately active overweight (HR 1.3, 95% CI 1.1-1.5) and inactive overweight (HR 1.4, 95% CI 1.2-1.6) had higher risk for any psychotropic medication compared with group of highly active normal-weight. After adjusting for prior medication, only the inactive overweight group had higher risk (HR 1.4, 95% CI 1.2-1.6). Other covariates made but a minor contribution to the examined associations. For antidepressants the associations were somewhat stronger than for sedatives. Both normal-weight and physical activity help prevent psychotropic medication but physical

  19. Clinical and ultrasonographic features associated to response to intraarticular corticosteroid injection. A one year follow up prospective cohort study in knee osteoarthritis patient with joint effusion.

    Calvet, Joan; Orellana, Cristóbal; Galisteo, Carlos; García-Manrique, María; Navarro, Noemí; Caixàs, Assumpta; Larrosa, Marta; Gratacós, Jordi

    2018-01-01

    Intraarticular injection is used for pain relief in knee osteoarthritis (OA), but there is not a well defined profile of patient who could get more benefit from it. The purpose of this study was to evaluate the frequency of pain relief at one year after corticosteroids intraarticular injection and to identify clinical factors associated to response in patients with knee osteoarthritis with joint effusion. One-year prospective cohort study of patients with knee OA with joint effusion confirmed by ultrasound. An intraarticular injection was performed following a clinical protocol. Anthropometric measurements, laboratory parameters, clinical severity, ultrasound parameters and radiological severity were collected. Response regarding pain and presence of synovial fluid on ultrasound at one month and at one year were evaluated. Clinical responder were consider in subjects with enough improvement to carry out normal daily activities with pain VAS<40mm. One hundred and thirty-two patients were included.A significant number of patients (61.4%) improved pain at one year following the protocol established in this study. Pain and ultrasound synovial fluid at one month appeared to predict the response at one year. The Lequesne index and the percentage of body fat were independently associated to pain at one year while the Lequesne index and ultrasound synovial hypertrophy were independently related to the presence of synovial fluid at one year. The status regarding pain or ultrasound synovial fluid at one month after an intraarticular joint injection appeared to predict the status at one year in patients with knee osteoarthritis and synovial effusion.

  20. Association Between History of Multiple Concussions and Health Outcomes Among Former College Football Players: 15-Year Follow-up From the NCAA Concussion Study (1999-2001).

    Kerr, Zachary Y; Thomas, Leah C; Simon, Janet E; McCrea, Michael; Guskiewicz, Kevin M

    2018-06-01

    Previous research has examined associations between concussion history and adverse health outcomes among former professional football players. Less is known about the potential effects of concussion among former college football players without additional exposure at the professional level. To examine the association between concussion and adverse health outcomes in a cohort of former college football players without exposure to professional football, 15 years after their playing careers ended. Cross-sectional study; Level of evidence, 3. A sample of 204 former collegiate football players (23.4% of eligible athletes with available contact information)-all of whom played at least 1 season of football from 1999 to 2001 in the National Collegiate Athletic Association (NCAA) and had no professional football exposure-completed a general health survey that assessed lifetime concussion history and included the following: the Veterans RAND 36 Item Health Survey, containing a physical composite score (PCS) and mental composite score (MCS); the depression module of the Patient Health Questionnaire; and the 4-item CAGE alcohol dependence questionnaire (for "cutting down, annoyance by criticism, guilty feeling, and eye-openers"). Multivariable binomial regression models estimated adjusted prevalence ratios (PRs) with 95% CIs while controlling for demographics and playing history covariates through forward selection model building. Most participants reported a concussion history (84.3%). Overall, 22.1% and 39.2% of participants reported a PCS and an MCS history of multiple concussions and adverse health outcomes were found among former collegiate football players without professional football exposure but were limited to those reporting ≥3 prior concussions. Because only 23.4% of eligible athletes responded to the survey, the possibility of ascertainment bias exists, and our findings should thus be interpreted with some caution. Continued examination within nonprofessional

  1. Incidence and association factors for the development of chronic post-hysterectomy pain at 4- and 6-month follow-up: a prospective cohort study

    Sng BL

    2018-03-01

    Full Text Available Ban Leong Sng,1,2 Yin Ying Ching,3 Nian-Lin R Han,4 Farida Binte Ithnin,1 Rehena Sultana,5 Pryseley Nkouibert Assam,6 Alex Tiong Heng Sia1,2 1Department of Women’s Anaesthesia, KK Women’s and Children’s Hospital, Singapore, Singapore; 2Duke-NUS Medical School, Singapore, Singapore; 3Ministry of Health Holdings, Singapore, Singapore; 4Division of Clinical Support Services, KK Women’s and Children’s Hospital, Singapore, Singapore; 5Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore; 6Singapore Clinical Research Institute, Singapore, Singapore Abstract: Chronic pain has major adverse effects on health-related quality of life and contributes to significant socioeconomic burden. Hysterectomy is a very common gynecological surgery, resulting in chronic post-hysterectomy pain (CPHP, an important pain syndrome. We conducted a prospective cohort study in 216 Asian women who underwent abdominal or laparoscopic hysterectomy for benign conditions. Demographic, psychological, and perioperative data were recorded. Postoperative 4- and 6-month phone surveys were conducted to assess the presence of CPHP and functional impairment. The incidence rates of CPHP at 4 and 6 months were 32% (56/175 and 15.7% (25/159, respectively. Women with CPHP at 4 and 6 months had pain that interfered with their activities of daily living. Independent association factors for CPHP at 4 months were higher mechanical temporal summation score, higher intraoperative morphine consumption, higher pain score in the recovery room, higher pain score during coughing and itching at 24 hours postoperatively, and preoperative pain in the lower abdominal region. Independent association factors for CPHP at 6 months were preoperative pain during sexual intercourse, higher mechanical temporal summation score, and higher morphine consumption during postoperative 24 and 48 hours. In a majority of cases, CPHP resolved with time, but may have significant impact on

  2. Association between vestibulo-ocular reflex suppression, balance, gait, and fall risk in ageing and neurodegenerative disease: protocol of a one-year prospective follow-up study.

    Srulijes, Karin; Mack, David J; Klenk, Jochen; Schwickert, Lars; Ihlen, Espen A F; Schwenk, Michael; Lindemann, Ulrich; Meyer, Miriam; Srijana, K C; Hobert, Markus A; Brockmann, Kathrin; Wurster, Isabel; Pomper, Jörn K; Synofzik, Matthis; Schneider, Erich; Ilg, Uwe; Berg, Daniela; Maetzler, Walter; Becker, Clemens

    2015-10-09

    Falls frequency increases with age and particularly in neurogeriatric cohorts. The interplay between eye movements and locomotion may contribute substantially to the occurrence of falls, but is hardly investigated. This paper provides an overview of current approaches to simultaneously measure eye and body movements, particularly for analyzing the association of vestibulo-ocular reflex (VOR) suppression, postural deficits and falls in neurogeriatric risk cohorts. Moreover, VOR suppression is measured during head-fixed target presentation and during gaze shifting while postural control is challenged. Using these approaches, we aim at identifying quantitative parameters of eye-head-coordination during postural balance and gait, as indicators of fall risk. Patients with Progressive Supranuclear Palsy (PSP) or Parkinson's disease (PD), age- and sex-matched healthy older adults, and a cohort of young healthy adults will be recruited. Baseline assessment will include a detailed clinical assessment, covering medical history, neurological examination, disease specific clinical rating scales, falls-related self-efficacy, activities of daily living, neuro-psychological screening, assessment of mobility function and a questionnaire for retrospective falls. Moreover, participants will simultaneously perform eye and head movements (fixating a head-fixed target vs. shifting gaze to light emitting diodes in order to quantify vestibulo-ocular reflex suppression ability) under different conditions (sitting, standing, or walking). An eye/head tracker synchronized with a 3-D motion analysis system will be used to quantify parameters related to eye-head-coordination, postural balance, and gait. Established outcome parameters related to VOR suppression ability (e.g., gain, saccadic reaction time, frequency of saccades) and motor related fall risk (e.g., step-time variability, postural sway) will be calculated. Falls will be assessed prospectively over 12 months via protocols and

  3. Follow-up study of memory deficits after ECT.

    Shellenberger, W; Miller, M J; Small, I F; Milstein, V; Stout, J R

    1982-06-01

    Twenty-four patients received ECT induced by either alternating sine wave or brief pulsed-square wave stimulus and were evaluated at follow-up for clinical functioning and subjective memory loss. The hypothesis of less memory loss in the group receiving a weaker stimulus (pulsed-square wave) was not supported. The two treatment groups and a group of controls showed no significant differences on the memory test. On measures of clinical functioning the sine wave group scored better on every measure than the square wave group, although not significantly better.

  4. Reversal reaction in borderline leprosy is associated with a polarized shift to type 1-like Mycobacterium leprae T cell reactivity in lesional skin: a follow-up study

    Verhagen, C. E.; Wierenga, E. A.; Buffing, A. A.; Chand, M. A.; Faber, W. R.; Das, P. K.

    1997-01-01

    Borderline leprosy patients often undergo acute changes in immune reactivity that manifest as reversal reaction (RR) in the course of the disease. RR is associated with an exacerbated local delayed-type cellular immune response to Mycobacterium leprae and is responsible for severe tissue damage. We

  5. Pregnancy-associated plasma protein A in a large cohort of Type 1 diabetic patients with and without diabetic nephropathy-a prospective follow--up study

    Astrup, A S; Tarnow, L; Christiansen, M

    2007-01-01

    AIM: Pregnancy-associated plasma protein A (PAPP-A) has been implicated in the aetiology of acute coronary syndromes and carotid and peripheral artherosclerosis. Diabetic nephropathy is characterized by increased cardiovascular risk. We investigated the prognostic value of PAPP-A in a large cohor...

  6. Rapid report on methodology: does loss to follow-up in a cohort study bias associations between early life factors and lifestyle-related health outcomes?

    Osler, Merete; Kriegbaum, Margit; Christensen, Ulla

    2008-01-01

    -life characteristics and these two health outcomes were calculated in the entire cohort and among responders, and the effect of non-response was described by a Relative Odd Ratio (ROR=OR(responders)/OR(entire cohort)). RESULTS: A low response rate at age 50 years was related to having a single mother at birth, low...... educational attainment at age 18, and low cognitive function at ages 12 and 18. The risk of alcohol overuse and tobacco-related diseases was also highest among non-responders. However, the associations between early-life characteristics and the outcomes were nearly the same in responders as in the entire...

  7. Association of Multiple Melanocytic Naevi with Education, Sex and Skin Type. A Northern Finland Birth Cohort 1966 Study with 46 Years Follow-up.

    Sinikumpu, Suvi-Päivikki; Huilaja, Laura; Jokelainen, Jari; Auvinen, Juha; Timonen, Markku; Tasanen, Kaisa

    2017-02-08

    Having multiple melanocytic naevi (sex, socioeconomic status (education) in childhood and adulthood, skin type and sunbathing habits. The prevalence of multiple melanocytic naevi was 11.6% (223/1,930). Higher education (odds ratio (OR) 2.11, 95% confidence interval (95% CI) 1.51-2.96), male sex (OR 1.48, 95% CI 1.07-2.06), sun-sensitive skin type (OR 2.09, 95% CI 1.34-3.27) and regular use of sunscreen (OR 2.03, 95% CI 1.23-3.37) were associated with increased risk of multiple naevi. Inflammatory skin diseases decreased (OR 0.49, 95 CI% 0.33-0.72) the risk of multiple naevi. In conclusion, several risk factors were found for multiple naevi among adults living in high latitudes, in Northern Finland.

  8. Attitudes to medication after kidney transplantation and their association with medication adherence and graft survival: a 2-year follow-up study

    M. Moors-Tielen (Mirjam); N.J.A. van Exel (Job); M. Hol - Laging (Mirjam); D.K. Beck (Denise); R. Khemai (Roshni); T. van Gelder (Teun); M.G.H. Betjes (Michiel); W. Weimar (Willem); E.K. Massey (Emma)

    2014-01-01

    textabstractBackground. Nonadherence to medication is a common problem after kidney transplantation. The aim of this study was to explore attitudes towards medication, adherence, and the relationship with clinical outcomes. Method. Kidney recipients participated in a Q-methodological study 6 weeks

  9. Follow up study and interested cases in subdural hematoma

    Kano, Mitsumasa; Goh, Jyunto; Koomura, Eiji; Nakao, Kazutami

    1983-01-01

    1. Out of 67 patients ranging from 16 to 82 years old, 20 were followed up by CT scan after operation. 2. Five patients presented hematoma on the both sides after operation, though they had suffered from the lesion of one side before operation. In four patients, hematoma was observed on the both sides before and after operation. Neither preoperative involved side changed nor hematoma appeared on the opposite side after operation in 11 patients. Follow-up examinations lasted up almost three months. 3. The maximum width of the subdural space was divided by the maximum intracranial width. These two factors were measured on horizontal CT scan. The calculated value was expressed in percentage and then, the result was regarded as Subdural Space (SDS) Index. Dividing a difference between the largest SDS Index (before operation) and the smallest by the number of days between the two points gave us a reduction rate of SDS Index. As a result, a reduction rate of 0.4 or less was obtained in all the patients less than 65 years old. There were three patients within the range from 0.7 to 1.0 of the rate. 76-year-old patients showed 2.6 and 5.7. Except the 76-old patients, mean duration of 35.5 days was calculated in Group I and SDS Index was 0, while Group II showed mean duration of 52.4 days, resulting in SDS Index of 0. 4. Specific progresses are shown below: 1) Hemorrhage of the caudate nucleus after operation 2) Subdural effusion of the both sides 3) Appearance of abscess 4) Subtentrial hemorrhage after operation 5) Postoperative epidural hematoma 6) Traumatic intracerebral hemorrhage, resulting in chronic subdural hematoma six months afterward (author)

  10. Follow-up study on histogenesis of microcephaly associated with ectopic gray matter induced by prenatal γ-irradiation in the mouse

    Sun, Xue-Zhi; Inouye, Monoru; Takagishi, Yoshiko

    1996-01-01

    Brain malformation with ectopic gray matter was visualized with magnetic resonance imaging in small-sized heads of prenatally exposed atomic bomb survivors. The identical brain malformation was reproduced in mice and its histogenesis was studied in the present experiment. Pregnant mice were exposed to 60 Co γ-irradiation at a single dose of 1.5 Gy on embryonic day 13 (E13), and then injected intraperitoneally with 30 mg/kg BrdU on E15. The extensive dead cells appeared throughout the brain mantle at 6 hours (h) after exposure. On E16 cell aggregations formed rosettes. On E18 a high proportion of BrdU-labeled cells reached the superficial layers of the cortical plate with the remaining cells located in the ectopic neuronal masses. The quantitative study showed that labeled cells in layers II to III were fewer and those in layers IV to VI more numerous in the prenatally irradiated adult mice than in controls. The anti-GFAP immunostaining revealed that the glial fibers in the irradiated mice were preserved, but disorganized. These findings suggested that the majority of migrating neurons were able to arrive at their normal layers, but some neurons remained due to the interrupted migratory pathway and eventually formed ectopic neuronal masses beneath the subcortical white matter. 60 refs., 5 figs., 1 tab

  11. Contraceptive utilization and associated factors among HIV positive women on chronic follow up care in Tigray Region, Northern Ethiopia: a cross sectional study.

    Yohannes Adama Melaku

    Full Text Available BACKGROUND: In sub-Sahara Africa, more than 60% of all new HIV infections are occurring in women, infants and young children. Maternal to child transmission is responsible for 90% of childhood HIV infection. Preventing unwanted pregnancy among HIV positive women is imperative to reduce maternal and infant morbidity and mortality. METHODS: A cross-sectional survey was conducted among 964 HIV positive women in selected 12 health centers of Tigray region. In this paper, analysis was restricted only for 847 women who were sexually active and non-pregnant. In each health center the number of study participants was allocated proportionally to the load of HIV positive women in chronic care clinics. The data were entered into EpiData version 3.1, and cleaned and analyzed using Stata version 11.1. Descriptive summary of data and logistic regression were used to identify possible predictors using odds ratio with 95% confidence interval and P-value of 0.05. FINDINGS: Three hundred ninety four (46.5% of all HIV positive women had intension to have more children. Three hundred seventy five (44.3% were using contraceptive methods at time of survey. Injectable (70.7% and male condom (47.6% were most commonly used type of contraceptives. In the multivariable analysis, women who were urban dwellers (AOR = 2.55; 95% CI: 1.27, 5.02, completed primary education (AOR = 2.27; 95% CI: 1.12, 2.86 and those openly discussed about contraceptive methods with their husbands or sexual partners (AOR = 6.3; 95% CI: 3.42, 11.76 were more likely to use contraceptive. Women who have one or more living children were also more likely to use contraceptive compared with women with no child. CONCLUSION: Less than half of women used contraceptive methods. The use of condoms could impact unintended pregnancies and reduced risks of vertical and sexual transmission. Efforts to increase contraceptive utilization focusing on the barrier methods should be strengthen in HIV

  12. Thyroid carcinoma: A follow-up study of 11 years

    Ritzl, F.; Siebers, G.; Neumann, C.; Ritzl, E.K.

    1987-01-01

    During a follow-up of 11 years of thyroid carcinoma 136 patients were repeatedly examined. 43% papillary, 43% follicular, 11% anaplastic and 2% medullary carcinomas was found. The incidence of these types of carcinoma differed considerably; the frequency peak of papillary carcinomas was reached in 45-year-old humans, that of the follicular carcinomas in people aged 60, that of the anaplastic carcinomas in 70-year-old humans. 84% of the patients was female. Classification in pTNM-system: 8% in pT1, 27% in pT2, 12% in pT3 and 49% in pT4. Local and distant metastases were found at a low rate equally in pT1, pT2 and pT3; 26% of patients in pT4 had local metastases and 18% had distant ones in addition. There were 6 patients with metastases of a differentiated adenocarcinoma accumulating no 131-iodine and with no thyroglobulin in serum. 29% of patients had after thyroidectomy an unilateral paresis of the nervus recurrens and 4% a bilateral one. 26% of patients had a permanent hypoparathyroidism after thyroidectomy. (orig.)

  13. Thyroid carcinoma: A follow-up study of 11 years

    Ritzl, F.; Siebers, G.; Neumann, C.; Ritzl, E.K.

    1987-09-01

    During a follow-up of 11 years of thyroid carcinoma 136 patients were repeatedly examined. 43% papillary, 43% follicular, 11% anaplastic and 2% medullary carcinomas was found. The incidence of these types of carcinoma differed considerably; the frequency peak of papillary carcinomas was reached in 45-year-old humans, that of the follicular carcinomas in people aged 60, that of the anaplastic carcinomas in 70-year-old humans. 84% of the patients was female. Classification in pTNM-system: 8% in pT1, 27% in pT2, 12% in pT3 and 49% in pT4. Local and distant metastases were found at a low rate equally in pT1, pT2 and pT3; 26% of patients in pT4 had local metastases and 18% had distant ones in addition. There were 6 patients with metastases of a differentiated adenocarcinoma accumulating no 131-iodine and with no thyroglobulin in serum. 29% of patients had after thyroidectomy an unilateral paresis of the nervus recurrens and 4% a bilateral one. 26% of patients had a permanent hypoparathyroidism after thyroidectomy.

  14. Association between subjective memory complaints and health care utilisation: a three-year follow up

    Waldorff, Frans Boch; Siersma, Volkert; Waldemar, Gunhild

    2009-01-01

    their general practitioner and reporting subjective memory complaints (SMC). METHODS: This study was conducted as a prospective cohort survey in general practice with three-year follow-up. Selected health care utilisation or costs relative to SMC adjusted for potential confounders were analyzed in a two......BACKGROUND: Subjective memory complaints (SMC) are common among elderly patients and little is know about the association between SMC and health care utilisation. Thus, the aim of this study was to investigate health care utilisation during a three-year follow-up among elderly patients consulting......-part model where the incidence of use of a selected health care service were analyzed separately from the quantity of use for those that use the service. The former analyzed in a Poisson regression approach, the latter in a generalized linear regression model. RESULTS: A total 758 non-nursing home residents...

  15. Association between subjective memory complaints and nursing home placement: a four-year follow-up

    Waldorff, Frans Boch; Siersma, Volkert; Waldemar, Gunhild

    2009-01-01

    nursing home placements were observed. Subjective memory complaints were associated with an adjusted Hazard Ratio (HR) of 2.59 for nursing home placement. Other statistical significant covariates were MMSE depression...... (HR = 4.74). The effect of subjective memory complaints is seen to moderate when subjects are older. CONCLUSION: The data of this study indicated that in an elderly primary care population the presence of subjective memory complaints was a significant independent predictor for nursing home placement......OBJECTIVE: In order to evaluate whether elderly persons with subjective memory complaints may be regarded as a group of potentially vulnerable patients who need close follow-up, we investigated the risk of nursing home placement during a 4-year follow-up period. METHODS: Prospective cohort survey...

  16. A history of childhood trauma is associated with slower improvement rates: Findings from a one-year follow-up study of patients with a first-episode psychosis.

    Aas, Monica; Andreassen, Ole A; Aminoff, Sofie R; Færden, Ann; Romm, Kristin L; Nesvåg, Ragnar; Berg, Akiah O; Simonsen, Carmen; Agartz, Ingrid; Melle, Ingrid

    2016-05-04

    The aim of this study was to investigate whether childhood trauma was associated with more severe clinical features in patients with first-episode psychosis, both at the initial assessment and after one year. Ninety-six patients with a first-episode of a DSM-IV diagnosis of psychosis, in addition to 264 healthy controls from the same catchment area, were recruited to the TOP NORMENT study. A history of childhood trauma was obtained using the Childhood Trauma Questionnaire (CTQ). Function and symptom severity were measured using the Global Assessment of Functioning (GAF) Scale divided into function (GAF-F) and symptoms (GAF-S), the Positive and Negative Syndrome Scale (PANSS) and the Young Mania Rating Scale (YMRS). All clinical assessments were completed at two time points: At an initial assessment within the first year of initiating treatment for psychosis and after one year. Childhood trauma was associated with significantly reduced global functioning and more severe clinical symptoms at both baseline and follow-up, whereas emotional neglect was associated with a significantly reduced improvement rate for global functioning (GAF-F) over the follow-up period. Our data indicate that patients with first-episode psychosis who report a history of childhood trauma constitute a subgroup characterized by more severe clinical features over the first year of treatment, as well as slower improvement rates.

  17. The Dutch Bipolar Offspring Study : 12-Year Follow-Up

    Mesman, Esther; Nolen, Willem A.; Reichart, Catrien G.; Wals, Marjolein; Hillegers, Manon N. J.

    Objective: Offspring of bipolar parents have a genetically increased risk of developing mood disorders. In a longitudinal study, the authors followed a bipolar offspring cohort from adolescence into adulthood to determine the onset, prevalence, and early course of mood disorders and other

  18. A Case Study: Follow-Up Assessment of Facilitated Communication.

    Simon, Elliott W.; And Others

    1996-01-01

    This study of an adolescent with multiple disabilities, including moderate mental retardation, who was reported to engage in validated facilitated communication (FC) found he did not engage in validated FC; performance was equivalent whether food or nonfood reinforcers were used; and the Picture Exchange Communication System was a valid and…

  19. Berekening van levensverwachting uit mortaliteits follow-up studies

    Hoogenveen RT; Schuit AJ; Visscher TLS; Feskens EJM; Nagelkerke NJD; CCM

    1998-01-01

    Survival analyses of longitudinal studies make often use of the Cox proportional hazards model. Mortality differences between risk groups are presented in terms of estimated regression coefficients or relative risks. The research question relates to the presentation of mortality differences in terms

  20. Hydrotherapy after total hip arthroplasty: a follow-up study.

    Giaquinto, S; Ciotola, E; Dall'armi, V; Margutti, F

    2010-01-01

    The aim of the study was to evaluate the subjective functional outcome of total hip arthroplasty (THA) in patients who underwent hydrotherapy (HT) 6 months after discharge. A prospective randomized study was performed on 70 elderly inpatients with recent THA, who completed a rehabilitation program. After randomization, 33 of them were treated in conventional gyms (no-hydrotherapy group=NHTG) and 31 received HT (hydrotherapy group=HTG). Interviews with the Western-Ontario MacMasters Universities Osteoarthritis Index (WOMAC) were performed at admission, at discharge and 6 months later. Kruskal-Wallis, Mann-Whitney and Wilcoxon tests were applied for statistical analysis. Both groups improved. Pain, stiffness and function were all positively affected. Statistical analysis indicated that WOMAC sub-scales were significantly lower for all patients treated with HT. The benefits at discharge still remained after 6 months. We conclude that HT is recommended after THA in a geriatric population.

  1. The Dutch Bipolar Offspring Study: 12-Year Follow-Up

    Mesman, Esther; Nolen, Willem A.; Reichart, Catrien G.; Wals, Marjolein; Hillegers, Manon N. J.

    2013-01-01

    Objective: Offspring of bipolar parents have a genetically increased risk of developing mood disorders. In a longitudinal study, the authors followed a bipolar offspring cohort from adolescence into adulthood to determine the onset, prevalence, and early course of mood disorders and other psychopathology. Method: The Dutch bipolar offspring cohort is a fixed cohort initiated in 1997 (N=140; age range at baseline, 12-21 years). Bipolar offspring were psychiatrically evaluated at baseline and a...

  2. On Suggestibility and Placebo: A Follow-Up Study.

    Lifshitz, Michael; Sheiner, Eli O; Olson, Jay A; Thériault, Rémi; Raz, Amir

    2017-04-01

    Identifying what makes some people respond well to placebos remains a major challenge. Here, we attempt to replicate an earlier study in which we found a relationship between hypnotic suggestibility and subjective ratings of relaxation following the ingestion of a placebo sedative (Sheiner, Lifshitz, & Raz, 2016). To assess the reliability of this effect, we tested 34 participants using a similar design. Participants ingested a placebo capsule in one of two conditions: (1) relaxation, wherein we described the capsule as a herbal sedative, or (2) control, wherein we described the capsule as inert. To index placebo response, we collected measures of blood pressure and heart rate, as well as self-report ratings of relaxation and drowsiness. Despite using a similar experimental design as in our earlier study, we were unable to replicate the correlation between hypnotic suggestibility and placebo response. Furthermore, whereas in our former experiment we observed a change in subjective ratings of relaxation but no change in physiological measures, here we found that heart rate dropped in the relaxation condition while subjective ratings remained unchanged. Even within a consistent context of relaxation, therefore, our present results indicate that placebos may induce effects that are fickle, tenuous, and unreliable. Although we had low statistical power, our findings tentatively accord with the notion that placebo response likely involves a complex, multifaceted interaction between traits, expectancies, and contexts.

  3. Scala tympani cochleostomy survey: a follow-up study.

    Iseli, Claire; Adunka, Oliver F; Buchman, Craig A

    2014-08-01

    To reassess cochleostomy techniques among North American cochlear implant surgeons after a 6-year period of widespread education and research on the topic. Prospective cohort study. A multiple-choice survey of cochlear implant techniques was distributed to surgeons attending the William House Cochlear Implant Study Group in 2006 and 2012. This survey contained questions regarding routine surgical access and cochleostomy techniques. Responses were anonymous, and >50% were repeat respondents. Statistical analysis sought changes in technique in the past 6 years. Comparisons between 2006 and 2012 responses revealed no significant changes in the proportion of surgeons identifying the facial nerve or chorda tympani. By contrast, respondents in 2012 were more likely to drill off the round window niche overhang (P < .001), use a round window insertion (P < .001), or make a smaller cochleostomy (P = .003). In two images of a transfacial recess approach, there was a significant increase in the proportion choosing an inferior or anterior cochleostomy site over a superior location (image 1, 76% in 2006 to 92% in 2012, P = .003; image 3, 78% to 90%, respectively, P = .044). This repeat survey documents a change in practice among cochlear implant surgeons. Specifically, scala tympani access techniques now appear to be more consistent with known anatomical relationships in the round window region. These findings may have resulted from the concerted education and research efforts over the past 6 years. © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  4. Long-time follow-up study of localized gastric mucosa-associated lymphoid tissue (MALT) lymphoma and the clinical features of antibiotic-resistant cases of gastric MALT lymphoma

    Akamatsu, Taiji; Sano, Kenji; Suzawa, Ken-ichi; Kaneko, Yasunori; Shikama, Naoto; Ota, Hiroyoshi; Miyabayashi, Hideharu

    2007-01-01

    To clarify the clinical features of gastric mucosa-associated lymphoid tissue (MALT) lymphoma (GML) with persistent lymphoma after eradication therapy of Helicobacter pylori (H. pylori), and the outcome of long-time follow-up study after treatment against GML, seventy-six patients with localized GML were studied. The median follow-up period was 44.4 months. Thirty-eight of 49 patients (77.6%) with H. pylori-positive GML had been cured of GML by antibiotic therapy alone. On the other hand, none of 13 patients with H. pylori-negative GML had been cured by antibiotic therapy (77.6% vs 0%, p<0.001). ''H. pylori-negative'' is one of the clinical features of antibiotic-resistant cases with GML. There was no significant difference in sex, age, stage, endoscopic finding, depth, and affected region between the two groups of cured and persistent GML with H. pylori infection. Twenty-two of 29 patients (75.6%) with antibiotic-resistant or H. pylori-negative cases of GML had been cured by 30 Gy radiation therapy. Low-dose radiation was thought to be a useful therapeutic procedure as a second line treatment'' of localized GML. (author)

  5. Effects of Medical Interventions on Gender Dysphoria and Body Image: A Follow-Up Study.

    van de Grift, Tim C; Elaut, Els; Cerwenka, Susanne C; Cohen-Kettenis, Peggy T; De Cuypere, Griet; Richter-Appelt, Hertha; Kreukels, Baudewijntje P C

    2017-09-01

    The aim of this study from the European Network for the Investigation of Gender Incongruence is to investigate the status of all individuals who had applied for gender confirming interventions from 2007 to 2009, irrespective of whether they received treatment. The current article describes the study protocol, the effect of medical treatment on gender dysphoria and body image, and the predictive value of (pre)treatment factors on posttreatment outcomes. Data were collected on medical interventions, transition status, gender dysphoria (Utrecht Gender Dysphoria Scale), and body image (Body Image Scale for transsexuals). In total, 201 people participated in the study (37% of the original cohort). At follow-up, 29 participants (14%) did not receive medical interventions, 36 hormones only (18%), and 136 hormones and surgery (68%). Most transwomen had undergone genital surgery, and most transmen chest surgery. Overall, the levels of gender dysphoria and body dissatisfaction were significantly lower at follow-up compared with clinical entry. Satisfaction with therapy responsive and unresponsive body characteristics both improved. High dissatisfaction at admission and lower psychological functioning at follow-up were associated with persistent body dissatisfaction. Hormone-based interventions and surgery were followed by improvements in body satisfaction. The level of psychological symptoms and the degree of body satisfaction at baseline were significantly associated with body satisfaction at follow-up.

  6. The association between compliance with recommended follow-up and glaucomatous disease severity in a county hospital population.

    Ung, Cindy; Murakami, Yohko; Zhang, Elisa; Alfaro, Tatyana; Zhang, Monica; Seider, Michael I; Singh, Kuldev; Lin, Shan C

    2013-08-01

    To assess the association between insufficient follow-up and clinical parameters such as disease severity and medication use among glaucoma patients at a metropolitan county hospital. Cross-sectional study. Two-hundred and six patients with established glaucoma were recruited from San Francisco General Hospital. Subjects were classified based on compliance with recommended follow-up examination intervals over the year preceding commencement of the study, as determined by patient medical records. Glaucoma severity was determined based on the American Academy of Ophthalmology Preferred Practice Patterns guidelines. Multivariate logistic regression analysis was used to assess the relationship between adherence with follow-up visits and disease severity. After adjustment for the impact of potential confounding variables, subjects with severe glaucomatous disease were found to have been less adherent to their recommended follow-up than those patients with mild or moderate glaucomatous disease (adjusted OR 1.89, 95% CI 1.21-2.94; P = .01). Subjects who were on glaucoma medications were found to be less adherent to follow-up recommendations (adjusted OR 3.29, 95% CI 1.41-7.65, P = .01). Subjects with poor follow-up adherence were significantly more likely to have severe glaucomatous disease, suggesting that poor follow-up may contribute to disease worsening or, alternatively, those with more severe disease are less inclined to follow up at appropriate intervals. Published by Elsevier Inc.

  7. Recovery, relapse, or else? Treatment outcomes in gambling disorder from a multicenter follow-up study.

    Müller, K W; Wölfling, K; Dickenhorst, U; Beutel, M E; Medenwaldt, J; Koch, A

    2017-06-01

    Gambling disorder is associated with various adverse effects. While data on the immediate effectiveness of treatment programs are available, follow-up studies examining long-term effects are scarce and factors contributing to a stable therapy outcome versus relapse are under-researched. Patients (n=270) finishing inpatient treatment for gambling disorder regularly participated in a prospective multicenter follow-up study (pre-treatment, post-treatment, 12-month follow-up). Criteria for gambling disorder, psychopathology, functional impairment were defined as endpoints. Changes in personality were defined as an additional parameter. At follow-up, three groups were identified: subjects maintaining full abstinence (41.6%), patients still meeting criteria for gambling disorder (29.2%), and subjects still participating in gambling without meeting the diagnostic criteria for gambling disorder (29.2%). Every group had improvements in functional impairment, abstinent subjects showed the lowest psychopathology. Significant decreases in neuroticism and increases in both extraversion and conscientiousness were found among abstinent subjects but not in patients still meeting criteria for gambling disorder. One year after treatment, a considerable percentage of patients kept on gambling but not all of them were classified with gambling disorder leading to the question if abstinence is a necessary goal for every patient. The changes of personality in abstinent patients indicate that after surmounting gambling disorder a subsequent maturing of personality might be a protective factor against relapse. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Association of midlife value priorities with health-related quality of life, frailty and mortality among older men: a 26-year follow-up of the Helsinki Businessmen Study (HBS).

    Urtamo, Annele; Kautiainen, Hannu; Pitkälä, Kaisu H; Strandberg, Timo E

    2018-05-01

    Personal values influence behavior and decision making, but their long-term associations with health-related quality of life (HRQoL), frailty, and mortality are less clear. We studied these associations from midlife to old age in a 26-year follow-up of the Helsinki Businessmen Study (HBS) cohort. In 1974, 1320 clinically healthy men (born 1919-1934) reported in a 12-item questionnaire their personal values. In 2000, a mailed questionnaire, including assessment of HRQoL with RAND-36 (SF-36) instrument, was sent to survivors, and 1025 men responded. In 2000, the presence of phenotypic frailty was assessed using modified Fried criteria including indicators of shrinking, physical weakness, exhaustion, and physical inactivity. Mortality through December 31, 2000 was verified from national registries. Using a factor analysis, the data of the 12-item questionnaire of personal values were loaded in 3 factors: valuing health ("Health"), enjoyable and varying life ("Enjoyment"), and comfort and work-oriented life ("Work-life-balance"). Adjusted for age, we found a significant positive association between valuing "Health" in midlife and RAND-36 domains of Physical functioning (p = .032) and Vitality (p = .005) in old age. "Health" also predicted less frailty (p = .008), and "Enjoyment" was associated with higher mortality (p = .017). Value priorities of men assessed in midlife had long-term associations with HRQoL and frailty in old age, and they may also predict mortality.

  9. Factors Associated With Follow-Up Attendance Among Rape Victims Seen in Acute Medical Care.

    Darnell, Doyanne; Peterson, Roselyn; Berliner, Lucy; Stewart, Terri; Russo, Joan; Whiteside, Lauren; Zatzick, Douglas

    2015-01-01

    Rape is associated with posttraumatic stress disorder (PTSD) and related comorbidities. Most victims do not obtain treatment for these conditions. Acute care medical settings are well positioned to link patients to services; however, difficulty engaging victims and low attendance at provided follow-up appointments is well documented. Identifying factors associated with follow-up can inform engagement and linkage strategies. Administrative, patient self-report, and provider observational data from Harborview Medical Center were combined for the analysis. Using logistic regression, we examined factors associated with follow-up health service utilization after seeking services for rape in the emergency department. Of the 521 diverse female (n = 476) and male (n = 45) rape victims, 28% attended the recommended medical/counseling follow-up appointment. In the final (adjusted) logistic regression model, having a developmental or other disability (OR = 0.40, 95% CI = 0.21-0.77), having a current mental illness (OR = 0.25, 95% CI = 0.13-0.49), and being assaulted in public (OR = 0.50, 95% CI = 0.28-0.87) were uniquely associated with reduced odds of attending the follow-up. Having a prior mental health condition (OR = 3.02, 95% CI = 1.86-4.91), a completed Sexual Assault Nurse Examiner's (SANE) examination (OR = 2.97, 95% CI = 1.84-4.81), and social support available to help cope with the assault (OR = 3.54, 95% CI = 1.76-7.11) were associated with an increased odds of attending the follow-up. Findings point to relevant characteristics ascertained at the acute care medical visit for rape that may be used to identify victims less likely to obtain posttraumatic medical and mental health services. Efforts to improve service linkage for these patients is warranted and may require alternative service delivery models that engage rape survivors and support posttraumatic recovery.

  10. Bladder dysfunction in multiple sclerosis: a 6-year follow-up study.

    Kisic Tepavcevic, Darija; Pekmezovic, Tatjana; Dujmovic Basuroski, Irena; Mesaros, Sarlota; Drulovic, Jelena

    2017-03-01

    Bladder dysfunction (BD) is the most common autonomic disturbance in multiple sclerosis, but often overlooked and undertreated. The purpose of this longitudinal study was to explore the changes in the frequency of BD symptoms in MS cohort after a period of 3 and 6 years of follow-up, as well as to investigate the correlations between the presence of BD symptoms and both clinical characteristics and the health-related quality of life (HRQoL) at each subsequent point of estimation. The study population comprises a cohort of 93 patients with MS (McDonald's criteria, 2001). At each time point (baseline, and at the 3- and 6-year follow-up) of estimation, Expanded Disability Status Scale, Hamilton Rating Scale for Depression, Fatigue Severity Scale, Szasz Sexual Functioning Scale and HRQoL (measured by MSQoL-54) were assessed. The proportion of patients with at least one symptom of BD significantly increased over time, for both men and women (from 48.1% at baseline to 51.9% after 3 years and to 71.4% after 6 years of follow-up for males and from 45.5% at baseline to 50.0% after 3 years and to 66.7% after 6 years of follow-up for females). The most common BD problem was urgency of urination. The presence of BD was statistically significantly associated with higher level of physical disability, sexual dysfunction and HRQoL at each point of follow-up, for both men and women. Our results suggested outstanding frequency of BD in patients with MS, with increasing tendency over time.

  11. Follow-up brain imaging of 37 children with congenital Zika syndrome: case series study.

    Petribu, Natacha Calheiros de Lima; Aragao, Maria de Fatima Vasco; van der Linden, Vanessa; Parizel, Paul; Jungmann, Patricia; Araújo, Luziany; Abath, Marília; Fernandes, Andrezza; Brainer-Lima, Alessandra; Holanda, Arthur; Mello, Roberto; Sarteschi, Camila; Duarte, Maria do Carmo Menezes Bezerra

    2017-10-13

    Objective  To compare initial brain computed tomography (CT) scans with follow-up CT scans at one year in children with congenital Zika syndrome, focusing on cerebral calcifications. Design  Case series study. Setting  Barão de Lucena Hospital, Pernambuco state, Brazil. Participants  37 children with probable or confirmed congenital Zika syndrome during the microcephaly outbreak in 2015 who underwent brain CT shortly after birth and at one year follow-up. Main outcome measure  Differences in cerebral calcification patterns between initial and follow-up scans. Results  37 children were evaluated. All presented cerebral calcifications on the initial scan, predominantly at cortical-white matter junction. At follow-up the calcifications had diminished in number, size, or density, or a combination in 34 of the children (92%, 95% confidence interval 79% to 97%), were no longer visible in one child, and remained unchanged in two children. No child showed an increase in calcifications. The calcifications at the cortical-white matter junction which were no longer visible at follow-up occurred predominately in the parietal and occipital lobes. These imaging changes were not associated with any clear clinical improvements. Conclusion  The detection of cerebral calcifications should not be considered a major criterion for late diagnosis of congenital Zika syndrome, nor should the absence of calcifications be used to exclude the diagnosis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Poststroke Epilepsy Is Associated With a High Mortality After a Stroke at Young Age: Follow-Up of Transient Ischemic Attack and Stroke Patients and Unelucidated Risk Factor Evaluation Study.

    Arntz, Renate M; Rutten-Jacobs, Loes C A; Maaijwee, Noortje A M; Schoonderwaldt, Hennie C; Dorresteijn, Lucille D A; van Dijk, Ewoud J; de Leeuw, Frank-Erik

    2015-08-01

    Poststroke epilepsy is a common complication after a young stroke. We investigated the association between poststroke epilepsy and mortality. We performed a prospective cohort study among 631 patients with a first-ever transient ischemic attack or ischemic stroke, aged 18 to 50 years. Survival analysis and Cox proportional hazard analysis were used to estimate cumulative mortality and hazard ratios for patients with and without epilepsy. After mean follow-up of 12.5 years (SD 8.6), 76 (12.0%) developed poststroke epilepsy. Case fatality was 27.4% for patients with poststroke epilepsy and 2.1% for those without. Poststroke epilepsy was associated with 30-day mortality (hazard ratio, 4.8; 95% confidence interval, 1.7-14.0) and long-term mortality (hazard ratio, 1.8; 95% confidence interval, 1.2-2.9). Epilepsy is a common problem after a young stroke and is associated with an increased short-term and long-term mortality. © 2015 American Heart Association, Inc.

  13. Adolescence physical activity is associated with higher tibial pQCT bone values in adulthood after 28-years of follow-up--the Cardiovascular Risk in Young Finns Study.

    Tolonen, S; Sievänen, H; Mikkilä, V; Telama, R; Oikonen, M; Laaksonen, M; Viikari, J; Kähönen, M; Raitakari, O T

    2015-06-01

    High peak bone mass and strong bone phenotype are known to be partly explained by physical activity during growth but there are few prospective studies on this topic. In this 28-year follow-up of Cardiovascular Risk in Young Finns Study cohort, we assessed whether habitual childhood and adolescence physical activity or inactivity at the age of 3-18 years were associated with adult phenotype of weight-bearing tibia and the risk of low-energy fractures. Baseline physical activity and data on clinical, nutritional and lifestyle factors were assessed separately for females and males aged 3-6-years (N=395-421) and 9-18-years (N=923-965). At the age of 31-46-years, the prevalence of low-energy fractures was assessed with a questionnaire and several tibial traits were measured with pQCT (bone mineral content (BMC; mg), total and cortical cross-sectional areas (mm(2)), trabecular (for the distal site only) and cortical (for the shaft only) bone densities (mg/cm(3)), stress-strain index (SSI; mm(3), for the shaft only), bone strength index (BSI; mg(2)/cm(4), for the distal site only) and the cortical strength index (CSI, for the shaft only)). For the statistical analysis, each bone trait was categorized as below the cohort median or the median and above and the adjusted odds ratios (OR) were determined. In females, frequent physical activity at the age of 9-18-years was associated with higher adulthood values of BSI, total and cortical areas, BMC, CSI and SSI at the tibia independently of many health and lifestyle factors (ORs 0.33-0.53, P≤0.05; P-values for trend 0.002-0.05). Cortical density at the tibial shaft showed the opposite trend (P-value for trend 0.03). Similarly in males, frequent physical activity was associated with higher values of adult total and cortical areas and CSI at the tibia (ORs 0.48-0.53, P≤0.05; P-values for trend 0.01-0.02). However, there was no evidence that childhood or adolescence physical activity was associated with lower risk of low

  14. Follow-up Assessment of Cognitive Remediation Therapy in Adolescent Anorexia Nervosa: A Pilot Study.

    Herbrich, Laura; van Noort, Betteke; Pfeiffer, Ernst; Lehmkuhl, Ulrike; Winter, Sibylle; Kappel, Viola

    2017-03-01

    Cognitive remediation therapy (CRT) is a specialized treatment approach targeting cognitive weaknesses in anorexia nervosa (AN). Regarding follow-up effects of CRT, there are only few studies available; for adolescents, there are no data. Forty-eight adolescents with AN were assigned to receive either CRT and treatment as usual (TAU) or TAU alone. Assessments were performed at baseline (n = 48) and compared with assessments at a 6-month follow-up (n = 33). Outcome measures were set-shifting, central coherence, eating disorder and general psychopathology. The completion rate was higher in CRT compared with TAU. There were no significant differences in neuropsychological and clinical variables. Changes in body mass index percentile showed a trend towards significance for CRT. Dropout analyses revealed no significant predictors. Results provide a first insight into follow-up-assessments of CRT in adolescent AN. More randomized controlled studies are needed to clarify the long-term effects of CRT. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  15. Workplace bullying and common mental disorders: a follow-up study.

    Lahelma, Eero; Lallukka, Tea; Laaksonen, Mikko; Saastamoinen, Peppiina; Rahkonen, Ossi

    2012-06-01

    Workplace bullying has been associated with mental health, but longitudinal studies confirming the association are lacking. This study examined the associations of workplace bullying with subsequent common mental disorders 5-7 years later, taking account of baseline common mental disorders and several covariates. Baseline questionnaire survey data were collected in 2000-2002 among municipal employees, aged 40-60 years (n=8960; 80% women; response rate 67%). Follow-up data were collected in 2007 (response rate 83%). The final data amounted to 6830 respondents. Workplace bullying was measured at baseline using an instructed question about being bullied currently, previously or never. Common mental disorders were measured at baseline and at follow-up using the 12-item version of the General Health Questionnaire. Those scoring 3-12 were classified as having common mental disorders. Covariates included bullying in childhood, occupational and employment position, work stress, obesity and limiting longstanding illness. Logistic regression analysis was used. After adjusting for age, being currently bullied at baseline was associated with common mental disorders at follow-up among women (OR 2.34, CI 1.81 to 3.02) and men (OR 3.64, CI 2.13 to 6.24). The association for the previously bullied was weaker. Adjusting for baseline common mental disorders, the association attenuated but remained. Adjusting for further covariates did not substantially alter the studied association. CONCLUSION The study confirms that workplace bullying is likely to contribute to subsequent common mental disorders. Measures against bullying are needed at workplaces to prevent mental disorders.

  16. Decrease in self-esteem mediates the association between symptoms of social phobia and depression in middle adolescence in a sex-specific manner: a 2-year follow-up of a prospective population cohort study.

    Väänänen, Juha-Matti; Isomaa, Rasmus; Kaltiala-Heino, Riittakerttu; Fröjd, Sari; Helminen, Mika; Marttunen, Mauri

    2014-03-19

    Social phobia and depression are common, highly comorbid disorders in middle adolescence. The mechanism underlying this comorbidity, however, is unclear. Decrease in self-esteem caused by the initial disorder might play a decisive role in the development of the subsequent disorder. The present study aimed to determine whether the association between symptoms of social phobia and depression is mediated by decrease in self-esteem in mid-adolescent girls and boys. As a part of the prospective Adolescent Mental Health Cohort (AMCH), subjects of this study were 9th grade pupils (mean age, 15.5) responding to a survey conducted in 2002-2003 (T1) and to a 2-year follow-up survey in 2004-2005 (T2) (N = 2070, mean age 17.6 years, 54.5% girls). Symptoms of social phobia without symptoms of depression at age 15 and symptoms of depression at age 17 were associated only among boys, and this association was mediated by decrease in self-esteem. Symptoms of depression without symptoms of social phobia at age 15 and symptoms of social phobia at age 17 were associated only among girls, and this association was partially mediated by decrease in self-esteem. Decrease in self-esteem plays a decisive role in the association between social phobia and depression. Self-esteem should be a key focus in interventions for adolescents suffering from social phobia or depression. Efficient intervention for the first disorder might help to prevent the decline in self-esteem and thus the incidence of the subsequent disorder. These findings are based on a sample of Finnish adolescents and should be confirmed in other jurisdictions or in more ethnically diverse samples.

  17. Association of helicobacter pylori infection and chronic atrophic gastritis with risk of colonic, pancreatic and gastric cancer: A ten-year follow-up of the ESTHER cohort study.

    Chen, Xin-Zu; Schöttker, Ben; Castro, Felipe Andres; Chen, Hongda; Zhang, Yan; Holleczek, Bernd; Brenner, Hermann

    2016-03-29

    To assess the association of H. pylori and chronic atrophic gastritis (AG) with colonic, pancreatic and gastric cancer in a population-based prospective cohort. Serum antibodies against H. pylori in general and specific to cytotoxin-associated gene A (CagA), as well as serum pepsinogen I and II were analyzed in 9,506 men and women, aged 50-75 years in a cohort study from Saarland, Germany. Incident cases of colonic, pancreatic and gastric cancer were ascertained by record linkage with data from the Saarland Cancer Registry. During an average follow-up of 10.6 years, 108 colonic, 46 pancreatic and 27 gastric incident cancers were recorded. There was no association between H. pylori infection and colonic cancer (HR = 1.07; 95% CI 0.73-1.56) or pancreatic cancer (HR = 1.32; 0.73-2.39), regardless of either CagA seropositivity or AG status. In contrast, CagA+ infection was associated with a strongly increased risk of gastric cancer, especially non-cardia gastric cancer, and this association was particularly pronounced in the presence of AG. Compared to people without AG and without CagA+ infection, people with both risk factors had a significantly increased risk of non-cardia gastric cancer (HR = 32.4; 7.6-137.6). This large cohort study did not observe an association of H. pylori infection or AG with colonic or pancreatic cancer, but underlines that the vast majority of non-cardia gastric cancers arise from AG and infection with CagA+ H. pylori strains.

  18. Associations between work-related stress in late midlife, educational attainment, and serious health problems in old age: a longitudinal study with over 20 years of follow-up.

    Nilsen, Charlotta; Andel, Ross; Fors, Stefan; Meinow, Bettina; Darin Mattsson, Alexander; Kåreholt, Ingemar

    2014-08-27

    People spend a considerable amount of time at work over the course of their lives, which makes the workplace important to health and aging. However, little is known about the potential long-term effects of work-related stress on late-life health. This study aims to examine work-related stress in late midlife and educational attainment in relation to serious health problems in old age. Data from nationally representative Swedish surveys were used in the analyses (n = 1,502). Follow-up time was 20-24 years. Logistic regressions were used to examine work-related stress (self-reported job demands, job control, and job strain) in relation to serious health problems measured as none, serious problems in one health domain, and serious problems in two or three health domains (complex health problems). While not all results were statistically significant, high job demands were associated with higher odds of serious health problems among women but lower odds of serious health problems among men. Job control was negatively associated with serious health problems. The strongest association in this study was between high job strain and complex health problems. After adjustment for educational attainment some of the associations became statistically nonsignificant. However, high job demands, remained related to lower odds of serious problems in one health domain among men, and low job control remained associated with higher odds of complex health problems among men. High job demands were associated with lower odds of complex health problems among men with low education, but not among men with high education, or among women regardless of level of education. The results underscore the importance of work-related stress for long-term health. Modification to work environment to reduce work stress (e.g., providing opportunities for self-direction/monitoring levels of psychological job demands) may serve as a springboard for the development of preventive strategies to improve public

  19. Decrease in self-esteem mediates the association between symptoms of social phobia and depression in middle adolescence in a sex-specific manner: a 2-year follow-up of a prospective population cohort study

    2014-01-01

    Background Social phobia and depression are common, highly comorbid disorders in middle adolescence. The mechanism underlying this comorbidity, however, is unclear. Decrease in self-esteem caused by the initial disorder might play a decisive role in the development of the subsequent disorder. The present study aimed to determine whether the association between symptoms of social phobia and depression is mediated by decrease in self-esteem in mid-adolescent girls and boys. Methods As a part of the prospective Adolescent Mental Health Cohort (AMCH), subjects of this study were 9th grade pupils (mean age, 15.5) responding to a survey conducted in 2002–2003 (T1) and to a 2-year follow-up survey in 2004–2005 (T2) (N = 2070, mean age 17.6 years, 54.5% girls). Results Symptoms of social phobia without symptoms of depression at age 15 and symptoms of depression at age 17 were associated only among boys, and this association was mediated by decrease in self-esteem. Symptoms of depression without symptoms of social phobia at age 15 and symptoms of social phobia at age 17 were associated only among girls, and this association was partially mediated by decrease in self-esteem. Conclusions Decrease in self-esteem plays a decisive role in the association between social phobia and depression. Self-esteem should be a key focus in interventions for adolescents suffering from social phobia or depression. Efficient intervention for the first disorder might help to prevent the decline in self-esteem and thus the incidence of the subsequent disorder. These findings are based on a sample of Finnish adolescents and should be confirmed in other jurisdictions or in more ethnically diverse samples. PMID:24641987

  20. What do predict anxiety and depression in breast cancer patients? A follow-up study.

    Vahdaninia, Mariam; Omidvari, Sepideh; Montazeri, Ali

    2010-03-01

    Psychological adjustment following cancer occurrence remains a key issue among the survivors. This study aimed to investigate psychological distress in patients with breast cancer following completion of breast cancer treatments and to determine its associated factors. This was a prospective study of anxiety and depression in breast cancer patients. Anxiety and depression were measured using the Hospital Anxiety and Depression Scale at three points in time: baseline (pre-diagnosis), 3 months after initial treatment and 1 year after completion of treatment (in all 18 months follow-up). At baseline, the questionnaires were administered to all the suspected patients while both patients and the interviewer were blind to the final diagnosis. Socio-demographic and clinical data included age, education, marital status, disease stage and initial treatment. Repeated measure analysis was performed to compare anxiety and depression over the study period. Logistic regression analysis was performed to determine variables that predict anxiety and depression. Altogether 167 patients were diagnosed with breast cancer. The mean age of breast cancer patients was 47.2 (SD = 13.5) years, and the vast majority underwent mastectomy (82.6%). At 18 months follow-up, data for 99 patients were available. The results showed that anxiety and depression improved over the time (P < 0.001) although at 18-month follow-up, 38.4% and 22.2% of the patients presented with severe anxiety and depression, respectively. 'Fatigue' was found to be a risk factor for developing anxiety and depression at 3 months follow-up [odds ratio (OR) = 1.04, 95% Confidence interval (CI) = 1.01-1.07 and OR = 1.04, 95% CI = 1.02-1.07 respectively]. At 18 months follow-up, anxiety was predicted by 'pain' (OR = 1.02, 95% CI = 1.00-1.05), whereas depression was predicted by both 'fatigue' (OR = 1.06, 95% CI = 1.02-1.09) and 'pain' (OR = 1.05, 95% CI = 1.01-1.08). Although the findings indicated that the levels of anxiety and

  1. Serum immunoglobulin A concentration in infancy, but not human milk immunoglobulin A, is associated with subsequent atopic manifestations in children and adolescents: a 20-year prospective follow-up study.

    Pesonen, M; Kallio, M J T; Siimes, M A; Savilahti, E; Ranki, A

    2011-05-01

    Serum and secretory IgA concentrations have been suggested to be inversely associated with allergic symptoms in children. Furthermore, low maternal milk IgA concentration has been suggested to be associated with the development of cow's milk allergy. Our aim was to explore whether the serum IgA concentrations in infancy and the IgA concentration of maternal milk predict atopic manifestations in childhood and up to age 20 years. A cohort of 200 unselected full-term newborns was prospectively followed up from birth to age 20 years with measurement of serum total IgA at ages 2 and 6 months. The mothers were encouraged to maintain exclusive breastfeeding for as long as possible. Total IgA concentration of maternal milk was measured at birth (colostrum, n=169) and at 2 (n=167) and 6 (n=119) months of lactation. The children were re-assessed at ages 5, 11 and 20 years for the occurrence of allergic symptoms, with skin prick testing and measurement of serum IgE. Children and adolescents with respiratory allergic symptoms and sensitization had a higher serum IgA concentration at age 2 months than the non-atopic subjects. Colostrum and breast milk IgA concentrations were not associated with the development of allergic symptoms in the recipient infant. However, maternal milk IgA concentration at 6 months of lactation was inversely associated with elevated serum total IgE and positive skin prick test to tree pollen in the offspring at age 20 years. Increased serum IgA concentration at age 2 months is associated with the development of subsequent allergic symptoms and sensitization in childhood and adolescence. Maternal milk IgA concentrations are not associated with subsequent allergic symptoms in the recipient infant. The present study provides novel information on the role of IgA in the development of respiratory allergy and sensitization. © 2011 Blackwell Publishing Ltd.

  2. Socio-Demographic, Social-Cognitive, Health-Related and Physical Environmental Variables Associated with Context-Specific Sitting Time in Belgian Adolescents: A One-Year Follow-Up Study

    Busschaert, Cedric; Ridgers, Nicola D.; De Bourdeaudhuij, Ilse; Cardon, Greet; Van Cauwenberg, Jelle; De Cocker, Katrien

    2016-01-01

    Introduction More knowledge is warranted about multilevel ecological variables associated with context-specific sitting time among adolescents. The present study explored cross-sectional and longitudinal associations of ecological domains of sedentary behaviour, including socio-demographic, social-cognitive, health-related and physical-environmental variables with sitting during TV viewing, computer use, electronic gaming and motorized transport among adolescents. Methods For this longitudinal study, a sample of Belgian adolescents completed questionnaires at school on context-specific sitting time and associated ecological variables. At baseline, complete data were gathered from 513 adolescents (15.0±1.7 years). At one-year follow-up, complete data of 340 participants were available (retention rate: 66.3%). Multilevel linear regression analyses were conducted to explore cross-sectional correlates (baseline variables) and longitudinal predictors (change scores variables) of context-specific sitting time. Results Social-cognitive correlates/predictors were most frequently associated with context-specific sitting time. Longitudinal analyses revealed that increases over time in considering it pleasant to watch TV (p electronic gaming. Conclusions Future intervention studies aiming to decrease TV viewing and computer use should acknowledge the importance of the behaviour of siblings and the pleasure adolescents experience during these screen-related behaviours. In addition, more time parents or care givers spent sitting may lead to more sitting during TV viewing of the adolescents, so that a family-based approach may be preferable for interventions. Experimental study designs are warranted to confirm the present findings. PMID:27936073

  3. A Three-Year Follow-Up Study of Antibiotic and Metal Residues, Antibiotic Resistance and Resistance Genes, Focusing on Kshipra—A River Associated with Holy Religious Mass-Bathing in India: Protocol Paper

    Vishal Diwan

    2017-05-01

    Full Text Available Background: Antibiotic resistance (ABR is one of the major health emergencies for global society. Little is known about the ABR of environmental bacteria and therefore it is important to understand ABR reservoirs in the environment and their potential impact on health. Method/Design: Quantitative and qualitative data will be collected during a 3-year follow-up study of a river associated with religious mass-bathing in Central India. Surface-water and sediment samples will be collected from seven locations at regular intervals for 3 years during religious mass-bathing and in absence of it to monitor water-quality, antibiotic residues, resistant bacteria, antibiotic resistance genes and metals. Approval has been obtained from the Ethics Committee of R.D. Gardi Medical College, Ujjain, India (No. 2013/07/17-311. Results: The results will address the issue of antibiotic residues and antibiotic resistance with a focus on a river environment in India within a typical socio-behavioural context of religious mass-bathing. It will enhance our understanding about the relationship between antibiotic residue levels, water-quality, heavy metals and antibiotic resistance patterns in Escherichia coli isolated from river-water and sediment, and seasonal differences that are associated with religious mass-bathing. We will also document, identify and clarify the genetic differences/similarities relating to phenotypic antibiotic resistance in bacteria in rivers during religious mass-bathing or during periods when there is no mass-bathing.

  4. A Three-Year Follow-Up Study of Antibiotic and Metal Residues, Antibiotic Resistance and Resistance Genes, Focusing on Kshipra-A River Associated with Holy Religious Mass-Bathing in India: Protocol Paper.

    Diwan, Vishal; Purohit, Manju; Chandran, Salesh; Parashar, Vivek; Shah, Harshada; Mahadik, Vijay K; Stålsby Lundborg, Cecilia; Tamhankar, Ashok J

    2017-05-29

    Antibiotic resistance (ABR) is one of the major health emergencies for global society. Little is known about the ABR of environmental bacteria and therefore it is important to understand ABR reservoirs in the environment and their potential impact on health. Quantitative and qualitative data will be collected during a 3-year follow-up study of a river associated with religious mass-bathing in Central India. Surface-water and sediment samples will be collected from seven locations at regular intervals for 3 years during religious mass-bathing and in absence of it to monitor water-quality, antibiotic residues, resistant bacteria, antibiotic resistance genes and metals. Approval has been obtained from the Ethics Committee of R.D. Gardi Medical College, Ujjain, India (No. 2013/07/17-311). The results will address the issue of antibiotic residues and antibiotic resistance with a focus on a river environment in India within a typical socio-behavioural context of religious mass-bathing. It will enhance our understanding about the relationship between antibiotic residue levels, water-quality, heavy metals and antibiotic resistance patterns in Escherichia coli isolated from river-water and sediment, and seasonal differences that are associated with religious mass-bathing. We will also document, identify and clarify the genetic differences/similarities relating to phenotypic antibiotic resistance in bacteria in rivers during religious mass-bathing or during periods when there is no mass-bathing.

  5. Socio-Demographic, Social-Cognitive, Health-Related and Physical Environmental Variables Associated with Context-Specific Sitting Time in Belgian Adolescents: A One-Year Follow-Up Study.

    Busschaert, Cedric; Ridgers, Nicola D; De Bourdeaudhuij, Ilse; Cardon, Greet; Van Cauwenberg, Jelle; De Cocker, Katrien

    2016-01-01

    More knowledge is warranted about multilevel ecological variables associated with context-specific sitting time among adolescents. The present study explored cross-sectional and longitudinal associations of ecological domains of sedentary behaviour, including socio-demographic, social-cognitive, health-related and physical-environmental variables with sitting during TV viewing, computer use, electronic gaming and motorized transport among adolescents. For this longitudinal study, a sample of Belgian adolescents completed questionnaires at school on context-specific sitting time and associated ecological variables. At baseline, complete data were gathered from 513 adolescents (15.0±1.7 years). At one-year follow-up, complete data of 340 participants were available (retention rate: 66.3%). Multilevel linear regression analyses were conducted to explore cross-sectional correlates (baseline variables) and longitudinal predictors (change scores variables) of context-specific sitting time. Social-cognitive correlates/predictors were most frequently associated with context-specific sitting time. Longitudinal analyses revealed that increases over time in considering it pleasant to watch TV (p time of parents/care givers (p time of siblings (p time in considering it pleasant to use a computer in leisure time (p time of siblings (p importance of the behaviour of siblings and the pleasure adolescents experience during these screen-related behaviours. In addition, more time parents or care givers spent sitting may lead to more sitting during TV viewing of the adolescents, so that a family-based approach may be preferable for interventions. Experimental study designs are warranted to confirm the present findings.

  6. Is the radiographic subsidence of stand-alone cages associated with adverse clinical outcomes after cervical spine fusion? An observational cohort study with 2-year follow-up outcome scoring.

    Zajonz, Dirk; Franke, Anne-Catherine; von der Höh, Nicolas; Voelker, Anna; Moche, Michael; Gulow, Jens; Heyde, Christoph-Eckhard

    2014-01-01

    The stand-alone treatment of degenerative cervical spine pathologies is a proven method in clinical practice. However, its impact on subsidence, the resulting changes to the profile of the cervical spine and the possible influence of clinical results compared to treatment with additive plate osteosynthesis remain under discussion until present. This study was designed as a retrospective observational cohort study to test the hypothesis that radiographic subsidence of cervical cages is not associated with adverse clinical outcomes. 33 cervical segments were treated surgically by ACDF with stand-alone cage in 17 patients (11 female, 6 male), mean age 56 years (33-82 years), and re-examined after eight and twenty-six months (mean) by means of radiology and score assessment (Medical Outcomes Study Short Form (MOS-SF 36), Oswestry Neck Disability Index (ONDI), painDETECT questionnaire and the visual analogue scale (VAS)). Subsidence was observed in 50.5% of segments (18/33) and 70.6% of patients (12/17). 36.3% of cases of subsidence (12/33) were observed after eight months during mean time of follow-up 1. After 26 months during mean time of follow-up 2, full radiographic fusion was seen in 100%. MOS-SF 36, ONDI and VAS did not show any significant difference between cases with and without subsidence in the two-sample t-test. Only in one type of scoring (painDETECT questionnaire) did a statistically significant difference in t-Test emerge between the two groups (p = 0.03; α = 0.05). However, preoperative painDETECT score differ significantly between patients with subsidence (13.3 falling to 12.6) and patients without subsidence (7.8 dropped to 6.3). The radiological findings indicated 100% healing after stand-alone treatment with ACDF. Subsidence occurred in 50% of the segments treated. No impact on the clinical results was detected in the medium-term study period.

  7. Newly diagnosed incident dizziness of older patients: a follow-up study in primary care

    Hummers-Pradier Eva

    2011-06-01

    Full Text Available Abstract Background Dizziness is a common complaint of older patients in primary care, yet not much is known about the course of incident dizziness. The aim of the study was to follow-up symptoms, subjective impairments and needs of older patients (≥65 with incident dizziness and to determine predictors of chronic dizziness. Furthermore, we analysed general practitioners' (GPs' initial diagnoses, referrals and revised diagnoses after six months. Methods An observational study was performed in 21 primary care practices in Germany, including a four-week and six-month follow-up. A questionnaire comprising characteristic matters of dizziness and a series of validated instruments was completed by 66 participants during enrolment and follow-up (after 1 month and 6 months. After six months, chart reviews and face-to-face interviews were also performed with the GPs. Results Mean scores of dizziness handicap, depression and quality of life were not or only slightly affected, and did not deteriorate during follow-up; however, 24 patients (34.8% showed a moderate or severe dizziness handicap, and 43 (62.3% showed a certain disability in terms of quality of life at the time of enrolment. In multivariate analysis, n = 44 patients suffering from chronic dizziness (dependent variable, i.e. relapsing or persistent at six months initially had a greater dizziness handicap (OR 1.42, 95%CI 1.05-1.47 than patients with transient dizziness. GPs referred 47.8% of the patients to specialists who detected two additional cases of benign paroxysmal positional vertigo (BPPV. Conclusions New-onset dizziness relapsed or persisted in a considerable number of patients within six months. This was difficult to predict due to the patients' heterogeneous complaints and characteristics. Symptom persistence does not seem to be associated with deterioration of the psychological status in older primary care patients. Management strategies should routinely consider BPPV as

  8. Follow-up methods for retrospective cohort studies in New Zealand.

    Fawcett, Jackie; Garrett, Nick; Bates, Michael N

    2002-01-01

    To define a general methodology for maximising the success of follow-up processes for retrospective cohort studies in New Zealand, and to illustrate an approach to developing country-specific follow-up methodologies. We recently conducted a cohort study of mortality and cancer incidence in New Zealand professional fire fighters. A number of methods were used to trace vital status, including matching with records of the New Zealand Health Information Service (NZHIS), pension records of Work and Income New Zealand (WINZ), and electronic electoral rolls. Non-electronic methods included use of paper electoral rolls and the records of the Registrar of Births Deaths and Marriages. 95% of the theoretical person-years of follow-up of the cohort were traced using these methods. In terms of numbers of cohort members traced to end of follow-up, the most useful tracing methods were fire fighter employment records, the NZHIS, WINZ, and the electronic electoral rolls. The follow-up process used for the cohort study was highly successful. On the basis of this experience, we propose a generic, but flexible, model for follow-up of retrospective cohort studies in New Zealand. Similar models could be constructed for other countries. Successful follow-up of cohort studies is possible in New Zealand using established methods. This should encourage the use of cohort studies for the investigation of epidemiological issues. Similar models for follow-up processes could be constructed for other countries.

  9. Recurrence of Ewing sarcoma: Is detection by imaging follow-up protocol associated with survival advantage?

    Heinemann, Melina; Ranft, Andreas; Langer, Thorsten; Jürgens, Herbert; Kreyer, Justus; Vieth, Volker; Schäfers, Michael; Weckesser, Matthias; Simon, Thorsten; Hassenpflug, Wolf; Corbacioglu, Selim; Bielack, Stefan; Mayer-Steinacker, Regina; Kühne, Thomas; van den Berg, Henk; Gelderblom, Hans; Bauer, Sebastian; Stegger, Lars; Dirksen, Uta

    2018-01-01

    The Cooperative Ewing Sarcoma Study and the Late Effects Surveillance System of the Society for Paediatric Oncology and Haematology recommend a structured follow-up imaging protocol (FUIP) for patients with Ewing sarcoma (EwS) with decreasing frequency of imaging over the first 5 years. The present

  10. The Association Between Self-Assessed Future Work Ability and Long-Term Sickness Absence, Disability Pension and Unemployment in a General Working Population: A 7-Year Follow-Up Study.

    Lundin, A; Kjellberg, K; Leijon, O; Punnett, L; Hemmingsson, T

    2016-06-01

    Purpose Work ability is commonly measured with self-assessments, in the form of indices or single items. The validity of these assessments lies in their predictive ability. Prospective studies have reported associations between work ability and sickness absence and disability pension, but few examined why these associations exist. Several correlates of work ability have been reported, but their mechanistic role is largely unknown. This study aims to investigate to what extent individual's own prognosis of work ability predicts labor market participation and whether this was due to individual characteristics and/or working conditions. Methods Self-assessed prognosis of work ability, 2 years from "now," in the Stockholm Public Health Questionnaire (2002-2003) was linked to national registers on sickness absence, disability pension and unemployment up to year 2010. Effects were studied with Cox regression models. Results Of a total of 12,064 individuals 1466 reported poor work ability. There were 299 cases of disability pension, 1466 long-term sickness absence cases and 765 long-term unemployed during follow-up. Poor work ability increased the risk of long-term sickness absence (HR 2.25, CI 95 % 1.97-2.56), disability pension (HR 5.19, CI 95 % 4.07-6.62), and long-term unemployment (HR 2.18, CI 95 % 1.83-2.60). These associations were partially explained by baseline health conditions, physical and (less strongly) psychosocial aspects of working conditions. Conclusions Self-assessed poor ability predicted future long-term sickness absence, disability pension and long-term unemployment. Self-assessed poor work ability seems to be an indicator of future labor market exclusion of different kinds, and can be used in public health monitoring.

  11. Socializing Intellectual Talk: A Case Study of Instructor Follow-Up Statements in Classroom Discourse

    Parsons, Caroline S.

    2017-01-01

    By analyzing the audio recording and transcription of classroom discourse, this case study focused on the ways in which the instructor used follow-up statements to socialize students into intellectual talk. Four relevant categories of follow-up statements emerged: (a) revoicing, (b) contextualization, (c) parallel elaboration, and (d) assistive…

  12. Loss to follow-up in an international, multicentre observational study

    Mocroft, A; Kirk, O; Aldins, P

    2008-01-01

    OBJECTIVE: The aim of this work was to assess loss to follow-up (LTFU) in EuroSIDA, an international multicentre observational cohort study. METHODS: LTFU was defined as no follow-up visit, CD4 cell count measurement or viral load measurement after 1 January 2006. Poisson regression was used...

  13. Antinuclear antibodies in patients with polymorphic light eruption: a long-term follow-up study.

    Tzaneva, S; Volc-Platzer, B; Kittler, H; Hönigsmann, H; Tanew, A

    2008-05-01

    Previous studies have shown elevated titres of antinuclear antibodies (ANA) in 2.9-19% of patients with polymorphic light eruption (PLE). A diagnosis of lupus erythematosus (LE) was finally established in some of these ANA-positive patients. To investigate whether the presence of ANA in patients with PLE merely represents an epiphenomenon or is associated with an increased risk of eventual progression to LE. We identified 472 patients with PLE who had received prophylactic photo(chemo)therapy between 1986 and 2003 and were routinely tested for the presence of ANA. All ANA-positive (ANA titre of>or=1:80) patients were asked to attend for a follow-up examination comprising a medical history, complete skin inspection and a detailed laboratory analysis including ANA and antibodies against extractable nuclear antigens. Of all the patients, 55 (11.7%) were found to be ANA positive on one or several occasions, and three (0.6%) also had antibodies to SS-A/Ro. Thirty-nine (71%) of all ANA-positive patients including all Ro+ subjects were available for follow-up after a median follow-up period of 8 years (interquartile range 5-11.5). Twenty-five patients showed persistence of ANA positivity with a median titre of 1:160 (range 1:80-1:640), whereas in 14 patients ANA titres had returned to normal levels. None of the patients revealed additional clinical, histopathological or laboratory abnormalities suggestive of LE. After a median follow-up period of 8 years none of the ANA-positive patients developed LE. Our findings indicate that PLE is a benign disease without tendency to progress to LE.

  14. Characteristics and follow-up of postmarketing studies of conditionally authorized medicines in the EU.

    Hoekman, Jarno; Klamer, Thea T; Mantel-Teeuwisse, Aukje K; Leufkens, Hubert G M; De Bruin, Marie L

    2016-07-01

    The aim of the present study was to provide an insight into the characteristics and follow-up of postmarketing studies of medicines that were conditionally authorized in the European Union (EU). We compiled a list of all postmarketing studies attached as specific obligations to the licence of medicines that were granted conditional marketing authorization from January 2006 to April 2014. Studies were characterized based on their objective, design, status upon marketing authorization (MA) and due data set by authorities. They were linked to online study registrations (Clinicaltrials.gov, ENCePP) to determine completion date. We described and associated characteristics of studies and medicines, and determined whether studies were completed on time. A total of 59 postmarketing studies were requested for 21 conditionally authorized medicines. Most studies had an interventional study design (73%), were ongoing upon MA (61%) and aimed to provide additional data on efficacy (45%). Interventional studies were more often ongoing and providing efficacy data, while observational and other studies were more often new and providing safety data. Frequent grounds for requesting postmarketing studies were 'long-term follow-up' and 'increase data on subpopulations'. Of the 34 studies eligible for follow-up analysis, 26 (76%) were completed and 17 (50%) completed on time. Actual completion time took a median (interquartile range) of 274 (-121 to 556) days longer than expected. Our results indicated that most postmarketing studies attached to a conditional marketing authorization were eventually completed but that half were completed with a substantial delay. The observations suggest caution when broadening the use of postmarketing studies for resolving uncertainties about benefits and risks after MA. © 2016 The British Pharmacological Society.

  15. 12-month follow-up study of drug treatment in pathological gamblers: a primary outcome study.

    Dannon, Pinhas N; Lowengrub, Katherine; Musin, Ernest; Gonopolsky, Yehudit; Kotler, Moshe

    2007-12-01

    Pathological gambling (PG) is a relatively common and highly disabling impulse control disorder. A range of psychotherapeutic agents including selective serotonin reuptake inhibitors, antiepileptic drugs, and opioid antagonists are shown to be effective in the short-term treatment of PG. The use of a wide range of pharmacological treatments for PG is consistent with the observation that PG shares features of obsessive-compulsive spectrum disorders, impulse control disorders, and addictive disorders. The aim of the study is to assess the rate of relapse in treatment-responder pathological gamblers after discontinuation of the active treatment. Our study sample was composed of 43 male pathological gamblers who had been full responders to 1 of 4 drug treatment regimens (fluvoxamine, topiramate, bupropion SR, or naltrexone) from several previous acute open-label (12-week) comparison studies. Full response was defined as the absence of gambling for a 1-month duration together with improvement on the Clinical Global Improvement scale. The 43 full responders were then followed prospectively for an additional 9 months, which included a 3-month open-label continuation phase and a 6-month medication-free follow-up phase. Follow-up visits were performed on a monthly basis throughout the duration of study. At every follow-up visit, a comprehensive psychiatric diagnostic evaluation was performed on all patients, and patients were assessed for symptoms of gambling using a self-report instrument and collateral family reports. The Clinical Global Impression Improvement scale was also administered at every follow-up visit. Raters were blind to the previous drug treatment. Most patients did not relapse during the 6-month medication-free follow-up phase. Three of 6 patients with fluvoxamine, 3 of 9 with topiramate, 7 of 18 with bupropion SR, and 4 of 10 with naltrexone relapsed. Relapse was strictly defined as gambling behavior at any time during the 6-month medication-free follow-up

  16. Overtime Work as a Predictor of Major Depressive Episode: A 5-Year Follow-Up of the Whitehall II Study

    Virtanen, Marianna; Stansfeld, Stephen A.; Fuhrer, Rebecca; Ferrie, Jane E.; Kivim?ki, Mika

    2012-01-01

    Background The association between overtime work and depression is still unclear. This study examined the association between overtime work and the onset of a major depressive episode (MDE). Methodology/Principal Findings Prospective cohort study with a baseline examination of working hours, psychological morbidity (an indicator of baseline depression) and depression risk factors in 1991?1993 and a follow-up of major depressive episode in 1997?1999 (mean follow-up 5.8 years) among British civ...

  17. Prevalence and associated factors of herbal medicine use among pregnant women on antenatal care follow-up at University of Gondar referral and teaching hospital, Ethiopia: a cross-sectional study.

    Mekuria, Abebe Basazn; Erku, Daniel Asfaw; Gebresillassie, Begashaw Melaku; Birru, Eshetie Melese; Tizazu, Balem; Ahmedin, Alima

    2017-02-01

    Improving maternal and child health is one of the public health priorities in several African countries including Ethiopia. However, research on herbal medicine use during pregnancy is scarce in Ethiopia. The present study aimed at assessing the prevalence and correlates of herbal medicine use among pregnant women on antenatal care (ANC) follow-up at Gondar university referral hospital, Ethiopia METHODS: An institutional-based cross sectional study was conducted on 364 pregnant women attending ANC clinic from March to May 2016 at University of Gondar referral and teaching hospital, northwest Ethiopia. Data on socio-demography, pregnancy related information as well as herbal medicine use was collected through an interviewer-administered questionnaire. Descriptive statistics, univariate and multivariate logistic regression analysis were performed to determine prevalence and associated factors of herbal medicine use. From 364 respondents, 48.6% used herbal medicine during current pregnancy. ginger (40.7%) and garlic (19%) were the two most commonly used herbs in pregnancy. Common cold (66%) and inflammation (31.6%) were the most common reasons for herbal use. Majority of herbal medicine users (89.8%) had not consulted their doctors about their herbal medicine use. Rural residency (Adjusted odds ratio (AOR): 3.15, Confidence interval (CI): 1.17-6.14), illiteracy (AOR: 4.05, CI: 2.47-6.62) and average monthly income less than 100 USD (AOR: 3.08CI: 1.221-7.77) were found to be strong predictors of herbal medicine use. The use of herbal medicine during pregnancy is a common practice and associated with residency, level of education and average monthly income. From the stand point of high prevalence and low disclosure rate, the health care providers should often consult pregnant women regarding herbal medicine use.

  18. A four-year follow-up study in fibromyalgia. Relationship to chronic fatigue syndrome

    Nørregaard, J; Bülow, P M; Prescott, E

    1993-01-01

    the overlap between fibromyalgia and chronic fatigue syndrome. Only in two of 91 the muscle pain was found to be caused by another somatic disease during the median 4 year follow-up period. In one of the 83 attending subjects a somatic disease associated with muscle symptoms was established at the follow......-up visit. 60 out of 83 reported increased pain, 8 reported improvement of pain. The 83 subjects showed no significant fall in muscle strength during the follow-up period. The majority reported severe fatigue but only one fifth fulfilled the proposed chronic fatigue syndrome criteria....

  19. Follow-up of participants in the Canadian Association of Gastroenterology Scholars’ Program, 2006 to 2012

    Lam, Mindy CW; Sey, Michael SL; Gregor, Jamie; Wong, Clarence

    2014-01-01

    The Canadian Association of Gastroenterology (CAG) Scholars’ Program (previously known as the Bright Lights Course) is designed to encourage trainees to consider a subspecialty career in gastroenterology. A formal analysis of the Scholars’ Program performed in 2007 revealed that 82% of participants invited to the program pursued or were planning to pursue a career in gastroenterology. The positive results are consistent with the CAG’s strategic plan of developing “the next generation of gastroenterology clinical practitioners, researchers, educators, and leaders” and to “attract, train, and retain the best and the brightest to gastroenterology”. The present study was a follow-up analysis of participants in the Scholars’ Program between 2006 and 2012. Although 93.1% of participants had an interest in gastroenterology before attending the Scholars’ Program, the majority (68.7%) reported a greater interest in gastroenterology after the program. Similar to the study from 2007, the present study again illustrates the importance and success of the Scholars’ Program in generating interest and retaining candidates in gastroenterology. PMID:24288694

  20. Follow-up of participants in the Canadian Association of Gastroenterology Scholars' Program, 2006 to 2012.

    Lam, Mindy Ching Wan; Sey, Michael Sl; Gregor, Jamie; Wong, Clarence

    2014-02-01

    The Canadian Association of Gastroenterology (CAG) Scholars' Program (previously known as the Bright Lights Course) is designed to encourage trainees to consider a subspecialty career in gastroenterology. A formal analysis of the Scholars' Program performed in 2007 revealed that 82% of participants invited to the program pursued or were planning to pursue a career in gastroenterology. The positive results are consistent with the CAG's strategic plan of developing "the next generation of gastroenterology clinical practitioners, researchers, educators, and leaders" and to "attract, train, and retain the best and the brightest to gastroenterology". The present study was a follow-up analysis of participants in the Scholars' Program between 2006 and 2012. Although 93.1% of participants had an interest in gastroenterology before attending the Scholars' Program, the majority (68.7%) reported a greater interest in gastroenterology after the program. Similar to the study from 2007, the present study again illustrates the importance and success of the Scholars' Program in generating interest and retaining candidates in gastroenterology.

  1. Is attention deficit/hyperactivity disorder among men associated with initiation or escalation of substance use at 15-month follow-up? A longitudinal study involving young Swiss men.

    Vogel, Tanja; Dom, Geert; van de Glind, Geurt; Studer, Joseph; Gmel, Gerhard; Strik, Werner; Moggi, Franz

    2016-10-01

    Young adults with attention deficit/hyperactivity disorder (ADHD) show higher substance use disorder (SUD) prevalence relative to non-ADHD controls; few longitudinal studies have examined the course of substance use with reference to conduct disorder (CD). We compared initiation and escalation of substance use at 15-month follow-up in men screened positive or negative for ADHD (ADHD(+) versus ADHD(-) ), controlling for CD presence in early adolescence. Participants were recruited during August 2010 and November 2011 from the census of all young men who have to pass mandatory army conscription from three of six Swiss Army recruitment centres. A two-wave data collection was performed via questionnaires at baseline and 15-month follow-up as a part of the longitudinal Cohort Study on Substance Use Risk Factors. Recruitment centres in Lausanne, Windisch and Mels, responsible for 21 cantons in German- and French-speaking areas of Switzerland. Consecutive sample of 5103 male Swiss Army conscripts who provided informed consent and responded to questionnaires at baseline and 15-month follow-up. Their mean age was 20.0 (standard deviation = 1.21) years at baseline. ADHD and CD were assessed using the adult ADHD Self-Report Scale and the MINI International Neuropsychiatric Interview Plus, respectively, at baseline, and substance use was measured via self-administered substance use questionnaires at baseline and follow-up. Compared with the ADHD(-) group, the ADHD(+) group (n = 215, 4.2%) showed heavier baseline substance use and increased likelihood of alcohol (χ(2)  = 53.96; P cannabis use disorders (χ(2)  = 48.43; P cannabis use in the two groups remained stable from baseline to follow-up (no escalation). The ADHD(+) group was more likely to initiate substance use compared with the ADHD(-) group (higher initiation rates), particularly with amphetamines [odds ratio (OR) = 3.81; 95% confidence interval (CI) = 2.20-6.60; P ADHD medication (OR

  2. Peer victimization and social phobia: a follow-up study among adolescents.

    Ranta, Klaus; Kaltiala-Heino, Riittakerttu; Fröjd, Sari; Marttunen, Mauri

    2013-04-01

    This study examined longitudinal associations between direct and relational peer victimization (DV/RV) and self-reported social phobia (SP) among adolescents from 15 to 17 years of age, controlling for depression and family socioeconomic covariates. A total of 3,278 Finnish adolescents with a mean age of 15.5 years were surveyed at baseline (T1), and followed up 2 years afterwards (T2) their mean age being 17.6 years. In all, 2,070 adolescents were reached for the follow-up. Both types of victimization were assessed with structured questions, SP with the Social Phobia Inventory, and depression with the 13-item Beck Depression Inventory. Socioeconomic covariates were assessed with items from the Life Events Checklist. Frequency of victimization and SP were assessed at T1 and T2, and incidence and persistence from T1 to T2. Longitudinal associations between victimization and SP were examined with three logistic regression analyses with depression and socioeconomic covariates controlled for, with SP, DV, and RV in turn as the dependent endpoint (T2) variables. Among boys a bidirectional association between DV and SP was found with DV both predicting SP [Odds Ratio (OR) 2.6] and being predicted by SP (OR 3.9). Among girls RV predicted SP (OR 2.8), but not vice versa, while depression in turn predicted DV (OR 4.3). Direct victimization and SP have a bidirectional association among boys, while among girls RV increases the risk of subsequent SP.

  3. New methods for estimating follow-up rates in cohort studies

    Xiaonan Xue

    2017-12-01

    Full Text Available Abstract Background The follow-up rate, a standard index of the completeness of follow-up, is important for assessing the validity of a cohort study. A common method for estimating the follow-up rate, the “Percentage Method”, defined as the fraction of all enrollees who developed the event of interest or had complete follow-up, can severely underestimate the degree of follow-up. Alternatively, the median follow-up time does not indicate the completeness of follow-up, and the reverse Kaplan-Meier based method and Clark’s Completeness Index (CCI also have limitations. Methods We propose a new definition for the follow-up rate, the Person-Time Follow-up Rate (PTFR, which is the observed person-time divided by total person-time assuming no dropouts. The PTFR cannot be calculated directly since the event times for dropouts are not observed. Therefore, two estimation methods are proposed: a formal person-time method (FPT in which the expected total follow-up time is calculated using the event rate estimated from the observed data, and a simplified person-time method (SPT that avoids estimation of the event rate by assigning full follow-up time to all events. Simulations were conducted to measure the accuracy of each method, and each method was applied to a prostate cancer recurrence study dataset. Results Simulation results showed that the FPT has the highest accuracy overall. In most situations, the computationally simpler SPT and CCI methods are only slightly biased. When applied to a retrospective cohort study of cancer recurrence, the FPT, CCI and SPT showed substantially greater 5-year follow-up than the Percentage Method (92%, 92% and 93% vs 68%. Conclusions The Person-time methods correct a systematic error in the standard Percentage Method for calculating follow-up rates. The easy to use SPT and CCI methods can be used in tandem to obtain an accurate and tight interval for PTFR. However, the FPT is recommended when event rates and

  4. Acute heart failure in the emergency department: a follow-up study.

    Fabbri, Andrea; Marchesini, Giulio; Carbone, Giorgio; Cosentini, Roberto; Ferrari, Annamaria; Chiesa, Mauro; Bertini, Alessio; Rea, Federico

    2016-02-01

    Acute heart failure (AHF) is a major public health issue due to high incidence and poor prognosis. Only a few studies are available on the long-term prognosis and on outcome predictors in the unselected population attending the emergency department (ED) for AHF. We carried out a 1-year follow-up analysis of 1234 consecutive patients from selected Italian EDs from January 2011 to June 2012 for an episode of AHF. Their prognosis and outcome-associated factors were tested by Cox proportional hazard model. Patients' mean age was 84, with 66.0% over 80 years and 56.2% females. Comorbidities were present in over 50% of cases, principally a history of acute coronary syndrome, chronic obstructive pulmonary disease, diabetes, chronic kidney disease, valvular heart disease. Death occurred within 6 h in 24 cases (1.9%). At 30-day follow-up, death was registered in 123 cases (10.0%): 110 cases (89.4%) died of cardiovascular events and 13 (10.6%) of non-cardiovascular causes (cancer, gastrointestinal hemorrhages, sepsis, trauma). At 1-year follow-up, all-cause death was recorded in 50.1% (over 3 out of 4 cases for cardiovascular origin). Six variables (older age, diabetes, systolic arterial pressure capacity (AUC = 0.649; SE 0.015). Recurrence of AHF was registered in 31.0%. The study identifies a cluster of variables associated with 1-year mortality in AHF, but their predictive capacity is low. Old age and the presence of comorbidities, in particular diabetes are likely to play a major role in dictating the prognosis.

  5. Workplace bullying and sleep difficulties: a 2-year follow-up study.

    Hansen, Ase Marie; Hogh, Annie; Garde, Anne Helene; Persson, Roger

    2014-04-01

    The aims of the present study were to investigate whether being subjected to bullying and witnessing bullying at the workplace was associated with concurrent sleep difficulties, whether frequently bullied/witnesses have more sleep difficulties than occasionally bullied/witnesses, and whether there were associations between being subjected to bullying or witnessing bullying at the workplace and subsequent sleep difficulties. A total of 3,382 respondents (67 % women and 33 % men) completed a baseline questionnaire about their psychosocial work environment and health. The overall response rate was 46 %. At follow-up 2 years later, 1671 of those responded to a second questionnaire (49 % of the 3,382 respondents at baseline). Sleep difficulties were measured in terms of disturbed sleep, awakening problems, and poor quality of sleep. Bullied persons and witnesses reported more sleep difficulties than those who were neither bullied nor witnesses to bullying at baseline. Frequently bullied/witnesses reported more sleep difficulties than respondents who were occasionally bullied or witnessing bullying at baseline. Further, odds ratios for subsequent sleep difficulties were increased among the occasionally bullied, but not among witnesses. However, the associations weakened when adjusting for sleep difficulties at baseline. Being subjected to occasional bullying at baseline was predictive of subsequent sleep difficulties. Witnessing bullying at baseline did not predict sleep difficulties at follow-up.

  6. Associations between follow-up screening after gestational diabetes and early detection of diabetes

    Olesen, Christinna Rebecca; Hyldgaard Nielsen, Jane; Mortensen, Rikke Nørmark

    2016-01-01

    BACKGROUND: Women whose pregnancy was complicated by gestational diabetes have a 7-fold higher risk of developing diabetes, primarily type 2. Early detection can prevent or delay the onset of late complications, for which follow-up screening is important. This study investigated the extent...... of participation in follow-up screening and the possible consequences of nonattendance in the Region of North Jutland, Denmark. METHOD: In Danish national registers covering the years 1994-2011 we identified 2171 birthing women whose pregnancy was complicated by first-time gestational diabetes. Control visits...... and treatment after gestational diabetes than women not attending. The results for women attending testing at biochemical departments also showed an increased risk of initiation of treatment. Women attending at least one general practitioners control had a significantly higher risk of early diabetes diagnosis...

  7. Postoperative follow-up studies in congenital dilatation of the common bile duct using hepatobiliary scintigraphy

    Hirobe, Seiichi; Ishida, Haruo; Hayashi, Akira; Kamagata, Shoichiro; Fuchimoto, Yasufumi; Mizuno, Dai; Yano, Tsunehiro [Tokyo Metropolitan Kiyose Children`s Hospital (Japan); Ishii, Katsumi

    1995-03-01

    Follow-up studies in congenital dilatation of the common bile duct were done in 20 cases ranging 3 to 20 years after operation. Operative cholangiography had shown dilatation of the intrahepatic bile ducts in 15 patients (75%), of these, 7 patients had cystic dilatation. Five cases of these 7 patients showed prolonged stasis of the nuclide in the cystic dilated intrahepatic bile ducts by {sup 99m}Tc-PMT hepatobiliary scintigraphy in the follow-up studies even at 10 years after operation. But none of 20 cases had complication such as intrahepatic lithiasis, cholangitis, and liver dysfunction. Hepatobiliary scintigraphy could provide moderate anatomic and excellent functional information which were useful for these follow-up studies and careful follow-up should be done in the case of cystic dilatation of the intrahepatic bile ducts. (author).

  8. Associations between sports participation and psychological difficulties during childhood: a two-year follow up.

    Vella, Stewart A; Cliff, Dylan P; Magee, Christopher A; Okely, Anthony D

    2015-05-01

    This paper assessed the associations between sports participation and the development of psychological strengths and difficulties during childhood. Two-year follow up study of a sample of 4042 Australian children who were followed from age 8 years to 10 years. Parents reported children's participation in organised sports, and completed the Strengths and Difficulties Questionnaire. Univariate general linear models were used to examine the association between changes in sports participation and psychological strengths and difficulties at 10 years, adjusting for psychological strengths and difficulties at age 8. Children who maintained participation in sport had lower rates of parent-reported psychological difficulties at 10 years compared with children who dropped out of sport. Less internalising problems were also reported for children who participated in organised sports compared to children who dropped out of sports and children who did not participate in sports. These relationships did not differ by BMI, socioeconomic status, or parental education. Greater psychological difficulties are experienced by children who drop out of sports, and greater social and emotional problems are experienced by children who drop out of sports and who do not participate in organised sports. Due consideration should be given to the quality and implementation of sporting programs to ensure that they provide benefits to mental health. Due consideration should also be given to the potential psychological difficulties being experienced by children who drop out of organised sports as a higher level of psychological difficulties may be experienced prior to or subsequent to dropout. Copyright © 2014 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  9. Navigated versus conventional total knee arthroplasty: A prospective study at three years follow-up.

    Martín-Hernández, C; Sanz-Sainz, M; Revenga-Giertych, C; Hernández-Vaquero, D; Fernández-Carreira, J M; Albareda-Albareda, J; Castillo-Palacios, A; Ranera-Garcia, M

    2018-03-28

    Computer-assisted surgery application in total knee arthroplasty (TKA) has shown more accurate implant alignment compared with conventional instrumentation and is associated with more homogeneous alignment results. Although longer implant survival and superior clinical outcomes should be expected from navigated TKA, currently available evidence does not support this hypothesis. The aim of this study was to compare navigated TKA with conventional TKA regarding clinical and radiological outcomes after a 3-year follow-up under the hypothesis that navigated TKA would provide better outcomes than conventional TKA. In a prospective multicentre study, 119 patients underwent navigated TKA and 80 patients received conventional instrumentation. Patients were evaluated at the baseline and at postoperative months 3, 12, 24, and 36. Analysis included the American Knee Society Score (KSS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), Short Form-12 (SF12) Health Survey, and radiographic assessment. All clinical scores improved significantly for all patients during the follow-up but were significantly better in the navigation group. The percentage of patients showing a mechanical axis between 3° of varus and 3° of valgus was significantly higher in the ATR group (93%) than in the conventional TKA group (71%) (P<.01). The use of computer-assisted surgery in TKA provides more accurate mechanical alignment and superior short-term functional outcomes compared to conventional TKA. Copyright © 2018 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Risk Factors for Mortality in Hemodialysis Patients: Two-Year Follow-Up Study

    Maria do Sameiro-Faria

    2013-01-01

    Full Text Available Background. End-stage renal disease (ESRD patients under hemodialysis (HD have high mortality rate. Inflammation, dyslipidemia, disturbances in erythropoiesis, iron metabolism, endothelial function, and nutritional status have been reported in these patients. Our aim was to identify any significant association of death with these disturbances, by performing a two-year follow-up study. Methods and Results. A large set of data was obtained from 189 HD patients (55.0% male; 66.4 ± 13.9 years old, including hematological data, lipid profile, iron metabolism, nutritional, inflammatory, and endothelial (dysfunction markers, and dialysis adequacy. Results. 35 patients (18.5% died along the follow-up period. Our data showed that the type of vascular access, C-reactive protein (CRP, and triglycerides (TG are significant predictors of death. The risk of death was higher in patients using central venous catheter (CVC (Hazard ratio [HR] =3.03, 95% CI = 1.49–6.13, with higher CRP levels (fourth quartile, compared with those with lower levels (first quartile (HR = 17.3, 95% CI = 2.40–124.9. Patients with higher TG levels (fourth quartile presented a lower risk of death, compared with those with the lower TG levels (first quartile (HR = 0.18, 95% CI = 0.05–0.58. Conclusions. The use of CVC, high CRP, and low TG values seem to be independent risk factors for mortality in HD patients.

  11. Atopic conditions and mental health problems: a 3-year follow-up study.

    Lien, Lars; Green, Kristian; Thoresen, Magne; Bjertness, Espen

    2010-09-01

    The aim of this study was to test the hypothesis that atopic conditions at 15/16 years of age affect both internalized and externalized mental health problems 3 years later. Combined school and postal survey was conducted in urban and rural settings. A total of 3,674 adolescents (70.1% response rate) were followed at two time points and interviewed with similar questionnaires at baseline and follow-up. Hopkins Symptoms Checklist (HSCL-10) was used to assess internalized problems, and two subscales (conduct problems and hyperactivity) from the Strength and Difficulties Questionnaire to measure externalized mental health problems. The atopic conditions investigated were asthma, hay fever and eczema by asking the adolescents whether these conditions were present or not. There was an increase in the prevalence of internalized mental health problems from about 17-25% and a decrease in externalized mental health problems and number of atopic conditions in the follow-up period. Of the atopic conditions, hay fever was most prevalent with about 34% at 15 years of age and 20% at 18. The asthma prevalence was at 10 and 5% and eczema at 25 and 10%, respectively. Internalized mental health problems among girls were significantly associated with atopic conditions 3 years earlier, also after controlling for confounding variables. To live with atopic conditions seem to affect the mood and level of anxiety among adolescent girls. This should be kept in mind by health professionals treating young girls with atopic conditions.

  12. Longitudinal magnetic resonance imaging study on whiplash injury patients. Minimum 10-year follow-up

    Ichihara, Daisuke; Okada, Eijiro; Chiba, Kazuhiro

    2009-01-01

    We conducted a prospective long-term follow-up study to assess associations between magnetic resonance imaging (MRI) findings and changes in clinical symptoms, as well as factors relating to the prognosis of symptoms. A total of 133 patients with acute whiplash injury between 1993 and 1996 participated in this follow-up study. They underwent neurological examinations by spine surgeons and second MRI scans of the cervical spine were obtained. They also filled out a questionnaire regarding cervical symptoms and the accident details. The items evaluated by MRI were a decrease in the signal intensity of the intervertebral disc; anterior compression of the dura and the spinal cord; posterior disc protrusion; disc space narrowing; and foraminal stenosis. Relations between the presence/absence of degenerative changes on MRI, accident details, and patients' symptoms were assessed by calculating the adjusted odds ratio (OR). Progression of some degenerative changes was recognized on MRI in 98.5% of the 133 whiplash injury patients, and clinical symptoms diminished in more than a half of the 133 patients. There were no statistically significant associations between MRI findings and changes in clinical symptoms. The prognosis for neck pain tended to be poor after accidents with double collisions (rear-end collision followed by front-end collision) [adjusted OR 5.83, 95% confidence interval (CI) 1.15-29.71] and accidents with serious car damage (2.87, 1.03-7.99). The prognosis for stiff shoulders tended to be poor in women (2.83, 1.23-6.51); and the prognosis for numbness in the upper extremities tended to be poor after accidents with serious car damage (3.39, 1.14-10.06). This study demonstrated that progression of degenerative changes of the cervical spine on MRI was not associated with clinical symptoms during the 10-year period after whiplash injury. (author)

  13. Medication overuse headache: a critical review of end points in recent follow-up studies

    Hagen, Knut; Jensen, Rigmor; Bøe, Magne Geir

    2010-01-01

    in headache index at the end of follow-up were reported in only one and two of nine studies, respectively. The present review demonstrated a lack of uniform end points used in recently published follow-up studies. Guidelines for presenting follow-up data on MOH are needed and we propose end points......No guidelines for performing and presenting the results of studies on patients with medication overuse headache (MOH) exist. The aim of this study was to review long-term outcome measures in follow-up studies published in 2006 or later. We included MOH studies with >6 months duration presenting...... a minimum of one predefined end point. In total, nine studies were identified. The 1,589 MOH patients (22% men) had an overall mean frequency of 25.3 headache days/month at baseline. Headache days/month at the end of follow-up was reported in six studies (mean 13.8 days/month). The decrease was more...

  14. Cigarette smoking during pregnancy and hyperactive-distractible preschooler's: a follow-up study

    Linnet, K. M.; Obel, C; Bonde, E

    2006-01-01

    singletons born to Danish-speaking mothers. Information on smoking habits during pregnancy and other lifestyle factors was obtained from self-administered questionnaires filled in during second and third trimester. Approximately 3.5 years later, the parents provided information on their child's behaviour......AIM: To study the association between intrauterine exposure to tobacco smoke and behavioural disorders in preschool children, primarily symptoms of inattention, hyperactivity and impulsivity but also hostile-aggressive and anxious-fearful symptoms. METHODS: We conducted a follow-up study in 1355...... born to women who smoked 10 or more cigarettes per day had a 60% increased risk of hyperactivity and distractibility perceived by the parents (OR 1.6; 95% CI 1.0-2.3; P

  15. [The Octabaix study. Baseline assessment and 5 years of follow-up].

    Ferrer, Assumpta; Formiga, Francesc; Padrós, Gloria; Badia, Teresa; Almeda, Jesús; Octabaix, Grupo Estudio

    This is a review of a prospective, community-based study with a follow-up period of 5years. It is a study of 328 participants aged 85 at baseline, of which 62% were female, 53% widows, and a third of them living alone. High blood pressure was observed in 75.9%, dyslipidaemia in 51.2%, and diabetes in 17.7%. At baseline the median Barthel Index was 95, the Spanish version of the Mini-Mental State Examination was 28, the Charlson index 1, the Mini Nutritional Assessment 25, the Gijón test 10, the visual analogue scale of the Quality of Life Test was 60, and with a mean of 6.1 prescription drugs. A lower quality of life was also associated with female gender, a phenotype of frailty, heart failure, and a high level of social risk. At 5years of follow-up, the mortality rate was high, with 138 (42.1%) of the population sample dying at the end of the period. It represents an annual mortality rate of 8.4%. Thus, a common denominator of this review has been the high importance of functionality and overall comorbidity factors associated with mortality in this very old age group, compared to other more traditional factors in younger populations. Several studies of frailty have also been assessed in this group, as well as falls, nutritional risk, diabetes and successful aging, including important aspects to better understand this population group. Copyright © 2016 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

  16. Prognostic factors and outcome in anorexia nervosa: a follow-up study.

    Errichiello, Luca; Iodice, Davide; Bruzzese, Dario; Gherghi, Marco; Senatore, Ignazio

    2016-03-01

    Anorexia nervosa is an eating disorder characterized by food restriction, irrational fear of gaining weight and consequent weight loss. High mortality rates have been reported, mostly due to suicide and malnutrition. Good outcomes largely vary between 18 and 42%. We aimed to assess outcome and prognostic factors of a large group of patients with anorexia nervosa. Moreover we aimed to identify clusters of prognostic factors related to specific outcomes. We retrospectively reviewed data of 100 patients diagnosed with anorexia nervosa previously hospitalized in a tertiary level structure. Then we performed follow-up structured telephone interviews. We identified four dead patients, while 34% were clinically recovered. In univariate analysis, short duration of inpatient treatment (p = 0.003), short duration of disorder (p = 0.001), early age at first inpatient treatment (p = 0.025) and preserved insight (p = 0.029) were significantly associated with clinical recovery at follow-up. In multiple logistic regression analysis, duration of first inpatient treatment, duration of disorder and preserved insight maintained their association with outcome. Moreover multiple correspondence analysis and cluster analysis allowed to identify different typologies of patients with specific features. Notably, group 1 was characterized by two or more inpatient treatments, BMI ≤ 14, absence of insight, history of long-term inpatient treatments, first inpatient treatment ≥30 days. While group 4 was characterized by preserved insight, BMI ≥ 16, first inpatient treatment ≤14 days, no more than one inpatient treatment, no psychotropic drugs intake, duration of illness ≤4 years. We confirmed the association between short duration of inpatient treatment, short duration of disorder, early age at first inpatient treatment, preserved insight and clinical recovery. We also differentiated patients with anorexia nervosa in well-defined outcome groups according to specific clusters of

  17. Successful careers and cognitive style: a follow-up study of childhood family discontinuity.

    Gordon, V Z

    1991-12-01

    It was predicted that those participants who experienced discontinuity (death, divorce, and separations) from their parent(s) in childhood and who had successful careers in adulthood would manifest more innovative than adaptive cognitive styles on the Kirton Adaption-Innovation Inventory. The original research showed 61% of the sample members (n = 41) experienced family discontinuity. Ninety percent (n = 37) of the previous participants responded and showed 59% family discontinuity. Fifty-four percent in the follow-up study chose an alternative career path (counterstriving), the same percentage as in the original sample. When both family discontinuity and counterstriving were present, statistically significant innovation scores occurred. Family discontinuity in childhood and a successful career in adulthood are likely to be associated with high striving-motivation and an innovative (paradigm-breaking) problem-solving style.

  18. Resilience dimensions and mental health outcomes in bipolar disorder in a follow-up study.

    Echezarraga, A; Calvete, E; González-Pinto, A M; Las Hayas, C

    2018-02-01

    The individual process of resilience has been related to positive outcomes in mental disorders. We aimed (a) to identify the resilience domains from the Resilience Questionnaire for Bipolar Disorder that are associated cross sectionally and longitudinally with mental health outcomes in bipolar disorder (BD) and (b) to explore cross-lagged associations among resilience factors. A clinical adult sample of 125 patients diagnosed with BD (62.10% female, mean age = 46.13, SD = 10.89) gave their informed consent and completed a battery of disease-specific tools on resilience, personal recovery, symptomatology, psychosocial functioning, and quality of life, at baseline and at follow-up (n = 63, 58.10% female, mean age = 45.13, SD = 11.06, participation rate = 50.40%). Resilience domains of self-management of BD, turning point, self-care, and self-confidence were significantly associated with mental health indicators at baseline. In addition, self-confidence at baseline directly predicted an increase in personal recovery at follow-up, and self-confidence improvement mediated the relationship between interpersonal support and self-care at baseline and personal recovery at follow-up. These findings highlight that resilience domains are significantly associated with positive mental health outcomes in BD and that some predict personal recovery at follow-up. Moreover, some resilience factors improve other resilience factors over time. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Long-term radiographic follow-up of bisphosphonate-associated atypical femur fractures

    Favinger, Jennifer L. [University of Washington, Department of Radiology, 1959 N.E. Pacific Street, Box 357115, Seattle, WA (United States); Hippe, Daniel [University of Washington, Department of Radiology, Seattle, WA (United States); Ha, Alice S. [University of Washington, Department of Radiology, 4245 Roosevelt Way NE, Box 354755, Seattle, WA (United States)

    2016-05-15

    To evaluate the appearance of bisphosphonate-related femur insufficiency fractures on long-term follow-up radiographic studies and to describe the rate of fracture line obscuration and cortical beak healing over time. In this retrospective study, bisphosphonate-related femur fracture radiographs were reviewed by two radiologists for the presence of a fracture line, callus, and the characteristic cortical beak. Kaplan-Meier curves were used to analyze the time to first indication of healing. Femurs were also subdivided into those who underwent early versus late surgical fixation and those who underwent early versus late discontinuation of bisphosphonate. Clinical data including pain level and medication history were collected. Forty-seven femurs with a bisphosphonate-related femur fracture were identified in 28 women. Eighty-five percent took a bisphosphonate for greater than 5 years and 59 % for greater than 10 years. The median time to beak healing was 265 weeks and the median time to fracture line healing was 56 weeks in the 31 femurs with a baseline fracture. No statistically significant difference was identified between surgical fixation and conservative management. Bisphosphonate-related fractures demonstrate notably prolonged healing time on long-term follow-up. (orig.)

  20. Determinants of aortic stiffness: 16-year follow-up of the Whitehall II study.

    Nanna B Johansen

    Full Text Available Aortic stiffness is a strong predictor of cardiovascular disease endpoints. Cross-sectional studies have shown associations of various cardiovascular risk factors with aortic pulse wave velocity, a measure of aortic stiffness, but the long-term impact of these factors on aortic stiffness is unknown.In 3,769 men and women from the Whitehall II cohort, a wide range of traditional and novel cardiovascular risk factors were determined at baseline (1991-1993 and aortic pulse wave velocity was measured at follow-up (2007-2009. The prospective associations between each baseline risk factor and aortic pulse wave velocity at follow-up were assessed through sex stratified linear regression analysis adjusted for relevant confounders. Missing data on baseline determinants were imputed using the Multivariate Imputation by Chained Equations.Among men, the strongest predictors were waist circumference, waist-hip ratio, heart rate and interleukin 1 receptor antagonist, and among women, adiponectin, triglycerides, pulse pressure and waist-hip ratio. The impact of 10 centimeter increase in waist circumference on aortic pulse wave velocity was twice as large for men compared with women (men: 0.40 m/s (95%-CI: 0.24;0.56; women: 0.17 m/s (95%-CI: -0.01;0.35, whereas the opposite was true for the impact of a two-fold increase in adiponectin (men: -0.30 m/s (95%-CI: -0.51;-0.10; women: 0.61 m/s (95%-CI: -0.86;-0.35.In this large prospective study, central obesity was a strong predictor of aortic stiffness. Additionally, heart rate in men and adiponectin in women predicted aortic pulse wave velocity suggesting that strategies to prevent aortic stiffening should be focused differently by sex.

  1. Effect of safe water on arsenicosis: A follow-up study

    Kunal K Majumdar

    2014-01-01

    Full Text Available Background: Arsenic pollution in groundwater, used for drinking purposes, has been envisaged as a problem of global concern. Treatment options for the management symptoms of chronic arsenicosis are limited. Mitigation option available for dealing with the health problem of ground water arsenic contamination rests mainly on supply of arsenic safe water in arsenic-endemic region of Indo-Bangladesh subcontinent. Limited information is available regarding the long-term effect of chronic arsenic toxicity after stoppage of consumption of arsenic-containing water. Objective: The current study was, therefore, done to assess, objectively, the effect of drinking arsenic safe water (<50 μg/L on disease manifestation of arsenicosis. Results: Manifestations of various skin lesions and systemic diseases associated with chronic arsenic exposure were ascertained initially by carrying on baseline study on 208 participants in Nadia (Cohort-I, with skin lesion and Cohort-II, without skin lesion using a scoring system, as developed by us, and compared objectively at the end of each year for 3 year follow-up period. All the participants who had arsenic contaminated drinking water source in their houses were supplied with arsenic removal filters for getting arsenic-free water during the follow-up period. In participants belonging to Cohort-I, the skin score was found to improve significantly at the end of each year, and it was found to be reduced significantly from 2.17 ± 1.09 to 1.23 ± 1.17; P < 0.001 at the end of 3 year′s intervention study indicating beneficial effect of safe water on skin lesions. The systemic disease symptom score was also found to improve, but less significantly, at the end of 3 years in both the cohorts. Most important observation during the follow-up study was persistence of severe symptoms of chronic lung disease and severe skin lesion including Bowen′s disease in spite of taking arsenic-safe water. Further, death could not be

  2. Association between ambient temperature and blood pressure and blood pressure regulators: 1831 hypertensive patients followed up for three years.

    Qing Chen

    Full Text Available Several studies have suggested an association between ambient air temperature and blood pressure. However, this has not been reliably confirmed by longitudinal studies. Also, whether the reaction to temperature stimulation is modified by other factors such as antihypertensive medication is rarely investigated. The present study explores the relationship between ambient temperature and blood pressure, without and with antihypertensive medication, in a study of 1,831 hypertensive patients followed up for three years, in two or four weekly check ups, accumulating 62,452 follow-up records. Both baseline and follow-up blood pressure showed an inverse association with ambient temperature, which explained 32.4% and 65.6% of variation of systolic blood pressure and diastolic blood pressure (P<0.05 respectively. The amplitude of individual blood pressure fluctuation with temperature throughout a year (a 29 degrees centigrade range was 9.4/7.3 mmHg. Medication with angiotensin converting enzyme inhibitor benazepril attenuated the blood pressure fluctuation by 2.4/1.3 mmHg each year, though the inverse association of temperature and blood pressure remained. Gender, drinking behavior and body mass index were also found to modify the association between temperature and diastolic blood pressure. The results indicate that ambient temperature may negatively regulate blood pressure. Hypertensive patients should monitor and treat blood pressure more carefully in cold days, and it could be especially important for the males, thinner people and drinkers.

  3. Micropulse diode laser trabeculoplasty (MDLT: A phase II clinical study with 12 months follow-up

    Antonio Maria Fea

    2008-06-01

    Full Text Available Antonio Maria Fea, Alex Bosone, Teresa Rolle, Beatrice Brogliatti, Federico Maria GrignoloIstituto di Fisiopatologia Clinica, Clinica Oculistica dell’ Università di Torino, Torino, ItalyObjective: This pilot study evaluates the pressure lowering potential of subthreshold micropulse diode laser trabeculoplasty (MDLT for a clinically meaningful duration in patients with medically uncontrolled open angle glaucoma (OAG.Design: prospective interventional case series.Participants: Thirty-two eyes of 20 consecutive patients with uncontrolled OAG (12 bilateral and 8 unilateral.Methods: Confluent subthreshold laser applications over the inferior 180° of the anterior TM using an 810 nm diode laser in a micropulse operating mode. The intraocular pressure (IOP was measured at baseline and at 1 hour, 1 day, 1 week, 3, 6, 9, and 12 months post-treatment. Flare was measured with a Kowa FM 500 flare-meter at baseline and at 3 hours, 1 day, 1 week, and 12 months post-treatment. After treatment, the patients were maintained on their pre-treatment drug regimen.Main outcome measures: Criteria for treatment response were IOP reduction ≥3 mm Hg and IOP ≤21 mm Hg within the first week after MDLT. Eyes not complying to the above criteria during the follow-up were considered treatment failure. Mean IOP change and percentage of IOP reduction during the follow-up were calculated.Results: One eye was analyzed for bilateral patients. A total of 20 eyes were thus included. Four eyes (20% did not respond to treatment during the first week. One additional eye failed at the 6 month visit. The treatment was successful in 15 eyes (75% at 12 months. The IOP was significantly lower throughout follow-up (p < 0.01. At 12 months, the mean percentage of IOP reduction in the 15 respondent eyes was 22.1% and 12 eyes (60% had IOP reduction higher than 20%. During the first two postoperative days, one eye with pigmentary glaucoma experienced a significant increase of flare

  4. Positive affect and cognitive decline: a 12-year follow-up of the Maastricht Aging Study.

    Berk, Lotte; van Boxtel, Martin; Köhler, Sebastian; van Os, Jim

    2017-12-01

    In cross-sectional studies, positive affect (PA) has been associated with higher levels of cognitive functioning. This study examined whether positive affect (PA) is associated with change in cognitive function over 12 years in an adult population sample. Participants (n = 258), aged 40 to 82 years, were drawn from a subsample of the Maastricht Aging Study (MAAS) and assessed at baseline, 6 years and 12 years. PA was measured at baseline with a Dutch translation of the Positive and Negative Affect Schedule (PANAS). PA scores and associations with cognitive decline were tested in random-effects models. Controlling for demographics and depressive symptoms, there was no significant association with PA scores and decline in memory (χ 2  = 1.52; df = 2; P = 0.47), executive functions (χ 2  = 0.99; df = 2; P = 0.61), and information processing speed (χ 2  = 0.52; df = 2; P = 0.77) at 6- and 12-year follow-up. PA did not predict cognitive change over time. These findings question the extent of protective effects of PA on cognitive aging in adulthood, and are discussed in terms of age range and types of measures used for PA and cognition. Copyright © 2016 John Wiley & Sons, Ltd.

  5. Mortality in myasthenia gravis: A nationwide population-based follow-up study in Denmark

    Hansen, Julie S; Danielsen, Ditte H; Somnier, Finn E

    2016-01-01

    INTRODUCTION: In previous studies of myasthenia gravis (MG), increased mortality has been reported. The aim of this study was to estimate mortality in patients with acetylcholine receptor antibody-positive (AChR-Ab-seropositive) MG in a nationwide population-based, long-term follow-up study...

  6. Forgotten antibiotics: a follow-up inventory study in Europe, the USA, Canada and Australia

    Pulcini, C.; Mohrs, S.; Beovic, B.; Gyssens, I.C.; Theuretzbacher, U.; Cars, O.

    2017-01-01

    The objective of this study was to update a 2011 survey, conducted on behalf of the ESCMID Study Group for Antibiotic Policies (ESGAP), studying the availability of old but clinically useful antibiotics in North America, Europe and Australia. This follow-up survey was performed in 2015 in 40

  7. Characteristics and follow-up of postmarketing studies of conditionally authorized medicines in the EU

    Hoekman, Jarno; Klamer, Thea T.; Mantel-Teeuwisse, Aukje K.; Leufkens, Hubert G M; De Bruin, Marie L.

    2016-01-01

    Aim: The aim of the present study was to provide an insight into the characteristics and follow-up of postmarketing studies of medicines that were conditionally authorized in the European Union (EU). Methods: We compiled a list of all postmarketing studies attached as specific obligations to the

  8. A prospective follow-up study of younger and older subjects with pathological gambling.

    Black, Donald W; Coryell, William; McCormick, Brett; Shaw, Martha; Allen, Jeff

    2017-10-01

    Pathological gambling (PG) is a common and costly public health problem associated with impaired quality of life and high suicide rates. Despite its frequency in the general population, PG course is poorly understood in older adults who are especially vulnerable to its devastating consequences. We enrolled 175 subjects in a longitudinal study of gambling behavior: our case group of 53 older adults with PG (≥ 60 years), and two comparison groups including 72 younger adults with PG (Gambling Screen (SOGS) and National Opinion Research Center DSM Screen for Gambling Problems (NODS) scores ≥ 5. Subjects were evaluated at intake and reassessed every 6 months and drop outs were replaced. Follow-up lasted a mean (SD) of 2.6 (1.4) years. At intake older PGs were more likely to be female, Caucasian, divorced, and to have a lower level of education. Older and younger PGs were similar in gambling severity, but older PGs were more likely to have sought PG treatment. Older PGs had lower rates of lifetime drug use disorders, attention deficit/hyperactivity disorder, and obsessive-compulsive disorder. They preferred slots, were more likely to receive PG treatment, and were less likely to discontinue participation in the study. Week by week gambling activity levels showed a significant general downward movement for older and younger PGs, although there were no differences between the groups. Elders without PG had no change in their level of gambling activity. We conclude that younger and older PGs moved toward a reduced level of gambling activity during follow-up. Our data challenge the notion that PG is chronic and progressive. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Survival analysis with functional covariates for partial follow-up studies.

    Fang, Hong-Bin; Wu, Tong Tong; Rapoport, Aaron P; Tan, Ming

    2016-12-01

    Predictive or prognostic analysis plays an increasingly important role in the era of personalized medicine to identify subsets of patients whom the treatment may benefit the most. Although various time-dependent covariate models are available, such models require that covariates be followed in the whole follow-up period. This article studies a new class of functional survival models where the covariates are only monitored in a time interval that is shorter than the whole follow-up period. This paper is motivated by the analysis of a longitudinal study on advanced myeloma patients who received stem cell transplants and T cell infusions after the transplants. The absolute lymphocyte cell counts were collected serially during hospitalization. Those patients are still followed up if they are alive after hospitalization, while their absolute lymphocyte cell counts cannot be measured after that. Another complication is that absolute lymphocyte cell counts are sparsely and irregularly measured. The conventional method using Cox model with time-varying covariates is not applicable because of the different lengths of observation periods. Analysis based on each single observation obviously underutilizes available information and, more seriously, may yield misleading results. This so-called partial follow-up study design represents increasingly common predictive modeling problem where we have serial multiple biomarkers up to a certain time point, which is shorter than the total length of follow-up. We therefore propose a solution to the partial follow-up design. The new method combines functional principal components analysis and survival analysis with selection of those functional covariates. It also has the advantage of handling sparse and irregularly measured longitudinal observations of covariates and measurement errors. Our analysis based on functional principal components reveals that it is the patterns of the trajectories of absolute lymphocyte cell counts, instead of

  10. Follow-up services for stroke survivors after hospital discharge--a randomized control study

    Andersen, Hanne Elkjaer; Eriksen, Karen; Brown, Anne

    2002-01-01

    OBJECTIVE: To evaluate whether follow-up services for stroke survivors could improve functional outcome and reduce readmission rate. In this paper results of functional outcome are reported. DESIGN: Randomized controlled trial allocating patients to one of three different types of aftercare: (1......) follow-up home visits by a physician, (2) physiotherapist instruction in the patient's home, or (3) standard aftercare. SUBJECTS: Stroke patients with persisting impairment and disability who, after completing inpatient rehabilitation, were discharged to their homes. OUTCOME MEASURES: Six months after...... discharge, functional outcome was assessed with Functional Quality of Movement, Barthel Index, Frenchay Activity Index and Index of Extended Activites of Daily Living. RESULTS: One-hundred and fifty-five stroke patients were included in the study. Fifty-four received follow-up home visits by a physician, 53...

  11. Gynecologic follow up of 129 women on dialysis and after kidney transplantation: a retrospective cohort study.

    Chakhtoura, Zeina; Meunier, Marie; Caby, Jacqueline; Mercadal, Lucile; Arzouk, Nadia; Barrou, Benoît; Touraine, Philippe

    2015-04-01

    To describe the gynecologic issues and follow-up in our referral center of women on dialysis and after kidney transplantation. This retrospective cohort study included 129 dialysed women among whom 102 had had transplants. Data on menstrual pattern, pregnancies, contraception, and cervical cytology were retrieved from patients' files. The follow-up started at age 41.6±14.2 years and lasted for 9.5±10.2 years. Of the women, 78.7% had regular menses before dialysis, decreasing to 30.6% on dialysis (pirregular menses and metrorrhagia which was improved by chlormadinone acetate. We noted high rates of obstetrical complications and abnormal smear tests. Consequently, this population must have close follow-up to identify and treat gynecologic issues. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  12. Prevalent pain and pain level among torture survivors: a follow-up study

    Dorthe Reff, Olsen; Montgomery, Edith; Carlsson, J

    2006-01-01

    AIM: To estimate change over nine months and over two years, as concerns the prevalence and level of pain in the head, back and feet, among previously tortured refugees settled in Denmark, and to compare associations between torture methods and the prevalence of pain at baseline and at follow...... pattern was found when examining the level of pain as indicated by Visual Analogue Scales. Pain in the feet at follow-up was associated with previous exposure to beating against the feet. Pain in the back at baseline and pain in the head at follow-up were associated with suffocation. CONCLUSION: More than...... ten years after the torture took place, survivors of torture continue to suffer from pain associated with the type of torture they had been subjected to. This presents a considerable challenge to future evidence-based development of effective treatment programmes....

  13. Parental involvement and association with adolescents’ fruit and vegetable intake at follow-up

    Jørgensen, Sanne Ellegaard; Jørgensen, Thea Suldrup; Aarestrup, Anne Kristine

    2016-01-01

    involvement was found among 30.5 %, 29.6 % and 39.4 % of the students respectively. Parental involvement was highest among women. More men agreed that the parental newsletters provided new information. Students with a medium and high level of parental involvement ate 47.5 and 95.2 g more FV per day compared...... (≈13- year-olds) in the school year 2010/11. The study included a school component: free FV in class and curricular activities; a local community component: fact sheets for sports- and youth clubs; and a parental component: presentation of Boost at a parent-school meeting, 6 newsletters to parents, 3...... guided student-parent curricular activities, and a student-parent Boost event. Study population: Students whose parent replied to the follow-up survey (n = 347). Data: Questionnaire data from students, parents and teachers at 20 intervention schools. Process evaluation measures: dose delivered, dose...

  14. Habitual active transport, TV viewing and weight gain: a four year follow-up study.

    Ding, Ding; Sugiyama, Takemi; Owen, Neville

    2012-01-01

    To examine the associations of TV viewing time and domain-specific physical activity with weight change; to determine whether domain-specific physical activity moderates the potential association of TV viewing time with weight change. We used four-year longitudinal data (baseline: 2003-2004, follow-up: 2007-2008) on 969 adults from selected neighborhoods in Adelaide, Australia (Age: 48.6 ± 10.6 years, 61% females). Mixed models examined four-year weight change as the dependent variable, with TV viewing time, habitual transport and past week domain-specific physical activity at baseline as independent variables. On average, participants gained 1.6 kg over four years. TV viewing time at baseline was positively associated with weight gain at follow-up. Each additional hour of TV viewing was associated with 0.24-0.27 kg of extra weight gain. This relationship was not moderated by recent recall of transport, leisure-time, and occupational physical activity, but was moderated by habitual transport: an additional hour of TV viewing time at baseline was significantly associated with an extra weight gain of 0.65 kg at follow-up among those who were inactive in everyday transport; TV time was not significantly associated with weight change among those who were regularly active in transport. Habitual active transport may protect adults against risk of weight gain associated with prolonged TV viewing time. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Irritable bowel syndrome--prognosis and diagnostic safety. A 5-year follow-up study

    Svendsen, Jesper Hastrup; Munck, L K; Andersen, J R

    1985-01-01

    The irritable bowel syndrome is the commonest diagnosis in gastroenterological clinics, although diagnostic criteria and investigatory programs vary. To elucidate the diagnostic safety and prognosis of the syndrome, a retrospective study was conducted. One hundred and twelve consecutive patients...... with irritable bowel syndrome as the final and only abdominal diagnosis in the period 1977-79 were followed up in 1984. Seventeen patients died during the follow-up period; two of these were considered diagnostic failures (chronic pancreatitis and pancreatic cancer). Of the remaining 95 patients, 93 were...

  16. Predictors of Attendance and Dropout at the Lung Health Study 11-Year Follow-Up

    Snow, Wanda M.; Connett, John E.; Sharma, Shweta; Murray, Robert P.

    2006-01-01

    Participant attrition and attendance at follow-up were examined in a multicenter, randomized, clinical trial. The Lung Health Study (LHS) enrolled a total of 5, 887 adults to examine the impact of smoking cessation coupled with the use of an inhaled bronchodilator on chronic obstructive pulmonary disease (COPD). Of the initial LHS 1 volunteers still living at the time of enrolment in LHS 3 (5,332), 4,457 (84%) attended the LHS 3 clinic visit, a follow-up session to determine current smoking s...

  17. Personality and cognitive decline in the Baltimore Epidemiologic Catchment Area follow-up study.

    Hock, Rebecca S; Lee, Hochang Benjamin; Bienvenu, O Joseph; Nestadt, Gerald; Samuels, Jack F; Parisi, Jeanine M; Costa, Paul T; Spira, Adam P

    2014-09-01

    To determine the association between personality domains and 11-year cognitive decline in a sample from a population-based study. Data from Waves 3 (1993-1996) and 4 (2003-2004) of the Baltimore cohort of the Epidemiologic Catchment Area (ECA) study were used for analyses. The sample included 561 adults (mean age ± SD: 45.2 ± 10.78 years) who completed the NEO Personality Inventory-Revised prior to Wave 4. Participants also completed the Mini-Mental State Examination (MMSE) and immediate and delayed word recall tests at Wave 3, and at Wave 4, 10.9 ± 0.6 years later. In models adjusted for baseline cognitive performance, demographic characteristics, medical conditions, depressive symptoms, and psychotropic medication use, each 10-point increase in Neuroticism T-scores was associated with a 0.15-point decrease in MMSE scores (B = -0.15, 95% confidence interval [CI]: -0.30, -0.01), whereas each 10-point increase in Conscientiousness T-scores was associated with a 0.18-point increase on the MMSE (B = 0.18, 95% CI: 0.04, 0.32) and a 0.21-point increase in immediate recall (B = 0.21, 95% CI: 0.003, 0.41) between baseline and follow-up. Findings suggest that greater Neuroticism is associated with decline, and greater Conscientiousness is associated with improvement in performance on measures of general cognitive function and memory in adults. Further studies are needed to determine the extent to which personality traits in midlife are associated with clinically significant cognitive outcomes in older adults, such as mild cognitive impairment and dementia, and to identify potential mediators of the association between personality and cognitive trajectories. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  18. Multicentre European study of thalamic stimulation for parkinsonian tremor: a 6 year follow-up

    Hariz, M. I.; Krack, P.; Alesch, F.; Augustinsson, L.-E.; Bosch, A.; Ekberg, R.; Johansson, F.; Johnels, B.; Meyerson, B. A.; N'Guyen, J.-P.; Pinter, M.; Pollak, P.; von Raison, F.; Rehncrona, S.; Speelman, J. D.; Sydow, O.; Benabid, A.-L.

    2008-01-01

    To evaluate the results of ventral intermediate (Vim) thalamic deep brain stimulation (DBS) in patients with tremor predominant Parkinson's disease (PD) at 6 years post surgery. This was a prolonged follow-up study of 38 patients from eight centres who participated in a multicentre study, the 1 year

  19. Extending a Community of Care beyond the Ninth Grade: A Follow-Up Study

    Ellerbrock, Cheryl R.; Kiefer, Sarah M.

    2013-01-01

    This qualitative within-site case study ("N" = 10) is a follow-up study to a 2006-2007 investigation that analyzed how 1 high school created a community of care for its ninth-grade students through the implementation of a ninth-grade transition program--Freshman Focus. All participants were interviewed again 3 years later during…

  20. Review of retention strategies in longitudinal studies and application to follow-up of ICU survivors.

    Tansey, Catherine M; Matté, Andrea L; Needham, Dale; Herridge, Margaret S

    2007-12-01

    To review the literature on retention strategies in follow-up studies and their relevance to critical care and to comment on the Toronto experience with the acute respiratory distress syndrome (ARDS) and severe acute respiratory syndrome (SARS) follow-up studies. Literature review and two cohort studies in a tertiary care hospital in Toronto, Canada. ARDS and SARS patients. Review articles from the social sciences and medicine are summarized and our own experience with two longitudinal studies is drawn upon to elucidate strategies that can be successfully used to attenuate participant drop-out from longitudinal studies. Three key areas for retention of subjects are identified from the literature: (a) respect for patients: respect for their ideas and their time commitment to the research project; (b) tracking: collect information on many patient contacts at the initiation of the study and outline tracking procedures for subjects lost to follow-up; and (c) study personnel: interpersonal skills must be reinforced, flexible working hours mandated, and support offered. Our 5-year ARDS and 1-year SARS study retention rates were 86% and 91%, respectively, using these methods. Strategies to reduce patient attrition are time consuming but necessary to preserve internal and external validity. When the follow-up system is working effectively, researchers can acquire the necessary data to advance knowledge in their field and patients are satisfied that they have an important role to play in the research project.

  1. A Predictive and Follow-Up Study of Abusive and Neglectful Families by Case Analysis.

    Heap, Kari Killen

    1991-01-01

    A case analysis, predictive study, and follow-up study of 17 abused and/or neglected children found that the prognosis for abusive and/or neglectful parents is poorer when they are scored high on immaturity than when they are scored high on emotional problems. (BRM)

  2. A Follow-up Study of Returning Students--A Concentration on Women.

    Plotsky, Frances; Ohm, Susan

    The office of Services for Returning Students (SRS) at the University of Texas (U.T.) at Austin conducted a follow-up study of men and women students who had visited the office from February 1969 to the end of 1971. The study ascertained the average interval between periods of formal education, the fulfillment of educational goals, and the use of…

  3. A five-year follow-up study of Swedish adults with gender identity disorder.

    Johansson, Annika; Sundbom, Elisabet; Höjerback, Torvald; Bodlund, Owe

    2010-12-01

    This follow-up study evaluated the outcome of sex reassignment as viewed by both clinicians and patients, with an additional focus on the outcome based on sex and subgroups. Of a total of 60 patients approved for sex reassignment, 42 (25 male-to-female [MF] and 17 female-to-male [FM]) transsexuals completed a follow-up assessment after 5 or more years in the process or 2 or more years after completed sex reassignment surgery. Twenty-six (62%) patients had an early onset and 16 (38%) patients had a late onset; 29 (69%) patients had a homosexual sexual orientation and 13 (31%) patients had a non-homosexual sexual orientation (relative to biological sex). At index and follow-up, a semi-structured interview was conducted. At follow-up, 32 patients had completed sex reassignment surgery, five were still in process, and five-following their own decision-had abstained from genital surgery. No one regretted their reassignment. The clinicians rated the global outcome as favorable in 62% of the cases, compared to 95% according to the patients themselves, with no differences between the subgroups. Based on the follow-up interview, more than 90% were stable or improved as regards work situation, partner relations, and sex life, but 5-15% were dissatisfied with the hormonal treatment, results of surgery, total sex reassignment procedure, or their present general health. Most outcome measures were rated positive and substantially equal for MF and FM. Late-onset transsexuals differed from those with early onset in some respects: these were mainly MF (88 vs. 42%), older when applying for sex reassignment (42 vs. 28 years), and non-homosexually oriented (56 vs. 15%). In conclusion, almost all patients were satisfied with the sex reassignment; 86% were assessed by clinicians at follow-up as stable or improved in global functioning.

  4. Association of pneumonia and lung cancer: the value of convalescent chest radiography and follow-up

    Holmberg, H.; Kragsbjerg, P.

    1993-01-01

    A retrospective study of 1011 hospitalized patients with pneumonia was undertaken to assess the value of routine convalescent chest radiography for detection of underlying lung cancer. To investigate the mode of clinical onset of pulmonary carcinoma, 232 inpatients with this diagnosis were also studied. The findings may be summarized as follows: 1. 13/1011 pneumonia patients were found to have previously undiagnosed pulmonary carcinoma; 2. many of these carcinomas (8/13) were disclosed by an acute chest X-ray; 3. pulmonary carcinoma was found by convalescent chest X-ray in 2/88 patients not feeling well and in 2/524 patients feeling well at follow-up, and non of these 4 patients benefitted from the carcinoma diagnosis; 4. ESR was of no value in detecting underlying pulmonary carcinoma at follow-up in patients with pneumonia; 5. of the 232 patients with pulmonary carcinoma, 29 (12.5%) presented with an acute respiratory tract infection; 6. most of these latter patients did not recover as expected and their correct diagnosis was made based on a chest X-ray performed because of persistent symptoms. We suggest that patients with radiologically verified pneumonia undergo clinical examination or are interviewed 4-5 weeks after the onset. If signs or symptoms of respiratory disease persist, chest X-ray should be performed. We consider, however, that routine convalescent chest radiography with the aim of detecting any underlying pulmonary tumour could be omitted if the patient has completely recovered 1 month after the acute onset of illness. (9 refs.)

  5. Work related stress, burnout, job satisfaction and general health of nurses: A follow-up study.

    Khamisa, Natasha; Peltzer, Karl; Ilic, Dragan; Oldenburg, Brian

    2016-12-01

    Nurses experience high levels of work related stress and burnout as well as low job satisfaction and poor general health owing to the nature of their work. This paper seeks to provide a better understanding of the nature of relationships between work related stress, burnout, job satisfaction and general health of nurses over one year. This study involved a longitudinal design. Two hundred and seventy seven nurses from four hospitals completed a follow up survey consisting of five questionnaires. Data were collected between 2013 and 2014. The data were analysed using generalized estimation equation analysis. Lack of support was associated with burnout, patient care was associated with job satisfaction and staff issues were associated with general health of nurses. Burnout is more strongly related to job satisfaction than general health. The findings of this study could inform evidence based policy and practice through interventions aimed at improving job satisfaction and reducing the impact of burnout on general health of nurses. © 2016 John Wiley & Sons Australia, Ltd.

  6. Rehabilitation after severe brain injury: a follow-up study of a behaviour modification approach.

    Eames, P; Wood, R

    1985-01-01

    Twenty four patients with severe brain injury who had disturbed behaviours preventing rehabilitation or care in ordinary settings were treated in a token economy. This long-term follow-up study indicates that post-traumatic behaviour disorders can be lastingly improved, and that lengthy rehabilitation can have surprisingly good effects.

  7. CT-follow-up-studies in neurocysticercosis during praziquantel-therapy

    Schwartz, A.; Aulich, A.; Hammer, B.

    1987-05-01

    Praziquanteltherapy has produced a much better prognosis in neurocysticercosis since 1980. The computertomographic findings and follow-up study in 4 patients with neurocysticercosis before and after praziquanteltherapy are described. The special difficulties of differential diagnosis and further diagnostic procedures are discussed in cases in which calcifications are absent and only solitary foci can be found.

  8. CT-follow-up-studies in neurocysticercosis during praziquantel-therapy

    Schwartz, A.; Aulich, A.; Hammer, B.

    1987-01-01

    Praziquanteltherapy has produced a much better prognosis in neurocysticercosis since 1980. The computertomographic findings and follow-up study in 4 patients with neurocysticercosis before and after praziquanteltherapy are described. The special difficulties of differential diagnosis and further diagnostic procedures are discussed in cases in which calcifications are absent and only solitary foci can be found. (orig.) [de

  9. Sexual dysfunction in multiple sclerosis: A 6-year follow-up study.

    Kisic-Tepavcevic, Darija; Pekmezovic, Tatjana; Trajkovic, Goran; Stojsavljevic, Nebojsa; Dujmovic, Irena; Mesaros, Sarlota; Drulovic, Jelena

    2015-11-15

    Sexual dysfunction (SD) is a common but often overlooked and undertreated symptom in multiple sclerosis (MS). The purpose of our longitudinal study was to explore the changes in the level of sexual functioning in MS cohort after a period of 3 and 6 years of follow-up, as well as to investigate the predictors of changes in SD during the period of observation. The study population comprise a cohort of 93 patients with MS (McDonald's criteria, 2001) who were assessed at three time points during the study (baseline, and at the 3- and 6-year follow-up). The presence and severity of SD was quantified by Szasz sexual functioning scale. Independent predictors of the ordinal-scaled measure of sexual problems were identified using a generalized linear mixed regression models. The number of reported SD symptoms increased markedly for both genders during the whole period of observation. Duration of follow-up, age, level of physical disability, depression and fatigue were identified as independent prognostic factors for deterioration of sexual functioning in patients with MS during the 6-year follow-up. Our study provides insight into dynamics of change in sexual function among patients with MS and predictors of change, over the period of 6 years. Copyright © 2015 Elsevier B.V. All rights reserved.

  10. Follow-Up Study of 1983 Legal Technology Graduates. Volume 12, No. 14.

    Hildebrandt, Sharrie; Lucas, John A.

    A follow-up study was conducted at William Rainey Harper College (WRHC) to determine the employment and educational status of graduates of the Legal Technology (LTE) program 6 months after receiving their degree. Attempts were made to contact all 59 1983 LTE graduates for telephone interviews and compare their responses to findings from previous…

  11. Osteogenesis imperfecta in childhood: impairment and disability. A prospective study with 4-year follow-up

    Engelbert, Raoul H.; Uiterwaal, Cuno S.; Gerver, Willem-Jan; van der Net, Jan-Jaap; Pruijs, Hans E.; Helders, Paul J.

    2004-01-01

    To study (1). changes in anthropometrics, joint range of motion (ROM), muscle strength, functional ability, caregiver assistance, and level of ambulation in children with osteogenesis imperfecta (OI) and (2). the prediction of clinical characteristics at the level of ambulation at follow-up and the

  12. Orbital irradiation for Graves' ophthalmopathy - Is it safe? A long-term follow-up study

    Wakelkamp, Iris M. M. J.; Tan, Hendra; Saeed, Peerooz; Schlingemann, Reinier O.; Verbraak, Frank D.; Blank, Leo E. C. M.; Prummel, Mark F.; Wiersinga, Wilmar M.

    2004-01-01

    Purpose: We evaluated the frequency of long-term complications of orbital irradiation (radiation-induced tumors, cataract, and retinopathy) in comparison with glucocorticoids. Design: We conducted a follow-up study in a cohort of 245 Graves' ophthalmopathy patients who had been treated with

  13. Exploring "Successful" Outcomes of Entrepreneurship Education: A Follow-Up Study

    Galloway, Laura; Kapasi, Isla; Whittam, Geoff

    2015-01-01

    During 2005-2006 entrepreneurship students in several UK universities completed a survey about their background and career intentions. This paper reports, eight years on, on a follow-up study with ten of these participants, with the aim of exploring the students' intentions and subsequent actions since graduating. Using a qualitative methodology,…

  14. Osteoarthritis after rotator cuff repair: A 10-year follow-up study.

    Flurin, P-H; Hardy, P; Valenti, P; Meyer, N; Collin, P; Kempf, J-F

    2017-06-01

    Joint surgery is often complicated by gradual bone and cartilage deterioration that eventually leads to secondary osteoarthritis. The primary objective of this study was to identify preoperative risk factors for gleno-humeral osteoarthritis after rotator cuff repair. The secondary objectives were to assess whether the risk of gleno-humeral osteoarthritis was influenced by the operative technique, occurrence of postoperative complications, cuff healing, and muscle degeneration and to determine whether gleno-humeral osteoarthritis affected the clinical outcome. The development of gleno-humeral osteoarthritis affects the postoperative clinical outcome. A retrospective multicentre study of patients who underwent rotator cuff repair in 2003 and were re-evaluated at least 10 years later was conducted under the aegis of the Société française de chirurgie orthopédique et traumatique (SOFCOT). Osteoarthritis severity was graded according to the Samilson-Prieto classification. Four hundred and one patients were included. At last follow-up, at least 10 years after surgery, the radiological Samilson-Prieto grades were distributed as follows: 0, n=181 (45%); 1, n=142 (n=35%); 2, n=57 (14%); 3, n=14 (4%); and 4, n=7 (2%). The mean Constant score was significantly higher in the patients without than with osteoarthritis at last follow-up (79/100 vs. 73/100, Posteoarthritis was significantly higher in the group with unhealed or re-torn cuffs (Sugaya type 4 or 5) than in the group with healed cuffs (Sugaya type 1, 2, or 3) (46% vs. 25%, P=0.012). Our study showed no associations linking the risk of gleno-humeral osteoarthritis to the patient activity profile, history of shoulder injury, or preoperative symptom duration. In contrast, statistically significant associations were identified between gleno-humeral osteoarthritis and age, male gender, initial tear severity, and the pain and mobility components of the preoperative Constant score. Decreased invasiveness of the

  15. Long-term follow-up of bronchus-associated lymphoid tissue lymphomas (BALTOMA)

    Gaffke, G.; Jost, D.; Stroszcynski, C.; Puls, R.; Schlecht, I.; Felix, R.; Ludwig, W.D.; Hosten, N.

    2002-01-01

    Purpose: The purpose of this work was to describe the findings and the long term follow up of pathologically confirmed bronchus-associated lymphoid tissue lymphoma (BALTOMA) in 6 patients. Methods: CT examinations and conventional radiological examinations were reviewed and compared to describe typical radiological findings and patterns of pulmonary manifestations. It were described the number of lesions and characteristics like presence of airspace consolidation, ground-glass attenuation, bubble-like radio-lucencies, air bronchogram, bronchial dilatation, Infiltration and the long term behaviour of the manifestations. Results: Lesions with a positive air bronchogram, no infiltration of extrapulmonary tissue or extrapulmonary manifestations were revealed as typical findings. Only a slow or no progression of disease was shown in most patients over a term of up to twelve years. Conclusions: The lymphoma of the bronchus-associated lymphoid tissue of the lung is a rare tumor. A positive air bronchogram, a multiplicity of disease, bilateral lesions, a fibrotic transformation of the lung tissue and no growth or only a slow groth over al long term of observation are typical radiological findings. (orig.) [de

  16. Follow-up study and evaluation of benign stricture of upper gastrointestinal tract with interventional procedure

    Cheng Yingsheng; Li Minghua; Zhuang Qixin; Shang Kezhong; Chen Weixiong; Chen Niwei

    2001-01-01

    Objective: To make follow-up study and evaluation of benign stricture of upper gastrointestinal tract (UGIT) with interventional procedure. Methods: There were 85 cases of benign stricture of UGIT with interventional procedure. There were 35 cases with pneumatic dilation (group A), 25 cases with permanent (group B) placement, and 25 cases with temporary (group C) placement of expandable metallic stent, respectively. All cases were completed under fluoroscopy. 35 cases of group A had 67 times dilations (mean 1.9 times). Fifteen partial covered and 10 uncovered expandable metallic stents were permanently placed in the 25 cases of group B. 25 partial covered expandable metallic stents were temporarily placed in the 25 cases of group C, and the stents were drawn out via gastroscopy 3-7 days later. All stents placement and drawing were technically successful. The most strictured diameters of UGIT were 0.7-8.5 mm before dilations and 5.1-20.0 mm after dilations. Dysphagia scores of all cases were from grade 2 to 4 before dilations, and from grade 0 to 1 after dilations. Follow-up time of all cases was from 6 months to 36 months (mean 19.1 months). Results: Complications in group A included chest pain (n =10), reflux (n = 8), and bleeding (n = 3). Seven (20%) in 35 cases of group A had dysphagia relapse during follow-up over 6 months; 32 (91%) in 35 cases of group A had dysphagia relapse during follow-up over 12 months; 19(95%) in 20 cases of group A had dysphagia relapse during follow-up over 36 months. Complications in group B included chest pain (n = 10), reflux (n = 15), bleeding (n = 3), and stent migration (n = 4). Five (20%) in 25 cases of group B had dysphagia relapse during follow-up over 6 months; 3(25%) in 12 cases of group B had dysphagia relapse during follow-up over 12 months; 3 (60%) in 5 cases of group B had dysphagia relapse during follow-up over 36 months. Complications in group C included chest pain (n = 10), reflux (n = 3), and bleeding (n = 4). 3

  17. Augmented cross-sectional studies with abbreviated follow-up for estimating HIV incidence.

    Claggett, B; Lagakos, S W; Wang, R

    2012-03-01

    Cross-sectional HIV incidence estimation based on a sensitive and less-sensitive test offers great advantages over the traditional cohort study. However, its use has been limited due to concerns about the false negative rate of the less-sensitive test, reflecting the phenomenon that some subjects may remain negative permanently on the less-sensitive test. Wang and Lagakos (2010, Biometrics 66, 864-874) propose an augmented cross-sectional design that provides one way to estimate the size of the infected population who remain negative permanently and subsequently incorporate this information in the cross-sectional incidence estimator. In an augmented cross-sectional study, subjects who test negative on the less-sensitive test in the cross-sectional survey are followed forward for transition into the nonrecent state, at which time they would test positive on the less-sensitive test. However, considerable uncertainty exists regarding the appropriate length of follow-up and the size of the infected population who remain nonreactive permanently to the less-sensitive test. In this article, we assess the impact of varying follow-up time on the resulting incidence estimators from an augmented cross-sectional study, evaluate the robustness of cross-sectional estimators to assumptions about the existence and the size of the subpopulation who will remain negative permanently, and propose a new estimator based on abbreviated follow-up time (AF). Compared to the original estimator from an augmented cross-sectional study, the AF estimator allows shorter follow-up time and does not require estimation of the mean window period, defined as the average time between detectability of HIV infection with the sensitive and less-sensitive tests. It is shown to perform well in a wide range of settings. We discuss when the AF estimator would be expected to perform well and offer design considerations for an augmented cross-sectional study with abbreviated follow-up. © 2011, The

  18. Predicting failure to follow-up screened high blood pressure in Japan: a cohort study.

    Kuriyama, Akira; Takahashi, Yoshimitsu; Tsujimura, Yuka; Miyazaki, Kikuko; Satoh, Toshihiko; Ikeda, Shunya; Nakayama, Takeo

    2015-09-01

    This study aimed to determine the prevalence and predictors of working-age individuals who did not follow-up for possible hypertension that was detected in the population-based screening. We conducted a retrospective cohort study, using the database of health insurance claims and health checkups from several health insurance societies for employees in Japan. Screened participants aged ≥20 years, with possible hypertension (systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg) and without known antihypertensive treatment, were included. The outcome was lack of clinical follow-up for possible hypertension within 6 months of the latest screening. Multivariate logistic regression analysis was performed to identify predictors. Among 17,173 participants (15,793 males and 1380 females) who were identified as possible hypertensives, 89.7 and 82.3% of them, respectively, did not consult physicians for screened possible hypertension. Predictors of no clinical follow-up for males included younger age, lower body mass index (BMI), lower hemoglobin A1c and milder hypertension. Predictors for females included younger age, lower BMI and being insured. Approximately 80% of participants failed to consult physicians even with positive screening results. Younger individuals with lower BMI are at high risk of no clinical follow-up. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. Diffusion-weighted MR imaging of neuro-Behcet's disease: initial and follow-up studies

    Heo, Suk Hee; Seo, Jeong Jin; Kim, Heung Joong; Chang, Nam Gyu; Shin, Sang Soo; Jeong, Yong Yeon; Jeong Gwang Woo; Kang, Heoung Keun

    2005-01-01

    To assess the usefulness of diffusion-weighted MR imaging (DWI) and apparent diffusion coefficient (ADC) in the initial and follow-up studies of patients with neuro-Behcet's disease. Six patients diagnosed with neuro-Behcet's disease were the subjects of this study. Initial and follow-up MR imaging were obtained in all six patients. Initial and follow-up DWI were also obtained is four of the six patients, with only an initial DWI in the other two. The DWI were obtained using multi-shot echo planar imaging, on a 1.5T MR unit, with two gradient steps (b values of 0, 1000 sec/mm 2 ). The ADC value and ADC maps were obtained using commercial software. The locations and signal intensities of the lesions were analyzed on conventional MRI and DWI, respectively. The ADC values of the lesions were calculated on the initial and follow-up DWI, and compared those of lesions in the normal contralateral regions. The initial DWI showed iso-signal intensities in four of the six patients, with high signal intensities in the other two. In five of the six patients, including three of the four that showed isosignal intensities and the two that showed high signal intensities on the initial DWI, the ADC values of the involved lesions were higher than those of the normal contralateral regions. In three of four that showed isosignal intensities, the ADC values of the lesions were decreased and normalized on the follow-up DWI. Obtaining DWI and ADC values in patients with neuro-Behcet's disease may be helpful in the understanding of pathophysiology and differential diagnosis of this disease

  20. Radiographic Measurements Associated With the Natural Progression of the Hallux Valgus During at Least 2 Years of Follow-up.

    Lee, Seung Yeol; Chung, Chin Youb; Park, Moon Seok; Sung, Ki Hyuk; Ahmed, Sonya; Koo, Seungbum; Kang, Dong-Wan; Lee, Kyoung Min

    2018-04-01

    This study aimed to investigate the radiographic measurements associated with the progression of hallux valgus during at least 2 years of follow-up. Seventy adult patients with hallux valgus who were followed for at least 2 years and underwent weightbearing foot radiography were included. Radiographic measurements included the hallux valgus angle (HVA), hallux interphalangeal angle, intermetatarsal angle (IMA), metatarsus adductus angle, distal metatarsal articular angle (DMAA), tibial sesamoid position, anteroposterior (AP) talo-first metatarsal angle, and lateral talo-first metatarsal angle. Patients were divided into progressive and nonprogressive groups. Binary logistic regression analysis was performed to identify factors that significantly affected the progression of hallux valgus deformity. The correlation between change in HVA and changes in other radiographic indices during follow-up was analyzed. The DMAA ( P = .027) and AP talo-first metatarsal angle ( P = .034) at initial presentation were found to be significant factors affecting the progression of hallux valgus deformity. Change in the HVA during follow-up was significantly correlated with changes in the IMA ( r = 0.423; P = .001) and DMAA ( r = 0.541; P < .001). The change in the HVA was found to be significantly correlated with changes in the IMA and DMAA. A future study is required to elucidate whether this correlation can be explained by the progressive instability of the first tarsometatarsal joint. We believe special attention needs to be paid to patients with pes planus and increased DMAA. Level III, comparative study.

  1. Long-Term Follow-Up Study of Legal Tech Graduates, 1984-1988. Volume XVIII, No. 5.

    Lucas, John A.; Hildebrandt, Sharrie

    In order to provide information for the 1989-90 program review at William Rainey Harper College (WRHC) and to fulfill American Bar Association accreditation guidelines, a long-term, follow-up study was conducted of all Legal Tech program alumni who graduated between 1984 and 1988. A telephone survey generated usable responses from 106 (73%) of the…

  2. Occupational Physical Activity, Overweight, and Mortality: A Follow-Up Study of 47,405 Norwegian Women and Men

    Graff-Iversen, Sidsel; Selmer, Randi; Sorensen, Marit; Skurtveit, Svetlana

    2007-01-01

    This population-based 24-year follow-up study evaluated the association of occupational physical activity (OPA) with overweight and mortality in 47,405 men and women, healthy at baseline, and reporting OPA as sedentary (reference), light, moderately heavy, or heavy. The adjusted odds ratio for overweight was slightly less than 1 for all categories…

  3. Do illness perceptions predict health outcomes in primary care patients? A 2-year follow-up study

    Frostholm, Lisbeth; Ørnbøl, Eva; Christensen, Kaj Aage Sparle

    2007-01-01

    OBJECTIVE: Little is known about whether illness perceptions affect health outcomes in primary care patients. The aim of this study was to examine if patients' illness perceptions were associated with their self-rated health in a 2-year follow-up period. METHODS: One thousand seven hundred eighty...... at follow-up for the whole group of patients. Patients presenting with MUS had more negative illness perceptions and lower mental and physical components subscale of the SF-36 scores at all time points. CONCLUSIONS: Patients' perception of a new or recurrent health problem predicts self-reported physical......-five primary care patients presenting a new or recurrent health problem completed an adapted version of the illness perception questionnaire and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) at baseline and 3, 12, and 24 months' follow-up. Linear regressions were performed for (1) all...

  4. Long-term follow-up of cyclophosphamide compared with azathioprine for initial maintenance therapy in ANCA-associated vasculitis

    Walsh, M.; Faurschou, M.; Berden, A.

    2014-01-01

    BACKGROUND AND OBJECTIVES: Treatment with azathioprine within 3 months of remission induction with cyclophosphamide is a common treatment strategy for patients with ANCA-associated vasculitis. This study comprised patients undergoing long-term follow-up who were randomly allocated to azathioprine...... after 3-6 months or after 12 months of cyclophosphamide treatment. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Patients from 39 European centers between 1995 and 1997 with a new diagnosis of ANCA-associated vasculitis that involved the kidneys or another vital organ were eligible. At the time...

  5. Incidence of chronic atrophic gastritis: systematic review and meta-analysis of follow-up studies.

    Adamu, Mariam Abdullahi; Weck, Melanie Nicole; Gao, Lei; Brenner, Hermann

    2010-07-01

    Chronic atrophic gastritis (CAG) is an important precursor lesion of intestinal gastric cancer. As it is typically asymptomatic, epidemiological data on the incidence of CAG are sparse. We aimed to provide an overview of published data on CAG incidence (overall and according to risk factors) from follow-up studies. Articles with information on incidence of CAG published in English until 26th of July 2009 were identified through a systematic MEDLINE and EMBASE search. Data extracted include study characteristics and key findings regarding the incidence of CAG. A meta-analysis was performed on the association between Helicobacter pylori infection and CAG incidence. Overall, data on CAG incidence were available from 14 studies, in 7 studies incidence could be estimated according to H. pylori infection. Most studies were conducted in symptomatic or high risk populations and the maximum number of incident cases was 284. Incidence estimates ranged from 0 to 11% per year and were consistently below 1% in patients not infected with H. pylori. The highest incidence was observed in a special study conducted on ulcer patients treated by proximal gastric vagotomy. Rate ratios for the association between H. pylori infection and CAG incidence ranged from 2.4 to 7.6 with a summary estimate of 5.0 (95% confidence interval: 3.1-8.3). Incidence of CAG is very low in the absence of H. pylori infection. There is a need for more population-based studies to provide comparable estimates of incidence and the impact of risk factors in the development of CAG.

  6. Effectiveness of a tinnitus management programme: a 2-year follow-up study

    Sørensen Jan

    2009-06-01

    Full Text Available Abstract Background Tinnitus impairs the possibility of leading a normal life in 0.5–1% of the population. While neither medical nor surgical treatment appears effective, counselling may offer some relief. An intervention combining counselling and hearing devices is offered to clients referred to the Centre for Help Aids and Communication (CHC in southern Denmark. The aims of this exploratory study were to examine i the characteristics of CHC's clients and their tinnitus, ii the effectiveness of the treatment, and iii whether particular client groups benefit more than others. Methods One hundred new clients presenting with tinnitus completed the Tinnitus Handicap Inventory (THI three times – before their first consultation, after one month and after 1–2 years. The scores were tested for significant differences over time using tests for paired data. Logistic regression was used to examine factors associated with a clinically important difference (i.e. THI score improvement of at least 20 points. Results At final follow-up, total THI score was significantly lower than baseline, i.e. 29.8 (CI 25.5–34.2 vs. 37.2 (CI 33.1–37.2, p Conclusion The tinnitus management programme appeared to provide significant benefit to many clients at a relatively low cost. It would be useful to conduct a randomised controlled study comparing the current programme with alternative forms of combination counselling/sound therapy approaches.

  7. Predictors of hyperglycaemic individuals who do not follow up with physicians after screening in Japan: a cohort study.

    Tsujimura, Yuka; Takahashi, Yoshimitsu; Ishizaki, Tatsuro; Kuriyama, Akira; Miyazaki, Kikuko; Satoh, Toshihiko; Ikeda, Shunya; Kimura, Shinya; Nakayama, Takeo

    2014-08-01

    Although people screened as being hyperglycaemic often fail to follow up with physicians for clinical assessment, epidemiologic findings on the frequency and predictors of not following up (hereafter, "no follow-up") are lacking. The purpose of this study was to examine the no follow-up rate with physicians after screening for diabetes and predictors of no follow-up. We assessed cases of no follow-up with physicians within six months after screening based on medical claims data from employee-based social health insurance programs in Japan, for people aged 20 to 68 years from 2005 to 2010. Among 3878 screened participants with hyperglycaemia, 2527 (65%) did not follow up with their physicians within six months after screening. Multiple logistic regression analysis revealed that younger age and lower blood glucose level predicted no follow-up among both men and women, while lower body mass index and negative proteinuria also predicted no follow-up among men. Treatment for dyslipidaemia facilitated follow-up among both genders, and treatment for hypertension or depression facilitated follow-up among men. Approximately two thirds of individuals screened as having hyperglycaemia did not follow up with their physicians within six months after screening. Predictors of no follow-up were younger age and milder hyperglycaemia. Being on treatment for co-morbidities tended to facilitate follow-up. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  8. Significance of atypia in conventional Papanicolaou smears and liquid-based cytology: a follow-up study

    Schledermann, D; Ejersbo, D; Hoelund, B

    2004-01-01

    The diagnosis of atypical squamous epithelial cells, borderline nuclear changes, is associated with some controversy, as it encompasses benign, reactive, as well as possible neoplastic conditions. The aim of this study was to evaluate the follow-up diagnoses of cytological atypia in conventional...... cytological samples was reduced by 41.3% (P Cytological and histological follow-up data showed the presence of neoplastic lesions in 34.7% of patients screened by TP versus 22.3% of patients screened by CP, corresponding to a 55.6% increase in TP (P

  9. Modic changes of the cervical spine in patients with whiplash injury: a prospective 11-year follow-up study.

    Matsumoto, Morio; Ichihara, Daisuke; Okada, Eijiro; Toyama, Yoshiaki; Fujiwara, Hirokazu; Momoshima, Suketaka; Nishiwaki, Yuji; Takahata, Takeshi

    2013-06-01

    There are few studies on Modic changes of the cervical spine in patients suffering from whiplash. This study compared Modic changes seen in whiplash patients 10 years after the injury with those observed in asymptomatic volunteers. This is a follow-up study of 133 patients who suffered whiplash injuries in 1994-1996 and underwent MRI with a superconductive imager (63 men, 70 women, mean age 49.6±15.3 years, mean follow-up 11.4 years). In addition, 223 healthy volunteers who underwent MRI during the same period were included as controls (123 men, 100 women, mean age 50.5±15.0 years, mean follow-up 11.6 years). All participants underwent follow-up MRI. We examined all participants for Modic changes, and investigated relationships between Modic changes and clinical symptoms or potentially related factors. Modic changes were observed in 4 patients (3%) and at 7 intervertebral levels in the initial study, and in 17 patients (12.8%) and at 30 intervertebral levels at the follow-up. Modic Type 2 changes were the most prevalent in the whiplash patients in both the initial and follow-up studies. There was no significant difference in the percentage of whiplash patients versus control subjects with positive Modic changes, either at the initial study or at follow-up. Modic changes were not related to clinical symptoms present at follow-up, but were associated with preexisting disc degeneration. There was no association between Modic changes and the details of the car accident that caused the injury. While Modic changes became more common in whiplash patients in the 10-year period after the accident, they occurred with a similar frequency in control subjects. We did not find any association between Modic changes and the nature of the car accident in which the whiplash occurred. Modic changes found in whiplash patients may be a result of the physiological ageing process rather than pathological findings relating to the whiplash injury. Copyright © 2012 Elsevier Ltd. All

  10. Soft drink intake at age six and nine and the association with BMI three and seven years later - A follow-up study based on the Copenhagen School Child Intervention Study (CoSCIS)

    Jensen, Britt Wang; Nielsen, Birgit Marie; Husby, Ida

    Introduction: The consumption of sugar-sweetened beverages is one of the few dietary components that have been associated with the development of obesity. However, most previous studies have been based on children or adolescents aged 8 years or more. Method: The study was based on the Copenhagen......-days pre-printed food record. Analyses were conducted using the mixed model approach for repeated measurements and were adjusted for gender, puberty, parental BMI, municipality, school, baseline BMI, SES and physical activity. Results: 154 children, 68 boys and 86 girls were included in the analyses....... Mean intake of soft drinks was 0.14 l/d at age 6 and 0.12 l/d at age 9 (difference p=0.08). No associations were found between intake of soft drink at age 6 and BMI at age 13 (b:-0.8; p=0.91), or intake at age 9 and BMI at age 13 (b:-0.3; p= 0.80). Neither was the change in intake of soft drinks from...

  11. Long-term follow-up study and long-term care of childhood cancer survivors

    Hyeon Jin Park

    2010-04-01

    Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.

  12. Detection of relapse in early stage Hodgkin's disease: role of routine follow up studies

    Torrey, Margaret J.; Poen, Joseph C.; Hoppe, Richard T.

    1995-01-01

    Purpose: To examine the costs and benefits of an established practice of routine follow-up in a cohort of patients treated with radiation therapy for early stage Hodgkin's disease. Materials and Methods: We retrospectively examined patterns of follow-up and methods of relapse detection among 709 patients with Ann Arbor Stage I-II Hodgkin's disease treated with sub-total lymphoid irradiation (STLI) or total lymphoid irradiation (TLI) between 1969-1994. We determined the probability of relapse detection for each of 7 routine follow up procedures, compared their relative costs, and determined the impact of each procedure on the likelihood of overall survival following salvage therapy. Results: Relapse has occurred in 157 patients (22%) at a median 1.9 years (range 0-13 years) following treatment. 133 relapses (85%) occurred during the first 5 years of follow. Detailed information concerning the method of relapse detection was available on 107 patients. These 107 patients form the basis of this analysis. Relapse was identified by history (Hx) alone in 55% of patients, physical exam (PE) in 14%, chest x-ray (CXR) in 23% and abdominal x-ray (KUB) in 7%. Only one relapse (1%) was identified by a routine laboratory study - erythrocyte sedimentation rate (ESR). The rate of relapse detection was highest for a combination of history and physical exam (78/10,000 exams) followed by CXR (26/10,000 exams), KUB (10/10,000 exams) and ESR (1/10,000 tests). Complete blood count (CBC) and serum chemistries were never the primary factor in detecting HD relapse. Radiographs accounted for greater than 60% of charges while laboratory studies and physician charges accounted for approximately 20% each. The projected charges (1994 dollars) of relapse detection by routine follow up Hx and PE was [dollar]10,600 compared with [dollar]68,200 for CXR, [dollar]141,800 for KUB and [dollar]156,400 for ESR. 10 year actuarial survival following salvage therapy was 65% overall, 65% for patients in whom

  13. Detection of relapse in early stage Hodgkin's disease: role of routine follow up studies

    Torrey, Margaret J; Poen, Joseph C; Hoppe, Richard T

    1995-07-01

    Purpose: To examine the costs and benefits of an established practice of routine follow-up in a cohort of patients treated with radiation therapy for early stage Hodgkin's disease. Materials and Methods: We retrospectively examined patterns of follow-up and methods of relapse detection among 709 patients with Ann Arbor Stage I-II Hodgkin's disease treated with sub-total lymphoid irradiation (STLI) or total lymphoid irradiation (TLI) between 1969-1994. We determined the probability of relapse detection for each of 7 routine follow up procedures, compared their relative costs, and determined the impact of each procedure on the likelihood of overall survival following salvage therapy. Results: Relapse has occurred in 157 patients (22%) at a median 1.9 years (range 0-13 years) following treatment. 133 relapses (85%) occurred during the first 5 years of follow. Detailed information concerning the method of relapse detection was available on 107 patients. These 107 patients form the basis of this analysis. Relapse was identified by history (Hx) alone in 55% of patients, physical exam (PE) in 14%, chest x-ray (CXR) in 23% and abdominal x-ray (KUB) in 7%. Only one relapse (1%) was identified by a routine laboratory study - erythrocyte sedimentation rate (ESR). The rate of relapse detection was highest for a combination of history and physical exam (78/10,000 exams) followed by CXR (26/10,000 exams), KUB (10/10,000 exams) and ESR (1/10,000 tests). Complete blood count (CBC) and serum chemistries were never the primary factor in detecting HD relapse. Radiographs accounted for greater than 60% of charges while laboratory studies and physician charges accounted for approximately 20% each. The projected charges (1994 dollars) of relapse detection by routine follow up Hx and PE was [dollar]10,600 compared with [dollar]68,200 for CXR, [dollar]141,800 for KUB and [dollar]156,400 for ESR. 10 year actuarial survival following salvage therapy was 65% overall, 65% for patients in whom

  14. The dyslipidemia-associated SNP on the APOA1/C3/A5 gene cluster predicts post-surgery poor outcome in Taiwanese breast cancer patients: a 10-year follow-up study

    Hsu, Mei-Chi; Lee, Kuo-Ting; Hsiao, Wei-Chiang; Wu, Chih-Hsing; Sun, Hung-Yu; Lin, I-Ling; Young, Kung-Chia

    2013-01-01

    Post-surgery therapies are given to early-stage breast cancer patients due to the possibility of residual micrometastasis, and optimized by clincopathological parameters such as tumor stage, and hormone receptor/lymph node status. However, current efficacy of post-surgery therapies is unsatisfactory, and may be varied according to unidentified patient genetic factors. Increases of breast cancer occurrence and recurrence have been associated with dyslipidemia, which can attribute to other known risk factors of breast cancer including obesity, diabetes and metabolic syndrome. Thus we reasoned that dyslipidemia-associated nucleotide polymorphisms (SNPs) on the APOA1/C3/A5 gene cluster may predict breast cancer risk and tumor progression. We analyzed the distribution of 5 selected APOA1/C3/A5 SNPs in recruited Taiwanese breast cancer patients (n=223) and healthy controls (n=162). The association of SNP (APOA1 rs670) showing correlation with breast cancer with baseline and follow-up parameters was further examined. APOA1 rs670 A allele carriage was higher in breast cancer patients than controls (59.64% vs. 48.77%, p=0.038). The rs670 A allele carrying patients showed less favorable baseline phenotype with positive lymph nodes (G/A: OR=3.32, 95% CI=1.77-6.20, p<0.001; A/A: OR=2.58, 95% CI=1.05-6.32, p=0.039) and negative hormone receptor expression (A/A: OR=4.85, 95%CI=1.83-12.83, p=0.001) in comparison to G/G carriers. Moreover, rs670 A/A carrying patients had higher risks in both tumor recurrence (HR=3.12, 95% CI=1.29-7.56, p=0.012) and mortality (HR=4.36, 95% CI=1.52-12.47, p=0.006) than patients with no A alleles after adjustments for associated baseline parameters. Furthermore, the prognostic effect of rs670 A/A carriage was most evident in lymph node-negative patients, conferring to the highest risks of recurrence (HR=4.98, 95% CI=1.40-17.70, p=0.013) and mortality (HR=9.87, 95%CI=1.60-60.81, p=0.014) than patients with no A alleles. APOA1 rs670 A/A carriage showed

  15. The dyslipidemia-associated SNP on the APOA1/C3/A5 gene cluster predicts post-surgery poor outcome in Taiwanese breast cancer patients: a 10-year follow-up study

    Hsu, Mei-Chi [Research Center for Medical Laboratory Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Lee, Kuo-Ting [Department of Surgery, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Hsiao, Wei-Chiang [Department of Surgery, Yang Ming Hospital, Chiayi, Taiwan (China); Wu, Chih-Hsing [Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Sun, Hung-Yu [Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Lin, I-Ling [Department of Medical Laboratory Science and Biotechnology, College of Health Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan (China); Young, Kung-Chia [Research Center for Medical Laboratory Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Department of Medical Laboratory Science and Biotechnology, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China); Center of Infectious Disease and Signaling Research, College of Medicine, National Cheng Kung University, Tainan, Taiwan (China)

    2013-07-05

    Post-surgery therapies are given to early-stage breast cancer patients due to the possibility of residual micrometastasis, and optimized by clincopathological parameters such as tumor stage, and hormone receptor/lymph node status. However, current efficacy of post-surgery therapies is unsatisfactory, and may be varied according to unidentified patient genetic factors. Increases of breast cancer occurrence and recurrence have been associated with dyslipidemia, which can attribute to other known risk factors of breast cancer including obesity, diabetes and metabolic syndrome. Thus we reasoned that dyslipidemia-associated nucleotide polymorphisms (SNPs) on the APOA1/C3/A5 gene cluster may predict breast cancer risk and tumor progression. We analyzed the distribution of 5 selected APOA1/C3/A5 SNPs in recruited Taiwanese breast cancer patients (n=223) and healthy controls (n=162). The association of SNP (APOA1 rs670) showing correlation with breast cancer with baseline and follow-up parameters was further examined. APOA1 rs670 A allele carriage was higher in breast cancer patients than controls (59.64% vs. 48.77%, p=0.038). The rs670 A allele carrying patients showed less favorable baseline phenotype with positive lymph nodes (G/A: OR=3.32, 95% CI=1.77-6.20, p<0.001; A/A: OR=2.58, 95% CI=1.05-6.32, p=0.039) and negative hormone receptor expression (A/A: OR=4.85, 95%CI=1.83-12.83, p=0.001) in comparison to G/G carriers. Moreover, rs670 A/A carrying patients had higher risks in both tumor recurrence (HR=3.12, 95% CI=1.29-7.56, p=0.012) and mortality (HR=4.36, 95% CI=1.52-12.47, p=0.006) than patients with no A alleles after adjustments for associated baseline parameters. Furthermore, the prognostic effect of rs670 A/A carriage was most evident in lymph node-negative patients, conferring to the highest risks of recurrence (HR=4.98, 95% CI=1.40-17.70, p=0.013) and mortality (HR=9.87, 95%CI=1.60-60.81, p=0.014) than patients with no A alleles. APOA1 rs670 A/A carriage showed

  16. Predictive validity of neurotic disorders: a 50-year follow-up study.

    Jepsen, Peter Winning; Butler, Birgitte; Rasmussen, Stig; Juel, Knud; Bech, Per

    2014-06-01

    In 1965, Erling Jacobsen (1919-1988) defended his doctoral thesis on neurosis in which he tested the psychoanalytic theory of eridophobia as an internalising hostility factor with a specific causality for anxiety neurosis. He found no marked difference between anxiety neurosis and obsessive-compulsive neurosis, which, however, both differed from hysterical neurosis. The aim of this follow-up study was to evaluate to which extent anxiety neurosis and obsessive-compulsive neurosis when compared with hysterical neurosis co-existed with depression, both at the level of diagnostic behaviour, including committed suicide, and with regard to symptom profile. A total of 112 patients were followed on the Danish Central Psychiatric Research Register and the Danish Cause of Death Register with regard to their diagnostic behaviour. In a subset of the sample (n = 24), the patients were assessed using the Hopkins Symptom Checklist (SCL)-90. Both at the diagnostic level, including suicide rate, and at the level of symptom severity (SCL-90), anxiety neurosis and obsessive-compulsive neurosis were similar, in contrast to hysterical neurosis which had no more association with the other two categories of neurosis than would be expected by chance. Anxiety neurosis and obsessive-compulsive neurosis are more severe disorders than hysterical neurosis, both in terms of symptom profile and depression, including suicidal behaviour. The identified suicides were committed within the first two decades after discharge from the index hospitalisation. Poul M. Færgemann's Grant and the Neurosis Grant of 22 July 1959. not relevant.

  17. Allogeneic blood transfusion and prognosis following total hip replacement: a population-based follow up study

    Overgaard Soren

    2009-12-01

    Full Text Available Abstract Background Allogeneic red blood cell transfusion is frequently used in total hip replacement surgery (THR. However, data on the prognosis of transfused patients are sparse. In this study we compared the risk of complications following THR in transfused and non-transfused patients. Methods A population-based follow-up study was performed using data from medical databases in Denmark. We identified 28,087 primary THR procedures performed from 1999 to 2007, from which we computed a propensity score for red blood cell transfusion based on detailed data on patient-, procedure-, and hospital-related characteristics. We were able to match 2,254 transfused with 2,254 non-transfused THR patients using the propensity score. Results Of the 28,087 THR patients, 9,063 (32.3% received at least one red blood cell transfusion within 8 days of surgery. Transfused patients had higher 90-day mortality compared with matched non-transfused patients: the adjusted OR was 2.2 (95% confidence interval (CI: 1.2-3.8. Blood transfusion was also associated with increased odds of pneumonia (OR 2.1; CI: 1.2-3.8, whereas the associations with cardiovascular or cerebrovascular events (OR 1.4; CI: 0.9-2.2 and venous thromboembolism (OR 1.2; CI: 0.7-2.1 did not reach statistical significance. The adjusted OR of reoperation due to infection was 0.6 (CI: 0.1-2.9. Conclusions Red blood cell transfusion was associated with an adverse prognosis following primary THR, in particular with increased odds of death and pneumonia. Although the odds estimates may partly reflect unmeasured bias due to blood loss, they indicate the need for careful assessment of the risk versus benefit of transfusion even in relation to routine THR procedures.

  18. Developing COPD: a 25 year follow up study of the general population

    Løkke, Anders; Lange, Peter; Scharling, H

    2006-01-01

    BACKGROUND: Smokers are more prone to develop chronic obstructive pulmonary disease (COPD) than non-smokers, but this finding comes from studies spanning 10 years or less. The aim of this study was to determine the 25 year absolute risk of developing COPD in men and women from the general...... of men with normal lung function ranged from 96% of never smokers to 59% of continuous smokers; for women the proportions were 91% and 69%, respectively. The 25 year incidence of moderate and severe COPD was 20.7% and 3.6%, respectively, with no apparent difference between men and women. Smoking...... cessation, especially early in the follow up period, decreased the risk of developing COPD substantially compared with continuous smoking. During the follow up period there were 2912 deaths, 109 of which were from COPD. 92% of the COPD deaths occurred in subjects who were current smokers at the beginning...

  19. The US Department of Defense Millennium Cohort Study: career span and beyond longitudinal follow-up.

    Smith, Tyler C

    2009-10-01

    To describe current and future career-span health research in the US Department of Defense Millennium Cohort Study. Collaborating with all military service branches and the Department of Veterans Affairs, the Millennium Cohort Study launched in 2001, before September 11 and the start of deployments in Afghanistan and Iraq, to conduct coordinated strategic research to determine any effects of military occupational and deployment-related exposures, on long-term health. More than 150,000 consenting members represent demographic, occupational, military, and health characteristics of the US military. More than 70% of the first two panels have submitted follow-up questionnaires and >50% have deployed since 2001. Prospective cohort data have identified subgroups of military populations at higher risk or more resilient to decrements in mental and physical health. Continued career span and beyond follow-up will answer long-term health questions related to military service.

  20. Brain shrinking in chronic alcoholism: CT follow-up study in 65 patients

    Schroth, G.; Remmes, U.; Schupmann, A.

    1985-04-01

    CT follow-up studies were done in 65 alcoholics before an inpatient treatment and after a period with confirmed abstinence of 5 weeks duration. The scans were rated 'blind' by linear measurement of well defined distances. An improvement (Significant reduction of brain 'atrophy') was found in 33 patients (50.8%), 5 patients (7,7%) showed a trend towards progression of brain 'atrophy'. The possibility of recovery tends to be significantly greater in younger subjects. These findings and the results of recent MR follow-up studies are consistent with decreased free water during alcohol intoxication and an increase in brain water during alcohol withdrawal.

  1. Long term functioning in early onset psychosis: Two years prospective follow-up study

    Taha Ghada RA

    2011-07-01

    Full Text Available Abstract Background There were few studies on the outcome of schizophrenia in developing countries. Whether the outcome is similar to or different from developed world is still a point for research. The main aim of the current study was to know if patients with early onset non affective psychosis can behave and function properly after few years from start of the illness or not. Other aims included investigation of possible predictors and associated factors with remission and outcome. Method The study prospectively investigated a group of 56 patients with onset of psychosis during childhood or adolescence. Diagnosis made according to DSM-IV criteria and included; schizophrenia, psychotic disorder not otherwise specified and acute psychosis. Severity of psychosis was measured by PANSS. Measures of the outcome included; remission criteria of Andreasen et al 2005, the children's global assessment scale and educational level. Results Analysis of data was done for only 37 patients. Thirty patients diagnosed as schizophrenia and 7 with Psychotic disorder not otherwise specified. Mean duration of follow up was 38.4 +/- 16.9 months. At the end of the study, 6 patients (16.2% had one episode, 23(62.1% had multiple episodes and 8 (21.6% continuous course. Nineteen patients (51.4% achieved full remission, and only 11(29.7% achieved their average educational level for their age. Twenty seven percent of the sample had good outcome and 24.3% had poor outcome. Factors associated with non remission and poor outcome included gradual onset, low IQ, poor premorbid adjustment, negative symptoms at onset of the illness and poor adherence to drugs. Moreover, there was tendency of negative symptoms at illness start to predict poor outcome. Conclusion Some patients with early onset non affective psychosis can behave and function properly after few years from the start of the illness. Although remission is a difficult target in childhood psychosis, it is still achievable.

  2. Complications associated with transobturator sling procedures: analysis of 233 consecutive cases with a 27 months follow-up

    Dubuisson Jean-Bernard

    2009-09-01

    Full Text Available Abstract Backround The transobturator tape procedure (TOT is an effective surgical treatment of female stress urinary incontinence. However data concerning safety are rare, follow-up is often less than two years, and complications are probably underreported. The aim of this study was to describe early and late complications associated with TOT procedures and identify risk factors for erosions. Methods It was a 27 months follow-up of a cohort of 233 women who underwent TOT with three different types of slings (Aris®, Obtape®, TVT-O®. Follow-up information was available for 225 (96.6% women. Results There were few per operative complications. Forty-eight women (21.3% reported late complications including de novo or worsening of preexisting urgencies (10.2%, perineal pain (2.2%, de novo dyspareunia (9%, and vaginal erosion (7.6%. The risk of erosion significantly differed between the three types of slings and was 4%, 17% and 0% for Aris®, Obtape® and TVT-O® respectively (P = 0.001. The overall proportion of women satisfied by the procedure was 72.1%. The percentage of women satisfied was significantly lower in women who experienced erosion (29.4% compared to women who did not (78.4% (RR 0.14, 95% CI 0.05-0.38, P Conclusion Late post operative complications are relatively frequent after TOT and can impair patient's satisfaction. Women should be informed of these potential complications preoperatively and require careful follow-up after the procedure. Choice of the safest sling material is crucial as it is a risk factor for erosion.

  3. Changes in occupational class differences in leisure-time physical activity: a follow-up study

    Lahelma Eero

    2011-03-01

    Full Text Available Abstract Background Physical activity is known to have health benefits across population groups. However, less is known about changes over time in socioeconomic differences in leisure-time physical activity and the reasons for the changes. We hypothesised that class differences in leisure-time physical activity would widen over time due to declining physical activity among the lower occupational classes. We examined whether occupational class differences in leisure-time physical activity change over time in a cohort of Finnish middle-aged women and men. We also examined whether a set of selected covariates could account for the observed changes. Methods The data were derived from the Helsinki Health Study cohort mail surveys; the respondents were 40-60-year-old employees of the City of Helsinki at baseline in 2000-2002 (n = 8960, response rate 67%. Follow-up questionnaires were sent to the baseline respondents in 2007 (n = 7332, response rate 83%. The outcome measure was leisure-time physical activity, including commuting, converted to metabolic equivalent tasks (MET. Socioeconomic position was measured by occupational class (professionals, semi-professionals, routine non-manual employees and manual workers. The covariates included baseline age, marital status, limiting long-lasting illness, common mental disorders, job strain, physical and mental health functioning, smoking, body mass index, and employment status at follow-up. Firstly the analyses focused on changes over time in age adjusted prevalence of leisure-time physical activity. Secondly, logistic regression analysis was used to adjust for covariates of changes in occupational class differences in leisure-time physical activity. Results At baseline there were no occupational class differences in leisure-time physical activity. Over the follow-up leisure-time physical activity increased among those in the higher classes and decreased among manual workers, suggesting the emergence of

  4. Changes in occupational class differences in leisure-time physical activity: a follow-up study.

    Seiluri, Tina; Lahti, Jouni; Rahkonen, Ossi; Lahelma, Eero; Lallukka, Tea

    2011-03-01

    Physical activity is known to have health benefits across population groups. However, less is known about changes over time in socioeconomic differences in leisure-time physical activity and the reasons for the changes. We hypothesised that class differences in leisure-time physical activity would widen over time due to declining physical activity among the lower occupational classes. We examined whether occupational class differences in leisure-time physical activity change over time in a cohort of Finnish middle-aged women and men. We also examined whether a set of selected covariates could account for the observed changes. The data were derived from the Helsinki Health Study cohort mail surveys; the respondents were 40-60-year-old employees of the City of Helsinki at baseline in 2000-2002 (n = 8960, response rate 67%). Follow-up questionnaires were sent to the baseline respondents in 2007 (n = 7332, response rate 83%). The outcome measure was leisure-time physical activity, including commuting, converted to metabolic equivalent tasks (MET). Socioeconomic position was measured by occupational class (professionals, semi-professionals, routine non-manual employees and manual workers). The covariates included baseline age, marital status, limiting long-lasting illness, common mental disorders, job strain, physical and mental health functioning, smoking, body mass index, and employment status at follow-up. Firstly the analyses focused on changes over time in age adjusted prevalence of leisure-time physical activity. Secondly, logistic regression analysis was used to adjust for covariates of changes in occupational class differences in leisure-time physical activity. At baseline there were no occupational class differences in leisure-time physical activity. Over the follow-up leisure-time physical activity increased among those in the higher classes and decreased among manual workers, suggesting the emergence of occupational class differences at follow-up. Women in

  5. Relapse after methylprednisolone oral minipulse therapy in childhood vitiligo: A 12-month follow-up study

    Imran Majid

    2013-01-01

    Full Text Available Background: Oral minipulse (OMP therapy with methylprednisolone is presently one of the most common oral treatments used for progressive vitiligo in children. The treatment is usually given for a period of 6 months during which majority of patients are reported to go into remission. However, there are no follow-up studies to comment upon what happens to the disease after OMP therapy is withdrawn. Aim of the study: To document the incidence of relapse over a period of 1 year after OMP therapy is stopped in children with vitiligo. Materials and Methods: The study was conducted in 180 patients of childhood vitiligo (<15 years of age who had been on OMP therapy with oral methylprednisolone for at least 6 months and who had achieved a complete remission of their disease during the treatment period. The enrolled patients were followed up for a period of 1 year and examined clinically for any sign of reactivation of their disease over either the old lesions or at any new area of the body. Results: Forty-two patients were lost and could not complete the follow-up period of 1 year. Out of the 138 patients available at the end of 1 year, relapse was observed in 48 patients (34.8%. Rest of 90 patients remained in remission over the follow-up period of 1 year. Relapse was more common in patients below 10 years of age (47.4% as compared with older children (25.9%. Conclusion: Relapse after using methylprednisolone OMP therapy in children with vitiligo is quite common especially in younger age groups. Studies are needed to see whether these relapses could be avoided by giving the treatment for a period longer than 6 months.

  6. Follow-Up Study of Behavioral Development and Parenting Stress Profiles in Children with Congenital Hypothyroidism

    Mei-Chyn Chao; Pinchen Yang; Hsiu-Yi Hsu; Yuh-Jyh Jong

    2009-01-01

    Recent longitudinal experiences have emphasized that the follow-up of children with treated congenital hypothyroidism (CHT) should not be limited to the cognitive domain. This study attempted to evaluate the emotional–behavioral profiles in children with CHT together with maternal parenting stress profiles. Data for child and family characteristics were collected from 47 families with a 3–12-year-old CHT child diagnosed and treated since the newborn period. Cognitive assessments were performe...

  7. Tele consultation and tele follow up of thyroid cancer patients: A pilot study

    Pradhan, P.K.; Das, B.K.; Mohanty, B.N.; Mishra, S.K.

    2005-01-01

    Full text: Radioiodine therapy is an essential component of thyroid cancer management and these patients require life long follow up at timed interval. Though radioiodine therapy is a well established adjuvant treatment for well differentiated thyroid cancer, still the acceptance by the surgical colleagues and patients is not uniform. In addition, this facility is not available in the eastern part of the country. Therefore, such patients are required to travel more than 1500 K.M. to avail this treatment and subsequent follow up at our Institution. The existing telemedicine facility between SGPGIMS, Lucknow and SCB Medical College, Cuttack provided the opportunity to utilise the system for tele-consultation and tele follow up of thyroid cancer patients. The rationale of this ongoing study is to evaluate the suitability of telemedicine for tele consultation prior to radioiodine therapy and tele follow up following radioiodine therapy of patients with well differentiated thyroid cancer. Thirty patients (10 new cases and 20 follow up cases) were included in this study. New cases were studied on the basis of case history inputs by the operating surgeon and direct patient consultation to find out their suitability for high dose radioiodine therapy. At the same time pre-therapy instructions as well as details of admission were finalised. Follow up of patients (20 in number) were discussed and examined on live along with operating surgeon with respect to compliance of thyroxine suppression therapy, local recurrence and need for further high dose radioiodine therapy. Each time, at least one surgeon and nuclear physician were involved during live evaluation of patients which was done with VSAT, broad band of 256 Kbps band width provided by ISRO, Bangalore, India and case history, radiological and nuclear medicine images were already transmitted prior to live evaluation. All ten new cases were found to be suitable for high dose radioiodine therapy. The appointment dates for

  8. Selective mutism: follow-up study 1 year after end of treatment.

    Oerbeck, Beate; Stein, Murray B; Pripp, Are H; Kristensen, Hanne

    2015-07-01

    Cognitive behavioral therapy (CBT) is generally considered the recommended approach for selective mutism (SM). Prospective follow-up studies of treated SM and predictors of outcome are scarce. We have developed a CBT home and school-based intervention for children with SM previously found to increase speech in a pilot efficacy study and in a randomized controlled treatment study. In the present report we provide outcome data 1 year after having completed the 6-month course of CBT for 24 children with SM, aged 3-9 years (mean age 6.5 years, 16 girls). Primary outcome measures were the teacher rated School Speech Questionnaire (SSQ) and diagnostic status. At follow-up, no significant decline was found on the SSQ scores. Age and severity of SM had a significant effect upon outcome, as measured by the SSQ. Eight children still fulfilled diagnostic criteria for SM, four were in remission, and 12 children were without diagnosis. Younger children improved more, as 78% of the children aged 3-5 years did not have SM, compared with 33% of children aged 6-9 years. Treatment gain was upheld at follow-up. Greater improvement in the younger children highlights the importance of an early intervention.

  9. [A follow-up study of the elderly in agricultural and piscatorial areas of Hokkaido].

    Mori, M; Goto, R; Masuoka, H; Yoshida, K; Miyake, H

    1990-02-01

    A base-line survey was performed for 3,185 persons over 40 years of age in 1984 and 1985 in agricultural and piscatorial areas of Hokkaido with regards to their dietary habits and life style. Of them, 147 persons died prior to the recent follow-up survey of 1988. As a result of a case-control study of the dead with those of the followed-up group, a more frequent intake of instant noodles was indicated as significantly increasing the risk of death, even after adjusting for the health status at the base-line survey and other confounding variables (the adjusted relative risk = 1.44 per a frequency class, p = 0.049).

  10. An Observational Study with Long-Term Follow-Up of Canine Cognitive Dysfunction

    Fast, R.; Schutt, T.; Toft, N.

    2013-01-01

    = .99). Conclusions and Clinical Importance: A few key questions addressing sleep-wake cycle, interaction, and signs of confusion and anxiety can be used as a clinical marker of CCD. Special attention should be paid to anxiety in dogs with CCD because it may be especially stressful to both dog and owner...... with neurodegenerative changes (eg, cortical atrophy and amyloid-beta deposits). Objectives: To investigate clinical characteristics, survival, and risk factors with CCD. Vitamin E was investigated as a potential marker of CCD. Methods: Ninety-four dogs >8 years of age were investigated with a validated CCD...... questionnaire and allocated to CCD, borderline CCD (b-CCD) and non-CCD groups. The dogs were included in 2008-2009 and followed up in an observational study until follow-up in 2012. Results: Four key clinical signs dominated in dogs with CCD: sleeping during the day and restless at night, decreased interaction...

  11. Radiographic follow-up study of Little Leaguer's shoulder

    Kanematsu, Yoshiji; Iwase, Takenobu [Tokushima National Hospital, Department of Orthopaedic Surgery, Tokushima (Japan); Matsuura, Tetsuya; Suzue, Naoto; Sairyo, Koichi [University of Tokushima Graduate School, Department of Orthopedics, Institute of Health Bioscience, Tokushima (Japan); Kashiwaguchi, Shinji [Japan Community Health Care Organization, Tokyo Shinjuku Medical Center, Department of Orthopaedic Surgery, Tokyo (Japan); Iwame, Toshiyuki [Tokushima Prefectural Central Hospital, Department of Orthopaedic Surgery, Tokushima (Japan)

    2015-01-15

    Little Leaguer's shoulder is a syndrome involving the proximal humeral epiphyseal plate. Conservative treatment usually resolves the symptoms. However, there are no reports of a radiographic follow-up study of this disease. The purpose of this study was to show the radiographic healing process of Little Leaguer's shoulder. A total of 19 male baseball players diagnosed as having Little Leaguer's shoulder were retrospectively evaluated. The mean age at first presentation was 12.7 years. External rotation anteroposterior radiographs of the shoulder were taken. All patients were treated with rest from throwing, and no throwing was recommended until remodeling was confirmed. Follow-up radiographs were taken at 1-month intervals to assess healing. All patients were observed until healing was confirmed radiographically, after which they returned to baseball. The mean follow-up period was 8.5 months. In addition to radiography, patients were asked whether they had any symptoms and whether they had been able to return to baseball. At the first examination, radiographs showed a wider epiphyseal plate of the throwing side compared with the asymptomatic contralateral shoulder. Healing was observed in all cases. Healing occurred first along the medial side and was then extended laterally. The mean time required for healing was 4.7 months. All patients were able to return to playing baseball at their pre-injury level of play and were asymptomatic when examined at the final follow-up. The healing process of Little Leaguer's shoulder advanced from medial to lateral, and healing was achieved about 5 months after initial examination. (orig.)

  12. Marriage and outcomes of people with schizophrenia in rural China: 14-year follow-up study.

    Ran, Mao-Sheng; Wong, Yin-Ling Irene; Yang, Shu-Yan; Ho, Petula S Y; Mao, Wen-Jun; Li, Jie; Chan, Cecilia Lai-Wan

    2017-04-01

    The influence of marriage on the long-term outcomes of schizophrenia is largely unknown. This study was to examine the impact of marriage on the 14-year outcomes and identify the correlates of marriage among persons with schizophrenia in rural community. All study participants with schizophrenia (n=510) were identified in 1994 in an epidemiological investigation of 123,572 people aged 15years and older and followed up in 2004 and 2008 in Xinjin County, Chengdu, China. The Patients Follow-up Schedule (PFS) was used in 2004 and 2008. The rate of follow-up in 2008 was 95.9%. Unmarried individuals in 1994 had higher rates of homelessness and suicide, and lower rate of survival in 2004 and 2008 than those married. In 14-year follow-up, unmarried individuals were more likely to be male, to have higher level of psychiatric symptoms and lower rate of full remission of illness, and to report lower level of work functioning, as well as with fewer family members and caregiver, and lower family economic status. The predictors of being married in 2008 included being married in 1994, shorter duration of illness, being female, and lower level of education. Being married is predictive of more favorable 14-year outcomes of persons with schizophrenia in the rural community. Given that marriage can be instrumental for enhancing family-based support and caregiving, as well as improving the community tenure of persons with schizophrenia, it is important to develop programs to enhance opportunity for persons with schizophrenia to get and stay married. Copyright © 2016 Elsevier B.V. All rights reserved.

  13. A 5-Year Follow-up Study on the Relationship between Obstructive Sleep Apnea and Parkinson Disease.

    Sheu, Jau-Jiuan; Lee, Hsin-Chien; Lin, Herng-Ching; Kao, Li-Ting; Chung, Shiu-Dong

    2015-12-15

    Sleep disturbances are among the most common nonmotor symptoms of Parkinson disease. However, no large epidemiological data regarding the association between obstructive sleep apnea (OSA) and Parkinson disease have been reported. The goal of this study was to investigate the risk for Parkinson disease during a 5-y follow-up period after a diagnosis of OSA using a population-based dataset. The data for this retrospective longitudinal cohort study were retrieved from the Taiwan Longitudinal Health Insurance Database 2000. We identified 1,532 patients with OSA as the study cohort and randomly selected 7,660 patients as the comparison cohort. Each subject was individually followed up for a 5-y period to identify those in whom Parkinson disease subsequently developed. Stratified Cox proportional hazard regressions were performed as a means of comparing the 5-y risk of subsequent Parkinson disease between the study cohort and comparison cohort. Of the 9,192 total patients, Parkinson disease developed in 0.73% during the 5-y follow-up period: 1.24% and 0.63% in the OSA and control cohorts, respectively. After censoring patients who died during the follow-up period and adjusting for socio-demographic characteristics, the hazard ratio (HR) of Parkinson disease during the 5-y follow-up period for patients with OSA was 2.26 (95% confidence interval [CI] = 1.32-3.88) compared with comparison patients. In addition, among females, the adjusted HR of Parkinson disease was 3.54 (95% CI = 1.50-8.34) for patients with OSA compared to patients without OSA. However, among males, there was no significantly increased hazard of Parkinson disease for patients with OSA compared to those without OSA. Female patients with OSA were found to be at a significant risk of subsequent Parkinson disease during a 5-y follow-up period. © 2015 American Academy of Sleep Medicine.

  14. Optic Neuritis in the Older Chinese Population: A 5-Year Follow-Up Study

    Junqing Wang

    2017-01-01

    Full Text Available Objective. This study aims to describe the clinical manifestations and outcomes in a cohort of older Chinese patients. Method. A retrospective study of patients aged ≥ 45 years who had a first episode of optic neuritis (ON between May 2008 and November 2012. Clinical features at onset and last follow-up were analyzed within subgroups (age 45–65 years and age ≥ 65 years. Results. 76 patients (99 eyes were included, of which 58% were females. The mean age at presentation was 55.53 ± 8.29 years (range: 45–83 years. Vision loss was severe at presentation, with initial best corrected vision activity (BCVA < 20/200 in 93% and final BCVA < 20/200 in 53% of patients at 5-year follow-up. Final BCVA significantly correlated with the initial BCVA and peripapillary retinal nerve fiber layer. At last follow-up, 14.5% were diagnosed with neuromyelitis optica spectrum disorder (NMOSD, 1.3% were diagnosed with multiple sclerosis (MS, 5.2% with chronic relapsing inflammatory optic neuropathy, 1.3% with infectious ON, and 19.7% with autoimmune ON. None of the elderly group (≥65 years developed NMOSD or MS. Conclusion. Chinese patients in the age group ≥ 65 years with ON are less likely to develop NMOSD or MS. Notwithstanding, they had more severe visual loss at onset and poor recovery.

  15. Follow-up study of Evolution-drum chipper; Evolution-energiapuuhakkurin kaeyttoeselvitys

    Lahti, P [Kotimaiset Energiat Ky, Kangashaekki (Finland); Vesisenaho, T [VTT Energy, Jyvaeskylae (Finland). Fuel Production

    1997-12-01

    The aim of this project was to test and further develop a new type of a drum chipper. It was assumed that this Evolution-chipper would be able to produce fuel chips without long splinters and would also be reliable and effective in chipping work at road-side landings. In this project the fuel chip quality and productivity of the chipper were found out. The follow-up study started in October 1995 and ended in the end of 1996. According to the follow-up study the mechanical availability of the chipper was 83 % during a period of one year. Because of the rather low level of fuel chip utilisation in Finland the work sites are located far from each other. Therefore the moving between working sites take as much as 1/5 of the total working hours. The chipper is easy to operate and the differences in the productivity between operators are modest. The chipping productivity varies mainly depending on the raw material. The average productivity was 45,8 m{sup 3} (loose) per gross effective hour during the follow-up period. The internal screening system of the chipper diminishes the amount of long splinters effectively. Other chipping parameters (such as rotating speed) affected the chip quality only a little. (orig.)

  16. Telemedicine Consultations in Oral and Maxillofacial Surgery: A Follow-Up Study.

    Wood, Eric W; Strauss, Robert A; Janus, Charles; Carrico, Caroline K

    2016-02-01

    The purpose of this study was to follow up on the previous study in evaluating the efficiency and reliability of telemedicine consultations for preoperative assessment of patients. A retrospective study of 335 patients over a 6-year period was performed to evaluate success rates of telemedicine consultations in adequately assessing patients for surgical treatment under anesthesia. Success or failure of the telemedicine consultation was measured by the ability to triage patients appropriately for the hospital operating room versus the clinic, to provide an accurate diagnosis and treatment plan, and to provide a sufficient medical and physical assessment for planned anesthesia. Data gathered from the average distance traveled and data from a previous telemedicine study performed by the National Institute of Justice were used to estimate the cost savings of using telemedicine consultations over the 6-year period. Practitioners performing the consultation were successful 92.2% of the time in using the data collected to make a diagnosis and treatment plan. Patients were triaged correctly 99.6% of the time for the clinic or hospital operating room. Most patients (98.0%) were given sufficient medical and physical assessment and were able to undergo surgery with anesthesia as planned at the clinic appointment immediately after telemedicine consultation. Most patients (95.9%) were given an accurate diagnosis and treatment plan. The estimated amount saved by providing consultation by telemedicine and eliminating in-office consultation was substantial at $134,640. This study confirms the findings from previous studies that telemedicine consultations are as reliable as those performed by traditional methods. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Endoscopic stent therapy in patients with chronic pancreatitis: a 5-year follow-up study.

    Weber, Andreas; Schneider, Jochen; Neu, Bruno; Meining, Alexander; Born, Peter; von Delius, Stefan; Bajbouj, Monther; Schmid, Roland M; Algül, Hana; Prinz, Christian

    2013-02-07

    This study analyzed clinical long-term outcomes after endoscopic therapy, including the incidence and treatment of relapse. This study included 19 consecutive patients (12 male, 7 female, median age 54 years) with obstructive chronic pancreatitis who were admitted to the 2(nd) Medical Department of the Technical University of Munich. All patients presented severe chronic pancreatitis (stage III°) according to the Cambridge classification. The majority of the patients suffered intermittent pain attacks. 6 of 19 patients had strictures of the pancreatic duct; 13 of 19 patients had strictures and stones. The first endoscopic retrograde pancreatography (ERP) included an endoscopic sphincterotomy, dilatation of the pancreatic duct, and stent placement. The first control ERP was performed 4 wk after the initial intervention, and the subsequent control ERP was performed after 3 mo to re-evaluate the clinical and morphological conditions. Clinical follow-up was performed annually to document the course of pain and the management of relapse. The course of pain was assessed by a pain scale from 0 to 10. The date and choice of the therapeutic procedure were documented in case of relapse. Initial endoscopic intervention was successfully completed in 17 of 19 patients. All 17 patients reported partial or complete pain relief after endoscopic intervention. Endoscopic therapy failed in 2 patients. Both patients were excluded from further analysis. One failed patient underwent surgery, and the other patient was treated conservatively with pain medication. Seventeen of 19 patients were followed after the successful completion of endoscopic stent therapy. Three of 17 patients were lost to follow-up. One patient was not available for interviews after the 1(st) year of follow-up. Two patients died during the 3(rd) year of follow-up. In both patients chronic pancreatitis was excluded as the cause of death. One patient died of myocardial infarction, and one patient succumbed to

  18. Osteoporosis - a risk factor for cardiovascular diseases: A follow-up study

    Tasić Ivan

    2015-01-01

    Full Text Available Introduction. Cardiovascular (CV diseases and bone fractures due to osteoporosis are the leading causes of death in the elderly. Objective. The aim of this study was to demonstrate a correlation between the overall risk for CV events, and low bone density in postmenopausal women, and its impact on the incidence of serious CV events. Methods. Our prospective study involved 300 postmenopausal women. All the examinees were divided into three groups based on their measured bone density: Group I - 84 examinees with osteoporosis; Group II - 115 examinees with osteopenia; and Group III - 101 examinees with normal bone density. In all examinees the overall ten-year risk for a fatal CV event was calculated using the SCORE system tables. Results. After a 36-month follow-up, CV events occurred in 19 (6.3% examinees. Significant differences in the incidence of CV events were demonstrated between the patients with osteoporosis, osteopenia, and normal bone density (χ2=28.7; p<0.001, as well as between those with a high and low CV risk (χ2=22.6; p<0.001. Multivariate logistic regression analysis showed that smoking (OR: 2.23; 95% CI: 1.02 to 6.19; p=0.035, and increase of overall CV score (OR: 1.36; 95% CI: 1.17 to 1.58; p<0.001 are associated with increased CV event risk, while the increase of T score value is associated with decreased risk of CV event (OR: 0.42; 95% CI: 0.25 to 0.73; p=0.002. Conclusion. Measurement of bone density with a standard assessment of the total CV risk could be useful for selecting women who need intensive prevention and treatment of atherosclerosis.

  19. Pro-/antiinflammatory dysregulation in early psychosis: results from a 1-year follow-up study.

    García-Bueno, Borja; Bioque, Miquel; MacDowell, Karina S; Santabárbara, Javier; Martínez-Cengotitabengoa, Mónica; Moreno, Carmen; Sáiz, Pilar A; Berrocoso, Esther; Gassó, Patricia; Fe Barcones, M; González-Pinto, Ana; Parellada, Mara; Bobes, Julio; Micó, Juan A; Bernardo, Miguel; Leza, Juan C

    2014-10-31

    Previous studies indicated a systemic deregulation of the pro-/antiinflammatory balance in subjects after 6 months of a first psychotic episode. This disruption was reexamined 12 months after diagnosis to identify potential risk/protective factors and associations with symptom severity. Eighty-five subjects were followed during 12 months and the determination of the same pro-/antiinflammatory mediators was carried out in plasma and peripheral blood mononuclear cells. Multivariate logistic regression analyses were used to identify risk/protective factors. Multiple linear regression models were performed to detect the change of each biological marker during follow-up in relation to clinical characteristics and confounding factors. This study suggests a more severe systemic pro-/antiinflammatory deregulation than in earlier pathological stages in first psychotic episode, because not only were intracellular components of the inflammatory response increased but also the majority of soluble elements. Nitrite plasma levels and cyclooxygenase-2 expression in peripheral blood mononuclear cells are reliable potential risk factors and 15d-prostaglandin-J2 plasma levels a protection biomarker. An interesting relationship exists between antipsychotic dose and the levels of prostaglandin-E2 (inverse) and 15d-prostaglandin-J2 (direct). An inverse relationship between the Global Assessment of Functioning scale and lipid peroxidation is also present. Summing up, pro-/antiinflammatory mediators can be used as risk/protection biomarkers. The inverse association between oxidative/nitrosative damage and the Global Assessment of Functioning scale, and the possibility that one of the targets of antipsychotics could be the restoration of the pro-/antiinflammatory balance support the use of antiinflammatory drugs as coadjuvant to antipsychotics. © The Author 2015. Published by Oxford University Press on behalf of CINP.

  20. The outcome of stroke: A six month follow-up study

    Kameran Hassan Ismail

    2018-04-01

    Full Text Available Background and objective: Stroke is an increasing problem in developing countries and is the principal cause of disability and dependency in the western world. This study aimed to find out the one- and six-month case fatality, dependency and recurrence rates of stroke in Erbil teaching hospitals. Methods: This hospital-based prospective study included 293 stroke patients hospitalized in Erbil teaching hospitals from January 1st, 2015 through December 31st, 2015. Stroke was diagnosed by a consultant internist or neurologist and confirmed by brain CT-scan and/or MRI. Patients were followed-up for six months, then one- and six-month outcomes were measured including case-fatality, dependency and recurrences rates. Results: The one and six month case fatality rates were 28.3% and 37.5%, respectively. The rates in females (33.3%, 42.6%, respectively were higher than that in males (23.7%, 32.9%, respectively, but there was no significant association between case-fatality rate and gender. A total of 74.3% and 45.4% of patients at one- and six-month were functionally dependent. The majority (88.9% of diabetic patients were functionally dependent. Also, the one and six month recurrence rates of stroke patients were 15.7% and 23.2%, respectively. For both one and six month post stroke more recurrence occurred from ischemic (16.2%, 14.3%, respectively than from hemorrhagic (24.5%, 19.5%, respectively strokes, but there was no significant association between the recurrence and stroke subtype (P = 0.691, P = 0.367, respectively. Conclusion: The reported outcomes are relatively comparable to that reported in other developing countries, although it is still more than the rates of developed countries. Outcome measures can help to give information and develop guidelines for clinical practice and research. Keywords: Stroke; Case fatality; Recurrence; Functional outcome.

  1. Psychopathology from adolescence into young adulthood: an 8-year follow-up study.

    Ferdinand, R F; Verhulst, F C

    1995-11-01

    This study investigated the stability of behavioral and emotional problems from adolescence into young adulthood. Subjects from the general population (N = 459), aged 13-16 years, were evaluated initially with the Child Behavior Checklist (completed by parents) and 8 years later with the Young Adult Self-Report. The scoring format and factor structure of the two assessment instruments are similar; syndromes constructed from the two instruments are based on parents', teachers', and self-report information derived from large clinical samples. Signs of maladjustment also were assessed at follow-up through interviews. Of the individuals with total problem scores in the deviant range on the Child Behavior Checklist, 27.3% had total problem scores in the deviant range on the Young Adult Self-Report at follow-up. The probability of having a total problem score in the deviant range at follow-up was raised 7.4-fold by having deviant-range scores on the Child Behavior Checklist somatic complaints and anxious/depressed syndromes (simultaneously) at the initial assessment. Referral to mental health services was predicted by deviant-range scores on the anxious/depressed syndrome, while suicide attempts were predicted by deviance on the withdrawn syndrome. Adolescent problems tended to persist into young adulthood to a moderate degree. High rates of withdrawal from social contacts, anxiety or depression, somatic complaints without known medical origin, social problems, attention problems, delinquent behavior, and aggressive behavior during adolescence were risk factors for specific types of psychopathology and maladjustment at 8-year follow-up. The presence of psychopathology in adolescence should not be regarded as normative.

  2. Patient relationship management: an overview and study of a follow-up system.

    Oinas-Kukkonen, Harri; Räisänen, Teppo; Hummastenniemi, Niko

    2008-01-01

    Customer relationship management research is utilized to explain the need for a more patient-oriented support in patient care. This article presents a European study on how various hospital units of a single healthcare organization have utilized a patient relationship management system--in particular a patient treatment follow-up system--and how it affects patient care and the knowledge work performed by the medical staff. Eight physicians were interviewed at a university hospital on whether patient treatment was improved through a follow-up system that had been in use in the case organization for three years. The interviewees represented various hospital units, and all of them had used the system at their own unit. The results indicate that it is possible to improve patient care through more personalized treatment. The follow-up treatment system seems to be a tool to create and maintain better communication with the patients rather than just a technological solution. It may help better understand and analyze both individual patients and patient groups. For individual physicians it provides a way to reflect professional skills. The system was lacking in its support for one-to-one communication with patients. Nevertheless, the system is an example of patient relationship management which may help healthcare units to move towards a more patient-oriented care.

  3. Travelers' health problems and behavior: prospective study with post-travel follow-up.

    Vilkman, Katri; Pakkanen, Sari H; Lääveri, Tinja; Siikamäki, Heli; Kantele, Anu

    2016-07-13

    The annual number of international tourist arrivals has recently exceeded one billion, yet surprisingly few studies have characterized travelers' behavior, illness, and risk factors in a prospective setting. Particularly scarce are surveys of data spanning travel, return, and follow-up of the same cohort. This study examines behavior and illness among travelers while abroad, after return home, and at follow-up. Patterns of behavior connected to type of travel and illness are characterized so as to identify risk factors and provide background data for pre-travel advice. Volunteers to this prospective cohort study were recruited at visits to a travel clinic prior to departure. Data on the subjects' health and behavior were collected by questionnaires before and after journeys and over a three-week follow-up. In addition, the subjects were asked to fill in health diaries while traveling. The final study population consisted of 460 subjects, 79 % of whom reported illness during travel or on arrival: 69 % had travelers' diarrhea (TD), 17 % skin problems, 17 % fever, 12 % vomiting, 8 % respiratory tract infection, 4 % urinary tract infection, 2 % ear infection, 4 % gastrointestinal complaints other than TD or vomiting, and 4 % other symptoms. Of all subjects, 10 % consulted a doctor and 0.7 % were hospitalized; 18 % took antimicrobials, with TD as the most common indication (64 %). Ongoing symptoms were reported by 25 % of all travelers upon return home. During the three-week follow-up (return rate 51 %), 32 % of respondents developed new-onset symptoms, 20 % visited a doctor and 1.7 % were hospitalized. Factors predisposing to health problems were identified by multivariable analysis: certain regions (Southern Asia, South-Eastern Asia, and Eastern Africa), female gender, young age, and long travel duration. Despite proper preventive measures like vaccinations, malaria prophylaxis, and travel advice, the majority of our subjects fell ill during or

  4. Psychological reactions after multifetal pregnancy reduction: a 2-year follow-up study.

    Garel, M; Stark, C; Blondel, B; Lefebvre, G; Vauthier-Brouzes, D; Zorn, J R

    1997-03-01

    This study had two objectives. Firstly we assessed the effects of multifetal pregnancy reduction on the mothers' emotional well-being and the relationship with the children during the 2 years following intervention. Secondly at 2 years we compared mothers who had a reduction with mothers who had not and had delivered triplets. The comparisons focused on the mothers' health and their relationship with the children. Women having had a reduction in two hospitals in Paris, between May 1992 and June 1993, were contacted just after intervention for a prospective study. In all, 18 women were included. At 1 and 2 years, 10 women participated. At 2 years, 10 additional women were included. The answers of these 20 mothers were compared to those of 11 consecutive mothers of 2 year old triplets, assessed by the same psychologist in a previous prospective study. Semi-structured interviews were conducted at home. The mothers' social characteristics, their parity, the children's condition at birth and 4 months were very similar between the reduction and triplet groups. One year after birth one-third of the women in the reduction group reported persistent depressive symptoms related to the reduction, mainly sadness and guilt. The others made medical and rational comments expressing no emotion. At 2 years all but two women seemed to have overcome the emotional pain associated with the reduction. The comparison with mothers of triplets indicated that the mothers' anxiety and depression, and difficult relationship with the children were less acute in the reduction group. These results presented some limitations, since a high number of women who miscarried or refused to participate in the follow-up were not assessed at 1 and 2 years. However, a majority of women who participated in the study 2 years after intervention seemed able to accept a multifetal pregnancy reduction to achieve parental goals.

  5. Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage.

    Gaudie, Jennifer; Mitrou, Francis; Lawrence, David; Stanley, Fiona J; Silburn, Sven R; Zubrick, Stephen R

    2010-02-11

    Many western nations continue to have high rates of teenage pregnancies and births, which can result in adverse outcomes for both mother and child. This study identified possible antecedents of teenage pregnancy using linked data from administrative sources to create a 14-year follow-up from a cross-sectional survey. Data were drawn from two sources - the 1993 Western Australian Child Health Survey (WACHS), a population-based representative sample of 2,736 children aged 4 to 16 years (1,374 girls); and administrative data relating to all their subsequent births and hospital admissions. We used weighted population estimates to examine differences between rates for teenage pregnancy, motherhood and abortion. We used Cox proportional hazards regression to model risk for teenage pregnancy. There were 155 girls aged less than 20 years at the time of their first recorded pregnancy. Teenage pregnancy was significantly associated with: family type; highest school year completed by primary carer; combined carer income; whether the primary carer was a smoker; and whether the girl herself displayed aggressive and delinquent behaviours. An age-interaction analysis on the association with aggressive and delinquent behaviours found that while girls with aggressive and delinquent behaviours who were older at the time of the survey were at highest risk of teenage pregnancy, there was elevated risk for future teenage pregnancy across all ages. Our findings suggest that interventions to reduce teenage pregnancy rates could be introduced during primary school years, including those that are focused on the prevention and management of aggressive and delinquent behaviour.

  6. Antecedents of teenage pregnancy from a 14-year follow-up study using data linkage

    Stanley Fiona J

    2010-02-01

    Full Text Available Abstract Background Many western nations continue to have high rates of teenage pregnancies and births, which can result in adverse outcomes for both mother and child. This study identified possible antecedents of teenage pregnancy using linked data from administrative sources to create a 14-year follow-up from a cross-sectional survey. Methods Data were drawn from two sources - the 1993 Western Australian Child Health Survey (WACHS, a population-based representative sample of 2,736 children aged 4 to 16 years (1,374 girls; and administrative data relating to all their subsequent births and hospital admissions. We used weighted population estimates to examine differences between rates for teenage pregnancy, motherhood and abortion. We used Cox proportional hazards regression to model risk for teenage pregnancy. Results There were 155 girls aged less than 20 years at the time of their first recorded pregnancy. Teenage pregnancy was significantly associated with: family type; highest school year completed by primary carer; combined carer income; whether the primary carer was a smoker; and whether the girl herself displayed aggressive and delinquent behaviours. An age-interaction analysis on the association with aggressive and delinquent behaviours found that while girls with aggressive and delinquent behaviours who were older at the time of the survey were at highest risk of teenage pregnancy, there was elevated risk for future teenage pregnancy across all ages. Conclusions Our findings suggest that interventions to reduce teenage pregnancy rates could be introduced during primary school years, including those that are focused on the prevention and management of aggressive and delinquent behaviour.

  7. Work, diabetes and obesity: a seven year follow-up study among Danish health care workers.

    Poulsen, Kjeld; Cleal, Bryan; Clausen, Thomas; Andersen, Lars L

    2014-01-01

    The rise in prevalence of diabetes is alarming and research ascribes most of the increase to lifestyle. However, little knowledge exists about the influence of occupational factors on the risk for developing diabetes. This study estimates the importance of work and lifestyle as risk factors for developing diabetes mellitus among healthcare workers and explores the association of work factors and obesity, which is a risk factor for diabetes. Questionnaire-based prospective cohort study among 7,305 health care workers followed for seven years in the Danish National Diabetes Register. We used bivariate comparisons to give an unadjusted estimate of associations, followed by adjusted survival analysis and logistic regression models to estimate the influences of potential risk factors related to job, health and lifestyle on diabetes and obesity. During seven years of follow up, 3.5% of participants developed diabetes, associated with obesity (HR  =  6.53; 95% CI 4.68-9.10), overweight (HR  =  2.89; CI 2.11-3.96) age 50-69 y (HR  =  2.27; 95% CI 1.57-3.43) and high quality of leadership (HR  =  1.60; CI 1.19-2.16). Obesity at baseline was most common among the youngest employees, and was mainly associated with developing diabetes (OR  =  3.84; CI 2.85-5.17), impaired physical capacity and physical inactivity. In the occupational setting, obesity was associated with shift work, severe musculoskeletal pain, low influence, but also by good management, fewer role conflicts and a positive work-life balance. Looking only at non-smokers, removed the influence of age and pain. However, non-smokers also had higher depression scores and more role conflicts. Confirming obesity as the strongest risk factor for developing diabetes, the present study identified few occupational risk factors. However, obesity, the key risk factor for diabetes, had a more variable relation with work than did diabetes.

  8. Work, diabetes and obesity: a seven year follow-up study among Danish health care workers.

    Kjeld Poulsen

    Full Text Available The rise in prevalence of diabetes is alarming and research ascribes most of the increase to lifestyle. However, little knowledge exists about the influence of occupational factors on the risk for developing diabetes. This study estimates the importance of work and lifestyle as risk factors for developing diabetes mellitus among healthcare workers and explores the association of work factors and obesity, which is a risk factor for diabetes.Questionnaire-based prospective cohort study among 7,305 health care workers followed for seven years in the Danish National Diabetes Register. We used bivariate comparisons to give an unadjusted estimate of associations, followed by adjusted survival analysis and logistic regression models to estimate the influences of potential risk factors related to job, health and lifestyle on diabetes and obesity.During seven years of follow up, 3.5% of participants developed diabetes, associated with obesity (HR  =  6.53; 95% CI 4.68-9.10, overweight (HR  =  2.89; CI 2.11-3.96 age 50-69 y (HR  =  2.27; 95% CI 1.57-3.43 and high quality of leadership (HR  =  1.60; CI 1.19-2.16. Obesity at baseline was most common among the youngest employees, and was mainly associated with developing diabetes (OR  =  3.84; CI 2.85-5.17, impaired physical capacity and physical inactivity. In the occupational setting, obesity was associated with shift work, severe musculoskeletal pain, low influence, but also by good management, fewer role conflicts and a positive work-life balance. Looking only at non-smokers, removed the influence of age and pain. However, non-smokers also had higher depression scores and more role conflicts.Confirming obesity as the strongest risk factor for developing diabetes, the present study identified few occupational risk factors. However, obesity, the key risk factor for diabetes, had a more variable relation with work than did diabetes.

  9. Tuberculosis screening and follow-up of asylum seekers in Norway: a cohort study

    Garåsen Helge

    2009-05-01

    Full Text Available Abstract Background About 80% of new tuberculosis cases in Norway occur among immigrants from high incidence countries. On arrival to the country all asylum seekers are screened with Mantoux test and chest x-ray aimed to identify cases of active tuberculosis and, in the case of latent tuberculosis, to offer follow-up or prophylactic treatment. We assessed a national programme for screening, treatment and follow-up of tuberculosis infection and disease in a cohort of asylum seekers. Methods Asylum seekers ≥ 18 years who arrived at the National Reception Centre from January 2005 to June 2006, were included as the total cohort. Those with a Mantoux test ≥ 6 mm or positive x-ray findings were included in a study group for follow-up. Data were collected from public health authorities in the municipality to where the asylum seekers had moved, and from hospital based internists in case they had been referred to specialist care. Individual subjects included in the study group were matched with the Norwegian National Tuberculosis Register which receive reports of everybody diagnosed with active tuberculosis, or who had started treatment for latent tuberculosis. Results The total cohort included 4643 adult asylum seekers and 97.5% had a valid Mantoux test. At least one inclusion criterion was fulfilled by 2237 persons. By end 2007 municipal public health authorities had assessed 758 (34% of them. Altogether 328 persons had been seen by an internist. Of 314 individuals with positive x-rays, 194 (62% had seen an internist, while 86 of 568 with Mantoux ≥ 15, but negative x-rays (16% were also seen by an internist. By December 31st 2006, 23 patients were diagnosed with tuberculosis (prevalence 1028/100 000 and another 11 were treated for latent infection. Conclusion The coverage of screening was satisfactory, but fewer subjects than could have been expected from the national guidelines were followed up in the community and referred to an internist. To

  10. Are risk estimates biased in follow-up studies of psychosocial factors with low base-line participation?

    Andersen Johan

    2011-07-01

    Full Text Available Abstract Background Low participation in population-based follow-up studies addressing psychosocial risk factors may cause biased estimation of health risk but the issue has seldom been examined. We compared risk estimates for selected health outcomes among respondents and the entire source population. Methods In a Danish cohort study of associations between psychosocial characteristics of the work environment and mental health, the source population of public service workers comprised 10,036 employees in 502 work units of which 4,489 participated (participation rate 45%. Data on the psychosocial work environment were obtained for each work unit by calculating the average of the employee self-reports. The average values were assigned all employees and non-respondent at the work unit. Outcome data on sick leave and prescription of antidepressant medication during the follow-up period (1.4.2007-31.12.2008 was obtained by linkage to national registries. Results Respondents differed at baseline from non-respondents by gender, age, employment status, sick leave and hospitalization for affective disorders. However, risk estimates for sick leave and prescription of antidepressant medication, during follow-up, based on the subset of participants, did only differ marginally from risk estimates based upon the entire population. Conclusions We found no indications that low participation at baseline distorts the estimates of associations between the work unit level of psychosocial work environment and mental health outcomes during follow-up. These results may not be valid for other exposures or outcomes.

  11. Physical activity initiated by employer and its health effects; an eight week follow-up study

    Marit Skogstad

    2016-05-01

    Full Text Available Abstract Background While the health benefits of physical activity are well established, little is known about health effects of physical activity programs initiated by employer. Methods Background data and level of physical activity were collected by questionnaire among 78 men and 43 women working in road maintenance pre and post an 8-week physical activity motivational program. As a part of the program steps measured by accelerometer were registered online where team and individual performances could be continuously monitored. The physical activity levels were registered as 1 those physical active ≤1 time per week, 2 2–3 times per week and 3 ≥4 times a week. Maximal oxygen uptake (VO2max, blood pressure, resting heart rate (RHR and blood samples (glycosylated hemoglobin, lipids and C-reactive protein were obtained at baseline and after eight weeks. Mixed models were applied to evaluate associations between physical activity and health parameters. Results With ≤1 time per week as reference, exercising 2–3 times per week at baseline was associated with higher levels of VO2max. During follow-up, VO2max increased with 2.8 mL ∙ kg−1∙ min−1 (95 % CI = 1.4, 4.3. Women had more favorable body mass index (BMI, blood pressure, RHR and lipid profile than men. Total cholesterol, low density lipoprotein (LDL, RHR and diastolic blood pressure (dBP were lower among participants who exercised 2–3 times per week or ≥4 times a week, compared with those with ≤1 time per week. Half of the participants reported increased daily PA during follow-up, with high intensity PA such as jogging by 8.6 min (SD 14.6 and 8.3 min (SD 18.2, among women and men, respectively. During follow-up dBP increased among men. Further, total cholesterol and LDL were reduced by 0.12 mmol/L and 0.13 mmol/L, respectively (95 % CI = −022, –0.01 and −0.22,–0.04. Conclusions Exercise several times a week was associated with lower blood pressure and a

  12. [Long-term Follow-up of Patients with Hepatitis-Associated Aplastic Anemia].

    You, Ya-Hong; Meng, Xian-Bin; Li, Xing-Xin; Ge, Mei-Li; Nie, Neng; Huang, Jin-Bo; Zhang, Jing; Huang, Zhen-Dong; Shao, Ying-Qi; Shi, Jun; Zheng, Yi-Zhou

    2017-08-01

    To explore the clinical characteristic, therapeutic efficacy and prognosis of patients with hepatitis-associated aplasitc anemia (HAAA). the clinical data and labrotatory examination results of 30 cases of HAAA were analyzed retrospectively, the 6-month response ratio and overall survival (OS) were assessed. HAAA most commonly occured in males, with the occurence rate of males and females was 4:1, the median onset age was 16 (4-43) years old, HAAA oriented focus on sever aplastic anemia (SAA)(4 cases,13%) and very sever aplastic anemia (VSAA)(22 cases,73%). Aplastic anemia (AA) could be seen on occurence of hepatitis (accompanied aplastic anemia) (7 cases,23%), or after the onset of hepatits (delayed aplastic anemia) (23 cases,77%), but more often occured in the latter. Statistical analysis showed that when compared with the patients of delayed aplastic anemia, patients accompanied aplastic anemia possesses lower levels of glutamic-pyruvic transaminase(ALT), aspertate aminotransferase (AST) and total bilirubin (TBIL)(P=0.042,0.012,0.001), and possessed a more obvious lymphoid cell disorder when AA occured, with more lower peripheral blood CD19 + B cells proportion (P=0.046) and more obvious imbalance of CD4 + /CD8 + ratio, but the difference was no statistical significant (P=0538). Factors affecting the 6-month respose were the severity of AA (P=0.044), the peak level of bilirubin of hepatitis (P=0.006) and the propotion of mature monocyte in bone marrow (P=0.034). The long-term follow-up showed that the 2-year OS of HAAA was 64.3±9.2%, the 6-month curative efficacy significantly affect the prognosis (Paplastic anemia, patients usually have a high incidence of early infection. Patients acompanied with aplastic anemia possess more obvious immunological derangement; the treatment efficacy for HAAA is poor, patients who haven't obtained 6-month response indicate a sinister prognosis, allogeneic hematopoietic stem cell transplantion is a better choice for these

  13. Comorbid cannabis use and panic disorder: short term and long term follow-up study.

    Dannon, Pinhas N; Lowengrub, Katherine; Amiaz, Revital; Grunhaus, Leon; Kotler, Moshe

    2004-03-01

    The aim of the study was to compare the treatment of panic disorder in patients with or without cannabis use according to response, relapse and side effects. 66 panic disorder (PD) patients were included in our study. All the subjects met the DSM-IV diagnosis of panic disorder (n=45) or panic disorder with agoraphobia (n=21). Twenty four patients experienced their first panic attack within 48 h of cannabis use and then went on to develop PD. All the patients received pharmacologic treatment with paroxetine (gradually increased up to 40 mg/d). A masked rater that was blind to the group allocation, assessed patients in order to rate anxiety symptoms and medication side effects. Relapse was defined as the occurrence of a single panic attack after remission of panic symptoms. The instruments were administered at baseline and also at the 4, 8 and 12 weeks visits and at the 1 year visit. The two groups responded equally well to paroxetine treatment as measured at the 8 weeks and 12 months follow-up visits. There were no significant effects of age, sex and duration of illness as covariates with response rates between the two groups. Also PD or PDA diagnosis did not affect the treatment response in either group. There were no significant differences in weight gain, sexual side effects or relapse rates between patients according to gender or comorbid diagnosis. Acute cannabis use can be associated with the onset of panic attacks and panic disorder, and panic disorder which develops after cannabis use is responsive to pharmacotherapy. Copyright 2004 John Wiley & Sons, Ltd.

  14. Health correlates of workplace bullying: a 3-wave prospective follow-up study.

    Bonde, Jens Peter; Gullander, Maria; Hansen, Åse Marie; Grynderup, Matias; Persson, Roger; Hogh, Annie; Willert, Morten Vejs; Kaerlev, Linda; Rugulies, Reiner; Kolstad, Henrik A

    2016-01-01

    This study aimed to examine the course of workplace bullying and health correlates among Danish employees across a four-year period. In total, 7502 public service and private sector employees participated in a 3-wave study from 2006 through 2011. Workplace bullying over the past 6-12 months and data on health characteristics were obtained by self-reports. We identified major depression using Schedules for Clinical Assessment in Neuropsychiatry interviews and the Major Depression Inventory. We performed cross-sectional and longitudinal analyses of outcomes according to self-labelled bullying at baseline using logistic regression. Reports of bullying were persistent across four years in 22.2% (57/257) of employees who initially reported bullying. Baseline associations between self-labelled bullying and sick-listing, poor self-rated health, poor sleep, and depressive symptoms were significant with adjusted odds ratios (OR) ranging from 1.8 [95% confidence interval (95% CI) 1.5-2.4] for poor sleep quality among those bullied "now and then" to 6.9 (95% CI 3.9-12.3) for depression among those reporting being bullied on a daily to monthly basis. In longitudinal analyses adjusting for bullying during follow-up, all health correlates except poor sleep quality persisted up to four years. Self-reported health correlates of workplace bullying including sick-listing, poor self-rated health, depressive symptoms, and a diagnosis of depression tend to persist for several years regardless of whether bullying is discontinued or not. Independent measures of bullying and outcomes are needed to learn whether these findings reflect long lasting health consequences of workplace bullying or whether self-labelled workplace bullying and health complaints are correlated because of common underlying factors.

  15. The impact of phone calls on follow-up rates in an online depression prevention study

    R.F. Muñoz

    2017-06-01

    Conclusions: Adding phone call contacts to email reminders and monetary incentives did increase follow-up rates. However, the rate of response to follow-up was low and the number of phone calls required to achieve one completed follow-up raises concerns about the utility of adding phone calls. We also discuss difficulties with using financial incentives and their implications.

  16. Recurrence of panic disorder during pregnancy: a 7-year naturalistic follow-up study.

    Dannon, Pinhas N; Iancu, Iulian; Lowengrub, Katherine; Grunhaus, Leon; Kotler, Moshe

    2006-01-01

    The aim of this naturalistic follow-up study was to examine the effect of pregnancy as a predicting factor of relapse in patients with panic disorder (PD). Eighty-five female patients with PD (between the ages of 20 and 35 years) were included in this study. They were divided into 2 groups based on whether the onset of PD had been during pregnancy (PD-pregnancy [PD-P]) or whether the onset of PD had been while not pregnant (PD-nonpregnant [PD-NP]). Patients were treated with paroxetine up to 40 mg/day for 12 months, and the full responders were tapered off their medication and were monitored for an additional 6 years. Treatment response was assessed using the Panic Self-Questionnaire (PSQ) with full response being defined as "0" panic attacks. Assessments using the PSQ were made at baseline and every 4 weeks for the first twelve months. During the 6-year drug-free follow-up period, patients were assessed using the PSQ every 3 months. Relapse was defined as the occurrence of a panic attack in any phase of the study. The effect of group membership (PD-P vs. PD-NP) and new pregnancies as risk factors for relapse were explored. Sixty-eight patients completed the 6-year follow-up, and each of the study groups (PD-P and PD-NP) was composed of 34 patients. Twenty-six of 34 (76.6%) patients in the PD-P group had another pregnancy, and 15/26 (57%) in this group experienced a relapse during the subsequent pregnancy. Three of 8 (37%) PD-P patients experienced a relapse without pregnancy. Among the second group (PD-NP), 18/34 (52.9%) became pregnant and 8/18 (44.4%) experienced a relapse at the time of pregnancy, whereas 4/16 (25%) experienced a relapse while not pregnant. Patients who relapsed during pregnancy had a more severe relapse (as defined by the severity of the PSQ score) compared with nonpregnant relapsers. Our naturalistic follow-up study demonstrated that pregnancy might confer an increased risk of relapse in PD. Moreover, when compared with patients who develop

  17. Poststroke Epilepsy Is Associated With a High Mortality After a Stroke at Young Age: Follow-Up of Transient Ischemic Attack and Stroke Patients and Unelucidated Risk Factor Evaluation Study

    Arntz, R.M.; Rutten-Jacobs, L.C.A.; Maaijwee, N.A.M.M.; Schoonderwaldt, H.C.; Dorresteijn, L.D.; Dijk, E.J. van; Leeuw, F.E. de

    2015-01-01

    BACKGROUND AND PURPOSE: Poststroke epilepsy is a common complication after a young stroke. We investigated the association between poststroke epilepsy and mortality. METHODS: We performed a prospective cohort study among 631 patients with a first-ever transient ischemic attack or ischemic stroke,

  18. The predictive value of microalbuminuria in IDDM. A five-year follow-up study

    Almdal, T; Nörgaard, K; Feldt-Rasmussen, B

    1994-01-01

    OBJECTIVE: To investigate the predictive value of microalbuminuria and the annual increase of albumin excretion as risk factors for diabetic nephropathy. RESEARCH DESIGN AND METHODS: A 5-year follow-up of patients with microalbuminuria (urinary albumin excretion [UAE] = 30-299 mg/24 h) and matched...... patients with normoalbuminuria (UAE classification was based on one single 24-h urine collection. The annual increase in UAE was calculated by linear regression analysis of log-transformed UAE on time. This study was conducted at the outpatient clinic of the Steno Diabetes Center...

  19. The outcome of children with selective mutism following cognitive behavioral intervention: a follow-up study.

    Lang, Claudia; Nir, Ziv; Gothelf, Ayelet; Domachevsky, Shoshi; Ginton, Lee; Kushnir, Jonathan; Gothelf, Doron

    2016-04-01

    Selective mutism (SM) is a relatively rare childhood disorder and is underdiagnosed and undertreated. The purpose of the retrospective naturalistic study was to examine the long-term outcome of children with SM who were treated with specifically designed modular cognitive behavioral therapy (MCBT). Parents of 36 children who met diagnostic criteria of SM that received MCBT treatment were invited for a follow-up evaluation. Parents were interviewed using structured scales and completed questionnaires regarding the child, including the Selective Mutism Questionnaire (SMQ). Twenty-four subjects were identified and evaluated. Their mean age ± SD of onset of SM symptoms, beginning of treatment, and age at follow-up were 3.4 ± 1.4, 6.4 ± 3.1, and 9.3 ± 3.4 years, respectively. There was robust improvement from beginning of treatment to follow-up evaluation in SM, social anxiety disorder, and specific phobia symptoms. The recovery rate from SM was 84.2 %. SM-focused MCBT is feasible in children and possibly effective in inducing long-term reduction of SM and comorbid anxiety symptoms. • There are limited empirical data on selective mutism (SM) treatment outcome and specifically on cognitive-behavioral therapy, with the majority of studies being uncontrolled case reports of 1 to 2 cases each. • There is also limited data on the long-term outcome of children with SM following treatment. What is New: • Modular cognitive behavioral treatment is a feasible and possibly effective treatment for SM. Intervention at a younger age is more effective comparing to an older age. • Treatment for SM also decreases the rate of psychiatric comorbidities, including separation anxiety disorder and specific phobia.

  20. [Professional outcomes and psychological health after workplace bullying: an exploratory follow-up study].

    Fiabane, Elena; Flachi, Daniela; Giorgi, Ines; Crepaldi, Ilaria; Candura, Stefano M; Mazzacane, Fulvio; Argentero, Piergiorgio

    2015-07-08

    The literature shows that workplace bullying can lead to negative consequences for both individuals' health and professional outcomes. Most of these studies used cross-sectional designs and self-report questionnaires and further research is needed in order to explore long-term effects of workplace bullying. This follow-up study aimed to explore professional and psychological outcomes in a sample of subjects who required a specialized and multidisciplinary assessment for psychological problems related, in their opinion, to workplace bullying. The sample includes 71 patients with a baseline diagnosis of work-related psychological disorder who were assessed at follow-up by means of a structured telephone interview. The interview included structured questions about professional career developments and psycho-somatic health, and administration of the General Health Questionnaire-12. 62.0% of the participants were currently working and, of these, 59.1% had changed workplace after experiencing mobbing. Patients who changed workplace scored significantly higher on job satisfaction levels (p<0.01) and showed lower levels of social dysfunction (p<0.01) compared to those who did not change their job. Patients with a baseline diagnosis of Adjustment disorder/Post-Traumatic Stress disorder had higher levels of general dysphoria (p<0.04) and social dysfunction (p<0.01) at follow-up than other patients. These findings  stress the importance of an accurate diagnostic assessment of mobbing-related psychopathological disorder. Victims of workplace bullying require early and continuous psychological support in order to promote their psychological well-being and work reinstatement.

  1. Studies of neurosonographic follow up images in intracranial cysts of neonat

    Oh, Ki Keun; Kim, Kyo Yun; Suh, Jung Ho; Lee, Chul

    1988-01-01

    Total 28 cases of intracranial cysts of high risk neonates were taken neurosonographic follow up study among 210 cases which has been done since April, 1986 through August, 1987. The results were as follows: 1. Intracranial cysts occurred in 28 cases among 210 high risk neonates taken on neurosonography. 2. There were no differences depending on sex of patients or the maturity of neonates. 3. 8 cases among 28 cases had intracranial cysts which were developed at previous hemorrhage sites and most cysts (6/8 cases) were developed on higher grade ICH, with which the higher grade of hemorrhage the much more enlarged and the more prolongation in cyst absorption. 4. 20 cases had developed cysts with no evidence of hemorrhage on initial neurosonography who had respiratory problem (4), sepsis (3), meningitis (1) and perinatal asphyxia (6) as other reports. 5. Subependymal area was the most common location of cysts (25/28 cases). 6. In following up the serial neurosonograms, the degree of resorption and remaining sequelae were different depending on the causes of size and location on cysts. Most of the smaller cysts less than 5mm were resolved in between 60-90 days. 7. The cysts resulted from initial ICH developed usually 7 days after, with findings of central echolucency, which followed by a thinner cyst wall. The smaller cysts resulted from non hemorrhagic origin and had the same progression in resolution. 8. In one case with perinatal asphyxia, the patient had similar ultrasonographic findings of brain edema initially which was followed by U/S manifestation of mixed echogenicity in the brain parenchyme with obliteration of gyrus and sulici in 1 week. Thereafter which was turned to multiple septated cystic leukoencephalomalacia in the 3 weeks follow up study

  2. Studies of neurosonographic follow up images in intracranial cysts of neonat

    Oh, Ki Keun; Kim, Kyo Yun; Suh, Jung Ho; Lee, Chul [College of Medicine, Yonsei University, Seoul (Korea, Republic of)

    1988-02-15

    Total 28 cases of intracranial cysts of high risk neonates were taken neurosonographic follow up study among 210 cases which has been done since April, 1986 through August, 1987. The results were as follows: 1. Intracranial cysts occurred in 28 cases among 210 high risk neonates taken on neurosonography. 2. There were no differences depending on sex of patients or the maturity of neonates. 3. 8 cases among 28 cases had intracranial cysts which were developed at previous hemorrhage sites and most cysts (6/8 cases) were developed on higher grade ICH, with which the higher grade of hemorrhage the much more enlarged and the more prolongation in cyst absorption. 4. 20 cases had developed cysts with no evidence of hemorrhage on initial neurosonography who had respiratory problem (4), sepsis (3), meningitis (1) and perinatal asphyxia (6) as other reports. 5. Subependymal area was the most common location of cysts (25/28 cases). 6. In following up the serial neurosonograms, the degree of resorption and remaining sequelae were different depending on the causes of size and location on cysts. Most of the smaller cysts less than 5mm were resolved in between 60-90 days. 7. The cysts resulted from initial ICH developed usually 7 days after, with findings of central echolucency, which followed by a thinner cyst wall. The smaller cysts resulted from non hemorrhagic origin and had the same progression in resolution. 8. In one case with perinatal asphyxia, the patient had similar ultrasonographic findings of brain edema initially which was followed by U/S manifestation of mixed echogenicity in the brain parenchyme with obliteration of gyrus and sulici in 1 week. Thereafter which was turned to multiple septated cystic leukoencephalomalacia in the 3 weeks follow up study.

  3. A long-term follow-up study of methotrexate in juvenile localized scleroderma (morphea).

    Zulian, Francesco; Vallongo, Cristina; Patrizi, Annalisa; Belloni-Fortina, Anna; Cutrone, Mario; Alessio, Maria; Martino, Silvana; Gerloni, Valeria; Vittadello, Fabio; Martini, Giorgia

    2012-12-01

    Recent studies report that methotrexate (MTX) is beneficial in the treatment of juvenile localized scleroderma (JLS) but little is known about its long-term effectiveness. We assessed the therapeutic role of MTX in children with JLS who were followed up for a prolonged period. A cohort of patients with JLS, previously enrolled in a double-blind, randomized controlled trial and treated with oral MTX (15 mg/m(2)/wk) and prednisone (1 mg/kg/d, maximum 50 mg) for the first 3 months, were prospectively followed up. Lesions were evaluated clinically, with infrared thermography, and by a computerized skin score. Response to treatment was defined as: (1) no new lesions; (2) skin score rate less than 1; and (3) decrease in lesion temperature by at least 10% compared with baseline. Clinical remission (CR) on medication was defined when response was maintained, on treatment, for at least 6 months, and complete CR when response was maintained, without treatment, for at least 6 months. Of 65 patients treated with MTX, 48 (73.8%) were responders, 10 (15.4%) relapsed by 24 months since MTX start, and 7 (10.8%) were lost to follow-up. Among the responders, 35 (72.9%) maintained CR for a mean of 25 months and 13 (27.1%) were in CR on medication. Adverse effects seen in 28 patients (48.3%) were generally mild and never required treatment discontinuation. The use of objective measures not widely available, such as infrared thermography and computerized skin score, makes it difficult to compare data from previous studies. Long-term MTX therapy is beneficial and well tolerated for JLS. Copyright © 2012 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  4. Suicide risk among young children after the Great East Japan Earthquake: A follow-up study.

    Fujiwara, Takeo; Yagi, Junko; Homma, Hiroaki; Mashiko, Hirobumi; Nagao, Keizo; Okuyama, Makiko

    2017-07-01

    On 11 March 2011, the Great East Japan Earthquake and subsequent tsunami hit East Japan. We aim to investigate the impact of trauma experiences related to the earthquake on suicide risk among young children, stratified by child sex. Participants at baseline were children who were exposed to the 2011 disaster at preschool age (affected area, n=198; unaffected area, n=82, total n=280). From July 2013 to May 2014, suicide risk was assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) in a follow-up interview conducted by a child psychiatrist or psychologist (N=210, follow-up rate: 75%). Among young girls in the affected area, 12 out of 65 (18.5%) showed suicidal ideation, which is significantly higher than girls in the unaffected area (4.7%, p for chi-square=0.036). In the multivariate model adjusted for potential confounders and mediators, the odds ratio for 4 or more trauma experiences related to the earthquake was 5.74 (95% confidence interval: 0.83-39.6, p=0.076) compared to no trauma experience related to the earthquake. Among young boys, trauma exposure was not associated with suicidal ideation. Our findings showed that young girls who experienced earthquake-related trauma at preschool age had a higher suicidal ideation 3 years after the earthquake. Copyright © 2017. Published by Elsevier B.V.

  5. Social relationships and depression: ten-year follow-up from a nationally representative study.

    Teo, Alan R; Choi, Hwajung; Valenstein, Marcia

    2013-01-01

    Social network characteristics have long been associated with mental health, but their longitudinal impact on depression is less known. We determined whether quality of social relationships and social isolation predicts the development of depression. The sample consisted of a cohort of 4,642 American adults age 25-75 who completed surveys at baseline in 1995-1996 and at ten-year follow-up. Quality of relationships was assessed with non-overlapping scales of social support and social strain and a summary measure of relationship quality. Social isolation was measured by presence of a partner and reported frequency of social contact. The primary outcome was past year major depressive episode at ten-year follow-up. Multivariable logistic regression was conducted, adjusting for the presence of potential confounders. Risk of depression was significantly greater among those with baseline social strain (OR, 1.99; 95% CI, 1.47-2.70), lack of social support (OR, 1.79; 95% CI, 1.37-2.35), and poor overall relationship quality (OR 2.60; 95% CI, 1.84-3.69). Those with the lowest overall quality of social relationships had more than double the risk of depression (14.0%; 95% CI, 12.0-16.0; psocial relationships is a major risk factor for major depression. Depression interventions should consider targeting individuals with low quality of social relationships.

  6. Patient, Provider, and System Factors Associated With Failure to Follow-Up Elevated Glucose Results in Patients Without Diagnosed Diabetes

    Michael E. Bowen

    2017-08-01

    Full Text Available Background: Although elevated glucose values are strongly associated with undiagnosed diabetes, they are frequently overlooked. Patient, provider, and system factors associated with failure to follow-up elevated glucose values in electronic medical records (EMRs are not well described. Methods: We conducted a chart review in a comprehensive EMR with a patient portal and results management features. Established primary care patients with no known diagnosis of diabetes and ≥ 1 glucose value >125 mg/dL were included. Follow-up failure was defined as (1 no documented comment on the glucose value or result communication to the patient within 30 days or (2 no hemoglobin A 1c (HbA 1c ordered within 30 days or resulted within 12 months. Associations were examined using Wilcoxon and χ 2 tests. Results: Of 150 charts reviewed, 97 met inclusion criteria. The median glucose was 133 mg/dL, and 20% of patients had multiple values >125 mg/dL. Only 36% of elevated glucose values were followed up. No associations were observed between patient characteristics, diabetes risk factors, or provider characteristics and follow-up failures. Automated flagging of glucose values ≥140 mg/dL by highlighting them red in the EMR was not associated with improved follow-up (46% vs 32%; P = .19. Even when follow-up occurred (n = 35, only 31% completed gold standard diabetes testing (HbA 1c within 12 months. Of the resulted HbA 1c tests (n = 11, 55% were in the prediabetes range (5.7%-6.4%. Conclusions: Two-thirds of elevated glucose values were not followed up, despite EMR features facilitating results management. Greater understanding of the results management process and improved EMR functionalities to support results management are needed.

  7. Associations of Maternal Pre-Pregnancy Body Mass Index and Gestational Weight Gain with Adult Offspring Cardio-Metabolic Risk Factors: The Jerusalem Perinatal Family Follow-up Study

    Hochner, Hagit; Friedlander, Yechiel; Calderon-Margalit, Ronit; Meiner, Vardiella; Sagy, Yael; Avgil-Tsadok, Meytal; Burger, Ayala; Savitsky, Bella; Siscovick, David S.; Manor, Orly

    2012-01-01

    Background Accumulating evidence demonstrates that both maternal pre-pregnancy body mass index (mppBMI) and gestational weight gain (GWG) are associated with adult offspring adiposity. However, whether these maternal attributes are related to other cardio-metabolic risk factors in adulthood has not been comprehensively studied. Methods and Results We used a birth cohort of 1400 young adults born in Jerusalem, with extensive archival data as well as clinical information at age 32, to prospectively examine the associations of mppBMI and GWG with adiposity and related cardio-metabolic outcomes. Greater mppBMI, independent of GWG and confounders, was significantly associated with higher offspring BMI, waist circumference (WC), systolic and diastolic BP, insulin and triglycerides and with lower HDL-C. For example, the effect sizes were translated to nearly 5kg/m2 higher mean BMI, 8.4cm higher WC, 0.13mmol/L (11.4mg/dL) higher triglycerides and 0.10mmol/L (3.8mg/dL) lower HDL-C among offspring of mothers within the upper mppBMI quartile (BMI>26.4kg/m2) compared to the lower (BMI14kg) and lower (GWG<9kg) quartiles of GWG were compared. Further adjustment for offspring adiposity attenuated to null the observed associations. Conclusions Maternal size both before and during pregnancy are associated with cardio-metabolic risk factors in young adult offspring. The associations appear to be driven mainly by offspring adiposity. Future studies that explore mechanisms underlying the intergenerational cycle of obesity are warranted to identify potentially novel targets for cardio-metabolic risk-reduction interventions. PMID:22344037

  8. Antipsychotic use in children and adolescents: a 1-year follow-up study.

    Baeza, Inmaculada; de la Serna, Elena; Calvo-Escalona, Rosa; Morer, Astrid; Merchán-Naranjo, Jessica; Tapia, Cecilia; Martínez-Cantarero, Ma Carmen; Andrés, Patrícia; Alda, José A; Sánchez, Bernardo; Arango, Celso; Castro-Fornieles, Josefina

    2014-10-01

    The objective of this study was to analyze the initial treatment with antipsychotics (APs) and its changes during the first year of treatment in patients visited in specialized child and adolescent psychiatry departments. Participants were 265 patients, aged 4 to 17 years, who attended consecutively at 4 different centers and were naive of AP or quasi-naive (less than 30 days since the beginning of AP treatment). Type of AP, dosage, and concomitant medication were registered at baseline, 1, 3, 6, and 12 months after beginning the treatment with AP. At baseline, the patients' mean age was 14.4 (2.9) years, and 145 (54.7%) patients were males. Antipsychotics were more prescribed in the following: schizophrenia spectrum disorders (30.2%), disruptive behavior disorders (DBDs) (18.9%), bipolar disorders (14.3%), depressive disorders (12.8%), and eating disorders (11.7%). A total of 93.2% of the patients were on an off-label indication of AP. Risperidone was the AP most prescribed in all the assessments, but differences were observed in the type of AP according to diagnosis. Thus, risperidone was significantly most prescribed in patients with DBD and olanzapine was most prescribed in patients with eating disorders. Olanzapine and quetiapine were the second-generation APs (SGAs) most prescribed after risperidone, and haloperidol was the most prescribed first-generation AP. Up to 8.3% of patients during the follow-up were on AP polypharmacy. Almost 16% patients had a change in its AP treatment during the follow-up, and the main switch was from one SGA to another. Second-generation APs were the APs most prescribed in our sample and approximately 93% of the patients used AP off-label. Risperidone was the most common AP used above all in patients with DBD, whereas olanzapine was most prescribed in patients with eating disorders. Antipsychotic polypharmacy and switch rates were low during the follow-up.

  9. Granulomatous colitis: findings on double contrast barium enema and follow-up studies

    Song, Jong Gi; Han, Joon Koo; Kim, Seung Hoon; Choo, Sung Wook; Kim, Seung Cheol; Choi, Byung Ihn

    1995-01-01

    To evaluate the radiologic findings of granulomatous colitis on double contrast barium enema and changes on follow-up studies. Serial double contrast barium enema of six patients with granulomatous colitis confirmed by endoscopic biopsy were reviewed. We analyzed the radiologic findings and their follow-up changes, including aphthous ulcers, lymphoid hyperplasia, deep ulcers, cobble stone appearance, geographic ulcers, asymmetric involvement of ulcers, skip lesions, sinus tract, fistula formation, pseudosacculation, focal stricture, and small bowel involvement. Pretreatment double contrast barium enema findings were aphthous ulcers in five patients, deep ulcer in six, cobble stone appearance in five, longitudinal geographic ulcers in two, fistulas in one, pseudosacculations in two, focal stricture in one, and pseudopolyps in six. Also, anal ulcers were observed in two patients, asymmetric involvement of ulcers in three, skip lesions in four, and small bowel involvement in five in five patients proved to have inactive disease after treatment, aphthous ulcers and deep ulcers disappeared. Geographic ulcers of two patients and anal ulcer of one patients decreased in size or depth. Pseudosacculation in one patient disappeared. Pseudopolyps decreased in two patients, increased in one, and decreased after increase in two. One patient whose disease remained active after treatment showed maintenance or increase of ulcers or fistula. And their pseudosacculation or focal stricture unchanged and pseudopolyps decreased. The major radiologic findings of chronic granulomatous colitis on double contrast barium enema are aphthous ulcer, deep ulcer, cobble stone appearance, discontinuity of the lesion and coexistence of ulcers and pseudopolyps. And, double contrast barium enema is good follow-up modality because its findings correlate with clinical course of the granulomatous colitis after treatment

  10. The depression in women in pregnancy and postpartum period: A follow-up study.

    Kirkan, Tulay Sati; Aydin, Nazan; Yazici, Esra; Aslan, Puren Akcali; Acemoglu, Hamit; Daloglu, Ali Gokhan

    2015-06-01

    This was a follow-up study to determine postpartum depression (PPD) and its causes in a population previously evaluated in the first trimester of pregnancy. The study sample consisted of pregnant women who were evaluated in the first trimester and 360 women who were re-evaluated in the postpartum period. Detailed sociodemographic data were obtained from the women, and depression was assessed with the Edinburgh Postpartum Depression scale (EPDS) and Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM) Axis I Disorders (SCID-I). In this follow-up study, the prevalence of PPD was 35% (n = 126). A depressive disorder in the first trimester of pregnancy, previous mental disorder, somatic disorder, exposure to domestic violence during pregnancy, baby's staying in the incubator and not breastfeeding were predictors of PPD. Exposure to violence and a history of previous depression predicted depression both in pregnancy and in the postpartum period. Depression rates are high in Eastern Turkey. Exposure to violence during pregnancy and the existence of a previous mental disorder were risk factors for perinatal depression in this study. Performing screening tests can identify women at risk of pregnancy-related depression. Prevention programs should be established in areas where the prevalence of depression is high. © The Author(s) 2014.

  11. Periodontitis in early and chronic rheumatoid arthritis: a prospective follow-up study in Finnish population.

    Äyräväinen, Leena; Leirisalo-Repo, Marjatta; Kuuliala, Antti; Ahola, Kirsi; Koivuniemi, Riitta; Meurman, Jukka H; Heikkinen, Anna Maria

    2017-01-31

    To investigate the association between rheumatoid arthritis (RA) and periodontitis with special emphasis on the role of antirheumatic drugs in periodontal health. Prospective follow-up study. Patients with early untreated RA and chronic active RA were examined at baseline and 16 months later. Controls were examined once. The study was conducted in Finland from September 2005 to May 2014 at the Helsinki University Hospital. Overall, 124 participants were recruited for dental and medical examinations: 53 were patients with early disease-modifying antirheumatic drug (DMARD) naїve RA (ERA), 28 were patients with chronic RA (CRA) with insufficient response to conventional DMARDs. After baseline examination, patients with ERA started treatment with synthetic DMARDs and patients with CRA with biological DMARDs. Controls were 43 age-matched, gender-matched and community-matched participants. Degree of periodontitis (defined according to the Center for Disease Control and Prevention and the American Academy of Periodontology). Prevalence of periodontal bacteria (analysed from plaque samples), clinical rheumatological status by Disease Activity Score, 28-joint count (DAS28), function by Health Assessment Questionnaire (HAQ) and treatment response by European League Against Rheumatism (EULAR) criteria. Moderate periodontitis was present in 67.3% of patients with ERA, 64.3% of patients with CRA and 39.5% of control participants (p=0.001). Further, patients with RA had significantly more periodontal findings compared with controls, recorded with common periodontal indexes. In the re-examination, patients with RA still showed poor periodontal health in spite of treatment with DMARDs after baseline examination. The prevalence of Porphyromonas gingivalis was higher in patients with ERA with periodontal probing depth ≥4 mm compared with patients with CRA and controls. Antirheumatic medication did not seem to affect the results. Moderate periodontitis was more frequent in

  12. Musculoskeletal disorders among construction workers: a one-year follow-up study

    Boschman Julitta S

    2012-10-01

    Full Text Available Abstract Background Work-related musculoskeletal disorders (MSDs are an important cause of functional impairments and disability among construction workers. An improved understanding of MSDs in different construction occupations is likely to be of value for selecting preventive measures. This study aimed to survey the prevalence of symptoms of MSDs, the work-relatedness of the symptoms and the problems experienced during work among two construction occupations: bricklayers and supervisors. Methods We randomly selected 750 bricklayers and 750 supervisors resident in the Netherlands in December 2009. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire one year later. The participants were asked about complaints of the musculoskeletal system during the last six months, the perceived work-relatedness of the symptoms, the problems that occurred during work and the occupational tasks that were perceived as causes or aggravating factors of the MSD. Results Baseline response rate was 37%, follow-up response was 80%. The prevalence of MSDs among 267 bricklayers and 232 supervisors was 67% and 57%, respectively. Complaints of the back, knee and shoulder/upper arm were the most prevalent among both occupations. Irrespective of the body region, most of the bricklayers and supervisors reported that their complaints were work-related. Complaints of the back and elbow were the most often reported among the bricklayers during work, whereas lower arm/wrist and upper leg complaints were the most often reported among the supervisors. In both occupations, a majority of the participants perceived several occupational physical tasks and activities as causes or aggravating factors for their MSD. Recurrent complaints at follow-up were reported by both bricklayers (47% of the complaints and supervisors (31% of the complaints. Participants in both occupations report that mainly back and knee complaints result in additional problems

  13. Diffusion-weighted imaging for the follow-up of patients after matrix-associated autologous chondrocyte transplantation

    Friedrich, Klaus M.; Mamisch, Tallal C.; Plank, Christina; Langs, Georg; Marlovits, Stefan; Salomonowitz, Erich; Trattnig, Siegfried; Welsch, Goetz

    2010-01-01

    Objective: To evaluate the use of diffusion-weighted imaging (DWI) for the assessment of cartilage maturation in patients after matrix-associated autologous chondrocyte transplantation (MACT). Materials and methods: Fifteen patients after MACT were examined by 3.0-T magnetic-resonance-tomography; the examination was up to 13 month after surgery in group 1, and later than 13 month after surgery in group 2. Both groups had a follow-up one-year later. DWI was acquired using a steady-state gradient-echo sequence. Mean values of the diffusion quotients of regions of interest within cartilage repair tissue and of reference regions were assessed. Each region-of-interest was subdivided into a deep, and a superficial area. Results: Mean diffusion quotients of cartilage repair tissues were 1.44 (baseline), and 1.44 (follow-up). Mean diffusion quotients of reference tissues were 1.29 (baseline) and 1.28 (follow-up). At the follow-up diffusion quotients of cartilage repair tissue were significantly higher than those of reference cartilage. In group 1 the diffusion quotients were significantly lower at the follow-up (1.45 versus 1.65); in group 2 no statistically significant differences between follow-up (1.39) and baseline (1.41) were found. Reference cartilages and cartilage repair tissues of group 2 showed a decrease of diffusion quotients from the deep to the superficial area being stable at the follow-up. In group 1 initially a significant increase (1.49 versus 1.78) of the diffusion quotients from deep to superficial area of the cartilage repair tissue was found changing into a decrease (1.65 versus 1.52) at the follow-up. Conclusions: DWI detected changes of diffusion within cartilage repair tissue that may reflect cartilage maturation. Changes in diffusity occurred up to two years after surgery and were stable later. Zonal variations within cartilage could be measured.

  14. A follow-up study of patients with DSM-IV schizophreniform disorder.

    Iancu, Iulian; Dannon, Pinhas N; Ziv, Reuven; Lepkifker, Elie

    2002-02-01

    Schizophreniform disorder (SFD) has an unclear diagnostic and prognostic status within the psychotic spectrum. We studied 36 inpatients admitted to our ward between 1983 and 1993 due to SFD. The patients were contacted an average of 12 years after index hospitalization, and we noted the course of their illness, as well as their present diagnosis. Of the sample, 84% had additional, mostly psychotic, episodes during the follow-up, and 70% had diagnoses in the schizophrenic spectrum (that is, schizophrenia and schizoaffective disorder). A survival analysis revealed that confusion and the presence of at least 2 good prognostic factors (GPF) at index hospitalization predicted better outcome. SFD seems to be an early manifestation of schizophrenia. Only a few of those sampled did not experience additional relapses--a pessimistic finding at 12-year follow-up. The findings of this study accord with DSM-IV criteria and the literature regarding the long-term prognosis of SFD and the importance of the GPF.

  15. Long-term follow-up study of I-131 therapy for Graves' disease

    Kusakabe, Kiyoko; Nakano, Keiko; Maki, Masako

    1990-01-01

    We have studied the follow-up of thyroid function in the patients with late-onset hypothyroidism and euthyroidism after I-131 therapy of hyperthyroidism. Thirty three patients who did not need the thyroid treatment until ten years after I-131 therapy were classified as euthyroid group. And eleven patients who needed the thyroid supplement of thyroid hormone for late-onset hypothyroidism were classified as hypothyroid group. Patients in both groups who required only a single dose of I-131 for successful treatment of hyperthyroidism had similar age, gland size, 24 hour I-131 uptake, pretreatment serum T 3 uptake level and T 4 concentration, and I-131 treatment dose. Subclinical hypothyroidism occurred in 28.6% of euthyroid group and 66.7% of hypothyroid group four months after I-131 therapy. The levels of T 3 were recovered to higher than normal range at 6 months in euthyroid group, while the levels of T 3 were kept within the normal range in the seventy percent of hypothyroid group. Patients who were still lower in the level of T 3 uptake than normal range at 6 months had a higher incidence of late-onset hypothyroidism. Our observation showed no significant difference in the course of follow-up studies after I-131 therapy between the patients with late-onset hypothyroidism and euthyroidism. (author)

  16. Atypical case of Reye's syndrome. Usefulness of CT for diagnosis and follow-up study

    Maehara, Fumiaki; Goto, Katsuya; Okudera, Toshio; Mitsudome, Akihisa; Hara, Kunio; Shiraishi, Masayuki [Fukuoka Univ. (Japan)

    1982-12-01

    An atypical case of Reye's syndrome was reported with emphasis on usefulness of CT for the diagnosis and follow-up study of this disease. The patient was a 13-month-old girl who had been transferred to our hospital because of status epilepticus, a comatous state and a high temperature. She was diagnosed as having Reye's syndrome according to data of liver function tests, findings in CSF and body CT which revealed swelling of the liver with diminished attenuation value suggesting fatty infiltration. However, there were atypical features in this patient: epileptic seizures since age 5 months, no vomiting at the time of onset and no evidence of brain swelling on CT in acute phase. She was discharged 2 months later with impaired neuropsychological functions of marked degree. When she was 2 year-old, she again went into status epilepticus, was comatous and had a high temperature. She was dead when she arrived at emergency room of our hospital. Autopsy findings revealed features of Reye's syndrome as follows: abundant accumulation of small fat droplets without nuclear displacement in the liver, fatty infiltration in the kidney and myocardium, and mild swelling in the cerebral cortex with marked ventricular dilatation. The possibility of recurrence of Reye's syndrome was discussed based on the clinical and autopsy findings. The value of CT in the diagnosis and the follow-up study of this disease was emphasized.

  17. Maple syrup urine disease encephalopathy: a follow-up study in the acute stage using diffusion-weighted MRI

    Ha, Jong Su; Kim, Taik-Kun; Lee, Ki Yeol; Seol, Hae Young; Cha, Sang Hoon; Eun, Baik-Lin; Lee, Hee Sun

    2004-01-01

    Neonatal maple syrup urine disease (MSUD) is associated with diffuse oedema and characteristic MSUD oedema. We present a newborn infant with two coexisting different types of oedema. The myelinated white matter showed a marked decrease in the water apparent diffusion coefficient (ADC) compatible with cytotoxic oedema. The unmyelinated white matter showed an increase in ADC, consistent with vasogenic-interstitial oedema. On follow-up studies, the cytotoxic oedema showed improvement, but the vasogenic-interstitial oedema progressed into brain atrophy. (orig.)

  18. Risk of Suicide Attempt among Adolescents with Conduct Disorder: A Longitudinal Follow-up Study.

    Wei, Han-Ting; Lan, Wen-Hsuan; Hsu, Ju-Wei; Bai, Ya-Mei; Huang, Kai-Lin; Su, Tung-Ping; Li, Cheng-Ta; Lin, Wei-Chen; Chen, Tzeng-Ji; Chen, Mu-Hong

    2016-10-01

    To assess the independent or comorbid effect of conduct and mood disorders on the risk of suicide. The Taiwan National Health Insurance Research Database was used to derive data for 3711 adolescents aged 12-17 years with conduct disorder and 14 844 age- and sex-matched controls between 2001 and 2009. The participants were followed up to the end of 2011, and those who attempted suicide during the follow-up period were identified. Adolescents with conduct disorder had a higher incidence of suicide (0.9% vs 0.1%; P suicide at a younger age (17.38 ± 2.04 vs 20.52 ± 1.70 years of age) than did the controls. The Cox proportional hazards regression model, after adjustment for demographic data and psychiatric comorbidities, determined that conduct disorder was an independent risk factor for subsequent suicide attempts (hazard ratio, 5.17; 95% CI, 2.29-11.70). The sensitivity after those with other psychiatric comorbidities were excluded revealed a consistent finding (hazard ratio, 10.32; 95% CI, 3.71-28.71). Adolescents with conduct disorder had an increased risk of suicide attempts over the next decade. Future studies are required to clarify the underlying pathophysiology and elucidate whether prompt intervention for conduct disorder could reduce this risk. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Total knee replacement with retention of both cruciate ligaments: a 22-year follow-up study.

    Sabouret, P; Lavoie, F; Cloutier, J-M

    2013-07-01

    We report on the long-term results of 163 bicruciate-retaining Hermes 2C total knee replacements in 130 patients at a mean follow-up of 22.4 years (20.3 to 23.5). Even when the anterior cruciate ligament had a partially degenerative appearance it was preserved as long as the knee had a normal anterior drawer and Lachman's test pre-operatively. The description and surgical technique of this minimally constrained prosthesis were published in 1983 and the ten-year clinical results in 1999. A total of 12% of the knees (20 of 163) in this study were revised because of wear of the polyethylene tibial insert. Excellent stability was achieved and the incidence of aseptic component loosening was 4.3% (seven of 163). The survival rate using revision for any reason as the endpoint was 82% (95% confidence interval 76.2 to 88.0). Although this series included a relatively small number of replacements, it demonstrated that the anterior cruciate ligament, even when partially degenerated at the time of TKR, remained functional and provided adequate stability at a long-term follow-up.

  20. Recidivism Patterns Among Two Types of Juvenile Homicide Offenders: A 30-Year Follow-Up Study.

    Khachatryan, Norair; Heide, Kathleen M; Hummel, Erich V

    2018-02-01

    Although juvenile homicide has been a matter of concern in the United States since the 1980s, prior research has not addressed long-term recidivism patterns for convicted juvenile murderers. Furthermore, a prominent juvenile homicide typology had not previously been tested with U.S. offenders. The present study examined whether juvenile offenders who killed or attempted to kill during the commission of a crime differed from those who killed due to some type of conflict on pre-incarceration, incarceration, and post-incarceration variables. These offenders were sentenced to adult prison in the early 1980s. Follow-up data spanned 30 years. The results indicated that approximately 88% of released offenders have been rearrested. Analyses of pre-incarceration variables revealed that crime-oriented offenders were significantly more likely to commit the homicide offense using accomplices than conflict-oriented offenders, and the latter were significantly more likely to use a firearm during the homicide incident. The circumstances of the homicide, however, were not significantly related to any other pre-incarceration variables, release from prison, number of post-release arrests, and number of post-release violent offenses. The implications of the findings, their comparability to previous follow-up research on this typology, and avenues for future research are discussed.

  1. Conservative Treatment Protocol for Keratocystic Odontogenic Tumour: a Follow-up Study of 3 Cases

    Gülsün Yildirim

    2010-07-01

    Full Text Available Background: The keratocystic odontogenic tumour is classified as a developmental cyst derived from the enamel organ or from the dental lamina. The treatment of keratocystic odontogenic tumour of the jaw remains controversial. The aim of this study was to report the outcome of our conservative treatment protocol for keratocystic odontogenic tumour.Methods: Three patients with different complaints referred to Oral and Maxillofacial Surgery Clinic, Faculty of Dentistry, Selçuk University. Initial biopsy was carried out in all patients and keratocystic odontogenic tumours was diagnosed subsequent to histopathological examination. The patients with keratocystic odontogenic tumours were treated by enucleation followed by open packing. This conservative treatment protocol was selected because of existing young aged patients. The average follow-up duration of the cases was 2 years.Results: Out of 3 cases, 2 lesions were present in mandible and 1 lesion in maxilla. There was no evidence of recurrence during follow-up. All the cases were monitored continuously with panoramic radiographs, computed tomography and clinical evaluations.Conclusions: This conservative treatment protocol for keratocystic odontogenic tumours, based on enucleation followed by open packing would be a possible choice with a view of offering low recurrence rate and low morbidity rate particularly in young patients.

  2. Factors Associated With Participation and Change Over Time in Domestic Life, Peer Relations, and School for Adolescents With and Without Self-Reported Neurodevelopmental Disorders. A Follow-Up Prospective Study

    Frida Lygnegård

    2018-04-01

    Full Text Available Even though participation in everyday events is a vital part in the fulfillment of human rights, adolescents with neurodevelopmental disorders (NDD often face participation restrictions in every-day activities. Few studies have investigated the predictors for participation in different contexts, over time and in relation to the same outcome variables.Objective: Objective of the current study was therefore to investigate predictors of change in participation operationalized as frequency of attendance and perceived importance in domestic life activities, peer related activities, and school activities as experienced by adolescents with and without self-reported neurodevelopmental disorders.Method: Associations with participation, both in terms of frequency and perceived importance, in domestic life, peer relations, and the school setting were investigated using six independent variables measuring experience of time and self, sex, age, stress, support from siblings, and atmosphere in family at two-time (with ~2 years in between. The sample consisted of adolescents with and without self-reported NDD (n = 916. Adolescents with self-reported NDD were n = 154 and adolescents without self-reported NDD was n = 762. Data was collected via self-reported questionnaires administered in schools.Results: Three key findings are presented. (1 more factors were associated with participation outcomes at time1 for adolescents without NDD than for adolescents with NDD, but this difference in the number of factors decreases with time; (2 few associations were related to time for both adolescents with and without NDD; and (3 patterns of predicting variables were different for adolescents with and without NDD.Conclusion: The findings indicate that the factors related to participation in and outside school differs between groups, when the impairment or disability is not considered as a predictor for participation. This study supports the need for using a multidimensional

  3. Radiation-associated disease: disease incidence and cost effectiveness of follow-up

    Schramm, V.L. Jr.; Carroll, R.G.

    1979-01-01

    The organization, costs and outcome of a metropolitan area-wide recall campaign for patients irradiated for benign disease is documented. The campaign resulted in an increase in the number of thyroid malignancies discovered in both the irradiated and the nonirradiated population. The organization of the campaign cost $100,000. An estimated excess of 100 thyroid carcinomas were found in the 17 months following the campaign compared to the 17 months prior to the campaign in the Pittsburgh Standard Metropolitan Statistical Area. Of 150 patients who were radium exposed as infants and remained in the Pittsburgh area, 60% knew of their exposure only by direct hospital contact and were not reached by media public education. Seven of those 150 patients had thyroid carcinoma on 35 year follow-up, and 30% had some benign or malignant tumor

  4. Smoking Status and Incidence of Cancer After Myocardial Infarction: A Follow-Up Study of over 20 Years.

    Lotan, Katrin; Goldbourt, Uri; Gerber, Yariv

    2017-09-01

    We evaluated long-term incidence of cancer after myocardial infarction among current, former, and never smokers, and assessed whether reducing cigarette consumption is associated with decreased cancer risk. Consecutive patients aged ≤65 years discharged from 8 hospitals in central Israel after first myocardial infarction in 1992-1993 were followed for cancer and death. Extensive data including smoking habits were obtained at the index hospitalization and 4 time points during follow-up. Survival methods were applied to assess the hazard ratios (HRs) for cancer associated with smoking categories. Included in the study were 1486 cancer-free participants (mean age, 54 years; 81% men), among whom 787 were current smokers at baseline (average daily cigarette consumption = 29). Smokers were younger than nonsmokers and more likely to be male and of lower socioeconomic status. Over a median follow-up of 21.4 years, 273 (18.4%) patients developed cancer. Baseline smoking was associated with a ∼40% excess adjusted risk of cancer; ∼25% after accounting for death as a competing event. Considering changes in smoking during follow-up, the excess risk was confined to persistent smokers (adjusted HR 1.75; 95% confidence interval [CI], 1.22-2.50), whereas post- (HR 1.14; 95% CI, 0.80-1.62) and pre-myocardial infarction quitters (HR 1.02; 95% CI, 0.71-1.47) were comparable with never smokers. Among persistent smokers, each reduction of 10 cigarettes relative to pre-myocardial infarction consumption was associated with a ∼10% reduced adjusted risk. Among young survivors of first myocardial infarction followed-up longitudinally, smoking cessation is associated with lower risk of cancer. Reducing consumption among smokers may also be beneficial. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Association of nursery and early school attendance with later health behaviours, biomedical risk factors, and mortality: evidence from four decades of follow-up of participants in the 1958 birth cohort study.

    Batty, G David; Ploubidis, George B; Goodman, Alissa; Bann, David

    2018-03-14

    Although early life education for improved long-term health and the amelioration of socioeconomically generated inequalities in chronic disease is advocated in influential policy statements, the evidence base is very modest. To address this dearth of evidence using data from a representative UK national birth cohort study. The analytical sample comprised men and women in the 1958 birth cohort study with prospectively gathered data on attendance at nursery or primary school before the age of 5 years who had gone on to participate in social survey at 42 years (n=11 374), or a biomedical survey at 44/5 years of age (n=9210), or had data on vital status from 18 to 55 years (n=17 657). Relative to study members who had not attended nursery, in those who had, there was in fact a higher prevalence of smoking and high alcohol intake in middle age. Conversely, nursery attenders had more favourable levels of lung function and systolic blood pressure in middle age. This apparent association between nursery attendance and lower systolic blood pressure was confined to study members from more deprived social backgrounds of origin (P value for interaction 0.030). There was no apparent link between early school attendance and any behavioural or biological risk factor. Neither nursery nor early school attendance was clearly related to mortality risk. We found no clear evidence for an association of either attendance at nursery or primary school before the age of 5 years and health outcomes around four decades later. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. Follow-up of patients with localized breast cancer and first indicators of advanced breast cancer recurrence: A retrospective study.

    Viot, Julien; Bachour, Martin; Meurisse, Aurélia; Pivot, Xavier; Fiteni, Frédéric

    2017-08-01

    We conducted a retrospective study to assess the follow-up of patients with localized breast cancer and the first indicators of advanced breast cancer recurrence. All patients with advanced breast cancer recurrence treated between January 2010 and June 2016 in our institution were registered. Among these patients, 303 patients initially treated for early breast cancer with curative intent were identified. After initial curative treatment, follow-up involved the oncologist, the general practitioner and the gynecologist in 68.0%, 48.9% and 19.1% of cases, respectively. The median DFI was 4 years for luminal A, 3.8 years for luminal B, 3.7 years for HER2-positive and 1.5 years for TNBC (p = 0.07). Breast cancer tumor marker was prescribed for 164 patients (54.1%). No difference in terms of follow-up was observed according to the molecular subtype. Symptoms were the primary indicator of relapse for 143 patients (47.2%). Breast cancer recurrence was discovered by CA 15.3 elevation in 57 patients (18.8%) and by CAE elevation in 3 patients (1%). The rate of relapse diagnosed by elevation of CA 15.3 or CAE was not statistically associated with the molecular subtype (p = 0.65). Luminal A cases showed a significantly higher rate of bone metastases (p = 0.0003). TNBC cases showed a significantly higher rate of local recurrence (p = 0.002) and a borderline statistical significant higher rate of lung/pleural metastases (p = 0.07). Follow-up recommendations could be adapted in clinical practice according to the molecular subtype. General practitioners should be more involved by the specialists in breast cancer follow-up. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Treatment of selective mutism: a 5-year follow-up study.

    Oerbeck, Beate; Overgaard, Kristin Romvig; Stein, Murray B; Pripp, Are Hugo; Kristensen, Hanne

    2018-01-22

    Selective mutism (SM) has been defined as an anxiety disorder in the diagnostic and statistical manual of mental disorders (DSM-5). Cognitive behavioral therapy (CBT) is the recommended approach for SM, but prospective long-term outcome studies are lacking. Reports from the children themselves, and the use of more global quality of life measures, are also missing in the literature. We have developed a school-based CBT intervention previously found to increase speech in a pilot efficacy study and a randomized controlled treatment study. Continued progress was found in our 1-year follow-up studies, where older age and more severe SM had a significant negative effect upon outcome. In the present study, we provide 5-year outcome data for 30 of these 32 children with SM who completed the same CBT for mean 21 weeks (sd 5, range 8-24) at mean age 6 years (10 boys). Mean age at the 5-year follow-up was 11 years (range 8-14). Outcome measures were diagnostic status, the teacher- and parent-rated selective mutism questionnaires, and child rated quality of life and speaking behavior. At the 5-year follow-up, 21 children were in full remission, five were in partial remission and four fulfilled diagnostic criteria for SM. Seven children (23%) fulfilled criteria for social phobia, and separation anxiety disorder, specific phobia and/or enuresis nocturna were found in a total of five children (17%). Older age and severity at baseline and familial SM were significant negative predictors of outcome. Treatment gains were maintained on the teacher- and parent questionnaires. The children rated their overall quality of life as good. Although most of them talked outside of home, 50% still experienced it as somewhat challenging. These results point to the long-term effectiveness of CBT for SM, but also highlight the need to develop more effective interventions for the subset of children with persistent symptoms.Clinical trials registration NCT01002196.

  8. Does trait mindfulness level affect quitting cannabis use? A six week follow-up study

    Salih Cihat Paltun

    Full Text Available Abstract Background: Only 29% of cannabis dependent individuals seek treatment, yet significant decreases in cannabis use are seen in 31-36% of individuals that seek treatment. Follow-up studies have found that over 60% in substance use disorders end in relapse, leading to potentially chronic and relapsing cases. New and effective therapies should be researched in order to increase the success of relapse prevention treatments. Objective: In this study we aimed to evaluate the relationship between trait mindfulness level, substance dependence severity and quitting cannabis use. Methods: A hundred and sixty four patients, diagnosed with cannabis dependence, were involved in the study; socidemographic datas were recorded and Addiction Profile Index (API, Mindfuness Attention and Awareness Scale (MAAS were carried out. Results: We found that the trait mindfulness level is significantly related with quitting cannabis use. Discussion: Trait mindfulness may be an important determining factor of the ability to quit substance use and achieve remission.

  9. Prescribed Renoprotective Chinese Herbal Medicines Were Associated with a Lower Risk of All-Cause and Disease-Specific Mortality among Patients with Chronic Kidney Disease: A Population-Based Follow-Up Study in Taiwan

    Chuan-Fa Hsieh

    2017-01-01

    Full Text Available Chinese herbal medicines (CHMs containing aristolochic acid (AA are associated with chronic kidney disease (CKD, but some prescribed CHMs have been shown to possess renoprotective effects. We conducted a nationwide retrospective cohort study to delineate the role of prescribed CHMs on the CKD progression. Renoprotective CHM (RPCHM was defined if a CHM contained dong chong xia cao (Cordyceps sinensis (Berk. Sacc., da huang (Rheum palmatum L, huang qi (Astragalus membranaceus, dan shen (Salvia miltiorrhiza Bge., and dong quai (Angelica sinensis (Oliv. Diels or belonged to specific mixture herbal formulations (Yishen capsule, Saireito, or Wen Pi Tang. Subjects who had ever used AA-containing CHMs, had cancer or HIV prior to CKD diagnosis, or died within the first month of CKD diagnosis were excluded. A total of 11,625 patients were eligible subjects. The adjusted hazard ratio (aHR for all-cause mortality was 0.6 (p < 0.001 and 0.6 (p = 0.013 among subjects receiving RPCHMs containing Angelica sinensis and those receiving other RPCHMs, respectively. For CKD-related mortality, the aHR among subjects receiving RPCHMs containing Angelica sinensis was 0.6 (p = 0.025. The use of specific RPCHMs, especially those that contained Angelica sinensis, was associated with a lower risk of mortality among CKD patients.

  10. Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

    Mariam, Tesfamichael G.; Alemayehu, Abebaw; Tesfaye, Eleni; Mequannt, Worku; Temesgen, Kiber; Yetwale, Fisseha

    2017-01-01

    Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer. PMID:28791310

  11. Prevalence of Diabetic Foot Ulcer and Associated Factors among Adult Diabetic Patients Who Attend the Diabetic Follow-Up Clinic at the University of Gondar Referral Hospital, North West Ethiopia, 2016: Institutional-Based Cross-Sectional Study

    Tesfamichael G. Mariam

    2017-01-01

    Full Text Available Diabetes mellitus is a metabolic disorder which is characterized by multiple long-term complications that affect almost every system in the body. Foot ulcers are one of the main complications of diabetes mellitus. However, there is limited evidence on the occurrence of foot ulcer and influencing factors in Ethiopia. An institutional-based cross-sectional study was conducted in Gondar University Hospital, Ethiopia, to investigate foot ulcer occurrence in diabetic patients. Systematic random sampling was used to select 279 study participants. Bivariate and multivariable logistic regression model was fitted to identify factors associated with diabetic foot ulcer. Odds ratio with 95% confidence interval was computed to determine the level of significance. Diabetic foot ulcer was found to be 13.6%. Rural residence [AOR = 2.57; 95% CI: 1.42, 5.93], type II diabetes mellitus [AOR = 2.58; 95% CI: 1.22, 6.45], overweight [AOR = 2.12; 95% CI: 1.15, 3.10], obesity [AOR = 2.65; 95% CI: 1.25, 5.83], poor foot self-care practice [AOR = 2.52; 95% CI: 1.21, 6.53], and neuropathy [AOR = 21.76; 95% CI: 8.43, 57.47] were factors associated with diabetic foot ulcer. Diabetic foot ulcer was found to be high. Provision of special emphasis for rural residence, decreasing excessive weight gain, managing neuropathy, and promoting foot self-care practice would decrease diabetic foot ulcer.

  12. Cardiac abnormalities in a follow-up study on carriers of Duchenne and Becker muscular dystrophy

    van Westrum, S. M. Schade; Hoogerwaard, E. M.; Dekker, L.; Standaar, T. S.; Bakker, E.; Ippel, P. F.; Oosterwijk, J. C.; Majoor-Krakauer, D. F.; van Essen, A. J.; Leschot, N. J.; Wilde, A. A. M.; de Haan, R. J.; de Visser, M.; van der Kooi, A. J.

    Objectives: Cardiac involvement has been reported in carriers of dystrophin mutations giving rise to Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD). The progress of these abnormalities during long-term follow-up is unknown. We describe the long-term follow-up of dilated

  13. Cardiac abnormalities in a follow-up study on carriers of Duchenne and Becker muscular dystrophy

    Schade van Westrum, S. M.; Hoogerwaard, E. M.; Dekker, L.; Standaar, T. S.; Bakker, E.; Ippel, P. F.; Oosterwijk, J. C.; Majoor-Krakauer, D. F.; van Essen, A. J.; Leschot, N. J.; Wilde, A. A. M.; de Haan, R. J.; de Visser, M.; van der Kooi, A. J.

    2011-01-01

    Objectives: Cardiac involvement has been reported in carriers of dystrophin mutations giving rise to Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD). The progress of these abnormalities during long-term follow-up is unknown. We describe the long-term follow-up of dilated

  14. A long-term follow-up study of subtotal splenectomy in children with hereditary spherocytosis.

    Rosman, C W K; Broens, P M A; Trzpis, M; Tamminga, R Y J

    2017-10-01

    Hereditary spherocytosis (HS) is a heterogeneous hemolytic anemia treated with splenectomy in patients suffering from severe or moderate disease. Total splenectomy, however, renders patients vulnerable to overwhelming postsplenectomy infection despite preventive measures. Although subtotal splenectomy has been advocated as an alternative to total splenectomy, long-term follow-up data are scarce. We investigated how often hematologic recurrences requiring secondary total splenectomy occurred. With a follow-up of at least 5 years, we analyzed the data of 12 patients, aged 11 years maximum (median 6.5 years), who had undergone intended subtotal splenectomy, and 9 patients (median age 11.9 years), who had undergone total splenectomy. We compared their hematologic results and searched for factors associated with secondary spleen surgery. Hemolysis was reduced after subtotal splenectomy and absent after total splenectomy. Subtotal splenectomy was not successful in three children because no functional splenic remnant remained after 6 months (one conversion at surgery; one necrosis of splenic remnant; one early secondary splenectomy). Four children required secondary splenectomy after a median of 5 years for hematologic recurrence. In the remaining five patients, a functional splenic remnant was present for at least 5.5 years. The median time to secondary total splenectomy after intended subtotal splenectomy was 5.2 years. In all patients requiring secondary total splenectomy, increased reticulocyte levels within 2 years indicated hematologic recurrence. Subtotal splenectomy can be an alternative for total splenectomy in young patients with HS. It allows for hematologic improvement and may preserve splenic immune function for as many as 5 years. © 2017 Wiley Periodicals, Inc.

  15. Allogeneic blood transfusion and prognosis following total hip replacement: a population-based follow up study

    Pedersen, Alma B; Mehnert, Frank; Overgaard, Søren

    2009-01-01

    BACKGROUND: Allogeneic red blood cell transfusion is frequently used in total hip replacement surgery (THR). However, data on the prognosis of transfused patients are sparse. In this study we compared the risk of complications following THR in transfused and non-transfused patients. METHODS......: A population-based follow-up study was performed using data from medical databases in Denmark. We identified 28,087 primary THR procedures performed from 1999 to 2007, from which we computed a propensity score for red blood cell transfusion based on detailed data on patient-, procedure-, and hospital......-related characteristics. We were able to match 2,254 transfused with 2,254 non-transfused THR patients using the propensity score. RESULTS: Of the 28,087 THR patients, 9,063 (32.3%) received at least one red blood cell transfusion within 8 days of surgery. Transfused patients had higher 90-day mortality compared...

  16. Lexical access changes in patients with multiple sclerosis: a two-year follow-up study.

    Sepulcre, Jorge; Peraita, Herminia; Goni, Joaquin; Arrondo, Gonzalo; Martincorena, Inigo; Duque, Beatriz; Velez de Mendizabal, Nieves; Masdeu, Joseph C; Villoslada, Pablo

    2011-02-01

    The aim of the study was to analyze lexical access strategies in patients with multiple sclerosis (MS) and their changes over time. We studied lexical access strategies during semantic and phonemic verbal fluency tests and also confrontation naming in a 2-year prospective cohort of 45 MS patients and 20 healthy controls. At baseline, switching lexical access strategy (both in semantic and in phonemic verbal fluency tests) and confrontation naming were significantly impaired in MS patients compared with controls. After 2 years follow-up, switching score decreased, and cluster size increased over time in semantic verbal fluency tasks, suggesting a failure in the retrieval of lexical information rather than an impairment of the lexical pool. In conclusion, these findings underline the significant presence of lexical access problems in patients with MS and could point out their key role in the alterations of high-level communications abilities in MS.

  17. Cytogenetic Follow-up Study of Population Occupationally Exposed to Nonionizing Radiation

    Garaj-Vrhovac, V.; Kasuba, V.; Vojvodic, S.

    1998-01-01

    The aim of this investigation was to analyse the results of a four year follow- up study of chromosome aberrations in a population occupationally exposed to microwave radiation. The study included a group of 30 healthy volunteers - radar technicians occupationally exposed to microwave radiation and a group of 30 healthy controls from the general population. The average duration of employment of the exposed subjects was 16 years. The chromosome aberrations assay was carried out on 48 h culture of lymphocytes. Microwave power density was measured with Raham model 4A (General Microwave Corporation, Farmingdale, NY) at different workplaces. The measurements of electromagnetic field power density distribution at different workplaces show that during an ordinary workday the examinees stay in zones with power density below 5 mW/cm 2 with a frequency range of 1250-1350 MHz. The chromosomal type of aberrations in the exposed group during the 4-year follow up study was predominantly higher than in the control group. The total percentage of chromosome aberrations for the exposed group in the first year of the study was 2.36%, in the second 1.43%, in the third 2.88%, and in the fourth year 2.60%, while for the control group was 1.39%. In every year of investigation in exposed group manifested dicentric chromosomes, while in last two years ring chromosome also detected. Mutagenic changes in the somatic cells detected in exposed subjects pointed to the fact that these cellular damages can be related to continuous occupational exposure to microwave radiation. (author)

  18. Technical quality of root canal fillings performed in a dental school and the associated retention of root-filled teeth: a clinical follow-up study over a 5-year period.

    Burke, F M

    2009-07-01

    The aim of this study was to examine the technical quality of root canal fillings performed in a dental school and to investigate the associated effect on the survival\\/retention of root-filled teeth. A review of case notes of patients who had root canal treatment performed in the department of Restorative Dentistry, University Dental School and Hospital, Cork, Ireland was carried out. The technical quality of the root canal filling was described according to its relationship with the radiographic apex on a post-treatment radiograph. Tooth status at review was defined as \\'tooth present\\' or \\'tooth absent\\' based on the presence or absence of the root-filled tooth recorded in the treatment records at a review appointment following placement of the root canal filling. One hundred and forty-eight teeth (129 patients) were considered. Of these, 69.6% (n = 103) were of acceptable technical quality, 23.6% (n = 35) were under-extended, and 6.8% (n = 10) were overextended. An increased number of intra-treatment radiographs to confirm the relationship of the canal preparation to the radiographic apex and operator experience were significant predictors of adequate root canal fillings (P < 0.05). Eighty-three per cent (n = 123) of teeth were present at a review appointment held an average of 40 months following completion of treatment (12-60 months). The technical quality of the root canal filling was the only significant factor in predicting tooth survival (P < 0.05), while the presence of pre-treatment periapical pathology had no significant effect on survival of the root-filled tooth. Determination and maintenance of the working length of the canal system is an important feature in producing good quality root canal fillings, which in turn, is associated with increased likelihood of survival\\/retention of root-filled teeth.

  19. Arachnoid cysts with spontaneous intracystic hemorrhage and associated subdural hematoma: Report of management and follow-up of 2 cases

    Mehmet Emin Adin, MD

    2018-04-01

    Full Text Available Arachnoid cysts are one of the most frequently encountered intracranial space-occupying lesions in daily neurosurgery and neuroradiology practice. Majority of arachnoid cysts, particularly those of smaller sizes, have a benign uneventful lifetime course. Certain symptoms may indicate serious complications related to underlying arachnoid cysts. Hemorrhage is one of the most fearsome complications of arachnoid cysts and almost all reported cases in the literature have undergone surgical correction. In this study, we aimed to present clinical and radiologic follow-up findings in two adult cases of intracranial arachnoid cyst with spontaneous intracystic hemorrhage and associated subdural hematoma, one of which was successfully treated conservatively. In addition, we broadly summarized and discussed pertinent studies in the English literature. Keywords: Arachnoid cyst, Subdural hematoma, Intracystic hemorrhage, Headache

  20. Progression of motor subtypes in Huntington's disease: a 6-year follow-up study.

    Jacobs, M; Hart, E P; van Zwet, E W; Bentivoglio, A R; Burgunder, J M; Craufurd, D; Reilmann, R; Saft, C; Roos, R A C

    2016-10-01

    The objective of this study is to investigate the progression of predominantly choreatic and hypokinetic-rigid signs in Huntington's disease (HD) and their relationship with cognitive and general functioning over time. The motor signs in HD can be divided into predominantly choreatic and hypokinetic-rigid subtypes. It has been reported in cross-sectional studies that predominantly choreatic HD patients perform better on functional and cognitive assessments compared to predominantly hypokinetic-rigid HD patients. The course of these motor subtypes and their clinical profiles has not been investigated longitudinally. A total of 4135 subjects who participated in the European HD Network REGISTRY study were included and classified at baseline as either predominantly choreatic (n = 891), hypokinetic-rigid (n = 916), or mixed-motor (n = 2328), based on a previously used method. The maximum follow-up period was 6 years. The mixed-motor group was not included in the analyses. Linear mixed models were constructed to investigate changes in motor subtypes over time and their relationship with cognitive and functional decline. Over the 6-year follow-up period, the predominantly choreatic group showed a significant decrease in chorea, while hypokinetic-rigid symptoms slightly increased in the hypokinetic-rigid group. On the Total Functional Capacity, Stroop test, and Verbal fluency task the rate of change over time was significantly faster in the predominantly choreatic group, while on all other clinical assessments the decline was comparable for both groups. Our results suggest that choreatic symptoms decrease over time, whereas hypokinetic-rigid symptoms slightly increase in a large cohort of HD patients. Moreover, different motor subtypes can be related to different clinical profiles.

  1. A follow-up study by CT scan of intracranial hemorrhages in newborn children

    Shibata, Iekado; Kushida, Yoshimasa; Seiki, Yoshikatsu; Tsutsumi, Shunichiro; Kuramitsu, Toru

    1983-01-01

    Intracranial hemorrhages in perinatal babies and their sequelae are two of the targets of recent investigations. This study was designed to make clear the correlation between intracranial hemorrhage in perinates and the sequential widening of the cerebrospinal fluid space, including ventricles. 600 cases with moderate or severe clinical symptoms were treated in the Neonatal Intensive Care Unit of the Toho University Hospital from February, 1981, to October, 1982. Of these, 137 cases were suspected clinically to have had an intracranial hemorrhage at birth. In the CT study of these cases, intracranial hemorrhages of various types were confirmed in 55 cases. These included subarachnoid hemorrhages (29 cases), intraventricular hemorrhages (3 cases), intracerebral hemorrhages (3 cases), and combined hemorrhages (20 cases). A follow-up check of these cases by means of CT scan and neurological examinations was done for a period of from 40 days to 20 months. In 35 cases (63.5%) out of the 55, a temporary or persistent enlagement of the ventricle and/or widenings of the CSF space of various types were demonstrated. The latter included subdural effusion, the widening of the Sylvian fissure and/or interhemispheric fissure, and the widening of the basal cisterns. An enlargement of the ventricle occurred often following an intraventricular or intracerebral hemorrhage. On the other hand, subdural effusion was a common sequela after a subarachnoid hemorrhage. These changes in the ventricle or CSF space seem to be benign in nature and were improved in most cases during the period of the follow-up study. The ventricular enlargement disappeared substantially in 5 cases, and in the remaining 30 cases the abnormalities on the CT scans were much improved. Clinically, retarded physical development was evident in 3 cases, but the others showed no developmental retardation

  2. Four-year follow-up study of pharmacological treatment in pathological gamblers.

    Rosenberg, Oded; Dinur, Limor Klein; Dannon, Pinhas N

    2013-01-01

    In the past decade, we have witnessed the emergence of pharmacological treatments for pathological gambling with some success but many question marks. We aimed to explore pharmacological treatments that have been previously explored with some success, with the intent of comparing their efficacy and pave the way to larger placebo-controlled trials. In this study, we allocated 78 patients to 4 different types of psychotropic medications: naltrexone, topiramate, bupropion, and escitalopram. We treated patients for more than 2 years, with additional 2-year follow-ups without medication. The sample was evaluated using the 21-item Hamilton Depression Rating Scale, the Hamilton Anxiety Rating Scale, the Global Assessment of Functioning, and the Visual Analog Scale to measure general well-being before enrollment as well as at 1 month, 6 months, 24 months, and 48 months after beginning medication treatment. During the first 2 years of treatment, 34 patients dropped out, with one more dropping out during the additional 2 years of follow-up. Significant improvement on all rating scales was seen in all groups after 2 years, except HAMD in the group that received topiramate. We found the naltrexone-treated group of patients to have a statistically significant lower dropout rate compared with other groups, statistically significant lower HAMD scores in comparison to the group treated with bupropion, statistically significant lower Hamilton Anxiety Rating Scale score compared to the groups treated with escitalopram and topiramate, and significantly higher Visual Analog Scale scores compared to the groups treated with bupropion and topiramate. Pathological gambling is essentially a biopsychological disorder that may be attenuated provided that patients adhere to medication. In our study, among 4 medications with different mechanisms of action, naltrexone was found to be the most effective. Placebo-controlled studies involving large numbers of subjects are required before

  3. Higher plasma soluble Receptor for Advanced Glycation End Products (sRAGE) levels are associated with incident cardiovascular disease and all-cause mortality in type 1 diabetes: a 12-year follow-up study

    Nin, Johanna W M; Jorsal, Anders; Merces Ferreira, Isabel Maria

    2010-01-01

    To investigate the associations of plasma levels of soluble receptor for advanced glycation end products (sRAGE) with incident cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes and the extent to which any such associations could be explained by endothelial and renal dysfunct......To investigate the associations of plasma levels of soluble receptor for advanced glycation end products (sRAGE) with incident cardiovascular disease (CVD) and all-cause mortality in type 1 diabetes and the extent to which any such associations could be explained by endothelial and renal...

  4. A follow-up study by CT and MRI in 3 cases of Japanese encephalitis

    Shoji, H.; Murakami, T.; Murai, I.; Kida, H.; Sato, Y.; Kojima, K.; Abe, T.; Okudera, T.

    1990-01-01

    A follow-up study by CT and MRI in 3 cases of Japanese encephalitis (JE) was performed. Neurologically dementia, forced laughing, tetraplegia and parkinsonism were observed as sequelae. In the CT and MR scans about 3 years after the onset of JE, low-density areas (LDAs) or abnormal signal intensities had remained in the thalamus and basal ganglia. The abnormalities were also found in the brain stem. When the main lesions shown by CT and MRI were compared with those of the acute stage, T2-weighted MRI clearly revealed multiple small areas with high signal intensities, although the ones at the acute stage had showed diffuse abnormal signals. These findings may be useful in helping to identity a long time after the onset. (orig.)

  5. Mortality in parents after death of a child in Denmark: A nationwide follow-up study

    Li, Jiong; Precht, Dorthe Hansen; Mortensen, Preben Bo

    2003-01-01

    a child who had died (exposed cohort), and 293745 controls--ie, parents whose children were alive, and whose family structure matched that of the exposed cohort. Natural deaths were defined with ICD8 codes 0000-7969 and ICD10 codes A00-R99, and unnatural deaths with codes 8000-9999 and V01-Y98. We used......BACKGROUND: Little is known about the effect of parental bereavement on physical health. We investigated whether the death of a child increased mortality in parents. METHODS: We undertook a follow-up study based on national registers. From 1980 to 1996, we enrolled 21062 parents in Denmark who had...... Cox's proportional-hazards regression models to assess the mortality rate of parents up to 18 years after bereavement. FINDINGS: We observed an increased overall mortality rate in mothers whose child had died (hazards ratio 1.43, 95% CI 1.24-1.64; p

  6. Thiopurines are associated with a reduction in surgical re-resections in patients with Crohn's disease: a long-term follow-up study in a regional and academic cohort.

    van Loo, Ellen S; Vosseberg, Ninke W; van der Heide, Frans; Pierie, Jean-Pierre E N; van der Linde, Klaas; Ploeg, Rutger J; Dijkstra, Gerard; Nieuwenhuijs, Vincent B

    2013-12-01

    Combination therapy of thiopurines and anti-tumor necrosis factor alpha (TNF-α) antibodies is the most effective medical treatment of Crohn's disease (CD). Data on thiopurines and anti-TNF-α antibodies in preventing surgical recurrence (need for re-resection) of CD are scarce. Therefore, we analyzed which factors were involved in surgical recurrence of CD in a large cohort of patients with CD operated in a regional and a university hospital. This is a retrospective cohort study of 567 patients who underwent surgery for CD. Clinical data and risk factors for surgical recurrence were analyzed, focusing on medical therapy and hospital type. Overall, 237 (41.8%) patients developed a surgical recurrence, after a median of 70 (2-482) months. Before surgical recurrence, 235 patients (41.4%) and 116 patients (20.5%) used thiopurines and anti-TNF-α antibodies, respectively. Multivariate analysis identified 3 independent risk factors associated with surgical recurrence of CD. A higher risk was seen in patients with colonic disease compared with patients with ileal disease (hazard ratio, 1.56; 95% confidence interval, 1.10-2.21; P = 0.012) and in patients using multiple types of medication (hazard ratio, 1.38; 95% confidence interval, 1.25-1.54; P < 0.001). However, a lower risk was seen in patients using thiopurines (hazard ratio, 0.51; 95% confidence interval, 0.34-0.77; P = 0.001). Thiopurines are effective in preventing surgical recurrence of CD. The role of anti-TNF-α antibodies seems promising as well. Combination therapy of thiopurines and anti-TNF-α antibodies for prevention of surgical recurrence of CD should be studied in a randomized trial.

  7. Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma. A follow-up study

    Rong, X.; Tang, Y.; Lu, K.; Peng, Y. [Sun Yat-sen Memorial Hospital, Guangzhou (China). Dept. of Neurology; Chen, M. [Sun Yat-sen Univ., Guangzhou (China). Dept. of Nasopharyngeal Carcinoma

    2012-03-15

    The purpose of the current study was to investigate the long-term characteristics of radiation-induced cranial nerve injury in nasopharyngeal carcinoma (NPC) patients. We studied cranial nerve palsy (CNP) in 328 NPC patients who received radiotherapy between 1994 and 2006. Follow-up was 93.6% complete as of December 2009. A total of 72 patients with CNP were recruited for analysis (56 men and 16 women). Patients with evidence of residual or recurrent tumor accompanied by CNP were excluded. The characteristics of CNP and the relationship with the radiation fields as well as re-radiotherapy were evaluated. After a mean follow-up of 11.2 years, 72 patients were found to have developed CNP. The latency of palsy ranged from 0.6-16.0 years. For the 67 patients with first course radiation, the glossopharyngeal and vagus nerves were the most vulnerable combination, occurring in 57 patients (85.1%). Patients with facial-cervical field radiation had a significantly longer latency comparing with that of patients with facial-cervical split fields (p = 0.021). In the first 5 years, 49.3% of patients developed CNP, while 40.3% presented CNP in the second 5-year period. In patients with first course radiation, 61 patients had more than one CNP. With regard to the 5 patients with re-radiation, most of them had multiple upper cranial nerve injuries. Radiation therapy of NPC patients may lead to cranial neuropathy. Patients with facial-cervical radiation fields had a longer latency for the manifestation of CNP compared with those patients who were treated with split fields. In patients with re-radiotherapy, the frequency of upper cranial nerve injury increased greatly.

  8. Positive Change in Feedback Perceptions and Behavior: A 10-Year Follow-up Study.

    Balmer, Dorene F; Tenney-Soeiro, Rebecca; Mejia, Erika; Rezet, Beth

    2018-01-01

    Providing and learning from feedback are essential components of medical education, and typically described as resistant to change. But given a decade of change in the clinical context in which feedback occurs, the authors asked if, and how, perceptions of feedback and feedback behaviors might have changed in response to contextual affordances. In 2017, the authors conducted a follow-up, ethnographic study on 2 general pediatric floors at the same children's hospital where another ethnographic study on a general pediatric floor was conducted in 2007. Data sources included (1) 21 and 34 hours of observation in 2007 and 2017, respectively, (2) 35 and 25 interviews with general pediatric attending physicians and residents in 2007 and 2017, respectively, and (3) a review of 120 program documents spanning 2007 to 2017. Data were coded and organized around 3 recommendations for feedback that were derived from 2007 data and served as standards for assessing change in 2017. Data revealed progress in achieving each recommendation. Compared with 2007, participants in 2017 more clearly distinguished between feedback and evaluation; residents were more aware of in-the-moment feedback, and they had shifted their orientation from evaluation and grades to feedback and learning. Explanations for progress in achieving recommendations, which were derived from the data, pointed to institutional and national influences, namely, the pediatric milestones. On the basis of follow-up, ethnographic data, changes in the clinical context of pediatric education may afford positive change in perceptions of feedback and feedback behavior and point to influences within and beyond the institution. Copyright © 2018 by the American Academy of Pediatrics.

  9. Hardiness, psychosocial factors and shift work tolerance among nurses - a 2-year follow-up study.

    Saksvik-Lehouillier, Ingvild; Bjorvatn, Bjørn; Magerøy, Nils; Pallesen, Ståle

    2016-08-01

    To examine the predictive power of the subfactors of hardiness (commitment, control and challenge) on shift work tolerance (measured with sleepiness, fatigue, anxiety and depression) over 2 years in nurses working shifts. We also investigated the direct effects of psychosocial variables such as role conflict, social support and fair leadership on shift work tolerance, as well as their moderating role on the relationship between hardiness and shift work tolerance. Several scholars have discussed the role of individual differences and psychosocial variables in predicting shift work tolerance. The conclusions are not clear. Longitudinal questionnaire study. A sample of Norwegian nurses employed in shift work including nights participated in this longitudinal questionnaire study: 1877 at baseline, 1228 at 1-year follow-up and 659 nurses at 2-year follow-up. Data were collected in three waves, first wave in 2008 and third in 2011 and were analysed with a series of hierarchical multiple regression analyses. We found that the subfactor commitment could predict fatigue over 1 year and anxiety and depression over 2 years. Challenge could predict anxiety over 1 year. Control was unrelated to shift work intolerance. Hardiness did not predict sleepiness. Social support, role conflict and fair leadership were important for some aspects of shift work tolerance; however, hardiness seemed to be more eminent for shift work tolerance than the psychosocial variables. Social support moderated the relationship between hardiness and shift work tolerance to some degree, but this interaction was weak. Hardiness can to some degree predict shift work tolerance over 2 years among nurses. © 2016 John Wiley & Sons Ltd.

  10. Clinical profile and follow-up of 51 pediatric neurocysticercosis cases: A study from Eastern India

    Shakya Bhattacharjee

    2013-01-01

    Full Text Available Introduction: Our present observational study attempted to evaluate the clinical profiles, diagnosis, treatment and follow-up results of 51 pediatric neurocysticercosis patients over a mean duration of five years (from January 2006 to December 2010. Materials and Methods: Diagnosis was mainly based on clinical features, computed tomography (CT/magnetic resonance imaging scan and exclusion of other causes. Patients with active, transitional cysts and seizure were treated with albendazole for 28 days, steroids and anticonvulsants. Results: A total of 38 patients completed this study. Mean age of the presentation was 8.47 ± 3.19 years 52.6% of the patients were female. Overall patients presented with generalized seizure in 55.3%, focal in 31.6%, headache ± vomiting in 63.2%, focal neurodeficit in 10.5% and combination of symptoms in 60.5% cases. Contrast CT brain showed a solitary lesion in 27 (71.1% and multiple in the rest. At presentation lesions were transitional in 58.2%, inactive in 20% and mixed in 14.6%. After a mean of 2 years, seizure persisted in 9 (23.7% and headache in 8 (21.1% of whom six had normal electroencephalography (EEG while one each showed focal slowing, generalized slowing and epileptiform discharges. During the follow-up, CT scan brain 44.7% lesions calcified, 31.6% disappeared, 10.5% regressed and the rest persisted. Conclusion: Solitary ring enhancing lesions (transitional stage involving the parietal lobe was the commonest CT picture at presentation. Generalized tonic-clonic seizure was the most common type of seizure. Number of lesions, persistence of lesion, number of seizures, EEG abnormality at presentation were not found to be prognostically significant (P > 0.05.

  11. Cardiovascular events after ischemic stroke in young adults: A prospective follow-up study.

    Aarnio, Karoliina; Siegerink, Bob; Pirinen, Jani; Sinisalo, Juha; Lehto, Mika; Haapaniemi, Elena; Nave, Alexander-Heinrich; Kaste, Markku; Tatlisumak, Turgut; Putaala, Jukka

    2016-05-17

    To study the long-term risk of recurrent cardiac, arterial, and venous events in young stroke patients, and whether these risks differed between etiologic subgroups. The study population comprised 970 patients aged 15-49 years from the Helsinki Young Stroke Registry (HYSR) who had an ischemic stroke in 1994-2007. We obtained follow-up data until 2012 from the Finnish Care Register and Statistics Finland. Cumulative 15-year risks were analyzed with life tables, whereas relative risks and corresponding confidence intervals (CI) were based on hazard ratios (HR) from Cox regression analyses. There were 283 (29.2%) patients with a cardiovascular event during the median follow-up of 10.1 years (range 0.1-18.0). Cumulative 15-year risk for venous events was 3.9%. Cumulative 15-year incidence rate for composite vascular events was 34.0 (95% CI 30.1-38.2) per 1,000 person-years. When adjusted for age and sex, patients with an index stroke caused by high-risk sources of cardioembolism had the highest HR for any subsequent cardiovascular events (3.7; 95% CI 2.6-5.4), whereas the large-artery atherosclerosis group had the highest HR (2.7; 95% CI 1.6-4.6) for recurrent stroke compared with patients with stroke of undetermined etiology. The risk for future cardiovascular events after ischemic stroke in young adults remains high for years after the index stroke, in particular when the index stroke is caused by high-risk sources of cardioembolism or large-artery atherosclerosis. © 2016 American Academy of Neurology.

  12. Postoperative Complications in the Ahmed Baerveldt Comparison Study during Five Years of Follow-up

    Budenz, Donald L.; Feuer, William J.; Barton, Keith; Schiffman, Joyce; Costa, Vital P.; Godfrey, David G.; Buys, Yvonne M.

    2016-01-01

    PURPOSE To compare the late complications in the Ahmed Baerveldt Comparison Study during 5 years of follow-up. DESIGN Multicenter, prospective, randomized clinical trial. METHODS SETTINGS Sixteen international clinical centers. STUDY POPULATION Two hundred seventy six subjects aged 18 to 85 years with previous intraocular surgery or refractory glaucoma with intraocular pressure of > 18 mmHg. INTERVENTIONS Ahmed Glaucoma Valve FP7 or Baerveldt Glaucoma Implant BG 101-350. MAIN OUTCOME MEASURES Late postoperative complications (beyond 3 months), reoperations for complications, and decreased vision from complications. RESULTS Late complications developed in 56 subjects (46.8 ± 4.8 5 year cumulative % ± SE) in the Ahmed Glaucoma Valve group and 67 (56.3 ± 4.7 5 year cumulative % ± SE) in the Baerveldt Glaucoma Implant group (P = 0.082). The cumulative rates of serious complications were 15.9% and 24.7% in the Ahmed Glaucoma Valve and Baerveldt Glaucoma Implant groups respectively (P = 0.034) although this was largely driven by subjects who had tube occlusions in the two groups (0.8% in the Ahmed Glaucoma Valve group and 5.7% in the Baerveldt Glaucoma Implant group, P = 0.037). Both groups had a relatively high incidence of persistent diplopia (12%) and corneal edema (20%), although half of the corneal edema cases were likely due to pre-existing causes other than the aqueous shunt. The incidence of tube erosion was 1% and 3% in the Ahmed Glaucoma Valve and Baerveldt Glaucoma Implant groups, respectively (P = 0.04). CONCLUSIONS Long term rates of vision threatening complications and complications resulting in reoperation were higher in the Baerveldt Glaucoma Implant than the Ahmed Glaucoma Valve group over 5 years of follow-up. PMID:26596400

  13. Radiation-induced cranial neuropathy in patients with nasopharyngeal carcinoma. A follow-up study

    Rong, X.; Tang, Y.; Lu, K.; Peng, Y.; Chen, M.

    2012-01-01

    The purpose of the current study was to investigate the long-term characteristics of radiation-induced cranial nerve injury in nasopharyngeal carcinoma (NPC) patients. We studied cranial nerve palsy (CNP) in 328 NPC patients who received radiotherapy between 1994 and 2006. Follow-up was 93.6% complete as of December 2009. A total of 72 patients with CNP were recruited for analysis (56 men and 16 women). Patients with evidence of residual or recurrent tumor accompanied by CNP were excluded. The characteristics of CNP and the relationship with the radiation fields as well as re-radiotherapy were evaluated. After a mean follow-up of 11.2 years, 72 patients were found to have developed CNP. The latency of palsy ranged from 0.6-16.0 years. For the 67 patients with first course radiation, the glossopharyngeal and vagus nerves were the most vulnerable combination, occurring in 57 patients (85.1%). Patients with facial-cervical field radiation had a significantly longer latency comparing with that of patients with facial-cervical split fields (p = 0.021). In the first 5 years, 49.3% of patients developed CNP, while 40.3% presented CNP in the second 5-year period. In patients with first course radiation, 61 patients had more than one CNP. With regard to the 5 patients with re-radiation, most of them had multiple upper cranial nerve injuries. Radiation therapy of NPC patients may lead to cranial neuropathy. Patients with facial-cervical radiation fields had a longer latency for the manifestation of CNP compared with those patients who were treated with split fields. In patients with re-radiotherapy, the frequency of upper cranial nerve injury increased greatly.

  14. Psychosocial work characteristics as predictors for burnout: findings from 3-year follow up of the PUMA Study

    Borritz, Marianne; Bültmann, Ute; Rugulies, Reiner

    2005-01-01

    OBJECTIVE: The objective of this study was to investigate the impact of psychosocial work characteristics on burnout. METHODS: A total of 1772 participants in different human service sector organizations were eligible for the cross-sectional analyses (baseline) and 952 for the prospective analyses....... We measured 14 psychosocial work characteristics and three types of burnout. Linear regression models were used for analyzing associations between psychosocial work characteristics at baseline and burnout at baseline and at 3 years of follow up. RESULTS: Low possibilities for development, high...... meaning of work, low predictability, high quality of leadership, low role clarity, and high role conflicts predicted burnout at 3 years of follow up after the psychosocial work characteristics were adjusted for each other, potential confounders, and burnout level at baseline. CONCLUSION: Psychosocial work...

  15. Can follow-up examination of tuberculosis patients be simplified? A study in Chhattisgarh, India.

    Debashish Kundu

    Full Text Available BACKGROUND: Each follow-up during the course of tuberculosis treatment currently requires two sputum examinations. However, the incremental yield of the second sputum sample during follow-up of different types of tuberculosis patients has never been determined precisely. OBJECTIVES: To assess the incremental yield of the second sputum sample in the follow-up of tuberculosis patients under the Revised National Tuberculosis Control Programme (RNTCP in Chhattisgarh, India. METHODOLOGY: A record review of tuberculosis (TB patients registered in 2009 using a structured proforma from two sources, Tuberculosis and Laboratory Register, was undertaken in the six districts of Chhattisgarh, India. RESULTS: In smear positive cases, of 10,048 follow-up examinations, 45 (0.5% were found to be smear positive only on the second sputum when the result of the first sample was negative. In smear negative pulmonary and extra pulmonary TB patients, of 6,206 follow-up smear examinations, 11(0.2% were found to be smear positive. CONCLUSIONS: The incremental yield of a second smear examination was very low, indicating that examination of one sputum sample is enough during follow-up among TB patients. There is insufficient yield to support sputum smear microscopy for monitoring smear negative pulmonary TB and extra pulmonary TB patients. These results indicate that the follow-up smear microscopy can be substantially simplified with favourable resource implications.

  16. Genome-Wide Association and Functional Follow-Up Reveals New Loci for Kidney Function

    Fuchsberger, Christian; Olden, Matthias; Chen, Ming-Huei; Tin, Adrienne; Taliun, Daniel; Li, Man; Gao, Xiaoyi; Gorski, Mathias; Yang, Qiong; Hundertmark, Claudia; Foster, Meredith C.; O'Seaghdha, Conall M.; Glazer, Nicole; Isaacs, Aaron; Liu, Ching-Ti; Smith, Albert V.; O'Connell, Jeffrey R.; Struchalin, Maksim; Tanaka, Toshiko; Li, Guo; Johnson, Andrew D.; Gierman, Hinco J.; Feitosa, Mary; Hwang, Shih-Jen; Atkinson, Elizabeth J.; Lohman, Kurt; Cornelis, Marilyn C.; Johansson, Åsa; Tönjes, Anke; Dehghan, Abbas; Chouraki, Vincent; Holliday, Elizabeth G.; Sorice, Rossella; Kutalik, Zoltan; Lehtimäki, Terho; Esko, Tõnu; Deshmukh, Harshal; Ulivi, Sheila; Chu, Audrey Y.; Murgia, Federico; Trompet, Stella; Imboden, Medea; Kollerits, Barbara; Pistis, Giorgio; Harris, Tamara B.; Launer, Lenore J.; Aspelund, Thor; Eiriksdottir, Gudny; Mitchell, Braxton D.; Boerwinkle, Eric; Schmidt, Helena; Cavalieri, Margherita; Rao, Madhumathi; Hu, Frank B.; Demirkan, Ayse; Oostra, Ben A.; de Andrade, Mariza; Turner, Stephen T.; Ding, Jingzhong; Andrews, Jeanette S.; Freedman, Barry I.; Koenig, Wolfgang; Illig, Thomas; Döring, Angela; Wichmann, H.-Erich; Kolcic, Ivana; Zemunik, Tatijana; Boban, Mladen; Minelli, Cosetta; Wheeler, Heather E.; Igl, Wilmar; Zaboli, Ghazal; Wild, Sarah H.; Wright, Alan F.; Campbell, Harry; Ellinghaus, David; Nöthlings, Ute; Jacobs, Gunnar; Biffar, Reiner; Endlich, Karlhans; Ernst, Florian; Homuth, Georg; Kroemer, Heyo K.; Nauck, Matthias; Stracke, Sylvia; Völker, Uwe; Völzke, Henry; Kovacs, Peter; Stumvoll, Michael; Mägi, Reedik; Hofman, Albert; Uitterlinden, Andre G.; Rivadeneira, Fernando; Aulchenko, Yurii S.; Polasek, Ozren; Hastie, Nick; Vitart, Veronique; Helmer, Catherine; Wang, Jie Jin; Ruggiero, Daniela; Bergmann, Sven; Kähönen, Mika; Viikari, Jorma; Nikopensius, Tiit; Province, Michael; Ketkar, Shamika; Colhoun, Helen; Doney, Alex; Robino, Antonietta; Giulianini, Franco; Krämer, Bernhard K.; Portas, Laura; Ford, Ian; Buckley, Brendan M.; Adam, Martin; Thun, Gian-Andri; Paulweber, Bernhard; Haun, Margot; Sala, Cinzia; Metzger, Marie; Mitchell, Paul; Ciullo, Marina; Kim, Stuart K.; Vollenweider, Peter; Raitakari, Olli; Metspalu, Andres; Palmer, Colin; Gasparini, Paolo; Pirastu, Mario; Jukema, J. Wouter; Probst-Hensch, Nicole M.; Kronenberg, Florian; Toniolo, Daniela; Gudnason, Vilmundur; Shuldiner, Alan R.; Coresh, Josef; Schmidt, Reinhold; Ferrucci, Luigi; Siscovick, David S.; van Duijn, Cornelia M.; Borecki, Ingrid; Kardia, Sharon L. R.; Liu, Yongmei; Curhan, Gary C.; Rudan, Igor; Gyllensten, Ulf; Wilson, James F.; Franke, Andre; Pramstaller, Peter P.; Rettig, Rainer; Prokopenko, Inga; Witteman, Jacqueline C. M.; Hayward, Caroline; Ridker, Paul; Parsa, Afshin; Bochud, Murielle; Heid, Iris M.; Goessling, Wolfram; Chasman, Daniel I.; Kao, W. H. Linda; Fox, Caroline S.

    2012-01-01

    Chronic kidney disease (CKD) is an important public health problem with a genetic component. We performed genome-wide association studies in up to 130,600 European ancestry participants overall, and stratified for key CKD risk factors. We uncovered 6 new loci in association with estimated glomerular filtration rate (eGFR), the primary clinical measure of CKD, in or near MPPED2, DDX1, SLC47A1, CDK12, CASP9, and INO80. Morpholino knockdown of mpped2 and casp9 in zebrafish embryos revealed podocyte and tubular abnormalities with altered dextran clearance, suggesting a role for these genes in renal function. By providing new insights into genes that regulate renal function, these results could further our understanding of the pathogenesis of CKD. PMID:22479191

  17. Genome-wide association and functional follow-up reveals new loci for kidney function.

    Pattaro, Cristian; Köttgen, Anna; Teumer, Alexander; Garnaas, Maija; Böger, Carsten A; Fuchsberger, Christian; Olden, Matthias; Chen, Ming-Huei; Tin, Adrienne; Taliun, Daniel; Li, Man; Gao, Xiaoyi; Gorski, Mathias; Yang, Qiong; Hundertmark, Claudia; Foster, Meredith C; O'Seaghdha, Conall M; Glazer, Nicole; Isaacs, Aaron; Liu, Ching-Ti; Smith, Albert V; O'Connell, Jeffrey R; Struchalin, Maksim; Tanaka, Toshiko; Li, Guo; Johnson, Andrew D; Gierman, Hinco J; Feitosa, Mary; Hwang, Shih-Jen; Atkinson, Elizabeth J; Lohman, Kurt; Cornelis, Marilyn C; Johansson, Åsa; Tönjes, Anke; Dehghan, Abbas; Chouraki, Vincent; Holliday, Elizabeth G; Sorice, Rossella; Kutalik, Zoltan; Lehtimäki, Terho; Esko, Tõnu; Deshmukh, Harshal; Ulivi, Sheila; Chu, Audrey Y; Murgia, Federico; Trompet, Stella; Imboden, Medea; Kollerits, Barbara; Pistis, Giorgio; Harris, Tamara B; Launer, Lenore J; Aspelund, Thor; Eiriksdottir, Gudny; Mitchell, Braxton D; Boerwinkle, Eric; Schmidt, Helena; Cavalieri, Margherita; Rao, Madhumathi; Hu, Frank B; Demirkan, Ayse; Oostra, Ben A; de Andrade, Mariza; Turner, Stephen T; Ding, Jingzhong; Andrews, Jeanette S; Freedman, Barry I; Koenig, Wolfgang; Illig, Thomas; Döring, Angela; Wichmann, H-Erich; Kolcic, Ivana; Zemunik, Tatijana; Boban, Mladen; Minelli, Cosetta; Wheeler, Heather E; Igl, Wilmar; Zaboli, Ghazal; Wild, Sarah H; Wright, Alan F; Campbell, Harry; Ellinghaus, David; Nöthlings, Ute; Jacobs, Gunnar; Biffar, Reiner; Endlich, Karlhans; Ernst, Florian; Homuth, Georg; Kroemer, Heyo K; Nauck, Matthias; Stracke, Sylvia; Völker, Uwe; Völzke, Henry; Kovacs, Peter; Stumvoll, Michael; Mägi, Reedik; Hofman, Albert; Uitterlinden, Andre G; Rivadeneira, Fernando; Aulchenko, Yurii S; Polasek, Ozren; Hastie, Nick; Vitart, Veronique; Helmer, Catherine; Wang, Jie Jin; Ruggiero, Daniela; Bergmann, Sven; Kähönen, Mika; Viikari, Jorma; Nikopensius, Tiit; Province, Michael; Ketkar, Shamika; Colhoun, Helen; Doney, Alex; Robino, Antonietta; Giulianini, Franco; Krämer, Bernhard K; Portas, Laura; Ford, Ian; Buckley, Brendan M; Adam, Martin; Thun, Gian-Andri; Paulweber, Bernhard; Haun, Margot; Sala, Cinzia; Metzger, Marie; Mitchell, Paul; Ciullo, Marina; Kim, Stuart K; Vollenweider, Peter; Raitakari, Olli; Metspalu, Andres; Palmer, Colin; Gasparini, Paolo; Pirastu, Mario; Jukema, J Wouter; Probst-Hensch, Nicole M; Kronenberg, Florian; Toniolo, Daniela; Gudnason, Vilmundur; Shuldiner, Alan R; Coresh, Josef; Schmidt, Reinhold; Ferrucci, Luigi; Siscovick, David S; van Duijn, Cornelia M; Borecki, Ingrid; Kardia, Sharon L R; Liu, Yongmei; Curhan, Gary C; Rudan, Igor; Gyllensten, Ulf; Wilson, James F; Franke, Andre; Pramstaller, Peter P; Rettig, Rainer; Prokopenko, Inga; Witteman, Jacqueline C M; Hayward, Caroline; Ridker, Paul; Parsa, Afshin; Bochud, Murielle; Heid, Iris M; Goessling, Wolfram; Chasman, Daniel I; Kao, W H Linda; Fox, Caroline S

    2012-01-01

    Chronic kidney disease (CKD) is an important public health problem with a genetic component. We performed genome-wide association studies in up to 130,600 European ancestry participants overall, and stratified for key CKD risk factors. We uncovered 6 new loci in association with estimated glomerular filtration rate (eGFR), the primary clinical measure of CKD, in or near MPPED2, DDX1, SLC47A1, CDK12, CASP9, and INO80. Morpholino knockdown of mpped2 and casp9 in zebrafish embryos revealed podocyte and tubular abnormalities with altered dextran clearance, suggesting a role for these genes in renal function. By providing new insights into genes that regulate renal function, these results could further our understanding of the pathogenesis of CKD.

  18. Genome-wide association and functional follow-up reveals new loci for kidney function.

    Cristian Pattaro

    Full Text Available Chronic kidney disease (CKD is an important public health problem with a genetic component. We performed genome-wide association studies in up to 130,600 European ancestry participants overall, and stratified for key CKD risk factors. We uncovered 6 new loci in association with estimated glomerular filtration rate (eGFR, the primary clinical measure of CKD, in or near MPPED2, DDX1, SLC47A1, CDK12, CASP9, and INO80. Morpholino knockdown of mpped2 and casp9 in zebrafish embryos revealed podocyte and tubular abnormalities with altered dextran clearance, suggesting a role for these genes in renal function. By providing new insights into genes that regulate renal function, these results could further our understanding of the pathogenesis of CKD.

  19. Intralesional curettage of central low-grade chondrosarcoma: A midterm follow-up study.

    Chen, Yi-Chou; Wu, Po-Kuei; Chen, Cheng-Fong; Chen, Wei-Ming

    2017-03-01

    The aim of this study was to review the experience of surgical treatment of low-grade chondrosarcoma and to assess the long-term oncological and functional outcomes between intralesional curettage and wide excision. We included 11 patients with central low-grade chondrosarcoma lesions treated with intralesional curettage or wide excision from 1998 to 2013. Seven patients were treated with intralesional curettage and local adjuvant treatment (Group A), and four patients were treated with wide excision and reconstructive surgery (Group B). The mean age of patients was 43.8±17.6 years (range, 20-71 years), and the mean duration of follow-up was 84.4±47.6 months (range, 48-194 months). Group A had a significantly lower complication rate than Group B; three complications were documented in Group B (0% vs. 75%, p=0.024). The operative time (177.1 hours vs. 366.3 hours, p=0.010) and the hospital stay (6.6 days vs. 12.5 days, p=0.010) were significantly shorter in Group A. There was one local recurrence in Group A without statistical significance. Also, there were no differences between intralesional curettage and wide excision with respect to the blood loss. No metastasis disease occurred in either group during the follow-up period. The Musculoskeletal Tumor Society (MSTS) scores in Groups A and B were 99.0±2.5 and 94.2±4.2, respectively, with statistically significant difference (p=0.048). Extended intralesional curettage has the benefits of good MSTS score, shorter operative time, shorter hospital stay, and lower complication rate without increasing local recurrence in central low-grade chondrosarcoma. For central low-grade chondrosarcoma, we suggest extended curettage to decrease soft tissue damage and surgical risk. Copyright © 2016. Published by Elsevier Taiwan LLC.

  20. Lung function studies in diagnostics and follow-up of pulmonary sarcoidosis

    Braadvik, I.

    1994-06-01

    In 66 patients the relationship between lung volumes and lung mechanics in pulmonary sarcoidosis was investigated. Lung volumes, static lung mechanics, lung resistance, dynamic lung mechanics and arterial blood gases at rest and during exercise were obtained. Fifteen functionally compromised patients received steroids during one year. They were re-investigated during the treatment and at a follow-up after an average of 7 years. In another 41 patients with newly diagnosed sarcoidosis, the kinetics of the lung clearance of 99m Tc-DTPA measured over 180 minutes was explored, and compared to kinetics in healthy smokers. The relationship between lung clearance and lung volumes, lung mechanics, arterial blood gases and disease activity assessed with serum angiotensin-converting enzyme and 67 Ga scintigraphy was studied. Reducing lung volumes and compliance, increased resistance and arterial oxygen tension were common. Vital capacity (VC), and changes of VC at follow-up, corresponded to the slope of the static elastic pressure/volume curve, and to the variation of it. Other static lung volumes reflected rather the position of the curve along the volume axis. Reduced VC also reflected obstruction. Forced expiratory volume in one second revealed to equal extent lung stiffness and obstruction. Lung mechanics showed abnormalities not always evident from spirometry.In 50% of the patients lung clearance of 99m Tc-DTPA disclosed an abnormally fast mono-exponential clearance or a bi-exponential clearance, which however differed from that in smokers. Lung clearance more readily detected abnormal function than did spirometry. Clearance did nor correlate with other investigations. 67 Ga lung activity was higher in patients with a pathologic lung clearance

  1. A long-term follow-up study after retro-orbital irradiation for graves' ophthalmopathy

    Schaefer, Ulrich; Hesselmann, Stefan; Micke, Oliver; Schueller, Patrick; Bruns, Frank; Palma, Curro; Willich, Normann

    2002-01-01

    Purpose: The aim of this retrospective analysis was to find out whether low-dose radiation, which is used in the treatment of Graves' ophthalmopathy, could cause radiation-induced cancer, which would in turn adversely affect the survival of the irradiated population and cause an increase in the cancer-specific death rate. Methods and Materials: From 1963 to 1978, 250 patients received bilateral orbital irradiation for a progressive Graves' ophthalmopathy. Median age was 49 years. Overall survival and causes of death were evaluated with the help of patients still living, registration offices, medical records, referring physicians, and relatives. Survival curves were calculated with the Kaplan-Meier method. The outcome for each patient was compared with data from life tables regarding gender, age, and calendar period-specific person-years at risk. In addition, treatment outcome for living patients was evaluated with a questionnaire. Results: After a median follow-up of 31 years, 102 patients are still alive, 123 patients have died, and 25 patients have been lost to follow-up. The 10-year, 20-year, and 30-year survival rates were 89%, 68%, and 49%, compared with the age-adapted survival rate of the normal population of 92%, 76%, and 52%. Evaluation of cancer-specific survival was possible in 166 cases. The 10-year, 20-year, and 30-year cancer-specific survival rates were 98%, 92%, and 88%, compared with 97%, 93%, and 87% in the normal population. Treatment response was evaluable in 94 cases. A complete response was reported in 41 patients, a partial response in 39 patients, and no change in 14 patients. Conclusion: No significant evidence of radiation-induced cancer death was seen in this small cohort of patients treated with radiotherapy for Graves' ophthalmopathy. The long-term treatment results seem to be satisfactory. Studies with greater numbers of patients are necessary to examine the risks and benefits more precisely

  2. A single measure of FEV1 is associated with risk of asthma attacks in long-term follow-up

    Kitch, BT; Paltiel, AD; Kuntz, KM; Dockery, DW; Schouten, JP; Weiss, ST; Fuhlbrigge, AL

    2004-01-01

    Background: Clinical practice guidelines for asthma care emphasize the use of objective measures of asthma severity, and vet little data exist oil the relationship between FEV1 and asthma outcomes over long-term follow-up. Methods: We explored the association between measures of FEV1 percentage of

  3. Love Death-A Retrospective and Prospective Follow-Up Mortality Study Over 45 Years.

    Lange, Lena; Zedler, Barbara; Verhoff, Marcel A; Parzeller, Markus

    2017-10-01

    friend, and in one case no information was provided. Natural deaths connected with sexual activity appear to be associated with male sex and pre-existing cardiovascular disorders. Most cases recorded occurred with mistresses, prostitutes, or during masturbation. If death occurs, the spouse or life partner might need psychological support. To our knowledge, the present study contains the largest collection of postmortem data on natural deaths connected with sexual activities. However, the cases presented were of forensic interest; a larger number of undetected cases especially in the marital or stable relationship sector must be assumed. Patients should be informed about the circumstances that could trigger the "love death." Lange L, Zedler B, Verhoff MA, Parzeller M. Love Death-A Retrospective and Prospective Follow-Up Mortality Study Over 45 Years. J Sex Med 2017;14:1226-1231. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  4. The value of routine follow-up after treatment for head and neck cancer. A national DAHANCA study

    Pagh, Anja; Vedtofte, Thomas; Lynggaard, Charlotte Duch

    BACKGROUND: The post-treatment follow-up is well-integrated in the oncologic care tradition, based on the risk of developing recurrent disease or new primary tumors in treated patients. Furthermore, follow-up serves as an opportunity to monitor treatment effects and to provide clinical care of side...... effects. In this study we measured the activity and effectiveness of routine follow-up in head and neck cancer and assessed the value of follow-up from the perspectives of both physicians and the patients. PATIENTS AND METHODS: During a period of six weeks a prospective national cross section cohort...

  5. Follow-up study of a pregnant woman 16 years after exposure in the Xinzhou radiation accident

    Zhang Zhaohui; Liang Li; Zhang Shu-lan; Jia Tingzhen; Liu Qingjie; Ma Liwen; Su Xu; Liu Ying; Chen Sen; Qing Bin; Cao Baoshan; Xiao Yu; Ying Wenchen; Zhang Yu; Wang Wenxue; Wang Zuoyuan

    2011-01-01

    To investigate the late effects of radiation on child-bearing women, a follow-up study was performed on a 39-year-old survivor 16 years after a 60 Co radiation accident. The woman, Fang, was 19 weeks pregnant at the time of exposure. Physical examinations, a full range of clinical laboratory and imaging tests, as well as cytogenetic analyses were conducted to evaluate Fang's current health conditions. Fang shows the appearance of premature ageing and has a decreased menstrual period. Laboratory studies and imaging tests suggest nodular goitre disease and osteoporosis. Otherwise, no apparent abnormalities were found in the major organs. No malignant tumours were detected by either tumour markers or imaging tests. However, the existence of chromosome aberrations warrants long-term follow-up for tumour incidence in the future. Fang became pregnant 8 years after the accident, but suffered a miscarriage due to the death of the foetus at 6 months into the pregnancy. In conclusion, our findings suggest that the intrauterine death of the foetus might be associated with the previous exposure. There is no evidence of malignant tumours as of the date of the follow-up study. Non-cancerous diseases, i.e. thyroid disease and osteoporosis, which may be related to radiation exposure, are the major manifestations of the long-term effects of the accident. (note)

  6. Prospective Associations of B-Type Natriuretic Peptide With Markers of Left Ventricular Function in Individuals With and Without Type 2 Diabetes An 8-year follow-up of the Hoorn Study

    Kroon, M.H.; Diamant, M.; van den Hurk, K.; Boomsma, F.; Alssema, M.J.; Nijpels, G.; Kamp, O.; Paulus, W.J.; Stehouwer, C.D.A.; Dekker, J.M.; Henry, R.M.

    2012-01-01

    OBJECTIVE - Heart failure is common in individuals with type 2 diabetes, and early detection of individuals at risk may offer opportunities for prevention. We aimed to explore 1) prospective associations of B-type natriuretic peptide (BNP) levels in a non-heart failure range with changes in markers

  7. Plasma advanced glycation end products are associated with incident cardiovascularevents in individuals with type 2 diabetes : A Case-Cohort study with a median follow-Up of 10 years (EPIC-NL)

    Hanssen, Nordin M J; Beulens, Joline W J; Van Dieren, Susan; Scheijen, Jean L J M; Van Der A, Daphne L.; Spijkerman, Annemieke M W; Van Der Schouw, Yvonne T.; Stehouwer, Coen D A; Schalkwijk, Casper G.

    2015-01-01

    Experimental data suggest a role for advanced glycation end products (AGEs) in cardiovascular disease (CVD), particularly in type 2 diabetes (T2DM). However, epidemiological evidence of an association between high plasma AGEs and increased cardiovascular risk remains inconclusive. Therefore, in a

  8. Osteogenesis imperfecta in childhood: impairment and disability--a follow-up study

    Engelbert, R. H.; Beemer, F. A.; van der Graaf, Y.; Helders, P. J.

    1999-01-01

    To evaluate differences over time (mean follow-up, 14 months) on impairment parameters (range of joint motion and muscle strength), functional limitation parameters (functional ability), and disability parameters (caregiver assistance in achieving functional skills) in osteogenesis imperfecta (OI),

  9. Prevalence and risk factors associated with non-attendance in neurodevelopmental follow-up clinic among infants with CHD.

    Loccoh, Eméfah C; Yu, Sunkyung; Donohue, Janet; Lowery, Ray; Butcher, Jennifer; Pasquali, Sara K; Goldberg, Caren S; Uzark, Karen

    2018-04-01

    Neurodevelopmental impairment is increasingly recognised as a potentially disabling outcome of CHD and formal evaluation is recommended for high-risk patients. However, data are lacking regarding the proportion of eligible children who actually receive neurodevelopmental evaluation, and barriers to follow-up are unclear. We examined the prevalence and risk factors associated with failure to attend neurodevelopmental follow-up clinic after infant cardiac surgery. Survivors of infant (neurodevelopmental clinic attendees and non-attendees in univariate and multivariable analyses. A total of 552 patients were included; median age at surgery was 2.4 months, 15% were premature, and 80% had moderate-severe CHD. Only 17% returned for neurodevelopmental evaluation, with a median age of 12.4 months. In univariate analysis, non-attendees were older at surgery, had lower surgical complexity, fewer non-cardiac anomalies, shorter hospital stay, and lived farther from the surgical center. Non-attendee families had lower income, and fewer were college graduates or had private insurance. In multivariable analysis, lack of private insurance remained independently associated with non-attendance (adjusted odds ratio 1.85, p=0.01), with a trend towards significance for distance from surgical center (adjusted odds ratio 2.86, p=0.054 for ⩾200 miles). The majority of infants with CHD at high risk for neurodevelopmental dysfunction evaluated in this study are not receiving important neurodevelopmental evaluation. Efforts to remove financial/insurance barriers, increase access to neurodevelopmental clinics, and better delineate other barriers to receipt of neurodevelopmental evaluation are needed.

  10. Partner-assisted emotional disclosure for patients with GI cancer: 8-week follow-up and processes associated with change.

    Porter, Laura S; Keefe, Francis J; Baucom, Donald H; Hurwitz, Herbert; Moser, Barry; Patterson, Emily; Kim, Hong Jin

    2012-08-01

    We recently reported that a partner-assisted emotional disclosure intervention for gastrointestinal cancer led to improvements in relationship quality and intimacy for couples in which the patient initially reported higher levels of holding back from discussing cancer-related concerns. The purposes of the present study were to examine outcomes at 8-week follow-up and process variables that may influence treatment effects. One hundred thirty couples were randomly assigned to either partner-assisted emotional disclosure or an education/support control condition. Participants completed measures of relationship quality, intimacy, and psychological distress before randomization, post-treatment, and 8 weeks later. Patients in the disclosure intervention completed measures of negative affect immediately following each treatment session, and their level of expressiveness during the sessions was rated by trained observers. Data were analyzed using multilevel modeling. Among couples in which the patient initially reported higher levels of holding back, the disclosure intervention led to improvements in relationship quality and intimacy that were maintained at 8-weeks follow-up. High levels of patient expressiveness during the disclosure sessions were associated with improvements in relationship quality and intimacy, and high levels of patient negative affect immediately following the sessions were associated with reductions in psychological distress at the post-test assessment. For couples in which the patient tends to hold back from discussing concerns, partner-assisted emotional disclosure is a beneficial intervention leading to improvements in relationship functioning that maintain over time. Future research is needed to examine methods of enhancing intervention effects, including encouraging patient expressiveness and negative affect during the sessions.

  11. Medication Adherence Mediates the Association between Type D Personality and High HbA1c Level in Chinese Patients with Type 2 Diabetes Mellitus: A Six-Month Follow-Up Study

    Xuemei Li

    2017-01-01

    Full Text Available Aims. To examine the association between Type D personality and HbA1c level and to explore the mediating role of medication adherence between them in patients with type 2 diabetes mellitus (T2DM. Methods. 330 patients went on to complete a self-report measure of medication adherence and the HbA1c tests. Chi-square test, T test, Ordinary Least Square Regression (OLS, and Recentered Influence Function Regression (RIF were employed. Results. Patients with Type D personality had significantly higher HbA1c value (P0.1. On the other hand, when Type D personality was operationalized as a continuous variable, only SI trait was associated with HbA1c level (P<0.01. When NA, SI, and NA×SI term together were entered into regression, only SI was not related to HbA1c level. Furthermore, medication adherence had a significant mediation effect between Type D personality and HbA1c, accounting for 54.43% of the total effect. Conclusion. Type D personality was associated with HbA1c in direct and indirect ways, and medication adherence acted as a mediator role.

  12. Selected factors associated with achievement of biology preparatory students and their follow-up to higher level biology courses

    Biermann, Carol A.; Sarinsky, Gary B.

    This study was undertaken to determine whether a biology preparatory course given at an urban community college was helping students to develop the proper skills and background necessary for them to successfully complete follow-up courses in biology. A group of students who enrolled in a biology preparatory course, and subsequently, a follow-up anatomy and physiology or general biology course (experimental group) was compared to a group of students who should have registered for the preparatory course, but who enrolled directly into the anatomy and physiology or general biology course (control group). It was shown that there was no significant difference in their anatomy and physiology or general biology grades. Furthermore, only 16% of the initial group of preparatory students enrolled in and passed a follow-up biology course. Examination of the preparatory group using discriminant analysis ascertained that mathematics score was the principle discriminator between pass/fail groups. A stepwise multiple regression analysis of the variables explaining the preparatory grade showed that mathematics score, reading score, and type of high school degree explained 33% of the variance. Of the students who did pass the preparatory course and enrolled in a follow-up biology class, their preparatory grade was a good predictor of their achievement (measured by follow-up course grade), as determined by multiple regression.

  13. 75 FR 54965 - Proposed Information Collection (Follow-Up Study of a National Cohort of Gulf War and Gulf Era...

    2010-09-09

    ... Collection (Follow-Up Study of a National Cohort of Gulf War and Gulf Era Veterans) Activity: Comment Request... needed to assist in VA's efforts to address the health concerns and problems of Gulf War Veterans. DATES... use of other forms of information technology. Titles: Follow-Up Study of a National Cohort of Gulf War...

  14. 75 FR 70365 - Agency Information Collection (Follow-Up Study of a National Cohort of Gulf War and Gulf Era...

    2010-11-17

    ... (Follow-Up Study of a National Cohort of Gulf War and Gulf Era Veterans) Activity Under OMB Review AGENCY...).'' SUPPLEMENTARY INFORMATION: Titles: Follow-Up Study of a National Cohort of Gulf War and Gulf Era Veterans, VA..., will help VA to assess the health of Gulf War veterans who were exposed to a variety of environmental...

  15. Inadequate Riboflavin Intake and Anemia Risk in a Chinese Population: Five-Year Follow Up of the Jiangsu Nutrition Study

    Shi, Zumin; Zhen, Shiqi; Wittert, Gary A.; Yuan, Baojun; Zuo, Hui; Taylor, Anne W.

    2014-01-01

    Objectives Riboflavin (vitamin B2) has been shown in animal studies to affect the absorption and metabolism of iron. Cross-sectional population studies show a relationship between riboflavin intake and anemia but prospective population studies are limited. The aim of the study was to determine the relationship between riboflavin intake and the risk of anemia in a Chinese cohort. Method The study used data from 1253 Chinese men and women who participated in two waves of the Jiangsu Nutrition Study (JIN), five years apart, in 2002 and 2007. Riboflavin intake and hemoglobin (Hb) were quantitatively assessed together with dietary patterns, lifestyle, socio-demographic and health-related factors. Results At baseline, 97.2% of participants had inadequate riboflavin intake (below the estimate average requirement). Riboflavin intake was positively associated with anemia at baseline, but low riboflavin intake was associated with an increased risk of anemia at follow-up among those anemic at baseline. In the multivariate model, adjusting for demographic and lifestyle factors and dietary patterns, the relative risk and 95% confidence interval for anemia at follow-up, across quartiles of riboflavin intake were: 1, 0.82(0.54–1.23), 0.56(0.34–0.93), 0.52(0.28–0.98) (p for trend 0.021). There was a significant interaction between riboflavin and iron intake; when riboflavin intake was low, a high iron intake was associated with a lower probability of anemia at follow-up. This association disappeared when riboflavin intake was high. Conclusion Inadequate riboflavin intake is common and increases the risk of anemia in Chinese adults. Given the interaction with iron intake correcting inadequate riboflavin intake may be a priority in the prevention of anemia, and population based measurement and intervention trials are required. PMID:24533156

  16. Genomic Ancestry, Self-Rated Health and Its Association with Mortality in an Admixed Population: 10 Year Follow-Up of the Bambui-Epigen (Brazil) Cohort Study of Ageing.

    Lima-Costa, M Fernanda; Macinko, James; Mambrini, Juliana Vaz de Melo; Cesar, Cibele C; Peixoto, Sérgio V; Magalhães, Wagner C S; Horta, Bernardo L; Barreto, Mauricio; Castro-Costa, Erico; Firmo, Josélia O A; Proietti, Fernando A; Leal, Thiago Peixoto; Rodrigues, Maira R; Pereira, Alexandre; Tarazona-Santos, Eduardo

    2015-01-01

    Self-rated health (SRH) has strong predictive value for mortality in different contexts and cultures, but there is inconsistent evidence on ethnoracial disparities in SRH in Latin America, possibly due to the complexity surrounding ethnoracial self-classification. We used 370,539 Single Nucleotide Polymorphisms (SNPs) to examine the association between individual genomic proportions of African, European and Native American ancestry, and ethnoracial self-classification, with baseline and 10-year SRH trajectories in 1,311 community dwelling older Brazilians. We also examined whether genomic ancestry and ethnoracial self-classification affect the predictive value of SRH for subsequent mortality. European ancestry predominated among participants, followed by African and Native American (median = 84.0%, 9.6% and 5.3%, respectively); the prevalence of Non-White (Mixed and Black) was 39.8%. Persons at higher levels of African and Native American genomic ancestry, and those self-identified as Non-White, were more likely to report poor health than other groups, even after controlling for socioeconomic conditions and an array of self-reported and objective physical health measures. Increased risks for mortality associated with worse SRH trajectories were strong and remarkably similar (hazard ratio ~3) across all genomic ancestry and ethno-racial groups. Our results demonstrated for the first time that higher levels of African and Native American genomic ancestry--and the inverse for European ancestry--were strongly correlated with worse SRH in a Latin American admixed population. Both genomic ancestry and ethnoracial self-classification did not modify the strong association between baseline SRH or SRH trajectory, and subsequent mortality.

  17. Reducing pharmacy wait time to promote customer service: a follow-up study.

    Slowiak, Julie M; Huitema, Bradley E

    2015-01-01

    The present study had 3 objectives: (1) to evaluate the effects of 2 different interventions (feedback regarding customer satisfaction with wait time and combined feedback and goal setting) on wait time in a hospital outpatient pharmacy; (2) to assess the extent to which the previously applied interventions maintained their effects; and (3) to evaluate the differences between the effects of the original study and those of the present follow-up study. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCB within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; and C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction. Wait time decreased after baseline when the combined intervention was introduced, and wait time increased with the reintroduction of satisfaction feedback (alone). The results of the replication study confirm the pattern of the results of the original study and demonstrate high sensitivity of levels of customer satisfaction with wait time. The most impressive result of the replication is the nearly 2-year maintenance of lower wait time between the end of the original study and the beginning (baseline) of the replication.

  18. Meta-analytic methods for pooling rates when follow-up duration varies: a case study

    Wolf Fredric M

    2004-07-01

    Full Text Available Abstract Background Meta-analysis can be used to pool rate measures across studies, but challenges arise when follow-up duration varies. Our objective was to compare different statistical approaches for pooling count data of varying follow-up times in terms of estimates of effect, precision, and clinical interpretability. Methods We examined data from a published Cochrane Review of asthma self-management education in children. We selected two rate measures with the largest number of contributing studies: school absences and emergency room (ER visits. We estimated fixed- and random-effects standardized weighted mean differences (SMD, stratified incidence rate differences (IRD, and stratified incidence rate ratios (IRR. We also fit Poisson regression models, which allowed for further adjustment for clustering by study. Results For both outcomes, all methods gave qualitatively similar estimates of effect in favor of the intervention. For school absences, SMD showed modest results in favor of the intervention (SMD -0.14, 95% CI -0.23 to -0.04. IRD implied that the intervention reduced school absences by 1.8 days per year (IRD -0.15 days/child-month, 95% CI -0.19 to -0.11, while IRR suggested a 14% reduction in absences (IRR 0.86, 95% CI 0.83 to 0.90. For ER visits, SMD showed a modest benefit in favor of the intervention (SMD -0.27, 95% CI: -0.45 to -0.09. IRD implied that the intervention reduced ER visits by 1 visit every 2 years (IRD -0.04 visits/child-month, 95% CI: -0.05 to -0.03, while IRR suggested a 34% reduction in ER visits (IRR 0.66, 95% CI 0.59 to 0.74. In Poisson models, adjustment for clustering lowered the precision of the estimates relative to stratified IRR results. For ER visits but not school absences, failure to incorporate study indicators resulted in a different estimate of effect (unadjusted IRR 0.77, 95% CI 0.59 to 0.99. Conclusions Choice of method among the ones presented had little effect on inference but affected the

  19. Meta-analytic methods for pooling rates when follow-up duration varies: a case study.

    Guevara, James P; Berlin, Jesse A; Wolf, Fredric M

    2004-07-12

    Meta-analysis can be used to pool rate measures across studies, but challenges arise when follow-up duration varies. Our objective was to compare different statistical approaches for pooling count data of varying follow-up times in terms of estimates of effect, precision, and clinical interpretability. We examined data from a published Cochrane Review of asthma self-management education in children. We selected two rate measures with the largest number of contributing studies: school absences and emergency room (ER) visits. We estimated fixed- and random-effects standardized weighted mean differences (SMD), stratified incidence rate differences (IRD), and stratified incidence rate ratios (IRR). We also fit Poisson regression models, which allowed for further adjustment for clustering by study. For both outcomes, all methods gave qualitatively similar estimates of effect in favor of the intervention. For school absences, SMD showed modest results in favor of the intervention (SMD -0.14, 95% CI -0.23 to -0.04). IRD implied that the intervention reduced school absences by 1.8 days per year (IRD -0.15 days/child-month, 95% CI -0.19 to -0.11), while IRR suggested a 14% reduction in absences (IRR 0.86, 95% CI 0.83 to 0.90). For ER visits, SMD showed a modest benefit in favor of the intervention (SMD -0.27, 95% CI: -0.45 to -0.09). IRD implied that the intervention reduced ER visits by 1 visit every 2 years (IRD -0.04 visits/child-month, 95% CI: -0.05 to -0.03), while IRR suggested a 34% reduction in ER visits (IRR 0.66, 95% CI 0.59 to 0.74). In Poisson models, adjustment for clustering lowered the precision of the estimates relative to stratified IRR results. For ER visits but not school absences, failure to incorporate study indicators resulted in a different estimate of effect (unadjusted IRR 0.77, 95% CI 0.59 to 0.99). Choice of method among the ones presented had little effect on inference but affected the clinical interpretability of the findings. Incidence rate

  20. Cardiorespiratory fitness and death from cancer: a 42-year follow-up from the Copenhagen Male Study.

    Jensen, Magnus Thorsten; Holtermann, Andreas; Bay, Hans; Gyntelberg, Finn

    2017-09-01

    Poor cardiorespiratory fitness (CRF) is associated with death from cancer. If follow-up time is short, this association may be confounded by subclinical disease already present at the time of CRF assessment. This study investigates the association between CRF and death from cancer and any cause with 42 years and 44 years of follow-up, respectively. Middle-aged, employed and cancer-free Danish men from the prospective Copenhagen Male Study , enrolled in 1970-1971, were included. CRF (maximal oxygen consumption (VO 2 max)) was estimated using a bicycle ergometer test and analysed in multivariable Cox models including conventional risk factors, social class and self-reported physical activity. Death from cancer and all-cause mortality was assessed using Danish national registers. Follow-up was 100% complete. In total, 5131 men were included, mean (SD) age 48.8 (5.4) years. During 44 years of follow-up, 4486 subjects died (87.4%), 1527 (29.8%) from cancer. In multivariable models, CRF was highly significantly inversely associated with death from cancer and all-cause mortality ((HR (95% CI)) 0.83 (0.77 to 0.90) and 0.89 (0.85 to 0.93) per 10 mL/kg/min increase in estimated VO 2 max, respectively). A similar association was seen across specific cancer groups, except death from prostate cancer (1.00 (0.82 to 1.2); p=0.97; n=231). The associations between CRF and outcomes remained essentially unchanged after excluding subjects dying within 10 years (n=377) and 20 years (n=1276) of inclusion. CRF is highly significantly inversely associated with death from cancer and all-cause mortality. The associations are robust for exclusion of subjects dying within 20 years of study inclusion, thereby suggesting a minimal influence of reverse causation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  1. Hospital Stay and Engagement in Outpatient Follow-Up After Alcohol Emergency Detox: A 1-Year Comparison Study.

    Azuar, Julien; Questel, Frank; Hispard, Eric; Scott, Jan; Vorspan, Florence; Bellivier, Frank

    2016-02-01

    Inpatient alcohol detoxifications are only proposed after motivational outpatient encounters because detoxification directly from the emergency department (ED) is believed to be associated with early dropout and poor adherence to outpatient follow-up. The aim of this prospective follow-up study was to test the feasibility of unscheduled (UP) alcohol detoxification directly from the ED and to compare the 1-year follow-up of these patients to that of scheduled (SP) patients. A quasi-naturalistic prospective follow-up study of 120 patients: 60 consecutively admitted patients referred directly by the ED for alcohol detoxification (UP) were compared to 60 consecutively admitted patients who had undergone the usual preparation for an inpatient detoxification program (SP). The length of hospitalization (in days) and attendance to postdischarge outpatient visits during the first year was compared. UP patients were older, less frequently employed, and had more somatic comorbidities compared with SP patients. The UP length of stay was significantly longer (20 ± 16 vs. 14 ± 6, p = 0.04). No difference in their postdischarge attendance was observed; the number of patients attending 1 session (57% UP vs. 65% SP, p = 0.227) and 5 sessions (22% UP vs. 32% SP, p = 0.151) and the mean number of postdischarge visits attended were comparable between the UP and SP groups (2.7 ± 6 vs. 4.5 ± 6; Mann-Whitney U = 1,517, p = 0.124). We did not find that UP patients who had been admitted for alcohol detoxification had a significantly higher dropout rate or lower postdischarge addiction treatment attendance. Because they may have several advantages, detoxification programs directly linked with EDs should be further evaluated. Copyright © 2016 by the Research Society on Alcoholism.

  2. An examination of hardiness throughout the sport-injury process: a qualitative follow-up study.

    Wadey, Ross; Evans, Lynne; Hanton, Sheldon; Neil, Rich

    2012-11-01

    This qualitative follow-up study aimed to enhance the interpretability and meaningfulness of the findings that emerged from a quantitative study that explored the effect of hardiness on the prediction of, and response to, sport injury (i.e., Wadey, Evans, Hanton, & Neil, 2012). Using theory-based and maximum-variation sampling to contextualize and provide an in-depth understanding of the previous findings, the participants comprised a purposeful sample of 10 athletes from the quantitative study (M age = 21.7; SD= 1.06). Data were derived through semi-structured interviews, and analysed and displayed using composite sequence analysis (Miles & Huberman, 1994). The findings extended Wadey et al.'s (2012) study by identifying the perceived mechanisms by which athletes high and low in hardiness exacerbated or attenuated the impact of pre-injury negative major life events (i.e., a significant predictor of sport injury) and post-injury responses. Specifically, the findings demonstrate that athletes high in hardiness possessed a refined repertoire of problem- and emotion-focused coping strategies that they used pre- and post-injury. Those athletes low in hardiness used avoidance coping strategies that had long-term negative implications. These findings have important implications for the structure, timing, and content of hardiness interventions that aim to reduce rates of injury occurrence and expedite injured athletes' return to competitive sport. ©2012 The British Psychological Society.

  3. Value of bone scintigraphy for pre-, postoperative assessment and follow-up study of breast cancer

    Lee, Hae Giu; Park, Jeong Mi; Chung, Soo Kyo; Kim, Choon Yul; Bahk, Yong Whee

    1985-01-01

    Early detection of neoplastic disease and metastatic spread is very important. Carcinoma of the breast is known to readily metastasize to the bone. The use of Tc-99m-phosphate as bone imaging agent has been shown to demonstrate early evidence of bone metastasis well before radiographic evidence is visualized and as thus become a very useful technique for establishing and monitoring the bony metastatic element of breast cancer. In this study, serial bone imaging studies were performed to monitor the management of 84 breast cancer patients before and after mastectomy and biopsy. We attempted to analyse bone scans of breast cancer and to correlate the scan findings with the clinical stage, status of lymph nodes, distant metastasis, bone pain, and laboratory data. The following useful patterns were emerged: 1. Positive bone scan rate was definitely higher in clinical stage III and IV (42, 57%) than in stage I and II (4, 18%) in initial studies. However, no correlation between positive bone scan rate and clinical stage was found in follow up studies. 2. Positive bone scan rate was high in both groups with locally advanced tumor (T3 and T4) and distant metastasis. 3. No correlation between positive bone scan and status of lymph node involvement was noted. 4. Positive bone scan rate was also very high in patients with bone pain and abnormal laboratory data

  4. Ten-year prospective follow-up study of the naturalistic course of dysthymic disorder and double depression.

    Klein, Daniel N; Shankman, Stewart A; Rose, Suzanne

    2006-05-01

    The purpose of this study was to describe the 10-year course and outcome of dysthymic disorder. The authors conducted a naturalistic, prospective, longitudinal follow-up of 97 adults with early-onset dysthymic disorder and 45 adults with nonchronic major depressive disorder selected from consecutive admissions to several outpatient facilities. Follow-up data were obtained for 90% of the cohort. Assessments were conducted at baseline, 30, 60, 90, and 120 months. Measures included the Longitudinal Interval Follow-Up Evaluation and the Hamilton Depression Rating Scale. The Kaplan-Meier estimated recovery rate from dysthymic disorder was 73.9%, with a median time to recovery of 52 months. Among patients who recovered, the estimated risk of relapse into another period of chronic depression was 71.4%. Chronic depressive relapses took a variety of forms and were not limited to dysthymia. Nonetheless, the distinction between chronic and nonchronic forms of depression was relatively stable over the follow-up period. Mixed-effects models indicated that patients with dysthymic disorder experienced a significantly slower rate of improvement in symptoms over time and exhibited significantly greater depression at the 10-year point, compared to patients with nonchronic major depression. Dysthymic disorder has a protracted course and is associated with a high risk of relapse. The nature of chronic depressive episodes varies over time within individuals, indicating that the various manifestations of chronic depression in DSM-IV do not represent distinct disorders. However, the distinction between chronic and nonchronic forms of depression is relatively stable and may provide a useful basis for subtyping in genetic and neurobiological research.

  5. Increased Risk of Clinically Significant Gallstones following an Appendectomy: A Five-Year Follow-Up Study.

    Shiu-Dong Chung

    Full Text Available Although the vermiform appendix is commonly considered a vestigial organ, adverse health consequences after an appendectomy have garnered increasing attention. In this study, we investigated the risks of gallstone occurrence during a 5-year follow-up period after an appendectomy, using a population-based dataset. We used data from the Taiwan Longitudinal Health Insurance Database 2005. The exposed cohort included 4916 patients who underwent an appendectomy. The unexposed cohort was retrieved by randomly selecting 4916 patients matched with the exposed cohort in terms of sex, age, and year. We individually tracked each patient for a 5-year period to identify those who received a diagnosis of gallstones during the follow-up period. Cox proportional hazard regressions were performed for the analysis. During the 5-year follow-up period, the incidence rate per 1000 person-years was 4.71 for patients who had undergone an appendectomy, compared to a rate of 2.59 for patients in the unexposed cohort (p<0.001. Patients who had undergone an appendectomy were independently associated with a 1.79 (95% CI = 1.29~2.48-fold increased risk of being diagnosed with gallstones during the 5-year follow-up period. We found that among female patients, the adjusted hazard ratio of gallstones was 2.25 (95% CI = 1.41~3.59 for patients who underwent an appendectomy compared to unexposed patients. However, for male patients, we failed to observe an increased hazard for gallstones among patients who underwent an appendectomy compared to unexposed patients. We found an increased risk of a subsequent gallstone diagnosis within 5 years after an appendectomy.

  6. The experience of emotional wellbeing for patients with physical injury: A qualitative follow-up study.

    Wiseman, Taneal; Foster, Kim; Curtis, Kate

    2016-09-01

    Traumatic physical injury is abrupt, painful, debilitating, costly and life-altering. The experience of emotional wellbeing following traumatic physical injury has not been well investigated, and the role of health services and how services can support the emotional recovery of injured patients has not been well understood. This has impacted on care provision and contributed to a lack of evidence-informed guidance for clinicians to support patients' emotional wellbeing. To explore the patient experience of emotional wellbeing following injury and to understand how injured patients manage their emotional wellbeing. The study comprises the follow-up qualitative phase of a mixed-methods explanatory sequential study. Semi-structured interviews were conducted with a purposive sample of 14 participants admitted to hospital following physical injury. Participants were purposely selected where they had reported high levels of depression, anxiety and stress on the DASS-21 at 3 and 6-months after injury. The qualitative data were analysed using thematic analysis. Three main themes were identified: experiencing the many impacts of injury; facing the emotional journey following injury; and being supported and managing the impacts of injury. Key findings were the extreme negative emotional responses experienced many months after the injury; a strong physical link between the emotional and physical aspects of health; participant reluctance to seek emotional support; a lack of emotional support provision by the health service and a subsequent need for individual and group support in order to develop resilience in the injured person. Finally, male participants who reported extreme emotional responses after injury, including suicidality, were less likely to seek help for their symptoms. Injured patients can experience substantial negative emotional responses following injury. The lack of support provided by health services to injured patients identified highlights the importance of

  7. Endocrine and exocrine pancreatic insufficiency after acute pancreatitis: long-term follow-up study.

    Tu, Jianfeng; Zhang, Jingzhu; Ke, Lu; Yang, Yue; Yang, Qi; Lu, Guotao; Li, Baiqiang; Tong, Zhihui; Li, Weiqin; Li, Jieshou

    2017-10-27

    Patients could develop endocrine and exocrine pancreatic insufficiency after acute pancreatitis (AP), but the morbidity, risk factors and outcome remain unclear. The aim of the present study was to evaluate the incidence of endocrine and exocrine pancreatic insufficiency after AP and the risk factors of endocrine pancreatic insufficiency through a long-term follow-up investigation. Follow-up assessment of the endocrine and exocrine function was conducted for the discharged patients with AP episodes. Oral Glucose Tolerance Test (OGTT) and faecal elastase-1(FE-1) test were used as primary parameters. Fasting blood-glucose (FBG), fasting insulin (FINS), glycosylated hemoglobin HBA1c, 2-h postprandial blood glucose (2hPG), Homa beta cell function index (HOMA-β), homeostasis model assessment of insulin resistance (HOMA-IR) and FE-1 were collected. Abdominal contrast-enhanced computed tomography (CECT) was performed to investigate the pancreatic morphology and the other related data during hospitalization was also collected. One hundred thirteen patients were included in this study and 34 of whom (30.1%) developed diabetes mellitus (DM), 33 (29.2%) suffered impaired glucose tolerance (IGT). Moreover, 33 patients (29.2%) developed mild to moderate exocrine pancreatic insufficiency with 100μg/gpancreatic insufficiency with FE-1pancreatic necrosis was significant higher than that in the non-pancreatic necrosis group (X 2  = 13.442,P = 0.001). The multiple logistic regression analysis showed that extent of pancreatic necrosisendocrine pancreatic insufficiency. HOMA-IR (P = 0.002, OR = 6.626), Wall-off necrosis (WON) (P = 0.013, OR = 184.772) were the risk factors. The integrated morbidity of DM and IGT after AP was 59.25%, which was higher than exocrine pancreatic insufficiency. 6.2% and 29.2% of patients developed severe and mild to moderate exocrine pancreatic insufficiency, respectively. The extent of pancreatic necrosis>50%, WON and insulin resistance were

  8. Effect of Safe Water on Arsenicosis: A Follow-up Study.

    Majumdar, Kunal K; Ghose, Aloke; Ghose, Nilima; Biswas, Anirban; Mazumder, D N Guha

    2014-04-01

    Arsenic pollution in groundwater, used for drinking purposes, has been envisaged as a problem of global concern. Treatment options for the management symptoms of chronic arsenicosis are limited. Mitigation option available for dealing with the health problem of ground water arsenic contamination rests mainly on supply of arsenic safe water in arsenic-endemic region of Indo-Bangladesh subcontinent. Limited information is available regarding the long-term effect of chronic arsenic toxicity after stoppage of consumption of arsenic-containing water. The current study was, therefore, done to assess, objectively, the effect of drinking arsenic safe water (water source in their houses were supplied with arsenic removal filters for getting arsenic-free water during the follow-up period. In participants belonging to Cohort-I, the skin score was found to improve significantly at the end of each year, and it was found to be reduced significantly from 2.17 ± 1.09 to 1.23 ± 1.17; P water on skin lesions. The systemic disease symptom score was also found to improve, but less significantly, at the end of 3 years in both the cohorts. Most important observation during the follow-up study was persistence of severe symptoms of chronic lung disease and severe skin lesion including Bowen's disease in spite of taking arsenic-safe water. Further, death could not be prevented to occur because of lung cancer and severe lung disease. It is, therefore, an urgent need to make arrangement for availability of safe water source among the arsenic-affected people in the district. Many of the people in the affected villages are not aware of contamination of their home tube wells with arsenic. Awareness generation and motivation of the people for testing their drinking water sources for arsenic and environmental interventions like rain water harvesting, ground water recharge, and restricting excessive use of ground water for domestic and agricultural purposes are also important to prevent further

  9. Is attention deficit/hyperactivity disorder among men associated with initiation or escalation of substance use at 15-month follow-up? A longitudinal study involving young Swiss men

    Vogel, Tanja; Dom, Geert; van de Glind, Geurt; Studer, Joseph; Gmel, Gerhard; Strik, Werner; Moggi, Franz

    2016-01-01

    Young adults with attention deficit/hyperactivity disorder (ADHD) show higher substance use disorder (SUD) prevalence relative to non-ADHD controls; few longitudinal studies have examined the course of substance use with reference to conduct disorder (CD). We compared initiation and escalation of

  10. The strength of the multivariable associations of major risk factors predicting coronary heart disease mortality is homogeneous across different areas of the Seven Countries Study during 50-year follow-up

    Menotti, Alessandro; Puddu, Paolo Emilio; Adachi, Hisashi; Kafatos, Anthony; Tolonen, Hanna; Kromhout, Daan

    2017-01-01

    Objectives: To compare the magnitude of multivariable coefficients and hazard ratios of four cardiovascular risk factors across five worldwide regions of the Seven Countries Study in predicting 50-year coronary deaths. Material and methods: A total of 13 cohorts of middle-aged men at entry (40–59

  11. Schizophrenia and work: aspects related to job acquisition in a follow-up study

    Larissa C. Martini

    2017-08-01

    Full Text Available Objective: Work is considered one of the main forms of social organization; however, few individuals with schizophrenia find work opportunities. The purpose of this study was to evaluate the relationship between schizophrenia symptoms and job acquisition. Method: Fifty-three individuals diagnosed with schizophrenia from an outpatient treatment facility were included in an 18-month follow-up study. After enrollment, they participated in a prevocational training group. At the end of training (baseline and 18 months later, sociodemographic, clinical data and occupational history were collected. Positive and negative symptoms (Positive and Negative Syndrome Scale – PANSS, depression (Calgary Depression Scale, disease severity (Clinical Global Impression – CGI, functionality (Global Assessment of Functioning – GAF, personal and social performance (Personal and Social Performance – PSP and cognitive functions (Measurement and Treatment Research to Improve Cognition in Schizophrenia – MATRICS battery were applied at baseline and at the end of the study. Results: Those with some previous work experience (n=19 presented lower scores on the PANSS, Calgary, GAF, CGI and PSP scales (p < 0.05 than those who did not work. Among those who worked, there was a slight worsening in positive symptoms (positive PANSS. Conclusions: Individuals with less severe symptoms were more able to find employment. Positive symptom changes do not seem to affect participation at work; however, this calls for discussion about the importance of employment support.

  12. Treatment of early breast cancer, a long-term follow-up study: the GOCS experience.

    Iturbe, Julián; Zwenger, Ariel; Leone, José Pablo; Verdera, Palmira Perez; Vallejo, Carlos; Romero, Alberto; Perez, Juán; Machiavelli, Mario; Leone, Bernardo

    2011-01-01

    Most cases of breast cancer are diagnosed at early stage of disease; therefore, treatment is oriented to increase the disease-free interval (DFI) and overall survival (OS). The prognosis, in comparison with other malignancies, has improved in the last decades as a result of mammographic screening. The aim of the study was to report the incidence of local and distant recurrence, DFI and OS in patients (pts) with stage I and stage II breast cancer over a period of 26 years divided into three groups. From January 1978 to December 2004, 927 women with early breast cancer (EBC) were included, 350 were stage I and 577 Stage II (AJCC 2002). Patients were divided according to the year of diagnosis into three periods of 10 years: Group A (1978-1987) 135 pts, Group B (1988-1997) 412 pts, and Group C (1998-2004) 380 pts. DFI was analyzed from the date of initial diagnosis to the date of local or distant recurrence. OS was estimated from the date of initial diagnosis to the last follow-up or date of death. Median age was 51 years (28-92). Conservative surgery was performed in 69% of pts, adjuvant radiation therapy in 78%, adjuvant chemotherapy in 29%, and adjuvant hormone therapy in 18%. The median follow-up was 8.4 years (0.3-30). The mean tumor size in Group A was 2.7 cm, in Group B 2.2 cm, and in Group C 1.94 cm (p = 0.0001). The percentage of pts with stage I increased from 13% in Group A to 38% in Group B and to 47% in Group C (p = 0.0001). Local recurrence was documented in 5% of all pts, whereas 28% developed metastatic disease. The DFI and OS showed a statistically significant difference among the three groups (p = 0.005). DFI rate at 5, 10, 15, 20, and 25 years was 71%, 67%, 65%, 65%, and 64%, respectively. OS at 5, 10, 15, 20, and 25 years was 82%, 62%, 49%, 39%, and 28%, respectively. Factors that had an effect in OS demonstrated by the multivariate regression analysis were: Tumor size, ER status, and nodal involvement (p < 0.001). Clinical outcomes in EBC in our

  13. Child Intelligence and Reductions in Water Arsenic and Manganese: A Two-Year Follow-up Study in Bangladesh.

    Wasserman, Gail A; Liu, Xinhua; Parvez, Faruque; Factor-Litvak, Pam; Kline, Jennie; Siddique, Abu B; Shahriar, Hasan; Uddin, Mohammed Nasir; van Geen, Alexander; Mey, Jacob L; Balac, Olgica; Graziano, Joseph H

    2016-07-01

    Arsenic (As) exposure from drinking water is associated with modest intellectual deficits in childhood. It is not known whether reducing exposure is associated with improved intelligence. We aimed to determine whether reducing As exposure is associated with improved child intellectual outcomes. Three hundred three 10-year-old children drinking from household wells with a wide range of As concentrations were enrolled at baseline. In the subsequent year, deep community wells, low in As, were installed in villages of children whose original wells had high water As (WAs ≥ 50 μg/L). For 296 children, intelligence was assessed by WISC-IV (Wechsler Intelligence Scale for Children, 4th ed.), with a version modified for the study population, at baseline and approximately 2 years later; analyses considered standardized scores for both Full Scale IQ and Verbal Comprehension, Perceptual Reasoning, Working Memory, and Processing Speed Indices. Creatinine-adjusted urinary arsenic (UAs/Cr), blood As (BAs), and blood manganese (BMn) were assessed at both times. UAs/Cr concentrations declined significantly by follow-up for both the high (≥ 50 μg/L) and low (intelligence, plasma ferritin, head circumference, home environment quality, school grade, and BMn, UAs/Cr was significantly negatively associated with Full Scale IQ, and with all Index scores (except Processing Speed). After adjustment for baseline Working Memory scores and school grade, each 100-μg/g reduction in UAs/Cr from baseline to follow-up was associated with a 0.91 point increase in Working Memory (95% CI: 0.14, 1.67). The change in UAs/Cr across follow-up was not significantly associated with changes in Full Scale IQ or Index scores. Installation of deep, low-As community wells lowered UAs, BAs, and BMn. A greater decrease in UAs/Cr was associated with greater improvements in Working Memory scores, but not with a greater improvement in Full Scale IQ. Wasserman GA, Liu X, Parvez F, Factor-Litvak P, Kline J

  14. Radioactive iodine therapy and breast cancer. A follow-up study of hyperthyroid women

    Goldman, M.B.; Maloof, F.; Monson, R.R.; Aschengrau, A.; Cooper, D.S.; Ridgway, E.C.

    1988-05-01

    A follow-up study of 1762 hyperthyroid women who were treated at the Massachusetts General Hospital Thyroid Unit between 1946 and 1964 was conducted. The average length of follow-up was 17.2 years. A 1978 mailing address or a death certificate was located for 92% of the women, and 88% of 1058 living patients responded to a mail questionnaire. The standardized mortality ratio (SMR) for all causes of death was 1.3 (95% confidence interval (CI) 1.2-1.4). The standardized mortality ratios for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.7-1.1) and 1.3 (95% CI 0.8-1.9), respectively. More deaths than expected were observed from endocrine and metabolic diseases (SMR = 1.8, 95% CI 1.2-2.7), circulatory system diseases (SMR = 1.4, 95% CI 1.3-1.6), and respiratory system diseases (SMR = 1.9, 95% CI 1.3-2.6). The standardized incidence ratios (SIR) for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.8-1.1) and 1.2 (95% CI 0.9-1.5), respectively. A nonsignificant excess breast cancer risk was observed 10 years after the onset of thyroid symptoms and was present at the end of 30 years of observation. A statistically significant excess number of pancreatic cancer cases (SIR = 2.0, 95% CI 1.0-3.7) and a nonsignificant excess of brain cancer cases (SIR = 2.3, 95% CI 0.7-5.3) were observed. Eighty per cent of the women were treated with radioactive iodine. When age at treatment and year of treatment were controlled, women who were ever treated with radioactive iodine had a standardized rate ratio for breast cancer of 1.9 (95% CI 0.9-4.1), compared with those who were never treated with radioactive iodine. Women who developed hypothyroidism as a result of their treatment for hyperthyroidism did not have an increased risk of developing breast cancer (SIR = 1.1, 95% CI 0.8-1.6).

  15. Radioactive iodine therapy and breast cancer. A follow-up study of hyperthyroid women

    Goldman, M.B.; Maloof, F.; Monson, R.R.; Aschengrau, A.; Cooper, D.S.; Ridgway, E.C.

    1988-01-01

    A follow-up study of 1762 hyperthyroid women who were treated at the Massachusetts General Hospital Thyroid Unit between 1946 and 1964 was conducted. The average length of follow-up was 17.2 years. A 1978 mailing address or a death certificate was located for 92% of the women, and 88% of 1058 living patients responded to a mail questionnaire. The standardized mortality ratio (SMR) for all causes of death was 1.3 (95% confidence interval (CI) 1.2-1.4). The standardized mortality ratios for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.7-1.1) and 1.3 (95% CI 0.8-1.9), respectively. More deaths than expected were observed from endocrine and metabolic diseases (SMR = 1.8, 95% CI 1.2-2.7), circulatory system diseases (SMR = 1.4, 95% CI 1.3-1.6), and respiratory system diseases (SMR = 1.9, 95% CI 1.3-2.6). The standardized incidence ratios (SIR) for all malignant neoplasms and for breast cancer were 0.9 (95% CI 0.8-1.1) and 1.2 (95% CI 0.9-1.5), respectively. A nonsignificant excess breast cancer risk was observed 10 years after the onset of thyroid symptoms and was present at the end of 30 years of observation. A statistically significant excess number of pancreatic cancer cases (SIR = 2.0, 95% CI 1.0-3.7) and a nonsignificant excess of brain cancer cases (SIR = 2.3, 95% CI 0.7-5.3) were observed. Eighty per cent of the women were treated with radioactive iodine. When age at treatment and year of treatment were controlled, women who were ever treated with radioactive iodine had a standardized rate ratio for breast cancer of 1.9 (95% CI 0.9-4.1), compared with those who were never treated with radioactive iodine. Women who developed hypothyroidism as a result of their treatment for hyperthyroidism did not have an increased risk of developing breast cancer (SIR = 1.1, 95% CI 0.8-1.6)

  16. MR imaging follow-up studies in patients with aplastic anemia

    Tscholakoff, D.; Herold, C.; Pongracz, I.; Hinterberger, W.; Kier, P.; Chott, A.; Imhof, H.

    1988-01-01

    Eight patients with aplastic anemia underwent MR imaging of the pelvis and thoracolumbar spine before and during treatment. Bone marrow patterns on MR images were correlated with stem-cell and peripheral-blood cell counts and Prussian blue stain of bone marrow (to estimate iron overload). Before treatment, two different bone marrow patterns were observed. Three patients had diffuse, homogeneous high signal intensity throughout the bone marrow, indicating fatty replacement of hematopoietic bone marrow. Bone marrow stains were negative for iron overload. Follow-up studies in these three patients showed multiple areas of hypointense foci in the bone marrow at the time when stem cell and blood cell counts returned to normal. The remaining five patients displayed inhomogeneous signal distribution (hypointense foci on T1-weighted images) in the bone marrow on the first and following MR studies. All five patients did not respond to therapy and had multiple transfusions. Bone marrow signal intensities (correlated to a phantom) were similar in patients with recovery of hematopoietic bone marrow and patients with hemochromatosis

  17. Dietary Acid-Base Balance in Adolescent Sprint Athletes: A Follow-up Study

    Peter Clarys

    2011-02-01

    Full Text Available Sprinters are advised to include additional protein sources in their diet. Basal metabolism and vigorous physical activities generate hydrogen ions that need to be buffered. The present follow-up study estimates the dietary potential renal acid load (PRAL and net endogenous acid production (NEAP in adolescent sprint athletes. Seven-day food diaries and anthropometrics of 60 adolescent sprint athletes (mean age at start 14.7 ± 1.9 years were collected every six months over a three year period. Comparisons were made between athletes with a negative (PRAL(− versus positive PRAL (PRAL(+. For the entire sample, mean PRAL values of up to 6 mEq/day were slightly positive despite a relatively high protein intake of around 1.5 g/kg. The NEAP ranging between 42 and 46 mEq/day remained stable during the study period. Athletes with a PRAL(− (−8 to −10 mEq/day consumed significantly more fruit and fruit juice than athletes with a PRAL(+ (+9 to 14 mEq/day. Athletes with a PRAL(+ did not consume more meat, fish and poultry than athletes with a PRAL(−. Grains and dairy products were only discriminative between the two groups on one measurement occasion. Lowering the PRAL can be obtained by increasing the consumption of potatoes, fruits, vegetables and vegetable soup.

  18. A NEPA follow-up study of DOE loan guarantee fuel ethanol plants

    Hunsaker, D.B. Jr.; Eddlemon, G.K.; Miller, R.L.; Webb, J.W.

    1989-04-01

    This study was implemented to examine and characterize the actual environmental impacts of three fuel ethanol plants constructed under the US Department of Energy, Office of Alcohol Fuels Loan Guarantee Program, and to compare actual impacts with those predicted about six years ago in environmental assessments (EAs) prepared for these facilities. The objective of the program, established under the Energy Security Act of 1980, was to conserve petroleum resources by promoting the use of fuel ethanol in motor vehicles. The plants were designed to produce fuel-grade ethanol for blending with gasoline and reflect differentfeedstocks, processes, fuel sources, and site locations. Although two of the facilities as constructed differed substantially from those assessed previously, actual environmental impacts generally occurred in the areas predicted by the EAs. Major impacts not anticipated include odor from air emissions, effects of wastewater discharge on operation of a municipal sewage treatment plant, possible classification of treated wastewater from a molasses-based process as a nuisance, and habitat losses from both vegetation removal and unforeseen construction of barge terminals. In all cases, impacts were judged to be not significantn the final outcome, either because plant management (or other involved parties) took corrective action or because the resources affected in these particular cases were not important. Mitigation measures reliedon in the EAs to limit adverse impacts to insignificant levels were implemented and were required by permit condition, law, or regulation. Future follow-up studies would benefit from the availability of ambientmonitoring data to more thoroughly characterize actual impacts

  19. Follow-Up Study of Behavioral Development and Parenting Stress Profiles in Children with Congenital Hypothyroidism

    Mei-Chyn Chao

    2009-11-01

    Full Text Available Recent longitudinal experiences have emphasized that the follow-up of children with treated congenital hypothyroidism (CHT should not be limited to the cognitive domain. This study attempted to evaluate the emotional–behavioral profiles in children with CHT together with maternal parenting stress profiles. Data for child and family characteristics were collected from 47 families with a 3–12-year-old CHT child diagnosed and treated since the newborn period. Cognitive assessments were performed. The main caregiver completed the following questionnaires: (1 Strengths and Difficulties Questionnaire, which rated behavioral symptoms in children; (2 Parenting Stress Index, which determined the quality and magnitude of parenting stress experienced by the caregiver; and (3 Symptom Checklist-90-R, which evaluated the psychopathological symptoms of the caregiver. In addition, 31 unaffected siblings were recruited as a comparative control group. The results revealed that children with treated CHT had normal intelligence quotients (mean, 93.6 ± 16.2 at the time of the study. However, CHT children had more problems in emotional–behavioral domains than sibling controls (p = 0.01. Overall, 29.8% (14/47 of the CHT children had emotional–behavioral problems above the clinical cutoff. In addition, 13% of the caregivers of CHT children had parenting stress above the clinical cutoff. Therefore, professional intervention is warranted in these subgroups of CHT children and parents.

  20. Isolated autosomal dominant growth hormone deficiency: an evolving pituitary deficit? A multicenter follow-up study.

    Mullis, Primus E; Robinson, Iain C A F; Salemi, Souzan; Eblé, Andrée; Besson, Amélie; Vuissoz, Jean-Marc; Deladoey, Johnny; Simon, Dominique; Czernichow, Paul; Binder, Gerhard

    2005-04-01

    Four distinct familial types of isolated GH deficiency have been described so far, of which type II is the autosomal dominant inherited form. It is mainly caused by mutations within the first 6 bp of intervening sequence 3. However, other splice site and missense mutations have been reported. Based on in vitro experiments and transgenic animal data, there is strong evidence that there is a wide variability in phenotype in terms of the severity of GH deficiency. Therefore, we studied a total of 57 subjects belonging to 19 families suffering from different splice site as well as missense mutations within the GH-1 gene. The subjects presenting with a splice site mutation within the first 2 bp of intervening sequence 3 (5'IVS +1/+2 bp) leading to a skipping of exon 3 were found to be more likely to present in the follow-up with other pituitary hormone deficiencies. In addition, although the patients with missense mutations have previously been reported to be less affected, a number of patients presenting with the P89L missense GH form, showed some pituitary hormone impairment. The development of multiple hormonal deficiencies is not age dependent, and there is a clear variability in onset, severity, and progression, even within the same families. The message of clinical importance from these studies is that the pituitary endocrine status of all such patients should continue to be monitored closely over the years because further hormonal deficiencies may evolve with time.

  1. Follow-up study of behavioral development and parenting stress profiles in children with congenital hypothyroidism.

    Chao, Mei-Chyn; Yang, Pinchen; Hsu, Hsiu-Yi; Jong, Yuh-Jyh

    2009-11-01

    Recent longitudinal experiences have emphasized that the follow-up of children with treated congenital hypothyroidism (CHT) should not be limited to the cognitive domain. This study attempted to evaluate the emotional-behavioral profiles in children with CHT together with maternal parenting stress profiles. Data for child and family characteristics were collected from 47 families with a 3-12-year-old CHT child diagnosed and treated since the newborn period. Cognitive assessments were performed. The main caregiver completed the following questionnaires: (1) Strengths and Difficulties Questionnaire, which rated behavioral symptoms in children; (2) Parenting Stress Index, which determined the quality and magnitude of parenting stress experienced by the caregiver; and (3) Symptom Checklist-90-R, which evaluated the psychopathological symptoms of the caregiver. In addition, 31 unaffected siblings were recruited as a comparative control group. The results revealed that children with treated CHT had normal intelligence quotients (mean, 93.6 +/- 16.2) at the time of the study. However, CHT children had more problems in emotional-behavioral domains than sibling controls (p = 0.01). Overall, 29.8% (14/47) of the CHT children had emotional-behavioral problems above the clinical cutoff. In addition, 13% of the caregivers of CHT children had parenting stress above the clinical cutoff. Therefore, professional intervention is warranted in these subgroups of CHT children and parents.

  2. Adherence to vaccination guidelines post splenectomy: A five year follow up study.

    Boam, Tristan; Sellars, Peter; Isherwood, John; Hollobone, Chloe; Pollard, Cristina; Lloyd, David M; Dennison, Ashley R; Garcea, Giuseppe

    Following a splenectomy patients are at increased risk of significant infections. In its most severe form, overwhelming post-splenectomy infection (OPSI) has a mortality rate of up to 80%. In this study we aim to establish the adherence to vaccination and antibiotic national guidelines in splenectomised patients. A retrospective study of 100 patients who underwent splenectomy (21 emergency, 79 elective), in two teaching hospitals was undertaken over a five-year period. Patients were followed up for five years. Hospital and GP records were reviewed for adherence to pre, intra and postoperative vaccination, thromboprophylaxis and antibiotic guidance. Eighty-six eligible patients (91.5%) received their Haemophilus influenzae B, meningococcal C and pneumococcus vaccinations peri-operatively. Eighty-one (86%) received post-operative antibiotics. Ninety-nine percent of patients received thromboprophylaxis treatment. Eighty-nine (95%) were treated with long-term antibiotic prophylaxis. Only 20 patients (23%) had an emergency supply of antibiotics. Ninety-five percent of patients were administered an annual influenza vaccination and 84% of eligible patients received a five-year pneumococcal booster vaccination. Improvement in the management of this patient cohort can be achieved by a multidisciplinary approach involving adherence to national guidelines, standardised trust protocols, patient information leaflets and advice detailing risk of infection, standardised GP letters and a splenectomy register to monitor and manage this vulnerable group of patients. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  3. A 3-year follow-up study of overdentures retained by mini-dental implants.

    Preoteasa, Elena; Imre, Marina; Preoteasa, Christina Teodora

    2014-01-01

    This study evaluated overdentures retained by mini-dental implants (MDIs) as a treatment option for complete edentulism during a 3-year follow-up period. This observational clinical study included completely edentulous patients who were treated with MDI-retained overdentures. The MDIs were supplied by the manufacturer. Twenty-three patients received 7 maxillary and 16 mandibular MDI overdentures retained by 110 MDIs. Of the 36 MDIs placed in the maxilla, 8 failed (in two patients), 2 had compromised survival, 3 displayed satisfactory survival, and 23 were successful. Of the 74 MDIs placed in the mandible, 11 displayed satisfactory survival and 63 were successful. The marginal bone loss was more pronounced for the MDIs placed mesially (intercalated), in areas of decreased ridge width and bone density, and with lower values of insertion torque. The overdentures fractured in seven patients; in 4 of them, this corresponded to the implant housing area. Self-reported reasons for patient dissatisfaction included occasional pain under the overdenture (n = 5) and instability of the maxillary antagonist complete denture (n = 4). Based on this research, considering its limitations, it is possible to conclude that survival rates and health status are better for MDI overdentures applied in the mandible than for those applied in the maxilla. The most severe prosthetic complications encountered were overdenture base fracture, matrix detachment, and instability of the maxillary antagonist denture.

  4. Periodic assessment of plasma sFlt-1 and PlGF concentrations and its association with placental morphometry in gestational hypertension (GH) - a prospective follow-up study.

    Jeevaratnam, Kamalan; Nadarajah, Vishna Devi; Judson, John Paul; Nalliah, Sivalingam; Abdullah, Mohd Farouk

    2010-09-28

    Hypertensive disorders in pregnancy contributes to about 12% of maternal deaths in Malaysia and similarly worldwide. Early detection and adequate management are preventable strategies. Biochemical markers of abnormal angiogenesis would be more specific in early detection than routine blood pressure and proteinuria measurements. The aim of this study was to estimate maternal plasma PlGF and sFlt-1 levels in pregnant women with gestational hypertension at three intervals of pregnancy and correlate these biomarker levels with placental morphometry. Venous blood samples (antepartum, intrapartum and post partum periods) were drawn to estimate for sFlt-1 and PlGF levels while placental tissue samples were examined for placental morphometry. PlGF levels were lower in gestational hypertension (GH) compared to normotensive during antepartum and intrapartum period, whereas sFlt-1 levels were elevated in GH at antepartum, intrapartum and postpartum intervals during pregnancy. An inverse relationship between these two biomarkers was observed through correlation analysis. PlGF levels were inversely correlated with total villous surface area of the placental periphery (TCsa-C) and villous capillarization (VC-C) of the placental periphery. We established periodic values of for sFlt-1 and PlGF levels for the first time in an ethnically diverse Malaysian setting. We suggest the development of GH in women is related to defective capillarization. In demonstrating periodic changes, this study suggest the possibility of developing GH and other long term health complications as a result of prolonged exposure to sFlt-1. The correlation between PlGF levels and morphometric findings also support possible capillarization defect.

  5. Periodic assessment of plasma sFlt-1 and PlGF concentrations and its association with placental morphometry in gestational hypertension (GH - a prospective follow-up study

    Nalliah Sivalingam

    2010-09-01

    Full Text Available Abstract Background Hypertensive disorders in pregnancy contributes to about 12% of maternal deaths in Malaysia and similarly worldwide. Early detection and adequate management are preventable strategies. Biochemical markers of abnormal angiogenesis would be more specific in early detection than routine blood pressure and proteinuria measurements. The aim of this study was to estimate maternal plasma PlGF and sFlt-1 levels in pregnant women with gestational hypertension at three intervals of pregnancy and correlate these biomarker levels with placental morphometry. Methods Venous blood samples (antepartum, intrapartum and post partum periods were drawn to estimate for sFlt-1 and PlGF levels while placental tissue samples were examined for placental morphometry. Results PlGF levels were lower in gestational hypertension (GH compared to normotensive during antepartum and intrapartum period, whereas sFlt-1 levels were elevated in GH at antepartum, intrapartum and postpartum intervals during pregnancy. An inverse relationship between these two biomarkers was observed through correlation analysis. PlGF levels were inversely correlated with total villous surface area of the placental periphery (TCsa-C and villous capillarization (VC-C of the placental periphery. Conclusion We established periodic values of for sFlt-1 and PlGF levels for the first time in an ethnically diverse Malaysian setting. We suggest the development of GH in women is related to defective capillarization. In demonstrating periodic changes, this study suggest the possibility of developing GH and other long term health complications as a result of prolonged exposure to sFlt-1. The correlation between PlGF levels and morphometric findings also support possible capillarization defect.

  6. [Gender dysphoria in children and adolescents - treatment guidelines and follow-up study].

    Meyenburg, Bernd; Kröger, Anne; Neugebauer, Rebecca

    2015-01-01

    Treatment guidelines for transidentity in children and adolescents are presently under discussion. We present an overview of the various treatment modalities. Further, follow-up data on children and adolescents referred for gender-identity problems are presented. Of the 84 patients seen for the first time more than 3 years before follow-up, 37 mailed in the completed questionnaires. In addition, 33 patients agreed to answer some short follow-up questions. We assessed steps of treatment, gender role, psychopathology, and psychotherapy. We compared differences in psychopathology in patients with vs. without gender role change and in patients with intense vs. less intense psychotherapy. A total of 22 patients had completely changed gender role, and some had started hormonal treatment und sex reassignment surgery. Most patients were satisfied with the treatment results. All patients showed less psychopathology on follow-up, independent of role change or intensity of psychotherapy. In general, the patients reported little psychopathology. Our follow-up results support the present treatment approach. In patients with little psychopathology, low-frequency supportive treatment appears sufficient to obtain safe judgement on hormonal of surgical treatment.

  7. Long term follow up of idiopathic gingival enlargement associated with chronic periodontitis: A case report and review

    Girish P Nagarale

    2013-01-01

    Full Text Available Background: Idiopathic gingival enlargement is a rare condition characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis. Case Description: This case report describes an unusual clinical form of gingival enlargement associated with chronic periodontitis. Clinical examination revealed diffuse gingival enlargement. The lesion was asymptomatic, firm, and pinkish red. Generalized periodontal pockets were observed. Radiographic evaluation revealed generalized severe alveolar bone loss. Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue. Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up. Clinical Implications: Successful treatment of idiopathic gingival enlargement depends on proper identification of etiologic factors and improving esthetics and function through surgical excision of the over growth. However, there may be recurrence.

  8. Long term follow up of idiopathic gingival enlargement associated with chronic periodontitis: A case report and review.

    Nagarale, Girish P; Ravindra, S; Thakur, Srinath; Setty, Swati

    2013-03-01

    Idiopathic gingival enlargement is a rare condition characterized by massive enlargement of the gingiva. It may be associated with other diseases/conditions characterizing a syndrome, but rarely associated with periodontitis. This case report describes an unusual clinical form of gingival enlargement associated with chronic periodontitis. Clinical examination revealed diffuse gingival enlargement. The lesion was asymptomatic, firm, and pinkish red. Generalized periodontal pockets were observed. Radiographic evaluation revealed generalized severe alveolar bone loss. Histopathological investigations revealed atrophic epithelium with dense fibrocollagenous tissue. Lesions healed successfully following extraction and surgical excision, and no recurrence was observed after 1 year follow-up but recurrence was observed at 3 and 5-years follow-up. Successful treatment of idiopathic gingival enlargement depends on proper identification of etiologic factors and improving esthetics and function through surgical excision of the over growth. However, there may be recurrence.

  9. Afterglow Population Studies from Swift Follow-Up Observations of Fermi LAT GRBs

    Racusin, Judith L.; Oates, S. R.; McEnery, J.; Vasileiou, V.; Troja, E.; Gehrels, N.

    2010-01-01

    The small population of Fermi LAT detected GRBs discovered over the last year has been providing interesting and unexpected clues into GRB prompt and afterglow emission mechanisms. Over the last 5 years, it has been Swift that has provided the robust data set of UV/optical and X-ray afterglow observations that opened many windows into other components of GRB emission structure. We explore the new ability to utilize both of these observatories to study the same GRBs over 10 orders of magnitude in energy, although not always concurrently. Almost all LAT GRBs that have been followed-up by Swift within 1-day have been clearly detected and carefully observed. We will present the context of the lower-energy afterglows of this special subset of GRBs that has > 100 MeV emission compared to the hundreds in the Swift database that may or may not have been observed by LAT, and theorize upon the relationship between these properties and the origin of the high energy gamma-ray emission.

  10. Conflict resolution patterns and longevity of adolescent romantic couples: a 2-year follow-up study.

    Shulman, Shmuel; Tuval-Mashiach, Rivka; Levran, Elisheva; Anbar, Shmuel

    2006-08-01

    This study examined the predictors of longevity among 40 late adolescent romantic couples (mean age males=17.71 years; mean age females=17.18 years). Subjects were given a revealed differences task where they were asked to solve their disagreements. The joint task was recorded, transcribed and analysed by two raters. At 3, 6, 9, 12, 18, and 24 months after this procedure, partners were contacted by telephone and asked whether their relationship was still intact. A cluster analysis was performed on couples' interaction indices and yielded three distinctive conflict resolution patterns. The Downplaying pattern was characterized by a high tendency to minimize the conflict. The relationships of the adolescents displaying this pattern stayed intact for a period of 9 months. Half of them were still together after 24 months. The adolescents displaying the Integrative pattern, which shows a good ability to negotiate differences tended to stay together over a period of 24 months. Those showing the Conflictive pattern, characterized by a confrontative interaction, were separated by the 3 months follow-up. Results are discussed within the context of developmental perspectives of conflict resolution tendencies and adolescent romance.

  11. Omalizumab in patients with eosinophilic granulomatosis with polyangiitis: a 36-month follow-up study.

    Detoraki, Aikaterini; Di Capua, Lorena; Varricchi, Gilda; Genovese, Arturo; Marone, Gianni; Spadaro, Giuseppe

    2016-01-01

    Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic vasculitis characterized by asthma and blood eosinophilia, with the lung being the organ most frequently affected. Oral glucocorticoids and/or immunosuppressive drugs are the mainstay therapy of EGPA. Occasional reports suggest that EGPA patients can be treated with omalizumab in addition to conventional therapy to achieve asthma control. To investigate the long-term effects of omalizumab in patients with EGPA and asthma (2 females, 3 males, age 41-64 years), we carried out a 36-month follow-up observational study. At the time of enrollment, the patients were on maintenance therapy and had moderate to severe allergic asthma, eosinophilia and rhinosinusitis. Mononeuropathy/polyneuropathy and/or histological evidence of tissue eosinophilic infiltration were also present. Patients were treated with omalizumab (300-600 mg s.c. every 2-4 weeks) as add-on therapy to prednisone, inhaled steroids and bronchodilators. During omalizumab treatment, spirometry, the asthma control test (ACT) score and eosinophilia were evaluated, and prednisone dosage was recorded. During the 36 months of omalizumab treatment asthma progressively improved as indicated by spirometry and the ACT score. Eosinophilia progressively decreased. The oral prednisone dose was reduced or withdrawn during treatment. No adverse events were recorded. In patients with EGPA and moderate to severe allergic asthma, omalizumab can be beneficial and safe. It enables corticosteroid tapering while decreasing eosinophilia and improving asthma symptoms over 36 months.

  12. Hematological follow-up studies on patients with thyroid neoplasms after 131I therapy

    Chone, B.; Engelken, G.; Schenck, P.

    1978-01-01

    Based on 391 thyroid neoplasms diagnostic hematological follow-up studies were registered in 34 patients with an overall J-131-dose of more than 500 mCi including the following parameters: 1. Peripheral blood control. 2. Bone marrow aspiration. 3. Cell volume distribution size of leukocytes after preparative enrichment. If in doubt a bone marrow scintigraphy was added. The adjunctive diagnostic procedure was correlated with histological criteria of thyroid carcinoma and J-131 retention after therapeutic application of radioiodine. In particular, a case report is given regarding a patient of 66 years with follicular thyroid carcinoma receiving 990 mCi J-131 during a period of 11 years after having had total thyroidectomy twice. The development of acute leucemia followed by death happened 16 years later. The moment of bone marrow transformation was determined exactly. The value of blood parameters can be calculated as follows: 1. Peripheral blood controls are limited by lack of efficiency. 2. Biopsy of bone marrow can detect hypoplastic alteration being latent in circulating blood for some years, even of J-131 cumulation dose below 500 mCi. 3. The analysis of distribution size of leukocytes represents a functional aspect after radiation induced in injury of bone marrow. (author)

  13. Cyclosporine nephrotoxicity in type 1 diabetic patients. A 7-year follow-up study

    Parving, H H; Tarnow, L; Nielsen, F S

    1999-01-01

    OBJECTIVE: To evaluate kidney function 7 years after the end of treatment with cyclosporine A (CsA) (initial dosage of 9.3 tapered off to 7.0 mg.kg-1.day-1) in young patients (mean age 20 years) with newly diagnosed type 1 diabetes participating in a randomized, double-blind, placebo-controlled Cs...... of study medication, two CsA group patients and one control patient were lost to follow-up. One placebo-treated patient developed IgA nephropathy (biopsy proven) and was excluded. Four CsA-treated patients developed persistently elevated UAER > 30 mg/24 h (n = 3 with microalbuminuria), whereas all the 17...... randomly selected CsA-treated patients had a kidney biopsy performed shortly after the CsA treatment was stopped. Interstitial fibrosis/tubular atrophy and/or arteriolopathy were present in two subjects who both subsequently developed persistent microalbuminuria. CONCLUSIONS: The results of our 7-year...

  14. Postural education program for elementary school: a one-year follow-up study

    Alexandre Luis Ritter

    2015-09-01

    Full Text Available AbstractThe objective of this study was to verify the short- and long-term effectiveness of the Elementary School Postural Program in the performance, generalization, and perception of daily school activities. The final sample consisted of 61 subjects divided into experimental (14 years ±0.93; ♀=22; ♂=10 and control group (15.38 years ±0.97; ♀=16; ♂=13, all participants attended a Brazilian public school in Porto Alegre, State of Rio Grande do Sul. The postural program included 20 sessions over a 10-week period. In each session, participants discussed and practiced routine actions that typically occurred at schools. Eight other meetings were required for the completion of the pre- and post-tests. The experimental group performed significantly better than the control group in the short-term evaluations, although there were no significant statistical differences in the long-term follow-up evaluations. The children demonstrated a good behavioral response to the postural program; nevertheless, the knowledge had not been completely mastered after a year.

  15. Immediate loading implants with mandibular overdenture: a 48-month prospective follow-up study

    Karla ZANCOPE

    2014-08-01

    Full Text Available The aim of this prospective clinical study was to evaluate patient rehabilitation with two immediately loaded implants and bar-retained mandibular overdentures after 48 months of follow-up. Twenty patients were treated with two implants each; of these, 17 patients were re-evaluated for comparison. Gender, age, plaque index, gingival inflammation, keratinized mucosa, probing depth, bleeding, and implant loss data were recorded, and periapical radiographs were obtained for measurement of marginal bone loss. The results were statistically analyzed with one-way analysis of variance (ANOVA followed by Student’s t-test and Pearson’s correlation test. To compare the data at baseline and after 48 months, a Wilcoxon Signed Rank Test was performed (α = 0.05. One implant failed (2.9% during the first year and was replaced. A total of 35 implants were evaluated. Bone loss values were 0.52–2.89 mm (mean, 1.46 mm. Probing depth was 1.75–3.75 mm (mean, 2.22 mm. Correlations were found between bone loss and plaque index and between bone loss and gender, but bone loss did not correlate with gingival inflammation, keratinized mucosa, probing depth, or age. The overall survival rate of the implants was 97.1%. Based on these results, the use of two immediately loaded splinted interforaminal implants to retain an overdenture with a bar attachment is a clinically viable option with a high survival rate.

  16. Ultraprocessed food consumption and risk of overweight and obesity: the University of Navarra Follow-Up (SUN) cohort study.

    Mendonça, Raquel de Deus; Pimenta, Adriano Marçal; Gea, Alfredo; de la Fuente-Arrillaga, Carmen; Martinez-Gonzalez, Miguel Angel; Lopes, Aline Cristine Souza; Bes-Rastrollo, Maira

    2016-11-01

    Ultraprocessed food consumption has increased in the past decade. Evidence suggests a positive association between ultraprocessed food consumption and the incidence of overweight and obesity. However, few prospective studies to our knowledge have investigated this potential relation in adults. We evaluated the association between ultraprocessed food consumption and the risk of overweight and obesity in a prospective Spanish cohort, the SUN (University of Navarra Follow-Up) study. We included 8451 middle-aged Spanish university graduates who were initially not overweight or obese and followed up for a median of 8.9 y. The consumption of ultraprocessed foods (defined as food and drink products ready to eat, drink, or heat and made predominantly or entirely from processed items extracted or refined from whole foods or synthesized in the laboratory) was assessed with the use of a validated semiquantitative 136-item food-frequency questionnaire. Cox proportional hazards models were used to estimate adjusted HRs and 95% CIs for incident overweight and obesity. A total of 1939 incident cases of overweight and obesity were identified during follow-up. After adjustment for potential confounders, participants in the highest quartile of ultraprocessed food consumption were at a higher risk of developing overweight or obesity (adjusted HR: 1.26; 95% CI: 1.10, 1.45; P-trend = 0.001) than those in the lowest quartile of consumption. Ultraprocessed food consumption was associated with a higher risk of overweight and obesity in a prospective cohort of Spanish middle-aged adult university graduates. Further longitudinal studies are needed to confirm our results. This trial was registered at clinicaltrials.gov as NCT02669602. © 2016 American Society for Nutrition.

  17. Malnutrition and associated factors among heart failure patients on follow up at Jimma university specialized hospital, Ethiopia.

    Amare, Hiwot; Hamza, Leja; Asefa, Henok

    2015-10-15

    Malnutrition and cachexia are serious consequences of numerous chronic diseases. Severe heart failure patients could be related with marked weight loss. Malnutrition is associated with poor prognosis among heart failure patients. Despite its implication, factors associated with malnutrition among heart failure patients in Africa and Ethiopia was not addressed. Hence, in this study we tried to determine factors associated with malnutrition among heart failure patients on follow up at Jimma University specialized hospital, Ethiopia. A cross-sectional study was done on 284 randomly selected heart failure patients. The nutritional status of the patients was assessed based on their serum albumin level (normal value 4-5 mg/dl) and triceps skin fold thickness. The data was analyzed using SPSS version 20.0. Multivariable logistic regression was used to identify factors associated with malnutrition among heart failure patients using SPSS 20.0. Based on serum albumin and triceps skin fold thickness, 77.8 % of patients were malnourished. Mean age of the patients was 48.3 ± 15.9 years. The commonest cause of heart failure was ischemic heart disease (34.9 %). Hypertension (36 %) was the commonest co morbid disease. Forty four percent of patients had New York heart association functional class II heart failure. Serum hemoglobin (AOR = 0.77, 95 % CI: 0.67-0.92) was found to be significantly associated with nutritional status of heart failure patients. As serum hemoglobin increases by 1gm/dl, the risk of malnutrition decreased by 15 % (P value = 0.03). The majority of patients were malnourished. A higher hemoglobin concentration was associated with reduced odds of being malnourished.

  18. Three-Year Follow-Up Study in Patients with Guillain-Barré Syndrome.

    Martic, Vesna; Bozovic, Ivo; Berisavac, Ivana; Basta, Ivana; Peric, Stojan; Babic, Milica; Rajic, Sonja Lukic; Bjelica, Bogdan; Stojiljkovic Tamas, Olivera; Stojanov, Aleksandar; Grunauer, Marija; Cobeljic, Mina; Komatina, Nenad; Djuric, Vanja; Petrovic, Milutin; Vujovic, Balsa; Dominovic Kovacevic, Aleksandra; Djordjevic, Gordana; Jovanovic, Dejana; Stevic, Zorica

    2018-05-01

    A majority of patients with Guillain-Barré syndrome (GBS) have tendency of a good recovery. Our aim was to evaluate the outcome of the disease 1 and 3 years after GBS symptom onset. During 2014, GBS was diagnosed in 82 patients in seven tertiary healthcare centers. Neurological follow-up was conducted in 57 (70%) patients after 1 year, and in 54 (66%) after 3 years. Functional disability was estimated according to the GBS disability scale (GDS), with a score of 0-3 indicating mild disability and a score of 4-6 indicating severe disability during acute phase, whereas a score >1 indicated poor recovery on follow-ups. Visual analog scale was used to assess sensory symptoms and musculoskelatal pain, and Krupp's Fatigue Severity Scale was used to asses fatigue. Poor functional outcome was found in 39% of GBS patients at year 1 and 30% at year 3. Paresthesias/dysesthesias were detected in 60% of patients after 1 year and 43% after 3 years. Musculoskeletal pain was present in 40% of patients at year 1 and 33% at year 3. Significant fatigue after 1 year was found in 21% of subjects and after 3 years in 7%. Parameters associated with poor functional outcome after 1 year were age >55 years (p=0.05), severe disability at admission (p1 indique une récupération difficile au moment des suivis. L'échelle visuelle analogue (EVA) a aussi été utilisée pour évaluer leurs symptômes sensoriels et leurs douleurs musculo-squelettiques. Enfin, l'échelle de gravité de la fatigue de Krupp a été utilisée pour évaluer leur degré de fatigue. Résultats: La première année, on a observé une piètre amélioration des capacités fonctionnelles chez 39% des patients atteints du SGB; pour la troisième année, cette proportion était de 30%. Au bout d'un an, on a aussi détecté la présence de paresthésie/dysesthésie chez 60% des patients; pour la troisième année, cette proportion était de 43%. Des douleurs musculo-squelettiques ont été rapportées chez 40% des patients

  19. Maternal Preeclampsia and Androgens in the Offspring around Puberty: A Follow-Up Study.

    Ingvild V Alsnes

    Full Text Available Children born after preeclampsia may have a dominant androgen profile in puberty compared with other children. Circulating androgen concentrations at 11-12 years of age were compared between offspring born after preeclampsia, and children whose mothers did not have preeclampsia.A total of 611 mother-offspring pairs were followed up 11 (daughters or 12 (sons years after birth: 218 pairs in the preeclampsia group, and 383 pairs without preeclampsia. Circulating total testosterone, androstenedione, dehydroepiandrosterone sulfate (DHEAS, and insulin-like growth factor I (IGF-I were measured in the children. In boys, testicular volume was also measured.Among girls born after preeclampsia, DHEAS concentrations were higher than in unexposed girls (p<0.001, however, girls born after preeclampsia with severe features had the lowest DHEAS levels. In contrast, testosterone concentrations were highest in girls born after preeclampsia with severe features, both compared to other girls in the preeclampsia group, and compared to unexposed girls (p<0.001. For boys, testosterone concentrations were higher in the preeclampsia group compared with unexposed boys (p<0.001, and boys born after preeclampsia with severe features had the lowest concentrations of DHEAS. Compared with unexposed boys, testicular volume (p = 0.015 and IGF-I (p = 0.004 were higher for boys in the preeclampsia group, except for boys in the clinically severe preeclampsia group.In utero exposure to preeclampsia is associated with androgen hormonal patterns in early puberty that depend on clinical severity of preeclampsia and sex of the offspring. The hormonal differences may reflect different timing of pubertal development, and may have consequences for future health of the offspring.

  20. Following-up study on radiation-induced retinopathy in nasopharyngeal carcinoma

    Zhang Qingping; Zhou Weiwei; Xie Chengxi; Huang Guangwu; Ruan Lin

    2003-01-01

    Objective: To investigate the frequency of ocular complication and the quality of patient's life after radiation therapy in nasopharyngeal carcinoma (NPC). Methods: 254 NPC patients who initially received radiation were followed and analysed. Visual acuity, automational visual field, slit-lamp microscopic findings, pattern visual evoked potential (P-VEP) and fundal findings were determined before, during and after radiation therapy. The severity of retinal impairment was assessed according to the international criteria on late tissue effects. Results: The radiation dose was more than 70 Gy in 241 (94.9%)NPC patients, giving a radiation retinopathy incidence of 8.7% (22) patients after a mean of 46.8±14.4 months. After being diagnosed as radiation retinopathy, 16 patients received combined-modality therapy of the modern medicine and Chinese traditional medicine. The disease condition was controlled in 56%(9) patients but progressed into optic neuropathy in 7 patients, 3 of whom developed radiation encephalopathy in 14 to 20 months after onset of retinopathy. The morbidity of radiation retinopathy was not associated with the patient's age, but was related to the radiation dose. The retinopathy rate was as high as 13.6% in the 75-79 Gy group, which is significantly higher than 5.6% in the 70-74 Gy group (P<0.05). Conclusions: Radiation retinopathy in NPC patients is related to the radiation dose and individual difference in radiosensitivity. Optic nerve and brain damage are already present when clinical manifestations of radiation retinopathy occur. Therefore CT and MRI of the brain should be carried out. The importance of long-term follow-up should be stressed for early diagnosis and treatment of radiation sequelae for the sake of complete return of visual function and good quality of life

  1. Infertility among women working in horticulture. A follow-up study in the Danish Occupational Hospitalization Register.

    Hougaard, Karin Sørig; Hannerz, Harald; Feveile, Helene; Bonde, Jens Peter; Burr, Hermann

    2009-04-01

    The possible association between employment in horticulture with potential exposure to pesticides and female infertility was examined by identification of women with hospital contact due to infertility and working in horticulture through the Danish Occupational Hospitalization Register. This follow-up study gave a standardized incidence ratio of 1.06 (95% confidence interval: 0.84-1.32) for treatment of infertility in women working in horticulture compared with the standard population and did not confirm that women working in the horticultural industry are at increased risk for infertility.

  2. Infertility among women working in horticulture. A follow-up study in the Danish Occupational Hospitalization Register

    Hougaard, Karin Sørig; Hannerz, Harald; Feveile, Helene

    2009-01-01

    The possible association between employment in horticulture with potential exposure to pesticides and female infertility was examined by identification of women with hospital contact due to infertility and working in horticulture through the Danish Occupational Hospitalization Register. This follow......-up study gave a standardized incidence ratio of 1.06 (95% confidence interval: 0.84-1.32) for treatment of infertility in women working in horticulture compared with the standard population and did not confirm that women working in the horticultural industry are at increased risk for infertility....

  3. Fate of clinical research studies after ethical approval--follow-up of study protocols until publication.

    Anette Blümle

    Full Text Available Many clinical studies are ultimately not fully published in peer-reviewed journals. Underreporting of clinical research is wasteful and can result in biased estimates of treatment effect or harm, leading to recommendations that are inappropriate or even dangerous.We assembled a cohort of clinical studies approved 2000-2002 by the Research Ethics Committee of the University of Freiburg, Germany. Published full articles were searched in electronic databases and investigators contacted. Data on study characteristics were extracted from protocols and corresponding publications. We characterized the cohort, quantified its publication outcome and compared protocols and publications for selected aspects.Of 917 approved studies, 807 were started and 110 were not, either locally or as a whole. Of the started studies, 576 (71% were completed according to protocol, 128 (16% discontinued and 42 (5% are still ongoing; for 61 (8% there was no information about their course. We identified 782 full publications corresponding to 419 of the 807 initiated studies; the publication proportion was 52% (95% CI: 0.48-0.55. Study design was not significantly associated with subsequent publication. Multicentre status, international collaboration, large sample size and commercial or non-commercial funding were positively associated with subsequent publication. Commercial funding was mentioned in 203 (48% protocols and in 205 (49% of the publications. In most published studies (339; 81% this information corresponded between protocol and publication. Most studies were published in English (367; 88%; some in German (25; 6% or both languages (27; 6%. The local investigators were listed as (co-authors in the publications corresponding to 259 (62% studies.Half of the clinical research conducted at a large German university medical centre remains unpublished; future research is built on an incomplete database. Research resources are likely wasted as neither health care

  4. Forgotten antibiotics: a follow-up inventory study in Europe, the USA, Canada and Australia.

    Pulcini, Céline; Mohrs, Simone; Beovic, Bojana; Gyssens, Inge; Theuretzbacher, Ursula; Cars, Otto

    2017-01-01

    The objective of this study was to update a 2011 survey, conducted on behalf of the ESCMID Study Group for Antibiotic Policies (ESGAP), studying the availability of old but clinically useful antibiotics in North America, Europe and Australia. This follow-up survey was performed in 2015 in 40 countries among specialists from the pharmaceutical, infectious diseases and microbiology sectors in North America, Europe and Australia in order to assess the availability through usual marketing processes of 36 systemic antibiotics (addition of 3 antibiotics compared with the 2011 survey) selected for their ability to treat infections caused by resistant bacteria and their unique value for specific criteria. The questionnaire was sent by e-mail to national contacts belonging to ESGAP and ReAct networks. In all, 39 of the 40 countries participated in this survey. The number of available antibiotics differed considerably from one drug to another as well as from one country to another (e.g. 7 antibiotics available in Estonia, 24 in France). Overall, 25/36 selected antibiotics were marketed in 20/39 countries or less. From 2011 to 2015 (data available for both periods in 37 countries for 33 antibiotics), the number of available selected antibiotics increased in 13 countries and decreased in 17. In conclusion, despite the ongoing bacterial resistance crisis, the situation regarding the availability of 'forgotten antibiotics' has worsened since 2011. Urgent measures are needed to ensure better availability of these antibiotics on a global scale as a conservation measure to ensure sustainable and responsible use of antibiotics. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

  5. Follow-up studies on children and adolescents with Graves' disease after 131I treatment

    Chen Danyun; Chen Tanghua

    2006-01-01

    Objective: To observe relative long-term radioactive therapy effects, clinical follow-up after 131 I treatment was conducted in children and adolescent patients with Graves' disease (GD). Methods: In 161 GD patients, aged from 8 to 17 years, m I was given at a dosage of 1.85 to 3.70 MBq per gram of thyroid tissue and a maximum dose ranging from 74 to 1221 MBq per patient. The patients were then followed up for 24 to 104 months [averagely (62±22) months]. Results: After 131 I treatment, ninety-eight (60.87%) patients were found to be euthyroid. Nine (5.59%) patients remained hyperthyroid and another three (1.86%) had recurrence of hyperthyroidism. Thirty-seven (22.98%) patients turned to be hypothyroid. Fourteen patients lost in follow-up. During the follow-up period, no thyroid cancer or genetic abnormalities were ever found in the group of patients, neither in their offsprings. Conclusion: 131 I may well be considered as an effective and safe method for treating children and adolescents with GD. . (authors)

  6. Distal tibiofibular synostosis after ankle fracture. A 14-year follow-up study

    Albers, G. H.; de Kort, A. F.; Middendorf, P. R.; van Dijk, C. N.

    1996-01-01

    Over an eight-year period up to 1983, a total of 322 consecutive patients had operations for ankle fractures; 176 were Weber type B and 128 type C. We were able to review 230 of these patients after a mean follow-up of six years (1 to 11) including 128 with Weber B and 102 with Weber C fractures. We

  7. Communication Audits and the Effects of Increased Information: A Follow-up Study.

    Hargie, Owen; Tourish, Dennis; Wilson, Noel

    2002-01-01

    Considers how communication audits are typically presented as one-shot events, whose impact is not measured. Employs a follow-up audit to track the effects of an initial audit upon a major health care organization. Illustrates how the audit can play a useful role in an organization's communication strategy. (SG)

  8. Information-seeking behaviour and information needs of LGBTQ health professionals: a follow-up study.

    Morris, Martin; Roberto, K R

    2016-09-01

    Except for one study in 2004, the literature has no data on the information-seeking behaviour of lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ) health professionals. After a decade of change for LGBTQ people, and the growth of electronic information sources and social networks, it is appropriate to revisit this subject. To gain an updated understanding of the information-seeking behaviour of LGBTQ health professionals and of how medical libraries can provide a culturally competent service to such users. A mixed-methods approach was adopted combining a Web-based questionnaire with email follow-up discussions. One hundred and twenty-three complete responses were received, mostly from the USA and Canada, between November 2012 and October 2013. LGBTQ health professionals remain more comfortable seeking LGBTQ health information from a medical librarian whom they know to be LGBTQ because they perceive LGBTQ librarians as more likely to have specialist knowledge, or through concern that non-LGBTQ librarians may be more likely to react in a stigmatising or discriminatory way. The study also provides evidence suggesting that online chat has marginal appeal for respondents seeking LGBTQ health information, despite its anonymity. Medical libraries seeking to demonstrate their cultural competency should provide visible evidence of this, such as through the creation of dedicated resource lists, promotion of LGBTQ literature on the library's website, and display of other symbols or statements supporting diversity. Opportunities exist for LGBTQ health professionals and medical librarians to work together to ensure that medical libraries are culturally competent and welcoming spaces for LGBTQ patrons, that library collections match their needs, and in the creation of guides to ensure maximum access to the results of LGBTQ health research. Medical libraries should also consider nominating and, if necessary, training a specialist in LGBTQ health information. Such

  9. Prospective follow-up study of artificial urinary sphincter placement preserving the bulbospongiosus muscle.

    Collado Serra, Argimiro; Domínguez-Escrig, José; Gómez-Ferrer, Álvaro; Batista Miranda, Emilio; Rubio-Briones, José; Solsona Narbón, Eduardo

    2017-06-01

    Artificial urinary sphincter (AUS) AMS-800® is an effective treatment for male stress urinary incontinence. The aim of the study was to assess the long-term effectiveness and complications of artificial urinary sphincter placement preserving the bulbospongiosus muscle. From April 2004 to March 2014, all consecutive male patients with urinary incontinence who underwent an AUS prosthesis insertion were prospectively evaluated. Surgical technique consisted of a perineal incision for cuff placement around the bulbous urethra preserving the bulbospongiosus muscle. Cure rate was defined as no pad use. A total of 82 consecutive patients (median age 68 years, range: 54-78) were prospectively evaluated (median follow-up 46 months, range: 12-135). Bulbospongiosus muscles were preserved intact in all cases with no intraoperative complications. Postoperative complications were reported in 14 patients (1 urethral erosion). The overall cure rate (dry rate) was 76.8% and the median ICIQ-UI score improved from 18 (range: 8-21) to 4 (range: 0-17) (P Artificial urinary sphincter survival rate was 95.5% (95%CI 89.4-100%) at 24 months and 62.6% (95%CI 45.5-79.6%) at 60 months. The mechanical failure rate was 6.3% (median 46.1 months, range: 22.2-100.9) and urethral atrophy and/or inadequate compression rate was 9.5% (median 58.6 months, range: 39-101.4 months). Our study suggests that placement of AUS preserving the bulbospongiosus muscle is technically easy and efficient, reports excellent continence rates and lower urethral erosion rates, and could delay the onset of urethral atrophy compared to other surgical procedures used for sphincter placement. © 2016 Wiley Periodicals, Inc.

  10. Postpartum physiology, psychology and paediatric follow up study (P4 Study) - Study protocol.

    Davis, Gregory K; Roberts, Lynne; Mangos, George; Henry, Amanda; Pettit, Franziska; O'Sullivan, Anthony; Homer, Caroline S E; Craig, Maria; Harvey, Samuel B; Brown, Mark A

    2016-10-01

    Women who have had hypertension in pregnancy are at greater risk of long term cardiovascular disease (CVD). Little is known about their cardiovascular risk postpartum or the effects on the woman's mental health and the outcomes of their infants. In this project we will study the physiological and psychological health of women and the physical health and development of their infants six months, two years and five years after birth. We will establish normal blood pressure (BP) and metabolic function for women who were normotensive in pregnancy and use these to assess women who had gestational hypertension (GH) or preeclampsia (PE). Women will be asked to participate if they have given birth in the preceding six months. They will be excluded if they had diabetes, hypertension, renal or other serious maternal disease prior to pregnancy or congenital anomaly in the pregnancy. We will recruit 292 women who were normotensive and their babies, 100 who had GH and 100 who had PE and their babies. They will be assessed at six months, two and five years after birth. At each assessment mothers will have their blood pressure (BP) assessed peripherally with a liquid crystal sphygmomanometer and 24h ambulatory blood pressure monitoring (ABPM), and centrally with non-invasive applanation tonometry. Additional physiological testing will include: body composition; energy balance; vascular compliance; cardiac function; liver and renal function, lipids and biochemistry; glucose and insulin; and urinalysis. Psychological status will be assessed with validated self-report questionnaires for depression, anxiety, post-traumatic stress disorder (PTSD) and mother-infant bonding. The babies will have a medical examination by a paediatrician at each assessment. Their behavioural development will be assessed with an Ages and Stages Questionnaire completed by their mother at each assessment and a developmental assessment by a child psychologist at two and five years. This study will re

  11. Four-year follow-up of pregnancy-associated osteoporosis: a case report.

    Takahashi, Naoto; Arai, Itaru; Kayama, Satoru; Ichiji, Kenji; Fukuda, Hironari; Handa, Jun-Ichi; Konno, Shin-Ichi

    2014-01-01

    A 22-year-old woman presented with complaints of severe pain in a wide region of the thoracolumbar spine. She developed severe pain in the thoracolumbar spine region 2 months after her first delivery and was referred 1 month later. A lateral thoracic X-ray showed depressed degenerative vertebrae (T7, T9). One month after the initial examination, thoracic sagittal magnetic resonance imaging showed low intensity areas on T1-weighted imaging and iso-high intensity areas on T2-weighted imaging at T5, 7, 8, 9 and 11. Bone mineral density measured by ultrasound was low (%YAM 76%). The bone metabolic markers were high, suggesting accelerated osteoclast activity. These findings prompted a diagnosis of pregnancy-associated osteoporosis. She was asked to stop breastfeeding and to wear a lumbar brace, and treatment with nutritional calcium, activated vitamin D3, and risedronate sodium was started. Her low back pain almost disappeared after treatment. Bone metabolic markers showed normalization 8 months after the initial examination. Risedronate sodium was stopped 2 years and 2 months after the initial examination. Teriparatide treatment was started because her bone mineral density remained low; however, the osteoblast marker P1NP was not increased 5 months after the start of teriparatide treatment.

  12. Spinal cord injury and Parkinson's disease: a population-based, propensity score-matched, longitudinal follow-up study.

    Yeh, T-S; Huang, Y-P; Wang, H-I; Pan, S-L

    2016-12-01

    To investigate whether patients with spinal cord injury (SCI) are at an increased risk of developing Parkinson's disease (PD). A population-based, propensity score-matched, longitudinal follow-up cohort study. The study was conducted using the National Health Insurance (NHI) Research Database. A total of 10 125 patients with at least 2 ambulatory visits with a diagnosis of SCI in 2001 were enrolled in the SCI group. The non-SCI group comprised 10 125 propensity score-matched patients without SCI. The propensity scores were computed using a logistic regression model that included age, sex, comorbidities and socioeconomic status. The PD-free survival rates of the two groups were estimated using the Kaplan-Meier method. Stratified Cox proportional hazard regression was used to estimate the effect of SCI on subsequent occurrence of PD. During the 3-year follow-up period, 99 subjects in the SCI group and 59 in the non-SCI group developed PD. The hazard ratio of PD for the SCI group compared with the non-SCI group was 1.65 (95% confidence interval 1.16-2.33, P=0.0049). The PD-free survival rate for the SCI group was lower than that for the non-SCI group (P=0.0017). This study shows that SCI is associated with a subsequent increased risk of PD. Further studies are needed to elucidate the mechanism underlying this association.

  13. Risk of developing obstructive sleep apnea among women with polycystic ovarian syndrome: a nationwide longitudinal follow-up study.

    Lin, Ting-Yang; Lin, Pei-Yin; Su, Tung-Ping; Li, Cheng-Ta; Lin, Wei-Chen; Chang, Wen-Hang; Chen, Tzeng-Ji; Bai, Ya-Mei; Chen, Mu-Hong

    2017-08-01

    Previous cross-sectional studies have suggested a comorbid relationship between polycystic ovarian syndrome (PCOS) and obstructive sleep apnea (OSA). However, the temporal association between these two distinct diseases has not yet been investigated. Using the Taiwan National Health Insurance Research Database, 4595 women with PCOS and 4595 (1:1) age-/sex-matched controls were enrolled into the present study between 1998 and 2009, and followed to the end of 2011. Those who developed OSA during the follow-up were identified. Women with PCOS had a greater incidence of developing OSA (1.71 vs 0.63 1000 person-years, p < 0.001) than those without PCOS. The Cox regression analysis after adjusting for demographic data and medical comorbidities showed that women with PCOS had an elevated likelihood of subsequent OSA (hazard ratio: 2.63, 95% CI 1.57-4.04) during the follow-up compared to the controls. Women with PCOS were associated with an increased risk of developing OSA in later life. Further studies would be required to investigate the underlying pathophysiology between PCOS and OSA, and to clarify whether prompt intervention for PCOS would reduce the risk of OSA. Copyright © 2017 Elsevier B.V. All rights reserved.

  14. The association between Modic changes and pain during 1-year follow-up in patients with lumbar radicular pain

    Schistad, Elina Iordanova; Roee, Cecilie; Espeland, Ansgar; Rygh, Lars Joergen; Gjerstad, Johannes

    2014-01-01

    To examine whether Modic changes influence pain during a 1-year follow-up in patients with lumbar radicular pain. A total of 243 patients with lumbar radicular pain due to disc herniation were recruited from two hospitals in Norway and followed up at 6 weeks, 6 months, and 12 months. On baseline lumbar magnetic resonance images, two observers independently evaluated Modic changes (types I-III; craniocaudal size 0-3). Outcomes were sensory pain (McGill Pain Questionnaire), back and leg pain (visual analogue scale, VAS). Association between Modic type and outcomes was explored with a mixed model and then by two-way analysis of variance (ANOVA) at each time point with Modic and treatment groups (surgical, n = 126; nonsurgical, n = 117) as fixed factors, adjusted for disc degeneration, age, sex, smoking, and duration of radicular pain. Modic size was also analyzed using ANOVA. Pain scores had decreased significantly at 1-year follow-up. Modic type was significantly related to McGill sensory scores (mixed model: p = 0.014-0.026; ANOVA: p = 0.007 at 6 weeks), but not to VAS back pain or VAS leg pain scores. At 6 weeks, the mean McGill sensory score was higher in Modic I than in Modic II-III patients (p = 0.003) and in patients without Modic changes (p = 0.018). Modic size L1-S1 was not associated with pain outcomes. Patients with lumbar radicular pain have a substantial pain reduction during 1-year follow-up, but Modic type I changes may imply a slower initial decrease in sensory pain. (orig.)

  15. The association between Modic changes and pain during 1-year follow-up in patients with lumbar radicular pain

    Schistad, Elina Iordanova; Roee, Cecilie [Oslo University Hospital, Department of Physical Medicine and Rehabilitation, Ullevaal, Nydalen, Postbox 4956, Oslo (Norway); University of Oslo, Faculty of Medicine, Oslo (Norway); Espeland, Ansgar [Haukeland University Hospital, Department of Radiology, Bergen (Norway); University of Bergen, Section for Radiology, Department of Clinical Medicine, Bergen (Norway); Rygh, Lars Joergen [Haukeland University Hospital, Department of Anesthesiology, Bergen (Norway); Gjerstad, Johannes [National Institute of Occupational Health, Oslo (Norway); University of Oslo, Department of Molecular Biosciences, Oslo (Norway)

    2014-09-15

    To examine whether Modic changes influence pain during a 1-year follow-up in patients with lumbar radicular pain. A total of 243 patients with lumbar radicular pain due to disc herniation were recruited from two hospitals in Norway and followed up at 6 weeks, 6 months, and 12 months. On baseline lumbar magnetic resonance images, two observers independently evaluated Modic changes (types I-III; craniocaudal size 0-3). Outcomes were sensory pain (McGill Pain Questionnaire), back and leg pain (visual analogue scale, VAS). Association between Modic type and outcomes was explored with a mixed model and then by two-way analysis of variance (ANOVA) at each time point with Modic and treatment groups (surgical, n = 126; nonsurgical, n = 117) as fixed factors, adjusted for disc degeneration, age, sex, smoking, and duration of radicular pain. Modic size was also analyzed using ANOVA. Pain scores had decreased significantly at 1-year follow-up. Modic type was significantly related to McGill sensory scores (mixed model: p = 0.014-0.026; ANOVA: p = 0.007 at 6 weeks), but not to VAS back pain or VAS leg pain scores. At 6 weeks, the mean McGill sensory score was higher in Modic I than in Modic II-III patients (p = 0.003) and in patients without Modic changes (p = 0.018). Modic size L1-S1 was not associated with pain outcomes. Patients with lumbar radicular pain have a substantial pain reduction during 1-year follow-up, but Modic type I changes may imply a slower initial decrease in sensory pain. (orig.)

  16. Effect of follow-up period on minimal-significant dose in the atomic-bomb survivor studies

    Cologne, John; Grant, Eric J.; Cullings, Harry M.; Ozasa, Kotaro [Radiation Effects Research Foundation, Hiroshima (Japan); Preston, Dale L. [Hirosoft International, Eureka, CA (United States)

    2018-03-15

    It was recently suggested that earlier reports on solid-cancer mortality and incidence in the Life Span Study of atomic-bomb survivors contain still-useful information about low-dose risk that should not be ignored, because longer follow-up may lead to attenuated estimates of low-dose risk due to longer time since exposure. Here it is demonstrated, through the use of all follow-up data and risk models stratified on period of follow-up (as opposed to sub-setting the data by follow-up period), that the appearance of risk attenuation over time may be the result of less-precise risk estimation - in particular, imprecise estimation of effect-modification parameters - in the earlier periods. Longer follow-up, in addition to allowing more-precise estimation of risk due to larger numbers of radiation-related cases, provides more-precise adjustment for background mortality or incidence and more-accurate assessment of risk modification by age at exposure and attained age. It is concluded that the latest follow-up data are most appropriate for inferring low-dose risk. Furthermore, if researchers are interested in effects of time since exposure, the most-recent follow-up data should be considered rather than the results of earlier reports. (orig.)

  17. Headache: an important factor associated with muscle soreness/pain at the two-year follow-up point among patients with major depressive disorder.

    Hung, Ching-I; Liu, Chia-Yih; Yang, Ching-Hui; Wang, Shuu-Jiun

    2016-01-01

    No study has compared the associations of headache, anxiety, and depression at baseline with muscle soreness or pain (MS/P) at baseline and at the two-year follow-up point among outpatients with major depressive disorder (MDD). This study aimed to investigate the above issue. This study enrolled 155 outpatients with MDD at baseline, and 131 attended a two-year follow-up appointment. At baseline, migraine was diagnosed based on the International Classification of Headache Disorders, 2(nd) edition. MDD and anxiety disorders were diagnosed using the Structured Clinical Interview for DSM-IV-TR. The visual analog scale was used to evaluate the intensities of headache and MS/P in the neck, shoulder, back, upper limbs, and lower limbs. Depression and anxiety were evaluated using the Hospital Anxiety and Depression Scale. Multiple linear regressions were used to compare the associations of these factors with MS/P. Compared with anxiety disorders, migraine was more strongly associated with MS/P in all areas at baseline and in the upper and lower limbs at follow-up. Headache intensity at baseline was the factor most strongly associated with MS/P in all areas at baseline and follow-up after controlling for depression and anxiety. Headache intensity at baseline predicted MS/P at baseline and follow-up. Migraine and headache intensity are important factors related to MS/P at baseline and follow-up among patients with MDD. Integrating depression and headache treatment might be indicated to improve MS/P.

  18. Social determinants of mental health: a Finnish nationwide follow-up study on mental disorders.

    Paananen, Reija; Ristikari, Tiina; Merikukka, Marko; Gissler, Mika

    2013-12-01

    Most mental disorders start in childhood and adolescence. Risk factors are prenatal and perinatal, genetic as well as environmental and family related. Research evidence is, however, insufficient to explain the life-course development of mental disorders. This study aims to provide evidence on factors affecting mental health in childhood and adolescence. The 1987 Finnish Birth Cohort covers all children born in Finland in 1987 (N=59 476) who were followed up until the age of 21 years. The study covers detailed health, social welfare and sociodemographic data of the cohort members and their parents from Finnish registers. Altogether, 7578 (12.7%) cohort members had had a diagnosed mental disorder. Several prenatal, perinatal and family-related risk factors for mental disorders were found, with sex differences. The main risk factors for mental disorders were having a young mother (OR 1.30 (1.16 to 1.47)), parents' divorce (OR 1.33 (1.26 to 1.41)), death of a parent (OR 1.27 (1.16 to 1.38)), parents' short education (OR 1.23(1.09 to 1.38)), childhood family receiving social assistance (OR 1.61 (1.52 to 1.71)) or having a parent treated at specialised psychiatric care (OR 1.47 (1.39 to 1.55)). Perinatal problem (OR 1.11 (1.01 to 1.22)) and prenatal smoking (OR 1.09 (1.02 to 1.16)) were risk factors for mental disorders, even after controlling for background factors. Elevated risk was seen if the cohort member had only basic education (OR 3.37 (3.14 to 3.62)) or had received social assistance (OR 2.45 (2.30 to 2.60)). Mental disorders had many social risk factors which are interlinked. Although family difficulties increased the risk for mental disorders, they were clearly determined by the cohort member's low education and financial hardship. This study provides evidence for comprehensive preventative and supporting efforts. Families with social adversities and with parental mental health problems should be supported to secure children's development.

  19. LOng-term follow-up after liVE kidney donation (LOVE) study: A longitudinal comparison study protocol

    S. Janki (Shiromani); K.W.J. Klop (Karel); H.J.A.N. Kimenai (Hendrikus); J. van de Wetering (Jacqueline); W. Weimar (Willem); E.K. Massey (Emma); A. Dehghan (Abbas); D. Rizopoulos (Dimitris); H. Völzke (Henry); A. Hofman (Albert); J.N.M. IJzermans (Jan)

    2016-01-01

    textabstractBackground: The benefits of live donor kidney transplantation must be balanced against the potential harm to the donor. Well-designed prospective studies are needed to study the long-term consequences of kidney donation. Methods: The "LOng-term follow-up after liVE kidney donation"

  20. Outcome of childhood anorexia nervosa-The results of a five- to ten-year follow-up study.

    Herpertz-Dahlmann, Beate; Dempfle, Astrid; Egberts, Karin Maria; Kappel, Viola; Konrad, Kerstin; Vloet, Jennifer Anne; Bühren, Katharina

    2018-04-01

    Although admissions of children with anorexia nervosa (AN) are increasing, there remains a dearth of up-to-date knowledge of the course and outcome of early-onset AN. The aim of the present study was to investigate the outcomes of patients with AN onset before the age of 14. Sixty-eight consecutive former patients who met the DSM-IV criteria for AN and who had been treated at one of three German university hospitals were asked to participate in a follow-up study. Body mass index, body height, outcome of the eating disorder (ED), psychiatric morbidity, and health related quality of life (HRQoL) were assessed through a personal examination after an average time span of 7.5 years (range: 4.5-11.5 years) after admission. One patient had died. Fifty-two subjects with a mean age of 12.5 (SD 1.0) years at admission and of 20.2 (SD 2.0) years at follow-up agreed to participate in the follow-up assessment, aggregating to 77.9% of the original sample. Approximately 41% of the participants had a good outcome, while 35% and 24% had intermediate and poor outcomes, respectively. Twenty-eight percent of the sample met the DSM-IV criteria for a current non-ED psychiatric disorder, and 64% met the criteria for a past non-ED psychiatric disorder. Mental HRQoL and ED-specific psychopathology was strongly associated with the outcome of AN. Average body height was below the normal range. A higher weight at admission was the only significant positive indicator of outcome. Childhood AN is a serious disorder with an unfavorable course in many patients and high rates of chronicity and psychiatric comorbidity in young adulthood. Early detection and intervention are urgently needed. © 2018 Wiley Periodicals, Inc.

  1. Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study.

    Chia-Wei Lin

    Full Text Available BACKGROUND: Prospective data on the association between ischemic stroke and ankylosing spondylitis (AS in the young are sparse. The purpose of this population-based, age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in young patients with AS. METHODS: A total of 4562 patients aged 18- to 45-year-old with at least two ambulatory visits in 2001 with a principal diagnosis of AS were enrolled in the AS group. The non-AS group consisted of 22810 age- and sex-matched, randomly sampled subjects without AS. The two-year ischemic stroke-free survival rate for each group were calculated using the Kaplan-Meier method. Cox proportional hazards regression analysis was used to estimate the hazard ratio of ischemic stroke after adjusting for demographic and clinical covariates. RESULTS: During follow-up, 21 patients in the AS group and 53 in the non-AS group developed ischemic stroke. The ischemic stroke-free survival rate over the 2 year follow-up was lower in the AS group than the non-AS group (p = 0.0021. The crude hazard ratio of ischemic stroke for the AS group was 1.98 (95% CI, 1.20-3.29; p = 0.0079 and the adjusted hazard ratio after controlling for demographic and comorbid medical disorders was 1.93 (95% CI, 1.16-3.20; p = 0.0110. CONCLUSION: Our study showed an increased risk of developing ischemic stroke in young patients with AS.

  2. Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study.

    Lin, Chia-Wei; Huang, Ya-Ping; Chiu, Yueh-Hsia; Ho, Yu-Tsun; Pan, Shin-Liang

    2014-01-01

    Prospective data on the association between ischemic stroke and ankylosing spondylitis (AS) in the young are sparse. The purpose of this population-based, age- and sex-matched longitudinal follow-up study was to investigate the risk of developing ischemic stroke in young patients with AS. A total of 4562 patients aged 18- to 45-year-old with at least two ambulatory visits in 2001 with a principal diagnosis of AS were enrolled in the AS group. The non-AS group consisted of 22810 age- and sex-matched, randomly sampled subjects without AS. The two-year ischemic stroke-free survival rate for each group were calculated using the Kaplan-Meier method. Cox proportional hazards regression analysis was used to estimate the hazard ratio of ischemic stroke after adjusting for demographic and clinical covariates. During follow-up, 21 patients in the AS group and 53 in the non-AS group developed ischemic stroke. The ischemic stroke-free survival rate over the 2 year follow-up was lower in the AS group than the non-AS group (p = 0.0021). The crude hazard ratio of ischemic stroke for the AS group was 1.98 (95% CI, 1.20-3.29; p = 0.0079) and the adjusted hazard ratio after controlling for demographic and comorbid medical disorders was 1.93 (95% CI, 1.16-3.20; p = 0.0110). Our study showed an increased risk of developing ischemic stroke in young patients with AS.

  3. Oral health knowledge, behaviors and parental practices among rural-urban migrant children in Guangzhou: a follow-up study.

    Pan, Ning; Cai, Li; Xu, Caijuan; Guan, Han; Jin, Yu

    2017-06-07

    Despite the growing number of rural-urban migrant children in China, follow-up observation on the oral health of migrant children is still scarce. This study described the changes of oral health knowledge, behaviors and parental practices in migrant children over a period of one year. Possible factors affecting changes were also investigated. The study used purposive sampling to select five private schools of migrant children in Guangzhou. A total of 1900 students in Grades 3 and 4 were recruited. A self-administered questionnaire was used in November 2011 to understand their basic situations, including oral health knowledge, behaviors and parental practices. A final survey was conducted in April 2013 to detect any changes. The mean accuracy of oral health knowledge was 53.17% and 59.42% in 2011 and 2013, respectively (p oral hygiene, dietary habits and parental practices increased at the follow-up evaluation (p oral health knowledge were more likely to achieve significantly positive changes in score of knowledge (p oral hygiene (beta estimate = 0.68, p parental practices in the baseline survey were more likely to obtain beneficial changes. No significant associations between demographic characteristics and changes of oral health knowledge and behaviors (p > 0.05) were observed. Oral health knowledge, behaviors and parental practices among migrant children significantly improved at the follow-up assessment. However, the overall situation was still poor. Positive and effective health education and prevention programs tailored to rural-urban migrant children with varying levels of oral health knowledge, behaviors and parental practices will be needed.

  4. BIOCHEMICAL CONTROL DURING LONG-TERM FOLLOW-UP OF 230 ADULT PATIENTS WITH CUSHING DISEASE: A MULTICENTER RETROSPECTIVE STUDY.

    Geer, Eliza B; Shafiq, Ismat; Gordon, Murray B; Bonert, Vivien; Ayala, Alejandro; Swerdloff, Ronald S; Katznelson, Laurence; Lalazar, Yelena; Manuylova, Ekaterina; Pulaski-Liebert, Karen J; Carmichael, John D; Hannoush, Zeina; Surampudi, Vijaya; Broder, Michael S; Cherepanov, Dasha; Eagan, Marianne; Lee, Jackie; Said, Qayyim; Neary, Maureen P; Biller, Beverly M K

    2017-08-01

    Cushing disease (CD) results from excessive exposure to glucocorticoids caused by an adrenocorticotropic hormone-secreting pituitary tumor. Inadequately treated CD is associated with significant morbidity and elevated mortality. Multicenter data on CD patients treated in routine clinical practice are needed to assess treatment outcomes in this rare disorder. The study purpose was to describe the burden of illness and treatment outcomes for CD patients. Eight pituitary centers in four U.S. regions participated in this multicenter retrospective chart review study. Subjects were CD patients diagnosed at ≥18 years of age within the past 20 years. Descriptive statistical analyses were conducted to examine presenting signs, symptoms, comorbidities, and treatment outcomes. Of 230 patients, 79% were female (median age at diagnosis, 39 years; range, 18 to 78 years). Length of follow-up was 0 to 27.5 years (median, 1.9 years). Pituitary adenomas were 0 to 51 mm. The most common presenting comorbidities included hypertension (67.3%), polycystic ovary syndrome (43.5%), and hyperlipidemia (41.5%). Biochemical control was achieved with initial pituitary surgery in 41.4% patients (91 of 220), not achieved in 50.0% of patients (110 of 220), and undetermined in 8.6% of patients (19 of 220). At the end of follow-up, control had been achieved with a variety of treatment methods in 49.1% of patients (110 of 224), not achieved in 29.9% of patients (67 of 224), and undetermined in 21.0% of patients (47 of 224). Despite multiple treatments, at the end of follow-up, biochemical control was still not achieved in up to 30% of patients. These multicenter data demonstrate that in routine clinical practice, initial and long-term control is not achieved in a substantial number of patients with CD. BLA = bilateral adrenalectomy CD = Cushing disease CS = Cushing syndrome eCRF = electronic case report form MRI = magnetic resonance imaging PCOS = polycystic ovary syndrome.

  5. Follow-Up Genotoxic Study: Chromosome Damage Two and Six Years after Exposure to the Prestige Oil Spill

    Hildur, Kristin; Templado, Cristina; Zock, Jan-Paul; Giraldo, Jesús; Pozo-Rodríguez, Francisco; Frances, Alexandra; Monyarch, Gemma; Rodríguez-Trigo, Gema; Rodriguez-Rodriguez, Emma; Souto, Ana; Gómez, Federico P.; Antó, Josep M.; Barberà, Joan Albert; Fuster, Carme

    2015-01-01

    Background The north-west coast of Spain was heavily contaminated by the Prestige oil spill, in 2002. Individuals who participated in the clean-up tasks showed increased chromosome damage two years after exposure. Long-term clinical implications of chromosome damage are still unknown. Objective To realize a follow-up genotoxic study to detect whether the chromosome damage persisted six years after exposure to the oil. Design Follow-up study. Setting Fishermen cooperatives in coastal villages. Participants Local fishermen who were highly exposed (n = 52) and non-exposed (n = 23) to oil seven years after the spill. Measurements Chromosome damage in circulating lymphocytes. Results Chromosome damage in exposed individuals persists six years after oil exposure, with a similar incidence than those previously detected four years before. A surprising increase in chromosome damage in non-exposed individual was found six years after Prestige spill vs. those detected two years after the exposure. Limitations The sample size and the possibility of some kind of selection bias should be considered. Genotoxic results cannot be extrapolated to the approximately 300,000 individuals who participated occasionally in clean-up tasks. Conclusion The persistence of chromosome damage detected in exposed individuals six years after oil exposure seems to indicate that the cells of the bone marrow are affected. A surprising increase in chromosome damage in non-exposed individuals detected in the follow-up study suggests an indirect exposition of these individuals to some oil compounds or to other toxic agents during the last four years. More long-term studies are needed to confirm the presence of chromosome damage in exposed and non-exposed fishermen due to the association between increased chromosomal damage and increased risk of cancer. Understanding and detecting chromosome damage is important for detecting cancer in its early stages. The present work is the first follow-up cytogenetic

  6. Follow-Up Genotoxic Study: Chromosome Damage Two and Six Years after Exposure to the Prestige Oil Spill.

    Kristin Hildur

    Full Text Available The north-west coast of Spain was heavily contaminated by the Prestige oil spill, in 2002. Individuals who participated in the clean-up tasks showed increased chromosome damage two years after exposure. Long-term clinical implications of chromosome damage are still unknown.To realize a follow-up genotoxic study to detect whether the chromosome damage persisted six years after exposure to the oil.Follow-up study.Fishermen cooperatives in coastal villages.Local fishermen who were highly exposed (n = 52 and non-exposed (n = 23 to oil seven years after the spill.Chromosome damage in circulating lymphocytes.Chromosome damage in exposed individuals persists six years after oil exposure, with a similar incidence than those previously detected four years before. A surprising increase in chromosome damage in non-exposed individual was found six years after Prestige spill vs. those detected two years after the exposure.The sample size and the possibility of some kind of selection bias should be considered. Genotoxic results cannot be extrapolated to the approximately 300,000 individuals who participated occasionally in clean-up tasks.The persistence of chromosome damage detected in exposed individuals six years after oil exposure seems to indicate that the cells of the bone marrow are affected. A surprising increase in chromosome damage in non-exposed individuals detected in the follow-up study suggests an indirect exposition of these individuals to some oil compounds or to other toxic agents during the last four years. More long-term studies are needed to confirm the presence of chromosome damage in exposed and non-exposed fishermen due to the association between increased chromosomal damage and increased risk of cancer. Understanding and detecting chromosome damage is important for detecting cancer in its early stages. The present work is the first follow-up cytogenetic study carried out in lymphocytes to determine genotoxic damage evolution between two

  7. Radiological evaluation of cartilage after microfracture treatment: A long-term follow-up study

    Von Keudell, A.; Atzwanger, J.; Forstner, R.; Resch, H.; Hoffelner, T.; Mayer, M.

    2012-01-01

    Introduction: Recent literature revealed good short-term results after microfracturing (MFX) of isolated focal cartilage defects in the knee joint. Study purpose was a long-term evaluation of patients who received MFX through a multimodal approach, correlating clinical scores and morphological pre- and postoperative MRI-scans. Materials and methods: Between 2000 and 2007 158 patients were treated with MFX for focal femoral or tibial defects at our department. Patients with instabilities, secondary surgical intervention, patellofemoral lesions, a plica mediopatellaris or more than one cartilage defect site and age >55 were excluded. 15 patients were included. Minimum postoperative follow-up (FU) was 18 months (18–78 m). Mean age at surgery was 45 years (27–54), mean FU-interval 48 months (18–78 m). Male to female ratio was 9:6. For clinical assessment the Knee Osteoarthritis Outcome Score (KOOS) and Lysholm Score were used, radiological evaluation was performed with radiographs and 3Tesla-MRI. Results: Clinical knee function was rated good to excellent in 1 patient, fair in 2 and poor in 10 patients. 2/15 patients received full knee replacement due to insufficient cartilage repair through MFX during FU period. Evaluation of pre- and postoperative MRI showed good cartilage repair tissue in 1 (7.7%), moderate repair in 2 (15.4%) and poor fill in 10 patients (76.9%). In these 10 patients the defect size increased. Average defect size preoperatively was 187 mm 2 (range 12–800 mm 2 ) and postoperatively 294 mm 2 (40–800 mm 2 ). The KOOS-Pain averaged 60 (39–94), KOOS-Symptoms 60.6 (21–100), KOOS-ADL 69 (21–91), KOOS-Sports 35.7 (5–60) and KOOS-QUL 37.2 (6–81). The average Lysholm Score was 73.9 (58–94). 10 patients showed a varus leg axis deviation (Ø 5.9°), 3 had a neutral alignment. The alignment correlated positively with KOOS and especially with the Lysholm Score. Conclusion: Our study demonstrated that MFX as a treatment option for cartilage

  8. Inconvenience due to travelers' diarrhea: a prospective follow-up study

    Soonawala Darius

    2011-11-01

    Full Text Available Abstract Background Limited data exist documenting the degree to which travelers are inconvenienced by travelers' diarrhea (TD. We performed a prospective follow-up study at the travel clinic of Leiden University Medical Center in The Netherlands to determine the degree of inconvenience and to determine how experiencing TD affects travelers' perception. Methods Healthy adults who intended to travel to the (subtropics for less than two months were invited to take part. Participants filled out a web-based questionnaire before departure and after returning home. TD was defined as three or more unformed stools during a 24-hour period. Results 390 of 776 Eligible travelers completed both questionnaires. Participants' median age was 31 years and mean travel duration 23 days. Of 160 travelers who contracted TD (incidence proportion 41%, median duration of TD episode 2.5 days the majority (107/160, 67% could conduct their activity program as planned despite having diarrhea. However, 21% (33/160 were forced to alter their program and an additional 13% (20/160 were confined to their accommodation for one or more daylight days; 53 travelers (33% used loperamide and 14 (9% an antibiotic. Eight travelers (5% consulted a physician for the diarrheal illness. When asked about the degree of inconvenience brought on by the diarrheal illness, 39% categorized it as minor or none at all, 34% as moderate and 27% as large or severe. In those who regarded the episode of TD a major inconvenience, severity of symptoms was greater and use of treatment and necessity to alter the activity program were more common. Travelers who contracted travelers' diarrhea considered it less of a problem in retrospect than they had thought it would be before departure. Conclusion Conventional definitions of TD encompass many mild cases of TD (in our study at least a third of all cases for which treatment is unlikely to provide a significant health benefit. By measuring the degree of

  9. Inconvenience due to travelers' diarrhea: a prospective follow-up study.

    Soonawala, Darius; Vlot, Jessica A; Visser, Leo G

    2011-11-20

    Limited data exist documenting the degree to which travelers are inconvenienced by travelers' diarrhea (TD). We performed a prospective follow-up study at the travel clinic of Leiden University Medical Center in The Netherlands to determine the degree of inconvenience and to determine how experiencing TD affects travelers' perception. Healthy adults who intended to travel to the (sub)tropics for less than two months were invited to take part. Participants filled out a web-based questionnaire before departure and after returning home. TD was defined as three or more unformed stools during a 24-hour period. 390 of 776 Eligible travelers completed both questionnaires. Participants' median age was 31 years and mean travel duration 23 days. Of 160 travelers who contracted TD (incidence proportion 41%, median duration of TD episode 2.5 days) the majority (107/160, 67%) could conduct their activity program as planned despite having diarrhea. However, 21% (33/160) were forced to alter their program and an additional 13% (20/160) were confined to their accommodation for one or more daylight days; 53 travelers (33%) used loperamide and 14 (9%) an antibiotic. Eight travelers (5%) consulted a physician for the diarrheal illness. When asked about the degree of inconvenience brought on by the diarrheal illness, 39% categorized it as minor or none at all, 34% as moderate and 27% as large or severe. In those who regarded the episode of TD a major inconvenience, severity of symptoms was greater and use of treatment and necessity to alter the activity program were more common. Travelers who contracted travelers' diarrhea considered it less of a problem in retrospect than they had thought it would be before departure. Conventional definitions of TD encompass many mild cases of TD (in our study at least a third of all cases) for which treatment is unlikely to provide a significant health benefit. By measuring the degree of inconvenience brought on by TD, researchers and policy makers

  10. Weight Fluctuation and Postmenopausal Breast Cancer in the National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study

    Marina Komaroff

    2016-01-01

    Full Text Available Objective. The aim of this study is to investigate if weight fluctuation is an independent risk factor for postmenopausal breast cancer (PBC among women who gained weight in adult years. Methods. NHANES I Epidemiologic Follow-Up Study (NHEFS database was used in the study. Women that were cancers-free at enrollment and diagnosed for the first time with breast cancer at age 50 or greater were considered cases. Controls were chosen from the subset of cancers-free women and matched to cases by years of follow-up and status of body mass index (BMI at 25 years of age. Weight fluctuation was measured by the root-mean-square-error (RMSE from a simple linear regression model for each woman with their body mass index (BMI regressed on age (started at 25 years while women with the positive slope from this regression were defined as weight gainers. Data were analyzed using conditional logistic regression models. Results. A total of 158 women were included into the study. The conditional logistic regression adjusted for weight gain demonstrated positive association between weight fluctuation in adult years and postmenopausal breast cancers (odds ratio/OR = 1.67; 95% confidence interval/CI: 1.06–2.66. Conclusions. The data suggested that long-term weight fluctuation was significant risk factor for PBC among women who gained weight in adult years. This finding underscores the importance of maintaining lost weight and avoiding weight fluctuation.

  11. Forensic state patients at Sterkfontein Hospital: A 3-year follow-up study

    Belinda Marais

    2015-08-01

    Full Text Available Background. State patients are individuals who have been charged with offences involving serious violence and who have been declared unfit to stand trial and/or who are not criminally responsible because of their mental illness or defect. They are referred by the courts for treatment, rehabilitation and indefinite detention at a forensic psychiatric facility. However, many of these state patients may ultimately be released back into the community. As these individuals may be considered a high-risk group, their rates of relapse and recidivism are of importance. There is a paucity of South African literature on the long-term outcome of state patients.  Objective. To describe the profile of state patients, and to examine their outcomes after 3 years, including recidivism rates.  Methods. A descriptive, retrospective study of the clinical records of 114 state patients admitted to Sterkfontein Hospital in 2004 and 2005 was conducted, and their profile and 3-year outcomes were determined. Results. The majority of state patients were male, single, unemployed, had a past psychiatric history (59%, and substance abuse history (71%. A third reported a past criminal history. The most common offences were assault with the intention to do grievous bodily harm (19%, rape (18% and murder (13%. Psychotic disorders represented the most common diagnostic category (69%, with schizophrenia being the most frequent diagnosis (44%. Most state patients had been found unfit to stand trial (96% and not criminally responsible (89%. At the end of the 3-year follow-up, the majority were in the community (69%, of whom most (72% were out on leave of absence (LOA, while a quarter had absconded and a minority were reclassified (3%. Most absconders (83% were state patients who had not returned from LOA. The recidivism rate was 4%.  Conclusion. Most state patients were out in the community at the end of the 3-year period. The following recommendations are suggested: improved

  12. Cancer among Scandinavian women with cosmetic breast implants: a pooled long-term follow-up study.

    Lipworth, Loren; Tarone, Robert E; Friis, Søren; Ye, Weimin; Olsen, Jørgen H; Nyren, Olof; McLaughlin, Joseph K

    2009-01-15

    No increased risks of specific types of cancer following breast implantation have been consistently reported, but data on risk beyond 15 years are limited. We have pooled the results of 2 nationwide cohort studies of 3,486 Swedish and 2,736 Danish women who underwent cosmetic breast implantation between 1965 and 1993. Cancer incidence through 2002 was ascertained through nationwide cancer registries. Standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were calculated to compare cancer incidence among women with implants with women in the general population. Mean duration of follow up was 16.6 years (range 0.1-37.8 years). Over 50% of women were followed for 15 years or more after breast implantation and 13.3% for at least 25 years. There was a reduced incidence of breast cancer (SIR=0.73; 95% CI 0.58-0.90), whereas lung cancer was above expectation (SIR=1.64; 95% CI 1.10-2.36). The increased risk of lung cancer is expected due to the high prevalence of smoking among the women with implants in our study. With respect to other site-specific cancers, no significantly increased or decreased SIR was observed. This study, which includes women followed for almost 4 decades, represents the longest follow up of women with cosmetic breast implants to date. The results provide no evidence of an association between breast implants and any type of cancer. Copyright (c) 2008 Wiley-Liss, Inc.

  13. Risk of death among children of atomic bomb survivors after 62 years of follow-up: a cohort study.

    Grant, Eric J; Furukawa, Kyoji; Sakata, Ritsu; Sugiyama, Hiromi; Sadakane, At