The risk of newly developed visual impairment in treated normal-tension glaucoma: 10-year follow-up.

Science.gov (United States)

Choi, Yun Jeong; Kim, Martha; Park, Ki Ho; Kim, Dong Myung; Kim, Seok Hwan

2014-12-01

To investigate the risk and risk factors for newly developed visual impairment in treated patients with normal-tension glaucoma (NTG) followed up on for 10 years. Patients with NTG, who did not have visual impairment at the initial diagnosis and had undergone intraocular pressure (IOP)-lowering treatment for more than 7 years, were included on the basis of a retrospective chart review. Visual impairment was defined as either low vision (0.05 [20/400] ≤ visual acuity (VA) visual field (VF) visual impairment, Kaplan-Meier survival analysis and generalized linear mixed effects models were utilized. During the 10.8 years mean follow-up period, 20 eyes of 16 patients were diagnosed as visual impairment (12 eyes as low vision, 8 as blindness) among 623 eyes of 411 patients. The cumulative risk of visual impairment in at least one eye was 2.8% at 10 years and 8.7% at 15 years. The risk factors for visual impairment from treated NTG were worse VF mean deviation (MD) at diagnosis and longer follow-up period. The risk of newly developed visual impairment in the treated patients with NTG was relatively low. Worse VF MD at diagnosis and longer follow-up period were associated with development of visual impairment. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Observed changes in cardiovascular risk factors among high-risk middle-aged men who received lifestyle counselling: a 5-year follow-up.

Science.gov (United States)

Siren, Reijo; Eriksson, Johan G; Vanhanen, Hannu

2016-12-01

To examine the long-term impact of health counselling among middle-aged men at high risk of CVD. An observational study with a 5-year follow-up. All men aged 40 years in Helsinki have been invited to a visit to evaluate CVD risk from 2006 onwards. A modified version of the North Karelia project risk tool (CVD risk score) served to assess the risk. High-risk men received lifestyle counselling based on their individual risk profile in 2006 and were invited to a follow-up visit in 2011. Of the 389 originally high-risk men, 159 participated in the follow-up visits in 2011. Based on their follow-up in relation the further risk communication, we divided the participants into three groups: primary health care, occupational health care and no control visits. Lifestyle and CVD risk score change. All groups showed improvements in lifestyles. The CVD risk score decreased the most in the group that continued the risk communication visits in their primary health care centre (6.1 to 4.8 [95% CI -1.6 to -0.6]) compared to those who continued risk communication visits in their occupational health care (6.0 to 5.4 [95% CI -1.3 to 0.3]), and to those with no risk communication visits (6.0 to 5.9 [95% CI -0.5 to 0.4]). These findings indicate that individualized lifestyle counselling improves health behaviour and reduces total CVD risk among middle-aged men at high risk of CVD. Sustained improvement in risk factor status requires ongoing risk communication with health care providers. KEY POINTS Studies of short duration have shown that lifestyle changes reduce the risk of cardiovascular disease among high-risk individuals. Sustaining these lifestyle changes and maintaining the lower disease risk attained can prove challenging. Cardiovascular disease (CVD) risk assessment and individualized health counselling for high-risk men, when implemented in primary health care, have the potential to initiate lifestyle changes that support risk reduction. Attaining a sustainable reduction in CVD

Long term follow-up after synovectomy with Y-90 in patients with arthritis

International Nuclear Information System (INIS)

Budihna, N.V.; Golja-Kos, M.; Batagelj, I.

1994-01-01

The purpose of the study was to evaluate the success rate of synoviorthesis in 273 patients with painful and swollen large joints (jts), up to nine years after the intraarticular application of Y-90. 402 knees, and 64 shoulders or ankles were treated. Rheumatoid arthritis was present in 449 jts, 64 jts were afflicted by osteoarthritis or other rheumatic diseases. 185 MBq were applied in knees and shoulders and 111 MBq of Y-90 in ankles. The effect of therapy was evaluated considering the degree of morning stiffness, pain and swelling. The effect of therapy was moderate in 42.5%%, good in 30.6% and very good in 14.9%% of jts. There was no improvement noted in 11.8%% of jts. The duration of improvement was in average 2.8 years. In 11 %% of pts the improvement lasted 6-9 years after therapy. Transient side effects were noted in 5.6%% of pts, pain and swelling were most frequent. Malignant diseases developed during the follow-up period (less than 4 years) in three pts. We conclude that radioisotopic synoviorthesis mostly has a satisfactory effect with mean duration of 2.8 years. Serious side effects were rare. (author)

Fast food consumption and the risk of metabolic syndrome after 3-years of follow-up: Tehran Lipid and Glucose Study.

Science.gov (United States)

Bahadoran, Z; Mirmiran, P; Hosseini-Esfahani, F; Azizi, F

2013-12-01

There are growing concern globally regarding fast food consumption and its related cardiometabolic outcomes. In this study we investigated whether fast food consumption could affect the occurrence of metabolic syndrome (MetS) after 3-years of follow-up in adults. This longitudinal study was conducted in the framework of Tehran Lipid and Glucose Study on 1476 adults, aged 19-70 y. The usual intakes of participants were measured using a validated semi-quantitative food frequency questionnaire at baseline. Biochemical and anthropometric measurements were assessed at baseline (2006-2008) and 3 years later (2009-2011). Multiple logistic regression models were used to estimate the occurrence of the MetS in each quartile of fast food consumption. The mean age of participants was 37.8±12.3 y, and mean BMI was 26.0±4.5 kg/m(2) at baseline. Participants in the highest quartile of fast food consumption were younger (33.7 vs 43.4 years, Pconsumption of fast food was accompanied with more increase in serum triglyceride levels and triglyceride to HDL-C ratio after the 3-year follow-up. After adjustment for all potential confounding variables, the risk of metabolic syndrome, in the highest quartile of fast foods compared with the lowest, was 1.85 (95% CI=1.17-2.95). The effects of fast food consumption on the occurrence of MetS were more pronounced in younger adults (foods or had low-fiber diet (Pconsumption of fast foods had undesirable effects on metabolic syndrome after 3-years of follow-up in Iranian adults.

HFE C282Y/H63D compound heterozygotes are at low risk of hemochromatosis-related morbidity.

Science.gov (United States)

Gurrin, Lyle C; Bertalli, Nadine A; Dalton, Gregory W; Osborne, Nicholas J; Constantine, Clare C; McLaren, Christine E; English, Dallas R; Gertig, Dorota M; Delatycki, Martin B; Nicoll, Amanda J; Southey, Melissa C; Hopper, John L; Giles, Graham G; Anderson, Gregory J; Olynyk, John K; Powell, Lawrie W; Allen, Katrina J

2009-07-01

The risk of hemochromatosis-related morbidity is unknown among HFE compound heterozygotes (C282Y/H63D). We used a prospective population-based cohort study to estimate the prevalence of elevated iron indices and hemochromatosis-related morbidity for compound heterozygotes. In all, 31,192 subjects of northern European descent were genotyped for HFE C282Y and H63D. An HFE-genotype stratified random sample of 1,438 subjects, followed for an average of 12 years to a mean age of 65 years, completed questionnaires and gave blood. Clinical examinations were blinded to HFE genotype. A total of 180 (84 males) clinically examined C282Y/H63D participants were compared with 330 (149 males) controls with neither HFE mutation; 132 (65 males) and 270 (122 males), respectively, had serum iron measures at both timepoints. Mean serum ferritin (SF) and transferrin saturation (TS) were significantly greater for male and female compound heterozygotes than for wild-types at baseline and follow-up (all P females who were premenopausal at baseline, where SF was similar in both genotype groups. For subjects with serum measures from both baseline and follow-up, mean SF and TS levels did not change significantly for men or for postmenopausal women, but for premenopausal women SF levels increased from 43 to 109 microg/L for compound heterozygotes and from 35 to 64 microg/L for wild-types (both P female compound heterozygotes had a similar prevalence of hemochromatosis-related morbidity to wild-types. One of 82 males and zero of 95 females had documented iron overload-related disease. For male compound heterozygotes, mean iron indices do not change during middle age but for female compound heterozygotes menopause results in increased mean SF. Although compound heterozygotes might maintain elevated iron indices during middle age, documented iron overload-related disease is rare.

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

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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.

Mortality risk in the french cohort of uranium miners: extended follow-up 1946-1999

International Nuclear Information System (INIS)

Blandine Vacquier; Dominique Laurier; Sylvaine Caer; Benoit Quesne

2006-01-01

Since the 1970's, exposure to radon and to its radioactive decay products has been studied in relation to lung cancer risk among cohorts of miners [1-3]. These studies concluded that cumulative exposure to radon was associated with an increased risk of death from lung cancer. In 1988, the International Agency for Research on Cancer (IARC) classified radon as a known pulmonary human carcinogen [4]. The French cohort of uranium miners has been established in order to assess the mortality risk of miners exposed to low levels of radon and its decay products as well as to other occupational hazards. The primary aim of the cohort study is the quantification of the relationship between cumulated radon exposure and risk of lung cancer death. The study has been conducted by the Institut de Radioprotection et de Surete Nucleaire (IRSN) since 1982, in collaboration with the Occupational Medical Service of COGEMA. The French Data Protection Authority (CNIL) gave approval for this study. Previous analyses have demonstrated an excess of lung cancer death associated with radon exposure. These results regarding lung cancer have been presented in several publications and congress [5-11]. In 2004, the follow-up of this cohort was extended from 31 December 1994 through 31 December 1999. The extension of the follow-up increases the statistical power of the cohort. The present article describes the extended cohort and the analysis of mortality based on the follow-up of the cohort to end of 1999. (authors)

The cost of long-term follow-up of high-risk infants for research studies.

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Doyle, Lex W; Clucas, Luisa; Roberts, Gehan; Davis, Noni; Duff, Julianne; Callanan, Catherine; McDonald, Marion; Anderson, Peter J; Cheong, Jeanie L Y

2015-10-01

Neonatal intensive care is expensive, and thus it is essential that its long-term outcomes are measured. The costs of follow-up studies for high-risk children who survive are unknown. This study aims to determine current costs for the assessment of health and development of children followed up in our research programme. Costs were determined for children involved in the research follow-up programme at the Royal Women's Hospital, Melbourne, over the 6-month period between 1st January 2012 and 30th June 2012. The time required for health professionals involved in assessments in early and later childhood was estimated, and converted into dollar costs. Costs for equipment and data management were added. Estimated costs were compared with actual costs of running the research follow-up programme. A total of 134 children were assessed over the 6-month period. The estimated average cost per child assessed was $1184, much higher than was expected. The estimated cost to assess a toddler was $1149, whereas for an 11-year-old it was $1443, the difference attributable to the longer psychological and paediatric assessments. The actual average cost per child assessed was $1623. The shortfall of $439 between the actual and estimated average costs per child arose chiefly because of the need to pay staff even when participants were late or failed to attend. The average costs of assessing children at each age for research studies are much higher than expected. These data are useful for planning similar long-term follow-up assessments for high-risk children. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

Follow Up for Emergency Department Patients After Intravenous Contrast and Risk of Nephropathy

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Getaw Worku Hassen

2014-05-01

poor outpatient follow up after CT of AP with IV contrast and biochemically CIN appears to be present in some patients. Unlike previous reports that CKD is the major risk factor for CIN, our results demonstrated that risk factors such as advanced age, DM and hypertension seem to predispose patients to CIN rather than abnormal baseline SCr.

Mortality risk in a historical cohort of nuclear power plant workers in Germany: results from a second follow-up

Energy Technology Data Exchange (ETDEWEB)

Merzenich, Hiltrud; Troeltzsch, Katrin; Ruecker, Kai; Buncke, Johanna; Blettner, Maria [University Medical Center Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz (Germany); Hammer, Gael P. [University Medical Center Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz (Germany); Laboratoire National de Sante E.P., Registre Morphologique des Tumeurs, Dudelange (Luxembourg); Fehringer, Franz [Berufsgenossenschaft Energie Textil Elektro Medienerzeugnisse (BGETEM), Cologne (Germany)

2014-05-15

Possible health effects of low and protracted doses of ionizing radiation are relevant for persons who are exposed to an occupational context like nuclear industry workers. A historical cohort study was therefore conducted to examine mortality risks following occupational radiation exposure among 4,844 German nuclear power plant workers. This cohort included workers from ten nuclear power plants with an observational period from 1991 until 1997. The results of an enlarged cohort with 8,972 workers from all 17 nuclear power plants in West Germany are now available. During the extended follow-up period from 1991 to 2008, a total of 310 deaths among men were observed. The standardized mortality ratio (SMR) from all causes of deaths was estimated at 0.50 [95 % confidence interval (CI) 0.45-0.56]. A total of 126 deaths due to cancer occurred (SMR = 0.65; 95 % CI 0.51-0.82) and seven deaths due to leukemia (SMR = 1.23; 95 % CI 0.42-2.84). Overall, a reduced mortality compared to the general population of West Germany was observed indicating a healthy worker effect. In the dose-response analysis, no statistically significant risk due to ionizing radiation was seen. The hazard ratio (HR/mSv) for leukemia excluding chronic lymphocytic leukemia was estimated at 1.004 (95 % CI 0.997-1.011). In conclusion, the cohort is small and made up of young workers, most of whom were still employed at the end of the observational period in 2008. Results of the external analysis are difficult to interpret as influenced by a healthy worker effect. In the internal analysis, no excess of risk due to radiation was detected. (orig.)

Mortality risk in a historical cohort of nuclear power plant workers in Germany: results from a second follow-up

International Nuclear Information System (INIS)

Merzenich, Hiltrud; Troeltzsch, Katrin; Ruecker, Kai; Buncke, Johanna; Blettner, Maria; Hammer, Gael P.; Fehringer, Franz

2014-01-01

Possible health effects of low and protracted doses of ionizing radiation are relevant for persons who are exposed to an occupational context like nuclear industry workers. A historical cohort study was therefore conducted to examine mortality risks following occupational radiation exposure among 4,844 German nuclear power plant workers. This cohort included workers from ten nuclear power plants with an observational period from 1991 until 1997. The results of an enlarged cohort with 8,972 workers from all 17 nuclear power plants in West Germany are now available. During the extended follow-up period from 1991 to 2008, a total of 310 deaths among men were observed. The standardized mortality ratio (SMR) from all causes of deaths was estimated at 0.50 [95 % confidence interval (CI) 0.45-0.56]. A total of 126 deaths due to cancer occurred (SMR = 0.65; 95 % CI 0.51-0.82) and seven deaths due to leukemia (SMR = 1.23; 95 % CI 0.42-2.84). Overall, a reduced mortality compared to the general population of West Germany was observed indicating a healthy worker effect. In the dose-response analysis, no statistically significant risk due to ionizing radiation was seen. The hazard ratio (HR/mSv) for leukemia excluding chronic lymphocytic leukemia was estimated at 1.004 (95 % CI 0.997-1.011). In conclusion, the cohort is small and made up of young workers, most of whom were still employed at the end of the observational period in 2008. Results of the external analysis are difficult to interpret as influenced by a healthy worker effect. In the internal analysis, no excess of risk due to radiation was detected. (orig.)

Ecotoxicological survey of MNEI and Y65R-MNEI proteins as new potential high-intensity sweeteners.

Science.gov (United States)

Rega, Michele Fortunato; Siciliano, Antonietta; Gesuele, Renato; Lofrano, Giusy; Carpentieri, Andrea; Picone, Delia; Guida, Marco

2017-04-01

Low-calorie sweeteners are widespread. They are routinely introduced into commonly consumed food such as diet sodas, cereals, and sugar-free desserts. Recent data revealed the presence in considerable quantities of some of these artificial sweeteners in water samples qualifying them as a class of potential new emerging contaminants. This study aimed at evaluating the ecotoxicity profile of MNEI and Y65R-MNEI, two engineered products derived from the natural protein monellin, employing representative test organism such as Daphnia magna, Ceriodaphnia dubia, and Raphidocelis subcapitata. Potential genotoxicity and mutagenicity effects on Salmonella typhimurium (strain TA97a, TA98, TA100, and TA1535) and Escherichia coli (strain WP2 pkM101) were evaluated. No genotoxicity effects were detected, whereas slight mutagenicity was highlighted by TA98 S. typhimurium. Ecotoxicity results evidenced effects approximately up to 14 and 20% with microalgae at 500 mg/L of MNEI and Y65R-MNEI, in that order. Macrophytes and crustaceans showed no significant effects. No median effective concentrations were determined. Overall, MNEI and Y65R-MNEI can be classified as not acutely toxic for the environment.

Opioids, antiepileptic and anticholinergic drugs and the risk of fractures in patients 65 years of age and older: a prospective population-based study.

Science.gov (United States)

Nurminen, Janne; Puustinen, Juha; Piirtola, Maarit; Vahlberg, Tero; Lyles, Alan; Kivelä, Sirkka-Liisa

2013-05-01

in men, the concomitant use of two or more benzodiazepines or two or more antipsychotics is associated with an increased risk of fracture(s). Potential associations between the concomitant use of drugs with central nervous system effects and fracture risk have not been studied. the purpose was to describe the gender-specific risk of fractures in a population aged 65 years or over associated with the use of an opioid, antiepileptic or anticholinergic drug individually; or, their concomitant use with each other; or the concomitant use of one of these with a psychotropic drug. this study was part of a prospective, population-based study performed in Lieto, Finland. Information about fractures in 1,177 subjects (482 men and 695 women) was confirmed with radiology reports. at 3 years of follow-up, the concomitant use of an opioid with an antipsychotic was associated with an increased risk of fractures in men. During the 6-year follow-up, the concomitant use of an opioid with a benzodiazepine was also related to the risk of fractures for males. No significant associations were found for females. the concomitant use of an opioid with an antipsychotic, or with a benzodiazepine may increase the risk of fractures in men aged 65 years and older.

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

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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.

Risk of cervical cancer after completed post-treatment follow-up of cervical intraepithelial neoplasia

DEFF Research Database (Denmark)

Rebolj, Matejka; Helmerhorst, Theo; Habbema, Dik

2012-01-01

To compare the risk of cervical cancer in women with histologically confirmed cervical intraepithelial neoplasia who returned to routine screening after having completed post-treatment follow-up with consecutive normal smear test results with women with a normal primary smear test result....

Long-term psychological impact of carrying a BRCA1/2 mutation and prophylactic surgery: a 5-year follow-up study

NARCIS (Netherlands)

van Oostrom, Iris; Meijers-Heijboer, Hanne; Lodder, Litanja N.; Duivenvoorden, Hugo J.; van Gool, Arthur R.; Seynaeve, Caroline; van der Meer, Conny A.; Klijn, Jan G. M.; van Geel, Bert N.; Burger, Curt W.; Wladimiroff, Juriy W.; Tibben, Aad

2003-01-01

To explore long-term psychosocial consequences of carrying a BRCA1/2 mutation and to identify possible risk factors for long-term psychological distress. Five years after genetic test disclosure, 65 female participants (23 carriers, 42 noncarriers) of our psychological follow-up study completed a

Job strain and risk of cardiovascular events in treated hypertensive Japanese workers: hypertension follow-up group study.

Science.gov (United States)

Uchiyama, Shuji; Kurasawa, Takashi; Sekizawa, Toshihiro; Nakatsuka, Hiroshi

2005-03-01

In Japan, Karoshi, which means "death from overwork", has become a focus of social concern. However, no previous study has examined long working hours and job strain simultaneously in relation to incidence of cardiovascular events (CVE) in Japanese workers. We prospectively evaluated the relation between job strain or long working hours and risk of CVE in treated hypertensives during the years 1994-2000. In this study, we followed a sample of 1,615 participants (908 men and 707 women) aged 40-65 yr who were working more than 5 working hours per day. Participants completed questions about work-related conditions and lifestyle variables at baseline, and were free of diagnosed cardiovascular disease, stroke or cancer. Job strain (the combination of job demands and job control) was assessed using a simple questionnaire developed with reference to Karasek's model. The main outcome measure was incidence of CVE. During the mean follow-up period of 5.6 yr, we documented 38 cases of initial CVE. Analyses were conducted using the Cox proportional hazard model. We found a significant association between incidence of CVE and job strain categories, but not long working hours. Multivariate relative risks for CVE in active jobs and high strain jobs overall were 2.89 (95% CI: 1.33-6.28) and 2.45 (95% CI: 0.87-6.93); for men 2.94 (95% CI: 1.29-6.73) and 1.86 (95% CI: 0.51-6.75), and for women 3.97 (95% CI: 0.34-46.88) and 9.05 (95% CI: 1.17-69.86), respectively. In conclusion, active jobs and high strain jobs were associated with increased risk of CVE for treated hypertensive workers.

Prevalence of cardiovascular risk factors in long-term survivors of childhood cancer: 16 years follow up from a prospective registry.

Science.gov (United States)

Felicetti, Francesco; D'Ascenzo, Fabrizio; Moretti, Claudio; Corrias, Andrea; Omedè, Pierluigi; Marra, Walter Grosso; Arvat, Emanuela; Fagioli, Franca; Brignardello, Enrico; Gaita, Fiorenzo

2015-06-01

Childhood cancer survivors (CCSs) have an increased risk of overweight and dyslipidaemia, but the distribution and the potential relationships between anticancer therapies and cardiovascular risk factors have been heterogeneously and not prospectively described. All consecutive CCSs with primary cancer diagnosed between 1973-2007 and subsequently referred to our outpatient clinic were enrolled. Hypercholesterolaemia (total cholesterol >200 and/or low density lipoprotein (LDL)>160 mg/dl) was the primary end point, hypertriglyceridaemia (triglycerides >200 mg/dl) and body mass index >30 kg/m(2) the secondary end points. Cox multivariate adjustments were performed to account for differences in cancer and treatments. A total of 340 patients were included (197 male, 143 female; mean age at last follow-up 24.1 ± 3.2). The most common diagnosis were haematological malignancies (n = 227) and brain tumours (n = 51). After a median follow-up of 16.1 years, hypercholesterolaemia was diagnosed in 67 CCSs (20%), hypertriglyceridaemia in 20 CCSs (6%) and obesity in 28 CCSs (8%). Total body irradiation and growth hormone deficiency increased the risk of both hypercholesterolaemia (hazard ratio (HR) = 2.7; confidence interval (CI) 1.2-4.4 and HR = 2.3; CI 1.1-4.9; all p < 0.05) and hypertriglyceridaemia (HR = 6.5; CI 1.4-31 and HR = 7.2; CI 1.1-43; all p < 0.05). The risk of hypercholesterolaemia was also higher in CCSs who underwent autologous haematopoietic stem cell transplantation (HR = 3.2; CI 1.7-5.9; p < 0.001) or platinum-based chemotherapy (HR = 2.7; CI 1.5-4.9; p < 0.001), whereas a previous diagnosis of brain tumour (HR = 10; CI 1.2-45; p < 0.05) and anthracyclines exposure (HR = 1.3; CI 1.2-26; p < 0.05) significantly predicted obesity. CCSs show a high and variable risk for developing dyslipidaemia and obesity, depending on cancer diagnosis and treatments. Therefore, they need accurate and tailored control of their cardiovascular risk profile. © The European Society

Risk of subsequent ischemic and hemorrhagic stroke in patients hospitalized for immune-mediated diseases: a nationwide follow-up study from Sweden

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Zöller Bengt

2012-06-01

Full Text Available Abstract Background Certain immune-mediated diseases (IMDs have been associated with increased risk for cardiovascular disorders. The aim of the present study was to examine whether there is an association between 32 different IMDs and first hospitalization for ischemic or hemorrhagic stroke. Methods All individuals in Sweden hospitalized with a main diagnosis of IMD (without previous or coexisting stroke, between January 1, 1987 and December 31, 2008 (n = 216,291, were followed for first hospitalization for ischemic or hemorrhagic stroke. The reference population was the total population of Sweden. Adjusted standardized incidence ratios (SIRs for ischemic and hemorrhagic stroke were calculated. Results Totally 20 and 15 of the 32 IMDs studied, respectively, were associated with an increased risk of ischemic and hemorrhagic stroke during the follow-up. The overall risks of ischemic and hemorrhagic stroke during the first year after hospitalization for IMD were 2.02 (95% CI 1.90–2.14 and 2.65 (95% CI 2.27–3.08, respectively. The overall risk of ischemic or hemorrhagic stroke decreased over time, to 1.50 (95% CI 1.46–1.55 and 1.83 (95% CI 1.69–1.98, respectively, after 1–5 years, and 1.29 (95% CI 1.23–1.35 and 1.47 (95% CI 1.31–1.65, respectively, after 10+ years. The risk of hemorrhagic stroke was ≥2 during the first year after hospitalization for seven IMDs: ankylosing spondylitis (SIR = 8.11, immune thrombocytopenic purpura (SIR = 8.60, polymyalgia rheumatica (SIR = 2.06, psoriasis (SIR = 2.88, rheumatoid arthritis (SIR = 3.27, systemic lupus erythematosus (SIR = 8.65, and Wegener´s granulomatosis (SIR = 5.83. The risk of ischemic stroke was ≥2 during the first year after hospitalization for twelve IMDs: Addison’s disease (SIR = 2.71, Crohn´s disease (SIR = 2.15, Grave´s disease (SIR = 2.15, Hashimoto´s thyroiditis (SIR = 2.99, immune thrombocytopenic purpura (SIR = 2

Risk of subsequent coronary heart disease in patients hospitalized for immune-mediated diseases: a nationwide follow-up study from Sweden.

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Bengt Zöller

Full Text Available BACKGROUND: Certain immune-mediated diseases (IMDs, such as rheumatoid arthritis and systemic lupus erythematosus, have been linked to cardiovascular disorders. We examined whether there is an association between 32 different IMDs and risk of subsequent hospitalization for coronary heart disease (CHD related to coronary atherosclerosis in a nationwide follow up study in Sweden. METHODS AND FINDINGS: All individuals in Sweden hospitalized with a main diagnosis of an IMD (n = 336,479 without previous or coexisting CHD, between January 1, 1964 and December 31 2008, were followed for first hospitalization for CHD. The reference population was the total population of Sweden. Standardized incidence ratios (SIRs for CHD were calculated. Overall risk of CHD during the first year after hospitalization for an IMD was 2.92 (95% CI 2.84-2.99. Twenty-seven of the 32 IMDs studied were associated with an increased risk of CHD during the first year after hospitalization. The overall risk of CHD decreased over time, from 1.75 after 1-5 years (95% CI 1.73-1.78, to 1.43 after 5-10 years (95% CI 1.41-1.46 and 1.28 after 10+ years (95% CI 1.26-1.30. Females generally had higher SIRs than males. The IMDs for which the SIRs of CDH were highest during the first year after hospitalization included chorea minor 6.98 (95% CI 1.32-20.65, systemic lupus erythematosus 4.94 (95% CI 4.15-5.83, rheumatic fever 4.65 (95% CI 3.53-6.01, Hashimoto's thyroiditis 4.30 (95% CI 3.87-4.75, polymyositis/dermatomyositis 3.81 (95% CI 2.62-5.35, polyarteritis nodosa 3.81 (95% CI 2.72-5.19, rheumatoid arthritis 3.72 (95% CI 3.56-3.88, systemic sclerosis 3.44 (95% CI 2.86-4.09, primary biliary cirrhosis 3.32 (95% CI 2.34-4.58, and autoimmune hemolytic anemia 3.17 (95% CI 2.16-4.47. CONCLUSIONS: Most IMDs are associated with increased risk of CHD in the first year after hospital admission. Our findings suggest that many hospitalized IMDs are tightly linked to coronary atherosclerosis.

Risk of Suicide Attempt among Adolescents with Conduct Disorder: A Longitudinal Follow-up Study.

Science.gov (United States)

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.

HFE C282Y/H63D Compound Heterozygotes Are at Low Risk of Hemochromatosis-Related Morbidity

OpenAIRE

Gurrin, Lyle C.; Bertalli, Nadine A.; Dalton, Gregory W.; Osborne, Nicholas J.; Constantine, Clare C.; McLaren, Christine E.; English, Dallas R.; Gertig, Dorota M.; Delatycki, Martin B.; Nicoll, Amanda J.; Southey, Melissa C.; Hopper, John L.; Giles, Graham G.; Anderson, Gregory J.; Olynyk, John K.

2009-01-01

The risk of hemochromatosis-related morbidity is unknown among HFE compound heterozygotes (C282Y/H63D). We used a prospective population-based cohort study to estimate the prevalence of elevated iron indices and hemochromatosis-related morbidity for compound heterozygotes. In all, 31,192 subjects of northern European descent were genotyped for HFE C282Y and H63D. An HFE-genotype stratified random sample of 1,438 subjects, followed for an average of 12 years to a mean age of 65 years, complete...

Gastritis OLGA-staging and gastric cancer risk: a twelve-year clinico-pathological follow-up study.

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Rugge, M; de Boni, M; Pennelli, G; de Bona, M; Giacomelli, L; Fassan, M; Basso, D; Plebani, M; Graham, D Y

2010-05-01

Intestinal-type gastric cancer (GC) still ranks among the high-incidence, highly lethal malignancies. Atrophic gastritis is the cancerization field in which GC develops. The current histological reporting formats for gastritis do not include any (atrophy-based) ranking of GC risk. To test the gastritis OLGA-staging (Operative Link for Gastritis Assessment) in prognosticating neoplastic progression. Ninety-three Italian patients were followed up for more than 12 years (range: 144-204 months). Clinical examinations, pepsinogen serology, endoscopy and histology (also assessing Helicobacter pylori status) were performed both at enrolment (T1) and at the end of the follow-up (T2). All invasive or intra-epithelial gastric neoplasia were consistently associated with high-risk (III/IV) OLGA stages. There was a significant inverse correlation between the mean pepsinogen ratio and the OLGA stage (test for trend; P gastritis OLGA-staging conveys relevant information on the clinico-pathological outcome of gastritis and therefore for patient management. According to OLGA-staging and H. pylori-status, gastritis patients could be confidently stratified and managed according to their different cancer risks.

Risk of stroke in patients hospitalized for isolated vertigo: a four-year follow-up study.

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Lee, Ching-Chih; Su, Yu-Chieh; Ho, Hsu-Chieh; Hung, Shih-Kai; Lee, Moon-Sing; Chou, Pesus; Huang, Yung-Sung

2011-01-01

vertigo is a common presenting symptom in ambulatory care settings, and stroke is its leading and most challenging concern. This study aimed to determine the risk of stroke in vertigo patients in a 4-year follow-up after hospitalization for acute isolated vertigo. the study cohorts consisted of all patients hospitalized with a principal diagnosis of vertigo (n=3021), whereas patients hospitalized for an appendectomy in 2004 (n=3021) comprised the control group and surrogate for the general population. Cox proportional hazard model was performed as a means of comparing the 4-year stroke-free survival rate between the 2 cohorts after adjusting for possible confounding and risk factors. Among vertigo patients, there was further stratification for risk factors to identify the group at high risk for stroke. of the 243 stroke patients, 185 (6.1%) were from the study cohort and 58 (1.9%) were from the control group. Comparing the 2 groups, patients with vertigo symptoms had a 3.01-times (95% CI, 2.20-4.11; Pstroke after adjusting for patient characteristics, comorbidities, geographic region, urbanization level of residence, and socioeconomic status. Vertigo patients with ≥ 3 risk factors had a 5.51-fold higher risk for stroke (95% CI, 3.10-9.79; Pstroke than the general population. They should have a comprehensive neurological examination, vascular risk factors survey, and regular follow-up for several years after hospital discharge after treatment of isolated vertigo.

Prevalence of H63D, S65C, and C282Y hereditary hemochromatosis gene variants in Madeira Island (Portugal).

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Spínola, Carla; Brehm, António; Spínola, Hélder

2011-01-01

Hereditary HFE Hemochromatosis is an inherited disorder of iron metabolism that results from mutations in the HFE gene. Almost all patients with hereditary hemochromatosis show a C282Y mutation in homozygosity or in compound heterozygosity with H63D. Also, the mutation S65C has been shown to be associated to a milder iron overload. Since allele and genotype frequencies of these three variants of the HFE gene vary between populations, the determination of their prevalence in Madeira Island will clarify the population susceptibility to hereditary hemochromatosis. One hundred and fifty-four samples from Madeira Island were genotyped for the three most common HFE gene mutations, H63D, C282Y, and S65C, by polymerase chain reaction followed by restriction fragment length polymorphism analysis. Results have shown a prevalence of 20.5%, 0.33%, and 1% for H63D, C282Y, and S65C, respectively. Accordingly to our estimates, both genotypes associated to hereditary hemochromatosis, C282Y homozygotes and C282/H63D compound heterozygotes, could be present in Madeira Island population in 1,648 individuals, which represents 0.65% of the total population.

Risk of heart failure after community acquired pneumonia: prospective controlled study with 10 years of follow-up

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Marrie, Thomas J; Minhas-Sandhu, Jasjeet K; Majumdar, Sumit R

2017-01-01

Abstract Objective To determine the attributable risk of community acquired pneumonia on incidence of heart failure throughout the age range of affected patients and severity of the infection. Design Cohort study. Setting Six hospitals and seven emergency departments in Edmonton, Alberta, Canada, 2000-02. Participants 4988 adults with community acquired pneumonia and no history of heart failure were prospectively recruited and matched on age, sex, and setting of treatment (inpatient or outpatient) with up to five adults without pneumonia (controls) or prevalent heart failure (n=23 060). Main outcome measures Risk of hospital admission for incident heart failure or a combined endpoint of heart failure or death up to 2012, evaluated using multivariable Cox proportional hazards analyses. Results The average age of participants was 55 years, 2649 (53.1%) were men, and 63.4% were managed as outpatients. Over a median of 9.9 years (interquartile range 5.9-10.6), 11.9% (n=592) of patients with pneumonia had incident heart failure compared with 7.4% (n=1712) of controls (adjusted hazard ratio 1.61, 95% confidence interval 1.44 to 1.81). Patients with pneumonia aged 65 or less had the lowest absolute increase (but greatest relative risk) of heart failure compared with controls (4.8% v 2.2%; adjusted hazard ratio 1.98, 95% confidence interval 1.5 to 2.53), whereas patients with pneumonia aged more than 65 years had the highest absolute increase (but lowest relative risk) of heart failure (24.8% v 18.9%; adjusted hazard ratio 1.55, 1.36 to 1.77). Results were consistent in the short term (90 days) and intermediate term (one year) and whether patients were treated in hospital or as outpatients. Conclusion Our results show that community acquired pneumonia substantially increases the risk of heart failure across the age and severity range of cases. This should be considered when formulating post-discharge care plans and preventive strategies, and assessing downstream episodes

Changes in BMI before and during economic development and subsequent risk of cardiovascular disease and total mortality: a 35-year follow-up study in China.

Science.gov (United States)

He, Yao; Lam, Tai Hing; Jiang, Bin; Li, Lan Sun; Sun, Dong Ling; Wu, Lei; Liu, Miao; Yang, Shan Shan; Wang, Yi Yan; Tobias, Deirdre K; Sun, Qi; Hu, Frank B

2014-09-01

It is unclear whether changes in BMI during rapid economic development influence subsequent mortality. We analyzed whether BMI in 1976 and 1994 and changes in BMI during 1976-1994 predict cardiovascular disease (CVD) and all-cause mortality in a 35-year follow-up cohort of 1,696 Chinese (1,124 men and 572 women, aged 35-65 years) in Xi'an, China. Participants were categorized as underweight (economic development was associated with elevated risks of all-cause and CVD mortality. Higher BMI measured before economic development was associated with lower mortality risk, whereas BMI measured afterward was associated with increased mortality. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

Clinical follow-up of unilateral, fixed dental prosthesis on maxillary implants.

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Wahlström, Monica; Sagulin, Gun-Britt; Jansson, Leif E

2010-11-01

The aims of the present study were to evaluate (1) the success rate of unilateral maxillary fixed dental prosthesis (FDPs) on implants in patients at a periodontal clinic referred for periodontal treatment, (2) the prevalence of varying mechanical and biological complications and (3) effects of potential risk factors on the success rate. Fifty consecutive patients were invited to participate in a follow-up. The patients had received FDPs on implants between November 2000 and December 2003 after treatment to achieve optimal peridontal health, and the FDPs had been in function for at least 3 years. A questionnaire was sent to the patients before the follow-up examination. Forty-six patients with 116 implants were examined. The follow-up comprised clinical and radiographic examinations and evaluations of treatment outcome. Before implant treatment, 13% of the teeth were extracted; of these, 80% were extracted due to periodontal disease. No implants had been lost before implant loading. One implant in one patient fractured after 3 years of functional loading and three implants in another patient after 6.5 years. The most frequent mechanical complications were veneer fractures and loose bridge screws. Patients with peri-implant mucositis had significantly more bleeding on probing around teeth and implants. Patients with peri-implantitis at the follow-up had more deep periodontal pockets around their remaining teeth compared with individuals without peri-implantitis, but these differences were not significant. Smokers had significantly fewer teeth, more periodontal pockets ≥ 4mm and a tendency towards greater marginal bone loss at the follow-up, compared with non-smokers. In the short term, overloading and bruxism seem more hazardous for implant treatment, compared with a history of periodontitis.

FRAT-up, a Web-based fall-risk assessment tool for elderly people living in the community.

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Cattelani, Luca; Palumbo, Pierpaolo; Palmerini, Luca; Bandinelli, Stefania; Becker, Clemens; Chesani, Federico; Chiari, Lorenzo

2015-02-18

-Lemeshow test indicated statistical significance of miscalibration. FRAT-up is a web-based tool for evaluating the fall risk of people aged 65 or up living in the community. Validation results of fall risks computed by FRAT-up show that its performance is comparable to externally validated state-of-the-art tools. A prototype is freely available through a web-based interface. ClinicalTrials.gov NCT01331512 (The InChianti Follow-Up Study); http://clinicaltrials.gov/show/NCT01331512 (Archived by WebCite at http://www.webcitation.org/6UDrrRuaR).

Personality disorder risk factors for suicide attempts over 10 years of follow-up.

Science.gov (United States)

Ansell, Emily B; Wright, Aidan G C; Markowitz, John C; Sanislow, Charles A; Hopwood, Christopher J; Zanarini, Mary C; Yen, Shirley; Pinto, Anthony; McGlashan, Thomas H; Grilo, Carlos M

2015-04-01

Identifying personality disorder (PD) risk factors for suicide attempts is an important consideration for research and clinical care alike. However, most prior research has focused on single PDs or categorical PD diagnoses without considering unique influences of different PDs or of severity (sum) of PD criteria on the risk for suicide-related outcomes. This has usually been done with cross-sectional or retrospective assessment methods. Rarely are dimensional models of PDs examined in longitudinal, naturalistic prospective designs. In addition, it is important to consider divergent risk factors in predicting the risk of ever making a suicide attempt versus the risk of making an increasing number of attempts within the same model. This study examined 431 participants who were followed for 10 years in the Collaborative Longitudinal Personality Disorders Study. Baseline assessments of personality disorder criteria were summed as dimensional counts of personality pathology and examined as predictors of suicide attempts reported at annual interviews throughout the 10-year follow-up period. We used univariate and multivariate zero-inflated Poisson regression models to simultaneously evaluate PD risk factors for ever attempting suicide and for increasing numbers of attempts among attempters. Consistent with prior research, borderline PD was uniquely associated with ever attempting. However, only narcissistic PD was uniquely associated with an increasing number of attempts. These findings highlight the relevance of both borderline and narcissistic personality pathology as unique contributors to suicide-related outcomes. (c) 2015 APA, all rights reserved).

Fertility drugs and endometrial cancer risk: results from an extended follow-up of a large infertility cohort.

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Brinton, Louise A; Westhoff, Carolyn L; Scoccia, Bert; Lamb, Emmet J; Trabert, Britton; Niwa, Shelley; Moghissi, Kamran S

2013-10-01

Do fertility drugs influence the subsequent risk of endometrial cancer in a manner that is independent of other risk predictors, such as parity? In this follow-up of a large cohort of women evaluated for infertility and for whom information was captured on fertility drugs, indications for usage and other risk factors that might influence cancer risk, we found no evidence for a substantial relationship between fertility drug use and endometrial cancer risk. Although the hormonal etiology of endometrial cancer has been well established, it remains unclear whether the use of fertility drugs has an influence on risk. Results regarding the effects of fertility drugs on endometrial cancer risk have been inconsistent, although several studies have shown some evidence for possible increases in risk. The relationship is of particular interest given that clomiphene, a commonly prescribed drug, is a selective estrogen receptor modulator, with chemical properties similar to tamoxifen, another drug linked to an increase in endometrial cancer risk. In a retrospective cohort of 12 193 women evaluated for infertility between 1965 and 1988 at five US sites, follow-up was pursued through 2010 via both passive as well as active (questionnaire) means. Among the 9832 subjects for whom follow-up was allowed and achieved, 259 346 at-risk person-years (i.e. prior to hysterectomy) were accrued, and 118 invasive endometrial cancers identified. Cox regression determined hazard ratios (HRs) and 95% confidence intervals (CIs) for fertility treatments adjusted for endometrial cancer risk factors and causes of infertility. Although we observed slight increases in endometrial cancer risk associated with clomiphene (HR = 1.39, 95% CI: 0.96-2.01) and the less commonly prescribed gonadotrophins (1.34, 0.76-2.37), there were no convincing relationships of risk with either cycles of use or cumulative exposures for either drug. A statistically significant risk associated with the use of clomiphene

Smoking Status and Incidence of Cancer After Myocardial Infarction: A Follow-Up Study of over 20 Years.

Science.gov (United States)

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.

Phosphorus-32 in polycythemia vera with and without maintenance treatment. Intermediate follow-up results

International Nuclear Information System (INIS)

Najean, Y.; Rain, J.D.

1995-01-01

Three-hundred and seventy-two patients with polycythemia vera, aged 65 years or more or with a high risk of vascular complications, were openly treated between 1979 and 1994 with 32 P or a combination of 32 P plus a small maintenance dose (7,5 mg/kg/day) of hydroxy urea. Although only a small number of patients was followed long enough to allow definite conclusions, some results are already significant in this intermediary study performed in November 1994. Maintenance treatment with hydroxy urea led to a significant prolongation of the intervals between 32 P administrations and to a decreased annual mean dose of radiophosphorus. Median survival does not differ between to the two treatment groups, 10,7 years compared to 10,0 years. The rate of vascular complications did not differ between groups. At 10 years follow-up, the risk of developing (epithelial) cancer was increased in the group of patients who received maintenance treatment, 30% compared to 10%. Similarly, development of myelodysplasia, acute leukemia or lymphoma was more common in patients receiving hydroxy urea, 25% compared to 12%. Myeloid transformation of the spleen occurred with the same frequency. Our intermediate follow-up results show that addition of hydroxy urea to 32 P treatment does not change survival or vascular complications in polycythemia vera patients, but probably increases the risk of developing cancer or leukemia. (authors). 2 refs., 4 figs

Daytime napping and the risk of all-cause and cause-specific mortality: a 13-year follow-up of a British population.

Science.gov (United States)

Leng, Yue; Wainwright, Nick W J; Cappuccio, Francesco P; Surtees, Paul G; Hayat, Shabina; Luben, Robert; Brayne, Carol; Khaw, Kay-Tee

2014-05-01

Epidemiologic studies have reported conflicting results on the relationship between daytime napping and mortality risk, and there are few data on the potential association in the British population. We investigated the associations between daytime napping and all-cause or cause-specific mortality in the European Prospective Investigation Into Cancer-Norfolk study, a British population-based cohort study. Among the 16,374 men and women who answered questions on napping habits between 1998 and 2000, a total of 3,251 died during the 13-year follow-up. Daytime napping was associated with an increased risk of all-cause mortality (for napping less than 1 hour per day on average, hazard ratio = 1.14, 95% confidence interval: 1.02, 1.27; for napping 1 hour or longer per day on average, hazard ratio = 1.32, 95% confidence interval: 1.04, 1.68), independent of age, sex, social class, educational level, marital status, employment status, body mass index, physical activity level, smoking status, alcohol intake, depression, self-reported general health, use of hypnotic drugs or other medications, time spent in bed at night, and presence of preexisting health conditions. This association was more pronounced for death from respiratory diseases (for napping less than 1 hour, hazard ratio = 1.40, 95% confidence interval: 0.95, 2.05; for napping 1 hour or more, hazard ratio = 2.56, 95% confidence interval: 1.34, 4.86) and in individuals 65 years of age or younger. Excessive daytime napping might be a useful marker of underlying health risk, particularly of respiratory problems, especially among those 65 years of age or younger. Further research is required to clarify the nature of the observed association.

Diet Quality and Change in Blood Lipids during 16 Years of Follow-up and Their Interaction with Genetic Risk for Dyslipidemia.

Science.gov (United States)

Sonestedt, Emily; Hellstrand, Sophie; Drake, Isabel; Schulz, Christina-Alexandra; Ericson, Ulrika; Hlebowicz, Joanna; Persson, Margaretha M; Gullberg, Bo; Hedblad, Bo; Engström, Gunnar; Orho-Melander, Marju

2016-05-09

A high diet quality according to the Swedish nutrition recommendations is associated with a reduced risk of cardiovascular disease in the population-based Malmö Diet and Cancer cohort. To further clarify this protective association, we examined the association between high diet quality and change in triglycerides, high density lipoprotein-cholesterol (HDL-C), and low density lipoprotein-cholesterol (LDL-C) after 16 years of follow-up in 3152 individuals (61% women; 46-68 years at baseline). In addition, we examined if genetic risk scores composed of 80 lipid-associated genetic variants modify these associations. A diet quality index based on intakes of saturated fat, polyunsaturated fat, sucrose, fiber, fruit and vegetables, and fish was constructed. A high diet quality was associated with lower risk of developing high triglycerides (p = 0.02) and high LDL-C (p = 0.03) during follow-up compared with a low diet quality. We found an association between diet quality and long-term change in HDL-C only among those with lower genetic risk for low HDL-C as opposed to those with higher genetic risk (p-interaction = 0.04). Among those with lower genetic risk for low HDL-C, low diet quality was associated with decreased HDL-C during follow-up (p = 0.05). In conclusion, individuals with high adherence to the Swedish nutrition recommendation had lower risk of developing high triglycerides and LDL-C during 16 years of follow-up.

Fate of males with urethral "Y-duplication": 40-year long follow-up in 8 patients.

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Lima, Mario; Destro, Francesca; Di Salvo, Neil; Gargano, Tommaso; Ruggeri, Giovanni

2017-08-01

The spectrum of male urethral duplication is heterogeneous and it includes the Y-duplication. The malformation is rare and there is only a few case series reported in the literature. The management of Y-forms remains challenging for the surgeon and the long-term follow-up is still scarcely investigated. We report our 40-year experience in the management of patients with Y-duplication. We conducted a restrospective analysis collecting information of patients with urethral Y-duplication treated at our department from April 1975 to April 2015. We investigated long-term effects of surgery by using a questionnaire. Ten male patients with Y-duplication came to our attention. One was treated conservatively, seven underwent surgery and two were lost. Surgery consisted of removal of the ectopic branch (via perineal or ASTRA/anterior sagittal trans-rectal approach approach) and reconstruction of the orthotopic urethra. Post-operative complications included stenosis and infections. Long-term results are influenced by associated anomalies and significant problems (incontinence, urinary tract infections and orchiepididimitis) have been reported. Y-duplication (or λ-duplication, as we prefer calling it) is a particular form of urethral duplication. The management of patients should be based upon the identification of the functional channel. The removal of the ectopic channel with ASTRA approach is safe and feasible. On the other hand, the reconstruction of the anterior urethra (when steno-atresic) is more challenging and justifies the need for many procedures. The P.A.D.U.A. (progressive augmentation by dilating the anterior urethra) technique was not effective. Skin tube grafts were responsible for infections ("hairy urethra"). BMFG (bladder mucosa free graft) urethroplasty is a good alternative, although associated with well-known complications. Associated anomalies influence long-term outcomes. Clinical study with type IV level of evidence. Copyright © 2016 Elsevier Inc

Factors relating to participation in follow-up to the 45 and up study in Aboriginal and non-Aboriginal individuals

Directory of Open Access Journals (Sweden)

Lina Gubhaju

2016-05-01

Full Text Available Abstract Background This study aimed to characterise the factors relating to participation in a postal follow-up study in Aboriginal and non-Aboriginal individuals, given the need to quantify potential biases from loss to follow-up and the lack of evidence regarding postal surveys among Aboriginal people. Methods The first 100,000 participants from the Sax Institute’s 45 and Up Study, a large scale cohort study, were posted a follow-up questionnaire gathering general demographic, health and risk factor data, emphasising Social, Economic and Environmental Factors (“The SEEF Study”. For each variable of interest, percentages of those invited who went on to participate in follow-up were tabulated separately for Aboriginal and non-Aboriginal participants and age- and sex-adjusted participation rate ratios (aPRR were calculated. Results Of the 692 Aboriginal and 97,178 non-Aboriginal invitees to the study, 314 Aboriginal (45 % and 59,175 non-Aboriginal (61 % individuals responded. While Aboriginal people were less likely to respond than non-Aboriginal people (aPRR 0.72, 95 % CI 0.66–0.78, factors related to response were similar. Follow-up study participants were more likely than non-participants to have university versus no educational qualifications (1.6, 1.3–2.0 [Aboriginal]; 1.5, 1.5–1.5 [non-Aboriginal] and an annual income of ≥70,000 versus < $20,000 (1.6, 1.3–2.0; 1.2, 1.2–1.3 [χ 2 = 7.7; p = 0.001]. Current smokers (0.55, 0.42–0.72; 0.76, 0.74–0.77 [χ 2 = 7.14; p = 0.03], those reporting poor self-rated health (0.68, 0.47–0.99; 0.65, 0.61–0.69, poor quality of life (0.63, 0.41–0.97; 0.61, 0.57–0.66 and very high psychological distress (0.71, 0.68–0.75 [non-Aboriginal] were less likely than other cohort members to respond. Conclusions Relatively large numbers of Aboriginal and non-Aboriginal individuals participated in the first 45 and Up Study follow-up suggesting that postal surveys

Nourodevelopmental follow-up in high-risk infants: review article

Directory of Open Access Journals (Sweden)

Farin Soleimani

2015-02-01

Full Text Available Growing and developing are influenced by genetic, social and environmental factors and it's most important and initial phase step is formed of the early life of the fetus and infant. According to the world health organization, the incidence of preterm birth and low birth weight are increasing in most countries that most of it related to developing countries. Low birth weight (LBW and preterm birth are one the most important causes of death in the world and therefore are considered as one of the major health problems that can affect growing and developing so that it can threaten public health. Advances in medical technology in recent decades at intensive care unit, increased survival of premature infants and high-risk specialist care is needed, but failed, to reduce the complications of premature birth but it couldn’t reduce complications of preterm birth. There is also an increased recognition of the potential disconnect between perinatal outcomes and long-term outcomes. The administration of oxygen and postnatal steroids are prime examples of interventions that may have immediate positive effects but negative long-term effects. Many premature babies will be encounter with mobility problems, cognitive, neurosensory impairments, cerebral palsy, cognitive and language delays, neuromotor developmental delay, blindness and hearing loss, behavioral and psychosocial disorders, learning difficulties and dysfunction in scholastic performances in the future. These disadvantages appear to persist into adulthood and therefore have broad implications for society. Without a doubt, one of the tragedies of the world is people with physical or mental damage caused by premature birth, many of these disorders are not early diagnosed and the prediction of long term complications of infants discharged from the NICU is difficult. Although nourodevelopmental follow-up of these babies is a necessary part of the neonatal assessment but there is no standard process

Mental disorder and long-term risk of mortality: 41 years of follow-up of a population sample in Stockholm, Sweden.

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Lundin, A; Modig, K; Halldin, J; Carlsson, A C; Wändell, P; Theobald, H

2016-08-01

An increased mortality risk associated with mental disorder has been reported for patients, but there are few studies are based on random samples with interview-based psychiatric diagnoses. Part of the increased mortality for those with mental disorder may be attributable to worse somatic health or hazardous health behaviour - consequences of the disorder - but somatic health information is commonly lacking in psychiatric samples. This study aims to examine long-term mortality risk for psychiatric diagnoses in a general population sample and to assess mediation by somatic ill health and hazardous health behaviour. We used a double-phase stratified random sample of individuals aged 18-65 in Stockholm County 1970-1971 linked to vital records. First phase sample was 32 186 individuals screened with postal questionnaire and second phase was 1896 individuals (920 men and 976 women) that participated in a full-day examination (participation rate 88%). Baseline examination included both a semi-structured interview with a psychiatrist, with mental disorders set according to the 8th version of the International Classification of Disease (ICD-8), and clinical somatic examination, including measures of body composition (BMI), hypertension, fasting blood glucose, pulmonary function and self-reported tobacco smoking. Information on vital status was obtained from the Total Population Register for the years 1970-2011. Associations with mortality were studied with Cox proportional hazard analyses. A total of 883 deaths occurred among the participants during the 41-year follow-up. Increased mortality rates were found for ICD-8 functional psychoses (hazard ratio, HR = 2.22, 95% confidence interval (95% CI): 1.15-4.30); psycho-organic symptoms (HR = 1.94, 95% CI: 1.31-2.87); depressive neuroses (HR = 1.71, 95% CI: 1.23-2.39); alcohol use disorder (HR = 1.91, 95% CI: 1.40-2.61); drug dependence (HR = 3.71, 95% CI: 1.80-7.65) and psychopathy (HR = 2.88, 95% CI: 1.02-8.16). Non

The natural history of serum iron indices for HFE C282Y homozygosity associated with hereditary hemochromatosis.

Science.gov (United States)

Gurrin, Lyle C; Osborne, Nicholas J; Constantine, Clare C; McLaren, Christine E; English, Dallas R; Gertig, Dorota M; Delatycki, Martin B; Southey, Melissa C; Hopper, John L; Giles, Graham G; Anderson, Gregory J; Olynyk, John K; Powell, Laurie W; Allen, Katrina J

2008-12-01

There are few longitudinal studies of serum ferritin (SF) and transferrin saturation (TS) levels in individuals homozygous for the C282Y mutation. We characterized the development of elevated iron measures in C282Y homozygotes followed for 12 years. From 31,192 people aged 40-69 years at baseline, we identified 203 C282Y homozygotes (95 males), of whom 116 had SF and fasting TS levels measured at baseline (mean age, 55 years) and 86 were untreated and had iron measures at follow-up (mean, 12 years later). The probabilities of SF at follow-up exceeding clinical thresholds were predicted from baseline SF and TS under a multivariate normal model. For C282Y homozygotes, at baseline, 84% of males and 65% of females had elevated SF and 37% of males and 3% of females had SF >1000 microg/L. For males with SF 300-1000 microg/L at baseline, the predicted probability of progressing to SF >1000 microg/L at follow-up was between 13% and 35% and, for females, between 16% and 22%. For C282Y homozygotes with normal baseline SF, 1000 microg/L if left untreated. The majority of C282Y homozygotes who are likely to develop SF levels sufficient to place them at risk of iron overload-related disease will have done so by mean age 55 years. TS >95% at mean age 55 years in males increases the likelihood that SF levels will be elevated at mean age 65 years, but this effect is absent in females, most likely because of physiologic blood loss associated with menstruation.

Low back pain and physical activity--A 6.5 year follow-up among young adults in their transition from school to working life.

Science.gov (United States)

Lunde, Lars-Kristian; Koch, Markus; Hanvold, Therese N; Wærsted, Morten; Veiersted, Kaj B

2015-11-12

The association between leisure time physical activity and low back pain in young adults is unclear and is in the need of prospectively obtained evidence. This study examined the course of low back pain and the association between low back pain and leisure time physical activity in a cohort of young adults in their transition from school to working life. Both low back pain and leisure time physical activity was monitored over a 6.5 year period in 420 subjects starting out as students within hairdressing, electrical installation and media/design. The association between physical activity and low back pain was investigated through the follow-up period by using linear mixed models analysis. Low back pain was significantly influenced by time and overall there was a decreasing trend of low back pain prevalence throughout the follow-up. Analysis showed a weak trend of decreasing low back pain with moderate/high physical activity levels, but this association was not significant. Low back pain decreased during follow-up with baseline as reference. Findings in our study did show non-significant trends of reduced low back pain with increased leisure time physical activity. Still, we could not support the theory of moderate/high levels of physical activity acting protective against low back pain in young adults entering working life. Our results, in combination with previous relevant research, cannot support a clear relationship between physical activity and low back pain for young adults. Thus, recommendations regarding effect of physical activity on reducing low back pain for this group are not clear.

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

Directory of Open Access Journals (Sweden)

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.

Risk Factors for Loss to Follow-Up among People Who Inject Drugs in a Risk Reduction Program at Karachi, Pakistan. A Case-Cohort Study.

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Rab Nawaz Samo

Full Text Available Retention of male people who inject drugs (PWIDs is a major challenge for harm reduction programs that include sterile needle/syringe exchange in resource-limited settings like Pakistan. We assessed the risk factors for loss to follow-up among male PWIDs enrolled in a risk reduction program in Karachi, Pakistan.We conducted a prospective cohort study among 636 HIV-uninfected male PWIDs enrolled during March-June 2009 in a harm reduction program for the estimation of incidence rate. At 24 months post-enrollment, clients who had dropped out of the program were defined as lost to follow-up and included as cases for case-cohort study.The median age of the participants was 29 years (interquartile range: 23-36. Active outreach accounted for 76% (483/636 of cohort recruits. Loss to follow-up at 24 months was 25.5% (162/636. In multivariable logistic regression, younger age (AOR: 0.97, 95% CI: 0.92-0.99, p = 0.028, clients from other provinces than Sindh (AOR: 1.49, 95% CI: 1.01-2.22, p = 0.046, having no formal education (AOR: 3.44, 95% CI: 2.35-4.90, p<0.001, a history of incarceration (AOR: 1.68, 95% CI: 1.14-2.46, p<0.008, and being homeless (AOR: 1.47, 95% CI: 1.00-2.19, p<0.049 were associated with loss to follow-up.Our cohort retained 74.5% of male PWIDs in Karachi for 24 months. Its loss to follow up rate suggested substantial ongoing programmatic challenges. Programmatic enhancements are needed for the highest risk male PWIDs, i.e., younger men, men not from Sindh Province, men who are poorly educated, formerly incarcerated, and/or homeless.

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

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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.

Long-term risks after splenectomy among 8,149 cancer-free American veterans: a cohort study with up to 27 years follow-up

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Kristinsson, Sigurdur Y.; Gridley, Gloria; Hoover, Robert N; Check, David; Landgren, Ola

2014-01-01

Although preservation of the spleen following abdominal trauma and spleen-preserving surgical procedures have become gold standards, about 22,000 splenectomies are still conducted annually in the USA. Infections, mostly by encapsulated organisms, are the most well-known complications following splenectomy. Recently, thrombosis and cancer have become recognized as potential adverse outcomes post-splenectomy. Among more than 4 million hospitalized USA veterans, we assessed incidence and mortality due to infections, thromboembolism, and cancer including 8,149 cancer-free veterans who underwent splenectomy with a follow-up of up to 27 years. Relative risk estimates and 95% confidence intervals were calculated using time-dependent Poisson regression methods for cohort data. Splenectomized patients had an increased risk of being hospitalized for pneumonia, meningitis, and septicemia (rate ratios=1.9–3.4); deep venous thrombosis and pulmonary embolism (rate ratios=2.2); certain solid tumors: buccal, esophagus, liver, colon, pancreas, lung, and prostate (rate ratios =1.3–1.9); and hematologic malignancies: non-Hodgkin lymphoma, Hodgkin lymphoma, multiple myeloma, acute myeloid leukemia, chronic lymphocytic leukemia, chronic myeloid leukemia, and any leukemia (rate ratios =1.8–6.0). They also had an increased risk of death due to pneumonia and septicemia (rate ratios =1.6–3.0); pulmonary embolism and coronary artery disease (rate ratios =1.4–4.5); any cancer: liver, pancreas, and lung cancer, non-Hodgkin lymphoma, Hodgkin lymphoma, and any leukemia (rate ratios =1.3–4.7). Many of the observed risks were increased more than 10 years after splenectomy. Our results underscore the importance of vaccination, surveillance, and thromboprophylaxis after splenectomy. PMID:24056815

Risk markers for affective disorder, a seven-years follow up study of a twin cohort at low and high risk for affective disorder

DEFF Research Database (Denmark)

Vinberg, Maj; Miskowiak, Kamilla; Kessing, Lars Vedel

2013-01-01

This study aims to investigate whether: familial history of affective disorder, subclinical depressive symptoms and life events (LEs) are predictive of a later development of mood disorder (onset). In a high-risk study, 234 healthy monozygotic and dizygotic twins with and without a co-twin history...... of affective disorder (high and low risk twins, respectively) were identified through nationwide registers and assessed from 2002 to 2005. Participants were followed longitudinally at 6-months intervals for up to nine years and finally reassessed with a personal interview to obtain information on whether...... they had an onset. During the follow-up period (mean time 7.0 years), 36 participants (15.4%) developed onset. Onset was significantly associated with risk status (Hazard ratio (HR) = 1.38, 95% CI 1.08-1.76), female sex, HR = 2.70, 95% CI 1.19-6.97, age HR = 0.97, 95% CI 0.93-0.99), and also with baseline...

Neonatal follow-up program: Where do we stand?

Science.gov (United States)

2012-01-01

Neonatal follow-up program (NFP) is becoming the corner stone of standard, high quality care provided to newborns at risk of future neuorodevelopmental delay. Most of the recognized neonatal intensive care units in the developed countries are adopting NFP as part of their mandatory care for the best long term outcome of high risk infants, especially very low birth weight (VLBW) infants. Unfortunately, in the developing and in underdeveloped countries, such early detection and intervention programs are rarely existing, mainly because of the lack of awareness of and exposure to such programs in spite of the increasing numbers of surviving sick newborns due to advancement in neonatal care in these countries. This is a review article to explore the Neonatal follow-up programs looking at historical development, benefts and aims, and standard requirements for successful program development that can be adopted in our countries. In conclusion, proper Neonatal follow-up programs are needed to improve neonatal outcome. Therefore all professionals working in the feld of neonatal care in developing countries should cooperate to create such programs for early detection and hence early intervention for any adverse long term outcome in high-risk newborn infants PMID:27493326

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

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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.

[Testicular cancer: a model to optimize the radiological follow-up].

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Stebler, V; Pauchard, B; Schmidt, S; Valerio, M; De Bari, B; Berthold, D

2015-05-20

Despite being rare cancers, testicular seminoma and non-seminoma play an important role in oncology: they represent a model on how to optimize radiological follow-up, aiming at a lowest possible radiation exposure and secondary cancer risk. Males diagnosed with testicular cancer undergo frequently prolonged follow-up with CT-scans with potential toxic side effects, in particular secondary cancers. To reduce the risks linked to ionizing radiation, precise follow-up protocols have been developed. The number of recommended CT-scanners has been significantly reduced over the last 10 years. The CT scanners have evolved technically and new acquisition protocols have the potential to reduce the radiation exposure further.

Serum 25-hydroxyvitamin D level and risk of falls in Japanese community-dwelling elderly women: a 1-year follow-up study.

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Shimizu, Y; Kim, H; Yoshida, H; Shimada, H; Suzuki, T

2015-08-01

The present prospective follow-up study among 1,393 community-dwelling elderly women aged 75 years or older was conducted to clarify the association between serum 25-hydroxyvitamin D (25(OH)D) level and risk of falls. Lower serum 25(OH)D, particularly level risk of falls. Serum 25(OH)D level has been revealed to be important factor not only for skeletal health but also for fall prevention among the elderly. Our previous cross-sectional study indicated that low serum 25(OH)D level is associated with inferior physical performance and falls among elderly Japanese women. The present prospective study was designed to clarify the association between serum 25(OH)D level and risk of falls before and after 1 year of follow-up. The community-dwelling elderly women aged 75 years or older (N = 1,393) who participated in a mass health examination were followed 1 year later by a mailed self-administered questionnaire. Responses were obtained from 1,285 subjects (response rate = 92.2%). The incidence of falls at baseline and at 1-year follow-up was 18.8 and 24.4%, respectively. The baseline prevalence of serum 25(OH)D falls and 1.47 (0.93-2.32) for recurrent falls vs. no falls adjusted for potential risk factors. Among elderly Japanese women, the lower serum 25(OH)D, particularly level risk of falls.

Usefulness of a Novel Mobile Diabetes Prevention Program Delivery Platform With Human Coaching: 65-Week Observational Follow-Up

Science.gov (United States)

Michaelides, Andreas; Major, Jennifer; Pienkosz Jr, Edmund; Wood, Meghan; Kim, Youngin

2018-01-01

Background It is widely recognized that the prevalence of obesity and comorbidities including prediabetes and type 2 diabetes continue to increase worldwide. Results from a 24-week Diabetes Prevention Program (DPP) fully mobile pilot intervention were previously published showing promising evidence of the usefulness of DPP-based eHealth interventions on weight loss. Objective This pilot study extends previous findings to evaluate weight loss results of core (up to week 16) and maintenance (postcore weeks) DPP interventions at 65 weeks from baseline. Methods Originally, 140 participants were invited and 43 overweight or obese adult participants with a diagnosis of prediabetes signed up to receive a 24-week virtual DPP with human coaching through a mobile platform. At 65 weeks, this pilot study evaluates weight loss and engagement in maintenance participants by means of repeated measures analysis of variances and backward multiple linear regression to examine predictors of weight loss. Last observation carried forward was used for endpoint measurements. Results At 65 weeks, mean weight loss was 6.15% in starters who read 1 or more lessons per week on 4 or more core weeks, 7.36% in completers who read 9 or more lessons per week on core weeks, and 8.98% in maintenance completers who did any action in postcore weeks (all P<.001). Participants were highly engaged, with 80% (47/59) of the sample completing 9 lessons or more and 69% (32/47) of those completing the maintenance phase. In-app actions related to self-monitoring significantly predicted weight loss. Conclusions In comparison to eHealth programs, this pilot study shows that a fully mobile DPP can produce transformative weight loss. A fully mobile DPP intervention resulted in significant weight loss and high engagement during the maintenance phase, providing evidence for long-term potential as an alternative to in-person DPP by removing many of the barriers associated with in-person and other forms of virtual DPP

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

NARCIS (Netherlands)

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

Long-term follow-up of functional hypothalamic amenorrhea and prognostic factors.

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Falsetti, Leopoldo; Gambera, Alessandro; Barbetti, Lorena; Specchia, Cristina

2002-02-01

This study evaluated the prognosis of functional hypothalamic amenorrhea (FHA) and the predictive factors of recovery, through a long-term follow-up. Ninety-three women affected by FHA underwent a follow-up for an average period of 8.1 yr (range 7-9 yr). At the end of the follow-up, 65 (70.7%) patients recovered. Statistical analysis showed that there was no association between recovery and anamnestic causes of FHA or with the echographic ovarian morphology but identified the predictive factors of recovery as the basal body mass index (BMI), the basal cortisol, and androstenedione plasma levels. A higher basal BMI and A, and lower cortisol values are positive prognostic factors for the recovery. Also the BMI, acquired during the follow-up, is important for FHA resolution: in fact, in recovered women the BMI increased or remained stable, whereas in nonrecovered women it decreased or remained stable. At the end of the follow-up, 52 (74.3%) patients treated with hormone replacement therapy and 8 (80%) with no therapy recovered, but only 5 (41.7%) with oral contraceptive pills recovered.

Risk factors for 90-day readmission in veterans with inflammatory bowel disease-Does post-discharge follow-up matter?

Science.gov (United States)

Malhotra, Ashish; Phatharacharukul, Parkpoom; Thongprayoon, Charat

2018-02-08

Repeat hospitalizations in veterans with inflammatory bowel disease (IBD) are understudied. The early readmission rate and potentially modifiable risk-factors for 90-day readmission in veterans with IBD were studied to avert avoidable readmissions. A retrospective cohort study was conducted using the data from veterans who were admitted to the Minneapolis VA Medical Center (MVMC) between January 1, 2007, and December 31, 2013, for an IBD-related problem. All-cause readmissions within 30 and 90 days were recorded to calculate early readmission rates. The multivariate logistic regression was used to identify the potential risk factors for 90-day readmission. There were 130 unique patients (56.9% with Crohn's disease and 43.1% with ulcerative colitis) with 202 IBD-related index admissions. The mean age at the time of index admission was 59.8 ± 15.2 years. The median time to re-hospitalization was 26 days (IQR 10-49), with 30- and 90-day readmission rates of 17.3% (35/202) and 29.2% (59/202), respectively. Reasons for all-cause readmission were IBD-related (71.2%), scheduled surgery (3.4%) and non-gastrointestinal causes (25.4%). The following reasons were independently associated with 90-day readmission: Crohn's disease (OR 3.90; 95% CI 1.82-8.90), use of antidepressants (OR 2.19; 95% CI 1.12-4.32), and lack of follow-up within 90 days with a primary care physician (PCP) (OR 2.63; 95% CI 1.32-5.26) or a gastroenterologist (GI) (OR 2.44; 95% CI 1.20-5.00). 51.0% and 49.0% of patients had documentation of a recommended outpatient follow-up with PCP and/or GI, respectively. Early readmission in IBD is common. Independent risk factors for 90-day readmission included Crohn's disease, use of antidepressants and lack of follow-up visit with PCP or GI. Further research is required to determine if the appropriate timing of post-discharge follow-up can reduce IBD readmissions.

Effect of follow-up period on minimal-significant dose in the atomic-bomb survivor studies

Energy Technology Data Exchange (ETDEWEB)

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.)

Change in lifestyle behaviors and diabetes risk: evidence from a population-based cohort study with 10 year follow-up.

Science.gov (United States)

Feldman, Adina L; Long, Gráinne H; Johansson, Ingegerd; Weinehall, Lars; Fhärm, Eva; Wennberg, Patrik; Norberg, Margareta; Griffin, Simon J; Rolandsson, Olov

2017-03-29

Promoting positive changes in lifestyle behavior in the whole population may be a feasible and effective approach to reducing type 2 diabetes burden, but the impact of population shifts of modifiable risk factors remains unclear. Currently most of the evidence on modifiable lifestyle behavior and type 2 diabetes risk on a population level comes from studies of between-individual differences. The objective of the study was to investigate the association and potential impact on disease burden for within-individual change in lifestyle behavior and diabetes risk. Population-based prospective cohort study of 35,680 participants aged 30-50 at baseline in 1990-2003 in Västerbotten County, Sweden (follow-up until 2013). Five self-reported modifiable lifestyle behaviors (tobacco use, physical activity, alcohol intake, dietary fiber intake and dietary fat intake) were measured at baseline and 10 year follow-up. Lifestyle behaviors were studied separately, and combined in a score. Incident diabetes was detected by oral glucose tolerance tests. Multivariate logistic regression models and population attributable fractions (PAF) were used to analyze the association between change in lifestyle behavior between baseline and 10 year follow-up, and risk of incident diabetes. Incident diabetes was detected in 1,184 (3.3%) participants at 10 year follow-up. There was a reduced diabetes risk associated with increase in dietary fiber intake, odds ratio (OR) 0.79 (95% confidence interval (CI) 0.66, 0.96) for increase of at least one unit standard deviation (3.0 g/1,000 kcal) of the baseline distribution, PAF 16.0% (95% CI 4.2, 26.4%). Increase in the lifestyle behavior score was associated with reduced diabetes risk, OR 0.92 (95% CI 0.85, 0.99) per unit increase of the score. These results support a causal link between lifestyle behavior and type 2 diabetes incidence. A small shift in lifestyle behaviors, in particular intake of dietary fiber, has the potential to reduce diabetes

Validation of a new mortality risk prediction model for people 65 years and older in northwest Russia: The Crystal risk score.

Science.gov (United States)

Turusheva, Anna; Frolova, Elena; Bert, Vaes; Hegendoerfer, Eralda; Degryse, Jean-Marie

2017-07-01

Prediction models help to make decisions about further management in clinical practice. This study aims to develop a mortality risk score based on previously identified risk predictors and to perform internal and external validations. In a population-based prospective cohort study of 611 community-dwelling individuals aged 65+ in St. Petersburg (Russia), all-cause mortality risks over 2.5 years follow-up were determined based on the results obtained from anthropometry, medical history, physical performance tests, spirometry and laboratory tests. C-statistic, risk reclassification analysis, integrated discrimination improvement analysis, decision curves analysis, internal validation and external validation were performed. Older adults were at higher risk for mortality [HR (95%CI)=4.54 (3.73-5.52)] when two or more of the following components were present: poor physical performance, low muscle mass, poor lung function, and anemia. If anemia was combined with high C-reactive protein (CRP) and high B-type natriuretic peptide (BNP) was added the HR (95%CI) was slightly higher (5.81 (4.73-7.14)) even after adjusting for age, sex and comorbidities. Our models were validated in an external population of adults 80+. The extended model had a better predictive capacity for cardiovascular mortality [HR (95%CI)=5.05 (2.23-11.44)] compared to the baseline model [HR (95%CI)=2.17 (1.18-4.00)] in the external population. We developed and validated a new risk prediction score that may be used to identify older adults at higher risk for mortality in Russia. Additional studies need to determine which targeted interventions improve the outcomes of these at-risk individuals. Copyright © 2017 Elsevier B.V. All rights reserved.

Does behaviour modification affect post-stroke risk factor control? Three-year follow-up of a randomized controlled trial.

Science.gov (United States)

McManus, Julie Ann; Craig, Alison; McAlpine, Christine; Langhorne, Peter; Ellis, Graham

2009-02-01

Little is known about the long-term effectiveness after stroke of interventions for behaviour modification and ensuring concordance with therapies. We describe a follow-up study of a previous randomized controlled trial of a brief period of behaviour modification. The aim of this study was to determine outcomes three years after the initial intervention. Survivors of the original cohort were contacted and asked to attend for follow-up interview, within a geriatric day hospital. This study was carried out in the Geriatric Day Hospital at Stobhill Hospital, Balornock Road, Glasgow. Details of risk factor control, including blood pressure, cholesterol levels and diabetic control, were assessed. Questionnaires used in the initial study were repeated including the Geriatric Depression Scale score, Euroqol Perceived Health Status and Stroke Services Satisfaction Questionnaire. Primary outcome was collective risk factor control. Clinical outcomes including recurrent cerebrovascular events, medication persistence and perceived health status were also recorded. Mean length of follow-up was 3.6 years (SD 0.43). Of the 205 patients enrolled in the initial study, 102 patients attended for repeat interview(49 intervention/53 control). There were no significant differences in the percentage of controlled risk factors between groups (intervention 51.7% versus control 55.9%, P = 0.53). Similarities were observed in the number of recurrent clinical events and medication persistence between groups. No overall difference was observed in perceived health status, satisfaction with care or depression scores. Brief intervention with respect to behaviour modification and risk factor control does not appear to have any long-term benefit. These results must be cautiously interpreted in light of the small study number and further research is required.

Nut consumption and incidence of metabolic syndrome after 6-year follow-up: the SUN (Seguimiento Universidad de Navarra, University of Navarra Follow-up) cohort.

Science.gov (United States)

Fernández-Montero, Alejandro; Bes-Rastrollo, Maira; Beunza, Juan J; Barrio-Lopez, Maria Teresa; de la Fuente-Arrillaga, Carmen; Moreno-Galarraga, Laura; Martínez-González, Miguel Angel

2013-11-01

To assess the long-term relationship between tree nut consumption and the risk of developing metabolic syndrome (MetS). Nut consumption was collected using a validated 136-item FFQ. The MetS was defined according to the International Diabetes Federation and American Heart Association/National Heart, Lung, and Blood Institute harmonizing definition. The association between nut consumption and MetS was assessed with logistic regression models adjusting for potential confounders. We compared the incidence of MetS between extreme categories of nut intake (> or = 2 servings/week v. never/almost never) after 6 years of follow-up. The SUN Project (Seguimiento Universidad de Navarra, University of Navarra Follow-up) is a prospective cohort study, formed of Spanish university graduates. Information is gathered by mailed questionnaires collected biennially. Nut consumption and MetS information was collected by self-reported data. Participants (n 9887) initially free of MetS or diabetes and followed up for a minimum of 6 years were included. We observed 567 new cases of MetS during follow-up. Participants who consumed nuts > or = 2 servings/week presented a 32% lower risk of developing MetS than those who never/almost never consumed (adjusted OR = 0.68, 95% CI 0.50, 0.92). The inverse association was stronger among participants who were health professionals. Nut consumption was significantly associated with lower risk of developing MetS after a 6-year follow-up period in a cohort of Spanish graduates.

The influence of follow-up on DS02 low-dose ranges with a significant excess relative risk of all solid cancer in the Japanese A-bomb survivors

Energy Technology Data Exchange (ETDEWEB)

Walsh, Linda; Schneider, Uwe [University of Zuerich, Department of Physics, Science Faculty, Zurich (Switzerland)

2016-11-15

Determinations of the lowest colon dose, D{sub min}, below which there is a statistically significant excess relative risk of all solid cancer, when analyses are restricted to the range [0, D{sub min}], are of current interest in research related to radiation protection and risk assessment. In reviewing recent cancer mortality reports on the Life Span Study (LSS) of Japanese A-bomb survivors, reported D{sub min} values were found to vary between different reports. The report 12 (follow-up: 1950-1990) found a D{sub min} of 50 mGy, but the most recent report 14 (follow-up: 1950-2003) found a D{sub min} of 200 mGy. There were small dosimetry changes between report 12, which used DS86, and report 14, which used DS02, but these changes are unlikely to account for a difference in D{sub min} of a factor of 4. This short communication examines the reasons for this difference in D{sub min} by presenting further investigations into D{sub min} using different trial values for D{sub min} and various follow-up time spans, all with the same DS02 dosimetry. Magnitudes of the low-dose risks in different dose ranges are also presented. It is shown here that the main influence on D{sub min} comes from the length of follow-up and a D{sub min} of 50 mGy may also be obtained with the most recent LSS mortality data and DS02, if a restricted follow-up is analyzed. A systematic trend was evident of lower D{sub min} values for earlier mortality follow-up periods, consistent with information from earlier LSS reports. Although it may seem surprising that the D{sub min} increases with longer follow-up and better statistics, this systematic trend appears to be a consequence of decreasing mortality risks with longer follow-up, even though the error bars on the risks are getting smaller with increasing follow-up. These systematic trends also persisted after accounting for differences between baseline cancer rates for two groups of survivors who were either proximal or distal to the A

Five-year follow-up of people diagnosed with compulsive shopping disorder.

Science.gov (United States)

Black, Donald W; Shaw, Martha; Allen, Jeff

2016-07-01

The authors assessed clinical symptoms and self-reported shopping and spending behavior in people diagnosed with compulsive shopping (CS) at a 5-year follow-up interview. All met the criteria of McElroy et al. for lifetime CS and had the disorder for >1year. Structured and semistructured instruments and self-report questionnaires were used to collect data. Of the original 26 subjects, 17 (65%) were interviewed and are the focus of this report. At follow-up, their ages ranged from 23 to 67years (mean=44years). Lifetime psychiatric comorbidity was common, but few had current psychiatric disorders at follow-up. Interest in shopping and spending decreased for eight (47%), stayed the same for five (29%), and increased for four (24%) subjects. Eleven subjects (65%) reported having attempted to quit their CS and three (18%) reported successfully doing so. Triggers for returning to CS included feelings of pressure/excitement/tension to shop; boredom; negative feelings such as sadness, depression, frustration, or anger; and the desire for positive feelings like happiness, power, or elation. Mean scores on the Compulsive Buying Scale (CBS) and the shopping version of the Yale-Brown Obsessive-Compulsive Scale showed overall improvement in CS symptoms (d=1.16 and d=-1.19, respectively); subjects were also less impulsive (d=-0.48). At baseline and follow-up, those with a lifetime mood disorder tended to have greater CS severity. While the subjects showed overall improvement, most had ongoing symptoms of CS. The implications of the findings are discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Increased risk of ischemic stroke after hyperosmolar hyperglycemic state: a population-based follow-up study.

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Jen-Yu Wang

Full Text Available BACKGROUND: Although much attention has been focused on the association between chronic hyperglycemia and cerebrovascular diseases in type 2 diabetes mellitus (DM patients, there is no data regarding the risk of ischemic stroke after a hyperosmolar hyperglycemic state (HHS attack. The objective of this study was to investigate the risk of ischemic stroke in type 2 DM patients after an HHS attack. METHODS: From 2004 to 2008, this retrospective observational study was conducted on a large cohort of Taiwanese using Taiwan's National Health Insurance Research Database (NHIRD. We identified 19,031 type 2 DM patients who were discharged with a diagnosis of HHS and 521,229 type 2 DM patients without an HHS diagnosis. Using the propensity score generated from logistic regression models, conditional on baseline covariates, we matched 19,031 type 2 DM patients with an HHS diagnosis with the same number from the comparison cohort. The one-year cumulative rate for ischemic stroke was estimated using the Kaplan-Meier method. After adjusting covariates, Cox proportional hazard regression was used to compute the adjusted one-year rate of ischemic stroke. RESULTS: Of the patients sampled, 1,810 (9.5% of the type 2 DM patients with HHS and 996 (5.2% of the comparison cohort developed ischemic stroke during the one-year follow-up period. After adjusting for covariates, the adjusted HR for developing ischemic stroke during the one-year follow-up period was 1.8 (95% C.I., 1.67 to 1.95, P<0.001 for type 2 DM patients with HHS compared with those without HHS. CONCLUSION: Although DM is a well-recognized risk factor for atherosclerosis, type 2 DM patients that have suffered a HHS attacks are at an increased risk of developing ischemic stroke compared with those without HHS.

Long-term Follow-up of Treatment with Ibrutinib and Rituximab in Patients with High-Risk Chronic Lymphocytic Leukemia.

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Jain, Preetesh; Keating, Michael J; Wierda, William G; Sivina, Mariela; Thompson, Philip A; Ferrajoli, Alessandra; Estrov, Zeev; Kantarjian, Hagop; O'Brien, Susan; Burger, Jan A

2017-05-01

Background: Ibrutinib is an active therapy with an acceptable safety profile for patients with chronic lymphocytic leukemia (CLL), including high-risk patients with del17p or with TP53 mutations. Ibrutinib is broadly indicated for the treatment of patients with CLL and specifically including those with 17p deletion. The optimal use of ibrutinib in combination with other agents remains controversial. Experimental Design: We report the long-term outcome [median follow-up of 47 months (range, 36-51 months)] of 40 patients with high-risk CLL, treated on the first ibrutinib combination trial with rituximab (IR). The majority of patients (36/40) were previously treated. Results: Median age was 65 years, and 21 patients (52%) had 17p deletion. Median duration on treatment was 41 months (range, 2-51 months), and median number of treatment cycles was 42 (range, 2-49). Overall response rate was 95%, and 9 patients (23%) attained a complete remission. Twenty-one patients discontinued treatment, 10 due to disease progression, 9 for other causes, and 2 due to stem cell transplantation; the remaining 19 patients continue on ibrutinib. Median progression-free survival for all patients was 45 months, which was significantly shorter in the subgroup of patients with del17p ( n = 21, 32.3 months, P = 0.02). Fourteen patients (35%) died, five from progressive disease, five from infections, and four from other causes. Median overall survival has not been reached. Conclusions: IR combination therapy leads to durable remissions in high-risk CLL; the possible benefit from the addition of rituximab is currently explored in a randomized trial. Clin Cancer Res; 23(9); 2154-8. ©2016 AACR . ©2016 American Association for Cancer Research.

Optic nerve sheath meningioma treated with radiation conformal therapy. Clinical case report with long follow up

International Nuclear Information System (INIS)

Zomosa R, Gustavo; Cruz T, Sebastian; Miranda G, Gonzalo; Harbst S, Hans

2016-01-01

Optic nerve sheath meningiomas (ONSM) are rare tumors of the anterior visual pathway. Without treatment, tumor growth leads to progressive loss of visual acuity and blindness due to optic nerve compression. Case report: Patient, female, 42 years without other morbility , begins in 1992 with decreased visual acuity of the left eye, magnetic resonance imaging (MRI) showed enlargement of the left optic nerve sheath, suggestive of ONSM. On that occasion, orbit exploration failed, so it was decided to follow up with annual clinical and imaging controls. About ten years later, begins with progressive deterioration of visual acuity and visual field , with ptosis and ocular motor palsy of the left eye, confirmed with neuro-ophthalmological examinations. MRI shows tumor progression. A new surgical approach was discarded by the risk of visual worsening. A conformal radiotherapy was performed with a fractionated 54 Gy dose. Today, at age 65, after 24 years of follow up,13 post radiation therapy. clinical and radiological stability of ONSM is confirmed. Discussion: Conformal radiotherapy has been shown as an effective therapy, with fewer complications and better outcomes in the preservation of visual function in the long term follow up Radio-fluoro guided surgery in high grade gliomas

The prevalence of risk factors for cardiovascular diseases among Polish surgical patients over 65 years

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Kołtuniuk A

2016-05-01

Full Text Available Aleksandra Kołtuniuk, Joanna Rosińczuk Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland Background: Cardiovascular diseases (CVDs are the leading cause of mortality among adults in Poland. A number of risk factors have significant influence on CVD incidence. Early identification of risk factors related to our lifestyle facilitates taking proper actions aiming at the reduction of their negative impact on health.Aim: The aim of the study was to compare the prevalence of CVD risk factors between patients aged over 65 years and patients of other age groups in surgical wards.Material and methods: The study was conducted for assessment and finding the distribution of major risk factors of CVD among 420 patients aged 18–84 years who were hospitalized in surgical wards. Interview, anthropometric measurements, blood pressure, and fasting blood tests for biochemical analysis were conducted in all subjects. Statistical analysis of the material was performed using Student’s t-test, chi-square test, Fisher’s exact test, Mann–Whitney U-test, and analysis of variance.Results: While abdominal obesity (83.3%, overweight and obesity (68%, hypertension (65.1%, hypercholesterolemia (33.3%, and low level of physical activity (29.1% were the most common CVD risk factors among patients over 65 years old, abdominal obesity (36.2%, overweight and obesity (36.1%, and current smoking were the most common CVD risk factors among patients up to the age of 35. In the age group over 65, the least prevalent risk factors for CVD were diabetes mellitus (14.8%, depressive episodes (13.6%, abuse of alcohol (11.4%, and smoking (7.8%. In the group under 35 years, we have not reported any cases of hypercholesterolemia and a lesser number of patients suffered from diabetes and HTN.Conclusion: Distribution of the major risk factors for CVD is quite high in the adult population, especially in the age group over 65

Comparison of magnetic resonance imaging signs and clinical findings in follow-up examinations in children and juveniles with temporomandibular joint involvement in juvenile idiopathic arthritis; Vergleich magnetresonanztomografischer und klinischer Befunde von Follow-up-Untersuchungen bei Kindern und Jugendlichen mit rheumatischer Temporomandibulararthritis

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Mussler, A.; Schroeder, R.J. [Charite Berlin (Germany). Radiologie; Allozy, B. [Martin-Gropius-Krankenhaus, Eberswalde (Germany). Klinik fuer Kinder- und Jugendpsychiatrie; Landau, H. [Charite Berlin (Germany). Inst. fuer Kieferorthopaedie, Orthodontie und Kinderzahnmedizin; Kallinich, T. [Charite Berlin (Germany). Centrum fuer Frauen-, Kinder- und Jugendmedizin; Trauzeddel, R. [HELIOS Klinikum Berlin-Buch (Germany). Klinik fuer Kinder- und Jugendmedizin

2010-01-15

The aim of this study was to analyze the extent to which pathological findings of temporomandibular joint (TMJ) in magnetic resonance imaging (MRI) follow-up examinations are correlated with clinical symptoms in patients with TMJ involvement in juvenile ideopathic arthritis (JIA) over time. Data from 34 patients with TMJ involvement in JIA was retrospectively examined. Shortly after two clinical examinations, the first MRI and the follow-up MRI were performed. The MRI examinations took place with 1.5 T MRI. In both MRI examinations alterations on the condyle (MRI1: 88 %, MRT2: 91 %) and contrast enhancement (MRT1: 76 %, MRT2 65 %) were found most frequently. TMJ pain (65 %) and lower mouth opening capacity (65 %) were the number one finding in the first clinical examination. A statistically significant correlation was found between the alterations on the condyle and TMJ pain (p = 0.025) and between the alterations on the condyle and lower mouth opening capacity (p = 0.019). By comparing the results of the first MRI with the results of the follow-up MRI, we identified a trend towards a progression of TMJ arthritis, while the clinical follow-up showed an improvement in most patients. We found a discrepancy between the progressive or stable trends of pathological findings in follow-up MRI and the decrease in clinical symptoms over time. Therefore, follow-up examination by MRI shows important information for correct evaluation about the stage of TMJ arthritis and about the need for treatment. Consequently, follow-up examination by MRI is an appropriate addition to clinical examination in the therapeutic concept. (orig.)

Use of 5-alpha-reductase inhibitors did not increase the risk of cardiovascular diseases in patients with benign prostate hyperplasia: a five-year follow-up study.

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Teng-Fu Hsieh

Full Text Available This nationwide population-based study investigated the risk of cardiovascular diseases after 5-alpha-reductase inhibitor therapy for benign prostate hyperplasia (BPH using the National Health Insurance Research Database (NHIRD in Taiwan.In total, 1,486 adult patients newly diagnosed with BPH and who used 5-alpha-reductase inhibitors were recruited as the study cohort, along with 9,995 subjects who did not use 5-alpha-reductase inhibitors as a comparison cohort from 2003 to 2008. Each patient was monitored for 5 years, and those who subsequently had cardiovascular diseases were identified. A Cox proportional hazards model was used to compare the risk of cardiovascular diseases between the study and comparison cohorts after adjusting for possible confounding risk factors.The patients who received 5-alpha-reductase inhibitor therapy had a lower cumulative rate of cardiovascular diseases than those who did not receive 5-alpha-reductase inhibitor therapy during the 5-year follow-up period (8.4% vs. 11.2%, P=0.003. In subgroup analysis, the 5-year cardiovascular event hazard ratio (HR was lower among the patients older than 65 years with 91 to 365 cumulative defined daily dose (cDDD 5-alpha-reductase inhibitor use (HR=0.63, 95% confidence interval (CI 0.42 to 0.92; P=0.018, however there was no difference among the patients with 28 to 90 and more than 365 cDDD 5-alpha-reductase inhibitor use (HR=1.14, 95% CI 0.77 to 1.68; P=0.518 and HR=0.83, 95% CI 0.57 to 1.20; P=0.310, respectively.5-alpha-reductase inhibitor therapy did not increase the risk of cardiovascular events in the BPH patients in 5 years of follow-up. Further mechanistic research is needed.

Indicators of Cardiovascular Risk in Metabolic Syndrome: Long Term Follow-up in Italian Patients.

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Mombelli, Giuliana; Pavanello, Chiara; Castelnuovo, Samuela; Bosisio, Raffaella; Simonelli, Sara; Pazzucconi, Franco; Sirtori, Cesare Riccardo

2017-01-01

Cardiovascular risk (CV) factors associated with the metabolic syndrome (MetS) may vary in different populations. In some, hypertension may be the major determinant, in others are low high-density lipoprotein cholesterol (HDL-C), high triglycerides, or another component. Subjects included in this analysis were identified in 2006, among those attending the Lipid Clinic of the Niguarda Hospital, and followed up through to 2013. Patient characteristics (including the occurrence of CV events) were obtained from electronic medical records. MetS was diagnosed according to the American Heart Association/National Heart, Lung and Blood Institute (AHA/NHLBI) guidelines. The carotid intima media thickness (cIMT) was also followed in these patients over the years. After 7 years a total of 858 subjects had a complete follow-up; 271 of those had MetS. Patients developing a CV event showed elevated baseline cIMT (e.g. cIMTmax ≥ 2.4 mm in males and ≥ 2.2 mm in females); moreover the cIMT in MetS patients was higher at baseline and the rise over 7 years was larger compared with patients without MetS. By examining each body variable for MetS we found that a waist to height ratio (WHtR) ≥ 0.5 was present in nearly all subjects with a CV event. The follow-up data of a series of Italian patients with and without MetS, clearly indicates that the former have a raised cIMT and their arterial IMT progression is greater and the presence of a larger WHtR is apparently linked to a higher incidence of CV events. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Periodontal disease and risk of non-Hodgkin lymphoma in the Health Professionals Follow-Up Study.

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Bertrand, Kimberly A; Shingala, Janki; Evens, Andrew; Birmann, Brenda M; Giovannucci, Edward; Michaud, Dominique S

2017-03-01

Periodontal disease is a chronic inflammatory condition that has been associated with chronic diseases, including cancer. In an earlier prospective cohort analysis within the Health Professionals Follow-Up Study (HPFS), we observed a 31% higher risk of non-Hodgkin lymphoma (NHL) among participants with severe periodontal disease at baseline. Here, we extend the study with an additional 8 years of follow-up, and conduct analyses with updated periodontal disease status and NHL subtypes. The HPFS is an ongoing prospective cohort study of 51,529 men in the USA Between baseline in 1986 and 2012, 875 cases of NHL were diagnosed, including 290 chronic lymphocytic leukemia/small lymphocytic lymphomas (CLL/SLL), 85 diffuse large B-cell lymphomas and 91 follicular lymphomas. We performed multivariable Cox proportional hazards regression to evaluate associations of interest. History of periodontal disease at baseline was positively associated with risk of NHL overall (hazard ratio (HR) = 1.26, 95% confidence interval (CI): 1.06-1.49) and CLL/SLL (HR = 1.41, 95% CI: 1.04-1.90). With updated periodontal status, HRs were 1.30 (95% CI: 1.11-1.51) for NHL overall and 1.41 (95% CI: 1.08-1.84) for CLL/SLL. In contrast, after adjusting for periodontal disease, tooth loss was inversely associated with NHL, suggesting that other causes or consequences of tooth loss may have different implications for NHL etiology. Our findings suggest that periodontal disease is a risk factor for NHL. Whether periodontal disease is a direct or indirect cause of NHL, or is a marker of underlying systemic inflammation and/or immune dysregulation, warrants further investigation. © 2016 UICC.

BASHH 2016 UK national audit and survey of HIV testing, risk assessment and follow-up: case note audit.

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Bhaduri, Sumit; Curtis, Hilary; McClean, Hugo; Sullivan, Ann K

2018-01-01

This national audit demonstrated discrepancies between actual practice and that indicated by clinic policies following enquiry about alcohol, recreational drugs and chemsex use. Clinics were more likely to enquire about risk behaviour if this was clinic policy or routine practice. Previous testing was the most common reason for refusing HIV testing, although 33% of men who have sex with men had a prior test of more than three months ago. Of the group declining due to recent exposure in the window period, 21/119 cases had an exposure within the four weeks prior to presentation, but had a previous risk not covered by previous testing. Recommendations include provision of risk assessments for alcohol, recreational drug use and chemsex, documenting reasons for HIV test refusal, provision of HIV point-of-care testing, follow-up for cases at higher risk of HIV and advice about community testing or self-sampling/testing.

Outcomes of Revision Hip Arthroscopy: 2-Year Clinical Follow-up.

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Gupta, Asheesh; Redmond, John M; Stake, Christine E; Dunne, Kevin F; Hammarstedt, Jon E; Domb, Benjamin G

2016-05-01

To evaluate clinical outcomes, pain, and patient satisfaction following revision hip arthroscopy with a minimum 2-year follow-up. From April 2008 to October 2011, data were prospectively collected on all patients undergoing revision hip arthroscopy. All patients were assessed pre- and postoperatively with 4 patient-reported outcome (PRO) measures: the modified Harris hip score (mHHS), nonarthritic hip score (NAHS), hip outcome score-activities of daily living (HOS-ADL), and hip outcome score-sport-specific subscales (HOS-SSS). Pain was estimated on the visual analog scale (VAS). Patient satisfaction was measured on a scale from 0 to 10. The number of patients who underwent subsequent revision arthroscopy or total hip arthroplasty during the study period is also reported. Eighty-seven patients underwent revision hip arthroscopy during the study period. Seventy (80.5%) patients were included in our study. Average follow-up time was 28 months (range, 20 to 47.4 months). In terms of residual femoroacetabular impingement morphology, 45.7% of patients had preoperative alpha angles ≥ 55°, and 7.14% of patients had a lateral center-edge angle ≥ 40°. The score improvement from preoperative to 2-year follow-up was 57.84 to 73.65 for mHHS, 62.79 to 83.04 for HOS-ADL, 37.33 to 54.93 for HOS-SSS, and 55.65 to 70.79 for NAHS. VAS decreased from 6.72 to 4.08. All scores demonstrated statistically significant improvement (P arthroscopy during the study period. We found an overall minor complication rate of 10%. Revision hip arthroscopy for all procedures performed on aggregate has improved clinical outcomes for all PROs, high survivorship, and high patient satisfaction scores at short-term follow-up. Patients should be counseled regarding the potential progression of degenerative change leading to arthroplasty and the potential for revision surgery. Level IV retrospective case series. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc

Diffusion-weighted imaging for the follow-up of patients after matrix-associated autologous chondrocyte transplantation

International Nuclear Information System (INIS)

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.

Rate of recurrence in Indian patients presenting with acute pancreatitis and identification of chronicity on follow up: Possible risk factors for progression.

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Kalaria, Rishikesh; Abraham, Philip; Desai, Devendra C; Joshi, Anand; Gupta, Tarun

2018-03-01

To study the profile and long-term outcome of Indian patients presenting with acute pancreatitis and the possible risk factors for progression. Consecutive patients with acute or recurrent acute pancreatitis seen in our department during July 2013 to December 2014 were included. Details of past episodes were collected and patients were followed up till March 2015. In the 97 patients included (mean age 47.2 [SD 16.9] years; 74 men), gallstones (37 [38.1%]) and alcohol (19 [19.6%]) were the major identified etiologies; the idiopathic (31 [32%]) group constituted a third of patients. Recurrences were more common with idiopathic etiology (14 patients out of 30 had recurrences [46.7%]) as compared to alcoholic (5 out of 19 [26.3%]) and biliary (4 out of 37 [10.8%]) pancreatitis and with mild index episode. Following the episode of acute pancreatitis, identification of chronic pancreatitis was more common with alcoholic (6 out of 18 [33%]) and idiopathic (9 out of 30 [30%]) etiology as compared to other etiologies. Longer duration of follow up, but not number of recurrent episodes, was associated with identification of chronicity in patients presenting as acute pancreatitis. Out of 97 patients with acute pancreatitis, 27 (27.8%) developed recurrences with risk factors being idiopathic etiology and mild index episode. Eighteen of 97 (18.6%) patients had evidence of chronic pancreatitis on follow up, risk factors being the alcoholic and idiopathic varieties, and longer duration of follow up.

The I.P.S.N. barometer on the risk perception and the safety, a tool of opinion follow up on the risks in France

International Nuclear Information System (INIS)

Charron, S.; Mansoux, H.

2001-01-01

The risk perception by the public is one of the policy elements of management, information, communication on the nuclear. the I.P.S.N. is working since 1977 on the psycho-social aspects of the risk. It makes inquiries about public opinion, attitudes, credibility of diffused information. The results of these polls are gathered in the I.P.S.N. barometer of the risk and safety perception and constitutes an unique tool in France by the number of data and their follow up in time. (N.C.)

Risk of death among children of atomic bomb survivors after 62 years of follow-up: a cohort study.

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Grant, Eric J; Furukawa, Kyoji; Sakata, Ritsu; Sugiyama, Hiromi; Sadakane, Atsuko; Takahashi, Ikuno; Utada, Mai; Shimizu, Yukiko; Ozasa, Kotaro

2015-10-01

No clear epidemiological hereditary effects of radiation exposure in human beings have been reported. However, no previous studies have investigated mortality into middle age in a population whose parents were exposed to substantial amounts of radiation before conception. We assessed mortality in children of the atomic bomb survivors after 62 years of follow-up. In this prospective cohort study, we assessed 75 327 singleton children of atomic bomb survivors in Hiroshima and Nagasaki and unexposed controls, born between 1946 and 1984, and followed up to Dec 31, 2009. Parental gonadal doses of radiation from the atomic bombings were the primary exposures. The primary endpoint was death due to cancer or non-cancer disease, based on death certificates. Median follow-up was 54·3 years (IQR 45·4-59·3). 5183 participants died from disease. The mean age of the 68 689 surviving children at the end of follow-up was 53·1 years (SD 7·9) with 15 623 (23%) older than age 60 years. For parents who were exposed to a non-zero gonadal dose of radiation, the mean dose was 264 mGy (SD 463). We detected no association between maternal gonadal radiation exposure and risk of death caused by cancer (hazard ratio [HR] for 1 Gy change in exposure 0·891 [95% CI 0·693-1·145]; p=0·36) or risk of death caused by non-cancer diseases (0·973 [0·849-1·115]; p=0·69). Likewise, paternal exposure had no effect on deaths caused by cancer (0·815 [0·614-1·083]; p=0·14) or deaths caused by non-cancer disease (1·103 [0·979-1·241]; p=0·12). Age or time between parental exposure and delivery had no effect on risk of death. Late effects of ionising radiation exposure include increased mortality risks, and models of the transgenerational effects of radiation exposure predict more genetic disease in the children of people exposed to radiation. However, children of people exposed to the atomic bombs in Hiroshima and Nagasaki had no indications of deleterious health effects after 62

Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care.

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Joslin, Jeremy D; Lloyd, Jarem B; Copeli, Nikoli; Cooney, Derek R

2017-01-01

Introduction . We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods . Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY) who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results . Out of 750 race participants, 35 (4.6%) athletes received event medical care. Of these 35, twenty-eight (28/35; 80%) consented to participate in the study and 17 (61%) were available on telephone follow-up. Of these 17 athletes, 11 (11/17; 65%) of participants reported that they had not followed up with a medical professional since the race. Only 5 (5/17; 29%) confirmed that they had seen a medical provider in some fashion since the race; of these, only 2 (2/17; 12%) sought formal medical follow-up resulting from the recommendation whereas the remaining athletes merely saw their medical providers coincidentally or as part of routine care. Conclusion . Only 2 (2/17; 12%) of athletes who received event medical care obtained postrace follow-up within a one-month time period following the race. Event medical care providers must be aware of potential nonadherence to follow-up recommendations.

Adherence to Follow-Up Recommendations by Triathlon Competitors Receiving Event Medical Care

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Jeremy D. Joslin

2017-01-01

Full Text Available Introduction. We sought to investigate triathlete adherence to recommendations for follow-up for participants who received event medical care. Methods. Participants of the 2011 Ironman Syracuse 70.3 (Syracuse, NY who sought evaluation and care at the designated finish line medical tent were contacted by telephone approximately 3 months after the initial encounter to measure adherence with the recommendation to seek follow-up care after event. Results. Out of 750 race participants, 35 (4.6% athletes received event medical care. Of these 35, twenty-eight (28/35; 80% consented to participate in the study and 17 (61% were available on telephone follow-up. Of these 17 athletes, 11 (11/17; 65% of participants reported that they had not followed up with a medical professional since the race. Only 5 (5/17; 29% confirmed that they had seen a medical provider in some fashion since the race; of these, only 2 (2/17; 12% sought formal medical follow-up resulting from the recommendation whereas the remaining athletes merely saw their medical providers coincidentally or as part of routine care. Conclusion. Only 2 (2/17; 12% of athletes who received event medical care obtained postrace follow-up within a one-month time period following the race. Event medical care providers must be aware of potential nonadherence to follow-up recommendations.

Radiosurgery of craniopharyngiomas. Results of long-term follow-up

International Nuclear Information System (INIS)

Kida, Yoshihisa; Hasegawa, Toshinori; Yoshimoto, Masayuki; Koike, Johzi; Kobayashi, Tatsuya

2007-01-01

Long-term follow-up results of craniopharyngiomas after radiosurgery are reported. Among 125 cases of craniopharyngioma, long-term follow-up more than 6 months is obtained in 108 cases. Majority of the cases have had surgical excision before radiosurgery. The tumors, 19 mm in mean diameter were treated with the mean maximum dose of 22.1 Gy and with the marginal dose of 11.6 Gy. The final radiological outcomes during 63 months of mean follow-up showed 9 complete responses (CRs), 61 partial responses (PRs), 1 minor response (MR), 19 no changes (NCs) and 18 PGs, indicating the response rate of 65% and the control rate of 83% respectively. Neurological and endocrinological signs were improved in 18%, unchanged in 53% and worsened in 15% of cases, meanwhile 8% of the patients were dead. Small and solid tumors were the best indication for radiosurgery due to excellent tumor control as well as no adverse effects. They may have a good chance for complete remission. In conclusion a sufficient tumor resection with microsurgery is required and subsequent radiosurgery is most adequate for treating craniopharyngiomas. (author)

The Value of Screening Parents for Their Risk of Developing Psychological Symptoms After PICU: A Feasibility Study Evaluating a Pediatric Intensive Care Follow-Up Clinic.

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Samuel, Victoria M; Colville, Gillian A; Goodwin, Sarah; Ryninks, Kirsty; Dean, Suzanne

2015-11-01

This study aimed to assess whether prospectively screening parents for psychological vulnerability would enable beneficial targeting of a subsequent follow-up clinic. Parents of children consecutively admitted to a PICU were assessed for risk of developing posttraumatic stress disorder at discharge using the Posttraumatic Adjustment Scale. High-risk parents were then randomized to the intervention (follow-up clinic, 2 mo after discharge) or control condition. All parents completed Impact of Event Scale-Revised and Hospital Anxiety and Depression Scale at 6 months. Of the 209 parents of 145 children recruited to the study, 78 (37%) were identified, on the basis of their Posttraumatic Adjustment Scale score at baseline, as being at risk of developing posttraumatic stress disorder, and randomized to the control or intervention condition. Follow-up data were provided by 157 of 209 parents (75%). Logistic regression analyses controlling for parent gender and child length of stay showed that high-risk control parents (n = 32) were significantly more likely to score above the clinical cutoff for all three psychological outcomes than parents deemed low risk at baseline (n = 89) (posttraumatic stress: odds ratio = 3.39; 95% CI, 1.28-8.92; p = 0.014; anxiety: odds ratio = 6.34; 95% CI, 2.55-15.76; p parents attended the follow-up clinic appointment they were offered. At follow-up, there were no statistically significant differences between the intervention and control groups, but there were small effect sizes in favor of the intervention for anxiety scores (Cohen d = 0.209) and depression scores (Cohen d = 0.254) CONCLUSIONS:: Screening parents for psychological vulnerability using measures such as the Posttraumatic Adjustment Scale may enable more efficient targeting of support. However, further research is needed on how best to provide effective follow-up intervention for families.

The value of ultrasound in the follow-up of thyroid cancer

DEFF Research Database (Denmark)

Bennedbæk, Finn Noe; Hegedüs, Laszlo

2014-01-01

The value of ultrasound in the follow-up of thyroid cancer The commonly used tumour-node-metastasis (TNM) staging system is designed to predict death and not recurrence. Based on this, patients with thyroid cancer are grouped into risk categories at the time of initial treatment. However, recent...... guidelines proposed a novel staging system focusing on microscopic invasion into the perithyroidal tissues, neck lymph node involvement and 131I uptake outside the thyroid bed following treatment. This risk re-assessment improves the prediction of recurrent/persistent disease. The cornerstone in the follow......-up is measurement of plasma-thyroglobulin concentration and ultrasound of the neck focusing on the thyroid bed and classification of lymph nodes according to their location and high risk signs....

Risk factors and disease prevalence in 3331 personal check-ups performed in preventive medicine between 2006 and 2011. cross-sectional and follow-up study.

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Keipes, M; Bellucci, A; Hansen, E

2012-01-01

The present data results from a retrospective analysis of 3331 check-ups made in the preventive medicine department of the "ZithaKlinik", named "ZithaGesondheetsZentrum". These check-ups are done for the employee's of several firm's and institutions. According to gender and age, several tests and examinations are performed and the results are given to the person's general practitioner or another doctor of his choice. We will present a global synthesis of all the results but also a follow-up study of persons having performed 2 check-ups or more over a 5-year period. In the cross-sectional part, the analysis is done on 3331 individual check-ups (1447 woman, 1884 men). The average age is 50.3 years +/- 11.4. In the follow-up study, 478 persons (191 women, 287 men) had at least 2 (maximum 5) check-ups in the 5-year period of our observation. Initial age was 54.1 +/- 10.9 years for woman and 51.4 +/- 11.4 for men, respectively 56.4 +/- 10.9 and 53.7+/- 11.2 at their last check-up. An alarming number of persons present with a weight or obesity problem (according to age ranging from 22.0% overweight and 7.3% obese from 18-29 years, respectively 37.5% and 11.3% from 30-49 years, finally 44.0% and 20.6% in the range 50-69 years). Associated risk factors and pathologies (Hypertension, Dyslipidemia, NASH, diabetes type 2 and complete metabolic syndromes) are extremely frequent and getting more so with growing age. Furthermore, physical activity is insufficient in grossly 2/3 of the studied population. The only positive point is a tendency of decreasing tobacco use in all age groups. The follow-up study is frustrating because most of the examined criteria get worse in-between check-ups instead of getting better with changes in lifestyle in an informed population. Asymptomatic diseases or risk factors for non-communicable diseases are extremely frequent in the population examined. The follow-up data shows that huge parts of this group are not sufficiently conscientious of their

Long-term follow-up results of umbilical hernia repair.

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Venclauskas, Linas; Jokubauskas, Mantas; Zilinskas, Justas; Zviniene, Kristina; Kiudelis, Mindaugas

2017-12-01

Multiple suture techniques and various mesh repairs are used in open or laparoscopic umbilical hernia (UH) surgery. To compare long-term follow-up results of UH repair in different hernia surgery groups and to identify risk factors for UH recurrence. A retrospective analysis of 216 patients who underwent elective surgery for UH during a 10-year period was performed. The patients were divided into three groups according to surgery technique (suture, mesh and laparoscopic repair). Early and long-term follow-up results including hospital stay, postoperative general and wound complications, recurrence rate and postoperative patient complaints were reviewed. Risk factors for recurrence were also analyzed. One hundred and forty-six patients were operated on using suture repair, 52 using open mesh and 18 using laparoscopic repair technique. 77.8% of patients underwent long-term follow-up. The postoperative wound complication rate and long-term postoperative complaints were significantly higher in the open mesh repair group. The overall hernia recurrence rate was 13.1%. Only 2 (1.7%) patients with small hernias ( 30 kg/m 2 , diabetes and wound infection were independent risk factors for umbilical hernia recurrence. The overall umbilical hernia recurrence rate was 13.1%. Body mass index > 30 kg/m 2 , diabetes and wound infection were independent risk factors for UH recurrence. According to our study results, laparoscopic medium and large umbilical hernia repair has slight advantages over open mesh repair concerning early postoperative complications, long-term postoperative pain and recurrence.

Parental separation in childhood as a risk factor for depression in adulthood: a community-based study of adolescents screened for depression and followed up after 15 years.

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Bohman, Hannes; Låftman, Sara Brolin; Päären, Aivar; Jonsson, Ulf

2017-03-29

Earlier research has investigated the association between parental separation and long-term health outcomes among offspring, but few studies have assessed the potentially moderating role of mental health status in adolescence. The aim of this study was to analyze whether parental separation in childhood predicts depression in adulthood and whether the pattern differs between individuals with and without earlier depression. A community-based sample of individuals with adolescent depression in 1991-93 and matched non-depressed peers were followed up using a structured diagnostic interview after 15 years. The participation rate was 65% (depressed n = 227; non-depressed controls n = 155). Information on parental separation and conditions in childhood and adolescence was collected at baseline. The outcome was depression between the ages 19-31 years; information on depression was collected at the follow-up diagnostic interview. The statistical method used was binary logistic regression. Our analyses showed that depressed adolescents with separated parents had an excess risk of recurrence of depression in adulthood, compared with depressed adolescents with non-separated parents. In addition, among adolescents with depression, parental separation was associated with an increased risk of a switch to bipolar disorder in adulthood. Among the matched non-depressed peers, no associations between parental separation and adult depression or bipolar disorder were found. Parental separation may have long-lasting health consequences for vulnerable individuals who suffer from mental illness already in adolescence.

Development of De Novo Diabetes in Long-Term Follow-up After Bariatric Surgery.

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Nor Hanipah, Zubaidah; Punchai, Suriya; Brethauer, Stacy A; Schauer, Philip R; Aminian, Ali

2018-03-09

While bariatric surgery leads to significant prevention and improvement of type 2 diabetes, patients may rarely develop diabetes after bariatric surgery. The aim of this study was to determine the incidence and the characteristic of new-onset diabetes after bariatric surgery over a 17-year period at our institution. Non-diabetic patients who underwent bariatric surgery at a single academic center (1997-2013) and had a postoperative glycated hemoglobin (HbA1c) ≥ 6.5%, fasting blood glucose (FBG) ≥ 126 mg/dl, or positive glucose tolerance test were identified and studied. Out of 2263 non-diabetic patients at the time of bariatric surgery, 11 patients had new-onset diabetes in the median follow-up time of 9 years (interquartile range [IQR], 4-12). Bariatric procedures performed were Roux-en-Y gastric bypass (n = 7), adjustable gastric banding (n = 3), and sleeve gastrectomy (n = 1). The median interval between surgery and diagnosis of diabetes was 6 years (IQR, 2-9). At the last follow-up, the median HbA1c and FBG values were 6.3% (IQR, 6.1-6.5) and 95 mg/dl (IQR, 85-122), respectively. Possible etiologic factors leading to diabetes were weight regain to baseline (n = 6, 55%), steroid-induced after renal transplantation (n = 1), pancreatic insufficiency after pancreatitis (n = 1), and unknown (n = 3). De novo diabetes after bariatric surgery is rare with an incidence of 0.4% based on our cohort. Weight regain was common (> 50%) in patients who developed new-onset diabetes suggesting recurrent severe obesity as a potential etiologic factor. All patients had good glycemic control (HbA1c ≤ 7%) in the long-term postoperative follow-up.

Chest HRCT signs predict deaths in long-term follow-up among asbestos exposed workers

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Vehmas, Tapio, E-mail: tapio.vehmas@ttl.fi [Health and Work Ability, Finnish Institute of Occupational Health, Topeliuksenkatu 41 a A, FI-00250 Helsinki (Finland); Oksa, Panu, E-mail: panu.oksa@ttl.fi [Health and Work Ability, Finnish Institute of Occupational Health, Uimalankatu 1, FI-33101 Tampere (Finland)

2014-10-15

Highlights: • Much lung and pleural pathology is found in chest CT studies. • HRCT signs were screened and subsequent mortality followed up. • Several signs were related to all-cause and disease specific deaths. • The HRCT classification system used was able to predict mortality. • Secondary preventive strategies should be developed for patients with such signs. - Abstract: Objectives: To study associations between chest HRCT signs and subsequent deaths in long-term follow-up. Methods: Lung and pleural signs of 633 asbestos exposed workers (age 45–86, mean 65) screened with HRCT were recorded by using the International Classification of Occupational and Environmental Respiratory Diseases (ICOERD) system, which contains detailed instructions for use and reference images. Subsequent mortality was checked from the national register. Cox regression adjusted for covariates (age, sex, BMI, asbestos exposure, pack-years) was used to explore the relations between HRCT signs and all-cause deaths, cardiovascular and benign respiratory deaths, and deaths from neoplasms – all according to the ICD-10 diagnostic system. Results: The follow-up totalled 5271.9 person-years (mean 8.3 y/person, range .04–10.3). 119 deaths were reported. Irregular/linear opacities, honeycombing, emphysema, large opacities, visceral pleural abnormalities and bronchial wall thickening were all significantly related to all-cause deaths. Most of these signs were associated also with deaths from neoplasms and benign respiratory disease. Deaths from cardiovascular disease were predicted by emphysema and visceral pleural abnormalities. Conclusions: Several HRCT signs predicted deaths. Careful attention should be paid on subjects with radiological signs predictive of deaths and new secondary preventive strategies developed. This calls for further focused studies among different populations.

Inadequate Riboflavin Intake and Anemia Risk in a Chinese Population: Five-Year Follow Up of the Jiangsu Nutrition Study

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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

Esophageal atresia: long-term interdisciplinary follow-up

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Lidia B. Giúdici

2016-07-01

-hospitalization for clinical causes: 0; surgical reinterventions: 7%.Conclusions: Patients with EA are at risk for long-term morbidity and impairments. Long-term follow-up should be warranted for them.

Improving Neurodevelopmental Surveillance and Follow-up in Infants with Congenital Heart Disease.

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Michael, Mark; Scharf, Rebecca; Letzkus, Lisa; Vergales, Jeffrey

2016-01-01

We hypothesize that neurodevelopmental surveillance of targeted patients with congenital heart disease during the admission for their cardiac surgery would improve neurodevelopmental assessment and outpatient follow-up rates. All patients under 12 months of age who were operated on between October 2013 and October 2014 and were considered at risk for neurodevelopmental delay in accordance with the 2012 American Heart Association Scientific Statement were included. A protocol was implemented to increase surveillance of targeted patients during the hospitalization for their cardiac surgery. A historical control cohort was used from a 6-month period that preceded initiation of the program from July 2012 to December 2012. Univariate analysis assessed the effects of patient demographics, anatomy, postoperative course, and distance from clinic on inpatient screening and follow-up to evaluate areas for future improvement. Neurodevelopmental surveillance in the post-protocol period increased from 21% to 82% (P neurodevelopmental surveillance of high risk patients. Individuals that were younger and in the hospital longer were more likely to be successfully seen and comply with outpatient follow-up than those not receiving inpatient risk assessment. Patients with single ventricle anatomy may benefit from a modified follow-up schedule to improve compliance rates. Travel distance has no effect on likelihood of outpatient cardiac neurodevelopmental follow-up. © 2016 Wiley Periodicals, Inc.

Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study.

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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.

Physical Activity on Prescription (PAP), in patients with metabolic risk factors. A 6-month follow-up study in primary health care.

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Lundqvist, Stefan; Börjesson, Mats; Larsson, Maria E H; Hagberg, Lars; Cider, Åsa

2017-01-01

There is strong evidence that inadequate physical activity (PA) leads to an increased risk of lifestyle-related diseases and premature mortality. Physical activity on prescription (PAP) is a method to increase the level of PA of patients in primary care, but needs further evaluation. The aim of this observational study was to explore the association between PAP-treatment and the PA level of patients with metabolic risk factors and the relationship between changes in the PA level and health outcomes at the 6 month follow-up. This study included 444 patients in primary care, aged 27-85 years (56% females), who were physically inactive with at least one component of metabolic syndrome. The PAP-treatment model included: individualized dialogue concerning PA, prescribed PA, and a structured follow-up. A total of 368 patients (83%) completed the 6 months of follow-up. Of these patients, 73% increased their PA level and 42% moved from an inadequate PA level to sufficient, according to public health recommendations. There were significant improvements (p≤ 0.05) in the following metabolic risk factors: body mass index, waist circumference, systolic blood pressure, fasting plasma glucose, cholesterol, and low density lipoprotein. There were also significant improvements regarding health-related quality of life, assessed by the Short Form 36, in: general health, vitality, social function, mental health, role limitation-physical/emotional, mental component summary, and physical component summary. Regression analysis showed a significant association between changes in the PA level and health outcomes. During the first 6-month period, the caregiver provided PAP support 1-2 times. This study indicates that an individual-based model of PAP-treatment has the potential to change people's PA behavior with improved metabolic risk factors and self-reported quality of life at the 6 month follow-up. Thus, PAP seems to be feasible in a clinical primary care practice, with minimum effort

Physical Activity on Prescription (PAP, in patients with metabolic risk factors. A 6-month follow-up study in primary health care.

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Stefan Lundqvist

Full Text Available There is strong evidence that inadequate physical activity (PA leads to an increased risk of lifestyle-related diseases and premature mortality. Physical activity on prescription (PAP is a method to increase the level of PA of patients in primary care, but needs further evaluation. The aim of this observational study was to explore the association between PAP-treatment and the PA level of patients with metabolic risk factors and the relationship between changes in the PA level and health outcomes at the 6 month follow-up. This study included 444 patients in primary care, aged 27-85 years (56% females, who were physically inactive with at least one component of metabolic syndrome. The PAP-treatment model included: individualized dialogue concerning PA, prescribed PA, and a structured follow-up. A total of 368 patients (83% completed the 6 months of follow-up. Of these patients, 73% increased their PA level and 42% moved from an inadequate PA level to sufficient, according to public health recommendations. There were significant improvements (p≤ 0.05 in the following metabolic risk factors: body mass index, waist circumference, systolic blood pressure, fasting plasma glucose, cholesterol, and low density lipoprotein. There were also significant improvements regarding health-related quality of life, assessed by the Short Form 36, in: general health, vitality, social function, mental health, role limitation-physical/emotional, mental component summary, and physical component summary. Regression analysis showed a significant association between changes in the PA level and health outcomes. During the first 6-month period, the caregiver provided PAP support 1-2 times. This study indicates that an individual-based model of PAP-treatment has the potential to change people's PA behavior with improved metabolic risk factors and self-reported quality of life at the 6 month follow-up. Thus, PAP seems to be feasible in a clinical primary care practice, with

About the contribution of occupational health's services for risk factors evaluation, medical and dosimetric follow-up in the workers monitoring exposed to ionising radiations in France

International Nuclear Information System (INIS)

Bailloeuil, C.; Gonin, M.; Gerondal, M.

2006-01-01

Full text of publication follows: French national regulation (31/03/2003) indicates principles of a global approach about the medical and dosimetric follow-up in the workers monitoring. Legislator insists on risks and expositions trace ability along all professional career and after. The aim of this French specific system is to institute medical clinic aspects in accordance with dosimetry and professional risks. The occupational practitioners are approved practitioners who have followed a specific training. The organisation guarantees that a worker will be followed by one specific practitioner in order to reinforce the quality and the traceability of follow up. Medical supervision is done at taking on and at least once a year. It means to identify and take care of risks and expositions at work stations. If necessary, biological measurements and recommendations about collective and individual protection equipments complete the estimation of risks. On the subject of emergency, first aid is delivered on sites by occupational health personnel, either for classic medical problem or for radiological accident. Furthermore, occupational health personnel assist outside emergency services with whom we have specific conventions. External dosimetric follow-up is done with radiation protection qualified expert of the company. The internal contamination supervision and internal dose evaluation are done by the occupational health services. Measurements either whole body counts or radio-toxicologic analysis are submitted to technical quality process. Beyond the respect of regulatory dose limits, the aim of the dosimetric follow-up is the contribution to the preparation of work places with strong dosimetric focus. Informations at workers are dispensed about every risks and every kinds of risks: ionising radiation health effects, ionising radiation and pregnancy, high exposition, chemical risks, work at heat, asbestos. All data are conserved 50 years after the exposure These data

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

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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

Fluctuations of epstein-barr virus serological antibodies and risk for nasopharyngeal carcinoma: a prospective screening study with a 20-year follow-up.

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Su-Mei Cao

Full Text Available BACKGROUND: The impact of variation of Epstein-Barr virus (EBV antibody titers before the development of nasopharyngeal carcinoma (NPC is still unclear. We analyzed the fluctuations of antibodies against EBV before histopathological diagnosis to assess the risk of NPC and aimed to provide a reliable basis for screening in high risk populations. METHODS: This study was based on a population-based screening program in Sihui County in Guangdong Province of China. A total of 18,986 subjects were recruited in 1987 and 1992, respectively. Baseline and repeated serological tests were performed for IgA antibodies against EBV capsid antigen (VCA/IgA and early antigen (EA/IgA. Follow-up until the end of 2007 was accomplished through linkage with population and health registers. Cox proportional hazards regression model was used to estimate the relative risk of NPC in association with EBV antibodies. Time-dependent receiver operating characteristic curve (ROC analysis was used to further evaluate the predictive ability. RESULTS: A total of 125 NPCs occurred during an average of 16.9 years of follow-up. Using baseline information alone or together with repeated measurements, serological levels of VCA/IgA and EA/IgA were significantly associated with increased risks for NPC, with a striking dose-response relationship and most prominent during the first 5 years of follow-up. Considering the fluctuant types of serological titers observed during the first three tests, relative risk was highest among participants with ascending titers of EBV VCA/IgA antibodies with an adjusted hazard ratio (HR of 21.3 (95% confidence interval [CI] 7.1 to 64.1, and lowest for those with decreasing titers (HR = 1.5, 95% CI 0.2 to 11.4, during the first 5 years of follow-up. Time-dependent ROC analysis showed that VCA/IgA had better predictive performance for NPC incidence than EA/IgA. CONCLUSION: Our study documents that elevated EBV antibodies, particularly with ascending

Automated medical follow-up and delayed industrial risks

International Nuclear Information System (INIS)

Smith, M.E.

In response to increasing demand for human data to identify social, environmental, and occupational influences upon health, Statistics Canada has been organizing existing files of vital and health records to facilitate such studies on a national scale. In particular, the development of a Canadian Mortality Data Base file, the initiation of the National Cancer Incidence system, and the development of new computer techniques have helped reduce the cost and increase the scale and efficiency of automated medical follow-up to produce statistics of sickness or death attributable to environmental factors. Specific occupational studies now in progress serve to illustrate the methods, practical difficulties, potential size, and products from such investigations

EARLY DISTANCE INTERVENTION AND FOLLOW-UP FOR FAMILIES OF INFANTS AND TODDLERS AT RISK FOR DEVELOPMENTAL DISABILITIES AND SEVERE BEHAVIOR PROBLEMS IN PERU

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Rosa Oyama-Ganiko

2013-11-01

Full Text Available http://dx.doi.org/10.5902/1984686X9946A major barrier to meeting the needs of low-income children and families with disabilities is distance from a center providing the diagnostics and treatment. In the U.S. several innovative ways of overcoming this difficulty have emerged, e.g. Call-In, Come-In Services in a Pediatric Psychology Practice, diagnostics and consultation via telemedicine, use of the Internet for webcasting conferences, library resources over the Internet, etc. These services are not yet available in many developing countries or in rural areas of the U.S., however.  We report below an inexpensive and effective method of early distance intervention using workshops every two months and monthly telephone follow-up at the Centro Ann Sullivan del Peru in Lima, Peru. While many poor families may not have regular access to radio, television, or the Internet, we and others (Bigelow, Carta, & LeFever, 2008 have found that almost all have cell phones, and they can be followed regularly. In our project on early prevention of severe aggression, self-injury, and stereotyped behavior among infants and toddlers at risk for developmental disabilities, monthly telephone follow-up attendance remained high throughout the one-year follow-up period (92%, while family attendance at the six bi-monthly workshops dropped off (75% to 28%. Mean BPI frequency scores decreased significantly over the year. BPI scores were significantly higher, and they decreased more in the high-attendance group than in the low-attendance group.  Family stress was reduced by 65%. Consumer satisfaction was 98%.A very similar workshop package has been given to many orphanages and to remote areas in Peru, where there is not any kind of education about disabilities and where parents have to be the best teachers. Having such tools gives them knowledge of what their children can achieve, so they would not relinquish them to government orphanages.  

Leisure-time physical activity and disability pension: 9 years follow-up of the HUNT Study, Norway.

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Fimland, M S; Vie, G; Johnsen, R; Nilsen, T I L; Krokstad, S; Bjørngaard, J H

2015-12-01

The objective of this study was to prospectively examine the association between leisure-time physical activity and risk of disability pension, as well as risk of disability pension because of musculoskeletal or mental disorders in a large population-based cohort. Data on participants aged 20-65 years in the Norwegian Nord-Trøndelag Health Study 1995-1997 (HUNT2) were linked to the National Insurance Database. Cox regression was used to calculate hazard ratios (HR) and 95% confidence intervals for disability pension across physical activity categories. During a follow-up of 9.3 years and 235,657 person-years, 1266 of 13,823 men (9%) and 1734 of 14,531 women (12%) received disability pension. Compared with individuals in the inactive group, those in the highly active group had a 50% lower risk of receiving disability pension (HR for men: 0.50, 0.40-0.64; women: 0.50, 0.39-0.63). After comprehensive adjustment for potential confounders, the risk remained 32-35% lower (HR for men: 0.68, 0.53-0.86; women: 0.65, 0.51-0.83). The associations were stronger for disability pension due to musculoskeletal disorders than mental disorders. In summary, we observed strong inverse associations between leisure-time physical activity and disability pension. Our findings strengthen the hypothesis that leisure-time physical activity may be important for occupational health in reducing disability pension. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Long-term HPV type-specific risks for ASCUS and LSIL: a 14-year follow-up of a randomized primary HPV screening trial.

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Elfström, K Miriam; Smelov, Vitaly; Johansson, Anna L V; Eklund, Carina; Naucler, Pontus; Arnheim-Dahlström, Lisen; Dillner, Joakim

2015-01-15

Human papillomavirus (HPV) infections result in a significant burden of low-grade cervical lesions. Between 1997 and 2000, our randomized trial of primary HPV screening enrolled 12,527 women participating in population-based screening. Women between 32 and 38 years of age (median: 34, interquartile range: 33-37) were randomized to HPV and cytology double testing (intervention arm, n = 6,257 enrolled, n = 5,888 followed-up) or to cytology, with samples frozen for future HPV testing (control arm, n = 6,270 enrolled, n = 5,795 followed-up). We estimated the HPV type-specific, long-term absolute risks (AR), and population attributable proportions (PAR) for cytological diagnoses of atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) and for histopathologically diagnosed cervical intraepithelial neoplasia grade 1 (CIN1). The women were followed using comprehensive, nationwide register-based follow-up. During a mean follow-up time of 11.07 years, 886 ASCUS and LSIL lesions were detected, 448 in the intervention arm and 438 in the control arm. Poisson regression estimated the incidence rate ratios (IRRs) of low-grade lesions by HPV type. The IRRs were strongly dependent on follow-up time. The IRRs for ASCUS/LSIL associated with high-risk HPV positivity were 18.6 (95% CI: 14.9-23.4) during the first screening round, 4.1 (95% CI: 2.8-6.2) during the second, 2.6 (95% CI: 1.7-4.1) during the third, and 1.1 (95% CI: 0.7-1.8) for >9 years of follow-up, with similar declines seen for the individual types. Type 16 contributed consistently to the greatest proportion of ASCUS, LSIL, and CIN1 risk in the population (first screening round PAR: ASCUS: 15.5% (95% CI: 9.7-21.9), LSIL: 14.7% (95% CI: 8.0-20.9), and CIN1: 13.4% (95% CI: 3.2-22.5)), followed by type 31 [8.4% (95% CI: 4.2-12.5) for ASCUS to 17.3% (95% CI: 6.8-26.6) for CIN1]. In summary, most ASCUS/LSIL lesions associated with HPV infection are caused by new HPV

Risk of developing obstructive sleep apnea among women with polycystic ovarian syndrome: a nationwide longitudinal follow-up study.

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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.

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

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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.

Prevalence and risk factors associated with non-attendance in neurodevelopmental follow-up clinic among infants with CHD.

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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.

Towards sustainability assessment follow-up

Energy Technology Data Exchange (ETDEWEB)

Morrison-Saunders, Angus, E-mail: a.morrison-saunders@murdoch.edu.au [Murdoch University (Australia); North-West University (South Africa); Pope, Jenny, E-mail: jenny@integral-sustainability.net [North-West University (South Africa); Integral Sustainability (Australia); Curtin University (Australia); Bond, Alan, E-mail: alan.bond@uea.ac.uk [North-West University (South Africa); University of East Anglia (United Kingdom); Retief, Francois, E-mail: francois.retief@nwu.ac.za [North-West University (South Africa)

2014-02-15

This paper conceptualises what sustainability assessment follow-up might entail for three models of sustainability assessment: EIA-driven integrated assessment, objectives-led integrated assessment and the contribution to sustainability model. The first two are characterised by proponent monitoring and evaluation of individual impacts and indicators while the latter takes a holistic view based around focused sustainability criteria relevant to the context. The implications of three sustainability challenges on follow-up are also examined: contested time horizons and value changes, trade-offs, and interdisciplinarity. We conclude that in order to meet these challenges some form of adaptive follow-up is necessary and that the contribution to sustainability approach is the best approach. -- Highlights: • We explore sustainability follow-up for three different sustainability models. • Long-time frames require adaptive follow-up and are a key follow-up challenge. • Other key challenges include interdisciplinarity, and trade-offs. • Sustainability follow-up should be a direction of travel and not an outcome. • Only the follow-up for contribution to sustainability model addresses sustainability challenges sufficiently.

Towards sustainability assessment follow-up

International Nuclear Information System (INIS)

Morrison-Saunders, Angus; Pope, Jenny; Bond, Alan; Retief, Francois

2014-01-01

This paper conceptualises what sustainability assessment follow-up might entail for three models of sustainability assessment: EIA-driven integrated assessment, objectives-led integrated assessment and the contribution to sustainability model. The first two are characterised by proponent monitoring and evaluation of individual impacts and indicators while the latter takes a holistic view based around focused sustainability criteria relevant to the context. The implications of three sustainability challenges on follow-up are also examined: contested time horizons and value changes, trade-offs, and interdisciplinarity. We conclude that in order to meet these challenges some form of adaptive follow-up is necessary and that the contribution to sustainability approach is the best approach. -- Highlights: • We explore sustainability follow-up for three different sustainability models. • Long-time frames require adaptive follow-up and are a key follow-up challenge. • Other key challenges include interdisciplinarity, and trade-offs. • Sustainability follow-up should be a direction of travel and not an outcome. • Only the follow-up for contribution to sustainability model addresses sustainability challenges sufficiently

Assessing factors for loss to follow-up of HIV infected patients in Guinea-Bissau

DEFF Research Database (Denmark)

Nordentoft, Pernille Bejer; Engell-Sørensen, Thomas; Jespersen, Sanne

2017-01-01

reasons were moving (29.1 %), travelling (17.5 %), and transferring to other clinics (11.7 %). Conclusion: A large proportion of the patients at the clinic were lost to follow-up. The main reason for this was found to be the geographic mobility of the population in Guinea-Bissau.......Purpose: The objective of this study was to ascertain vital status of patients considered lost to follow-up at an HIV clinic in Guinea-Bissau, and describe reasons for loss to follow-up (LTFU). Methods: This study was a cross-sectional sample of a prospective cohort, carried out between May 15...... and 12.6 % HIV-1/2) living within the DSS, 292 patients had been lost to follow-up and were, therefore, eligible for active follow-up. Vital status was ascertained in 65.9 % of eligible patients and 42.7 % were alive, while 23.2 % had died. Information on reasons for LTFU existed for 103 patients. Major...

Alcohol, tabaco y deterioro cognoscitivo en adultos mexicanos mayores de 65 años Cognitive impairment and alcohol and cigarette consumption in Mexican adults older than 65 years

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Sara Gloria Aguilar-Navarro

2007-01-01

Full Text Available OBJETIVO: Conocer la prevalencia del consumo de alcohol y tabaco y su asociación con deterioro cognoscitivo en la población mexicana mayor de 65 años. MATERIAL Y MÉTODOS: Se incluyeron 4 872 mayores de 65 años en la muestra del Estudio Nacional sobre Salud y Envejecimiento en México (ENASEM 2001. Se interrogó sobre el consumo de alcohol y tabaco. Para la clasificación de los sujetos con deterioro cognoscitivo, se utilizó la escala total de los diferentes dominios cognoscitivos. Se aplicaron ji cuadrada, Mann Whitney U y regresión logística para encontrar asociaciones. RESULTADOS: La prevalencia de alcoholismo según CAGE fue de 2.8% y la del consumo de tabaco de 14 por ciento. Factores asociados con el consumo de alcohol: edad 65-69 años (p OBJECTIVE: To determine the prevalence of the consumption of alcohol and cigarette smoking and their association with cognitive impairment among older Mexican adults. MATERIAL AND METHODS: A total of 4 872 people over 65 years of age included in the sample of the National Mexican Health and Aging Study carried out in 2001 were questioned about their consumption of alcohol and cigarette smoking. For the classification of those subjects with cognitive impairment, the total scale of the different cognitive domains was used. The chi-square, Mann-Whitney U test, and logistical regression were used in order to find associations. RESULTS: The prevalence of alcoholism according to CAGE was 2.8% and the prevalence of the consumption of cigarette smoking was 14%. Factors associated with the consumption of alcohol were:age 65-69 (p <0.001, men (RR 3.17,p <0.001, and high level of education (p <0.001. The association between the consumption of alcohol and cognitive impairment (X2=6.59, p <0.01 was statistically significant. CONCLUSIONS: The prevalence of consumption of alcohol and cigarette smoking in older Mexican adults are similar to that reported in other countries; the consumption of alcohol and its

Intakes of Lutein, Zeaxanthin, and Other Carotenoids and Age-Related Macular Degeneration During 2 Decades of Prospective Follow-up.

Science.gov (United States)

Wu, Juan; Cho, Eunyoung; Willett, Walter C; Sastry, Srinivas M; Schaumberg, Debra A

2015-12-01

Despite strong biological plausibility, evidence from epidemiologic studies and clinical trials on the relations between intakes of lutein and zeaxanthin and age-related macular degeneration (AMD) has been inconsistent. The roles of other carotenoids are less thoroughly investigated. To investigate the associations between intakes of carotenoids and AMD. Prospective cohort study, with cohorts from the Nurses' Health Study and the Health Professionals Follow-up Study in the United States. A total of 63,443 women and 38,603 men were followed up, from 1984 until May 31, 2010, in the Nurses' Health Study and from 1986 until January 31, 2010, in the Health Professionals Follow-up Study. All participants were aged 50 years or older and were free of diagnosed AMD, diabetes mellitus, cardiovascular disease, and cancer at baseline. Predicted plasma carotenoid scores were computed directly from food intake, assessed by repeated food frequency questionnaires at baseline and follow-up, using validated regression models to account for bioavailability and reporting validity of different foods, and associations between predicted plasma carotenoid scores and AMD were determined. We confirmed 1361 incident intermediate and 1118 advanced AMD cases (primarily neovascular AMD) with a visual acuity of 20/30 or worse by medical record review. Comparing extreme quintiles of predicted plasma lutein/zeaxanthin score, we found a risk reduction for advanced AMD of about 40% in both women and men (pooled relative risk comparing extreme quintiles = 0.59; 95% CI, 0.48-0.73; P for trend carotenoid scores for other carotenoids, including β-cryptoxanthin, α-carotene, and β-carotene, were associated with a 25% to 35% lower risk of advanced AMD when comparing extreme quintiles. The relative risk comparing extreme quintiles for the predicted plasma total carotenoid index was 0.65 (95% CI, 0.53-0.80; P for trend carotenoids, either as predicted plasma score or calculated intake, with

Estudo das mutações C282Y, H63D e S65C do gene HFE em doentes brasileiros com sobrecarga de ferro Study of C282Y, H63D and S65C mutations in the HFE gene in Brazilian patients with iron overload

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Rodolfo D. Cançado

2007-12-01

Full Text Available Hemocromatose é uma das doenças genéticas mais freqüentes no ser humano e uma das causas mais importantes de sobrecarga de ferro. Os objetivos deste estudo foram determinar a freqüência das mutações C282Y, H63D e S65C do gene HFE em doentes brasileiros com sobrecarga de ferro, verificar a coexistência de anemia hemolítica hereditária, hepatite C e consumo excessivo de bebida alcoólica nestes doentes e avaliar a influência destas variáveis sobre os depósitos de ferro do organismo. Saturação da transferrina, ferritina sérica e análise das mutações C282Y, H63D e S65C do gene HFE, pelo método da PCR, foram determinadas em cinqüenta doentes com sobrecarga de ferro atendidos no Hemocentro da Santa Casa de São Paulo entre janeiro de 2000 e maio de 2004. A freqüência de mutação do gene HFE nos doentes com sobrecarga de ferro foi de 76,0% (38/50. Saturação da transferrina e ferritina foram significativamente maiores nos doentes homozigotos para a mutação C282Y confirmando a correlação entre genótipo C282Y/C282Y e maior risco de sobrecarga de ferro. A coexistência de hepatite C, consumo excessivo de bebida alcoólica ou anemia hemolítica hereditária estão implicados em aumento dos estoques de ferro e constituem fator de risco adicional em pacientes com mutação do gene HFE para a condição de sobrecarga de ferro.Hemochromatosis is one of the most frequent genetic diseases in humans and one of the most important causes of iron overload. The aims of this study were to determine the frequency of C282Y, H63D and S65C mutations of the HFE gene in Brazilian patients with iron overload, to verify the coexistence of chronic hemolytic anemia, hepatitis C and excessive alcohol consumption and to evaluate the influence of these variables on body iron deposits. Transferrin saturation, serum ferritin and C282Y, H63D and S65C HFE gene mutations (by PCR method were determined in 50 patients with iron overload in the Hemocentro da

Follow-up of basal cell carcinomas: an audit of current practice.

Science.gov (United States)

Mc Loone, N M; Tolland, J; Walsh, M; Dolan, O M

2006-07-01

Follow-up of patients after treatment of basal cell carcinoma (BCC) allows for monitoring of recurrence and detection of new tumours, but adds a significant burden to outpatient clinics. At the skin tumour clinic in the dermatology department, the Royal Hospitals, Belfast, all patients are reviewed for 2 years after surgical excision of a low-risk primary BCC. An audit was undertaken to determine the quality of data set recorded relating to prognostic factors for BCCs to determine the rate of recurrence and number of new primary tumours detected and to determine the completeness of follow-up by patients. Patients who had primary BCCs treated by excision were identified from a database held at the clinic. Medical charts were reviewed to determine data recorded about lesions, the number of recurrent BCCs and new tumours detected, and the number of patients completing follow-up. Between January 1999 and December 2000, 114 patients had 121 primary BCCs excised. BCC location and size were recorded in 100% and 35% of cases, respectively. Histological type was stated for morphoeic or multifocal lesions. Two years of follow-up was completed by 53% of patients and 1 year by 78% of patients. The rate of recurrence was low, with 2 BCC recurring within 2 years of excision. The risk of developing a new BCC was 11.6% in the first year and 6.3% in the second year. Follow-up of patients after excision of a low-risk BCC at the clinic has been reduced to 1 year. A proforma has been developed to encourage documentation of prognostic factors.

Younger age increases the risk of early prosthesis failure following primary total knee replacement for osteoarthritis. A follow-up study of 32,019 total knee replacements in the Finnish Arthroplasty Register.

Science.gov (United States)

Julin, Jaakko; Jämsen, Esa; Puolakka, Timo; Konttinen, Yrjö T; Moilanen, Teemu

2010-08-01

Total knee replacements (TKRs) are being increasingly performed in patients aged age of the patient and prosthesis survival following primary TKR using nationwide data collected from the Finnish Arthroplasty Register. From Jan 1, 1997 through Dec 31, 2003, 32,019 TKRs for primary or secondary osteoarthritis were reported to the Finnish Arthroplasty Register. The TKRs were followed until the end of 2004. During the follow-up, 909 TKRs were revised, 205 (23%) due to infection and 704 for other reasons. Crude overall implant survival improved with increasing age between the ages of 40 and 80. The 5-year survival rates were 92% and 95% in patients aged 65 years of age (p age groups 65 years remained after adjustment for these factors (p age impairs the prognosis of TKR and is associated with increased revision rates for non-infectious reasons. Diagnosis, sex, type of TKR, use of patellar component, and fixation method partly explain the differences, but the effects of physical activity, patient demands, and obesity on implant survival in younger patients warrant further research.

Neoplasia in Turner syndrome. The importance of clinical and screening practices during follow-up.

Science.gov (United States)

Larizza, Daniela; Albanesi, Michela; De Silvestri, Annalisa; Accordino, Giulia; Brazzelli, Valeria; Maffè, Gabriella Carnevale; Calcaterra, Valeria

2016-05-01

Turmer syndrome (TS) patients show increased morbidity due to metabolic, autoimmune and cardiovascular disorders. A risk of neoplasia is also reported. Here, we review the prevalence of neoplasia in a cohort of Turner patients. We retrospectively evaluated 87 TS women. Follow-up included periodic ultrasound of the neck, abdominal and pelvic organs, dermatologic evaluation and fecal occult blood test. Karyotype was 45,X in 46 patients. During follow-up, 63 girls were treated with growth hormone, 65 with estro-progestin replacement therapy and 20 with L-thyroxine. Autoimmune diseases were present in 29 TS. A total of 17 neoplasms in 14 out of 87 patients were found. Six skin neoplasia, 3 central nervous system tumors, 3 gonadal neoplasia, 2 breast tumors, 1 hepatocarcinoma, 1 carcinoma of the pancreas and 1 follicular thyroid cancer were detected. Age at tumor diagnosis was higher in 45,X pts than in those with other karyotypes (p = 0.003). Adenomioma gallbladdder (AG) was detected in 15.3% of the patients, with a lower age in girls at diagnosis with an associated neoplasia in comparison with TS without tumors (p = 0.017). No correlation between genetic make up, treatment, associated autoimmune diseases and neoplastia was found. In our TS population an increased neoplasia prevalence was reported. A high prevalence of AG was also noted and it might be indicative of a predisposition to neoplasia. Further studies are needed to define the overall risk for neoplasia, and to determine the role of the loss of the X-chromosome and hormonal therapies. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Utility of MRI in the follow-up of pyogenic spinal infection in children

International Nuclear Information System (INIS)

Wang, Qiuyan; Babyn, Paul; Branson, Helen; Davila, Jorge; Mueller, Edrise L.; Tran, Dat

2010-01-01

MRI is used at an increasing rate in evaluation of pediatric spinal infections both at the time of diagnosis and in follow-up. However, the impact of MRI in follow-up has been rarely evaluated to date. To evaluate serial follow-up spinal MRI changes compared to clinical outcome and assess their impact on clinical management. All pediatric (<18 years) patients with pyogenic spinal infection over a 9-year period with at least one follow-up after treatment were included. Atypical infections were excluded. We examined 35 whole-spine and 16 localized spinal scans from 17 patients (2 months to 16 years, 9F:8 M) who had 51 follow-ups done 2 weeks to 4.75 years after baseline. Seven children (41%) younger than 3 years underwent 33 follow-ups (65%); most required GA or sedation. Short-term follow-up scans demonstrated epidural and/or paraspinal soft-tissue changes correlating with clinical status and laboratory findings in all cases. However, MRI showed that bone and/or disc abnormalities continued and progressed in some cases despite clinical improvement. Long-term follow-up scans showed bone, disc and soft-tissue changes 1-3 years after baseline, despite children being symptom free. Extension of antibiotics occurred in 47% of children partly based on follow-up MRI. Epidural and paraspinal soft-tissue changes correlated with children's clinical symptoms. Progression of bone and disc changes can manifest despite adequate clinical response. Long-term or serial routine follow-ups were not necessary. Management should be made based on clinical response. (orig.)

Increased risk of ischemic stroke in young patients with ankylosing spondylitis: a population-based longitudinal follow-up study.

Directory of Open Access Journals (Sweden)

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.

Increase in physical activity and cardiometabolic risk profile change during lifestyle intervention in primary healthcare: 1-year follow-up study among individuals at high risk for type 2 diabetes.

Science.gov (United States)

Kujala, Urho M; Jokelainen, Jari; Oksa, Heikki; Saaristo, Timo; Rautio, Nina; Moilanen, Leena; Korpi-Hyövälti, Eeva; Saltevo, Juha; Vanhala, Mauno; Niskanen, Leo; Peltonen, Markku; Tuomilehto, Jaakko; Uusitupa, Matti; Keinänen-Kiukaannemi, Sirkka

2011-01-01

Objectives To investigate the association between increase in physical activity and changes in cardiometabolic risk factors during a lifestyle intervention programme in routine clinical settings. Design Prospective follow-up. Setting 400 primary healthcare centres and occupational healthcare outpatient clinics in Finland. Participants Individuals at high risk for type 2 diabetes identified in the implementation project of the national diabetes prevention programme (FIN-D2D) and participating in baseline and 1-year follow-up visits. Final study group comprised the 1871 non-diabetic participants who responded at follow-up visit to a question on stability versus increase of physical activity. Interventions Lifestyle intervention. Primary outcome measures Cardiometabolic risk factors (body composition, blood pressure and those measured from fasting venous blood samples) measured at baseline and follow-up visits. Results Of the participants, 310 (16.6% of all responders) reported at follow-up having clearly increased their physical activity during the past year, while 1380 (73.8%) had been unable to increase their physical activity. Those who increased their activity decreased their weight by 3.6 kg (95% CI 2.9 to 4.3, age and sex adjusted, p<0.001) and waist circumference by 3.6 cm (95% CI 2.9 to 4.3, p<0.001) more than those who did not increase their activity. Similarly, those who increased their physical activity had greater reductions in total cholesterol (group difference in reduction 0.17 mmol/l, 95% CI 0.06 to 0.28, p=0.002), low-density lipoprotein cholesterol (0.16 mmol/l, 95% CI 0.06 to 0.26, p=0.001), low-density lipoprotein/high-density lipoprotein ratio (0.17, 95% CI 0.08 to 0.25, p<0.001) as well as fasting glucose (0.09 mmol/l, 95% CI 0.03 to 0.15, p=0.004) and 2 h glucose levels (0.36 mmol/l, 95% CI 0.17 to 0.55, p=0.023) than those who did not increase their physical activity. Conclusion Increasing physical activity seems to be an important feature of

Human papillomavirus type specific risk of progression and remission during long-term follow-up of equivocal and low-grade HPV-positive cervical smears.

Science.gov (United States)

Vintermyr, Olav Karsten; Andersland, Marie Songstad; Bjørge, Tone; Skar, Robert; Iversen, Ole Erik; Nygård, Mari; Haugland, Hans Kristian

2018-03-23

The prevalence of clinically relevant HPV types and their specific risk for progression and regression in women with atypical squamous cells of uncertain significance (ASCUS) and low-grade squamous intraepithelial lesions (LSIL) were studied in a routine screening population. A 4-year cohort of women (n = 820) with ASCUS/LSIL and a positive HPV test in triage were followed for 6-9 years. The progression risks for CIN2+/CIN3+ were determined for single (71.2%) and multiple HPV infections (28.8%). The CIN2+ progression risk for all HPV 16, all HPV 35, single HPV 16 and single HPV 35 infections were 65.3% (95% CI: 59.6-71.0), 64.4% (95% CI: 50.4-78.4), 63.8% (95% CI: 56.2-71.4) and 73.7% (95% CI: 53.9-93.5), respectively. Based on CIN2+ progression risks four main groups were defined; the HPV 16 group, the HPV 31/33/35 group, the HPV 18/45/51/52 group and the HPV 39/56/58/59/66/68 group with progression risks of 65.3% (95% CI: 59.6-71.0), 62.1% (95% CI: 54.8-69.4), 52.6 (95% CI: 45.9-59.3) and 39.5 (95% CI: 33.0-46.0), respectively. In multivariate analyses, women in the age group 40-49 years had an increased risk of CIN2+ progression. As for CIN3+, HPV 16 had a higher progression risk than other HPV risk groups (p HPV 16 had a significant additive CIN3+ progression risk (p HPV risk groups. In summary, HPV types 16 and 35, including the HPV risk group 31/33/35, had a similar CIN2+ progression risk, but only HPV 16 had a higher risk for CIN3+ progression. © 2018 UICC.

Evaluation of the relationship between compliance with the follow-up and treatment protocol and health literacy in bladder tumor patients.

Science.gov (United States)

Turkoglu, Ali Riza; Demirci, Hakan; Coban, Soner; Guzelsoy, Muhammet; Toprak, Erdem; Aydos, Mustafa Murat; Ture, Deniz Azkan; Ustundag, Yasemin

2018-03-07

To investigate the relationship between the compliance of bladder cancer patients with cystoscopic follow-up and the treatment protocol, and their health literacy. Patients who underwent transurethral resection surgery for bladder tumor were found to have non-muscular invasive bladder carcinoma on pathology examination and then underwent cystoscopic follow-up for 1 year or more were included in the study. Cystoscopic follow-up was recommended to the low- and high-risk groups in terms of progression and recurrence. The patients were evaluated with the Health Literacy Survey-European Union scale. The mean age of the patients was 67.13 ± 10.77 years. The treatment continuity rate was 80.50% (n = 33) in the adequate health literacy group (n = 41) and significantly higher than the 56.50% (n = 48) rate in the inadequate health literacy group (n = 85) (p = .008). The health literacy results revealed that the health promotion and general index score was higher in the group of patients under the age of 65. Adequate health literacy in bladder cancer patients is associated with better compliance with the treatment protocol. Young patients show better compliance with the follow-up protocol recommended by the physician. Increasing the follow-up protocol compliance of elderly patients with inadequate health literacy is necessary.

Risk Factors for 30-Day Readmission Following Shoulder Arthroscopy.

Science.gov (United States)

Hill, J Ryan; McKnight, Braden; Pannell, William C; Heckmann, Nathanael; Sivasundaram, Lakshmanan; Mostofi, Amir; Omid, Reza; Rick Hatch, George F

2017-01-01

The purpose of this study was to evaluate a large population of shoulder arthroscopy cases in order to provide insight into the risk factors associated with readmission following this common orthopaedic procedure. The American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) database was queried using current procedural terminology (CPT) billing codes to identify all patients older than 18 years of age who underwent shoulder arthroscopy between 2011 and 2013. Univariate and multivariate analyses were conducted to identify factors associated with 30-day readmission. We identified 15,015 patients who had undergone shoulder arthroscopy, with a 30-day readmission rate of 0.98%. The most common reason for readmission was pulmonary embolism (0.09%). On multivariate analysis, operative time > 1.5 hours (odds ratio [OR], 1.80; 95% confidence interval [CI], 1.29 to 2.50), age 40 to 65 years (OR, 3.80; 95% CI, 1.37 to 10.59), age > 65 years (OR, 3.91; 95% CI, 1.35 to 11.35), American Society of Anesthesiologists (ASA) class 3 (OR, 4.53; 95% CI, 1.90 to 10.78), ASA class 4 (OR, 7.73; 95% CI, 2.91 to 27.25), chronic obstructive pulmonary disease (COPD; OR, 2.65; 95% CI, 1.54 to 4.55), and chronic steroid use (OR, 2.96; 95% CI, 1.46 to 6.01) were identified as independent risk factors for readmission. Operative time > 1.5 hours, age > 40 years, ASA classes 3 or 4, COPD, and chronic steroid use are independent risk factors for readmission following elective arthroscopic shoulder surgery, although the readmission rate following these procedures is low. Level III, retrospective comparative study. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Spinal cord injury and Parkinson's disease: a population-based, propensity score-matched, longitudinal follow-up study.

Science.gov (United States)

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.

HFE gene C282Y, H63D and S65C mutations frequency in the Transylvania region, Romania.

Science.gov (United States)

Trifa, Adrian P; Popp, Radu A; Militaru, Mariela S; Farcaş, Marius F; Crişan, Tania O; Gana, Ionuţ; Cucuianu, Andrei; Pop, Ioan V

2012-06-01

HFE-associated haemochromatosis is one of the most frequent autosomal recessive disorders in the Caucasian population. Although most of the cases are homozygous individuals for the C282Y mutation, another two mutations, H63D and S65C, have been reported to be associated with milder forms of the disease. This study was a first attempt to evaluate the distribution of these HFE gene mutations in the Transylvania region. Two-hundred and twenty-five healthy, unrelated volunteers originating from the Transylvania region, Romania, were screened for the HFE gene C282Y, H63D and S65C mutations, using molecular genetics assays (Polymerase Chain Reaction-Restriction Fragments Length Polymorphism). For the C282Y mutation, 7 heterozygotes (3.1%) were found, but no homozygous individual. In the case of the H63D mutation, 40 heterozygotes (17.8%) and 4 homozygotes (1.75%) for the mutant allele were evidenced. We found a compound heterozygous genotype (C282Y/H63D) in one individual (0.45%). Thus, the allele frequencies of the C282Y and H63D were 1.75% and 10.9%, respectively. Three individuals (1.3%) were found to harbour the S65C mutation in a heterozygous state, but none in a homozygous state: the allele frequency of the mutant allele was 0.75%. The distribution of the HFE gene C282Y, H63D and S65C mutations found in our group matches the tendencies observed in other European countries: a decreasing gradient from Northern to Southern Europe for the C282Y mutation; high frequency for the H63D mutation, and low frequency for the S65C mutation in most of the countries.

The CHADS2 Score to Predict Stroke Risk in the Absence of Atrial Fibrillation in Hypertensive Patients Aged 65 Years or Older.

Science.gov (United States)

Morillas, Pedro; Pallarés, Vicente; Fácila, Lorenzo; Llisterri, Jose Luis; Sebastián, María Eugenia; Gómez, Manuel; Castilla, Elena; Camarasa, Raquel; Sandin, Miriam; García-Honrubia, Antonio

2015-06-01

The CHADS2 score is a proven, essential tool for estimating cardioembolic risk (mainly stroke) in patients with nonvalvular atrial fibrillation, with the purpose of determining the indication for anticoagulant therapy. In this study we analyzed the use of CHADS2 in hypertensive patients without known atrial fibrillation in a Mediterranean population. The study included 887 hypertensive patients aged 65 years or older without atrial fibrillation or anticoagulant therapy, who attended a medical consultation. Data on the patients' main risk factors, cardiovascular history, and medication were collected, basic laboratory analyses and electrocardiography were performed, and the CHADS2 score (heart failure, hypertension, age ≥ 75 years, diabetes mellitus, and previous stroke or transient ischemic attack) was calculated. A clinical follow-up was carried out, recording hospital admissions for a stroke or transient ischemic attack. The median duration of follow-up was 804 days. Mean age was 72.5 (SD,5.7) years, 46.6% were men, 27.8% had diabetes, and 8.6% were smokers. During follow-up, 40 patients were hospitalized for a stroke or transient ischemic attack (4.5%). The event-free survival analysis showed significant differences according to the CHADS2 score (log rank test, P < .001). On multivariate analysis, smoking and CHADS2 ≥3 were independent predictors of stroke or transient ischemic attack. The CHADS2 may be useful for estimating the risk of stroke or transient ischemic attack in hypertensive patients without known atrial fibrillation. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Delirium en ancianos hospitalizados: Seguimiento de 18 meses Delirium in elderly inpatients: An 18 month follow-up

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Fernando J. Vázquez

2010-02-01

Full Text Available El objetivo de este trabajo fue describir la prevalencia de síndrome confusional agudo en ancianos hospitalizados, la evolución durante la internación y a los 18 meses. Se evaluó en forma prospectiva a pacientes de 70 años de edad o mayores, internados en el Servicio de Clínica Médica de nuestro hospital, entre septiembre de 2005 y mayo de 2006. Se utilizó una versión validada en español del Confussion Assessment Method para diagnosticar delirium. A los 18 meses se evaluó el estado vital, lugar de residencia, actividades de la vida diaria, dependencia de cuidadores y reinternaciones. Se evaluaron 194 pacientes y 74 fueron excluidos. De los 120 casos incluidos, 52 (43.3% presentaron delirium. La edad media fue de 82.6 años (DS: 7.4 en el grupo de pacientes con síndrome confusional agudo y de 80.4 años (DS: 5.6 en el grupo de pacientes sin delirium. Al comparar estos dos grupos encontramos diferencias significativas en las características, siendo más frecuentes en el grupo con delirium la residencia previa en un centro de tercer nivel (17.3% vs. 1.5%; p Delirium usually hardens care during hospitalization and increases morbidity during hospital stay and after discharge. The objective of this study was to describe the prevalence of delirium in elderly inpatients in a Buenos Aires hospital, its morbidity and mortality during hospital stay and the next 18 month follow-up. Patients aged 70 or older admitted to internal medicine unit between September 2005 and May 2006 were enrolled. Delirium was assessed with the Spanish version of Confusion Assessment Method. Demographic data, cause of admition and length of stay, destination after discharge and mortality were registered. A new evaluation was made 18 months after discharge. We evaluated 194 patients and 74 were excluded. Of the 120 included, 52 (43.3% presented delirium. We found significant differences between patients with and without delirium in previous placement in nursing home

Quality of life after laparoscopic gastric banding: Prospective study (152 cases) with a follow-up of 2 years.

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Champault, Axèle; Duwat, Olivier; Polliand, Claude; Rizk, Nabil; Champault, Gérard G

2006-06-01

To evaluate influence of laparoscopic gastric banding (LGB) on quality of life (QOL) in patients with morbid obesity. Laparoscopic adjustable gastric banding is a popular bariatric operation in Europe. The objectives of surgical therapy in patients with morbid obesity are reduction of body weight, and a positive influence on the obesity-related comorbidity as well the concomitant psychologic and social restrictions of these patients. In a prospective clinical trial, development of the individual patient QOL was analyzed, after LGB in patients with morbid obesity. From October 1999 to January 2001, 152 patients [119 women, 33 men, mean age 38.4 y (range 24 to 62), mean body mass index 44.3 (range 38 to 63)] underwent evaluation for LGB according the following protocol: history of obesity; concise counseling of patients and relative on nonsurgical treatment alternatives, risk of surgery, psychologic testing, questionnaire for eating habits, necessity of lifestyle change after surgery; medical evaluation including endocrinologic and nutritionist work-up, upper GI endoscopy, evaluation of QOL using the Gastro Intestinal Quality of Life Index (GIQLI). Decision for surgery was a multidisciplinary consensus. This group was follow-up at least 2 years, focusing on weight loss and QOL. Mean operative time was 82 minutes; mean hospital stay was 2.3 days and the mean follow-up period was 34 months. The BMI dropped from 44.3 to 29.6 kg/m and all comorbid conditions improved markedly: diabetes melitus resolved in 71% of the patients, hypertension in 33%, and sleep apnea in 90%. However, 26 patients (17%) had late complications requiring reoperation. Preoperative global GIQLI score was 95 (range 56 to 140), significant different of the healthy volunteers score (120) (70 to 140) P < 0.001. Correlated with weight loss (percentage loss of overweight and BMI), the global score of the group increased to 100 at 3 months, 104 at 6, 111 at 1 year to reach 119 at 2 years which is no

Fetal growth and subsequent risk of breast cancer: results from long term follow up of Swedish cohort

OpenAIRE

McCormack, V A; dos Santos Silva, I; De Stavola, B L; Mohsen, R; Leon, D A; Lithell, H O

2003-01-01

OBJECTIVE: To investigate whether size at birth and rate of fetal growth influence the risk of breast cancer in adulthood. DESIGN: Cohort identified from detailed birth records, with 97% follow up. SETTING: Uppsala Academic Hospital, Sweden. PARTICIPANTS: 5358 singleton females born during 1915-29, alive and traced to the 1960 census. MAIN OUTCOME MEASURES: Incidence of breast cancer before (at age <50 years) and after (> or = 50 years) the menopause. RESULTS: Size at birth was positive...

Efficacy Trial of a Brief Cognitive-Behavioral Depression Prevention Program for High-Risk Adolescents: Effects at 1- and 2-Year Follow-Up

Science.gov (United States)

Stice, Eric; Rohde, Paul; Gau, Jeff M.; Wade, Emily

2010-01-01

Objective: To evaluate the effects of a brief group cognitive-behavioral (CB) depression prevention program for high-risk adolescents with elevated depressive symptoms at 1- and 2-year follow-up. Method: In this indicated prevention trial, 341 at-risk youths were randomized to a group CB intervention, group supportive expressive intervention, CB…

Aetiology and risk factors of musculoskeletal disorders in physically active conscripts: a follow-up study in the Finnish Defence Forces

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Pihlajamäki Harri

2010-07-01

Full Text Available Abstract Background Musculoskeletal disorders (MSDs are the main reason for morbidity during military training. MSDs commonly result in functional impairment leading to premature discharge from military service and disabilities requiring long-term rehabilitation. The purpose of the study was to examine associations between various risk factors and MSDs with special attention to the physical fitness of the conscripts. Methods Two successive cohorts of 18 to 28-year-old male conscripts (N = 944, median age 19 were followed for six months. MSDs, including overuse and acute injuries, treated at the garrison clinic were identified and analysed. Associations between MSDs and risk factors were examined by multivariate Cox's proportional hazard models. Results During the six-month follow-up of two successive cohorts there were 1629 MSDs and 2879 health clinic visits due to MSDs in 944 persons. The event-based incidence rate for MSD was 10.5 (95% confidence interval (CI: 10.0-11.1 per 1000 person-days. Most MSDs were in the lower extremities (65% followed by the back (18%. The strongest baseline factors associated with MSDs were poor result in the combined outcome of a 12-minute running test and back lift test (hazard ratio (HR 2.9; 95% CI: 1.9-4.6, high waist circumference (HR 1.7; 95% CI: 1.3-2.2, high body mass index (HR 1.8; 95% CI: 1.3-2.4, poor result in a 12-minute running test (HR 1.6; 95% CI: 1.2-2.2, earlier musculoskeletal symptoms (HR 1.7; 95% CI: 1.3-2.1 and poor school success (educational level and grades combined; HR 2.0; 95% CI: 1.3-3.0. In addition, risk factors of long-term MSDs (≥10 service days lost due to one or several MSDs were analysed: poor result in a 12-minute running test, earlier musculoskeletal symptoms, high waist circumference, high body mass index, not belonging to a sports club and poor result in the combined outcome of the 12-minute running test and standing long jump test were strongly associated with long-term MSDs

Active life expectancy from annual follow-up data with missing responses.

Science.gov (United States)

Izmirlian, G; Brock, D; Ferrucci, L; Phillips, C

2000-03-01

Active life expectancy (ALE) at a given age is defined as the expected remaining years free of disability. In this study, three categories of health status are defined according to the ability to perform activities of daily living independently. Several studies have used increment-decrement life tables to estimate ALE, without error analysis, from only a baseline and one follow-up interview. The present work conducts an individual-level covariate analysis using a three-state Markov chain model for multiple follow-up data. Using a logistic link, the model estimates single-year transition probabilities among states of health, accounting for missing interviews. This approach has the advantages of smoothing subsequent estimates and increased power by using all follow-ups. We compute ALE and total life expectancy from these estimated single-year transition probabilities. Variance estimates are computed using the delta method. Data from the Iowa Established Population for the Epidemiologic Study of the Elderly are used to test the effects of smoking on ALE on all 5-year age groups past 65 years, controlling for sex and education.

Long term follow-up of bifurcation aneurysms treated with braided stent assisted coiling and complex T- and Y- stent constructs.

Science.gov (United States)

Cheung, Nicholas K; Chiu, Albert Hy; Cheung, Andrew; Wenderoth, Jason D

2018-06-01

Stent assisted coil embolization (SACE) of bifurcation aneurysms is challenging. Heterogeneous results have been achieved to date, but largely for laser cut stents. While braided stents offer multiple technical advantages, their long term efficacy has yet to be validated. To report the first long term 18 month results for the durability of bifurcation aneurysms treated with braided stents. Over a 4 year period, 59 consecutive patients with 60 bifurcation aneurysms underwent elective braided SACE across three Australian neurovascular centers. 17 of these aneurysms underwent T- or Y-shaped stent constructs. All patients had immediate, 6 month and 18 month clinical and radiological follow-up. Radiological assessment was made on modified Raymond-Roy occlusion scores while clinical assessment was based on the modified Rankin Scale. Subgroup analysis of 17 aneurysms treated with multi-stent constructs was conducted. 6 month follow-up data were available for 59 aneurysms and 18 month follow-up data for 58 aneurysms. Satisfactory aneurysm occlusion was achieved in 97% at inception and at 6 months, and 98% at 18 months. Good neurological outcomes were achieved in 95% at 18 months. Similar satisfactory results were achieved with the multi-stent construct cohort. Intraprocedural thromboembolic events were recorded in 5% and delayed events in 2%. Technical complications were found in 5%. All complication rate was 13%. Braided SACE was safe, efficacious, and durable at the long term 18 month follow-up, including for multi-stent constructs. Preliminary results indicate favorable clinical and radiological outcomes compared with laser cut stents. © 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.

Follow-up of rheumatic carditis using 67Ga-citrate imaging

International Nuclear Information System (INIS)

Calegaro, J.U.M.; Bae, S.H.; Prado, E.S.; Gomes, E.F.

2002-01-01

Aim: This study reports the follow -up of 25 patients (pts) with rheumatic carditis (9 male, 16 females; 4-29 years, mean 12,12) using 67-gallium citrate. Materials and Methods: the pts were divided in 2 groups: I- first attack (7pts, 2 males, with a mean follow-up of 5,65 years); II- recurrence (18 pts, 7 males, with a mean follow-up of 5,27 years).Images of the thorax and semi quantitative indexes were obtained 72 hours after intravenous injection of 37-74 MBq (1-2 mCi) of 67-gallium citrate, using a LFOV scintillation camera. 67-gallium uptake in the cardiac area was graded as mild, moderate or severe using the tracer uptake in the lung as a reference (normal up to 130%). Results: all pts in group I (2 severe, 2 moderate, and 3 mild carditis) had normal gallium uptake in up to 9 weeks after the institution of cortico therapy, with a better outcome in follow-up.In group II, 8 pts presented moderately active carditis (2 had good and 6 had a poor outcome) and 10 mildly active carditis (7 had good and 3 had poor outcome). The evolution of the disease was better in 8 pts that the reduction of 67- gallium uptake to normal limits occurred in up to 9 weeks, than in 9 pts that the scintigraphy was only normal after 10 weeks of therapy. Conclusion: normal gallium uptake in up to 9 weeks of treatment seems to be a good predictor of evolution in rheumatic carditis first attack or recurrence; in recurrence, reduction of 67-gallium uptake only after 10 weeks or increasing uptake seems to be worse predictors

Effect of the third element on the structure of liquid Mg{sub 65}Cu{sub 25}Y{sub 10} alloy

Energy Technology Data Exchange (ETDEWEB)

Liu, Dan [Key Laboratory for Liquid–Solid Structural Evolution and Processing of Materials (Ministry of Education), Shandong University, Jinan 250061 (China); Weihai Wanfeng Magnesium Industry Science and Technology Development Co. Ltd., Weihai 264209 (China); Zhu, Xun Ming [Weihai Wanfeng Magnesium Industry Science and Technology Development Co. Ltd., Weihai 264209 (China); Qin, Jing Yu, E-mail: qinjy@sdu.edu.cn [Key Laboratory for Liquid–Solid Structural Evolution and Processing of Materials (Ministry of Education), Shandong University, Jinan 250061 (China); Duan, Jun Peng; Wang, Ai Min [Weihai Wanfeng Magnesium Industry Science and Technology Development Co. Ltd., Weihai 264209 (China); Gu, Ting Kun [School of Electrical Engineering, Shandong University, Jinan 250061 (China)

2016-08-12

The liquid structures of Mg{sub 65}Cu{sub 25}Y{sub 10} and its three homologous binary liquid alloys are investigated via ab initio molecular dynamics in the present work. The chemical and topological environments in all four liquid alloys are analyzed using pair distribution function, coordination number, and the Voronoi polyhedron. It shows that the Cu atoms play significant role in deciding the chemical and topological short-range orders of the Mg{sub 65}Cu{sub 25}Y{sub 10} liquid alloy. The Voronoi polyhedra in the ternary liquid alloy illustrate less varieties and longer lifetime. Moreover, the diffusion coefficients are decreased significantly in the ternary liquid alloys according to the mean square displacements. All above offer a deeper insight into how the three species work in the Mg{sub 65}Cu{sub 25}Y{sub 10} liquid alloy. - Highlights: • Cu plays crucial role in Mg{sub 65}Cu{sub 25}Y{sub 10}'s chemical and topological SROs. • Additive elements decrease varieties and prolong lifetimes of Voronoi polyhedra. • Additive elements hinder the diffusion of Mg and Y efficiently.

CHANGES IN QUALITY OF LIFE AFTER SHORT AND LONG TERM FOLLOW-UP OF ROUX-EN-Y GASTRIC BYPASS FOR MORBID OBESITY

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Rafael M. LAURINO NETO

2013-09-01

Full Text Available Context It is unclear whether health-related quality of life (HRQL is sustained in a long-term follow-up of morbidly obese patients who underwent Roux-en-Y gastric bypass (RYGB. Objective This study aims to analyze the HRQL changes following RYGB in short and long-term follow-up. Methods We compared the health-related quality of life among three separate patient groups, using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36. Group A - 50 preoperative morbidly obese patients; Group B - 50 RYGB patients 1-2 years post-surgery; Group C - 50 RYGB patients more than 7 years post-surgery. Results The groups were similar for gender, age and body mass index before surgery. We observed that physical functioning, social function, emotional role functioning and mental health scales did not vary between the three groups. The physical role functioning scale was unchanged in the short-term and decreased compared to the preoperative scale in the long-term follow-up. Bodily pain improved after the operation but returned to the initial level after 7 years. The vitality and general health perceptions improved after the operation and maintained these results after 7 years compared with the preoperative perceptions. Conclusions RYGB improved health-related quality of life in three SF-36 domains (bodily pain, general health perceptions and vitality in the short-term and two SF-36 domains (general health perceptions and vitality in the long-term.

Fractures as an independent predictor of functional decline in older people: a population-based study with an 8-year follow-up.

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Piirtola, Maarit; Löppönen, Minna; Vahlberg, Tero; Isoaho, Raimo; Kivelä, Sirkka-Liisa; Räihä, Ismo

2012-01-01

Fractures among older people are common, but there is scant evidence about the impact of fractures on functional decline in an unselected older population. The objective of this study was to analyze the impact of lower and upper body fractures on functional performance among older adults during an 8-year follow-up. A population-based cohort of 616 Finnish persons aged 65 and over was followed for up to 8 years, and the association between fractures and the risk of short-term (0-2 years) and long-term (up to 8 years) functional decline was analyzed. Fractures were categorized according their functional influence on mobility and activities of daily living (ADL) into lower and upper body fractures. Multivariate cumulative logistic regression model was used in the analyses. During the 8-year follow-up, 112 (18%) persons sustained at least one fracture. In the multivariate analyses, lower body fractures predicted both short-term and long-term decline in mobility [cumulative odds ratio (COR) 4.7, 95% confidence interval (95% CI) 1.9-11.7 and COR 2.6, 95% CI 1.1-6.2, respectively] and in ADL performance (COR 3.1, 95% CI 1.3-7.6 and COR 4.7, 95% CI 2.0-11.4, respectively). Upper body fractures predicted decline in ADL performance during the long-term follow-up (COR 2.5, 95% CI 1.3-4.8). Pre-fracture functional decline and inactivity in leisure time physical exercise were independently associated with the risk of decline in extensive activities. Fractures have an independent influence on the development of functional decline in older persons regardless of the pre-fracture health. Prevention of falls and fractures and improvement of treatment, rehabilitation and follow-up process after fractures are needed. Copyright © 2011 S. Karger AG, Basel.

Modifiable risk factors predicting major depressive disorder at four year follow-up: a decision tree approach.

Science.gov (United States)

Batterham, Philip J; Christensen, Helen; Mackinnon, Andrew J

2009-11-22

Relative to physical health conditions such as cardiovascular disease, little is known about risk factors that predict the prevalence of depression. The present study investigates the expected effects of a reduction of these risks over time, using the decision tree method favoured in assessing cardiovascular disease risk. The PATH through Life cohort was used for the study, comprising 2,105 20-24 year olds, 2,323 40-44 year olds and 2,177 60-64 year olds sampled from the community in the Canberra region, Australia. A decision tree methodology was used to predict the presence of major depressive disorder after four years of follow-up. The decision tree was compared with a logistic regression analysis using ROC curves. The decision tree was found to distinguish and delineate a wide range of risk profiles. Previous depressive symptoms were most highly predictive of depression after four years, however, modifiable risk factors such as substance use and employment status played significant roles in assessing the risk of depression. The decision tree was found to have better sensitivity and specificity than a logistic regression using identical predictors. The decision tree method was useful in assessing the risk of major depressive disorder over four years. Application of the model to the development of a predictive tool for tailored interventions is discussed.

Modifiable risk factors predicting major depressive disorder at four year follow-up: a decision tree approach

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Christensen Helen

2009-11-01

Full Text Available Abstract Background Relative to physical health conditions such as cardiovascular disease, little is known about risk factors that predict the prevalence of depression. The present study investigates the expected effects of a reduction of these risks over time, using the decision tree method favoured in assessing cardiovascular disease risk. Methods The PATH through Life cohort was used for the study, comprising 2,105 20-24 year olds, 2,323 40-44 year olds and 2,177 60-64 year olds sampled from the community in the Canberra region, Australia. A decision tree methodology was used to predict the presence of major depressive disorder after four years of follow-up. The decision tree was compared with a logistic regression analysis using ROC curves. Results The decision tree was found to distinguish and delineate a wide range of risk profiles. Previous depressive symptoms were most highly predictive of depression after four years, however, modifiable risk factors such as substance use and employment status played significant roles in assessing the risk of depression. The decision tree was found to have better sensitivity and specificity than a logistic regression using identical predictors. Conclusion The decision tree method was useful in assessing the risk of major depressive disorder over four years. Application of the model to the development of a predictive tool for tailored interventions is discussed.

Predictors of Post-concussion Rehabilitation Outcomes at Three-month Follow-up.

Science.gov (United States)

Scott, Katie L; Strong, Carrie-Ann H; Gorter, Bethany; Donders, Jacobus

2016-01-01

To determine factors related to three-month follow-up outcomes for individuals participating in an outpatient rehabilitative treatment program for mild traumatic brain injury (TBI). Fifty participants underwent neuropsychological screening prior to treatment initiation and completed the Mayo-Portland Adaptability Inventory-4 (MPAI-4) at treatment initiation, discharge from treatment, and three months following discharge. Regression models indicated that information garnered from the neuropsychological screening prior to treatment initiation (e.g., mood symptoms and prior psychiatric history) accounted for unique variance in three-month post-discharge outcomes on several MPAI-4 subscales. Specifically, after controlling for baseline MPAI-4 ratings, higher Beck Depression Inventory-second edition (BDI-II) scores were associated with worse MPAI-4 Ability scores at three-month follow-up, and the presence of a psychiatric history was associated with worse MPAI-4 Adjustment scores at three-month follow-up. Neuropsychological screening prior to the initiation of treatment for mild TBI can help to identify patients who may be at greater risk for poorer rehabilitation outcomes, thus allowing for the implementation of specific interventions to address these risk factors.

Steroid injections in the treatment of humeral unicameral bone cysts: long-term follow-up and review of the literature.

Science.gov (United States)

Pavone, V; Caff, G; Di Silvestri, C; Avondo, S; Sessa, G

2014-05-01

Retrospective evaluation of long-term effectiveness of the steroid injections treatment in patients with unicameral bone cysts (UBC). From January 1993 to April 2005, 23 children affected by proximal humeral UBC were evaluated according to the Neer-Cole classification system and treated with serial methylprednisolone acetate's injections. The patients were followed up at 1, 3, 6 and 12 months and then every year until the adolescence. After treatment, in 15 out of 23 patients (65.2%), the humeral cysts were referred, respectively, as Grade 1 and in four as Grade 2. In 4 patients, a refracture occurred. Statistical analysis showed an overall good response in 82.6% of patients at the end of the follow-up. Minor complication including skin discoloration accounted for 13.04%. The steroid injections showed to be an alternative excellent treatment for UBC, with complete healing of the lesions in the majority of cases. This procedure is not expensive, mini-invasive, with low surgical risk and short hospitalization.

A Facebook Follow-Up Strategy for Rural Drug-Using Women.

Science.gov (United States)

Dickson, Megan F; Staton-Tindall, Michele; Smith, Kirsten E; Leukefeld, Carl; Webster, J Matthew; Oser, Carrie B

2017-06-01

Facebook (FB) use has grown exponentially over the past decade, including in rural areas. Despite its popularity, FB has been underutilized as a research follow-up approach to maintain contact with research participants and may have advantages in less densely populated areas and among more hard-to-reach, at-risk groups. The overall goal of this study was to examine FB as a supplemental follow-up approach to other follow-up strategies with rural drug-using women. Face-to-face interviews were conducted with randomly selected women who completed baseline interviews in 3 rural jails in 1 state. Analyses focus on participants who were released from jail and were eligible for 3-month follow-up (n = 284). Bivariate analyses were used to examine differences between FB users and nonusers, and multivariate logistic regression models examined predictors of 3-month follow-up participation and being located for follow-up using FB. About two-thirds (64.4%) of participants were regular FB users. Bivariate analyses indicated that FB users were younger, more educated, and more likely to have used alcohol in the 30 days before incarceration but less likely to have a chronic health problem. Regression analyses indicated that rural FB users had more than 5 times the odds of being located for the 3-month follow-up interview, even after controlling for other variables. There were no significant predictors of being followed up using FB. Findings suggest that FB is widely used and well accepted among rural drug-using women. Among hard-to-reach populations, including those in rural, geographically isolated regions, FB serves as a method to improve participant follow-up. © 2016 National Rural Health Association.

Gastric cancer risk in achlorhydric patients. A long-term follow-up study

DEFF Research Database (Denmark)

Svendsen, Jesper Hastrup; Dahl, C; Svendsen, L B

1986-01-01

Achlorhydria, determined by the augmented histamine test, is the functional expression of the most severe atrophic gastritis and is followed by a 4- to 6-fold increased risk of gastric cancer, as we found 5 cancers in 114 patients after a mean observation period of 8.4 years. The cancers developed...... from 1 to 17 years after achlorhydria diagnosis--three cases after more than 9 years. The study showed no difference in gastric cancer risk between patients with and without pernicious anaemia. Spontaneous achlorhydria is the late result of atrophic gastritis, which should be regarded the premalignant...... condition. The development of gastric cancer from pharmacologically reduced acid secretion must be regarded as highly hypothetical, since this is not followed by atrophic gastritis....

Increased amino acids levels and the risk of developing of hypertriglyceridemia in a 7-year follow-up

OpenAIRE

Mook-Kanamori, D. O.; Römisch-Margl, W.; Kastenmüller, G.; Prehn, C.; Petersen, A. K.; Illig, T.; Gieger, C.; Wang-Sattler, R.; Meisinger, C.; Peters, A.; Adamski, J.; Suhre, K.

2014-01-01

Background Recently, five branched-chain and aromatic amino acids were shown to be associated with the risk of developing type 2 diabetes (T2D). Aim We set out to examine whether amino acids are also associated with the development of hypertriglyceridemia. Materials and methods We determined the serum amino acids concentrations of 1,125 individuals of the KORA S4 baseline study, for which follow-up data were available also at the KORA F4 7 years later. After exclusion for hypertriglyceridemia...

[Cardiovascular risk by Framingham and SCORE in patients 40-65 years old].

Science.gov (United States)

González, Carmen; Rodilla, Enrique; Costa, José A; Justicia, Jorge; Pascual, José M

2006-04-15

The aim of this study was to compare the clinical and treatment implications of 2 cardiovascular risk stratification systems in a population of patients 40-65 years old. 929 non diabetic patients (40-65 years old) (51% female) with no evidence of previous cardiovascular disease were included in the study. The risk of cardiovascular death was assessed with the charts of the Systematic Coronary Risk Evaluation (SCORE), and coronary risk by the Framingham function (National Cholesterol Education Program Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults -NCEP-ATP-III-). Patients were considered of high risk if risk of cardiovascular death was >or= 5% and coronary risk was > 20%, respectively. 4.1% of patients were considered as high risk by SCORE and 2.5% by Framingham. Only 0.2% of females were classified as high risk with either system. 8.2% and 4.8% of male population were considered as high risk by SCORE and Framingham, respectively. There was a low level of concordance between both systems. Patients classified as high risk by SCORE but not by Framingham were older, smoke less and had a better lipid profile. According to European Guidelines 28% of male and 23% of female were candidates to hypolipemic treatment, that proportion was higher, 43% of males and 28% of females, by NCEP-ATP-III guidelines. In Spanish patients 40-65 years old, SCORE charts almost duplicate the number of high risk individuals compared to Framingham. although the number of patients candidates to hypolipemic treatment is lower with the European than ATP-III guidelines. Differences were more evident in male.

Role of imaging in the follow-up of T2-T3 glottic cancer treated by transoral laser microsurgery.

Science.gov (United States)

Marchi, Filippo; Piazza, Cesare; Ravanelli, Marco; Gaggero, Giovanna; Parrinello, Giampiero; Paderno, Alberto; Perotti, Pietro; Filauro, Marta; Maroldi, Roberto; Peretti, Giorgio

2017-10-01

An unblinded retrospective analysis of prospectively collected data was carried out on 138 patients affected by glottic pT2 and selected pT3 squamous cell carcinomas (SCC) treated by transoral laser microsurgery (TLM). The entire cohort was divided into two groups: Group A included 78 "high-risk" patients (pT2 with impaired vocal cord mobility, pT3 for anterior paraglottic and/or pre-epiglottic space invasion, presence of angioembolization, perineural spread, and positive lymph nodes in the neck) who underwent postoperative surveillance by endoscopy and imaging (CT or MR), while Group B included 60 "low-risk" patients (pT2 with absence of the above-mentioned features) who underwent endoscopic follow-up alone. Aim of the present study was to assess the diagnostic gain in performing combined endoscopic and radiologic surveillance in the "high-risk" group compared to endoscopy alone in the "low-risk" one. There was no significant difference in terms of overall and disease-specific survivals between the two follow-up policies in spite of their different risk profiles. The same was true for organ preservation rate, which was 81% in the "high-risk" and 89% in the "low-risk" group. In contrast, the cumulative probability of disease-free survival was 54% for Group A and 65% for Group B (p = 0.0023). Therefore, our combined endoscopy and imaging surveillance protocol allowed increasing the submucosal recurrence detection rate in "high-risk" pT2-pT3 glottic SCC to 43%. An earlier detection of submucosal recurrences made salvage surgery by TLM feasible in at least half of cases, thus closing the gap between oncologic outcomes obtained in "high-"- vs. "low-risk" patients and leading to organ preservation rates that are favorably comparable to those obtained with open-neck partial laryngectomies and non-surgical organ preservation protocols.

Initial non-participation and loss to follow-up in a Danish youth cohort

DEFF Research Database (Denmark)

Winding, Trine Nøhr; Andersen, Johan H; Labriola, Merete

2014-01-01

BACKGROUND: Initial non-participation and loss to follow-up in the Danish youth cohort Vestliv could introduce selection bias of the measured risk estimates. OBJECTIVE: To investigate the impact of initial non-participation and loss to follow-up on the validity of descriptive measures and selected...

The value of ultrasound in the follow-up of thyroid cancer

DEFF Research Database (Denmark)

Bennedbæk, Finn Noe; Hegedüs, Laszlo

2014-01-01

The value of ultrasound in the follow-up of thyroid cancer The commonly used tumour-node-metastasis (TNM) staging system is designed to predict death and not recurrence. Based on this, patients with thyroid cancer are grouped into risk categories at the time of initial treatment. However, recent......-up is measurement of plasma-thyroglobulin concentration and ultrasound of the neck focusing on the thyroid bed and classification of lymph nodes according to their location and high risk signs....

Attrition in a 30-year follow-up of a perinatal birth risk cohort: factors change with age

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Jyrki Launes

2014-07-01

Full Text Available Background. Attrition is a major cause of potential bias in longitudinal studies and clinical trials. Attrition rate above 20% raises concern of the reliability of the results. Few studies have looked at the factors behind attrition in follow-ups spanning decades.Methods. We analyzed attrition and associated factors of a 30-year follow-up cohort of subjects who were born with perinatal risks for neurodevelopmental disorders. Attrition rates were calculated at different stages of follow-up and differences between responders and non-responders were tested. To find combinations of variables influencing attrition and investigate their relative importance at birth, 5, 9, 16 and 30 years of follow-up we used the random forest classification.Results. Initial loss of potential participants was 13%. Attrition was 16% at five, 24% at nine, 35% at 16 and 46% at 30 years. The only group difference that emerged between responders and non-responders was in socioeconomic status (SES. The variables identified by random forest classification analysis were classified into Birth related, Development related and SES related. Variables from all these categories contributed to attrition, but SES related variables were less important than birth and development associated variables. Classification accuracy ranged between 0.74 and 0.96 depending on age.Discussion. Lower SES is linked to attrition in many studies. Our results point to the importance of the growth and development related factors in a longitudinal study. Parents’ decisions to participate depend on the characteristics of the child. The same association was also seen when the child, now grown up, decided to participate at 30 years. In addition, birth related medical variables are associated with the attrition still at the age of 30. Our results using a data mining approach suggest that attrition in longitudinal studies is influenced by complex interactions of a multitude of variables, which are not

Risk factors for cervical and trochanteric hip fractures in elderly women: a population-based 10-year follow-up study.

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Jokinen, Heikki; Pulkkinen, Pasi; Korpelainen, Juha; Heikkinen, Jorma; Keinänen-Kiukaanniemi, Sirkka; Jämsä, Timo; Korpelainen, Raija

2010-07-01

We evaluated the contribution of lifestyle-related factors, calcaneal ultrasound, and radial bone mineral density (BMD) to cervical and trochanteric hip fractures in elderly women in a 10-year population-based cohort study. The study population consisted of 1,681 women (age range 70-73 years). Seventy-two percent (n = 1,222) of them participated in the baseline measurements. Calcaneal ultrasound was assessed with a quantitative ultrasound device. BMD measurements were performed at the distal and ultradistal radius by dual-energy X-ray absorptiometry. Forward stepwise logistic regression analysis was used to find the most predictive variables for hip fracture risk. During the follow-up, 53 of the women had hip fractures, including 32 cervical and 21 trochanteric ones. The fractured women were taller and thinner and had lower calcaneal ultrasound values than those without fractures. High body mass index (BMI) was a protective factor against any hip fractures, while low functional mobility was a risk factor of hip fractures. Specifically, high BMI protected against cervical hip fractures, while low physical activity was a significant predictor of these fractures. Similarly, high BMI protected against trochanteric fractures, whereas low functional mobility and high coffee consumption were significant predictors of trochanteric fractures. Cervical and trochanteric hip fractures seem to have different risk factors. Therefore, fracture type should be taken into account in clinical fracture risk assessment and preventative efforts, including patient counseling. However, the study is not conclusive due to the limited number of observed fractures during follow-up, and the results have to be confirmed in future studies.

Risk factors for non-adherence and loss to follow-up in a three-year clinical trial in Botswana.

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Deborah A Gust

Full Text Available BACKGROUND: Participant non-adherence and loss to follow-up can compromise the validity of clinical trial results. An assessment of these issues was made in a 3-year tuberculosis prevention trial among HIV-infected adults in Botswana. METHODS AND FINDINGS: Between 11/2004-07/2006, 1995 participants were enrolled at eight public health clinics. They returned monthly to receive bottles of medication and were expected to take daily tablets of isoniazid or placebo for three years. Non-adherence was defined as refusing tablet ingestion but agreeing to quarterly physical examinations. Loss to follow-up was defined as not having returned for appointments in ≥60 days. Between 10/2008-04/2009, survey interviews were conducted with 83 participants identified as lost to follow-up and 127 identified as non-adherent. As a comparison, 252 randomly selected adherent participants were also surveyed. Multivariate logistic regression analysis was used to identify associations with selected risk factors. Men had higher odds of being non-adherent (adjusted odds ratio (AOR, 2.24; 95% confidence interval [95%CI] 1.24-4.04 and lost to follow-up (AOR 3.08; 95%CI 1.50-6.33. Non-adherent participants had higher odds of reporting difficulties taking the regimen or not knowing if they had difficulties (AOR 3.40; 95%CI 1.75-6.60 and lower odds associated with each year of age (AOR 0.95; 95%CI 0.91-0.98, but other variables such as employment, distance from clinic, alcohol use, and understanding study requirements were not significantly different than controls. Among participants who were non-adherent or lost to follow-up, 40/210 (19.0% reported that they stopped the medication because of work commitments and 33/210 (15.7% said they thought they had completed the study. CONCLUSIONS: Men had higher odds of non-adherence and loss to follow-up than women. Potential interventions that might improve adherence in trial participants may include:targeting health education for men

Risk factors for non-adherence and loss to follow-up in a three-year clinical trial in Botswana.

Science.gov (United States)

Gust, Deborah A; Mosimaneotsile, Barudi; Mathebula, Unami; Chingapane, Balladiah; Gaul, Zaneta; Pals, Sherri L; Samandari, Taraz

2011-04-25

Participant non-adherence and loss to follow-up can compromise the validity of clinical trial results. An assessment of these issues was made in a 3-year tuberculosis prevention trial among HIV-infected adults in Botswana. Between 11/2004-07/2006, 1995 participants were enrolled at eight public health clinics. They returned monthly to receive bottles of medication and were expected to take daily tablets of isoniazid or placebo for three years. Non-adherence was defined as refusing tablet ingestion but agreeing to quarterly physical examinations. Loss to follow-up was defined as not having returned for appointments in ≥60 days. Between 10/2008-04/2009, survey interviews were conducted with 83 participants identified as lost to follow-up and 127 identified as non-adherent. As a comparison, 252 randomly selected adherent participants were also surveyed. Multivariate logistic regression analysis was used to identify associations with selected risk factors. Men had higher odds of being non-adherent (adjusted odds ratio (AOR), 2.24; 95% confidence interval [95%CI] 1.24-4.04) and lost to follow-up (AOR 3.08; 95%CI 1.50-6.33). Non-adherent participants had higher odds of reporting difficulties taking the regimen or not knowing if they had difficulties (AOR 3.40; 95%CI 1.75-6.60) and lower odds associated with each year of age (AOR 0.95; 95%CI 0.91-0.98), but other variables such as employment, distance from clinic, alcohol use, and understanding study requirements were not significantly different than controls. Among participants who were non-adherent or lost to follow-up, 40/210 (19.0%) reported that they stopped the medication because of work commitments and 33/210 (15.7%) said they thought they had completed the study. Men had higher odds of non-adherence and loss to follow-up than women. Potential interventions that might improve adherence in trial participants may include:targeting health education for men, reducing barriers, clarifying study expectations, educating

[Laparoscopic management of ureteroileal stenosis: Long term follow up.

Science.gov (United States)

Emiliani, Esteban; Gavrilov, Pavel; Mayordomo, Olga; Salvador, Josep; Palou, Joan; Rosales, Antonio; Villavicencio, Humberto

2017-05-01

To describe the laparoscopic approach for uretero-ileal anastomosis strictures and to analyse our long term series. A retrospective review was performed evaluating our series of patients with benign ureteroileal anastomosis strictures treated laparoscopically from 2011 to 2017. Demographics and perioperative data were obtained and analyzed. Complications were described with the Clavien-Dindo classification. The surgical technique was described and a literature review was performed. Eleven procedures were performed in ten patients. Mean blood loss was 180 ml. All the operations were performed laparoscopically without conversion. Mean hospital stay was 10 days (4-23). Early complications were Clavien-Dindo I y II: Two cases of limited anastomosis leakage, one lymphorrea, one paralitic ileum and one accidental descent of the ureteral catheter. Mean follow-up was 56 months (12-179) No late complications have been described. Based on our series with 5 year follow up, the laparoscopic approach for uretero-ileal anastomosis strictures is feasible and safe.

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

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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.

Risk of Future Suicide Attempts in Adolescent Psychiatric Inpatients at 18-Month Follow-Up.

Science.gov (United States)

Brinkman-Sull, David C.; Overholser, James C.; Silverman, Eden

2000-01-01

Investigates potential predictors of suicidal behavior in adolescent psychiatric patients (N=60) during an 18-month follow-up period. Follow-up suicidality was most strongly predicted by high intake levels of hopelessness, and an increase in or persistent problems with depression. Proposes a model in which the impact of family functioning on…

Diagnostic 131I whole-body scintigraphy 1 year after thyroablative therapy in patients with differentiated thyroid cancer: correlation of results to the individual risk profile and long-term follow-up

International Nuclear Information System (INIS)

Berger, Frank; Friedrich, Ulla; Knesewitsch, Peter; Hahn, Klaus

2011-01-01

131 I whole-body scan (WBS) and serum thyroglobulin (TG) are important in detecting thyroid remnants or recurrent disease in patients with differentiated thyroid cancer. Usually, a diagnostic WBS is carried out 6 months after ablation to exclude residual disease. We retrospectively analysed results of a second routine diagnostic WBS and TG measurements at 1 year after thyroablation and correlated these to the risk profile of patients with long-term follow-up. A total of 197 patients were followed up after thyroidectomy and ablative 131 I therapy. Follow-up included clinical examination, radioiodine WBS and thyroid-stimulating hormone (TSH), free thyroxine and TG measurements at 3-6 months and 1 year after ablation. WBS (+) patients received a therapeutic activity of 131 I. The risk profile of patients was defined according to clinical results before the 1-year control. Clinical results at 1 year after ablation were analysed in correlation to the patient risk profile and long-term follow-up data (mean 7.2 years). One year after thyroablation, 95.8% of low-risk patients had no residual disease when diagnostic WBS was carried out using 370 MBq 131 I; 4.2% of low-risk patients had residual disease at this time point. In the high-risk group of this cohort, 54.5% were disease-free 1 year after ablation, but 45.5% demonstrated residual disease. After the 1-year control, 94% of all applied radioiodine therapies were executed in the high-risk group, compared with 6% in the low-risk group (p < 0.01). A second routine WBS 1 year after thyroablation is not indicated in low-risk patients. Risk stratification according to the early clinical course effectively identified patients with higher likelihood of persistent or recurrent disease in the long-term follow-up. (orig.)

Occupational disease disclosed by preventive follow-up of former uranium ore miners

International Nuclear Information System (INIS)

Pacina, V.; Vich, Z.; Elterlein, E.

1982-01-01

The aim of preventive follow-up examinations of former employees of the concern Czechoslovak Uranium Mines is to determine possible health damage of chronically exposed workers in an area that can become manifest even following a long time after leaving the high-risk working environment. In a group of 1,139 persons that had undergone preventive follow-up examinations in the years 1977 to 1980 there were 63 cases of newly detected affections that were reported as occupational diseases, and other serious affections. The system of preventive follow-up examinations represents a significant contribution to the improvement of health care of the workers. (author)

Association between red meat consumption and metabolic syndrome in a Mediterranean population at high cardiovascular risk: cross-sectional and 1-year follow-up assessment.

Science.gov (United States)

Babio, N; Sorlí, M; Bulló, M; Basora, J; Ibarrola-Jurado, N; Fernández-Ballart, J; Martínez-González, M A; Serra-Majem, L; González-Pérez, R; Salas-Salvadó, Jordi

2012-03-01

Little is known about the role that red meat and processed red meat (RM) consumption plays in the development of the metabolic syndrome (MetS). The aim was to assess the relationship between RM consumption and the prevalence or incidence of the MetS and its components in a Mediterranean population at high risk of cardiovascular disease. Cross-sectional analyses were carried out at baseline and at 1-year follow-up and longitudinal analysis were conducted in a cohort of individuals at high risk of cardiovascular disease from the PREDIMED study. A 137-item validated semi-quantitative food frequency questionnaire, anthropometric measurements, blood pressure, fasting plasma glucose and lipid profile were evaluated both at baseline and after 1-year follow-up. The MetS was defined in accordance with the updated ATP III criteria. Subjects in the upper quartile of RM consumption were more likely to meet the criteria for the MetS at baseline (OR, 2.3; 95% CI, 1.4-3.9; P-trend = 0.001) and after 1-year follow-up (OR, 2.2; 95% CI, 1.3-3.7; P-trend = 0.034) compared with those in the quartile of reference, even after adjusting for potential confounders. The longitudinal analyses showed that individuals in the fourth quartile of RM consumption had an increased risk of MetS (OR, 2.7; 95% CI, 1.1-6.8; P-trend = 0.009) or central obesity incidence (OR, 8.1; 95% CI, 1.4-46.0; P-trend = 0.077) at the end of the follow-up compared to the lowest quartile. Higher RM consumption is associated with a significantly higher prevalence and incidence of MetS and central obesity in individuals at high risk of cardiovascular disease. Copyright © 2010 Elsevier B.V. All rights reserved.

Radioimmunotherapy for non-Hodgkin's lymphoma; positioning, safety, and efficacy of 90Y-Ibritumomab. 10 years of experience and follow-up.

Science.gov (United States)

Martínez, A; Martínez-Ramirez, M; Martínez-Caballero, D; Beneit, P; Clavel, J; Figueroa, G; Verdú, J

Radioimmunotherapy (RIT) is one of the therapies directed against molecular targets in non-Hodgkin's lymphoma (NHL). To evaluate the positioning, safety, and effectiveness of RIT with 90Y-Ibritumomab in NHL patients. A retrospective study was conducted on patients with NHL who received RIT with 90Y-Ibritumomab. An evaluation was made of the concordance with clinical guidelines, toxicity as rated by the Common Terminology Criteria for Adverse Events (CTCAE), and effectiveness was assessed based on response to treatment, overall survival (OS), and progression-free survival (PFS). RIT was requested in 26 patients, of whom 21 (11 women, mean age 56±10 years) were included in the study, with the following distribution: Follicular NHL, 67%, Mantle NHL, 14%, Diffuse large B-cell NHL, 9.5%, and Transformed NHL 9.5%. Twelve patients with refractory NHL, 7 for consolidation response, and 2 transplant conditioning, were treated. Adverse effects were observed in 71% of patients, which were usually manageable and transient, and with the most common being thrombocytopenia. At 3-4 months, overall response rate was 76.2% (71.4% complete and 4.8% partial response), and 19% had progression of disease. With a median follow up of 70 months, the OS was 96±8 months, and the PFS was 54±11 months. RIT showed a moderate correlation with clinical guidelines, and is probably underused. Adverse effects were common, mild, and manageable. The data show a high complete response rate and an increase in the OS and PFS. Copyright © 2016 Elsevier España, S.L.U. y SEMNIM. All rights reserved.

Timing of pregnancy, postpartum risk of virologic failure and loss to follow-up among HIV-positive women.

Science.gov (United States)

Onoya, Dorina; Sineke, Tembeka; Brennan, Alana T; Long, Lawrence; Fox, Matthew P

2017-07-17

We assessed the association between the timing of pregnancy with the risk of postpartum virologic failure and loss from HIV care in South Africa. This is a retrospective cohort study of 6306 HIV-positive women aged 15-49 at antiretroviral therapy (ART) initiation, initiated on ART between January 2004 and December 2013 in Johannesburg, South Africa. The incidence of virologic failure (two consecutive viral load measurements of >1000 copies/ml) and loss to follow-up (>3 months late for a visit) during 24 months postpartum were assessed using Cox proportional hazards modelling. The rate of postpartum virologic failure was higher following an incident pregnancy on ART [adjusted hazard ratio 1.8, 95% confidence interval (CI): 1.1-2.7] than among women who initiated ART during pregnancy. This difference was sustained among women with CD4 cell count less than 350 cells/μl at delivery (adjusted hazard ratio 1.8, 95% CI: 1.1-3.0). Predictors of postpartum virologic failure were being viremic, longer time on ART, being 25 or less years old and low CD4 cell count and anaemia at delivery, as well as initiating ART on stavudine-containing or abacavir-containing regimen. There was no difference postpartum loss to follow-up rates between the incident pregnancies group (hazard ratio 0.9, 95% CI: 0.7-1.1) and those who initiated ART in pregnancy. The risk of virologic failure remains high among postpartum women, particularly those who conceive on ART. The results highlight the need to provide adequate support for HIV-positive women with fertility intention after ART initiation and to strengthen monitoring and retention efforts for postpartum women to sustain the benefits of ART.

Reduction of the n-6:n-3 long-chain PUFA ratio during pregnancy and lactation on offspring body composition: follow-up results from a randomized controlled trial up to 5 y of age.

Science.gov (United States)

Brei, Christina; Stecher, Lynne; Much, Daniela; Karla, Marie-Theres; Amann-Gassner, Ulrike; Shen, Jun; Ganter, Carl; Karampinos, Dimitrios C; Brunner, Stefanie; Hauner, Hans

2016-06-01

It has been hypothesized that the n-6:n-3 (ω-6:ω-3) long-chain polyunsaturated fatty acid (LCPUFA) ratio in the maternal diet during the prenatal and early postnatal phase positively affects the body composition of the offspring. However, only limited data from prospective human intervention studies with long-term follow-up are available. We assessed the long-term effects of a reduced n-6:n-3 LCPUFA ratio in the diets of pregnant and lactating women [1020 mg docosahexaenoic acid (DHA) plus 180 mg eicosapentaenoic acid (EPA)/d together with an arachidonic acid-balanced diet compared with a control diet] on the body weights and compositions of their offspring from 2 to 5 y of age with a focus on the 5-y results. Participants in the randomized controlled trial received follow-up assessments with annual body-composition measurements including skinfold thickness (SFT) measurements (primary outcome), a sonographic assessment of abdominal subcutaneous and preperitoneal fat, and child growth. In addition, abdominal MRI was performed in a subgroup of 5-y-old children. For the statistical analysis, mixed models for repeated measures (MMRMs) were fit with the use of data from each visit since birth (except for MRI). Maternal LCPUFA supplementation did not significantly influence the children's sum of 4 SFTs [means ± SDs at 5 y of age: intervention, 23.9 ± 4.7 mm (n = 57); control, 24.5 ± 5.0 mm (n = 55); adjusted mean difference, -0.5 (95% CI: -2.2, 1.2)], growth, or ultrasonography measures at any time point in the adjusted MMRM model (all P values n = 44) at 5 y of age, which showed no significant differences in subcutaneous and visceral adipose tissue volumes and ratios. The current study provides no evidence that a dietary reduction of the n-6:n-3 LCPUFA ratio in the maternal diet during pregnancy and lactation is a useful early preventive strategy against obesity at preschool age. This trial was registered at clinicaltrials.gov as NCT00362089. © 2016 American

Posttreatment follow-up of radiation oncology patients in a managed care environment

International Nuclear Information System (INIS)

Steinberg, Michael L.; Rose, Christopher M.

1996-01-01

Purpose: Health care delivery in the United States is in the midst of a structural revolution called managed care. Demands for cost control within the managed care environment force radiation oncologists to defend the need and obligation to follow their patients. Methods and Materials: We have analyzed this follow-up requirement from six potential justifications: patient care, medical-legal, quality assurance, outcome measurement, cost, and improvement of care. Results: Practical recommendations for discussing the need for follow-up with the medical directors and primary care physicians of managed care entities are given. Follow-up without valid documentation of benefit is hard to justify in this era of managed care. Conclusions: Collaborative follow-up between the referring physician, the treating radiation oncologist, and the other oncologic specialists will allow for outcome measurement and improvement in practice without driving up cost or exposing the patient to undue risk.

Association analysis identifies 65 new breast cancer risk loci

OpenAIRE

Michailidou, Kyriaki; Lindström, Sara; Dennis, Joe; Beesley, Jonathan; Hui, Shirley; Kar, Siddhartha; Lemaçon, Audrey; Soucy, Penny; Glubb, Dylan; Rostamianfar, Asha; Bolla, Manjeet K; Wang, Qin; Tyrer, Jonathan; Dicks, Ed; Lee, Andrew

2017-01-01

Breast cancer risk is influenced by rare coding variants in susceptibility genes, such as BRCA1, and many common, mostly non-coding variants. However, much of the genetic contribution to breast cancer risk remains unknown. Here we report the results of a genome-wide association study of breast cancer in 122,977 cases and 105,974 controls of European ancestry and 14,068 cases and 13,104 controls of East Asian ancestry. We identified 65 new loci that are associated with overall breast cancer ri...

Prediction of Parkinson's disease subsequent to severe depression: a ten-year follow-up study.

Science.gov (United States)

Walter, Uwe; Heilmann, Robert; Kaulitz, Lara; Just, Tino; Krause, Bernd Joachim; Benecke, Reiner; Höppner, Jacqueline

2015-06-01

Major depressive disorder (MDD) has been associated with an increased risk of subsequent Parkinson's disease (PD) in case-control and cohort studies. However, depression alone is unlikely to be a useful marker of prodromal PD due to its low specificity. In this longitudinal observational study, we assessed whether the presence of other potential markers of prodromal PD predicts the subsequent development of PD in MDD patients. Of 57 patients with severe MDD but no diagnosis of PD who underwent a structured interview, olfactory and motor investigation and transcranial sonography at baseline, 46 (36 women; mean age 54.9 ± 11.7 years) could be followed for up to 11 (median, 10) years. Three patients (2 women; age 64, 65 and 70 years) developed definite PD after 1, 7, and 9 years, respectively. The combined finding of mild asymmetric motor slowing, idiopathic hyposmia, and substantia nigra hyperechogenicity predicted subsequent PD in all patients who could be followed for longer than 1 year. Out of the whole study cohort, only the subjects with subsequent PD presented with the triad of asymmetric motor slowing, idiopathic hyposmia, and substantia nigra hyperechogenicity in combination with at least two out of four reportable risk factors (family history of PD, current non-smoker, non-coffee drinker, constipation) at baseline investigation. Post-hoc analysis revealed that additional rating of eye and eye-lid motor abnormalities might further improve the prediction of PD in larger cohorts. Findings of this pilot-study suggest that MDD patients at risk of subsequent PD can be identified using an inexpensive non-invasive diagnostic battery.

Alcohol consumption and risk of gastric cancer: a cohort study of men in Kaunas, Lithuania, with up to 30 years follow-up

Directory of Open Access Journals (Sweden)

Everatt Ruta

2012-10-01

Full Text Available Abstract Background Gastric cancer is the second most common cause of death from cancer in the world. Epidemiological findings on alcohol use in relation to gastric cancer remain controversial. The aim of this study was to examine the effect of alcohol consumption on the risk of gastric cancer. Methods The association between alcohol intake and the risk of gastric cancer was examined in a population-based cohort of 7,150 men in Kaunas, Lithuania, who were enrolled during 1972–1974 or 1976–1980. After up to 30 years of follow-up, 185 gastric cancer cases were identified. Multivariate Cox proportional hazards models were used to estimate hazard ratios (HR and corresponding 95% confidence intervals (95% CI. The attained age was used as a time-scale. Results After adjustment for smoking, education level and body mass index, the HR of gastric cancer was 2.00 (95% CI: 1.04–3.82 for the highest alcohol consumption frequency (2–7 times per week compared with occasional drinking (a few times per year and 1.90 (95% CI: 1.13–3.18 for ≥100.0 g ethanol/week versus 0.1–9.9 g ethanol/week. A stronger effect of alcohol consumption on gastric cancer risk was observed during the second half of the study (1993–2008. In the analysis of gastric cancer risk by alcoholic beverage type, all beverages were included simultaneously in the model. The multivariate HR for men who consumed ≥0.5 litre of wine per occasion (compared with those who consumed Conclusions This study supports a link between alcohol consumption (primarily from ethanol and the development of gastric cancer in the Lithuanian population. Although an association with heavy wine consumption was observed, the effect of exposure to acetaldehyde on the development of gastric cancer in this cohort was not confirmed. Further research is needed to provide a more detailed evaluation of alcohol drinking and gastric cancer risk.

Posturography and risk of recurrent falls in healthy non-institutionalized persons aged over 65.

Science.gov (United States)

Buatois, Séverine; Gueguen, René; Gauchard, Gérome C; Benetos, Athanase; Perrin, Philippe P

2006-01-01

A poor postural stability in older people is associated with an increased risk of falling. The posturographic tool has widely been used to assess balance control; however, its value in predicting falls remains unclear. The purpose of this prospective study was to determine the predictive value of posturography in the estimation of the risk of recurrent falls, including a comparison with standard clinical balance tests, in healthy non-institutionalized persons aged over 65. Two hundred and six healthy non-institutionalized volunteers aged over 65 were tested. Postural control was evaluated by posturographic tests, performed on static, dynamic and dynamized platforms (static test, slow dynamic test and Sensory Organization Test [SOT]) and clinical balance tests (Timed 'Up & Go' test, One-Leg Balance, Sit-to-Stand-test). Subsequent falls were monitored prospectively with self-questionnaire sent every 4 months for a period of 16 months after the balance testing. Subjects were classified prospectively in three groups of Non-Fallers (0 fall), Single-Fallers (1 fall) and Multi-Fallers (more than 2 falls). Loss of balance during the last trial of the SOT sensory conflicting condition, when visual and somatosensory inputs were distorted, was the best factor to predict the risk of recurrent falls (OR = 3.6, 95% CI = 1.3-10.11). Multi-Fallers showed no postural adaptation during the repetitive trials of this sensory condition, contrary to Non-Fallers and Single-Fallers. The Multi-Fallers showed significantly more sway when visual inputs were occluded. The clinical balance tests, the static test and the slow dynamic test revealed no significant differences between the groups. In a sample of non-institutionalized older persons aged over 65, posturographic evaluation by the SOT, especially with repetition of the same task in sensory conflicting condition, compared to the clinical tests and the static and dynamic posturographic test, appears to be a more sensitive tool to

Risk of leukaemia following intravenous treatment with 224Ra - results of a long term follow-up study of ankylosing spondylitis patients

International Nuclear Information System (INIS)

Wick, R.R.; Chmelevsky, D.; Goessner, W.

1993-01-01

In an epidemiological study of the somatic late effects risk following incorporation of a short lived α-emitter, 1473 ankylosing spondylitis patients treated with repeated intravenous injections of 224 Ra in the years 1948 - 75, have been observed in the GSF. The usual therapeutic plan consisted of a total of 10 - 12 injections of 1.036 MBq (28 μCi) of 224 Ra each, given at weekly intervals; this would result in an cumulative α-dose of 0.56 - 0.67 Gy to the marrow-free skeleton of a 70-kg-man (standard man). These patients have been followed together with a control group of ankylosing spondylitis patients not treated with radioactive drugs and/or X-rays. Until May 1993 (mean follow-up time 19.9 yr), 595 patients of the exposure group and 722 patients of the control group have died, causes of death have been ascertained for 578, resp. 668 patients. Among others we observed in the exposure group 10 cases of leukaemia (vs. 2.7 - 2.8 cases expected, p 239 Pu, an α-emitter which like 224 Ra deposits preferentially on the bone surface. (orig.) [de

Differences in risk factors for voluntary early retirement and disability pension: a 15-year follow-up in a cohort of nurses' aides

DEFF Research Database (Denmark)

Jensen, L. D.; Ryom, P. K.; Christensen, M. V.

2012-01-01

of nurses' aides established in 1993 with a follow-up period of 15 years. SETTING: Nurses' aides working in nursery homes, homecare or hospitals. PARTICIPANTS: 3332 gainfully employed nurses' aides at the time of inclusion in the study. OUTCOME: Disability pension or early voluntary retirement. RESULTS: 16......OBJECTIVE: To estimate the extent of early retirement and to examine risk factors for voluntary early retirement and disability pension in a cohort of nurses' aides. DESIGN: Register study including baseline questionnaire and register data covering all transfer incomes from 1991 to 2008 in a cohort.......2% of the population was granted disability pension and 27.1% entered early voluntary retirement in the follow-up period representing 11 186 lost working years with a direct cost in transfer payment amounting about euro410 million. Health-related risk factors for disability pension was long-lasting low-back pain (HR 2...

CONTRACT FOLLOW UP TRAINING

CERN Multimedia

Technical Training; Tel. 74460

2001-01-01

SPL is organizing Training Sessions on the Contract Follow Up application. CFU is a Web based tool, developped and supported by the Administrative Information Services. It allows the creation of Divisional Requests and the follow up of their processing, from the Market Survey to the Invitation to Tender or Price Enquiry, approval by the Finance Committee, up to the actual signature of a Contract, acccording to the CERN Purchasing procedures. It includes a document management component. It also provides link with other AIS applications such as BHT and EDH. The course is primarily intended for DPOs, Contract Technical responsibles in the division and their assistants, but is beneficial to anybody involved in the follow up of such Purchasing Procedures. This course is free of charge, but application is necessary. The details of the course may be found at http://training.web.cern.ch/Training/ENSTEC/P2001/Bureautique/cfu4_f.htm General information of CFU may be found at http://ais.cern.ch/apps/cfu/ The dates of t...

Association analysis identifies 65 new breast cancer risk loci

DEFF Research Database (Denmark)

Michailidou, Kyriaki; Lindström, Sara; Dennis, Joe

2017-01-01

Breast cancer risk is influenced by rare coding variants in susceptibility genes, such as BRCA1, and many common, mostly non-coding variants. However, much of the genetic contribution to breast cancer risk remains unknown. Here we report the results of a genome-wide association study of breast...... cancer in 122,977 cases and 105,974 controls of European ancestry and 14,068 cases and 13,104 controls of East Asian ancestry. We identified 65 new loci that are associated with overall breast cancer risk at P risk single-nucleotide polymorphisms in these loci fall......-nucleotide polymorphisms in regulatory features was 2-5-fold enriched relative to the genome-wide average, with strong enrichment for particular transcription factor binding sites. These results provide further insight into genetic susceptibility to breast cancer and will improve the use of genetic risk scores...

The association of APOE genotype and cognitive decline in interaction with risk factors in a 65–69 year old community sample

Directory of Open Access Journals (Sweden)

Mack Holly A

2008-07-01

Full Text Available Abstract Background While the evidence of an association between the apolipoprotein E (APOE *E4 allele and Alzheimer's disease is very strong, the effect of the *E4 allele on cognitive decline in the general population is more equivocal. A cross-sectional study on the lifespan effects of the *E4 allele 1 failed to find any effect of the *E4 allele on cognitive performance at ages 20–24, 40–44 or 60–64 years. Methods In this four year follow-up study, we reexamine the effect of *E4 in the sample of 2,021 individuals, now aged 65–69 years. Results Performance on the Mini-Mental State Examination (MMSE was significantly poorer for *E4 homozygotes than heterozygotes or non-carriers. The effects of the *E4 genotype on cognitive decline over four years were found on the MMSE and Symbol-Digit Modalities test but only when controlling for risk factors such as head injury and education. Analyses were repeated with the exclusion of participants diagnosed with a mild cognitive disorder, with little change. Conclusion It is possible that *E4 carriers become vulnerable to greater cognitive decline in the presence of other risk factors at 65–69 years of age.

Long-term follow-up after choledochojejunostomy for bile duct stones with complex clearance of the bile duct

NARCIS (Netherlands)

Gouma, D. J.; Konsten, J.; Soeters, P. B.; Von Meyenfeldt, M.; Obertop, H.

1989-01-01

In this retrospective study, the long-term follow-up of patients undergoing choledochojejunostomy (Roux-en-Y) for bile duct stones with complex clearance of the bile duct is evaluated. Bile duct exploration and subsequent choledochojejunostomy (Roux-en-Y) was performed in 43 patients (median age 67

Dynapenic Abdominal Obesity Increases Mortality Risk among English and Brazilian Older Adults: A 10-Year Follow-Up of the ELSA and SABE Studies.

Science.gov (United States)

da Silva Alexandre, T; Scholes, S; Ferreira Santos, J L; de Oliveira Duarte, Y A; de Oliveira, C

2018-01-01

There is little epidemiological evidence demonstrating that dynapenic abdominal obesity has higher mortality risk than dynapenia and abdominal obesity alone. Our main aim was to investigate whether dynapenia combined with abdominal obesity increases mortality risk among English and Brazilian older adults over ten-year follow-up. Cohort study. United Kingdom and Brazil. Data came from 4,683 individuals from the English Longitudinal Study of Ageing (ELSA) and 1,490 from the Brazilian Health, Well-being and Aging study (SABE), hence the final sample of this study was 6,173 older adults. The study population was categorized into the following groups: non-dynapenic/non-abdominal obese, abdominal obese, dynapenic, and dynapenic abdominal obese according to their handgrip strength ( 102 cm for men and > 88 cm for women). The outcome was all-cause mortality over a ten-year follow-up. Adjusted hazard ratios by sociodemographic, behavioural and clinical characteristics were estimated using Cox proportional hazards models. The fully adjusted model showed that dynapenic abdominal obesity has a higher mortality risk among the groups. The hazard ratios (HR) were 1.37 for dynapenic abdominal obesity (95% CI = 1.12 - 1.68), 1.15 for abdominal obesity (95% CI = 0.98 - 1.35), and 1.23 for dynapenia (95% CI = 1.04 - 1.45). Dynapenia is an important risk factor for mortality but dynapenic abdominal obesity has the highest mortality risk among English and Brazilian older adults.

Role of human papillomavirus testing and cytology in follow-up after conization

DEFF Research Database (Denmark)

Gosvig, Camilla F; Huusom, Lene D; Deltour, Isabelle

2015-01-01

intraepithelial neoplasia grade 2 or worse (CIN2+) after conization. DESIGN: Prospective cohort study. SETTING: Denmark. POPULATION: 667 women attending for conization. METHODS: Cervical specimens were collected during 2002-2006 at first visit after conization for cytological examination and Hybrid Capture 2......OBJECTIVE: Adequate follow-up of women who have undergone conization for high-grade cervical lesions is crucial in cervical cancer screening programs. We evaluated the performance of testing for high-risk human papillomavirus (HPV) types, cytology alone, and combined testing in predicting cervical...... detection of high-risk HPV. The women were passively followed until 2 years after first follow-up visit by linkage to the nationwide Pathology Data Bank. RESULTS: At first visit after conization (median time, 3.4 months), 20.4% were HPV-positive and 17.2% had atypical squamous intraepithelial lesions...

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

Science.gov (United States)

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.

Follow-up of abnormal or inadequate test results in the Danish Cervical Cancer Screening Program

DEFF Research Database (Denmark)

Kristiansen, Bettina Kjær

2014-01-01

Denmark has a higher incidence of cervical cancer than other Nordic countries, although all Danish women (aged 23–65) are screened regularly to identify possible cervical dysplasia or asymptomatic invasive cancer. Annually 40 000 women receives an abnormal or inadequate test result and a follow......-up recommendation. However problems with delayed follow-up may threaten the effectiveness of the Danish Cervical Cancer Screening Program, as 20% of women are delayed and dysplasia potentially can progress into cancer. Delayed follow-up is found in situations where women either consciously or unconsciously postpone...... up will be sent to the women (RCT). The intention is to ensure that all women will be notified about the test result, quickly, homogenously and in layman’s written language, still with the opportunity to contact or be contacted by the GP, if there is special needs. Furthermore, it is assumed that GP...

Strict follow-up programme including CT and (18) F-FDG-PET after curative surgery for colorectal cancer

DEFF Research Database (Denmark)

Sørensen, N F; Jensen, A B; Wille-Jørgensen, P

2010-01-01

Aim The risk of local recurrence following curative surgery for colorectal cancer (CRC) is up to 50%. A rigorous follow-up program may increase survival. Guidelines on suitable methods for scheduled follow up examinations are needed. This study evaluates a strict follow-up program including...... supported a strict follow-up program following curative surgery for colorectal cancer. FDG-PET combined with CT should be included in control programs....

Follow-up of colorectal cancer patients: quality of life and attitudes towards follow-up

NARCIS (Netherlands)

Stiggelbout, A. M.; de Haes, J. C.; Vree, R.; van de Velde, C. J.; Bruijninckx, C. M.; van Groningen, K.; Kievit, J.

1997-01-01

The aims of our study were to assess the effect of follow-up on the quality of life of colorectal cancer patients and to assess the attitudes of patients towards follow-up as a function of patient characteristics. Patients who had been treated with curative intent were selected from four types of

Meeting increased demand for total knee replacement and follow-up: determining optimal follow-up.

Science.gov (United States)

Meding, J B; Ritter, M A; Davis, K E; Farris, A

2013-11-01

The strain on clinic and surgeon resources resulting from a rise in demand for total knee replacement (TKR) requires reconsideration of when and how often patients need to be seen for follow-up. Surgeons will otherwise require increased paramedical staff or need to limit the number of TKRs they undertake. We reviewed the outcome data of 16 414 primary TKRs undertaken at our centre to determine the time to re-operation for any reason and for specific failure mechanisms. Peak risk years for failure were determined by comparing the conditional probability of failure, the number of failures divided by the total number of TKRs cases, for each year. The median times to failure for the most common failure mechanisms were 4.9 years (interquartile range (IQR) 1.7 to 10.7) for femoral and tibial loosening, 1.9 years (IQR 0.8 to 3.9) for infection, 3.1 years (IQR 1.6 to 5.5) for tibial collapse and 5.6 years (IQR 3.4 to 9.3) for instability. The median time to failure for all revisions was 3.3 years (IQR 1.2 to 8.5), with an overall revision rate of 1.7% (n = 282). Results from our patient population suggest that patients be seen for follow-up at six months, one year, three years, eight years, 12 years, and every five years thereafter. Patients with higher pain in the early post-operative period or high body mass index (≥ 41 kg/m(2)) should be monitored more closely.

Dermoscopy, Digital Dermoscopy and Other Diagnostic Tools in the Early Detection of Melanoma and Follow-up of High-risk Skin Cancer Patients.

Science.gov (United States)

Thomas, Luc; Puig, Susana

2017-07-05

Early detection is a key strategy for reducing the mortality and economic burden associated with melanoma. Dermoscopy is a non-invasive and cost-effective tool for melanoma diagnosis, which has been shown to be a reliable and sensitive method for detecting early-stage skin cancer and reducing the number of unnecessary excisions. Patients at high risk of developing melanoma require long-term surveillance. Use of digital dermoscopy follow-up of these patients has led to improved outcomes. Combined follow-up programmes using total-body photography and digital dermoscopy have led to further improvements in early diagnosis and diagnostic accuracy. Dermoscopy is now widely used by dermatologists, but the public health impact of this tool is yet to be evaluated. Despite the clear advantages of dermoscopy and digital follow-up meth-ods, dermoscopy training and access to digital dermoscopy among dermatologists and general practitioners needs to be improved.

[Long-term infectious risks after splenectomy: A retrospective cohort study with up to 10 years follow-up].

Science.gov (United States)

Meriglier, E; Puyade, M; Carretier, M; Roblot, F; Roblot, P

2017-07-01

Although most infections occur within the first 2 years after splenectomy, the relatively short follow-up reported in many studies may underestimate the frequency of infections. The objective of the study was to determine the incidence of infective outcomes and factors associated with infection after splenectomy by studying a group of patients who underwent splenectomy over a 10-year period. A retrospective and monocentric study of patients who underwent splenectomy between January 1st, 1997 and December 31st, 2004 in a French university hospital. Age, sex, indication for splenectomy, infectious events, death, vaccination and antibiotic prophylaxis were collected in January 2015. One hundred and sixty-five patients were included. The most common reasons for splenectomy were therapeutic hematological indications (37.5%). Ninety-seven per cent received pneumococcal vaccine. Prophylactic antibiotics were prescribed in 78% of patients. Thirty-seven patients had 42 severe infections with a median incidence rate of 4 years after splenectomy (2 days-12 years). The rate of infection after splenectomy declined over time but 57% occurred after 2 years and 14.3% after 10 years. Respiratory infections were the most common sites of infections. The incidence of infection differed according to age was highest among the elderly (HR=6.2; 95%CI: 1.4-27.1; after 65 years old) and underlying reason for splenectomy (P=0.02). There is no difference with or without prophylactic antibiotics. After splenectomy, the incidence of severe infection declined over time but can occur after 10 years. The onset of infection is linked to age and reason for splenectomy. Copyright © 2017 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier SAS. All rights reserved.

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

Energy Technology Data Exchange (ETDEWEB)

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

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

International Nuclear Information System (INIS)

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

Extracranial Carotid Artery Stenting in Surgically High-Risk Patients Using the Carotid Wallstent Endoprosthesis:Midterm Clinical and Ultrasound Follow-Up Results

International Nuclear Information System (INIS)

Maleux, Geert; Bernaerts, Pauwel; Thijs, Vincent; Daenens, Kim; Vaninbroukx, Johan; Fourneau, Inge; Nevelsteen, Andre

2003-01-01

The purpose of this study was to evaluate the feasibility, safety and midterm outcome of elective implantation of the Carotid Wallstent (registered) in patients considered to be at high surgical risk. In a prospective study, 54 carotid artery stenoses in 51 patients were stented over a 24-month period. Three patients underwent bilateral carotid artery stenting. Institutional inclusion criteria for invasive treatment of carotid occlusive disease (carotid endarterectomy or carotid artery stenting) are patients presenting with a 70% or more symptomatic stenosis and those with an 80% or more asymptomatic stenosis having a life-expectancy of more than 1 year. All patients treated by carotid artery stenting were considered at high risk for carotid endarterectomy because of a hostile neck (17 patients-31.5%) or because of severe comorbidities (37 patients-68.5%). No cerebral protection device was used. Of the 54 lesions, 33 (61.1%) were symptomatic and 21 (38.8%) were asymptomatic. Follow-up was performed by physical examination and by duplex ultrasonography at 1 month, 6 months, 1 year and 2 years after the procedure. All 54 lesions could be stented successfully without periprocedural stroke. Advert events during follow-up (mean 13.9 ± 5.7 months) were non-stroke-related death in 6 patients (11.1%), minor stroke in 4 stented hemispheres(7.4%), transient ipsilateral facial pain in 1 patient (1.8%),infection of the stented surgical patch in 1 patient (1.8%) and asymptomatic in stent restenosis in 4 patients (7.4%). The percutaneous implantation of the Carotid Wallstent (registered) , even without cerebral protection device, appears to be a safe procedure with acceptable clinical and ultrasonographic follow-up results in patients at high surgical risk. But some late adverse events such as ipsilateral recurrence of non-disabling (minor) stroke or in stent restenosis still remain real challenging problems

[Metabolic Control, Evaluation and Follow-up Interventions in Patients With Schizophrenia].

Science.gov (United States)

Oviedo, Gabriel Fernando; Gómez Restrepo, Carlos; Bohórquez Peñaranda, Adriana; García Valencia, Jenny; Jaramillo, Luis Eduardo; Tamayo, Nathalie; Arenas, María Luisa; Vélez Fernández, Carolina

2015-01-01

To determine the laboratory tests, related to metabolic risk that should be practiced to adult patients diagnosed with schizophrenia. To assist the clinician decision-making process about complementary diagnostic evaluation strategies in adult diagnosed with schizophrenia. A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. The evidence of NICE guide 82 was adopted and updated. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. The risk of overall mortality in schizophrenia is higher than in the general population excluding suicide. Results related with mortality associated to antipsychotics showed contradictory results. Metabolic outcomes showed a higher incidence and association with schizophrenia and treatment with antipsychotics (AP). The diagnosis of dyslipidemia in men with schizophrenia appears to be lower in comparison with the general population. However, changes in weight, blood sugar levels, HDL cholesterol and triglycerides are influenced by the use of antipsychotics in general there is a higher risk of developing diabetes mellitus in adults with schizophrenia. Based on the evidence found a plan was formulated for the evaluation of physiological and paraclinical variables during and before the management with AP in adult diagnosed with schizophrenia. The overall quality of evidence is low considering that most of the reports come from observational studies that have risk of bias and some designs have methodological limitations. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Prevalence of H63D, S65C and C282Y hereditary hemochromatosis gene mutations in Slovenian population by an improved high-throughput genotyping assay

Directory of Open Access Journals (Sweden)

Rupreht Ruth

2007-11-01

Full Text Available Abstract Background Hereditary hemochromatosis (HH is a common genetic disease characterized by excessive iron overload that leads to multi-organ failure. Although the most prevalent genotype in HH is homozygosity for C282Y mutation of the HFE gene, two additional mutations, H63D and S65C, appear to be associated with a milder form of HH. The aim of this study was to develop a high-throughput assay for HFE mutations screening based on TaqMan technology and to determine the frequencies of HFE mutations in the Slovenian population. Methods Altogether, 1282 randomly selected blood donors from different Slovenian regions and 21 HH patients were analyzed for the presence of HFE mutations by an in-house developed real-time PCR assay based on TaqMan technology using shorter non-interfering fluorescent single nucleotide polymorphism (SNP-specific MGB probes. The assay was validated by RFLP analysis and DNA sequencing. Results The genotyping assay of the H63D, S65C and C282Y mutations in the HFE gene, based on TaqMan technology proved to be fast, reliable, with a high-throughput capability and 100% concordant with genotypes obtained by RFLP and DNA sequencing. The observed frequency of C282Y homozygotes in the group of HH patients was only 48%, others were of the heterogeneous HFE genotype. Among 1282 blood donors tested, the observed H63D, S65C and C282Y allele frequency were 12.8% (95% confidence interval (CI 11.5 – 14.2%, 1.8% (95% CI 1.4 – 2.5% and 3.6% (95% CI 3.0 – 4.5%, respectively. Approximately 33% of the tested subjects had at least one of the three HH mutations, and 1% of them were C282Y homozygotes or compound heterozygotes C282Y/H63D or C282Y/S65C, presenting an increased risk for iron overload disease. A significant variation in H63D allele frequency was observed for one of the Slovenian regions. Conclusion The improved real-time PCR assay for H63D, S65C and C282Y mutations detection is accurate, fast, cost-efficient and ready for

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

Science.gov (United States)

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.

Shillapoo Wildlife Area 2007 Follow-up HEP Report.

Energy Technology Data Exchange (ETDEWEB)

Ashley, Paul R.

2008-03-01

In April and May 2007 the Regional HEP Team (RHT) conducted a follow-up HEP analysis on the Egger (612 acres) and Herzog (210 acres) parcels located at the north end of the Shillapoo Wildlife Area. The Egger and Herzog parcels have been managed with Bonneville Power Administration funds since acquired in 1998 and 2001 respectively. Slightly more than 936 habitat units (936.47) or 1.14 HUs per acre was generated as an outcome of the 2007 follow-up HEP surveys. Results included 1.65 black-capped chickadee HUs, 280.57 great blue heron HUs, 581.45 Canada goose HUs, 40 mallard HUs, and 32.80 mink HUs. Introduction A follow-up Habitat Evaluation Procedures (HEP) (USFWS 1980) analysis was conducted by the Columbia Basin Fish and Wildlife Authority's (CBFWA) Regional HEP Team (RHT) during April and May 2007 to document changes in habitat quality and to determine the number of habitat units (HUs) to credit Bonneville Power Administration (BPA) for providing operation and maintenance (O&M) funds since WDFW acquired the parcels. The 2007 follow-up HEP evaluation was limited to Shillapoo Wildlife Area (SWA) parcels purchased with Bonneville Power Administration funds. D. Budd (pers. comm.) reported WDFW purchased the 612 acre Egger Farms parcel on November 2, 1998 for $1,737,0001 and the 210 acre Herzog acquisition on June 21, 2001 for $500,000 with Memorandum of Agreement funds (BPA and WDFW 1996) as partial fulfillment of BPA's wildlife mitigation obligation for construction of Bonneville and John Day Dams (Rasmussen and Wright 1989). Anticipating the eventual acquisition of the Egger and Herzog properties, WDFW conducted HEP surveys on these lands in 1994 to determine the potential number of habitat units to be credited to BPA. As a result, HEP surveys and habitat unit calculations were completed as much as seven years prior to acquiring the sites. The term 'Shillapoo Wildlife Area' will be used to describe only the Herzog and Egger parcels in this

Longitudinal relationship between traumatic brain injury and the risk of incident optic neuropathy: A 10-year follow-up nationally representative Taiwan survey.

Science.gov (United States)

Chen, Ying-Jen; Liang, Chang-Min; Tai, Ming-Cheng; Chang, Yun-Hsiang; Lin, Tzu-Yu; Chung, Chi-Hsiang; Lin, Fu-Huang; Tsao, Chang-Huei; Chien, Wu-Chien

2017-10-17

Accumulating evidences had shown that traumatic brain injury was associated with visual impairment or vision loss. However, there were a limited number of empirical studies regarding the longitudinal relationship between traumatic brain injury and incident optic neuropathy. We studied a cohort from the Taiwanese National Health Insurance data comprising 553918 participants with traumatic brain injury and optic neuropathy-free in the case group and 1107836 individuals without traumatic brain injury in the control group from 1st January 2000. After the index date until the end of 2010, Cox proportional hazards analysis was used to compare the risk of incident optic neuropathy. During the follow-up period, case group was more likely to develop incident optic neuropathy (0.24%) than the control group (0.11%). Multivariate Cox regression analysis demonstrated that the case group had a 3-fold increased risk of optic neuropathy (HR = 3.017, 95% CI = 2.767-3.289, p optic neuropathy. Our study provided evidence of the increased risk of incident optic neuropathy after traumatic brain injury during a 10-year follow-up period. Patients with traumatic brain injury required periodic and thorough eye examinations for incident optic neuropathy to prevent potentially irreversible vision loss.

Follow-up after rectal cancer

DEFF Research Database (Denmark)

Hovdenak Jakobsen, Ida; Juul, Therese; Bernstein, Inge

2017-01-01

BACKGROUND: The main treatment for non-metastatic rectal cancer (RC) is surgical resection. Late adverse effects that are highly prevalent and negatively impact patients' symptom burden and quality of life are: bowel-, urological and sexual dysfunctions; psychological distress; fear of recurrence....... As a consequence, the randomized controlled trial Follow-up after Rectal Cancer (FURCA) has been launched, testing the effect of a new patient-led, follow-up program. The aim of this paper is to describe the methodology used in the FURCA study and to report results from the development of the patient-led, follow......, or a control group following the current follow-up program with routine medicals. The primary outcomes are symptom burden and quality of life, measured by the Functional Assessment of Cancer Therapy - Colorectal (FACT-C) questionnaire. Other outcome and demographic data are collected as patient...

Gastric cancer risk in achlorhydric patients. A long-term follow-up study

DEFF Research Database (Denmark)

Svendsen, Jesper Hastrup; Dahl, C; Svendsen, L B

1986-01-01

Achlorhydria, determined by the augmented histamine test, is the functional expression of the most severe atrophic gastritis and is followed by a 4- to 6-fold increased risk of gastric cancer, as we found 5 cancers in 114 patients after a mean observation period of 8.4 years. The cancers developed...

Follow-up in Childhood Functional Constipation

DEFF Research Database (Denmark)

Modin, Line; Walsted, Anne-Mette; Rittig, Charlotte Siggaard

2016-01-01

OBJECTIVES: Guidelines recommend close follow-up during treatment of childhood functional constipation. Only sparse evidence exists on how follow-up is best implemented. Our aim was to evaluate if follow-up by phone or self-management through web-based information improved treatment outcomes....... METHODS: In this randomized, controlled trial, conducted in secondary care, 235 children, aged 2-16 years, who fulfilled the Rome III criteria of childhood constipation, were assigned to one of three follow-up regimens: (I) control group (no scheduled contact), (II) phone group (2 scheduled phone contacts......: Improved self-management behavior caused by access to self-motivated web-based information induced faster short-term recovery during treatment of functional constipation. Patient empowerment rather than health care promoted follow-up might be a step towards more effective treatment for childhood...

Poor nutritional status of older subacute patients predicts clinical outcomes and mortality at 18 months of follow-up.

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Charlton, K; Nichols, C; Bowden, S; Milosavljevic, M; Lambert, K; Barone, L; Mason, M; Batterham, M

2012-11-01

Older malnourished patients experience increased surgical complications and greater morbidity compared with their well-nourished counterparts. This study aimed to assess whether nutritional status at hospital admission predicted clinical outcomes at 18 months follow-up. A retrospective analysis of N=2076 patient admissions (65+ years) from two subacute hospitals, New South Wales, Australia. Analysis of outcomes at 18 months, according to nutritional status at index admission, was performed in a subsample of n = 476. Nutritional status was determined within 72 h of admission using the Mini Nutritional Assessment (MNA). Outcomes, obtained from electronic patient records, included hospital readmission rate, total Length of Stay (LOS), change in level of care at discharge and mortality. Survival analysis, using a Cox proportional hazards model, included age, sex, Major Disease Classification, mobility and LOS at index admission as covariates. At baseline, 30% of patients were malnourished and 53% were at risk of malnutrition. LOS was higher in malnourished and at risk, compared with well-nourished patients (median (interquartile range): 34 (21, 58); 26 (15, 41); 20 (14, 26) days, respectively; Pclinical outcomes and identifies a need to target this population for nutritional intervention following hospital discharge.

Increased risk for invasive breast cancer associated with hormonal therapy: a nation-wide random sample of 65,723 women followed from 1997 to 2008.

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Jung-Nien Lai

Full Text Available BACKGROUND: Hormonal therapy (HT either estrogen alone (E-alone or estrogen plus progesterone (E+P appears to increase the risk for breast cancer in Western countries. However, limited information is available on the association between HT and breast cancer in Asian women characterized mainly by dietary phytoestrogens intake and low prevalence of contraceptive pills prescription. METHODOLOGY: A total of 65,723 women (20-79 years of age without cancer or the use of Chinese herbal products were recruited from a nation-wide one-million representative sample of the National Health Insurance of Taiwan and followed from 1997 to 2008. Seven hundred and eighty incidents of invasive breast cancer were diagnosed. Using a reference group that comprised 40,052 women who had never received a hormone prescription, Cox proportional hazard models were constructed to determine the hazard ratios for receiving different types of HT and the occurrence of breast cancer. CONCLUSIONS: 5,156 (20% women ever used E+P, 2,798 (10.8% ever used E-alone, and 17,717 (69% ever used other preparation types. The Cox model revealed adjusted hazard ratios (HRs of 2.05 (95% CI 1.37-3.07 for current users of E-alone and 8.65 (95% CI 5.45-13.70 for current users of E+P. Using women who had ceased to take hormonal medication for 6 years or more as the reference group, the adjusted HRs were significantly elevated and greater than current users and women who had discontinued hormonal medication for less than 6 years. Current users of either E-alone or E+P have an increased risk for invasive breast cancer in Taiwan, and precautions should be taken when such agents are prescribed.

Risk of gastrointestinal cancer in patients with unexplained chest/epigastric pain and normal upper endoscopy: a Danish 10-year follow-up study

DEFF Research Database (Denmark)

Munk, Estrid Muff; Drewes, Asbjørn Mohr; Gorst-Rasmussen, Anders

2007-01-01

Unexplained chest/epigastric pain is a common symptom in the general population. However, it has not previously been studied whether such pain could be a marker of subsequent gastrointestinal cancer. We aimed to estimate the risk of gastrointestinal cancers in a Danish 10-year follow-up study amo...

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

Science.gov (United States)

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.

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

Directory of Open Access Journals (Sweden)

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.

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

CSIR Research Space (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...

Perceived psychological pressure at work, social class, and risk of stroke: a 30-year follow-up in Copenhagen male study.

Science.gov (United States)

Suadicani, Poul; Andersen, Lars L; Holtermann, Andreas; Mortensen, Ole S; Gyntelberg, Finn

2011-12-01

Investigate if the association between perceived psychological work pressure and risk of stroke is modified by socioeconomic status. Thirty-year follow-up of 4943 middle-aged men without cardiovascular disease. In the higher social classes (I, II, and III), perceived regular exposure to psychological work pressure was common and a significant predictor of stroke; almost 10% of the stroke events could be attributed to this exposure in the higher social classes; among lower social classes (IV and V), perceived psychological pressure was no predictor at all. Regular psychological work pressure is a highly prevalent and independent risk factor for stroke among men in higher social classes. In contrast, no association to stroke risk was found among low social class men.

Temporal relationship between depression and dementia – findings from a large community-based 15 year follow-up study

Science.gov (United States)

Li, Ge; Wang, Lucy Y.; Shofer, Jane B.; Thompson, Mary Lou; Peskind, Elaine R.; McCormick, Wayne; Bowen, James D.; Crane, Paul K.; Larson, Eric B.

2012-01-01

Context Late-life depression is associated with increased risk of dementia but the temporal relationship between depression and development of dementia remains unclear. Objectives To examine the association between risk of dementia and 1) baseline depressive symptoms ; 2) past history of depression, particularly early-life (depression; and 3) individual domains of the Center for Epidemiologic Studies Depression Scale (CESD). Design A large cohort with initially non-demented participants was followed biennially for up to 15 years for incident dementia. Baseline depressive symptoms were assessed using the 11-item version of CESD (CESD-11), and defined as CESD-11 score ≥ 11. Self-reported history of depression was collected at the baseline interview. Cox proportional hazards regression was used to assess the association between depression and the dementia risk. Setting Population-based cohort drawn from members of Group Health Cooperative in Seattle, Washington. Participants A cohort of 3,410 participants without dementia aged ≥ 65 years. Results Over an average of 7.1 years follow-up, 658 participants (19%) developed dementia. At baseline, 9% of participants had depressive symptoms (CESD-11 ≥ 11) and 21% reported a past history of depression. The adjusted hazard ratio (aHR) for dementia associated with baseline depressive symptoms was 1.71 (95% confidence interval 1.37, 2.13), after adjusting for age-at-entry, gender, education, and wave of enrollment. Compared to participants without depression history, those with late-life depression were at increased dementia risk (aHR =1.46 [1.16, 1.84]), but early-life depression had no association with dementia risk (aHR=1.10 [0.83, 1.47]). Depressed mood (aHR 1.48 [1.25, 1.76]) and perceived performance difficulty (aHR 1.39 [1.15, 1.67]) were independently associated with dementia. Conclusions This study confirmed previous observations of an association between late-life depression and increased risk of dementia and

[Follow-up of children conceived by assisted reproductive technologies].

Science.gov (United States)

Bouillon, C; Fauque, P

2013-05-01

Since the birth of the first baby conceived by in vitro fertilization (IVF) 30 years ago (Louise Brown in 1978), there has been a rapid and constant increase in the number of couples using assisted reproductive technologies (ART). Around four million of children have been born from couples experiencing fertility problems, through the use of ART, comprising roughly 2-3 % of all births in Europe and U.S. That highlights that these modes of fertilization are now well assumed by our societies. However, several questions on health of these children remain to be elucidated. As evoked in this review, even if methodological limitations exist, numerous studies have reported increased risks of birth defects, like prematurity, foetal hypotrophy, neonatal complications, congenital malformations and epigenetic diseases among ART-conceived children as compared to naturally conceived children. Nowadays, it is difficult to determine if these increased risks found in ART infants are a consequence of the ART procedures or are inherent to the infertility problems per se. However, absolute risks remain moderate and reassuring as well as the data on follow-up into infancy and early childhood. Nevertheless, because the effects may occur at the adulthood, there is a need for long-term follow-up of children born after ART. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Follow-Up Testing

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... second should occur after 1 year on the gluten-free diet. After that, a celiac should receive follow-up ... test result is straightforward—a celiac on the gluten-free diet should have a negative test. The numerical value ...

Childhood maltreatment and BMI trajectories to mid-adult life: follow-up to age 50 y in a British birth cohort.

Directory of Open Access Journals (Sweden)

Chris Power

Full Text Available Childhood maltreatment including abuse and neglect has been associated with adult obesity, but evidence on life-course development of obesity or BMI gain is unclear. We aim to establish whether childhood maltreatments are related to obesity or BMI at different life-stages 7 y-50 y and to identify possible explanations for associations.Childhood physical, psychological and sexual abuse, neglect and BMI at seven ages were recorded in the 1958 birth cohort (n~15,000. Associations of child maltreatments with BMI at separate ages were tested using linear regression or logistic regression for obesity, and with rate of child-to-adult BMI gain using multilevel models. We adjusted for potential covariates.Abuse was reported in ~12% of the population. Abuse was not associated with elevated childhood BMI, but adult associations were observed: i.e. the abused had faster child-adult BMI gain than the non-abused; associations were independent of adult covariates. For physical abuse in both genders there was a positive linear association of ~0.006/y zBMI gain with age after adjustment for all covariates. Similarly, there was a linear association of physical abuse with obesity risk: e.g. among females from a low OR(adjusted of 0.34 (0.16,0.71 at 7 y to 1.67 (1.25,2.24 at 50 y. In females faster zBMI gains with age of ~0.0034/y were observed for sexual abuse and increases in obesity risk were faster: from a low OR(adjusted of 0.23 (0.06,0.84 at 7 y to 1.34 (0.86,2.10 at 50 y. Psychological abuse and neglect associations were less consistent.Childhood maltreatment associations with BMI or obesity varied across life: physical and, in females, sexual abuse were associated with faster lifetime BMI gains, which may have detrimental long-term health consequences.

Effectiveness of assigning BI-RADS category-3 to breast lesion with respect to follow-up

International Nuclear Information System (INIS)

Masroor, I.

2008-01-01

To determine the effectiveness of assigning BI-RADS category-3 to breast lesion with respect to follow-up. Women undergoing X-ray mammography and assigned BI-RADS category-3 and recommended short-term (6-monthly) follow-up were included. Out of these, 44 patients were lost to follow-up and were excluded from the study. The lesions that remained stable after short-term follow-up were recommended routine (annual) follow-up. Needle localization and open surgical biopsy was performed, if the lesion progressed or calcifications increased in number/size and/or on physician or patient preference. The effectiveness of this approach was analyzed by determining the sensitivity, specificity, positive and negative predictive value for BI-RADS category-3. Of the 65 lesions, 55 remained stable. Of the remaining 10 lesions, two showed increase in number of microcalcification prompting biopsy. Both turned out to be ductal carcinoma in situ. Eight biopsies were performed on clinician or patient preference which turned out to be benign. The sensitivity, specificity, positive and negative predictive values were 100%, 87%, 20% and 100% respectively. Assessment with short-interval mammographic follow-up is useful to confirm the nature of most non-palpable breast lesions considered probably benign and permits detection of a small number of breast cancers at an early stage. The local setup, patient compliance is a major limitation for performing a follow-up study, as the available numbers can have a profound effect on the determined accuracy value. (author)

The effect of race on postsurgical ambulatory medical follow-up among United States Veterans.

Science.gov (United States)

Schonberger, Robert B; Dai, Feng; Brandt, Cynthia; Burg, Matthew M

2017-08-01

To investigate the association between self-identified black or African American race and the presence of ambulatory internal medicine follow-up in the year after surgery. Our hypothesis was that among US Veterans who presented for surgery, black or African American race would be associated with a decreased likelihood to receive ambulatory internal medicine follow-up in the year after surgery. Retrospective observational. All US Veterans Affairs hospitals. A total of 236,200 Veterans undergoing surgery between 2006 and 2011 who were discharged within 10 days of surgery and survived the full 1-year exposure period. None. Attendance at an internal medicine follow-up appointment within 1 year after surgery. After controlling for year of surgery, age, age ≥65 years, sex, Hispanic ethnicity, and number of inpatient days, black or African American patients were 11% more likely to lack internal medicine follow-up after surgery (adjusted odds ratio, 1.11; 95% confidence interval, 1.06-1.16). When accounting for geographic region, this difference remained significant at the Bonferoni-corrected P < .007 level only in the Midwest United States where black or African American patients were 28% more likely to lack medical follow-up in the year after surgery (odds ratio, 1.28; 95% confidence interval, 1.16-1.42; P < .0001). The disparity in ambulatory medical follow-up following surgery among black or African American vs nonblack or non-African American Veterans in the Midwest region deserves further study and may lead to important quality improvement initiatives aimed specifically at this population. Copyright © 2016 Elsevier Inc. All rights reserved.

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

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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.

The consumption of fish cooked by different methods was related to the risk of hyperuricemia in Japanese adults: A 3-year follow-up study.

Science.gov (United States)

Ren, Z; Huang, C; Momma, H; Cui, Y; Sugiyama, S; Niu, K; Nagatomi, R

2016-09-01

Fish consumption is a recognized risk factor for elevated serum uric acid (UA) levels, hyperuricemia, and gout. However, the relationship between the consumption of fish cooked by different methods and the risk of hyperuricemia is unclear. Therefore, we aimed to investigate the relationship between the consumption of fish cooked by different methods and the risk of hyperuricemia in Japanese adults. A 3-year follow-up study was conducted with 424 Japanese adults aged 29-74 years. Fish consumption was assessed using a validated self-administered dietary history questionnaire, and hyperuricemia was defined as serum UA ≥7 mg/dL in men and ≥6 mg/dL in women or the use of any anti-gout treatment. During the 3-year follow-up period, we documented 30 newly diagnosed cases of hyperuricemia. After adjusting for potential confounders, multivariate logistic regressions analysis revealed a significant positive relationship between the risk of hyperuricemia and raw (sashimi and sushi) or roasted fish consumption, but not boiled or fried fish consumption. The odds ratios (95% CI) for hyperuricemia with increasing raw fish consumption were 1.00 (reference), 2.51 (0.85, 7.39), and 3.46 (1.07, 11.14) (P for trend: 0.036). Similarly, the odds ratios (95% CI) with increasing roasted fish consumption were 1.00 (reference), 3.00 (0.75, 11.89), and 5.17 (1.30, 20.62) (P for trend: 0.018). This 3-year follow-up study showed that the consumption of raw or roasted fish, but not boiled or fried fish, was related with a higher risk of hyperuricemia in Japanese adults. Copyright © 2016 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.

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

DEFF Research Database (Denmark)

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...

Reasons for women’s non-participation in follow-up screening after gestational diabetes

DEFF Research Database (Denmark)

Hyldgaard Nielsen, Jane; Olesen, Christinna Rebecca; Kristiansen, Tine Mechlenborg

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...

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

Science.gov (United States)

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

Cytology and high risk HPV testing in cervical cancer screening program: Outcome of 3-year follow-up in an academic institute.

Science.gov (United States)

Yang, Jack; Nolte, Fredrick S; Chajewski, Olga S; Lindsey, Kathryn G; Houser, Patricia M; Pellicier, Jalidsa; Wang, Qun; Ehsani, Laleh

2018-01-01

Combination of cervical cytology and high-risk human papillomavirus (HR-HPV) testing, co-testing, has been increasingly used in screening cervical cancers. The present study summarized the outcome of co-testing by reviewing 3-year clinical and pathological follow-up information. Patients were retrospectively identified via computerized search and were grouped based on the cytologic diagnosis and HR-HPV status as negative for intraepithelial lesion or malignancy (NILM)/HPV-, NILM/HPV+, atypical squamous cells of undetermined significance (ASC-US)/HPV-, ASC-US/HPV+, low grade squamous intraepithelial lesion (LSIL)/HPV-, LSIL/HPV+, atypical squamous cells, cannot exclude high grade squamous intraepithelial lesion (ASC-H)/HPV-, ASC-H/HPV+, high grade squamous intraepithelial lesion (HSIL)/HPV-, and HSIL/HPV+. The patients' pertinent past medical history and follow-up information were analyzed. During 3-year follow-up period, histologically proven HSIL was found in 5 of 1565 (0.3%) patients with NILM/HPV-, 7 of 141 (5.0%) with NILM/HPV+, 2 of 502 (0.4%) with ASC-US/HPV-, 30 of 274 (10.9%) with ASC-US/HPV+, 1 of 81 (1.2%) with LSIL/HPV-, 28 of 159 (17.6%) with LSIL/HPV+, 3 of 18 (16.7%) with ASC-H/HPV-, 34 of 69 (49.3%) with ASC-H/HPV+, 7 of 7 (100%) with HSIL/HPV-, and 35 of 56 (62.5%) HSIL/HPV+. In reviewing 12 HSIL cases that were originally diagnosed as NILM, 7 remained as NILM, and the other 5 were reclassified as 1 HSIL, 1 ASC-H, and 3 ASC-US, respectively. In 18 HSIL cases with negative HR-HPV, 12 patients had a prior history of positive HR-HPV testing and/or positive p16 IHC stain in the follow-up cervical biopsy. HR-HPV testing plays an important role in cervical cancer screening by identifying HSIL in patients with ASC-US, LSIL, and NILM. Co-testing is an optimal method to identifying the patients with higher risk for developing cervical abnormalities. © 2017 Wiley Periodicals, Inc.

Hepatic pseudoaneurysm after traumatic liver injury; is CT follow-up warranted?

DEFF Research Database (Denmark)

Østerballe, Lene; Helgstrand, Frederik; Axelsen, Thomas

2014-01-01

INTRODUCTION: Hepatic pseudoaneurysm (HPA) is a rare complication after liver trauma, yet it is potentially fatal, as it can lead to sudden severe haemorrhage. The risk of developing posttraumatic HPA is one of the arguments for performing follow-up CT of patients with liver injuries. The aim...... no treatment failures. There was no correlation between the severity of the liver injury and development of HPA. 5 out of 7 patients were asymptomatic and would have been discharged without treatment if the protocol did not include a default follow-up CT. CONCLUSIONS: In conclusion, this study shows that HPA...

Intake of High-Fat Yogurt, but Not of Low-Fat Yogurt or Prebiotics, Is Related to Lower Risk of Depression in Women of the SUN Cohort Study.

Science.gov (United States)

Perez-Cornago, Aurora; Sanchez-Villegas, Almudena; Bes-Rastrollo, Maira; Gea, Alfredo; Molero, Patricio; Lahortiga-Ramos, Francisca; Martínez-González, Miguel Angel

2016-09-01

Yogurt and prebiotic consumption has been linked to better health. However, to our knowledge, no longitudinal study has assessed the association of yogurt and prebiotic consumption with depression risk. We longitudinally evaluated the association of yogurt and prebiotic consumption with depression risk in a Mediterranean cohort. The SUN (Seguimiento Universidad de Navarra) Project is a dynamic, prospective cohort of Spanish university graduates. A total of 14,539 men and women (mean age: 37 y) initially free of depression were assessed during a median follow-up period of 9.3 y. Validated food-frequency questionnaires at baseline and after a 10-y follow-up were used to assess prebiotic (fructans and galacto-oligosaccharide) intake and yogurt consumption (yogurt intake was associated with reduced depression risk: HR for the highest [≥7 servings/wk (1 serving = 125 g)] compared with the lowest (yogurt consumption was associated with a higher incidence of depression (HR: 1.32; 95% CI: 1.06, 1.65; P-trend = 0.001), although this association lost significance after the exclusion of early incident cases, suggesting possible reverse causation bias. Prebiotic consumption was not significantly associated with depression risk. Our study suggests that high consumption of whole-fat yogurt was related to a lower risk of depression in women of the SUN cohort. No association was observed for prebiotics. Further studies are needed to clarify why the yogurt-depression association may differ by fat content of the yogurt. © 2016 American Society for Nutrition.

Seasonal variation in cause-specific mortality: are there high-risk groups? 25-year follow-up of civil servants from the first Whitehall study

NARCIS (Netherlands)

C.T.M. van Rossum (Caroline); M.J. Shipley; H. Hemingway; D.E. Grobbee (Diederick); J.P. Mackenbach (Johan); M.G. Marmot

2001-01-01

textabstractOBJECTIVES: To determine the seasonal effect on all-cause and cause-specific mortality and to identify high-risk groups. METHODS: A 25-year follow-up of 19,019 male civil servants aged 40-69 years. RESULTS: All-cause mortality was seasonal (ratio of highest mortality

Risk factors for the need of hip arthroscopy following periacetabular osteotomy

DEFF Research Database (Denmark)

Hartig-Andreasen, Charlotte; Troelsen, Anders; Thillemann, Theis M

2015-01-01

was to identify risk factors predicting the need for a hip arthroscopy (HA) after periacetabular osteotomy (PAO). Ninety-nine patients (104 hips) scheduled for PAO were evaluated preoperatively and at 2-year follow-up. MRA was performed in all patients prior to PAO. At follow-up, patients were divided into a non-arthroscopy...... and arthroscopy group. The two groups were compared clinical and radiological, and risk factors for HA after PAO were calculated. Patient reported outcome measures (WOMAC, Oxford Hip and SF36) were filled out before PAO and at follow-up. Ninety-five hips (91.3%) were evaluated. Twenty-six hips (27%) required...... an arthroscopy within 2 years of the PAO. Risk factors were preoperative borderline dysplasia, acetabular retroversion and complete labral detachment. Labral tearing, degeneration or hypertrophy did not negatively affect the outcome of PAO. Patients not requiring an arthroscopy had a statistically significant...

Long-Term Follow-up of Uterine Artery Embolization for Symptomatic Adenomyosis

International Nuclear Information System (INIS)

Smeets, A. J.; Nijenhuis, R. J.; Boekkooi, P. F.; Vervest, H. A. M.; Rooij, W. J. van; Lohle, P. N. M.

2012-01-01

Introduction: Long-term results of uterine artery embolization (UAE) for adenomyosis are largely unknown. We assess long-term outcome of UAE in 40 women with adenomyosis. Materials and methods: Between March 1999 and October 2006, 40 consecutive women with adenomyosis (22 in combination with fibroids) were treated with UAE. Changes in junction zone thickness were assessed with magnetic resonance imaging (MRI) at baseline and again at 3 months. After a mean clinical follow-up of 65 months (median 58 [range 38–129]), women filled out the uterine fibroid symptom and quality of life (UFS-QoL) questionnaire, which had additional questions on the long-term evolution of baseline symptoms and adverse events. Results: During follow-up, 7 of 40 women (18%) underwent hysterectomy. Among these 7 women, the junction zones were significantly thicker, both at baseline (mean 23 vs. 16 mm, P = 0.028) and at 3-month follow-up (mean 15 vs. 9 mm, P = 0.034). Of 33 women with preserved uterus, 29 were asymptomatic. Four patients had symptom severity scores of 50 to 85 and overall QoL scores of 60 to 66, indicating substantial clinical symptoms. There was no relation between clinical outcome and the initial presence of fibroids in addition to adenomyosis. Conclusion: In women with therapy-resistant adenomyosis, UAE resulted in long-term preservation of the uterus in the majority. Most patients with preserved uterus were asymptomatic. The only predictor for hysterectomy during follow-up was initial thickness of the junction zone. The presence or absence of fibroids in addition to adenomyosis had no relation with the need for hysterectomy or clinical outcome.

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

Science.gov (United States)

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.

Morbidity follow-up feasibility study

International Nuclear Information System (INIS)

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

Cumulative effective dose and cancer risk for pediatric population in repetitive full spine follow-up imaging: How micro dose is the EOS microdose protocol?

Science.gov (United States)

Law, Martin; Ma, Wang-Kei; Lau, Damian; Cheung, Kenneth; Ip, Janice; Yip, Lawrance; Lam, Wendy

2018-04-01

To evaluate and to obtain analytic formulation for the calculation of the effective dose and associated cancer risk using the EOS microdose protocol for scoliotic pediatric patients undergoing full spine imaging at different age of exposure; to demonstrate the microdose protocol capable of delivering lesser radiation dose and hence of further reducing cancer risk induction when compared with the EOS low dose protocol; to obtain cumulative effective dose and cancer risk for both genders scoliotic pediatrics of US and Hong Kong population using the microdose protocol. Organ absorbed doses of full spine exposed scoliotic pediatric patients have been simulated with the use of EOS microdose protocol imaging parameters input to the Monte Carlo software PCXMC. Gender and age specific effective dose has been calculated with the simulated organ absorbed dose using the ICRP-103 approach. The associated radiation induced cancer risk, expressed as lifetime attributable risk (LAR), has been estimated according to the method introduced in the Biological Effects of Ionizing Radiation VII report. Values of LAR have been estimated for scoliotic patients exposed repetitively during their follow up period at different age for US and Hong Kong population. The effective doses of full spine imaging with simultaneous posteroanterior and lateral projection for patients exposed at the age between 5 and 18 years using the EOS microdose protocol have been calculated within the range of 2.54-14.75 μSv. The corresponding LAR for US and Hong Kong population was ranged between 0.04 × 10 -6 and 0.84 × 10 -6 . Cumulative effective dose and cancer risk during follow-up period can be estimated using the results and are of information to patients and their parents. With the use of computer simulation and analytic formulation, we obtained the cumulative effective dose and cancer risk at any age of exposure for pediatric patients of US and Hong Kong population undergoing repetitive

The value of gynecologic cancer follow-up

DEFF Research Database (Denmark)

Lajer, Henrik; Jensen, Mette B.; Kilsmark, Jannie

2010-01-01

that follow-up affects the women's quality of life. CONCLUSIONS:: The main purpose of follow-up after treatment of cancer is improved survival. Our review of the literature showed no evidence of a positive effect on survival in women followed up after primary treatment of endometrial or ovarian cancer......INTRODUCTION:: To explore the extent of evidence-based data and cost-utility of follow-up after primary treatment of endometrial and ovarian cancer, addressing perspectives of technology, organization, economics, and patients. METHODS:: Systematic literature searches according......:: None of the identified studies supported a survival benefit from hospital-based follow-up after completion of primary treatment of endometrial or ovarian cancer. The methods for follow-up were of low technology (gynecologic examination with or without ultrasound examination). Other technologies had...

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

Science.gov (United States)

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.

Final results of a long-term, clinical follow-up in fatty liver patients

DEFF Research Database (Denmark)

Dam-Larsen, Sanne; Becker, Ulrik; Franzmann, Maria-Benedicte

2009-01-01

OBJECTIVE: There is increasing focus on non-alcoholic fatty liver disease (NAFLD). The aim of the present study was to conduct a long-term clinical follow-up of patients with biopsy-confirmed fatty liver without inflammation or significant fibrosis (pure fatty liver), to analyse for potential risk....... All admissions, discharge diagnoses and causes of death during follow-up were collected. All surviving patients were invited to a clinical follow-up. RESULTS: The follow-up period was 20.4 and 21.0 years, respectively, for the NAFLD and alcoholic fatty liver disease (AFLD) groups. Two NAFLD patients...... of death. Patients with AFLD died primarily from cirrhosis and other alcohol-related disorders, whereas in patients with NAFLD the main causes of death were cardiovascular disease and cancer. CONCLUSIONS: For patients with pure non-alcoholic fatty liver, survival was good and independent...

Sleep During Menopausal Transition: A 6-Year Follow-Up.

Science.gov (United States)

Lampio, Laura; Polo-Kantola, Päivi; Himanen, Sari-Leena; Kurki, Samu; Huupponen, Eero; Engblom, Janne; Heinonen, Olli J; Polo, Olli; Saaresranta, Tarja

2017-07-01

Menopausal transition is associated with increased dissatisfaction with sleep, but the effects on sleep architecture are conflicting. This prospective 6-year follow-up study was designed to evaluate the changes in sleep stages and sleep continuity that occur in women during menopausal transition. Sixty women (mean age 46.0 years, SD 0.9) participated. All women were premenopausal at baseline, and at the 6-year follow-up, women were in different stages of menopausal transition. Polysomnography was used to study sleep architecture at baseline and follow-up. The effects of aging and menopause (assessed as change in serum follicle-stimulating hormone [S-FSH]) on sleep architecture were evaluated using linear regression models. After controlling for body mass index, vasomotor, and depressive symptoms, aging of 6 years resulted in shorter total sleep time (B -37.4, 95% confidence interval [CI] -71.5 to (-3.3)), lower sleep efficiency (B -6.5, 95%CI -12.7 to (-0.2)), as well as in increased transitions from slow-wave sleep (SWS) to wakefulness (B 1.0, 95%CI 0.1 to 1.9), wake after sleep onset (B 37.7, 95%CI 12.5 to 63.0), awakenings per hour (B 1.8, 95%CI 0.8 to 2.8), and arousal index (B 2.3, 95%CI 0.1 to 4.4). Higher S-FSH concentration in menopausal transition was associated with increased SWS (B 0.09, 95%CI 0.01 to 0.16) after controlling for confounding factors. A significant deterioration in sleep continuity occurs when women age from 46 to 52 years, but change from premenopausal to menopausal state restores some SWS. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Obese patients lose weight independently of nutritional follow-up after bariatric surgery

Directory of Open Access Journals (Sweden)

Beatriz Helena Tess

2015-04-01

Full Text Available Summary Objective: to examine the association between preoperative body weight, adherence to postsurgical nutritional follow-up, length of postoperative period, and weight loss during the first 18 months among adults who have undergone bariatric surgery. Methods: a retrospective cohort study was conducted on 241 consecutive patients who underwent open Roux-en-Y gastric bypass (RYGBP from January 2006 to December 2008, in a teaching hospital in São Paulo (Brazil. Data were collected through hospital records review and the variables analyzed included sex, age, immediate preoperative weight, adherence to postsurgical nutritional visits and length of postoperative period. Proportional body weight reductions during the 18-month follow-up period were examined using generalized estimating equations. Results: 81% (n=195 of participants were female, with overall mean age of 44.4 ± 11.6 years, mean preoperative weight of 123.1± 21.2 kg and mean preoperative body mass index of 47.2± 6.2 kg/m2. The overall adherence to postoperative follow- up schedule was 51% (95%CI: 44.5-57.5%. Preoperative body weight and adherence were not associated with proportional weight reduction (Wald’s test p > 0.18. Weight loss leveled off at the end of the 18-month follow-up period for both compliant and non-compliant patients (Wald’s test p = 0.00. Conclusions: our study showed that weight loss occurred steadily over the first 18 months after RYGBP, leveling off at around 40% weight reduction. It was associated with neither presurgical weight, nor nutritional follow-up and it may be primarily dependent on the surgical body alterations themselves. This finding may have implications for intervention strategies aimed at motivating patients to comply with early postsurgical and life-long follow-up.

Association analysis identifies 65 new breast cancer risk loci

Science.gov (United States)

Lemaçon, Audrey; Soucy, Penny; Glubb, Dylan; Rostamianfar, Asha; Bolla, Manjeet K.; Wang, Qin; Tyrer, Jonathan; Dicks, Ed; Lee, Andrew; Wang, Zhaoming; Allen, Jamie; Keeman, Renske; Eilber, Ursula; French, Juliet D.; Chen, Xiao Qing; Fachal, Laura; McCue, Karen; McCart Reed, Amy E.; Ghoussaini, Maya; Carroll, Jason; Jiang, Xia; Finucane, Hilary; Adams, Marcia; Adank, Muriel A.; Ahsan, Habibul; Aittomäki, Kristiina; Anton-Culver, Hoda; Antonenkova, Natalia N.; Arndt, Volker; Aronson, Kristan J.; Arun, Banu; Auer, Paul L.; Bacot, François; Barrdahl, Myrto; Baynes, Caroline; Beckmann, Matthias W.; Behrens, Sabine; Benitez, Javier; Bermisheva, Marina; Bernstein, Leslie; Blomqvist, Carl; Bogdanova, Natalia V.; Bojesen, Stig E.; Bonanni, Bernardo; Børresen-Dale, Anne-Lise; Brand, Judith S.; Brauch, Hiltrud; Brennan, Paul; Brenner, Hermann; Brinton, Louise; Broberg, Per; Brock, Ian W.; Broeks, Annegien; Brooks-Wilson, Angela; Brucker, Sara Y.; Brüning, Thomas; Burwinkel, Barbara; Butterbach, Katja; Cai, Qiuyin; Cai, Hui; Caldés, Trinidad; Canzian, Federico; Carracedo, Angel; Carter, Brian D.; Castelao, Jose E.; Chan, Tsun L.; Cheng, Ting-Yuan David; Chia, Kee Seng; Choi, Ji-Yeob; Christiansen, Hans; Clarke, Christine L.; Collée, Margriet; Conroy, Don M.; Cordina-Duverger, Emilie; Cornelissen, Sten; Cox, David G; Cox, Angela; Cross, Simon S.; Cunningham, Julie M.; Czene, Kamila; Daly, Mary B.; Devilee, Peter; Doheny, Kimberly F.; Dörk, Thilo; dos-Santos-Silva, Isabel; Dumont, Martine; Durcan, Lorraine; Dwek, Miriam; Eccles, Diana M.; Ekici, Arif B.; Eliassen, A. Heather; Ellberg, Carolina; Elvira, Mingajeva; Engel, Christoph; Eriksson, Mikael; Fasching, Peter A.; Figueroa, Jonine; Flesch-Janys, Dieter; Fletcher, Olivia; Flyger, Henrik; Fritschi, Lin; Gaborieau, Valerie; Gabrielson, Marike; Gago-Dominguez, Manuela; Gao, Yu-Tang; Gapstur, Susan M.; García-Sáenz, José A.; Gaudet, Mia M.; Georgoulias, Vassilios; Giles, Graham G.; Glendon, Gord; Goldberg, Mark S.; Goldgar, David E.; González-Neira, Anna; Grenaker Alnæs, Grethe I.; Grip, Mervi; Gronwald, Jacek; Grundy, Anne; Guénel, Pascal; Haeberle, Lothar; Hahnen, Eric; Haiman, Christopher A.; Håkansson, Niclas; Hamann, Ute; Hamel, Nathalie; Hankinson, Susan; Harrington, Patricia; Hart, Steven N.; Hartikainen, Jaana M.; Hartman, Mikael; Hein, Alexander; Heyworth, Jane; Hicks, Belynda; Hillemanns, Peter; Ho, Dona N.; Hollestelle, Antoinette; Hooning, Maartje J.; Hoover, Robert N.; Hopper, John L.; Hou, Ming-Feng; Hsiung, Chia-Ni; Huang, Guanmengqian; Humphreys, Keith; Ishiguro, Junko; Ito, Hidemi; Iwasaki, Motoki; Iwata, Hiroji; Jakubowska, Anna; Janni, Wolfgang; John, Esther M.; Johnson, Nichola; Jones, Kristine; Jones, Michael; Jukkola-Vuorinen, Arja; Kaaks, Rudolf; Kabisch, Maria; Kaczmarek, Katarzyna; Kang, Daehee; Kasuga, Yoshio; Kerin, Michael J.; Khan, Sofia; Khusnutdinova, Elza; Kiiski, Johanna I.; Kim, Sung-Won; Knight, Julia A.; Kosma, Veli-Matti; Kristensen, Vessela N.; Krüger, Ute; Kwong, Ava; Lambrechts, Diether; Marchand, Loic Le; Lee, Eunjung; Lee, Min Hyuk; Lee, Jong Won; Lee, Chuen Neng; Lejbkowicz, Flavio; Li, Jingmei; Lilyquist, Jenna; Lindblom, Annika; Lissowska, Jolanta; Lo, Wing-Yee; Loibl, Sibylle; Long, Jirong; Lophatananon, Artitaya; Lubinski, Jan; Luccarini, Craig; Lux, Michael P.; Ma, Edmond S.K.; MacInnis, Robert J.; Maishman, Tom; Makalic, Enes; Malone, Kathleen E; Kostovska, Ivana Maleva; Mannermaa, Arto; Manoukian, Siranoush; Manson, JoAnn E.; Margolin, Sara; Mariapun, Shivaani; Martinez, Maria Elena; Matsuo, Keitaro; Mavroudis, Dimitrios; McKay, James; McLean, Catriona; Meijers-Heijboer, Hanne; Meindl, Alfons; Menéndez, Primitiva; Menon, Usha; Meyer, Jeffery; Miao, Hui; Miller, Nicola; Mohd Taib, Nur Aishah; Muir, Kenneth; Mulligan, Anna Marie; Mulot, Claire; Neuhausen, Susan L.; Nevanlinna, Heli; Neven, Patrick; Nielsen, Sune F.; Noh, Dong-Young; Nordestgaard, Børge G.; Norman, Aaron; Olopade, Olufunmilayo I.; Olson, Janet E.; Olsson, Håkan; Olswold, Curtis; Orr, Nick; Pankratz, V. Shane; Park, Sue K.; Park-Simon, Tjoung-Won; Lloyd, Rachel; Perez, Jose I.A.; Peterlongo, Paolo; Peto, Julian; Phillips, Kelly-Anne; Pinchev, Mila; Plaseska-Karanfilska, Dijana; Prentice, Ross; Presneau, Nadege; Prokofieva, Darya; Pugh, Elizabeth; Pylkäs, Katri; Rack, Brigitte; Radice, Paolo; Rahman, Nazneen; Rennert, Gadi; Rennert, Hedy S.; Rhenius, Valerie; Romero, Atocha; Romm, Jane; Ruddy, Kathryn J; Rüdiger, Thomas; Rudolph, Anja; Ruebner, Matthias; Rutgers, Emiel J. Th.; Saloustros, Emmanouil; Sandler, Dale P.; Sangrajrang, Suleeporn; Sawyer, Elinor J.; Schmidt, Daniel F.; Schmutzler, Rita K.; Schneeweiss, Andreas; Schoemaker, Minouk J.; Schumacher, Fredrick; Schürmann, Peter; Scott, Rodney J.; Scott, Christopher; Seal, Sheila; Seynaeve, Caroline; Shah, Mitul; Sharma, Priyanka; Shen, Chen-Yang; Sheng, Grace; Sherman, Mark E.; Shrubsole, Martha J.; Shu, Xiao-Ou; Smeets, Ann; Sohn, Christof; Southey, Melissa C.; Spinelli, John J.; Stegmaier, Christa; Stewart-Brown, Sarah; Stone, Jennifer; Stram, Daniel O.; Surowy, Harald; Swerdlow, Anthony; Tamimi, Rulla; Taylor, Jack A.; Tengström, Maria; Teo, Soo H.; Terry, Mary Beth; Tessier, Daniel C.; Thanasitthichai, Somchai; Thöne, Kathrin; Tollenaar, Rob A.E.M.; Tomlinson, Ian; Tong, Ling; Torres, Diana; Truong, Thérèse; Tseng, Chiu-chen; Tsugane, Shoichiro; Ulmer, Hans-Ulrich; Ursin, Giske; Untch, Michael; Vachon, Celine; van Asperen, Christi J.; Van Den Berg, David; van den Ouweland, Ans M.W.; van der Kolk, Lizet; van der Luijt, Rob B.; Vincent, Daniel; Vollenweider, Jason; Waisfisz, Quinten; Wang-Gohrke, Shan; Weinberg, Clarice R.; Wendt, Camilla; Whittemore, Alice S.; Wildiers, Hans; Willett, Walter; Winqvist, Robert; Wolk, Alicja; Wu, Anna H.; Xia, Lucy; Yamaji, Taiki; Yang, Xiaohong R.; Yip, Cheng Har; Yoo, Keun-Young; Yu, Jyh-Cherng; Zheng, Wei; Zheng, Ying; Zhu, Bin; Ziogas, Argyrios; Ziv, Elad; Lakhani, Sunil R.; Antoniou, Antonis C.; Droit, Arnaud; Andrulis, Irene L.; Amos, Christopher I.; Couch, Fergus J.; Pharoah, Paul D.P.; Chang-Claude, Jenny; Hall, Per; Hunter, David J.; Milne, Roger L.; García-Closas, Montserrat; Schmidt, Marjanka K.; Chanock, Stephen J.; Dunning, Alison M.; Edwards, Stacey L.; Bader, Gary D.; Chenevix-Trench, Georgia; Simard, Jacques; Kraft, Peter; Easton, Douglas F.

2017-01-01

Breast cancer risk is influenced by rare coding variants in susceptibility genes such as BRCA1 and many common, mainly non-coding variants. However, much of the genetic contribution to breast cancer risk remains unknown. We report results from a genome-wide association study (GWAS) of breast cancer in 122,977 cases and 105,974 controls of European ancestry and 14,068 cases and 13,104 controls of East Asian ancestry1. We identified 65 new loci associated with overall breast cancer at pcancer due to all SNPs in regulatory features was 2-5-fold enriched relative to the genome-wide average, with strong enrichment for particular transcription factor binding sites. These results provide further insight into genetic susceptibility to breast cancer and will improve the utility of genetic risk scores for individualized screening and prevention. PMID:29059683

Frequency of the hemochromatosis HFE mutations C282Y, H63D, and S65C in blood donors in the Faroe Islands

DEFF Research Database (Denmark)

Milman, Nils; á Steig, Torkil; Koefoed, Pernille

2004-01-01

on the HFE gene was assessed by genotyping using the polymerase chain reaction (PCR) technique and calculated from direct allele counting. We found no C282Y homozygous subjects; 28 (14.0%) subjects were C282Y heterozygous and four subjects were C282Y/H63D compound heterozygous (2.0%). The C282Y allele......The aim of the study was to assess the frequencies of the hereditary hemochromatosis HFE mutations C282Y, H63D, and S65C in the population in the Faroe Islands. The series comprised 200 randomly selected blood donors of Faroese heritage. The frequency of the C282Y, H63D, and S65C mutations.......6%. Screening of larger groups of the Faroese population for HFE mutations especially C282Y should be considered in order to establish the penetrance....

Occurrence of gastric cancer and carcinoids in atrophic gastritis during prospective long-term follow up.

Science.gov (United States)

Lahner, Edith; Esposito, Gianluca; Pilozzi, Emanuela; Purchiaroni, Flaminia; Corleto, Vito D; Di Giulio, Emilio; Annibale, Bruno

2015-07-01

Atrophic gastritis (AG) is a risk condition for gastric cancer and type I gastric carcinoids. Recent studies assessing the overall risk of gastric cancer and carcinoids in AG at long-term follow up are lacking. This study aimed to investigate in a prospective cohort of AG patients the occurrence of gastric cancer and carcinoids at long-term follow up. A total of 200 AG patients from a prospective cohort (67% female, median age 55 years) with a follow up of 7.5 (range: 4-23.4) years were included. Inclusion criteria were presence of AG and at least one follow-up gastroscopy with biopsies at ≥4 years after AG diagnosis. Follow-up gastroscopies at 4-year intervals were performed. Overall, 22 gastric neoplastic lesions were detected (crude incidence 11%). Gastric cancer was diagnosed in four patients at a median follow up of 7.2 years (crude incidence 2%). Eleven type I gastric carcinoids were detected at a median follow up of 5.1 years (crude incidence of 5.5%). In seven patients, six low-grade and one high-grade dysplasia were found. The annual incidence rate person-year were 0.25% (95% confidence interval [CI]: 0.067-0.63%), 0.43% (95% CI: 0.17-0.89%), and 0.68% (95% CI: 0.34-1.21%) for gastric cancer, dysplasia, and type I-gastric carcinoids, respectively. The incidence rates of gastric cancer and carcinoids were not different (p = 0.07). This study shows an annual incidence rate of 1.36% person-year for gastric neoplastic lesions in AG patients at long-term follow up. AG patients are similarly exposed to gastric cancer and type I gastric carcinoids.

Serological follow-up of infants born to mothers with positive syphilis serology - real-world experiences.

Science.gov (United States)

Wallace, Harriet E; Broomhall, Harriet M; Isitt, Catherine E; Miall, Lawrence S; Wilson, Janet D

2016-11-01

The 2008 UK syphilis guideline recommends infants born to women with any positive syphilis serology be followed up until both treponemal and nontreponemal tests are negative to exclude congenital syphilis, whereas Centers for Disease Control and Prevention guidelines recommend using only nontreponemal tests. Historically, we had low infant follow-up rates with no coherent pathways. We initiated a change in multidisciplinary team practice of infant testing for syphilis in 2011 and evaluated the results before and after by retrospective review of testing of infants born to women with positive syphilis serology between 2005 and 2012. A total of 28 infants' mothers were treated in pregnancy (termed 'high risk'); 26 had adequate treatment prior to pregnancy (termed 'low risk'). There was a significant increase in serological testing after 2011 compared with before (83% versus 48%; OR 5.07 [95% CI 1.22-22.77] p = 0.01) but mainly in low risk infants with no significant improvement in high risk infants who are the priority group. Using nontreponemal tests only in the infants would have reduced the tests required by at least 50%, allowing health resources to be concentrated on achieving adequate follow-up for those infants most at risk. © The Author(s) 2015.

Seven-year follow-up of percutaneous closure of patent foramen ovale.

Science.gov (United States)

Mirzada, Naqibullah; Ladenvall, Per; Hansson, Per-Olof; Johansson, Magnus Carl; Furenäs, Eva; Eriksson, Peter; Dellborg, Mikael

2013-12-01

Observational studies favor percutaneous closure of patent foramen ovale (PFO) over medical treatment to reduce recurrent stroke while randomized trials fail to demonstrate significant superiority of percutaneous PFO closure. Few long-term studies are available post PFO closure. This study reports long-term clinical outcomes after percutaneous PFO closure. Between 1997 and 2006, 86 consecutive eligible patients with cerebrovascular events, presumably related to PFO, underwent percutaneous PFO closure. All 86 patients were invited to a long-term follow-up, which was carried out during 2011 and 2012. Percutaneous PFO closure was successfully performed in 85 of 86 patients. The follow-up rate was 100%. No cardiovascular or cerebrovascular deaths occurred. Two patients (both women) died from lung cancer during follow-up. Follow-up visits were conducted for 64 patients and the remaining 20 patients were followed up by phone. The mean follow-up time was 7.3 years (5 to 12.4 years). Mean age at PFO closure was 49 years. One patient had a minor stroke one month after PFO closure and a transient ischemic attack (TIA) two years afterwards. One other patient suffered from a TIA six years after closure. No long-term device-related complications were observed. Percutaneous PFO closure was associated with very low risk of recurrent stroke and is suitable in most patients. We observed no mortality and no long-term device-related complications related to PFO closure, indicating that percutaneous PFO closure is a safe and efficient treatment even in the long term.

Cognitive predictors and risk factors of PTSD following stillbirth: a short-term longitudinal study.

OpenAIRE

Horsch, A.; Jacobs, I.; McKenzie-McHarg, K.

2015-01-01

This short-term longitudinal study investigated cognitive predictors and risk factors of posttraumatic stress disorder (PTSD) in mothers following stillbirth. After a stillbirth at ≥ 24 weeks gestational age, 65 women completed structured clinical interviews and questionnaires assessing PTSD symptoms, cognitive predictors (appraisals, dysfunctional strategies), and risk factors (perceived social support, trauma history, obstetric history) at 3 and 6 months. PTSD symptoms decreased between 3 a...

Pediatric Systemic Lupus Erythematosus: Learning From Longer Follow Up to Adulthood

Directory of Open Access Journals (Sweden)

Giorgio Costagliola

2018-05-01

Full Text Available Background: Pediatric systemic lupus erythematosus (pSLE is a rare condition, representing approximately 10% of SLE cases. The aim of this study was to identify variables to improve the diagnostic awareness and management of pSLE patients.Methods: This retrospective study included 25 patients diagnosed with pSLE and followed at the University of Pisa. We collected data about clinical profile at disease onset and during a long-term follow-up, including disease activity, organ damage development, and treatments received.Results: The mean patient age at disease onset was 14.6 ± 1.6 years, and the mean follow-up period was 14.17 ± 8.04 years. The most common initial manifestations were arthritis, malar rash, and cytopenias. The median time to diagnosis since the first symptoms was 6 months, and was significantly longer in patients with hematological onset (54 months. During follow-up, the number of patients with renal involvement showed a significant increase, from 36% at diagnosis to 72.2% after 10 years of disease evolution. Patients who developed chronic organ damage maintained a higher time-averaged disease activity during follow-up and received a significantly higher dose of corticosteroids.Conclusion: Patients with immune cytopenia represent a group deserving strict clinical follow-up for the risk of evolution to SLE. Intense surveillance of renal function, early treatment and steroid-sparing strategies should be strongly considered in the management of pSLE patients.

Impact of sympathetic innervation on recurrent life-threatening arrhythmias in the follow-up of patients with idiopathic ventricular fibrillation

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Paul, Matthias; Acil, Tayfun; Breithardt, Guenter; Wichter, Thomas [Hospital of the University of Muenster, Department of Cardiology and Angiology, Muenster (Germany); Schaefers, Michael; Kies, Peter; Schaefers, Klaus; Schober, Otmar [Hospital of the University of Muenster, Department of Nuclear Medicine, Muenster (Germany)

2006-08-15

Idiopathic ventricular fibrillation (IVF) is defined as VF in the absence of any identifiable structural or functional cardiac disease. The underlying pathophysiological mechanisms are unknown. This study was performed to investigate the potential impact of sympathetic dysfunction, assessed by {sup 123}I-meta-iodo-benzylguanidine scintigraphy ({sup 123}I-MIBG SPECT), on the long-term prognosis of patients with IVF. {sup 123}I-MIBG SPECT was performed in 20 patients (mean age 37{+-}13 years) with IVF. Mean follow-up of patients after study entry was 7.2{+-}1.5 years (range 4.9-10.5 years). Ten patients (five men, five women; mean age 43{+-}12 years; p=NS versus study group) with medullary carcinoma of the thyroid gland served as an age-matched control group. Abnormal {sup 123}I-MIBG uptake was observed in 13 patients (65%). During follow-up, 18 episodes of VF/fast polymorphic ventricular tachycardias occurred in four IVF patients with abnormal {sup 123}I-MIBG uptake whereas only two episodes of monomorphic ventricular tachycardia (and no VF) occurred in a single IVF patient with normal {sup 123}I-MIBG uptake. Impairment of sympathetic innervation may indicate a higher risk of future recurrent episodes of life-threatening ventricular tachyarrhythmias in patients with IVF. Studies in larger cohorts are required to validate the significance of {sup 123}I-MIBG SPECT during the long-term follow-up of these patients. (orig.)

Rectal neoplasms. Postoperative follow-up

International Nuclear Information System (INIS)

Galano Urgelles, Rolando; Rodriguez Fernandez, Zenen; Casaus Prieto, Arbelio

1997-01-01

A study of 31 patients operated on for rectal neoplasms between September, 1989 and September, 1995 in SantiAug de Cuba was performed. Patients Webre followed-up during this period for the purpose of the study. There was a frank predominance of males and ages between 45 and 64, of the stage II and the groups BI and BII according to Dukes' classification. Most patients received 5-fluoracil, without tumor relapses. The current survival rate of the series was 76 % at the end of the investigation. It is recommended that all patients operated on for this segment be followed-up after the operation; to continue with cytostatic treatment using 5-fluoracil, and to emphasize the importance of the use of tumor markers during the follow-up, in addition to transrectal ultrasound, as well as to make an early diagnosis through mass screening methods

Role of cytology in screening, staging and follow-up

International Nuclear Information System (INIS)

Fischnaller, M.

1986-01-01

Cytology has become an integral component in the battery of diagnostic tools for a rational diagnosis of tumors. When all materials obtainable with sophisticated methods are utilized, almost every pulmonary lesion can be defined micromorphologically. In urgent cases instant staining techniques will permit a 'stat diagnosis'. The characterization of a tumor cell by cytology with accurate typing and grading offers preliminary information for subsequent staging efforts. Bronchial cancer may be both of the single-cell and of the mixed-cell type with the more aggressive cell elements determining the metastasising potential and prognosis. Sampling for cytology is devoid of risks and does not make any special demands on the patients; it can safely be repeated for follow-up studies; it helps to detect tumor regrowths or secondaries at an early stage during postoperative follow-up programs and to monitor treatment-related cellular changes. (Author)

Adherence to Follow-up Recommendations Among Individuals in the Philadelphia Glaucoma Detection and Treatment Project.

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Hark, Lisa A; Leiby, Benjamin E; Waisbourd, Michael; Myers, Jonathan S; Fudemberg, Scott J; Mantravadi, Anand V; Dai, Yang; Gilligan, John P; Resende, Arthur F; Katz, L Jay

2017-08-01

To evaluate rates of adherence to free follow-up eye exam appointments among participants in the Philadelphia Glaucoma Detection and Treatment Project. Ophthalmologists and testing equipment were brought directly to participants at risk for glaucoma at 43 community sites in Philadelphia. Those diagnosed with glaucoma-related pathology were recommended to return for follow-up to be reexamined on site. Rates of adherence and clinical and demographic risk factors for adherence were evaluated. Five hundred thirty-one participants were diagnosed with glaucoma-related conditions and recommended to attend community-based follow-up exams. Follow-up adherence rate was 61.2% (n=325/531). Significant factors associated with greater eye exam appointment adherence, based on our univariable analysis, included final diagnosis of glaucoma (risk ratio [RR]=1.33; 95% confidence interval [CI], 1.13-1.57), male sex (RR=1.19; 95% CI, 1.04-1.36), white race (RR=1.26; 95% CI, 1.08-1.48), age (RR=1.17; 95% CI, 1.00-1.37) recommendation for glaucoma medication (RR=1.52; 95% CI, 1.35-1.71), recommendation for laser peripheral iridotomy (RR=1.18; 95% CI, 1.02-1.35), diagnosis of age-related macular degeneration (RR=1.42; 95% CI, 1.13-1.77) and an increased intraocular pressure (>22 mm Hg in the worse eye) (RR=1.23; 95% CI, 1.06-1.42). On the basis of our multivariable model, diagnosis, sex, and recommended glaucoma medications were significantly associated with follow-up adherence. This study demonstrates that individuals living in underserved urban communities would take advantage of free eye exams in community sites and return for follow-up eye exams in these same settings. Future studies could investigate interventions to improve eye exam appointment adherence in community-based settings to detect glaucoma-eye conditions.

Gestational Diabetes Mellitus: Post-partum Risk and Follow Up.

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Poola-Kella, Silpa; Steinman, Rachel A; Mesmar, Bayan; Malek, Rana

2018-01-31

Women with gestational diabetes mellitus (GDM) are at an increased risk for developing metabolic syndrome, type 2 diabetes mellitus (T2DM), and cardiovascular disease. In this review, we will discuss postpartum cardiovascular and diabetes risk in women with a history of GDM and different ways to improve postpartum screening. This review involves a comprehensive literature review on gestational diabetes and postpartum risk for cardiovascular disease and diabetes mellitus as well as post-partum screening methods. Cardiovascular risk post-partum is potentiated by increased inflammatory markers leading to worsening atherosclerosis and cardiovascular events downstream. Decreased insulin sensitivity and β cell compensation, recurrent GDM, maternal factors such as pre and post-partum weight gain and lactation may contribute to T2DM risk. Postpartum glucose testing is essential in screening women as hyperglycemia in pregnancy has long term effects on both cardiovascular disease and diabetes risk on the mother. Long and short term improvement to post-partum glucose testing is essential to decreasing cardiometabolic and diabetes risk in women with gestational diabetes mellitus. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Relative risks for stroke by age, sex, and population based on follow-up of 18 European populations in the MORGAM Project

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Asplund, Kjell; Karvanen, Juha; Giampaoli, Simona

2009-01-01

BACKGROUND AND PURPOSE: Within the framework of the MOnica Risk, Genetics, Archiving and Monograph (MORGAM) Project, the variations in impact of classical risk factors of stroke by population, sex, and age were analyzed. METHODS: Follow-up data were collected in 43 cohorts in 18 populations in 8...... European countries surveyed for cardiovascular risk factors. In 93 695 persons aged 19 to 77 years and free of major cardiovascular disease at baseline, total observation years were 1 234 252 and the number of stroke events analyzed was 3142. Hazard ratios were calculated by Cox regression analyses....... RESULTS: Each year of age increased the risk of stroke (fatal and nonfatal together) by 9% (95% CI, 9% to 10%) in men and by 10% (9% to 10%) in women. A 10-mm Hg increase in systolic blood pressure involved a similar increase in risk in men (28%; 24% to 32%) and women (25%; 20% to 29%). Smoking conferred...

Exploration of Postoperative Follow-up Strategies for Early Staged NSCLC Patients on the Basis of Follow-up Result of 416 Stage I NSCLC Patients after Lobectomy

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Liang DAI

2018-03-01

Full Text Available Background and objective Currently, there is no consensus on the follow-up strategy (follow-up time interval and content of non-small cell lung cancer (NSCLC in the world, and the relevant clinical evidence is also very limited. In this study, we aimed to summarize the recurrence/metastasis sites and timings of stage I NSCLC patients based on their follow-up data, aiming to provide a basis of follow-up time interval and content for this group of patients. Methods We retrospectively analyzed the 416 stage I NSCLC patients that underwent continuous anatomic lobectomy between Jan. 2000 to Oct. 2013 in our prospective lung cancer database. According to the recurrence/metastasis sites and timings, the long term follow-up time interval and content were explored. Results The 5-yr disease free survival (DFS and overall survival (OS in the whole group were 82.4% and 85.4%, respectively. There were 76 cases (18.3% had recurrence/metastasis during follow-up, among which the most frequent site was pulmonary metastasis (21 cases, 5.0%, followed by brain metastasis (20 cases, 4.8%, bone metastasis (12 cases, 2.9%, and mediastinal lymph node metastasis (12 cases, 2.9%. Among the factors that could influence recurrence/metastasis, patients with pT2a suffered from a higher recurrence/metastasis rate compared to patients with pT1 (P=0.006, with 5-yr DFS being 73.8% and 87.3%, respectively (P=0.002, and the 5-yr OS being 77.7% and 90.3%, respectively (P=0.011. Conclusion The commonest recurrence/metastasis sites of stage I NSCLC after anatomic lobectomy are lung, brain and mediastinal lymph nodes, the risk of recurrence/metastasis within 2 years were equal to that between 3 years and 5 years. The follow-up frequencies and content within 2 years could be adjusted according to T stages.

Perfil lipídico en mayores de 65 años.: Prevalencia de hipercolesterolemia y factores de riesgo cardiovascular.

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Tomás Casado Cornejo

1996-07-01

Full Text Available La hipercolesterolemia es frecuente en las personas mayores de 65 años. Objetivo: determinar la prevalencia de hipercolesterolemia y de los factores de riesgo para enfermedad cardiovascular en personas mayores de 65 años residentes en Lima. Material y métodos: se evaluaron en forma prospectiva 214 gerontes (187 mujeres y 27 hombres no institucionalizados, determinándose los niveles séricos de colesterol total, LDL-colesterol, HDL-colesterol, VLDL-colesterol y triglicéridos por un método enzimático-colorimétrico (Laboratorio Human. Resultados y conclusiones: el valor promedio de colesterol total en el grupo sin factores de riesgo para enfermedad cardiovascular fue de 222.48 ± 42.60 mg/dl. La prevalencia de hipercolesterolemia fue de 39% (41% en mujeres y 26% en hombres. El 40% presentó LDL-colesterol≥160 mg/dl y solo un participante tuvo HDL-colesterol<35 mg/dl. Los factores de riesgo de enfermedad cardiovascular más frecuentes fueron: hipertensión arterial 49.5%, obesidad 22.4% y diabetes mellitus 10.2%. La prevalencia de hipercolesterolemia en nuestra población gerente es similar a lo reportado en la literatura. La aplicación de los criterios del Nacional Colesterol Educations Program en nuestra muestra nos permitió establecer que el 57% necesita un análisis completo de lípidos (Rev Med Hered 1996; 7: 125-31.

Risk-adapted treatment and follow-up management in childhood-onset craniopharyngioma.

Science.gov (United States)

Müller, Hermann L

2016-05-01

Craniopharyngiomas are rare embryonic malformations of the sellar/parasellar region with low histological grade. Here, we review findings on the diagnosis, treatment, clinical course, follow-up, and prognosis of craniopharyngioma patients. Clinical manifestations develop from increased intracranial pressure, anterior visual pathway damage, and hypothalamic/pituitary deficiencies. If the tumor is favorably localized (no anatomical involvement with the hypothalamic and optical structures) therapy of choice is complete resection, meticulously performed to preserve hypothalamic and optic functions. In patients with unfavorable tumor involvement, optimal therapy is limited hypothalamus-sparing surgical strategy, followed by judicious irradiation dosage to minimize recurrences and progression. Surgical lesions and/or anatomical involvement of posterior hypothalamic areas result in serious sequelae, mainly hypothalamic syndrome. Craniopharyngioma is a chronic disease and must be managed as such, providing ongoing care of pediatric and adult patients by experienced multidisciplinary teams in the context of multicenter trials.

Endodontic flare up: incidence and association of possible risk factors.

Science.gov (United States)

Gbadebo, S O; Sulaiman, A O; Anifowose, O O

2016-06-01

Endodontic emergency during root canal treatment (flare up) is a common occurrence in multivisit root canal treatment (RCT) and it may be associated with many factors. The occurrence however can affect the prognosis of the tooth and the patient -clinician relationship. To determine the incidence and risk factors associated with occurrence of flare up in a multi visit RCT. Patients planned for multi-visit (RCT) were recruited for the research. Standard protocol was followed in all cases. After the first visit, the patients were followed up for possible development of flare up. Patients' demographics, presence or absence of preoperative pain, status of the pulp and occurrence of flare up were among the data collected. Data was analyzed using SPSS version 20 with level of significance set at P flare up was 8.5%. Prior to treatment, 47% of the cases had pain, 61.3% had apical radioluscency and 83% had pulpal necrosis. Majority (7, 77.8%) of the flare up occurred after the first visit (p=0.000). Only pre- treatment pain had a statistical significant ielationship with occurrence of flare up (p=0.009). Incidence of flare up was 8.5% and the major risk factor was preoperative pain. First visit in a multi visit RCT is an important stage which if well handled, can reduce the incidence of flare up.

Studies of neurosonographic follow up images in intracranial cysts of neonat

International Nuclear Information System (INIS)

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

Studies of neurosonographic follow up images in intracranial cysts of neonat

Energy Technology Data Exchange (ETDEWEB)

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.

Long-Term Serological Follow-Up of Acute Q-Fever Patients after a Large Epidemic.

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Cornelia C H Wielders

Full Text Available Serological follow-up of acute Q-fever patients is important for detection of chronic infection but there is no consensus on its frequency and duration. The 2007-2009 Q-fever epidemic in the Netherlands allowed for long-term follow-up of a large cohort of acute Q-fever patients. The aim of this study was to validate the current follow-up strategy targeted to identify patients with chronic Q-fever.A cohort of adult acute Q-fever patients, diagnosed between 2007 and 2009, for whom a twelve-month follow-up sample was available, was invited to complete a questionnaire and provide a blood sample, four years after the acute episode. Antibody profiles, determined by immunofluorescence assay in serum, were investigated with a special focus on high titres of IgG antibodies against phase I of Coxiella burnetii, as these are considered indicative for possible chronic Q-fever.Of the invited 1,907 patients fulfilling inclusion criteria, 1,289 (67.6% were included in the analysis. At any time during the four-year follow-up period, 58 (4.5% patients were classified as possible, probable, or proven chronic Q-fever according to the Dutch Q-fever Consensus Group criteria (which uses IgG phase I ≥1:1,024 to as serologic criterion for chronic Q-fever. Fifty-two (89.7% of these were identified within the first year after the acute episode. Of the six patients that were detected for the first time at four-year follow-up, five had an IgG phase I titre of 1:512 at twelve months.A twelve-month follow-up check after acute Q-fever is recommended as it adequately detects chronic Q-fever in patients without known risk factors. Additional serological and clinical follow-up is recommended for patients with IgG phase I ≥1:512, as they showed the highest risk to progress to chronic Q-fever.

Cause-Specific Mortality after Stroke: Relation to Age, Sex, Stroke Severity, and Risk Factors in a 10-Year Follow-Up Study

DEFF Research Database (Denmark)

Mogensen, UB; Olsen, TS; Andersen, KK

2013-01-01

We investigated cause-specific mortality in relation to age, sex, stroke severity, and cardiovascular risk factor profile in the Copenhagen Stroke Study cohort with 10 years of follow-up. In a Copenhagen community, all patients admitted to the hospital with stroke during 1992-1993 (n = 988) were.......2% for nonvascular disease. Death after stroke was associated with older age, male sex, greater stroke severity, and diabetes regardless of the cause of death. Previous stroke and hemorrhagic stroke were associated with death by stroke, ischemic heart disease was associated with death by heart/arterial disease...... registered on admission. Evaluation included stroke severity, computed tomography scan, and a cardiovascular risk profile. Cause of death within 10 years according to death certificate information was classified as stroke, heart/arterial disease, or nonvascular disease. Competing-risks analyses were...

Long-term follow-up of treatment for synthetic mesh complications.

Science.gov (United States)

Hansen, Brooke L; Dunn, Guinn Ellen; Norton, Peggy; Hsu, Yvonne; Nygaard, Ingrid

2014-01-01

The objectives of this study are (1) to describe the presenting symptoms, findings, and treatment and (2) to describe the self-reported improvement and function at least 6 months after presentation in women presenting to 1 urogynecology division for complications associated with synthetic vaginal mesh. Women evaluated between 2006 and 2011 were identified by diagnostic codes. We abstracted information from the medical record and attempted to contact all women to complete a follow-up telephone survey questionnaire consisting of several validated instruments. A total of 111 women were evaluated for complications associated with synthetic vaginal mesh. The mean interval from index surgery was 2.4 years. Of these, 84% were referred from outside hospitals. Index surgeries included vaginal mesh kits/vaginally placed mesh (47%), midurethral mesh slings (37%), abdominally placed vaginal mesh (11%), and vaginal mesh kit with concomitantly placed mesh sling (5%). The most common complications were extrusion (65%), contraction (17%), and chronic pelvic pain (16%). A total of 98 women underwent some type of treatment (85 surgical) by urogynecologists, pelvic pain specialists, or physical therapists. Eighty-four (76%) provided follow-up information at mean interval since presentation of 2.3 years. At follow-up, the mean (SD) Pelvic Floor Distress Inventory score was 98 (67), the mean (SD) EQ-5D index score was 0.69 (0.23), and 22% reported vaginal discharge, 15% vaginal bleeding or spotting, and 45% sexual abstinence due to problems related to mesh. A total of 71% reported being overall better, whereas 29% were the same or worse. Two years after tertiary care level multidisciplinary treatment of vaginal mesh complications, many women still report symptoms that negatively impact their quality of life.

The Fate of Iliopsoas Muscle in the Long-term Follow-up After Open Reduction of Developmental Dysplasia of the Hip by Medial Approach. Part 1: MRI Evaluation.

Science.gov (United States)

Yilmaz, Serdar; Aksahin, Ertugrul; Duran, Semra; Bicimoglu, Ali

2017-09-01

There has been little information about the long-term status of the iliopsoas, which is the main flexor of the hip, after iliopsoas tenotomy in the treatment of developmental dysplasia of the hip (DDH). The aim of this study was to assess the status of the iliopsoas muscle and other flexors and extensors of the hip in long-term follow-up with magnetic resonance imaging after complete iliopsoas tenotomy in patients with unilateral DDH treated with open reduction with a medial approach. The study included 20 patients who underwent open reduction with a medial approach for unilateral DDH and had long-term follow-up. Magnetic resonance imaging assessment of iliopsoas, rectus femoris, tensor fasia lata, sartorius, and gluteus maximus muscles was applied and the muscles of the hip that was operated on were compared with the unoperated hip. In addition, the iliopsoas muscle was examined for reattachment and the effect of reattachment was evaluated. The mean age at the time of operation was 10.53±3.61 months (range, 5 to 18 mo), and mean follow-up was 16.65±2.16 years (range, 13 to 20 y). Spontaneous reattachment of the iliopsoas was observed in 18 patients (90%), either in the lesser trochanter (65%) or the superior part of it (25%). There was no significant difference between the hips that were operated on and those that were not with regard to the mean cross-sectional areas (CSA) of the tensor fascia lata, rectus femoris, sartorius, and gluteus maximus muscles. The CSA of the tensor fascia lata, rectus femoris, sartorius, and gluteus maximus muscles showed no significant difference (P>0.05); however, CSA of iliopsoas muscle was significantly reduced in the operated hip (P<0.001). Although the iliopsoas tendon was atrophied after complete iliopsoas tenotomy, it was reattached in 90% of the patients spontaneously in long-term follow-up. There was no statistically significant compensatory hypertrophy in any muscles in response to iliopsoas atrophy. Level IV-Therapeutic.

The development of insight and its relationship with suicidality over one year follow-up in patients with first episode psychosis.

Science.gov (United States)

Barrett, Elizabeth A; Mork, Erlend; Færden, Ann; Nesvåg, Ragnar; Agartz, Ingrid; Andreassen, Ole A; Melle, Ingrid

2015-03-01

Insight into psychosis has been linked to suicidality, although inconsistently. The co-variation between insight and suicidality over time is under-investigated. The aim of the present study was to investigate predictors of suicidality in patients with first episode of psychosis (FEP) over one year, focusing on the relationship between insight and suicidality. Patients with FEP (n=146) were interviewed as soon as possible after treatment starts and at one year follow-up. At baseline 37% of patients were suicidal, significantly reduced to 20% at follow-up. The effect of insight on suicidality was in different directions at different time-points, with insight at baseline increasing and insight at follow-up decreasing the risk of suicidality at follow-up. Patients with stable levels of insight across baseline and follow-up did not differ in risk for suicidality at follow-up. However, patients who lost insight from baseline to follow-up were more often suicidal at follow-up, whilst patients who gained insight were more seldom suicidal at follow-up. Other predictors of suicidality at follow-up were more depressive episodes before study entry, longer duration of untreated psychosis, more suicide attempts six months prior to follow-up, and depression at follow-up. The results indicate that the effect of insight on suicidality in FEP-patients depends on time of assessment and of changes in insight. Gaining insight during treatment was associated with reduced risk for suicidality, whilst losing insight had the opposite effect, underlining the need to monitor insight over time and tailor interventions according to illness phase. Copyright © 2015 Elsevier B.V. All rights reserved.

Risk factors for the need of hip arthroscopy following periacetabular osteotomy

Science.gov (United States)

Hartig-Andreasen, Charlotte; Troelsen, Anders; Thillemann, Theis M.; Gelineck, John; Søballe, Kjeld

2015-01-01

Despite the frequency of labral tears in symptomatic developmental dysplasia of the hip, no consensus exists regarding the treatment of coexisting dysplasia of the hip and tearing of the acetabular labrum. The purpose of this prospective, MR arthrography (MRA) based 2-year follow-up study was to identify risk factors predicting the need for a hip arthroscopy (HA) after periacetabular osteotomy (PAO). Ninety-nine patients (104 hips) scheduled for PAO were evaluated preoperatively and at 2-year follow-up. MRA was performed in all patients prior to PAO. At follow-up, patients were divided into a non-arthroscopy and arthroscopy group. The two groups were compared clinical and radiological, and risk factors for HA after PAO were calculated. Patient reported outcome measures (WOMAC, Oxford Hip and SF36) were filled out before PAO and at follow-up. Ninety-five hips (91.3%) were evaluated. Twenty-six hips (27%) required an arthroscopy within 2 years of the PAO. Risk factors were preoperative borderline dysplasia, acetabular retroversion and complete labral detachment. Labral tearing, degeneration or hypertrophy did not negatively affect the outcome of PAO. Patients not requiring an arthroscopy had a statistically significant better outcome measured by patients reported outcome measures. After PAO, 27% of the hips needed intra-articular assessment. Conventional radiographs and MRA analysis can be used to identify predictors for patients requiring HA after PAO. At 2-year follow-up, the clinical outcome improved in all patients. However, those patients who had no need of a HA after their PAO had superior results. PMID:27011862

Psicoterapia breve psicodinâmica preventiva: pesquisa exploratória de resultados e acompanhamento Psicoterapia breve psicodinamica preventiva: pesquisa exploratoria de resultados y acompañamiento Brief preventive psychodynamic psychotherapy: exploratory research on results and follow-up

Directory of Open Access Journals (Sweden)

Tales Vilela Santeiro

2008-12-01

Full Text Available Há escassez de estudos sistemáticos sobre processos de psicoterapia nas clínicas-escola brasileiras, inclusive os de caráter preventivo. A proposta focaliza Psicoterapias Breves Psicodinâmicas (PBPs conduzidas por estudantes em contexto de clínica-escola. Tem como objetivo avaliar os graus de depressão e ansiedade e o neuroticismo em voluntários, estudantes de curso de psicologia (N=6, no início, no final e após seis meses do término das PBP (follow-up. As Escalas Beck de Depressão e Ansiedade (BD/BAI e de Ajustamento Emocional/Neuroticismo foram os instrumentos empregados. As sessões foram semanais, num total de 10, gravadas em áudio e observadas em sala de espelho unidirecional. De modo geral foram constatadas mudanças em relação às variáveis analisadas, o que ficou mais evidente do início à 10ª sessão e quando as escalas BDI e BAI foram utilizadas como medidas. Os eventuais ganhos obtidos quando do término nem sempre foram mantidos no follow-up.Hay escasez de estudios sistemáticos sobre los procesos de psicoterapia en las clínicas-escuelas brasileñas, incluso los estudios de carácter preventivo. La propuesta focaliza psicoterapias breves psicodinámicas (PBP conducidas en contexto de clínica-escuela. Este estudio tiene como objetivos evaluar los grados de depresión y ansiedad y el neuroticismo en voluntarios, estudiantes del curso de psicología (N=6, en el inicio, en el final y después de seis meses del término de las PBP (follow-up. Las Escalas Beck de Depresión y Ansiedad (BD/BAI y de Ajustamiento Emocional/Neuroticismo fueron semanales, totalizando diez, grabadas en audio y observadas en sala de espejo unidireccional. De un modo general fueron constatados cambios en relación a las variables analizadas, lo que dejó más evidente del inicio a la décima sesión y cuando las escalas BDI y BAI fueron utilizadas como medidas. Los eventuales logros obtenidos en el término no siempre fueron mantenidos en el

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

DEFF Research Database (Denmark)

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...

Strategy utilized for assessing baseline risks to human health from K-65 and metal oxide residues stored at the Fernald Site

International Nuclear Information System (INIS)

Harmon, J.E.; Janke, R.C.

1995-01-01

The U.S. Department of Energy (DOE) is responsible for cleanup activities at the Fernald Environmental Management Project (FEMP) site in southwestern Ohio. The 425-hectare site consists of a former 55-hectare Production Area, an adjacent Waste Storage Area and various support facilities. From 1952 until 1989, the FEMP processed uranium into metallic open-quotes feedclose quotes materials for other DOE facilities in the nation's defense program. In accordance with the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), the FEMP site is currently listed on the National Priorities List (NPL). To facilitate an expeditious cleanup effort, environmental issues associated with site cleanup are being managed under five operable units. This paper summarizes the risk assessment strategy employed to determine baseline human health risks associated with K-65 and metal oxide residues currently stored in Operable Unit 4. The K-65 and metal oxide residues were generated during the 1950s as a result of the extraction of uranium from uranium-bearing ores and concentrates. These residues are currently stored within Operable Unit 4 in concrete silos. Silos I and 2 contain approximately 6,120 cubic meters [m 3 ] (8,005 cubic yards [yd 3 ]) of K-65 residues, while silos 3 contains approximately 3890 m 3 (5,080 yd 3 ) of cold metal oxides. These concrete silos are beyond their design life and require remedial action. The risk assessment conducted for Operable Unit 4 constitutes the first detailed human health risk assessment to be approved by the Environmental Protection Agency (EPA) for the CERCLA clean-up effort at the FEMP Site. This paper discusses the FEMP's use of a Risk Information Quality Objective process in concert with the traditional risk assessment approach to determine baseline risk to human health and the environment posed by Operable Unit 4. A summary of the baseline risks to human health is also presented

All-cause mortality and risk factors in a cohort of retired military male veterans, Xi'an, China: an 18-year follow up study

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Li Liang S

2007-10-01

Full Text Available Abstract Background Risk factors of all-cause mortality have not been reported in Chinese retired military veterans. The objective of the study was to examine the risk factors and proportional mortality in a Chinese retired military male cohort. Methods A total of 1268 retired military men aged 55 or older were examined physically and interviewed using a standard questionnaire in 1987. The cohort was followed up every two years and the study censored date was June30, 2005 with a follow-up of up to 18 years. Death certificates were obtained from hospitals and verified by two senior doctors. Data were entered (double entry by Foxbase, and analysis was carried out by SAS for Windows 8.2. Multivariate Cox proportional hazard regression model was used to compute hazard ratio (HR and 95% confidence interval (CI. Results The total person-years of follow-up was 18766.28. Of the initial cohort of 1268 men, 491 had died, 748 were alive and 29 were lost to follow up. Adjusted mortality (adjusted for age, blood pressure, body mass index, cholesterol, triglycerides, alcohol, exercise, and existing disease was 2,616 per 100,000 person years. The proportional mortality of cancer, vascular disease and Chronic Obstructive Pulmonary Disease (COPD were 39.71%, 28.10% and 16.90% respectively. Multivariate analysis showed that age, cigarettes per day, systolic blood pressure, triglyceride, family history of diseases (hypertension, stroke and cancer, existing diseases (stroke, diabetes and cancer, body mass index, and age of starting smoking were associated with all-cause mortality, HR (95%CI was1.083(1.062–1.104, 1.026(1.013–1.039, 1.009(1.003–1.015, 1.002(1.001–1.003, 1.330(1.005–1.759, 1.330(1.005–1.759, 1.444(1.103–1.890, 2.237(1.244–4.022, 1.462(1.042–2.051, 2.079(1.051–4.115, 0.963(0.931–0.996and 0.988(0.978–0.999respectively. Compared with never-smokers, current smokers had increased risks of total mortality [HR 1.369(1.083–1

Risk factors of vitamin D deficiency in children with epilepsy taking anticonvulsants at initial and during follow-up

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Seung Ho Lee

2015-12-01

Full Text Available PurposeVitamin D status was evaluated in children with epilepsy taking anticonvulsants to determine the prevalence and risk factors of vitamin D deficiency.MethodsThis study was designed as both a cross-sectional and a retrospective cohort study. A sum of 198 children who were diagnosed with epilepsy at the Department of Pediatrics in Dankook University Hospital was included. Their serum vitamin D levels were reviewed based on clinical information, and analyzed using IBM SPSS ver. 20.0.ResultsOne hundred twenty-four children (62.6% had vitamin D deficiency. Two risk factors were associated: winter to spring season (odds ratio [OR], 3.71; 95% confidence interval [CI], 1.835-7.492 and age more than 12 years (OR, 3.22; 95% CI, 1.377-7.542. Out of the 57 patients who were not vitamin D deficient at the time of initial assay, 47 patients (82.5% became vitamin D deficient during followup. The change of serum 25-hydroxy vitamin D3 (25(OHD levels during follow up showed a weak negative correlation with the duration of medication (r=-0.283, P=0.033. Medication duration was longer and brain magnetic resonance imaging (MRI abnormality, abnormal underlying conditions, and nonambulatory status were more frequently present in twenty-five patients (44% who showed a decline of more than 15 ng/mL during follow-up (P<0.05.ConclusionVitamin D deficiency is common in children with epilepsy taking anticonvulsants, especially in adolescents more than 12 years of age. This study emphasizes the regular monitoring of vitamin D level, especially in the presence of longer duration of medication, brain MRI abnormality, abnormal underlying conditions, and nonambulatory status.

Prevalence of C282Y, H63D, and S65C mutations in hereditary HFE-hemochromatosis gene in Lithuanian population.

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Kucinskas, Laimutis; Juzenas, Simonas; Sventoraityte, Jurgita; Cedaviciute, Ruta; Vitkauskiene, Astra; Kalibatas, Vytenis; Kondrackiene, Jurate; Kupcinskas, Limas

2012-04-01

HFE-hemochromatosis is a common autosomal recessive disease caused by HFE gene mutations and characterized as iron overload and failure of different organs. The aim of this study was to determine the prevalence of C282Y (c.845 G>A), H63D (c.187 C>G), and S65C (c.193A>T) alleles of HFE gene in the Lithuanian population. One thousand and eleven healthy blood donors of Lithuanian nationality were examined in four different ethnic Lithuanian regions to determine HFE gene alleles and genotype frequencies. The samples of DNA were analyzed for the presence of restriction fragment length polymorphism and validated by DNA sequencing. Among 1,011 blood donors tested, the frequency of C282Y, H63D, and S65C alleles were 2.6%, 15.9%, and 1.9%, respectively. One third of the tested subjects (n = 336) had at least one of the C282Y or H63D HFE gene mutations. The screening of Lithuanian blood donors has detected 13 (1.3%) subjects with a genotype C282Y/C282Y or C282Y/H63D responsible for the development of HFE-hemochromatosis. The prevalence of C282Y mutation was significantly higher among the inhabitants of Zemaitija (Somogitia) at the Baltic Sea area (5.9%) in comparison to the regions of continental part of Lithuania (2.4% in Dzukija, 2.3% in Aukstaitija, and 2% in Suvalkija, p HFE gene mutations in ethnic Lithuanians showed that the frequencies of H63D, C282Y, and S65C of HFE gene alleles are similar to the other North-Eastern Europeans, especially in the Baltic region (Estonia, Latvia), Poland, and part of Russia (Moscow region).

Incidence and predictors of cognitive impairment and dementia in Aboriginal Australians: A follow-up study of 5 years.

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Lo Giudice, Dina; Smith, Kate; Fenner, Stephen; Hyde, Zoë; Atkinson, David; Skeaf, Linda; Malay, Roslyn; Flicker, Leon

2016-03-01

Aboriginal Australians are reported to develop dementia earlier than the general population. The causes remain unknown. This was a longitudinal study of 363 participants aged ≥45 years. Consensus diagnoses were established for cognitive impairment or dementia. At follow-up, 189 people (mean ± standard deviation age, 65.4 ± 10.3 years) participated, as 109 (30%) had died and 65 (18%) were unavailable. The incidence of cognitive impairment or dementia was 52.6 (95% confidence interval 33.9, 81.5) per 1000 person-years (380.3 total person-years) and for dementia was 21.0 (10.5, 42.1) per 1000 person-years (380.3 person-years total) over the age 60 years. Longitudinal risk factors associated with a decline from normal cognition to impairment were age and head injury. Other associations with cognitive decline were stroke, head injury, nonaspirin analgesics, lower BMI, and higher systolic BP. Dementia incidence in Aboriginal Australians is among the highest in the world, and is associated with age and head injury. Copyright © 2016 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.

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

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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).

[Analysis of clinical relevance applied to 3methods of reducing weight in overweight or obesity followed-up for one year].

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Tárraga Marcos, M L; Panisello Royo, J M; Carbayo Herencia, J A; Rosich Domenech, N; Alins Presas, J; Castell Panisello, E; Tárraga López, P J

To analyse the effect of the use/implementation of 3methods to reduce weight in overweight or obese patients during one year of follow up. The design corresponds to a double-blind, randomised, controlled clinical trial with 3arms, and 12 months of follow-up. Patients were randomised into 3intervention groups: obesity motivational intervention, with a nurse previously trained in motivational intervention by expert psychologists (G1; n=60); lower intensity consultation, non-motivational group, with digital platform support (G2; N=61), and a third group that received recommendations for weight loss and follow-up in Primary Care Clinic (G3; n=59). Anthropometric variables (weight, height, and abdominal-waist circumference) were measured, and the percentage of patients who managed to reduce their weight ≥5% was considered as the main measurement of treatment effectiveness. All groups significantly decreased body weight at the end of the study, with a reduction in G1 (-5.6kg) followed by G2 (-4.3kg), and G3 (-1.7kg), with an overall mean: -3.9kg. The indicators of clinical relevance were in G1/G3: relative risk (RR): 4.99 (95% CI: from 2.71 to 9.18); relative risk reduction (RRR): 399.1% (171.3 to 818.0); Absolute risk reduction (RAR): 65.3% (from 51.5 to 79.1) and NNT: 2 (from 2 to 2). In the G2/G3 groups: RR: 3.01 (from 1.57 to 5.76); RRR: 200.5% (from 57.0 to 475.5); RAR: 32.8% (from 16.9 to 48.7) and NNT: 4 (from 3 to 6). In the G1/G2 groups: RR: 1.66 (from 1.25 to 2.20); RRR: 66.1% (from 25.3 to 120.1); RAR: 32.5% (from 16.6 to 48.4) and NNT: 4 (from 3 to 7). All 3groups were able to reduce weight. Although the group with motivational intervention achieved the greatest decrease, as well as the most favourable clinical relevance indicators. Copyright © 2017 SEH-LELHA. Publicado por Elsevier España, S.L.U. All rights reserved.

5-year follow-up of combined non-topography guided photorefractive keratectomy and corneal collagen cross linking for keratoconus

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Abdulrahman Mohammed Al-Amri

2018-01-01

Full Text Available AIM: To evaluate the visual outcomes of simultaneous non-topography guided photorefractive keratectomy (PRK and corneal collagen cross-linking (CXL in eyes with keratoconus 5y after the procedure. METHODS: Prospective, interventional, non-randomized, and non-controlled case series design was used. Sixty eyes of 30 patients (16 males and 14 females; age: 21-41y with mild, non-progressive (stages 1-2 keratoconus were enrolled. Refraction, uncorrected distance visual acuity (UDVA and corrected distance visual acuity (CDVA , flat and steep keratometry readings, and adverse events were evaluated preoperatively and postoperatively. Data were collected preoperatively and postoperatively at 3mo, 1, 2, 3, 4, and 5y follow-up visits after combined non-topography-guided PRK with CXL was performed. All patients had at least 5y of follow-up. RESULTS: All study parameters showed a statistically significant improvement at 5y over baseline values. The mean follow-up time was 68.20±4.71mo (range: 60-106mo. Patients showed a significant improvement in UDVA from 1.24±0.79 logMAR prior to combined non-TG-PRK+CXL to 0.06±0.15 logMAR postoperatively at the time of their last follow-up visit. CDVA significantly increased from 0.06±0.19 logMAR preoperatively to 0.03±0.12 logMAR postoperatively. A significant decrease in the mean spherical equivalent (SE refraction was observed from -2.28±1.8 to -0.79±0.93 diopters (D (P<0.05, and the manifest sphere decreased from -1.62±1.23 to -0.27±0.21 D (P=0.001. The manifest cylinder significantly decreased from -1.73±0.86 to -0.29±0.34 D postoperatively (P=0.001. The mean steep keratometry was 45.13±1.32 vs 47.28±2.12 D preoperatively (P<0.05, and the preoperative mean steepest keratometry (Kmax 48.6±3.1 was reduced significantly to 46.8±2.9 postoperatively (P<0.05. CONCLUSION: Combined non-TG-PRK with 15min CXL is an effective and safe option for correcting mild refractive error and improving visual acuity in

Lifetime competing risks between coronary heart disease mortality and other causes of death during 50years of follow-up.

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Puddu, Paolo Emilio; Piras, Paolo; Menotti, Alessandro

2017-02-01

To study coronary heart disease (CHD) death versus 11 other causes of death using the cumulative incidence function (CIF) and the competing risks procedures to disentangle the differential role of risk factors for different end-points. Standard Cox and Fine-Gray models among 1712 middle-aged men were compared during 50years of follow-up. CHD death was the primary event, while deaths from 11 selected causes, mutually exclusive from the primary end-point, were considered as secondary events. Reverse solutions were also performed. We considered 10 selected risk factors. CHD death risk was the second highest among 12 mostly specific causes of death. Some risk factors were specific: serum cholesterol for CHD death whereas, systolic blood pressure, cigarette smoking and age may have a differential role in other causes of death. Application of the Fine-Gray model based on CIF enabled to dissect, at least in part, the respective role that baseline covariates may have to segregate the probabilities of two types of death in contrast from each other. They also point to the absence of contributing significance for some of the selected risk factors and this calls for a parsimonious approach in predictions. The relative rarity of competing risk challenges when defining the risk factors role at long-term needs now be corrected since we have clearly shown, with Fine-Gray model, at direct or reverse use, that comparing different end-points heavily influences the risk factor predictive capacity. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Convergence of prevalence rates of diabetes and cardiometabolic risk factors in middle and low income groups in urban India: 10-year follow-up of the Chennai Urban Population Study.

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Deepa, Mohan; Anjana, Ranjit Mohan; Manjula, Datta; Narayan, K M Venkat; Mohan, Viswanathan

2011-07-01

The aim of this study was to look for temporal changes in the prevalence of diabetes and cardiometabolic risk factors in two residential colonies in Chennai. Chennai Urban Population Study (CUPS) was carried out between 1996-1998 in Chennai in two residential colonies representing the middle income group (MIG) and lower income group (LIG), respectively. The MIG had twice the prevalence rate of diabetes as the LIG and higher prevalence rates of hypertension, obesity, and dyslipidemia. They were motivated to increase their physical activity, which led to the building of a park. The LIG was given standard lifestyle advice. Follow-up surveys of both colonies were performed after a period of 10 years. In the MIG, the prevalence of diabetes increased from 12.4 to 15.4% (24% increase), while in the LIG, it increased from 6.5 to 15.3% (135% increase, p India with a convergence of prevalence rates among people in the MIG and LIG. This could have a serious economic impact on poor people in developing countries such as India. © 2011 Diabetes Technology Society.

Incidence of ovarian cancer after hysterectomy: a nationwide controlled follow up.

Science.gov (United States)

Loft, A; Lidegaard, O; Tabor, A

1997-11-01

To estimate the risk of developing ovarian cancer after abdominal (total or subtotal) hysterectomy on benign indication. Prospective historical cohort study with 12.5 years of follow up. Denmark, nationwide. All Danish women (aged 0 to 99 years) having undergone hysterectomy with conservation of at least one ovary for a benign indication from 1977 to 1981 (n = 22,135). Follow up was conducted from 1977 to 1991. The reference group included all Danish women who had not undergone hysterectomy, age-standardised according to the hysterectomy group (n = 2,554,872). Registry data derived from the Danish National Register of Patients (diagnoses and operation codes) and the Civil Registration System (information about general population, including time of death). Incidence rate of ovarian cancer, lifetime risk of ovarian cancer, relative risk of ovarian cancer. Seventy-one women developed ovarian cancer on average 7.0 years after hysterectomy and 10,659 women in the reference group had ovarian cancer diagnosed after on average 6.4 years. The incidence rate of ovarian cancer was 0.27 per 1000 person-years in the group that had undergone hysterectomy and 0.34 per 1000 person-years in the general population (age-standardised). The extrapolated lifetime risk of developing ovarian cancer was 2.1% after hysterectomy and 2.7% in the general population (RR 0.78; 95% CI 0.60-0.96). The risk of ovarian cancer is lower among women who have undergone hysterectomy compared with those who have not. The protection seems to decrease with time.

Pre- and postfortification intake of folate and risk of colorectal cancer in a large prospective cohort study in the United States.

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Gibson, Todd M; Weinstein, Stephanie J; Pfeiffer, Ruth M; Hollenbeck, Albert R; Subar, Amy F; Schatzkin, Arthur; Mayne, Susan T; Stolzenberg-Solomon, Rachael

2011-10-01

A higher folate intake is associated with a decreased colorectal cancer risk in observational studies, but recent evidence suggests that excessive folate supplementation may increase colorectal cancer risk in some individuals. Therefore, mandatory folic acid fortification of grain products in the United States may have unintended negative consequences. We examined the association between folate intake and colorectal cancer risk, including 8.5 y of postfortification follow-up. We examined the association between folate intake and colorectal cancer in the NIH-AARP Diet and Health Study-a US cohort study of 525,488 individuals aged 50-71 y initiated in 1995-1996. Dietary, supplemental, and total folate intakes were calculated for the pre- and postfortification periods (before and after 1 July 1997) based on a baseline food-frequency questionnaire. HRs and 95% CIs were calculated by using multivariable Cox proportional hazards regression models. During follow-up through 31 December 2006 (mean follow-up: 9.1 y), 7212 incident colorectal cancer cases were identified. In the postfortification analysis (6484 cases), a higher total folate intake was associated with a decreased colorectal cancer risk (HR for ≥900 compared with pattern of associations was similar for the prefortification period, and no significant differences between time periods were observed. In this large prospective cohort study that included 8.5 y of postfortification follow-up, folate intake was associated with a decreased colorectal cancer risk. Given that the adenoma-carcinoma sequence may take ≥10 y, additional follow-up time is needed to fully examine the effect of folic acid fortification.

Follow-up utterances in QA dialogue

NARCIS (Netherlands)

van Schooten, B.W.; op den Akker, Hendrikus J.A.

2006-01-01

The processing of user follow-up utterances by a QA system is a topic which is still in its infant stages, but enjoys growing interest in the QA community. In this paper, we discuss the broader issues related to handling follow-up utterances in a real-life "information kiosk" setting. With help of a

Long-term follow-up of children with high-risk neuroblastoma: the ENSG5 trial experience.

Science.gov (United States)

Moreno, Lucas; Vaidya, Sucheta J; Pinkerton, C Ross; Lewis, Ian J; Imeson, John; Machin, David; Pearson, Andrew D J

2013-07-01

Therapy for high-risk neuroblastoma is intensive and multimodal, and significant long-term adverse effects have been described. The aim of this study was to identify the nature and severity of late complications of metastatic neuroblastoma survivors included in the ENSG5 clinical trial. The trial protocol included induction chemotherapy (randomized "Standard" OPEC/OJEC vs. "Rapid" COJEC), surgery of primary tumor and high-dose melphalan with stem cell rescue. Two hundred and sixty-two children were randomized, 69 survived >5 years, and 57 were analyzed. Data were obtained from the ENSG5 trial database and verified with questionnaires sent to participating centers. Median follow-up was 12.9 (6.9-16.5) years. No differences were found in late toxicities between treatment arms. Twenty-eight children (49.1%) developed hearing loss. Nine patients (15.8%) developed glomerular filtration rate <80 ml/min/1.73 m(2), but no cases of chronic renal failure were documented. Endocrine complications (28.1% of children) included mainly hypogonadism and delayed growth. Four children developed second malignancies, three of them 5 years after diagnosis: one osteosarcoma, one carcinoma of the parotid gland and one ependymoma. There were no hematological malignancies or deaths in remission. This study analyzed a wide cohort of high-risk neuroblastoma survivors from a multi-institutional randomized trial and established the profile of long-term toxicity within the setting of an international clinical trial. Copyright © 2012 Wiley Periodicals, Inc.

Progression of Myopic Maculopathy during 18-Year Follow-up.

Science.gov (United States)

Fang, Yuxin; Yokoi, Tae; Nagaoka, Natsuko; Shinohara, Kosei; Onishi, Yuka; Ishida, Tomoka; Yoshida, Takeshi; Xu, Xian; Jonas, Jost B; Ohno-Matsui, Kyoko

2018-06-01

To examine the progression pattern of myopic maculopathy. Retrospective, observational case series. Highly myopic patients who had been followed up for 10 years or more. Using fundus photographs, myopic features were differentiated according to Meta-analysis of Pathologic Myopia (META-PM) Study Group recommendations. Progression pattern of maculopathy. The study included 810 eyes of 432 patients (mean age, 42.3±16.8 years; mean axial length, 28.8±1.9 mm; mean follow-up, 18.7±7.1 years). The progression rate of myopic maculopathy was 47.0 per 1000 eye-years. Within the pathologic myopia (PM) group (n = 521 eyes), progression of myopic maculopathy was associated with female gender (odds ratio [OR], 2.21; P = 0.001), older age (OR, 1.03; P = 0.002), longer axial length (OR, 1.20; P = 0.007), greater axial elongation (OR, 1.45; P = 0.005), and development of parapapillary atrophy (PPA; OR, 3.14; P < 0.001). Diffuse atrophy, found in 217 eyes without choroidal neovascularization (CNV) or lacquer cracks (LCs) at baseline, progressed in 111 (51%) eyes, leading to macular diffuse atrophy (n = 64; 64/111 or 58%), patchy atrophy (n = 59; 53%), myopic CNV (n = 18; 16%), LCs (n = 9; 5%), and patchy-related macular atrophy (n = 3; 3%). Patchy atrophy, detected in 63 eyes without CNV or LCs at baseline, showed progression in 60 eyes (95%), leading to enlargement of original patchy atrophy (n = 59; 59/60 or 98%), new patchy atrophy (n = 29; 48%), CNV-related macular atrophy (n = 13; 22%), and patchy-related macular atrophy (n = 5; 8%). Of 66 eyes with LCs, 43 eyes (65%) showed progression with development of new patchy atrophy (n = 38; 38/43 or 88%) and new LCs (n = 7; 16%). Reduction in best-corrected visual acuity (BCVA) was associated mainly (all P < 0.001) with the development of CNV or CNV-related macular atrophy and enlargement of macular atrophy. The most frequent progression patterns were an extension of peripapillary diffuse atrophy to macular diffuse

Babies born with gastroschisis and followed up to the age of six years faced long-term morbidity and impairments.

Science.gov (United States)

Giúdici, Lidia; Bokser, Vivian Susana; Maricic, Maximiliano Alejo; Golombek, Sergio G; Ferrario, Claudia Cecilia

2016-06-01

The aims of this Argentinian study were to describe and analyse the outcomes of a continuous interdisciplinary follow-up programme of patients with gastroschisis. This was a prospective, longitudinal study of babies with gastroschisis admitted from 1 November 2003 to 31 October 2014, and this paper presents results at one, three and six years of age. Matched-pairs analyses were carried out when they were one and six. We enrolled 62 babies and assessed 52 at one year of age, 34 at three years and 17 at six years. This showed that 63% had mental health problems and 5% had recurrent wheezing. Normal outcomes at one, three and six years were growth (80%, 85% and 80%), neurology-psychomotor development index (64%, 50% and 82%), audiology (100%, 76% and 76%), vision (98%, 94% and 89%) and language (55%, 62% and 65%). The rehospitalisation rates were 30%, 0.3% and zero, and the surgical re-intervention rates were 9%, 0.3% and 12%. Matched-pairs analysis showed no significant differences between outcomes at the ages of one and six. Babies born with gastroschisis were at risk for long-term morbidity and impairments, according to follow-up assessments at the ages of one, three and six years. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Semiquantitative SPECT myocardial perfusion with dipyridamole in patients unable to exercise. Event rate during 4 years of follow up

International Nuclear Information System (INIS)

Balestrini, V.R.; Arja, V.J.; Sandrin, A.L.; Calvo, G.R.; Gomez Bosh, Z.; Quiroga, W.; Balestrini, C.E.; Joekes, S.

2002-01-01

The increasingly numbers of patients (P) that can't reach an adequate level of exercise in order to evaluate CAD, lead us to use pharmacological and technical tools available for this subgroup of P. Aim: evaluate the prognostic significance of myocardial perfusion SPECT imaging with pharmacological stress in P without LBBB, unable to exercise. Material and Methods: 209 P were included. Mean age: 65 years old (39-88), male 66%. Clinical: Pre test likelihood 8: 28%; SDS 0 and SRS 0: 31.7%; SDS 0 + SRS >=1: 21%; SDS >=1: 47.3%. III) Follow up: 13 patients were early re-vascularized induced by SPECT study results, 10 patients get lost and 186 were follow up by a mean 1086 days. Cumulative events rate: 1st year SCE 9.7%, HCE 1.6%; 2nd year SCE 14%, HCE 4.3%; 3rd year SCE 17.7%, HCE 5.4%; 4th year SCE 21%, HCE 5,4%. Scintigraphic indices and events rate relationship are presented. Conclusion: There was a relationship between scintigraphic indices and hard cardiac events. The semiquantitative myocardial perfusion with dipyridamole stress was a safe test and useful to discriminate groups of P with different risk of events

Analysis of the value of imaging as part of the follow-up of splenic injury in children

Energy Technology Data Exchange (ETDEWEB)

Huebner, S. [Dept. of Radiology, Helath Sciences Centre, Winnipeg, MB (Canada); Reed, M.H. [Pediatric Radiology, Children' s Hospital, Winnipeg, Man. (Canada)

2001-12-01

Objective: A recent article suggested that routine follow-up imaging is still frequently used in the conservative management of splenic trauma in children. The purpose of this study was to use decision analysis to assess the value of routine imaging as part of the long-term follow-up of splenic injury in children managed nonoperatively. Methods: A literature review (1970-1999) on the management of blunt splenic trauma in children was performed. Data, including the use of follow-up imaging and the occurrence of delayed splenic rupture and death, on those patients managed nonoperatively were collected. The data were used to construct a decision tree. A Poisson distribution was used to determine the risk of delayed splenic rupture. Results: Information was extracted from 26 cohort studies. Nineteen of these studies were retrospective and six were prospective. One study had both retrospective and prospective arms. The study population consisted of 1,083 children. Of these patients, 920 (85 %) underwent routine follow-up imaging (US, CT, or scintigraphy). Follow-up imaging was either not performed or selectively performed in 163 patients (15 %). No cases of post-discharge splenic rupture or death were encountered in any of these groups. The maximum risk of delayed splenic rupture in the entire group was 0.3 % (0-3.7 cases). Conclusion:. The risk of delayed splenic rupture following blunt injury in children is very low, and is apparently unaffected by imaging protocols. No deaths, even in cases of delayed presentation, were identified in our study. These findings do not support the use of routine follow-up imaging of children with blunt splenic trauma. (orig.)

Analysis of the value of imaging as part of the follow-up of splenic injury in children

International Nuclear Information System (INIS)

Huebner, S.; Reed, M.H.

2001-01-01

Objective: A recent article suggested that routine follow-up imaging is still frequently used in the conservative management of splenic trauma in children. The purpose of this study was to use decision analysis to assess the value of routine imaging as part of the long-term follow-up of splenic injury in children managed nonoperatively. Methods: A literature review (1970-1999) on the management of blunt splenic trauma in children was performed. Data, including the use of follow-up imaging and the occurrence of delayed splenic rupture and death, on those patients managed nonoperatively were collected. The data were used to construct a decision tree. A Poisson distribution was used to determine the risk of delayed splenic rupture. Results: Information was extracted from 26 cohort studies. Nineteen of these studies were retrospective and six were prospective. One study had both retrospective and prospective arms. The study population consisted of 1,083 children. Of these patients, 920 (85 %) underwent routine follow-up imaging (US, CT, or scintigraphy). Follow-up imaging was either not performed or selectively performed in 163 patients (15 %). No cases of post-discharge splenic rupture or death were encountered in any of these groups. The maximum risk of delayed splenic rupture in the entire group was 0.3 % (0-3.7 cases). Conclusion:. The risk of delayed splenic rupture following blunt injury in children is very low, and is apparently unaffected by imaging protocols. No deaths, even in cases of delayed presentation, were identified in our study. These findings do not support the use of routine follow-up imaging of children with blunt splenic trauma. (orig.)

Treatment and Follow Up

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... Close Celiac Disease Understanding Celiac Disease What is Celiac Disease? Symptoms Screening and Diagnosis Treatment and Follow-Up Dermatitis ... you find the right healthcare practitioner to discuss symptoms, diagnose, and ... Our nationwide Healthcare Practitioner Directory lists primary care ...

Follow-up Care Education and Information: Identifying Cancer Survivors in Need of More Guidance.

Science.gov (United States)

O'Malley, Denalee M; Hudson, Shawna V; Ohman-Strickland, Pamela A; Bator, Alicja; Lee, Heather S; Gundersen, Daniel A; Miller, Suzanne M

2016-03-01

Cancer survivors engage in cancer screenings and protective health behaviors at suboptimal rates despite their increased risk for future illness. Survivorship care plans and other educational strategies to prepare cancer survivors to adopt engaged roles in managing long-term follow-up care and health risks are needed. In a sample of cancer survivors, we identified patient characteristics and psychosocial predictors associated with increased follow-up care informational needs. Cross-sectional surveys were administered to early-stage breast and prostate survivors (N = 278; 68 % breast) at least 2 years post treatment from four community hospital programs in New Jersey between May 2012 and July 2013. Patient demographics, medical history, psychosocial characteristics (i.e., worries about the future, fear of disease recurrence, and patient activation), and perceptions of oncology and primary care were assessed. African-American survivors (AOR = 2.69, 95 % confidence interval [CI] 1.27-5.68) and survivors with higher comorbidity (AOR =1.16, CI 1.01-1.33) were more likely to want additional information to guide follow-up care. Adjusting for race and comorbidities, survivors who wanted more information to guide their follow-up care reported greater worries about the future (p < 0.05) and fears about disease recurrence (p < 0.05) compared to those who did not want additional information. Results emphasize the need to develop cancer survivorship educational strategies that are both responsive to the needs of specific populations (e.g., African-American survivors and patients with multiple comorbidities) and the psychosocial profiles that motivate requests for more extensive follow-up guidance.

Association analysis identifies 65 new breast cancer risk loci.

Science.gov (United States)

Michailidou, Kyriaki; Lindström, Sara; Dennis, Joe; Beesley, Jonathan; Hui, Shirley; Kar, Siddhartha; Lemaçon, Audrey; Soucy, Penny; Glubb, Dylan; Rostamianfar, Asha; Bolla, Manjeet K; Wang, Qin; Tyrer, Jonathan; Dicks, Ed; Lee, Andrew; Wang, Zhaoming; Allen, Jamie; Keeman, Renske; Eilber, Ursula; French, Juliet D; Qing Chen, Xiao; Fachal, Laura; McCue, Karen; McCart Reed, Amy E; Ghoussaini, Maya; Carroll, Jason S; Jiang, Xia; Finucane, Hilary; Adams, Marcia; Adank, Muriel A; Ahsan, Habibul; Aittomäki, Kristiina; Anton-Culver, Hoda; Antonenkova, Natalia N; Arndt, Volker; Aronson, Kristan J; Arun, Banu; Auer, Paul L; Bacot, François; Barrdahl, Myrto; Baynes, Caroline; Beckmann, Matthias W; Behrens, Sabine; Benitez, Javier; Bermisheva, Marina; Bernstein, Leslie; Blomqvist, Carl; Bogdanova, Natalia V; Bojesen, Stig E; Bonanni, Bernardo; Børresen-Dale, Anne-Lise; Brand, Judith S; Brauch, Hiltrud; Brennan, Paul; Brenner, Hermann; Brinton, Louise; Broberg, Per; Brock, Ian W; Broeks, Annegien; Brooks-Wilson, Angela; Brucker, Sara Y; Brüning, Thomas; Burwinkel, Barbara; Butterbach, Katja; Cai, Qiuyin; Cai, Hui; Caldés, Trinidad; Canzian, Federico; Carracedo, Angel; Carter, Brian D; Castelao, Jose E; Chan, Tsun L; David Cheng, Ting-Yuan; Seng Chia, Kee; Choi, Ji-Yeob; Christiansen, Hans; Clarke, Christine L; Collée, Margriet; Conroy, Don M; Cordina-Duverger, Emilie; Cornelissen, Sten; Cox, David G; Cox, Angela; Cross, Simon S; Cunningham, Julie M; Czene, Kamila; Daly, Mary B; Devilee, Peter; Doheny, Kimberly F; Dörk, Thilo; Dos-Santos-Silva, Isabel; Dumont, Martine; Durcan, Lorraine; Dwek, Miriam; Eccles, Diana M; Ekici, Arif B; Eliassen, A Heather; Ellberg, Carolina; Elvira, Mingajeva; Engel, Christoph; Eriksson, Mikael; Fasching, Peter A; Figueroa, Jonine; Flesch-Janys, Dieter; Fletcher, Olivia; Flyger, Henrik; Fritschi, Lin; Gaborieau, Valerie; Gabrielson, Marike; Gago-Dominguez, Manuela; Gao, Yu-Tang; Gapstur, Susan M; García-Sáenz, José A; Gaudet, Mia M; Georgoulias, Vassilios; Giles, Graham G; Glendon, Gord; Goldberg, Mark S; Goldgar, David E; González-Neira, Anna; Grenaker Alnæs, Grethe I; Grip, Mervi; Gronwald, Jacek; Grundy, Anne; Guénel, Pascal; Haeberle, Lothar; Hahnen, Eric; Haiman, Christopher A; Håkansson, Niclas; Hamann, Ute; Hamel, Nathalie; Hankinson, Susan; Harrington, Patricia; Hart, Steven N; Hartikainen, Jaana M; Hartman, Mikael; Hein, Alexander; Heyworth, Jane; Hicks, Belynda; Hillemanns, Peter; Ho, Dona N; Hollestelle, Antoinette; Hooning, Maartje J; Hoover, Robert N; Hopper, John L; Hou, Ming-Feng; Hsiung, Chia-Ni; Huang, Guanmengqian; Humphreys, Keith; Ishiguro, Junko; Ito, Hidemi; Iwasaki, Motoki; Iwata, Hiroji; Jakubowska, Anna; Janni, Wolfgang; John, Esther M; Johnson, Nichola; Jones, Kristine; Jones, Michael; Jukkola-Vuorinen, Arja; Kaaks, Rudolf; Kabisch, Maria; Kaczmarek, Katarzyna; Kang, Daehee; Kasuga, Yoshio; Kerin, Michael J; Khan, Sofia; Khusnutdinova, Elza; Kiiski, Johanna I; Kim, Sung-Won; Knight, Julia A; Kosma, Veli-Matti; Kristensen, Vessela N; Krüger, Ute; Kwong, Ava; Lambrechts, Diether; Le Marchand, Loic; Lee, Eunjung; Lee, Min Hyuk; Lee, Jong Won; Neng Lee, Chuen; Lejbkowicz, Flavio; Li, Jingmei; Lilyquist, Jenna; Lindblom, Annika; Lissowska, Jolanta; Lo, Wing-Yee; Loibl, Sibylle; Long, Jirong; Lophatananon, Artitaya; Lubinski, Jan; Luccarini, Craig; Lux, Michael P; Ma, Edmond S K; MacInnis, Robert J; Maishman, Tom; Makalic, Enes; Malone, Kathleen E; Kostovska, Ivana Maleva; Mannermaa, Arto; Manoukian, Siranoush; Manson, JoAnn E; Margolin, Sara; Mariapun, Shivaani; Martinez, Maria Elena; Matsuo, Keitaro; Mavroudis, Dimitrios; McKay, James; McLean, Catriona; Meijers-Heijboer, Hanne; Meindl, Alfons; Menéndez, Primitiva; Menon, Usha; Meyer, Jeffery; Miao, Hui; Miller, Nicola; Taib, Nur Aishah Mohd; Muir, Kenneth; Mulligan, Anna Marie; Mulot, Claire; Neuhausen, Susan L; Nevanlinna, Heli; Neven, Patrick; Nielsen, Sune F; Noh, Dong-Young; Nordestgaard, Børge G; Norman, Aaron; Olopade, Olufunmilayo I; Olson, Janet E; Olsson, Håkan; Olswold, Curtis; Orr, Nick; Pankratz, V Shane; Park, Sue K; Park-Simon, Tjoung-Won; Lloyd, Rachel; Perez, Jose I A; Peterlongo, Paolo; Peto, Julian; Phillips, Kelly-Anne; Pinchev, Mila; Plaseska-Karanfilska, Dijana; Prentice, Ross; Presneau, Nadege; Prokofyeva, Darya; Pugh, Elizabeth; Pylkäs, Katri; Rack, Brigitte; Radice, Paolo; Rahman, Nazneen; Rennert, Gadi; Rennert, Hedy S; Rhenius, Valerie; Romero, Atocha; Romm, Jane; Ruddy, Kathryn J; Rüdiger, Thomas; Rudolph, Anja; Ruebner, Matthias; Rutgers, Emiel J T; Saloustros, Emmanouil; Sandler, Dale P; Sangrajrang, Suleeporn; Sawyer, Elinor J; Schmidt, Daniel F; Schmutzler, Rita K; Schneeweiss, Andreas; Schoemaker, Minouk J; Schumacher, Fredrick; Schürmann, Peter; Scott, Rodney J; Scott, Christopher; Seal, Sheila; Seynaeve, Caroline; Shah, Mitul; Sharma, Priyanka; Shen, Chen-Yang; Sheng, Grace; Sherman, Mark E; Shrubsole, Martha J; Shu, Xiao-Ou; Smeets, Ann; Sohn, Christof; Southey, Melissa C; Spinelli, John J; Stegmaier, Christa; Stewart-Brown, Sarah; Stone, Jennifer; Stram, Daniel O; Surowy, Harald; Swerdlow, Anthony; Tamimi, Rulla; Taylor, Jack A; Tengström, Maria; Teo, Soo H; Beth Terry, Mary; Tessier, Daniel C; Thanasitthichai, Somchai; Thöne, Kathrin; Tollenaar, Rob A E M; Tomlinson, Ian; Tong, Ling; Torres, Diana; Truong, Thérèse; Tseng, Chiu-Chen; Tsugane, Shoichiro; Ulmer, Hans-Ulrich; Ursin, Giske; Untch, Michael; Vachon, Celine; van Asperen, Christi J; Van Den Berg, David; van den Ouweland, Ans M W; van der Kolk, Lizet; van der Luijt, Rob B; Vincent, Daniel; Vollenweider, Jason; Waisfisz, Quinten; Wang-Gohrke, Shan; Weinberg, Clarice R; Wendt, Camilla; Whittemore, Alice S; Wildiers, Hans; Willett, Walter; Winqvist, Robert; Wolk, Alicja; Wu, Anna H; Xia, Lucy; Yamaji, Taiki; Yang, Xiaohong R; Har Yip, Cheng; Yoo, Keun-Young; Yu, Jyh-Cherng; Zheng, Wei; Zheng, Ying; Zhu, Bin; Ziogas, Argyrios; Ziv, Elad; Lakhani, Sunil R; Antoniou, Antonis C; Droit, Arnaud; Andrulis, Irene L; Amos, Christopher I; Couch, Fergus J; Pharoah, Paul D P; Chang-Claude, Jenny; Hall, Per; Hunter, David J; Milne, Roger L; García-Closas, Montserrat; Schmidt, Marjanka K; Chanock, Stephen J; Dunning, Alison M; Edwards, Stacey L; Bader, Gary D; Chenevix-Trench, Georgia; Simard, Jacques; Kraft, Peter; Easton, Douglas F

2017-11-02

Breast cancer risk is influenced by rare coding variants in susceptibility genes, such as BRCA1, and many common, mostly non-coding variants. However, much of the genetic contribution to breast cancer risk remains unknown. Here we report the results of a genome-wide association study of breast cancer in 122,977 cases and 105,974 controls of European ancestry and 14,068 cases and 13,104 controls of East Asian ancestry. We identified 65 new loci that are associated with overall breast cancer risk at P < 5 × 10 -8 . The majority of credible risk single-nucleotide polymorphisms in these loci fall in distal regulatory elements, and by integrating in silico data to predict target genes in breast cells at each locus, we demonstrate a strong overlap between candidate target genes and somatic driver genes in breast tumours. We also find that heritability of breast cancer due to all single-nucleotide polymorphisms in regulatory features was 2-5-fold enriched relative to the genome-wide average, with strong enrichment for particular transcription factor binding sites. These results provide further insight into genetic susceptibility to breast cancer and will improve the use of genetic risk scores for individualized screening and prevention.

Extended Follow-up Confirms Early Vaccine-Enhanced Risk of HIV Acquisition and Demonstrates Waning Effect Over Time Among Participants in a Randomized Trial of Recombinant Adenovirus HIV Vaccine (Step Study)

Science.gov (United States)

Duerr, Ann; Huang, Yunda; Buchbinder, Susan; Coombs, Robert W.; Sanchez, Jorge; del Rio, Carlos; Casapia, Martin; Santiago, Steven; Gilbert, Peter; Corey, Lawrence; Robertson, Michael N.

2012-01-01

Background. The Step Study tested whether an adenovirus serotype 5 (Ad5)–vectored human immunodeficiency virus (HIV) vaccine could prevent HIV acquisition and/or reduce viral load set-point after infection. At the first interim analysis, nonefficacy criteria were met. Vaccinations were halted; participants were unblinded. In post hoc analyses, more HIV infections occurred in vaccinees vs placebo recipients in men who had Ad5-neutralizing antibodies and/or were uncircumcised. Follow-up was extended to assess relative risk of HIV acquisition in vaccinees vs placebo recipients over time. Methods. We used Cox proportional hazard models for analyses of vaccine effect on HIV acquisition and vaccine effect modifiers, and nonparametric and semiparametric methods for analysis of constancy of relative risk over time. Results. One hundred seventy-two of 1836 men were infected. The adjusted vaccinees vs placebo recipients hazard ratio (HR) for all follow-up time was 1.40 (95% confidence interval [CI], 1.03–1.92; P = .03). Vaccine effect differed by baseline Ad5 or circumcision status during first 18 months, but neither was significant for all follow-up time. The HR among uncircumcised and/or Ad5-seropositive men waned with time since vaccination. No significant vaccine-associated risk was seen among circumcised, Ad5-negative men (HR, 0.97; P = 1.0) over all follow-up time. Conclusions. The vaccine-associated risk seen in interim analysis was confirmed but waned with time from vaccination. Clinical Trials Registration. NCT00095576. PMID:22561365

The value of routine follow-up after treatment for head and neck cancer. A National Survey from DAHANCA

DEFF Research Database (Denmark)

Pagh, Anja; Vedtofte, Thomas; Lynggaard, Charlotte Duch

2013-01-01

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....

Estimating Loss to Follow-Up in HIV-Infected Patients on Antiretroviral Therapy: The Effect of the Competing Risk of Death in Zambia and Switzerland

Science.gov (United States)

Mwango, Albert; Stringer, Jeffrey; Ledergerber, Bruno; Mulenga, Lloyd; Bucher, Heiner C.; Westfall, Andrew O.; Calmy, Alexandra; Boulle, Andrew; Chintu, Namwinga; Egger, Matthias; Chi, Benjamin H.

2011-01-01

Background Loss to follow-up (LTFU) is common in antiretroviral therapy (ART) programmes. Mortality is a competing risk (CR) for LTFU; however, it is often overlooked in cohort analyses. We examined how the CR of death affected LTFU estimates in Zambia and Switzerland. Methods and Findings HIV-infected patients aged ≥18 years who started ART 2004–2008 in observational cohorts in Zambia and Switzerland were included. We compared standard Kaplan-Meier curves with CR cumulative incidence. We calculated hazard ratios for LTFU across CD4 cell count strata using cause-specific Cox models, or Fine and Gray subdistribution models, adjusting for age, gender, body mass index and clinical stage. 89,339 patients from Zambia and 1,860 patients from Switzerland were included. 12,237 patients (13.7%) in Zambia and 129 patients (6.9%) in Switzerland were LTFU and 8,498 (9.5%) and 29 patients (1.6%), respectively, died. In Zambia, the probability of LTFU was overestimated in Kaplan-Meier curves: estimates at 3.5 years were 29.3% for patients starting ART with CD4 cells Switzerland since only few patients died. The results from Cox and Fine and Gray models were similar: in Zambia the risk of loss to follow-up and death increased with decreasing CD4 counts at the start of ART, whereas in Switzerland there was a trend in the opposite direction, with patients with higher CD4 cell counts more likely to be lost to follow-up. Conclusions In ART programmes in low-income settings the competing risk of death can substantially bias standard analyses of LTFU. The CD4 cell count and other prognostic factors may be differentially associated with LTFU in low-income and high-income settings. PMID:22205933

Treatment and violent behavior in persons with first episode psychosis during a 10-year prospective follow-up study

DEFF Research Database (Denmark)

Langeveld, Johannes; Bjørkly, Stål; Auestad, Bjørn

2014-01-01

BACKGROUND: First episode psychosis (FEP) patients have an increased risk for violence and criminal activity prior to initial treatment. However, little is known about the prevalence of criminality and acts of violence many years after implementation of treatment for a first episode psychosis. AIM......: To assess the prevalence of criminal and violent behaviors during a 10-year follow-up period after the debut of a first psychosis episode, and to identify early predictors and concomitant risk factors of violent behavior. METHOD: A prospective design was used with comprehensive assessments of criminal...... follow-up period, 20% of subjects had been apprehended or incarcerated. At 10-year follow-up, 15% of subjects had exposed others to threats or violence during the year before assessment. Illegal drug use at baseline and five-year follow-up, and a longer duration of psychotic symptoms were found...

Risk of recurrence, prognosis, and follow-up for Danish women with cervical cancer in 2005-2013

DEFF Research Database (Denmark)

Taarnhøj, Gry Assam; Christensen, Ib Jarle; Lajer, Henrik

2018-01-01

BACKGROUND: In developed countries, women attend follow-up after treatment for cervical cancer to detect recurrence. The aim of this study was to describe the Danish population of women with early-stage cervical cancer at risk for recurrence and death due to recurrence. METHODS: Data were extracted...... from 3 nationwide databases to find women diagnosed with stage 1A1 to 1B1 cervical cancer in 2005-2013. Recurrences were determined from data on oncological or surgical treatment more than 3 months after the initial diagnosis and were cross-checked with patient journals. RESULTS: In all, 1523 patients...... were diagnosed with stage 1A1 to 1B1 cervical cancer. Eighty women experienced recurrences: 8 at International Federation of Gynecology and Obstetrics (FIGO) stage 1A1, 0 at FIGO stage 1A2, and 72 at FIGO stage 1B1. The 5-year recurrence rate was 6.4%; 67.5% of the women had symptomatic recurrences...

The value of routine follow-up after treatment for head and neck cancer. A national DAHANCA study

DEFF Research Database (Denmark)

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...

Pessimism and the risk for coronary heart disease among middle-aged and older Finnish men and women: a ten-year follow-up study.

Science.gov (United States)

Pänkäläinen, Mikko T; Kerola, Tuomas V; Hintikka, Jukka J

2015-10-02

Despite the growth in knowledge about coronary heart disease (CHD) risk factors, and the advances made in preventing and treating them, the incidence of CHD is still notably quite high. Research has concentrated on the physiological factors that present risks for CHD, but there is an increasing amount of evidence for the connection of mental health, personal traits and CHD. Data on the connection of disposition (optimism or pessimism) and CHD are relatively scarce. The aim of this study was to investigate the long-term connection between optimism, pessimism and the risk for having CHD. This was a ten-year prospective cohort study on a regional sample of three cohorts aged 52-56, 62-66 and 72-76 years at baseline (N = 2815). The study groups were personally interviewed four times (in 2002, 2005, 2008 and 2012). The revised Life Orientation Test (LOT-R) was completed at the first appointment to determine the level of dispositional optimism or pessimism. During the ten-year follow-up, the incidence of new cases of coronary heart diseases was measured. The association between dispositional optimism/pessimism and the incidence of CHD during the follow-up was studied with logistic regression. Those who developed coronary heart disease during the ten-year follow-up were significantly more pessimistic at baseline than the other subjects. Using multivariate logistic regression models separately for men and women, we noticed no elevated risk for CHD in the pessimistic women compared to the non-pessimistic women. However, among men in the highest quartile of pessimism, the risk for CHD was approximately four-fold (OR 4.11, 95 % CI 1.68-11.04) that of the men in the lowest quartile. Optimism did not seem to have any role in the risk for developing CHD. Our main finding is that pessimism seemed to be a clear risk factor for coronary heart disease in men even after adjusting for classical well-known risk factors while optimism did not seem to be a protective factor

Individualized nutrition intervention is of major benefit to colorectal cancer patients: long-term follow-up of a randomized controlled trial of nutritional therapy.

Science.gov (United States)

Ravasco, Paula; Monteiro-Grillo, Isabel; Camilo, Maria

2012-12-01

In our published randomized trial in colorectal cancer, group 1 (n = 37) received individualized nutritional counseling and education about regular foods, group 2 (n = 37) received dietary supplements and consumed their usual diet of regular foods, and group 3 (n = 37) consumed their usual diet of regular foods. Neither group 2 nor group 3 received individualized counseling. Early nutritional counseling during radiotherapy was highly effective at reducing acute radiotherapy toxicity and improving nutritional intake/status and quality of life (QoL). Efficacy persisted for 3 mo after the intervention. The objective was to perform long-term follow-up in survivors of that clinical trial to specifically evaluate survival, late toxicity, QoL, and nutritional variables. Medical data were collected from patients' records, and prescheduled interviews were conducted by dietitians for individualized evaluations. Analyses and comparisons between groups (adjusted for stage) were performed after a median follow-up of 6.5 (range: 4.9-8.1) y. Patients complied with the Radiotherapy Department's follow-up protocol. Nutritional deterioration was higher (P nutritional status was maintained in 91% of group 1 patients but not in any of the group 3 patients (P group 2 > group 1 (P group 1 (P nutritional status and intake (P nutritional status, and QoL predicted shorter survival and late toxicity (HR: 8.25; 95% CI: 2.74, 1.47; P nutrition at improving long-term prognosis in colorectal cancer. Overall, the data indicate that early individualized nutritional counseling and education during radiotherapy is valuable for patients.

High and intermediate risk prostate cancer treated with three-dimensional computed tomography-guided brachytherapy: 2-8-year follow-up

International Nuclear Information System (INIS)

Koutrouvelis, Panos G.; Gillenwater, Jay; Lailas, Niko; Hendricks, Fred; Katz, Stuart; Sehn, James; Gil-Montero, Guillermo; Khawand, Nabil

2003-01-01

Purpose: To report post-brachytherapy results in high and intermediate risk patients of prostatic adenocarcinoma. Methods and materials: From June 1994 to June 2000, 356 consecutive high and intermediate risk patients were treated with three-dimensional computed tomography-guided stereotactic pararectal brachytherapy. The age was 42-90 years (median, 68 years), the initial prostate volume was 14-180 cm 3 (median, 59 cm 3 ), and initial PSA was 1.7-143 ng/ml (median, 10.5 ng/ml). Three hundred forty-eight patients were available for follow-up for 2 - 8 years (median, 4.5 years). Two hundred eighty patients had one or more high risk factors (PSA >20 ng/ml, Gleason>7, Stage T2b, T3a, or T3b). Sixty-eight patients had only one intermediate risk factor (PSA 10-20 ng/ml or Gleason=7). Patients with both intermediate risks were considered high risk. The high-risk group was further stratified into subgroups with similar risk profile. A dose of 144 Gy with 125 I or 120 Gy with 103 Pd was achieved in 90-100% of the target. Thirty (30) patients (9%) had prior transurethral resection and 229 (64%) were treated with 3 months neoadjuvant androgen ablation. Results: Biochemical disease-free survival was 92% of 280 high risk patients and 96% of 68 intermediate risk patients. Seven patients (2%) required catheterization during the first year for urinary retention, nine patients (3%) required TUR 1-3 years post-implant, three patients (1%) developed grade 1 or 2 incontinence after a second TUR, and four patients (1%) developed grade 3 rectal complications. Conclusion: This method produces a high level of biochemical control 2-8 years (median 4.5 years). Morbidity is acceptable regardless of risk profile or initial prostate volume

Does exposure to parental substance use disorders increase offspring risk for a substance use disorder? A longitudinal follow-up study into young adulthood.

Science.gov (United States)

Yule, Amy M; Wilens, Timothy E; Martelon, MaryKate; Rosenthal, Lindsay; Biederman, Joseph

2018-05-01

The main aim of this study was to examine the risk of exposure to parental substance use disorders (SUD; alcohol or drug abuse or dependence) on the risk for SUD in offspring with and without attention deficit hyperactivity disorder (ADHD) followed into young adult years. Subjects were derived from two longitudinal case-control studies of probands of both sexes, 6-17 years, with and without DSM-III-R ADHD and their parents. Probands were followed for ten years into young adulthood. Probands with a parental history of non-nicotine SUD were included in this analysis. Exposure to SUD was determined by active non-nicotine parental SUD while the parent was living with their child after birth. Cox proportional hazard models were used to calculate the risk of non-nicotine SUD in offspring. 171 of the 404 probands reassessed at ten-year follow up had a family history of parental SUD. 102 probands were exposed to active parental SUD. The average age of our sample was 22.2 ± 3.5 years old. Exposure to maternal but not paternal SUD increased offspring risk for an alcohol use disorder in young adulthood independently of ADHD status (OR: 2.7; 95% CI: 1.1, 6.9; p = 0.04). Exposure to maternal SUD increases the risk for an alcohol use disorder in offspring ten years later in young adult years irrespective of ADHD status. Copyright © 2018 Elsevier B.V. All rights reserved.

The Prognostic Validity of the Timed Up and Go Test With a Dual Task for Predicting the Risk of Falls in the Elderly

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Martin Hofheinz

2016-03-01

Full Text Available Objective: The aim is to examine the prognostic validity of the Timed Up and Go Test with a cognitive and a manual dual task for predicting the risk of falls. Method: A follow-up study was performed. The data were recorded for 120 volunteers in an outpatient physiotherapy center, with a 12-month follow-up. The sample included 120 elderly men and women aged 60 to 87 years ( M age = 72.2 years living at home. The main measurements were as follows: The Timed Up and Go Test (TUG, the TUG with a cognitive dual task (TUGcog, and the TUG with a manual dual task (TUGman and falls. Results: In the 12-month follow-up, 37 persons (30.8% had a locomotive fall. The receiver operating characteristic (ROC curve shows significant results for the TUGcog. The area under the curve is 0.65 ( p = .008, with a 95% confidence interval (CI = [0.55, 0.76]. For the TUGman, the area under the curve is 0.57 with a 95% CI = [0.45, 0.68], which is not significant ( p = .256. For the TUG, the area under the curve is 0.58, which is not significant ( p = .256, 95% CI = [0.47, 0.69]. Conclusion: The TUGcog is a valid prognostic assessment to predict falls in community-dwelling elderly people.

Poor adherence to P2Y12 antagonists increased cardiovascular risks in Chinese PCI-treated patients.

Science.gov (United States)

Sun, Yang; Li, Chenze; Zhang, Lina; Hu, Dong; Zhang, Xudong; Yu, Ting; Tao, Min; Wang, Dao Wen; Shen, Xiaoqing

2017-03-01

Low adherence to secondary prevention medications (ATM) of patients after acute coronary syndrome (ACS) is associated with poor clinical outcomes. However, literature provides limited data on assessment of ATM and risks associated with poor in Chinese patients with ACS. In the current work, ATM was assessed in consecutively recruited patients with ACS in Tongji Hospital from November 5, 2013 to December 31, 2014. A total of 2126 patients were classified under low adherence (proportion of days covered (PDC) C50%) groups based on their performance after discharge. All patients were followed up at the 1st, 6th, and 12th month of discharge while recording ATM and major adverse cardiac events (MACE). Bivariate logistic regression was used to identify the factors associated with ATM. Cox regression was used to analyze the association between ATM and MACE within one year after discharge. Results showed that coronary artery bypass grafting (CABG) alone had significantly lower proportion of high adherence to P2Y12 antagonists (83.0% vs. 90.7%, P < 0.01) than patients treated with percutaneous coronary intervention (PCI) only. Moreover, in patients undergoing PCI, high adherence to P2Y12 antagonists decreased the risk of MACE (hazard ratio = 0.172, 95% confidence interval: 0.039-0.763; P = 0.021). In conclusion, PCI-treated patients are more prone to remaining adherent to medications than CABG-treated patients. High adherence to P2Y12 antagonists was associated with lower risk of MACE.

Follow up study and interested cases in subdural hematoma

International Nuclear Information System (INIS)

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)

The incidence of HIV among women recruited during late pregnancy and followed up for six years after childbirth in Zimbabwe

Directory of Open Access Journals (Sweden)

Chirenje Mike Z

2010-11-01

Full Text Available Abstract Background HIV incidence is a useful tool for improving the targeting of populations for interventions and assessing the effectiveness of prevention strategies. A study in Harare, Zimbabwe reported cumulative incidences of 3.4% (3.0-3.8 and 6.5% (5.7-7.4 among post-partum women followed for 12 and 24 months respectively between 1997 and 2001. According to a Government report on HIV the prevalence of HIV fell from about 30% in 1999 to 14% in 2008. The purpose of this study was to determine the incidence of HIV-1 among women enrolled during late pregnancy and followed for six years after childbirth and to identify risk factors associated with acquisition of HIV. Methods HIV-uninfected pregnant women around 36 weeks gestation were enrolled from primary health care clinics in peri-urban settlements around Harare and followed-up for up to six years after childbirth. At every visit a questionnaire was interview-administered to obtain socio-demographic data and sexual history since the previous visit. A genital examination was performed followed by the collection of biological samples. Results Of the 552 HIV-uninfected women 444 (80.4% were seen at least twice during the six years follow-up and 39 acquired HIV, resulting in an incidence (95% CI of 2.3/100 woman-years-at-risk (wyar (1.1-4.1. The incidence over the first nine months post-partum was 5.7/100 wyar (3.3-8.1. A greater proportion of teenagers (15.3% contributed to a high incidence rate of 2.9/100 (0.6-8.7 wyar. In multivariate analysis lower education of participant, RR 2.1 (1.1-4.3 remained significantly associated with HIV acquisition. Other risk factors associated with acquisition of HIV-1 in univariate analysis were young age at sexual debut, RR 2.3, (1.0-5.6 and having children with different fathers, RR 2.7(1.3-5.8. Women that knew that their partners had other sexual partners were about four times more likely to acquire HIV, RR 3.8 (1.3-11.2. Conclusion The incidence of HIV

The follow-up time issue on small roundabouts

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Janusz WOCH

2008-01-01

Full Text Available The follow-up time was investigated. The aim of this analysis was to create a formula that allows the follow-up time calculated using the most important external parameters. The studies were based on empirical data collected at small roundabouts localized on Upper Silesia. The follow-up time is the average time gap between two cars of the minor stream being queued and entered the same major stream gap one behind the other. Follow-up times were measured directly by observing traffic flow. Resulting follow-up times were analyzed to determine their dependence on parameters such as intersection layout, roundabouts diameter and left visibility. These parameters were tested using the conventional calculation method (regression analysis. The dependence of follow-up time was then integrated into the own capacity estimation method for small roundabouts localized on urban areas. One of the biggest advantages this dependence is that capacity and traffic flow on small roundabouts can be determined reliably and appropriately for actual situations. The new follow-up time values for all range of external diameters of small roundabout 26 (22 – 40 m have been presented in this article.

Bladder cancer mortality of workers exposed to aromatic amines: a 58-year follow-up.

Science.gov (United States)

Pira, Enrico; Piolatto, Giorgio; Negri, Eva; Romano, Canzio; Boffetta, Paolo; Lipworth, Loren; McLaughlin, Joseph K; La Vecchia, Carlo

2010-07-21

We previously investigated bladder cancer risk in a cohort of dyestuff workers who were heavily exposed to aromatic amines from 1922 through 1972. We updated the follow-up by 14 years (through 2003) for 590 exposed workers to include more than 30 years of follow-up since last exposure to aromatic amines. Expected numbers of deaths from bladder cancer and other causes were computed by use of national mortality rates from 1951 to 1980 and regional mortality rates subsequently. There were 394 deaths, compared with 262.7 expected (standardized mortality ratio = 1.50, 95% confidence interval = 1.36 to 1.66). Overall, 56 deaths from bladder cancer were observed, compared with 3.4 expected (standardized mortality ratio = 16.5, 95% confidence interval = 12.4 to 21.4). The standardized mortality ratio for bladder cancer increased with younger age at first exposure and increasing duration of exposure. Although the standardized mortality ratio for bladder cancer steadily decreased with time since exposure stopped, the absolute risk remained approximately constant at 3.5 deaths per 1000 man-years up to 29 years after exposure stopped. Excess risk was apparent 30 years or more after last exposure.

Deterioro cognitivo y horas de sueño en mayores de 65 años no institucionalizados: estudio en farmacia comunitaria

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Climent MT

2015-06-01

Full Text Available Objetivo: Determinar factores de riesgo, relacionados con el estilo de vida, asociados con la presencia de deterioro cognitivo en personas mayores de 65 años. Método: Para ello se diseñó un estudio observacional transversal con personas mayores de 65 años no institucionalizadas mediante entrevista personal estructurada. El estudio se realizó en 14 farmacias de la Comunidad Valenciana desde marzo 2011 hasta marzo de 2013. Se utilizan como test de cribado el Short Portable Mental State Questionnaire (SPMSQ de Pfeiffer y el Mini-Mental State Examination (MMSE versión NORMACODERM de Blesa. Se definió deterioro cognitivo por SPMSQ ≥ 3 (para analfabetos ≥ 4 y/o MMSE ≤ 24. Resultados: Participaron en el estudio 729 personas. Se encontró que el 17,6% de los participantes (n = 128 presentaban resultados compatibles con deterioro cognitivo. Se determinó que dormir 9 o más horas diarias es causa o consecuencia y, por tanto, un factor de riesgo y/o de alarma en el desarrollo de deterioro cognitivo en personas mayores de 65 años. El ejercicio físico y pocas horas de sueño no obtuvo relación con el deterioro cognitivo. Conclusión: El cambio de hábitos de sueño en el anciano (pasar a dormir más horas es una señal de alerta para estudiar la presencia de un posible deterioro cognitivo.

A prospective 20-year longitudinal follow-up of dementia in persons with Down syndrome.

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McCarron, M; McCallion, P; Reilly, E; Dunne, P; Carroll, R; Mulryan, N

2017-09-01

To examine dementia characteristics, age at onset and associated co-morbidities in persons with Down syndrome. A total of 77 people with Down syndrome aged 35 years and older were followed up from 1996 to 2015. The diagnosis of dementia was established using the modified ICD 10 Criteria and a combination of objective and informant-based tests. Cognitive tests included the Test for Severe Impairment and the Down Syndrome Mental Status Examination; adaptive behaviour was measured using the Daily Living Skills Questionnaire, and data from the Dementia Questionnaire for People with Intellectual Disabilities have been available since 2005. Over the 20-year period, 97.4% (75 of 77) persons developed dementia with a mean age of dementia diagnosis of 55 years (SD = 7.1, median = 56 years). Clinical dementia was associated with cognitive and function decline and seizure activity. Risk for dementia increased from 23% in those aged 50 years to 80% in those aged 65 years and above. There were no differences by level of ID. The previously reported high risk levels for dementia among people with Down syndrome were confirmed in this data as was the relationship with late onset epilepsy. The value of the instruments utilised in tracking decline and helping to confirm diagnosis is further highlighted. © 2017 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

The importance of complete follow-up for results after femoro-infrapopliteal vascular surgery

DEFF Research Database (Denmark)

Jensen, L P; Nielsen, O M; Schroeder, T V

1996-01-01

intervals and all data have been recorded prospectively in a vascular registry. As part of a randomised trial on adjuvant medication in femorocrural bypass surgery, 102 patients, operated on between 1990 and 1992 were independently and simultaneously monitored. This subgroup was examined at 3 and 12 months...... is lost to follow-up, since failure to examine the patient for any reason may be related to the patients health. In addition to the number of patients at risk, it is suggested, that life-table plots should be supplemented with information on the number of patients lost to follow-up....

Body composition and body fat distribution in relation to later risk of acute myocardial infarction: a Danish follow-up study

DEFF Research Database (Denmark)

Stegger, Jakob; Schmidt, E B; Obel, Tina

2011-01-01

distribution.Methods and results:From 1993 to 1997, 27¿148 men and 29¿863 women, aged 50 to 64 year, were recruited into the Danish prospective study Diet, Cancer and Health. During 11.9 years of follow-up we identified 2028 cases of incident MI (1487 men and 541 women). BMI, waist circumference (WC), hip....... Estimates of obesity achieved by BIA seemed not to add additional information to classical anthropometric measures regarding MI risk. Both high and low LBM may be positively associated with MI.International Journal of Obesity advance online publication, 1 February 2011; doi:10.1038/ijo.2010.278....

U.S. Navy Womens Experience with Cervical Cancer Screening and Follow-up Care

Science.gov (United States)

2015-07-15

cancer screening (CCS) results; 2)"Freaked" --- the emotional toll of receiving an abnormal CCS; 3) "I didn’t understand"--- self-discovery to make sense...have a greater risk for acquiring cervical cancer. 14- 18 These risks include: higher rates of smoking, hormonal contraceptive use, unprotected sexual...Women described CCS notification experiences, self-discovery process, emotional impact, colposcopic process anticipation, importance of follow-up care

Childhood IQ and survival to 79: Follow-up of 94% of the Scottish Mental Survey 1947.

Science.gov (United States)

Čukić, Iva; Brett, Caroline E; Calvin, Catherine M; Batty, G David; Deary, Ian J

2017-07-01

To extend previous literature that suggests higher IQ in youth is associated with living longer. Previous studies have been unable to assess reliably whether the effect differs across sexes and ages of death, and whether the effect is graded across different levels of IQ. We test IQ-survival associations in 94% of the near-entire population born in Scotland in 1936 who took an IQ test at age 11 (n = 70,805) and were traced in a 68-year follow-up. Higher IQ at age 11 years was associated with a lower risk of death (HR = 0.80, 95% CI = 0.79, 0.81). The decline in risk across categories of IQ scores was graded across the full range with the effect slightly stronger in women (HR = 0.79, 95% CI = 0.77, 0.80) than in men (HR = 0.82, 95% CI = 0.81, 0.84). Higher IQ had a significantly stronger association with death before and including age 65 (HR = 0.76, 95% CI = 0.74, 0.77) than in those participants who died at an older age (HR = 0.79, 95% CI = 0.78, 0.80). Higher childhood IQ is associated with lower risk of all-cause mortality in both men and women. This is the only near-entire population study to date that examines the association between childhood IQ and mortality across most of the human life course.

Electrocardiographic Changes Improve Risk Prediction in Asymptomatic Persons Age 65 Years or Above Without Cardiovascular Disease

DEFF Research Database (Denmark)

Jørgensen, Peter Godsk; Jensen, Jan S; Marott, Jacob L

2014-01-01

endpoint was fatal cardiovascular disease (CVD) event and the secondary was fatal or nonfatal CVD event. In our study, 2,236 fatal CVD and 3,849 fatal or nonfatal CVD events occurred during a median of 11.9 and 9.8 years of follow-up. RESULTS: ECG changes were frequently present (30.6%) and associated......: In all, 6,991 participants from the Copenhagen Heart Study attending an examination at age ≥65 years were included. ECG changes were defined as Q waves, ST-segment depression, T-wave changes, ventricular conduction defects, and left ventricular hypertrophy based on the Minnesota code. The primary...

Cardiovascular events after ischemic stroke in young adults: A prospective follow-up study.

Science.gov (United States)

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.

ATLANTIC DIP: simplifying the follow-up of women with previous gestational diabetes.

LENUS (Irish Health Repository)

Noctor, E

2013-11-01

Previous gestational diabetes (GDM) is associated with a significant lifetime risk of type 2 diabetes. In this study, we assessed the performance of HbA1c and fasting plasma glucose (FPG) measurements against that of 75 g oral glucose tolerance testing (OGTT) for the follow-up screening of women with previous GDM.

Fetal growth and subsequent risk of breast cancer: results from long term follow up of Swedish cohort.

Science.gov (United States)

McCormack, V A; dos Santos Silva, I; De Stavola, B L; Mohsen, R; Leon, D A; Lithell, H O

2003-02-01

To investigate whether size at birth and rate of fetal growth influence the risk of breast cancer in adulthood. Cohort identified from detailed birth records, with 97% follow up. Uppsala Academic Hospital, Sweden. 5358 singleton females born during 1915-29, alive and traced to the 1960 census. Incidence of breast cancer before (at age or = 50 years) the menopause. Size at birth was positively associated with rates of breast cancer in premenopausal women. In women who weighed > or =4000 g at birth rates of breast cancer were 3.5 times (95% confidence interval 1.3 to 9.3) those in women of similar gestational age who weighed birth. Rates in women in the top fifths of the distributions of birth length and head circumference were 3.4 (1.5 to 7.9) and 4.0 (1.6 to 10.0) times those in the lowest fifths (adjusted for gestational age). The effect of birth weight disappeared after adjustment for birth length or head circumference, whereas the effects of birth length and head circumference remained significant after adjustment for birth weight. For a given size at birth, gestational age was inversely associated with risk (P=0.03 for linear trend). Adjustment for markers of adult risk factors did not affect these findings. Birth size was not associated with rates of breast cancer in postmenopausal women. Size at birth, particularly length and head circumference, is associated with risk of breast cancer in women aged rate, as measured by birth size adjusted for gestational age, rather than size at birth may be the aetiologically relevant factor in premenopausal breast cancer.

Quality of life of elderly persons with cancer: a 6-month follow-up

DEFF Research Database (Denmark)

Esbensen, Bente Appel; Osterlind, Kell; Hallberg, Ingalill Rahm

2007-01-01

aged (age 65+) recently diagnosed with cancer (74 women, 27 men), but was reduced to 75 (57 women, 18 men) by the 6-month investigation point. EORTC QLQ C30, Katz ADL, Nowotny's Hope Scale and Interview Schedule for Social Interaction were used in structured personal interviews and questionnaires......L, by the significant >/=10 units, from baseline to 6-month follow-up, while about 70% remained stable in QoL from baseline. The majority of the elderly persons with cancer showed an ability to adjust to the new condition. However, in clinical practice, specific attention should be paid to the most vulnerable groups...

The younger siblings of teenage mothers: a follow-up of their pregnancy risk.

Science.gov (United States)

East, P L; Jacobson, L J

2001-03-01

This study followed 243 younger brothers and younger sisters of parenting teens and nonparenting teens across a 1.5-year period. The average age of siblings was 13.6 years at Time 1 and 15 years at Time 2. Relative to other youths, the sisters of parenting teens exhibited a sharp increase in drug and alcohol use and partying behavior across time and had the highest pregnancy rate at Time 2 (15%). The siblings of parenting teens spent 10 hr a week caring for their sisters' children, and, for girls, many hours of child care was associated with negative outcomes including permissive sexual behavior. Findings suggest that the younger sisters of parenting teens are at very high risk of early pregnancy and that this risk becomes increasingly pronounced across time.

Predictors of residual flow in embolized intracranial ruptured aneurysms at early follow-up.

Science.gov (United States)

Serafin, Zbigniew; Strześniewski, Piotr; Beuth, Wojciech

2014-01-01

The possibility of recanalization and the need for retreatment are the most important drawbacks of intracranial aneurysm embolization. The purpose of the study was to prospectively analyze the results of early follow-up angiography of embolized ruptured aneurysms in an attempt to determine factors predicting the presence of residual flow. Evaluation included 72 patients with 72 aneurysms, which were followed-up 3 months after the treatment. Analysis of residual flow predictors included: age and gender, clinical state in Hunt-Hess scale, aneurysm localization, aneurysm three dimensions and volume, neck width, sac-to-neck ratio, initial result of embolization, number of coils used and the use of hydrogel coils and stents. Mean sac diameter was 6.5±3.9 mm, and mean neck width was 2.9±1.4 mm. Follow-up angiography presented residual flow in 26 aneurysms (36.1%): class 2 in 8 aneurysms (11.1%), and class 3 in 18 cases (25.0%). Stable aneurysm filling was observed in 45 cases (62.5%), progression of residual flow in 25 cases (34.7%), and regression in 2 cases (2.8%). According to ROC analysis independent predictors of residual flow were aneurysm neck diameter (AUC 0.857, 95% CI: 0.755-0.928, p<0.0001) and sac-to-neck ratio (AUC 0.817, 95% CI: 0.708-0.898, p<0.0001). Cut-off point of the ROC curve was established at 2.8 mm for neck diameter, and 1.73 for sac-to-neck ratio. Aneurysm neck diameter and sac-to-neck ratio are independently related to the residual flow in embolized ruptured aneurysms at early follow-up.

The Danish Cerebral Palsy Follow-up Program

DEFF Research Database (Denmark)

Rasmussen, Helle Mätzke; Nordbye-Nielsen, Kirsten; Møller-Madsen, Bjarne

2016-01-01

AIM OF DATABASE: The Danish Cerebral Palsy Follow-up Program is a combined follow-up program and national clinical quality database that aims to monitor and improve the quality of health care for children with cerebral palsy (CP). STUDY POPULATION: The database includes children with CP aged 0...... indicators in three of five regions in Denmark comprising 432 children with CP, corresponding to a coverage of 82% of the expected population. CONCLUSION: The Danish Cerebral Palsy Follow-up Program is currently under development as a national clinical quality database in Denmark. The database holds...

Rothmund-Thomson Syndrome: A 13-Year Follow-Up

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Guillermo Antonio Guerrero-González

2014-07-01

Full Text Available Rothmund-Thomson syndrome (RTS is a rare autosomal recessive disorder presenting with poikiloderma and other clinical features, affecting the bones and eyes and, in type II RTS, presenting an increased risk for malignancy. With about 300 cases reported so far, we present a 13-year follow-up including clinical images, X-rays and genetic analysis. A 13-month-old female started with a facial rash with blisters on her cheeks and limbs at the age of 3 months along with congenital hypoplastic thumbs, frontal bossing and fine hair, eyebrows and eyelashes. The patient was lost to follow-up and returned 12 years later with palmoplantar hyperkeratotic lesions, short stature, disseminated poikiloderma and sparse scalp hair, with absence of eyelashes and eyebrows. Radiographic analysis showed radial ray defect, absence of the thumb and three wrist carpal bones, and reduced bone density. Gene sequencing for the RECQL4 helicase gene revealed a mutation on each allele. RTS is a rare disease, and in this patient we observed the evolution of her skin lesions and other clinical features, which were important for the classification of type II RTS. The next years will provide even more information on this rare disease.

OSTA program: A French follow up intervention program for suicide prevention.

Science.gov (United States)

Mouaffak, Fayçal; Marchand, Arnaud; Castaigne, Emmanuelle; Arnoux, Armelle; Hardy, Patrick

2015-12-30

Attempted suicide is a strong risk factor for subsequent suicidal behavior. In recent years, a particular interest has been given to follow-up interventions as a potential effective strategy in preventing recurrent suicidal behavior. We developed a follow-up intervention program called OSTA (organization of a suitable monitoring for suicide attempters) aimed at addressing this issue and tested its effectiveness in a 1-year randomized controlled trial. Individuals who attempted suicide and were admitted to the emergency department (ED) of Bicêtre Hospital (n=320) were randomly allocated to receive either the OSTA program or a control treatment. On an intention to treat basis, the proportion of patients who reattempted suicide did not differ significantly between the interventional group (IG) 14.5% (22/152) and the control group (CG) 14% (21/150). There were also no significant differences, between the two arms, in the number of suicide attempts. Although no significant difference has been found between the OSTA program and the control treatment concerning the rate of suicide reattempts, we believe that further studies should be conducted to test the effectiveness of more standardized follow-up studies in suicide prevention. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Patient dose during radiological examination in the follow-up of bariatric surgery

International Nuclear Information System (INIS)

Moro, L.; Cazzani, C.; Tomarchio, O.; Morone, G.; Catona, A.; Fantinato, D.

2007-01-01

A patient dose survey was carried out measuring the kerma-area product (KAP) values during radiological evaluation in the follow-up of bariatric surgery. The procedures were performed by three radiologists to adjust laparoscopic gastric bands and to detect postoperative complications after Roux-en-Y gastric bypass procedures to treat morbid obesity. Total fluoroscopy time, exposure factors and the overall contribution of fluoroscopy to the accumulated KAP value were recorded. The median KAP values were used to estimate organ doses and effective dose to a standard patient; the radiation risk associated with the procedures was also evaluated. The doses were smaller for one of the three radiologists, owing to a more appropriate beam collimation and a reduction of the screening time. The KAP values ranged from 1.6 to 7.1 Gy cm 2 for the laparoscopic adjustable gastric banding management, and from 3.0 and 8.3 Gy cm 2 for the radiological examinations after gastric bypass. As a whole, the effective doses associated to these procedures were between 0.5 and 2.7 mSv. The organs receiving the highest doses were not only breast, stomach, pancreas and liver, but also lungs, owing to of their high radiosensitivity, significantly contributed to the effective dose. (authors)

Is there an increased risk of second primaries following prostate irradiation?

International Nuclear Information System (INIS)

Movsas, Benjamin; Hanlon, Alexandra L.; Pinover, Wayne; Hanks, Gerald E.

1998-01-01

Purpose: To assess the risk of developing a second primary cancer following prostate irradiation compared to the underlying risk in patients with prostate cancer. Methods and Materials: The baseline rate of secondary cancers following prostate cancer was obtained from a study of 18,135 patients from the Connecticut Tumor Registry, of whom only 12.5% received radiotherapy. These patients, with a mean age of 72 and a mean follow-up of 3.9 years, were compared to a cohort of 543 patients (median age 70) with similar follow-up (median 3.9 years), all of whom were treated with definitive radiotherapy at Fox Chase Cancer Center. The possible association between various covariates (age, dose, palpation stage, field size, Gleason score, pretreatment PSA) and the development of a secondary cancer was assessed. Results: 1,053 of 18,135 patients (5.8%) in the Connecticut Tumor Registry developed a second primary cancer compared with 31 of 543 (5.7%) patients treated with prostate radiation (p = 0.99). Although this risk increases gradually over time, it is not significantly different, at any time period, between the two groups of patients. Of the 31 secondary primaries in the irradiated group, 82% had a history of tobacco and/or alcohol use. Only melanomas were significantly increased compared to the expected rate in an age-matched population (p <0.001). Five of the 31 secondary cancers occurred within the radiation field (four bladder, one colon), four within 3 years and only one occurred 9 years after radiotherapy. No association was found between age (<70 vs. ≥70 and as a continuous variable), dose (<74 vs. ≥74 Gy), palpation stage (< T2C vs. ≥T2C), field size (prostate vs. pelvic), radiation technique (conventional vs. conformal), Gleason score (2-6 vs. 7-10), or pretreatment PSA (<15 vs. ≥15 and as a continuous variable) and the risk of developing a second primary. Although a lower radiation dose (as a continuous variable) correlated with an increased risk of

Strategy utilized for assessing baseline risks to human health from K-65 and metal oxide residues stored at the Fernald Site

Energy Technology Data Exchange (ETDEWEB)

Harmon, J.E. [FERMCO, Cincinnati, OH (United States). Fernald Environmental Management Project; Janke, R.C.

1995-04-01

The U.S. Department of Energy (DOE) is responsible for cleanup activities at the Fernald Environmental Management Project (FEMP) site in southwestern Ohio. The 425-hectare site consists of a former 55-hectare Production Area, an adjacent Waste Storage Area and various support facilities. From 1952 until 1989, the FEMP processed uranium into metallic {open_quotes}feed{close_quotes} materials for other DOE facilities in the nation`s defense program. In accordance with the Comprehensive Environmental Response, Compensation and Liability Act (CERCLA), the FEMP site is currently listed on the National Priorities List (NPL). To facilitate an expeditious cleanup effort, environmental issues associated with site cleanup are being managed under five operable units. This paper summarizes the risk assessment strategy employed to determine baseline human health risks associated with K-65 and metal oxide residues currently stored in Operable Unit 4. The K-65 and metal oxide residues were generated during the 1950s as a result of the extraction of uranium from uranium-bearing ores and concentrates. These residues are currently stored within Operable Unit 4 in concrete silos. Silos I and 2 contain approximately 6,120 cubic meters [m{sup 3}] (8,005 cubic yards [yd{sup 3}]) of K-65 residues, while silos 3 contains approximately 3890 m{sup 3} (5,080 yd{sup 3}) of cold metal oxides. These concrete silos are beyond their design life and require remedial action. The risk assessment conducted for Operable Unit 4 constitutes the first detailed human health risk assessment to be approved by the Environmental Protection Agency (EPA) for the CERCLA clean-up effort at the FEMP Site. This paper discusses the FEMP`s use of a Risk Information Quality Objective process in concert with the traditional risk assessment approach to determine baseline risk to human health and the environment posed by Operable Unit 4. A summary of the baseline risks to human health is also presented.

Socioeconomic Status and Poor Health Outcome at 10 Years of Follow-Up in the Multi-Ethnic Study of Atherosclerosis.

Directory of Open Access Journals (Sweden)

Steven Shea

Full Text Available Predictors of healthy aging have not been well-studied using longitudinal data with demographic, clinical, subclinical, and genetic information. The objective was to identify predictors of poor health outcome at 10 years of follow-up in the Multi-Ethnic Study of Atherosclerosis (MESA.Prospective cohort study.Population-based sample from 6 U.S. communities.4,355 participants In the MESA Study.Poor health outcome at 10 years of follow-up was defined as having died or having clinical cardiovascular disease, depression, cognitive impairment, chronic obstructive pulmonary disease, or cancer other than non-melanoma skin cancer. Absolute risk regression was used to estimate risk differences in the outcome adjusting for demographic variables, clinical and behavioral risk factors, subclinical cardiovascular disease, and ApoE genotype. Models were weighted to account for selective attrition.Mean age at 10 years of follow-up was 69.5 years; 1,480 participants had a poor health outcome, 2,157 participants were in good health, and 718 were unknown. Older age, smoking, not taking a statin, hypertension, diabetes, and higher coronary calcium score were associated with higher probability of poor health outcome. After multivariable adjustment, participants in the lowest income and educational categories had 7 to 14% greater absolute risk of poor health outcome at 10 years of follow-up compared to those in the next highest categories of income or education (P = 0.002 for both. Those in the lowest categories of both income and education had 21% greater absolute risk of poor health outcome compared to those in the highest categories of both income and education.Low income and educational level predict poor health outcome at 10 years of follow-up in an aging cohort, independent of clinical and behavioral risk factors and subclinical cardiovascular disease.

Pre- and postfortification intake of folate and risk of colorectal cancer in a large prospective cohort study in the United States123

Science.gov (United States)

Gibson, Todd M; Weinstein, Stephanie J; Pfeiffer, Ruth M; Hollenbeck, Albert R; Subar, Amy F; Schatzkin, Arthur; Mayne, Susan T; Stolzenberg-Solomon, Rachael

2011-01-01

Background: A higher folate intake is associated with a decreased colorectal cancer risk in observational studies, but recent evidence suggests that excessive folate supplementation may increase colorectal cancer risk in some individuals. Therefore, mandatory folic acid fortification of grain products in the United States may have unintended negative consequences. Objective: We examined the association between folate intake and colorectal cancer risk, including 8.5 y of postfortification follow-up. Design: We examined the association between folate intake and colorectal cancer in the NIH-AARP Diet and Health Study—a US cohort study of 525,488 individuals aged 50–71 y initiated in 1995–1996. Dietary, supplemental, and total folate intakes were calculated for the pre- and postfortification periods (before and after 1 July 1997) based on a baseline food-frequency questionnaire. HRs and 95% CIs were calculated by using multivariable Cox proportional hazards regression models. Results: During follow-up through 31 December 2006 (mean follow-up: 9.1 y), 7212 incident colorectal cancer cases were identified. In the postfortification analysis (6484 cases), a higher total folate intake was associated with a decreased colorectal cancer risk (HR for ≥900 compared with pattern of associations was similar for the prefortification period, and no significant differences between time periods were observed. Conclusions: In this large prospective cohort study that included 8.5 y of postfortification follow-up, folate intake was associated with a decreased colorectal cancer risk. Given that the adenoma-carcinoma sequence may take ≥10 y, additional follow-up time is needed to fully examine the effect of folic acid fortification. PMID:21813806

Standard psychological consultations and follow up for women at increased risk of hereditary breast cancer considering prophylactic mastectomy

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Tan Murly BM

2009-03-01

Full Text Available Abstract Background Women at increased (genetic risk of breast cancer have to weigh the personal pros and cons of prophylactic mastectomy (PM as an option to reduce their cancer risk. So far, no routine referral to a psychologist has been investigated for women considering PM. Aim of this study was to asses: 1 the acceptance of the offer of a standard psychological consultation as part of pre-surgical decision-making in high-risk women, 2 reasons for PM and reasons for postponing it, 3 the need for additional psychological interventions, and factors associated, and 4 the frequency of psychiatric/psychological treatment history. Methods During a 30 months period, women at high risk considering PM were offered a psychological consultation. The content of these, and follow-up, consultations were analyzed. Results Most women (70 out of 73 accepted the psychological consultation, and 81% proceeded with PM. Main reasons for undergoing PM were to reduce anxiety about cancer, and to reduce the cancer risk. Uncertainty about surgery and the need for further information were the reasons given most frequently for postponing PM. Additional psychological support was given to 31% before and 14% after PM. The uptake of additional support was significantly higher in women with a BRCA1/2 mutation. A history of psychiatric/psychological treatment was present in 36%, mainly consisting of depression and grief after death of a mother. Conclusion The uptake-rate of the standard psychological consultation indicates a high level of acceptability of this service for women deciding about PM. Since anxiety is one of the main reasons for considering PM, and depression and grief were present in a third, a standard consultation with a psychologist for high-risk women considering PM may be indicated. This may help them arrive at an informed decision, to detect and manage psychological distress, and to plan psychological support services.

HPV-Testing in Follow-up of Patients Treated for CIN2+ Lesions

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Mariani, Luciano; Sandri, Maria Teresa; Preti, Mario; Origoni, Massimo; Costa, Silvano; Cristoforoni, Paolo; Bottari, Fabio; Sideri, Mario

2016-01-01

Persistent positivity of HPV-DNA testing is considered a prognostic index of recurrent disease in patients treated for CIN2+. HPV detection, and particularly genotyping, has an adequate high rate of sensitivity and specificity (along with an optimal reproducibility), for accurately predicting treatment failure, allowing for an intensified monitoring activity. Conversely, women with a negative HPV-test 6 months after therapy have a very low risk for residual/recurrent disease, which leads to a more individualized follow-up schedule, allowing for a gradual return to the normal screening scheme. HPV testing should be routinely included (with or without cytology) in post-treatment follow-up of CIN2+ patients for early detection of recurrence and cancer progression. HPV genotyping methods, as a biological indicator of persistent disease, could be more suitable for a predictive role and risk stratification (particularly in the case of HPV 16/18 persistence) than pooled HPV-based testing. However, it is necessary to be aware of the performance of the system, adhering to strict standardization of the process and quality assurance criteria. PMID:26722366

29 CFR 99.315 - Audit findings follow-up.

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2010-07-01

... 29 Labor 1 2010-07-01 2010-07-01 true Audit findings follow-up. 99.315 Section 99.315 Labor Office... § 99.315 Audit findings follow-up. (a) General. The auditee is responsible for follow-up and corrective... include the reference numbers the auditor assigns to audit findings under § 99.510(c). Since the summary...

Complications and long-term follow-up results in titanium mesh cage reconstruction after cervical corpectomy.

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Nakase, Hiroyuki; Park, Young-Su; Kimura, Hajime; Sakaki, Toshisuke; Morimoto, Tetsuya

2006-07-01

The incidence of the complications and long-term outcome with a minimum 2-year follow-up of anterior cervical reconstruction using titanium mesh cage is evaluated. Relevant literature was also reviewed to discuss the potential risk factors of the complications of this procedure. From 1999 to 2003, 26 patients with cervical spine disorders, (12 patients with OPLL, 7 with cervical spondylosis, 3 with vertebral tumors, 2 with osteomyelitis, and 2 with traumatic lesions) were operated on by this procedure. The series included 14 males and 12 females with a mean age of 60.9 years. Corpectomy was performed on 1 (14 cases), 2 (12 cases). Autologous bone fragments were taken from the excised vertebra. The average improvement rate as scored on the neurosurgical cervical spine scale was 67.4%. The average follow-up period was 54.3 months (range, 24 to 72 months) in 21 who were followed up, and bone union was observed in all cases (22/22 cases) that could be followed up for more than 6 months postoperatively. The average time required for fusion was 6.7 months. Postoperative complications included dyspnea (1 case) and cerebrospinal fluid leakage (2 cases), which was treated by lumbar drainage, without any additional repair operation. No hardware-related complications or adjacent segment degenerative changes were encountered during the follow-up periods. This reconstruction technique yielded good clinical results and helped to avoid complications associated with harvesting bone from the iliac crest donor site. However, risk factors related to the method should be carefully considered.

[LDL-cholesterol control in patients with genetic dyslipidemia followed up by Lipid and Vascular Risk Units of the Spanish Society of Arteriosclerosis].

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Lahoz, Carlos; Mostaza, José María; Pintó, Xavier; de la Cruz, Juan José; Banegas, José Ramón; Pedro-Botet, Juan

2015-01-01

To evaluate low-density lipoprotein-cholesterol (LDLc) achieved in patients with genetic dyslipidemia treated during one year in Lipid and Vascular Risk Units (LVRU) of the Spanish Society of Arteriosclerosis (SSA). Observational, longitudinal, retrospective, multicenter national study that included consecutive patients of both sexes over 18 years of age referred due to dyslipidemia to LVRU of the SSA. Information was collected from medical records corresponding to two visits in the lipid unit. A total of 527 patients (mean age 48 years, 60.0% men) diagnosed with genetic dyslipidemia (241 with heterozygous familial hypercholesterolemia, and 286 with familial combined hyperlipidemia) were included. The mean follow-up was 12.9 months. In the last visit, 94% were taking statins, one third combined with ezetimibe, although only 41% were taking a high-intensity hypolipidemic treatment. Overall, 28.5% of patients attained an LDLc level50%, and 53.8% achieved one of the two. Predictors of target LDLc levels in the multivariate analysis were age, smoking habit and the presence of vascular disease. Over half of the patients with genetic dyslipidemia followed up by LVRU of SSA achieve LDLc objectives after one year of follow-up. The use of high-intensity hypolipidemic treatment could improve these results. Copyright © 2014 Sociedad Española de Arteriosclerosis. Published by Elsevier España. All rights reserved.

Self-Reported Periodontitis and Incident Type 2 Diabetes among Male Workers from a 5-Year Follow-Up to MY Health Up Study.

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Atsushi Miyawaki

Full Text Available The purpose of this study was to examine whether periodontitis is associated with incident type 2 diabetes in a Japanese male worker cohort.The study participants were Japanese men, aged 36-55 years, without diabetes. Data were extracted from the MY Health Up study, consisting of self-administered questionnaire surveys at baseline and following annual health examinations for an insurance company in Japan. The oral health status of the participants was classified by two self-reported indicators: (1 gingival hemorrhage and (2 tooth loosening. Type 2 diabetes incidence was determined by self-reporting or blood test data. Modified Poisson regression approach was used to estimate the relative risks and the 95% confidence intervals of incident diabetes with periodontitis. Covariates included age, body mass index, family history of diabetes, hypertension, current smoking habits, alcohol use, dyslipidemia, and exercise habits.Of the 2895 candidates identified at baseline in 2004, 2469 men were eligible for follow-up analysis, 133 of whom were diagnosed with diabetes during the 5-year follow-up period. Tooth loosening was associated with incident diabetes [adjusted relative risk = 1.73, 95% confidence interval = 1.14-2.64] after adjusting for other confounding factors. Gingival hemorrhage displayed a similar trend but was not significantly associated with incident diabetes [adjusted relative risk = 1.32, 95% confidence interval = 0.95-1.85].Tooth loosening is an independent predictor of incident type 2 diabetes in Japanese men.

Breast cancer after multiple chest fluoroscopies: second follow-up of Massachusetts women with tuberculosis

International Nuclear Information System (INIS)

Hrubec, Z.; Boice, J.D. Jr.; Monson, R.R.; Rosenstein, M.

1989-01-01

A second follow-up was conducted of 1742 women with tuberculosis who were treated in one of two sanatoria in Massachusetts between 1930 and 1956. One hospital treated only children under the age of 17. Patient follow-up was extended from 1975 through 1980, and an additional 18 breast cancers were identified from hospital records, death certificates, and responses to a mailed questionnaire. Vital status was established for 97% of the subjects. Among 1044 women who were examined an average of 101 times with X-ray fluoroscopies during lung collapse therapy, 55 breast cancers were observed in contrast to 35.8 expected, based on incidence rates from the general population. No excess was found for 698 women treated by other means (19 observed versus 22.8 expected). Excess breast cancer risk did not appear until 15 years after initial exposure and was present at the end of 50 years of observation. Risk appeared to decrease with increasing age at exposure. Estimates of radiation dose to the breast for individuals (mean = 96 rad) were based on the most current information for the numbers of fluoroscopies, reconstruction of exposure conditions, and absorbed dose calculations. The relation between dose and breast cancer risk was consistent with linearity up to 400 rads (4 Gy). For 10-year survivors, the absolute excess risk was 5.5/1 million woman-year-rad, the excess relative risk per rad was 0.73%, and the relative risk at 100 rad was 1.7. These data indicate that a woman's lifetime risk of breast cancer is influenced by events occurring in early reproductive life, that low-dose fractionated exposures are as effective as single exposures of the same total dose in inducing breast cancer, and that risk of radiogenic breast cancer persists for many years, and perhaps for life

Neurobehavioral toxicity of total body irradiation: a follow-up in long-term survivors

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Peper, Martin; Steinvorth, Sarah; Schraube, Peter; Fruehauf, Stefan; Haas, Rainer; Kimmig, Bernhard N.; Lohr, Frank; Wenz, Frederik; Wannenmacher, Michael

2000-01-01

Purpose: Total body irradiation (TBI) in preparation for bone marrow transplantation (BMT) is a routine treatment of hematological malignancy. A retrospective and a prospective group study of long-term cerebral side effects was performed, with a special emphasis on neurobehavioral toxicity effects. Methods and Materials: Twenty disease-free patients treated with hyperfractionated TBI (14.4 Gy, 12 x 1.2 Gy, 4 days), 50 mg/kg cyclophosphamide, and autologous BMT (mean age 38 years, range 17-52 years; age at TBI 35 years, 16-50 years; follow-up time 32 months, 9-65 months) participated in a neuropsychological, neuroradiological, and neurological examination. Data were compared to 14 patients who were investigated prior to TBI. Eleven patients with renal insufficiencies matched for sex and age (38 years, 20-52 years) served as controls. In a longitudinal approach, neuropsychological follow-up data were assessed in 12 long-term survivors (45 years, 23-59 years; follow-up time 8.8 years, 7-10.8 years; time since diagnosis 10.1 years, 7.5-14.2 years). Results: No evidence of neurological deficits was found in post-TBI patients except one case of peripheral movement disorder of unknown origin. Some patients showed moderate brain atrophy. Neuropsychological assessment showed a subtle reduction of memory performance of about one standard deviation. Cognitive decline in individual patients appeared to be associated with pretreatment (brain irradiation, intrathecal methotrexate). Ten-years post disease onset, survivors without pretreatment showed behavioral improvement up to the premorbid level. Conclusion: The incidence of long-term neurobehavioral toxicity was very low for the present TBI/BMT regimen

Risk factors for development of non-specific musculoskeletal pain in preteens and early adolescents: a prospective 1-year follow-up study

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Auvinen Anssi

2007-05-01

Full Text Available Abstract Background Musculoskeletal pain symptoms are common in children and adolescents. These symptoms have a negative impact on children's physical and emotional well-being, but their underlying aetiology and risk factors are still poorly understood. Most of the previous cohort studies were conducted among mid and/or late adolescents and were mainly focused on a specific pain location (e.g. low back pain or neck pain. The purpose of this study is to estimate occurrence of new-onset pain symptoms, in all musculoskeletal locations, in preteens and early adolescents and investigate risk factors for development of these symptoms. Methods 1756 schoolchildren (mean age 10.8 were recruited from schools in southern Finland. Information was extracted as to whether they experienced musculoskeletal pain and a total of 1192 children were identified as free of musculoskeletal pain symptoms. Information was collected on factors which could potentially predict the development of musculoskeletal pain: headache, abdominal pain, sadness/feeling down, day-time tiredness, difficulty in falling asleep, waking up during nights, level of physical activity and hypermobility. These children were followed-up 1-year later and those with new episodes of non-traumatic and traumatic musculoskeletal pain symptoms were identified. Results A total of 1113 schoolchildren (93% of baseline pain-free children were found at one-year follow-up. New episodes of musculoskeletal pain were reported by 21.5% of these children. Of them 19.4% reported non-traumatic pain and 4.0% reported traumatic pain. The neck was the most commonly reported site with non-traumatic pain, while the lower limb was the most common site for traumatic pain. The independent risk factors for non-traumatic musculoskeletal pain were headache (OR = 1.68, [95% CI 1.16–2.44] and day-time tiredness (OR = 1.53, [95% CI 1.03–2.26]. The risk factors for traumatic musculoskeletal pain were vigorous exercise (OR = 3

Efficacy and safety of bariatric surgery for craniopharyngioma-related hypothalamic obesity: a matched case-control study with 2 years of follow-up.

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Wijnen, M; Olsson, D S; van den Heuvel-Eibrink, M M; Wallenius, V; Janssen, J A M J L; Delhanty, P J D; van der Lely, A J; Johannsson, G; Neggers, S J C M M

2017-02-01

Hypothalamic obesity is a devastating consequence of craniopharyngioma. Bariatric surgery could be a promising therapeutic option. However, its efficacy and safety in patients with craniopharyngioma-related hypothalamic obesity remain largely unknown. We investigated the efficacy of bariatric surgery for inducing weight loss in patients with craniopharyngioma-related hypothalamic obesity. In addition, we studied the safety of bariatric surgery regarding its effects on hormone replacement therapy for pituitary insufficiency. In this retrospective matched case-control study, we compared weight loss after bariatric surgery (that is, Roux-en-Y gastric bypass and sleeve gastrectomy) between eight patients with craniopharyngioma-related hypothalamic obesity and 75 controls with 'common' obesity during 2 years of follow-up. We validated our results at 1 year of follow-up in a meta-analysis. In addition, we studied alterations in hormone replacement therapy after bariatric surgery in patients with craniopharyngioma. Mean weight loss after bariatric surgery was 19% vs 25% (difference -6%, 95% confidence of interval (CI) -14.1 to 4.6; P=0.091) at 2 years of follow-up in patients with craniopharyngioma-related hypothalamic obesity compared with control subjects with 'common' obesity. Mean weight loss was 25% vs 29% (difference -4%, 95% CI -11.6 to 8.1; P=0.419) after Roux-en-Y gastric bypass and 10% vs 20% (difference -10%, 95% CI -14.1 to -6.2; P=0.003) after sleeve gastrectomy at 2 years of follow-up in patients with craniopharyngioma-related hypothalamic obesity vs control subjects with 'common' obesity. Our meta-analysis demonstrated significant weight loss 1 year after Roux-en-Y gastric bypass, but not after sleeve gastrectomy. Seven patients with craniopharyngioma suffered from pituitary insufficiency; three of them required minor adjustments in hormone replacement therapy after bariatric surgery. Weight loss after Roux-en-Y gastric bypass, but not sleeve gastrectomy

Relapse from remission at two- to four-year follow-up in two treatments for adolescent anorexia nervosa.

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Le Grange, Daniel; Lock, James; Accurso, Erin C; Agras, W Stewart; Darcy, Alison; Forsberg, Sarah; Bryson, Susan W

2014-11-01

Long-term follow-up studies documenting maintenance of treatment effects are few in adolescent anorexia nervosa (AN). This exploratory study reports relapse from full remission and attainment of remission during a 4-year open follow-up period using a convenience sample of a subgroup of 65% (n = 79) from an original cohort of 121 participants who completed a randomized clinical trial comparing family-based therapy (FBT) and adolescent-focused individual therapy (AFT). Follow-up assessments were completed up to 4 years posttreatment (average, 3.26 years). Available participants completed the Eating Disorder Examination as well as self-report measures of self-esteem and depression at 2 to 4 years posttreatment. Two participants (6.1%) relapsed (FBT: n = 1, 4.5%; AFT: n = 1, 9.1%), on average 1.98 years (SD = 0.14 years) after remission was achieved at 1-year follow-up. Ten new participants (22.7%) achieved remission (FBT: n = 1, 5.9%; AFT: n = 9, 33.3%). Mean time to remission for this group was 2.01 years (SD = 0.82 years) from 1-year follow-up. There were no differences based on treatment group assignment in either relapse from full remission or new remission during long-term follow-up. Other psychopathology was stable over time. There were few changes in the clinical presentation of participants who were assessed at long-term follow-up. These data suggest that outcomes are generally stable posttreatment regardless of treatment type once remission is achieved. Clinical trial registration information-Effectiveness of Family-Based Versus Individual Psychotherapy in Treating Adolescents With Anorexia Nervosa; http://www.clinicaltrials.gov/; NCT00149786. Copyright © 2014 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.

Can follow-up controls improve the confidence of MR of the breast? A retrospective analysis of follow-up MR images of the breast

International Nuclear Information System (INIS)

Betsch, A.; Arndt, E.; Stern, W.; Claussen, C.D.; Mueller-Schimpfle, M.; Wallwiener, D.

2001-01-01

Purpose: To assess the change in diagnostic confidence between first and follow-up dynamic MR examination of the breast (MRM). Methods: The reports of a total of 175 MRM in 77 patients (mean age 50 years; 36-76) with 98 follow-up MRM were analyzed. All examinations were performed as a dynamic study (Gd-DTPA, 0.16 mmol/kg; 6-7 repetitive studies). The change in diagnostic confidence was retrospectively classified as follows: Controlled lesion vanished during follow-up (category I); diagnostic confidence increases during follow-up (II), more likely benign (IIa), more suspicious (IIb); no difference in diagnostic confidence (III). Long-term follow-up over an average of four years was obtained for 57 patients with category IIa/III findings. Results: In 98 follow-up examinations, only two lesions vanished (2%). In 77/98 cases a category IIa lesion was diagnosed, in 11 cases a category IIb lesion. In 8 cases (8%) there was no change in diagnostic confidence during follow-up. Lesions in category IIb underwent biopsy in 10/11 cases, in one case long-term follow-up proved a completely regredient inflammatory change. In 8/11 suspicious findings (IIb) a malignant tumor was detected. The mean time interval between first and follow-up MRM was 8 months for I-IIb lesions, and 4 months for category III lesions. In the longterm follow-up two patients with a category II a lesion developed a carcinoma in a different breast area after four and five years. Conclusion: MRM follow up increases the diagnostic confidence if the time interval is adequate (>4 months). A persistently or increasingly suspicious finding warrants biopsy. (orig.) [de

Chronic fatigue in 812 testicular cancer survivors during long-term follow-up: increasing prevalence and risk factors.

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Sprauten, M; Haugnes, H S; Brydøy, M; Kiserud, C; Tandstad, T; Bjøro, T; Bjerner, J; Cvancarova, M; Fosså, S D; Oldenburg, J

2015-10-01

Chronic fatigue (CF) has been reported to be slightly more prevalent in testicular cancer survivors (TCSs) than in the general population. In this study, we wished to explore possible determinants of CF in TCSs median 12 (survey I) and 19 years (survey II) after treatment, in particular the relation to late effects after treatment. Overall, 812 TCSs treated between 1980 and 1994 provided blood samples (testosterone and luteinizing hormone) and completed questionnaires at survey I (1998-2002) and survey II (2007-2008). Hormone levels were categorized according to quartile thresholds for decadal age groups of controls. Associations between CF and possible risk factors, including the Hospital Anxiety and Depression Scale (HADS), treatment, physical activity, hormone levels, neurotoxicity, and comorbidity, were analyzed by logistic regression. Prevalence of CF increased from 15% at survey I to 27% at survey II (P < 0.001). At survey II, risk for CF was increased three- to four-fold for high levels of neuropathy compared with no neuropathy, and two- to three-fold for high levels of Raynaud-like phenomena, and having testosterone levels in the lowest quartile, while being moderately and highly physically active, had a protective effect. Risk for CF in TCSs with higher levels of HADS-Anxiety and HADS-Depression was increased two- to five-fold, respectively. The increasing prevalence of CF in TCSs is a novel finding. Lifestyle interventions, early detection and treatment of depression and anxiety, and possibly testosterone substitution might reduce the risk of CF. Extended long-term follow-up seems to be important. © The Author 2015. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Risks of fracture of Björk-Shiley 60 degree convexo-concave prosthetic heart valves: long-term cohort follow up in the UK, Netherlands and USA.

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Blot, W J; Omar, R Z; Kallewaard, M; Morton, L S; Fryzek, J P; Ibrahim, M A; Acheson, D; Taylor, K M; van der Graaf, Y

2001-03-01

Approximately 82,000 Björk-Shiley convexo-concave (BSCC) 60 degree prosthetic heart valves were implanted in patients worldwide between 1979 and 1986. Outlet strut fractures (OSF) of some of the valves were first reported shortly after their introduction. Here, the determinants of OSF are examined, and the between-country variation and long-term risk are assessed. Cohorts of patients in the UK, Netherlands and USA with 15,770 BSCC 60 degree heart valves were followed up to 18 years for the occurrence of OSF. Crude rates of OSF were highest in the UK (0.18% per year), intermediate in the Netherlands (0.13%), and lowest in the USA (0.06%), although risk factor adjustment reduced the inter-country differences. Furthermore, in the UK and Netherlands, OSF rates (particularly for mitral valves) declined with time since implantation, and between-country differences were considerably diminished 10 or more years post implantation. The risk of OSF decreased steadily with advancing patient age. Fracture rates were lower among women than men, and also varied significantly with valve size and position and OSF status of other valves in the same shoporder. This long-term follow up of BSCC 60 degree heart valve patients indicates that risk factors for valve fracture are generally similar in the UK, Netherlands and USA. It also identifies a strong association between fracture risk and age, newly reveals gender-related differences, and shows that the risk of valve fracture persisted, albeit at a reduced rate, into the 1990s.

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

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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.

Medicare Under Age 65 and Medicaid Patients Have Poorer Bowel Preparations: Implications for Recommendations for an Early Repeat Colonoscopy.

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Bryan B Brimhall

Full Text Available Colonoscopy is performed on patients across a broad spectrum of demographic characteristics. These characteristics may aggregate by patient insurance provider and influence bowel preparation quality and the prevalence of adenomas. The purpose of this study was to evaluate the association of insurance status and suboptimal bowel preparation, recommendation for an early repeat colonoscopy due to suboptimal bowel preparation, adenoma detection rate (ADR, and advanced ADR (AADR.This is a cohort study of outpatient colonoscopies (n = 3113 at a single academic medical center. Patient insurance status was categorized into five groups: 1 Medicare < 65y; 2 Medicare ≥ 65y; 3 Tricare/VA; 4 Medicaid/Colorado Indigent Care Program (CICP; and 5 commercial insurance. We used multivariable logistic or linear regression modeling to estimate the risks for the association between patient insurance and suboptimal bowel preparation, recommendation for an early repeat colonoscopy due to suboptimal bowel preparation, ADR, and AADR. Models were adjusted for appropriate covariates.Medicare patients < 65y (OR 4.91; 95% CI: 3.25-7.43 and Medicaid/CICP patients (OR 4.23; 95% CI: 2.65-7.65 were more likely to have a suboptimal preparation compared to commercial insurance patients. Medicare patients < 65y (OR 5.58; 95% CI: 2.85-10.92 and Medicaid/CICP patients (OR 3.64; CI: 1.60-8.28 were more likely to receive a recommendation for an early repeat colonoscopy compared to commercial insurance patients. Medicare patients < 65y had a significantly higher adjusted ADR (OR 1.50; 95% CI: 1.03-2.18 and adjusted AADR (OR 1.99; 95% CI: 1.15-3.44 compared to commercial insurance patients.Understanding the reasons for the higher rate of a suboptimal bowel preparation in Medicare < 65y and Medicaid/CICP patients and reducing this rate is critical to improving colonoscopy outcomes and reducing healthcare costs in these populations.

Follow-up of Antihypertensive Therapy Improves Blood Pressure Control: Results of HYT (HYperTension survey) Follow-up.

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Fici, F; Seravalle, G; Koylan, N; Nalbantgil, I; Cagla, N; Korkut, Y; Quarti-Trevano, F; Makel, W; Grassi, G

2017-09-01

Although improved during the past few years, blood pressure control remains sub optimal. The impact of follow-up assessment on blood pressure control was evaluated in a group of patients of the HYT (HYperTension survey), treated with a combination of different dihydropyridine calcium-channel blockers (CCBs regimen) and inhibitors of renin-angiotensin-aldosterone system (RAAS) and with uncontrolled blood pressure. This was obtained assessing (a) the rate of blood pressure control at 3 and 6 months of follow-up in the whole group of patients, (b) the rate of blood pressure control and the average blood pressure values in subjects treated with different DHP-CCBs regimen. From the 4993 patients with uncontrolled blood pressure, (BP ≥ 140/90 or ≥140/85 in patients with diabetes), 3729 (mean age 61.2 ± 11.5 years), maintained CCBs regimen combined wih RAAS blockers and were evaluated at 3 and 6 months follow-up. At each visit BP (semiautomatic device, Omron-M6, 3 measurements), heart rate, adverse events and treatment persistence were collected. At 1st and 2nd follow-up the rate of controlled BP was 63.5 and 72.8% respectively (p blood pressure control; (b) there is no significant difference in the antihypertensive effect between different CCBs regimen; (c) lipophilic CCBs induce less ankle edema.

Enhancing capacity for risk factor surveillance at the regional/local level: a follow-up review of the findings of the Canadian Think Tank Forum after 4 years.

Science.gov (United States)

Choi, Bernard Ck; Decou, Mary Lou; Rasali, Drona; Martens, Patricia J; Mancuso, Michelina; Plotnikoff, Ronald C; Neudorf, Cory; Thanos, Joanne; Svenson, Lawrence W; Denny, Keith; Orpana, Heather; Stewart, Paula; King, Michael; Griffith, Jane; Erickson, Tannis; van Dorp, Renate; White, Deanna; Ali, Amira

2014-01-22

National health surveys are sometimes used to provide estimates on risk factors for policy and program development at the regional/local level. However, as regional/local needs may differ from national ones, an important question is how to also enhance capacity for risk factor surveillance regionally/locally. A Think Tank Forum was convened in Canada to discuss the needs, characteristics, coordination, tools and next steps to build capacity for regional/local risk factor surveillance. A series of follow up activities to review the relevant issues pertaining to needs, characteristics and capacity of risk factor surveillance were conducted. Results confirmed the need for a regional/local risk factor surveillance system that is flexible, timely, of good quality, having a communication plan, and responsive to local needs. It is important to conduct an environmental scan and a gap analysis, to develop a common vision, to build central and local coordination and leadership, to build on existing tools and resources, and to use innovation. Findings of the Think Tank Forum are important for building surveillance capacity at the local/county level, both in Canada and globally. This paper provides a follow-up review of the findings based on progress over the last 4 years.

Maternal mental health predicts risk of developmental problems at 3 years of age: follow up of a community based trial

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Leew Shirley

2008-05-01

Full Text Available Abstract Background Undetected and untreated developmental problems can have a significant economic and social impact on society. Intervention to ameliorate potential developmental problems requires early identification of children at risk of future learning and behaviour difficulties. The objective of this study was to estimate the prevalence of risk for developmental problems among preschool children born to medically low risk women and identify factors that influence outcomes. Methods Mothers who had participated in a prenatal trial were followed up three years post partum to answer a telephone questionnaire. Questions were related to child health and development, child care, medical care, mother's lifestyle, well-being, and parenting style. The main outcome measure was risk for developmental problems using the Parents' Evaluation of Developmental Status (PEDS. Results Of 791 children, 11% were screened by the PEDS to be at high risk for developmental problems at age three. Of these, 43% had previously been referred for assessment. Children most likely to have been referred were those born preterm. Risk factors for delay included: male gender, history of ear infections, a low income environment, and a mother with poor emotional health and a history of abuse. A child with these risk factors was predicted to have a 53% chance of screening at high risk for developmental problems. This predicted probability was reduced to 19% if the child had a mother with good emotional health and no history of abuse. Conclusion Over 10% of children were identified as high risk for developmental problems by the screening, and more than half of those had not received a specialist referral. Risk factors for problems included prenatal and perinatal maternal and child factors. Assessment of maternal health and effective screening of child development may increase detection of children at high risk who would benefit from early intervention. Trial registration Current

Low ficolin-3 levels in early follow-up serum samples are associated with the severity and unfavorable outcome of acute ischemic stroke

DEFF Research Database (Denmark)

Füst, George; Munthe-Fog, Lea; Illes, Zsolt

2011-01-01

demonstrated the significance of MBL in ischemic stroke, the role of ficolins has not been examined. METHODS: Sera were obtained within 12 hours after the onset of ischemic stroke (admission samples) and 3-4 days later (follow-up samples) from 65 patients. The control group comprised 100 healthy individuals......-up samples an inverse correlation was observed between ficolin-3 levels and concentration of S100β, an indicator of the size of cerebral infarct. Patients with low ficolin-3 levels and high CRP levels in the follow up samples had a significantly worse outcome (adjusted ORs 5.6 and 3.9, respectively...

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

DEFF Research Database (Denmark)

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...

Diabetes-related lower-extremity amputation incidence and risk factors: a prospective seven-year study in Costa Rica Incidencia y factores de riesgo de la amputación de extremidades inferiores relacionada con la diabetes: estudio prospectivo de siete años en Costa Rica

Directory of Open Access Journals (Sweden)

Adriana Laclé

2012-09-01

Full Text Available OBJECTIVE: To analyze the incidence and determinants of lower-extremity amputation (LEA in people with diabetes in a low-income community in Costa Rica. METHODS: Data on LEA incidence were collected during a seven-year follow-up (2001-2007 in a diabetes patient cohort (n = 572. Risk factors were analyzed using the Cox proportional hazards regression model and baseline variables from the year 2000 (socio- demographic characteristics, comorbidity, metabolic control, treatment, and chronic microvascular complications. RESULTS: LEA incidence was 6.02 per 1 000 person-years (8.65 in men and 4.50 in women. Known risk factors (sex, years of diabetes, elevated glycated hemoglobin [HbA1c], retinopathy, insulin therapy, and prior amputation were highly significant. CONCLUSIONS: Those most likely to undergo LEA among Costa Rican diabetic patients were men with 10 or more years of diabetes and average HbA1c > 8% who used insulin and had diabetic retinopathy. Patients on insulin therapy were at greatest risk, especially those with a previous amputation. Diabetic patients with the above-mentioned profile should be considered to be at very high risk of LEA and followed closely by the health care system.OBJETIVO: Analizar la incidencia y los determinantes de la amputación de extremidades inferiores (AEI en personas diabéticas de una comunidad con bajos ingresos de Costa Rica. MÉTODOS: Se recopilaron datos sobre la incidencia de la AEI durante un período de seguimiento de siete años (del 2001 al 2007 en una cohorte de pacientes diabéticos (n = 572. Se analizaron los factores de riesgo usando el modelo de regresión de Cox de riesgos proporcionales y los valores de referencia del año 2000 de las variables (características sociodemográficas, comorbilidad, control metabólico, tratamiento y complicaciones microvasculares crónicas. RESULTADOS: La incidencia de la AEI fue de 6,02 por 1 000 personas-año (8,65 en varones y 4,50 en mujeres. Los factores de

Prevalencia y estudio de factores asociados al deterioro cognitivo en personas mayores de 65 años del entorno de la farmacia comunitaria

Directory of Open Access Journals (Sweden)

Climent Catalá MT

2012-09-01

Full Text Available INTRODUCCIÓN El deterioro cognitivo y la demencia en la población anciana constituyen un problema de salud importante por su magnitud y gravedad. Estudios epidemiológicos apoyan la existencia de factores de riesgo de deterioro cognitivo prevenibles: factores vasculares y factores relacionados con el estilo de vida. El objetivo es detectar posibles casos de deterioro cognitivo en mayores de 65 años del entorno de la farmacia y analizar en un estudio posterior la eficacia de un programa de educación sanitaria para mejorar la función cognitiva. MATERIAL Y MÉTODOS Estudio transversal de prevalencia de deterioro cognitivo en personas mayores de 65 años. Los datos aportados en este estudio se obtuvieron de marzo a junio 2011, en cuatro farmacias de la Comunidad Valenciana. Recogemos: “hoja de consentimiento informado”, “registro Dader” y ”cuestionario específico de las variables a estudio”, cuestionario que recoge datos demográficos, de estilos de vida (ejercicio, lectura, sueño, patologías crónicas y tratamiento farmacológico. El test de cribado utilizado es el SPMSQ-Short (Portable Mental State Questionaire de Pfeiffer. Los pacientes con test de Pfeiffer positivo serán considerados casos y participarán posteriormente en un programa de intervención sanitaria de educación en “higiene del sueño”, “ejercicio físico” y “entrenamiento cognitivo”. RESULTADOS Han colaborado 245 pacientes: 97 hombres (40% y 148 mujeres (60%, lo que supone el 76% de los entrevistados. Nivel de estudios: analfabetos 26 (11%, primarios 125 (51%, secundarios 65 (26% y superiores 29 (12%. Presentan puntuación en Pfeiffer compatible con deterioro cognitivo 31 participantes (13%. El deterioro cognitivo es mayor entre los analfabetos (23% y aquellos que cursaron estudios primarios (13%, y menor entre los participantes que cursaron estudios superiores y los que practican diariamente la lectura. Entre los pacientes estudiados, hay una menor

Effects of bioaerosol exposure on respiratory health in compost workers: a 13-year follow-up study.

Science.gov (United States)

van Kampen, V; Hoffmeyer, F; Deckert, A; Kendzia, B; Casjens, S; Neumann, H D; Buxtrup, M; Willer, E; Felten, C; Schöneich, R; Brüning, T; Raulf, M; Bünger, J

2016-12-01

To determine the risk of German compost workers developing chronic respiratory effects from long-term exposure to bioaerosols. Respiratory health was determined in 74 currently exposed compost workers and 37 non-exposed controls after 13 years of follow-up. In addition, 42 former compost workers (drop-outs) who left their work during the follow-up period were also examined. Respiratory symptoms and working conditions were assessed using identical questionnaires as at baseline. In addition, lung function was measured using the same spirometer as in the initial study. Sera from both surveys were tested for specific IgE and IgG antibodies to moulds and the risk of work-related symptoms was evaluated using regression approaches for prospective studies with binary data. In the follow-up period, the number of participants reporting cough significantly increased in compost workers and drop-outs compared to the controls. Working as a compost worker for at least 5 years increased the relative risk for cough (RR 1.28; 95% CI 1.2 to 1.4) and for cough with phlegm (RR 1.32; 95% CI 1.2 to 1.5). Current and former compost workers had slightly lower predicted percentage of forced expiratory volume in 1 s and predicted percentage of forced vital capacity than controls, but decrease in lung function during follow-up was not different among the 3 groups. In addition, no significant changes could be detected in antibody concentrations. Our results suggest that chronic exposure to bioaerosols in composting plants is related to a significantly higher risk for cough with phlegm, indicating chronic bronchitis. However, compost workers showed no higher incidence of deterioration of pulmonary function over the study. 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/.

Behavioral and psychosocial effects of two middle school sexual health education programs at tenth-grade follow-up.

Science.gov (United States)

Markham, Christine M; Peskin, Melissa F; Shegog, Ross; Baumler, Elizabeth R; Addy, Robert C; Thiel, Melanie; Escobar-Chaves, Soledad Liliana; Robin, Leah; Tortolero, Susan R

2014-02-01

An earlier randomized controlled trial found that two middle school sexual education programs-a risk avoidance (RA) program and a risk reduction (RR) program-delayed initiation of sexual intercourse (oral, vaginal, or anal sex) and reduced other sexual risk behaviors in ninth grade. We examined whether these effects extended into 10th grade. Fifteen middle schools were randomly assigned to RA, RR, or control conditions. Follow-up surveys were conducted with participating students in 10th grade (n = 1,187; 29.2% attrition). Participants were 60% female, 50% Hispanic, and 39% black; seventh grade mean age was 12.6 years. In 10th grade, compared with the control condition, both programs significantly delayed anal sex initiation in the total sample (RA: adjusted odds ratio [AOR], .64, 95% confidence interval [CI], .42-.99; RR: AOR, .65, 95% CI, .50-.84) and among Hispanics (RA: AOR, .53, 95% CI, .31-.91; RR: AOR, .82, 95% CI, .74-.93). Risk avoidance students were less likely to report unprotected vaginal sex, either by using a condom or by abstaining from sex (AOR: .61, 95% CI, .45-.85); RR students were less likely to report recent unprotected anal sex (AOR: .34, 95% CI, .20-.56). Both programs sustained positive impact on some psychosocial outcomes. Although both programs delayed anal sex initiation into 10th grade, effects on the delayed initiation of oral and vaginal sex were not sustained. Additional high school sexual education may help to further delay sexual initiation and reduce other sexual risk behaviors in later high school years. Copyright © 2014 Society for Adolescent Health and Medicine. All rights reserved.

Assessment of follow-up sonography and clinical improvement among infants with congenital muscular torticollis.

Science.gov (United States)

Park, H-J; Kim, S S; Lee, S-Y; Lee, Y-T; Yoon, K; Chung, E-C; Rho, M-H; Kwag, H-J

2013-04-01

Infants grow rapidly, which causes the SCM to thicken physiologically. Therefore some cases of physiologically-thickened SCM can be confused with a poor response to physical therapy. There have been only a few quantitative ultrasonographic studies on the clinical outcome of rehabilitation for CMT. Our aim was to evaluate whether a new sonographic assessment method that uses the muscular thickness ratio of the SCM can help quantify the outcome of rehabilitation therapy for patients with CMT. We evaluated 48 patients (male/female, 17:31; mean age, 3.9 months) who were diagnosed with CMT and who underwent initial and follow-up sonography. The ratio of the thickness of the involved SCM to the thickness of the intact SCM (SCM thickness ratio) was calculated. A scoring system based on the range of motion of the neck was used to assess clinical improvement. The correlations between clinical improvement and the thickness of the involved muscle, the difference in involved muscle thickness, the SCM thickness ratio, and the difference in the SCM thickness ratio were evaluated with Spearman rank correlations. Follow-up Cheng scores were higher than initial scores; this difference indicates clinical resolution (follow-up, 4.90; initial, 3.38). The SCM thickness ratio at follow-up was lower than that at the initial evaluation (follow-up, 1.29-1.34; initial, 1.65-1.77). Intra- and interobserver agreements were excellent. Most variables were moderately correlated with clinical improvement (correlation coefficients, 0.36-0.509). R1 showed the highest correlation with clinical improvement (0.481 and 0.509), followed by the initial maximal thickness of the SCM (0.434 and 0.488). ΔP (P1-P2) and ΔR showed similar correlation coefficients with clinical improvement. Measurement of the SCM thickness ratio appears to overcome the problem of a false-positive diagnosis of clinical aggravation of CMT resulting from physiologic growth. R1 and ΔR are accurate objective measurements, which

Technical, economic, environmental and social follow-up of innovating farm-based small methanization plants: BIOGAZ PLUS - Report after a 12-month follow-up; Installation: EARL Guilbaud - Report after a 15-month follow-up; Installation: GAEC Des Buissons - Report after a 12-month follow-up

International Nuclear Information System (INIS)

Lalanne, Mathieu; Cordelier, Marine; Pouech, Philippe; Thual, Julien; Bastide, Guillaume; Faure, Benoit; Faure, Jean-Marie; Bousquet, Dominique; El Habti, Audrey; L'Heriau, Germain; Guianvarch, David; Farcy, Alexandre; Banville, Sandrine; Chauvin, Damien; Frederic, Sylvain; Haumont, Francois; Guilbaud, Gerard; Leroux, Yannick; Tronc, Jean-Sebastien; Menard, Anthony

2015-08-01

This document contains three follow-up reports, each concerning a small farm-based methanization unit. For each one, the report proposes a technical description (operation, provisional exploitation assessment, process principle and implementation, installed instrumentation), describes the status of production (noticed dysfunctions and identified causes, returns on experience), an operation assessment after 12 or 15 months in terms of biological performance (composition of input mixture, methane generation potential, organic load) and energetic performance (biogas, electric, thermal and energetic assessments), an assessment of environmental and social performance (time spent, energy efficiency, greenhouse gas assessment, integration of the installation within the farm, risk and pollution assessment), an economic assessment in terms of investment, of operating statements and of indicators of financial profitability. Results of composition measurements performed on input materials and digestates are provided

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

Science.gov (United States)

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

Six years of following up a glomus jugulare tumor - a case report

Directory of Open Access Journals (Sweden)

Ivanka Štenc Bradvica

2012-02-01

Full Text Available This case report followed up a patient for six years after she had been successfully treated by embolization and gamma knife surgery, while a complete surgical resection was contraindicated because of the high risk of possible mortality outcome. A development of internal hydrocephalus in a subacute postoperative period as a probable postoperative complication related to gamma knife surgery was noted.

Study of excitation of low energy for the low-temperature internal friction in the metallic glass Co35Y65

International Nuclear Information System (INIS)

Jin, Z.; Zou, X.; Liu, F.

1990-01-01

Based on the unified theory of low-frequency fluctuation, dissipation, and relaxation processes, we studied the broad and asymmetric low-temperature internal friction peak of the metallic glass Co 35 Y 65 . This theory, which differs from that of distributed relaxation times, involves only a single relaxation time τ P . By this theory, the calculated infrared-divergence exponent n=0.62, characteristic relaxation time τ ∞ =2x10 -14 s, actual activation energy E A =0.2 eV, and apparent activation energy E * A =0.52 eV. They are in agreement with available experimental results (τ ∞ =2.2x10 -14 s, E A =0.25 eV, and E * A =0.56 eV). Since the composition is very close to that of the intermetallics CoY 2 , the chemical short range order exists partly in the metallic glass Co 35 Y 65 . We notice from the behavior of this peak that it is not caused by the motion of gas atoms dissolved in the sample. From the much smaller radius of a Co atom compared with that of Y, we suggest this peak results from migration of Co atoms to neighboring vacancy with infrared divergence

Long-term follow-up of testicular function following radiation therapy for early-stage Hodgkin's disease

International Nuclear Information System (INIS)

Kinsella, T.J.; Trivette, G.; Rowland, J.; Sorace, R.; Miller, R.; Fraass, B.; Steinberg, S.M.; Glatstein, E.; Sherins, R.J.

1989-01-01

Seventeen male patients with pathological staged I-IIIA1 Hodgkin's disease were followed prospectively for radiation damage to the testes from low-dose scattered irradiation. During conventionally fractionated radiation therapy, the testicular dose ranged from 6 to 70 cGy. Testicular function was measured in a prospective fashion by repeated analyses (every 6 to 12 months) of serum follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone. Patients were also followed by serial semen analyses and by a questionnaire on fertility. The follow-up period ranged from 3 to 7 years after completion of radiation therapy. In patients receiving greater than or equal to 20 cGy, there was a dose-dependent increase in serum FSH values following irradiation, with the maximum difference at 6 months compared with pretreatment levels. All patients showed a return to normal FSH values within 12 to 24 months following irradiation. No significant changes in LH and testosterone were observed in this patient group. Eight patients with a normal pretreatment semen analysis provided serial semen samples and two patients showed transient oligospermia with complete recovery by 18 months following treatment. Four patients have fathered normal offspring following radiation therapy. We conclude that low doses (greater than 20 cGy) of scatter irradiation during treatment for Hodgkin's disease can result in transient injury to the seminiferous tubule as manifested by elevations of FSH for 6 to 24 months following treatment. Below 20 cGy, FSH values remained in the normal range. No evidence of Leydig cell injury (using LH and testosterone) was seen in this dose range (up to 70 cGy). Thus, patients with early-stage Hodgkin's disease can be treated with radiation therapy with little to no risk of irreversible testicular injury. Radiation treatment techniques to shield the testes are discussed

Resultados de un seguimiento educativo a personas con diabetes mellitus tipo 2 y sobrepeso u obesidad Results of educational follow-up of persons with type 2 diabetes mellitus and overweight/obesity

Directory of Open Access Journals (Sweden)

Rosario García

2003-12-01

Full Text Available El presente trabajo muestra los resultados de un seguimiento educativo a personas con diabetes mellitus tipo 2 y sobrepeso corporal u obesidad, realizado como continuidad del estudio latinoamericano PEDNID-LA, con el objetivo de evaluar, en forma prospectiva, los cambios clínicos, bioquímicos y terapéuticos obtenidos después de participar en un programa de educación grupal con metodología interactiva. El estudio incluyó 40 pacientes no insulino dependientes, obesos o en sobrepeso y preferentemente de reciente inicio de la enfermedad, seleccionados en orden cronológico de asistencia a la consulta ambulatoria. Se estableció una consulta interactiva trimestral, donde cuidados y educación se desarrollaban como una unidad, y el contenido educativo iba surgiendo de las necesidades reales y sentidas del grupo, lo que se centró en promover la participación activa del paciente y aumentar la adhesión al tratamiento, con prioridad del plan de alimentación, la actividad física, la reducción del peso corporal y el automonitoreo de glucosa en orina, tal como se había hecho con otros grupos de personas con diabetes. Los conocimientos sobre diabetes se midieron en cuestionarios idénticos diseñados en el protocolo general multicéntrico del estudio PEDNID-LA y aplicados al inicio y final de dicho estudio y a los 4 años del seguimiento interactivo. El resto de las variables fueron valoradas antes, después del año del estudio PEDNID-LA y a los 4 años del seguimiento interactivo. Los datos fueron procesados mediante el uso del programa Epi-Info. Las diferencias estadísticas se determinaron por prueba de Chi cuadrado, y se aceptó p The present paper showed the results of educational follow-up of persons with type 2 diabetes mellitus and overweight/obesity carried out as part of the Latin American study PEDNID-LA, with the objective of prospectively evaluating the clinical, biological and therapeutic changes after their participation in a

Follow-up on Small Abdominal Aortic Aneurysms Using Three Dimensional Ultrasound

DEFF Research Database (Denmark)

Ghulam, Q. M.; Bredahl, K. K.; Lönn, L.

2017-01-01

Objectives Rupture risk in abdominal aortic aneurysms (AAAs) is assessed using AAA diameter; yet 10% of ruptures occur in a small aneurysm. This underlines the inadequacy of diameter as a standalone parameter. In this prospective follow-up study, ultrasound determined aneurysm diameter was compared...... with aneurysm volume determined by three dimensional ultrasound (3D-US) in a group of 179 AAAs. Design This was a prospective cohort study with repeated diameter and volume measurements by 3D-US. Material and methods In total, 179 patients with small infrarenal AAAs (diameter 30–55 mm) were enrolled......L) were recorded. In post-hoc analysis, it was found that more AAAs with a stable diameter and a growing volume than AAAs with a stable diameter and volume were undergoing aortic repair during follow-up, based on the maximum diameter. Conclusion In this cohort of small AAAs, 40% of patients with a stable...

Post-trauma ratings of pre-collision pain and psychological distress predict poor outcome following acute whiplash trauma: A 12-month follow-up study

DEFF Research Database (Denmark)

Carstensen, Tina; Frostholm, Lisbeth; Ørnbøl, Eva

2008-01-01

emergency departments or primary care after car accidents in four counties in Denmark. After the collision patients received a questionnaire on psychological distress, unspecified pain and socio-demographics and 12 months later a follow-up on work capability and neck pain was performed. Risk factors were......Patients with acute whiplash trauma were followed to examine if post-trauma ratings of pre-collision pain and psychological distress were associated with reduced work capability and neck pain at 12 months follow-up. The study included 740 consecutive patients (474 females, 266 males) referred from...... identified by multiple logistic regression analysis. Factors associated with affected work capacity at the 12-month follow-up were pre-collision unspecified pain condition (OR = 2.4, p = 0.002) and socio-demographic characteristics: female gender, low educational level, unemployment and blue collar worker...

Cancer Development Following Childhood Exposure to Ionizing Radiation - 45 Years of Follow-up

International Nuclear Information System (INIS)

Sadetzki, S.; Chetrit, A.; Novikov, I.; Modan, B.

2002-01-01

Between the years 1949 and 1959, the period of mass migration to Israel, more than 20,000 children were treated with radiotherapy for tinea capitis, a benign fungal infection of the scalp. In 1965, our group initiated a comprehensive prospective follow-up in order to determine possible delayed radiation effects among this group. The aim of this study is to update risk of developing cancer by site and to examine the influence of dose, age at irradiation, attained age and latent period on cancer risk, controlling for gender and origin. Description of the Work: The tinea capitis cohort includes 10,834 irradiated subjects, an equal number of non-irradiated population controls, and 5,392 non-irradiated sibling controls. The controls are matched to the irradiated group by sex, age, country of origin and immigration year. Dosimetric studies revealed that the brain received 140 cGy, the thyroid 9 cGy and the breast 1.6 cGy. The present analysis brings the latent period to over 45 years since exposure

Energy-conserving programming of VVI pacemakers: a telemetry-supported, long-term, follow-up study.

Science.gov (United States)

Klein, H H; Knake, W

1990-06-01

Thirty patients with VVI pacemakers (Quantum 253-09, 253-19, Intermedics Inc., Freeport, TX) were observed for a mean of 65 months. Within 12 months after implantation, optimized output programming was performed in 29 patients. This included a decrease in pulse amplitude (22 patients), pulse width (4 patients), and/or pacing rate (11 patients). After 65 months postimplantation, telemetered battery voltage and battery impedance were compared with the predicted values expected when the pulse generator constantly stimulates at nominal program conditions (heart rate 72.3 beats/min, pulse amplitude 5.4 V, pulse width 0.61 ms). Instead of an expected cell voltage of 2.6 V and a cell impedance of 10 k omega mean telemetered values amounted to 2.78 V and 1.4 k omega, respectively. These data correspond to a battery age of 12-15 months at nominal program conditions. This long-term follow-up study suggests that adequate programming will extend battery longevity and thus pulse generator survival in many patients.

Long-term follow-up and outcome in patients with recurrent respiratory laryngeal papillomatosis

DEFF Research Database (Denmark)

Rasmussen, Eva Rye; Schnack, Didde T; Jørkov, Andreas Schjellerup

2017-01-01

adult and four juvenile patients were identified. The male-to-female ratio was 2.4. In the adult population, the mean age at onset was 45 years. The median number of surgeries was four (interquartile range: 2.8). The mean follow-up time was 8.7 years (range: 7 days-30 years). Three cases of malignant...... transformation were observed. In the juvenile population, the mean age of onset was 8.5 years (range: 3-12 years). The mean follow-up time was 11.5 years (range: 2-23 years), and the number of surgeries per year at risk was one/year. CO2-laser and microdebrider were the surgical techniques usually employed. 43...

Information, support, and follow-up offered to women who experienced severe maternal morbidity.

Science.gov (United States)

Furniss, Mary; Conroy, Molly; Filoche, Sara; MacDonald, E Jane; Geller, Stacie E; Lawton, Beverley

2018-06-01

To determine what information, support, and follow-up were offered to women who had experienced severe maternal morbidity (SMM). The present retrospective case review included patients who experienced SMM (admission to intensive care during pregnancy or up to 42 days postpartum) who had previously been reviewed for potential preventability as part of a nationwide New Zealand study performed between January 1 and December 31, 2014. Data were audited to ascertain documented evidence of an event debrief or explanation; referral to social support and/or mental health services; a detailed discharge letter; and a follow-up appointment with a specialist. Of 257 patients who experienced SMM, 23 (8.9%) were offered all four components of care, 99 (38.5%) an event debrief, 102 (39.7%) a referral to social support and/or mental health services, 148 (57.6%) a detailed discharge letter, and 131 (51.0%) a follow-up appointment. Many women who had experienced SMM did not receive explanatory information about their illness, an offer of psychosocial support, or a follow-up appointment prior to discharge from hospital. It is incumbent on clinicians and the maternity care system to improve these aspects of care for all women experiencing a potentially life-changing SMM event to minimize the risk and burden of long-term mental illness. © 2018 International Federation of Gynecology and Obstetrics.

Socioeconomic differences in health check-ups and medically certified sickness absence: a 10-year follow-up among middle-aged municipal employees in Finland.

Science.gov (United States)

Piha, Kustaa; Sumanen, Hilla; Lahelma, Eero; Rahkonen, Ossi

2017-04-01

There is contradictory evidence on the association between health check-ups and future morbidity. Among the general population, those with high socioeconomic position participate more often in health check-ups. The main aims of this study were to analyse if attendance to health check-ups are socioeconomically patterned and affect sickness absence over a 10-year follow-up. This register-based follow-up study included municipal employees of the City of Helsinki. 13 037 employees were invited to age-based health check-up during 2000-2002, with a 62% attendance rate. Education, occupational class and individual income were used to measure socioeconomic position. Medically certified sickness absence of 4 days or more was measured and controlled for at the baseline and used as an outcome over follow-up. The mean follow-up time was 7.5 years. Poisson regression was used. Men and employees with lower socioeconomic position participated more actively in health check-ups. Among women, non-attendance to health check-up predicted higher sickness absence during follow-up (relative risk =1.26, 95% CI 1.17 to 1.37) in the fully adjusted model. Health check-ups were not effective in reducing socioeconomic differences in sickness absence. Age-based health check-ups reduced subsequent sickness absence and should be promoted. Attendance to health check-ups should be as high as possible. Contextual factors need to be taken into account when applying the results in interventions in other settings. 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/.

Sustained safety and efficacy of extended-shelf-life {sup 90}Y glass microspheres: long-term follow-up in a 134-patient cohort

Energy Technology Data Exchange (ETDEWEB)

Lewandowski, Robert J.; Minocha, Jeet; Memon, Khairuddin; Riaz, Ahsun; Gates, Vanessa L.; Ryu, Robert K.; Sato, Kent T.; Omary, Reed; Salem, Riad [Northwestern University, Department of Radiology, Chicago, IL (United States)

2014-03-15

To validate our initial pilot study and confirm sustained safety and tumor response of extended-shelf-life {sup 90}Y glass microspheres. We hypothesized that for the same planned tissue dose, the increase in number of glass microspheres (decayed to the second week of their allowable shelf-life) administered for the same absorbed dose would result in better tumor distribution of the microspheres without causing additional adverse events. Between June 2007 and January 2010, 134 patients underwent radioembolization with extended-shelf-life {sup 90}Y glass microspheres; data from 84 new patients were combined with data from our 50-patient pilot study cohort. Baseline and follow-up imaging and laboratory data were obtained 1 and 3 months after therapy and every 3 months thereafter. Clinical and biochemical toxicities were prospectively captured and categorized according to the Common Terminology Criteria. Response in the index lesion was assessed using WHO and EASL guidelines. The mean delivered radiation dose was 123 Gy to the target liver tissue. The mean increase in number of microspheres with this approach compared to standard {sup 90}Y glass microsphere dosimetry was 103 %, corresponding to an increase from 3.84 to 7.78 million microspheres. Clinical toxicities included fatigue (89 patients, 66 %), abdominal pain (49 patients, 36.6 %), and nausea/vomiting (25 patients, 18.7 %). Grade 3/4 bilirubin toxicity was seen in three patients (2 %). Two (1 %) of the initial 50-patient cohort showed gastroduodenal ulcers; gastroduodenal ulcers were not seen in any of the subsequent 84 patients. According to WHO and EASL guidelines, response rates were 48 % and 57 %, respectively, and 21 % demonstrated a complete EASL response. This study showed sustained safety and efficacy of extended-shelf-life {sup 90}Y glass microspheres in a larger, 134-patient cohort. The increase in number of microspheres administered theoretically resulted in better tumor distribution of the

Measurement of photo-neutron cross sections and isomeric yield ratios in the {sup 89}Y(γ,xn){sup 89-x}Y reactions at the bremsstrahlung end-point energies of 65, 70 and 75 MeV

Energy Technology Data Exchange (ETDEWEB)

Tatari, Mansoureh [Yazd Univ. (Iran, Islamic Republic of). Physics Dept.; Naik, Haladhara [Bhabha Atomic Research Centre, Mumbai (India). Radiochemistry Div.; Kim, Guinyun; Kim, Kwangsoo [Kyungpook National Univ., Daegu (Korea, Republic of). Dept. of Physics; Shin, Sung-Gyun; Cho, Moo-Hyun [Pohang Univ. of Science and Technology (Korea, Republic of). Div. of Advanced Nuclear Engineering

2017-07-01

The flux-weighted average cross sections of the {sup 89}Y(γ,xn; x=1-4){sup 89-x}Y reactions and the isomeric yield ratios of the {sup 87m,g}Y, {sup 86m,g}Y, and {sup 85m,g}Y radionuclides produced in these reactions with the bremsstrahlung end-point energies of 65, 70 and 75 MeV have been determined by an activation and off-line γ-ray spectrometric technique using the 100 MeV electron linac in Pohang Accelerator Laboratory, Korea. The theoretical {sup 89}Y(γ,xn; x=1-4){sup 89-x}Y reaction cross sections for mono-energetic photons have been calculated using the computer code TALYS 1.6. Then the flux-weighted theoretical values were obtained to compare with the present data. The flux-weighted experimental and theoretical {sup 89}Y(γ,xn; x=1-4){sup 89-x}Y reaction cross sections increase very fast from the threshold values to a certain bremsstrahlung energy, where the other reaction channels open up. Thereafter it remains constant a while and then slowly decreases with the increase of cross sections for other reactions. Similarly, the isomeric yield ratios of {sup 87m,g}Y, {sup 86m,g}Y and {sup 85m,g}Y in the {sup 89}Y(γ,xn; x=2-4){sup 89-x}Y reactions from the present work and literature data show an increasing trend from their respective threshold values to a certain bremsstrahlung energy. After a certain point of energy, the isomeric yield ratios increase slowly with the bremsstrahlung energy. These observations indicate the role of excitation energy and its partitioning in different reaction channels.

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

Science.gov (United States)

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

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

Science.gov (United States)

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

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

Science.gov (United States)

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

Mortality of aircraft maintenance workers exposed to trichloroethylene and other hydrocarbons and chemicals: extended follow up

Science.gov (United States)

Radican, Larry; Blair, Aaron; Stewart, Patricia; Wartenberg, Daniel

2009-01-01

Objective To extend follow-up of 14,455 workers from 1990 to 2000, and evaluate mortality risk from exposure to trichloroethylene (TCE) and other chemicals. Methods Multivariable Cox models were used to estimate relative risk for exposed vs. unexposed workers based on previously developed exposure surrogates. Results Among TCE exposed workers, there was no statistically significant increased risk of all-cause mortality (RR=1.04) or death from all cancers (RR=1.03). Exposure-response gradients for TCE were relatively flat and did not materially change since 1990. Statistically significant excesses were found for several chemical exposure subgroups and causes, and were generally consistent with the previous follow up. Conclusions Patterns of mortality have not changed substantially since 1990. While positive associations with several cancers were observed, and are consistent with the published literature, interpretation is limited due to the small numbers of events for specific exposures. PMID:19001957

Developing a useful, user-friendly website for cancer patient follow-up: users' perspectives on ease of access and usefulness.

Science.gov (United States)

Bartlett, Y K; Selby, D L; Newsham, A; Keding, A; Forman, D; Brown, J; Velikova, G; Wright, P

2012-11-01

UK cancer survival has improved, leading to an increase in review patients and pressure on clinics. Use of the Internet for information exchange between patients and healthcare staff may provide a useful adjunct or alternative to traditional follow-up. This study aimed to develop and evaluate a website for use in follow-up cancer care in terms of usability, feasibility and acceptability. A website was developed and underwent iterative amendment following patient usability testing in focus groups. Patients on follow-up completed a Computer and Internet Usage Questionnaire. Internet users consented to a randomised crossover study to complete paper and online questionnaires, browse the website and participate in a website evaluation interview. Patient website use was tracked. Usability: Website changes were made following patient testing (n= 21). Patients would have liked a 'personalized' website with links to their clinical team, out with the scope of this study. Feasibility: The majority of participants (65%) had Internet access. Age remained a differentiating factor. Acceptability: Final evaluation (n= 103) was positive although many would like to maintain face-to-face hospital contact. User involvement in website design can ensure patient needs are met. A website model for follow-up will suit some patients but others will prefer clinical contact. © 2012 Blackwell Publishing Ltd.

Bleb needling outcomes for failed trabeculectomy blebs in Asian eyes: a 2-year follow up.

Science.gov (United States)

Tsai, Andrew S H; Boey, Pui Yi; Htoon, Hla M; Wong, Tina T

2015-01-01

To describe the outcomes of bleb needling in primary glaucoma in an Asian tertiary eye centre over a 2y period. To compare the success rates between primary angle-closure glaucoma (PACG) and primary open angle glaucoma (POAG). Lastly, to identify factors associated with success of bleb needling. This was a retrospective review of 227 patients who underwent bleb needling between June 2009 and June 2011 in Singapore National Eye Centre. The 5-fluorouracil (5-FU) augmented bleb needling was performed either at the slit lamp or in the operating theatre. Repeat bleb needlings were performed as necessary. Complete success was defined as maintenance of intraocular pressure (IOP) ≥6 mm Hg and ≤21 mm Hg, in the absence of further surgery or use of antiglaucoma medication. Qualified success met the above criteria with or without use of antiglaucoma medications. One hundred and seventy-five eyes completed the two-year follow up. Sixty-nine percent of participants had POAG and 31% had PACG. The mean interval between filtering surgery and bleb needling was 299.9±616.4d for POAG and 167.1±272.2d for PACG. Mean needling attempts were 1.9±1.4 and 2±1.6 for POAG and PACG respectively. In general, there was a statistically significant reduction of IOP ranging from 21.9% to 26.8% from month 1 through to month 24. The complete success rates at month 6 were 70.0% for POAG and 65.7% for PACG. At month 12, this decreased to 62.2% for POAG and PACG and at month 24, 57.9% for POAG and 63.0% for PACG respectively. The qualified success rates at month 6 for POAG and PACG were 23.8% and 29.9% respectively, 32.2% and 29.2% at month 12, and 34.7% and 29.6% at month 24. The success rates between POAG and PACG were not significantly different (P>0.05 for complete and qualified success at months 6, 12 and 24). An increased number of needlings and higher pre-needling IOP were associated with failure. The 5-FU augmented bleb needling within one year of trabeculectomy in Asian eyes can

Bleb needling outcomes for failed trabeculectomy blebs in Asian eyes:a 2-year follow up

Directory of Open Access Journals (Sweden)

Andrew S. H. Tsai

2015-08-01

Full Text Available AIM:To describe the outcomes of bleb needling in primary glaucoma in an Asian tertiary eye centre over a 2y period. To compare the success rates between primary angle-closure glaucoma (PACG and primary open angle glaucoma (POAG. Lastly, to identify factors associated with success of bleb needling.METHODS:This was a retrospective review of 227 patients who underwent bleb needling between June 2009 and June 2011 in Singapore National Eye Centre. The 5-fluorouracil (5-FU augmented bleb needling was performed either at the slit lamp or in the operating theatre. Repeat bleb needlings were performed as necessary. Complete success was defined as maintenance of intraocular pressure (IOP ≥6 mm Hg and ≤21 mm Hg, in the absence of further surgery or use of antiglaucoma medication. Qualified success met the above criteria with or without use of antiglaucoma medications.RESULTS:One hundred and seventy-five eyes completed the two-year follow up. Sixty-nine percent of participants had POAG and 31% had PACG. The mean interval between filtering surgery and bleb needling was 299.9±616.4d for POAG and 167.1±272.2d for PACG. Mean needling attempts were 1.9±1.4 and 2±1.6 for POAG and PACG respectively. In general, there was a statistically significant reduction of IOP ranging from 21.9% to 26.8% from month 1 through to month 24. The complete success rates at month 6 were 70.0% for POAG and 65.7% for PACG. At month 12, this decreased to 62.2% for POAG and PACG and at month 24, 57.9% for POAG and 63.0% for PACG respectively. The qualified success rates at month 6 for POAG and PACG were 23.8% and 29.9% respectively, 32.2% and 29.2% at month 12, and 34.7% and 29.6% at month 24. The success rates between POAG and PACG were not significantly different (P>0.05 for complete and qualified success at months 6, 12 and 24. An increased number of needlings and higher pre-needling IOP were associated with failure.CONCLUSION:The5-FU augmented bleb needling within one year

Hospital Stay and Engagement in Outpatient Follow-Up After Alcohol Emergency Detox: A 1-Year Comparison Study.

Science.gov (United States)

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.

15-Year Follow-Up

OpenAIRE

Karjula, Salla; Morin-Papunen, Laure; Auvinen, Juha; Ruokonen, Aimo; Puukka, Katri; Franks, Stephen; Jarvelin, Marjo-Riitta; Tapanainen, Juha S.; Jokelainen, Jari; Miettunen, Jouko; Piltonen, Terhi T.

2017-01-01

Context: Polycystic ovary syndrome (PCOS) is associated with increased psychological distress, obesity and hyperandrogenism being suggested as key promoters. Objectives: To investigate the prevalence of anxiety/depression and their coexistence in women with PCOS/PCOS-related symptoms at ages 31 and 46. The roles of obesity, hyperandrogenism, and awareness of PCOS on psychological distress were also assessed. Design: Population-based follow-up. Setting: Northern Finland Birth Cohort 1966 with ...

Chernobyl cleanup workers from Estonia: follow-up for cancer incidence and mortality

Science.gov (United States)

Rahu, Kaja; Auvinen, Anssi; Hakulinen, Timo; Tekkel, Mare; Inskip, Peter D; Bromet, Evelyn J; Boice, John D; Rahu, Mati

2013-01-01

This study examined cancer incidence (1986–2008) and mortality (1986–2011) among the Estonian Chernobyl cleanup workers in comparison with the Estonian male population. The cohort of 4,810 men was followed through nationwide population, mortality and cancer registries. Cancer and death risks were measured by standardized incidence ratio (SIR) and standardized mortality ratio (SMR), respectively. Poisson regression was used to analyze the effects of year of arrival, duration of stay, and time since return on cancer and death risks. The SIR for all cancers was 1.06 with 95% confidence interval 0.93–1.20 (232 cases). Elevated risks were found for cancers of pharynx, oesophagus, and the joint category of alcohol-related sites. No clear evidence of an increased risk of thyroid cancer, leukaemia, or radiation-related cancer sites combined was apparent. The SMR for all causes of death was 1.02 with 95% confidence interval 0.96–1.08 (1,018 deaths). Excess mortality was observed for mouth and pharynx cancer, alcohol-related cancer sites together, and suicide. Duration of stay rather than year of arrival was associated with increased mortality. Twenty-six years of follow-up of this cohort indicates no definite health effects attributable to radiation, but the elevated suicide risk has persisted. PMID:23532116

Chernobyl cleanup workers from Estonia: follow-up for cancer incidence and mortality

International Nuclear Information System (INIS)

Rahu, Kaja; Tekkel, Mare; Rahu, Mati; Auvinen, Anssi; Hakulinen, Timo; Inskip, Peter D; Bromet, Evelyn J; Boice Jr, John D

2013-01-01

This study examined cancer incidence (1986–2008) and mortality (1986–2011) among the Estonian Chernobyl cleanup workers in comparison with the Estonian male population. The cohort of 4810 men was followed through nationwide population, mortality and cancer registries. Cancer and death risks were measured by standardised incidence ratio (SIR) and standardised mortality ratio (SMR), respectively. Poisson regression was used to analyse the effects of year of arrival, duration of stay and time since return on cancer and death risks. The SIR for all cancers was 1.06 with 95% confidence interval 0.93–1.20 (232 cases). Elevated risks were found for cancers of the pharynx, the oesophagus and the joint category of alcohol-related sites. No clear evidence of an increased risk of thyroid cancer, leukaemia or radiation-related cancer sites combined was apparent. The SMR for all causes of death was 1.02 with 95% confidence interval 0.96–1.08 (1018 deaths). Excess mortality was observed for mouth and pharynx cancer, alcohol-related cancer sites together and suicide. Duration of stay rather than year of arrival was associated with increased mortality. Twenty-six years of follow-up of this cohort indicates no definite health effects attributable to radiation, but the elevated suicide risk has persisted. (paper)

Determinación de la concentración de cadmio en un chocolate colombiano con 65% de cacao y chocolates extranjeros con diferentes porcentajes de cacao

OpenAIRE

Echeverry, A.; Reyes, H.

2016-01-01

Se evaluó de forma cualitativa y cuantitativa la presencia de cadmio en un chocolate amargo con 65% de cacao producido en Colombia y en chocolates extranjeros con diferentes porcentajes de cacao. Para la preparación de las muestras se tomaron 0,5 gramos y se realizó una digestión ácida con ácido nítrico concentrado (HNO3 65%). La determinación del metal se llevó a cabo por medio de la técnica de espectrofotometría de absorción atómica de llama (FAAS). Se determinó el límite de detección (LOD)...

Prevalence of metabolic syndrome and associated factors in women aged 35 to 65 years who were enrolled in a family health program in Brazil.

Science.gov (United States)

Schmitt, Ana Carolina Basso; Cardoso, Maria Regina Alves; Lopes, Heno; Pereira, Wendry Maria Paixão; Pereira, Elaine Cristina; de Rezende, Debora Aparecida Paccola; Guarizi, Rubia Guibo; Dellu, Mayra Cecilia; Oliveira, Jéssica de Moura; Flauzino, Erika; Blümel, Juan E; Aldrighi, José Mendes

2013-04-01

The aims of this study were to estimate the prevalence of metabolic syndrome among women aged 35 to 65 years and to identify associated factors. This was a cross-sectional study. We randomly selected 581 women (aged 35-65 y) from among those enrolled in a family health program in the city of Pindamonhangaba, Brazil. Metabolic syndrome was identified in accordance with the definition of the National Cholesterol Education Program Adult Treatment Panel III. Health conditions and lifestyle habits were evaluated by a survey, and anthropometric measurements were obtained. The prevalence of metabolic syndrome was estimated, and Poisson regression was used to evaluate the associations between metabolic syndrome `and the factors investigated. The prevalence of metabolic syndrome was 42.2% (95% CI, 38.1-46.2). The most common metabolic syndrome component was abdominal obesity (60.6%), followed by low levels of high-density lipoprotein cholesterol (51.3%), high levels of triglycerides (41.4%), high blood pressure (31.7%), and diabetes (13.9%). The following factors were associated with metabolic syndrome: the 45- to 54-year age group (prevalence ratio, 1.54; 95% CI, 1.08-2.01), the 55- to 65-year age group (prevalence ratio, 3.51; 95% CI, 1.49-3.10), hyperuricemia (prevalence ratio, 2.95; 95% CI, 1.15-1.86), and sleep apnea risk (prevalence ratio, 2.41; 95% CI, 1.16-1.82). We found an inverse association between metabolic syndrome and having had more than 5 years of schooling (prevalence ratio, 0.65; 95% CI, 0.65-1.04). The prevalence of metabolic syndrome is high, and the associated clinical factors are hyperuricemia and risk of sleep apnea.

Cancer among Scandinavian women with cosmetic breast implants: a pooled long-term follow-up study.

Science.gov (United States)

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.

Peritoneal inclusion cysts: Changes on follow-up ultrasonography

International Nuclear Information System (INIS)

Kim, Jung Sik; Lee, Jin Hee; Lee, Hee Jung; Lee, Sung Moon; Woo, Seong Ku

2003-01-01

To evaluate the volume change of peritoneal inclusion cysts on the follow-up ultrasonography (US). From March 1995 to May 1999, thirty seven women with ultrasonographically diagnosed peritoneal inclusion cysts were included in this study. Six patients underwent surgery for several reasons. Follow-up ultrasonography was performed 70-456 days (mean=191 days) after initial US examination in 12 of the remaining 31 patient with no further treatment. US was performed with a 3.5 or 4 MHz transabdominal probe in all 18 patients who underwent either surgery or follow-up US, and additional tranvaginal US examination using a 5-7 MHz probe in 15 of 18 patients. The volume change of the cysts was recorded for each US examination. Three cysts (25%) (volume=170 cm 3 , 61 cm 3 , and 38 cm 3 , respectively) were completely resolved on the follow-up US while the other nine cysts showed a decreased volume in seven patients (58%) and increased volume in two patients (17%). Spontaneous regression of peritoneal inclusion cysts is more common than it is believed to be, and ultrasonography may be a useful follow-up examination for peritoneal inclusion cysts.

Long-term follow-up in 128 patients with primary antiphospholipid syndrome: do they develop lupus?

Science.gov (United States)

Gómez-Puerta, José A; Martín, Helena; Amigo, Mary-Carmen; Aguirre, Maria A; Camps, Maria T; Cuadrado, Maria J; Hughes, Graham R V; Khamashta, Munther A

2005-07-01

We retrospectively studied a large cohort of patients with primary antiphospholipid syndrome (APS) from 4 different referral centers to analyze the clinical and serologic features and, specifically, to determine the number of patients going on to develop systemic lupus erythematosus (SLE) or other autoimmune disease after long-term follow-up. The study included 128 unselected patients with primary APS who fulfilled the Sapporo International Criteria from 4 different tertiary hospitals in the United Kingdom, Mexico, and Spain. The patients had attended the referral centers between January 1987 and July 2001. We reviewed clinical and serologic characteristics according to a pre-established protocol. We used univariate analysis with the chi-squared or Fisher exact test and logistic regression to analyze possible factors related to the coexistence of SLE and APS. Ninety-seven female and 31 male patients fulfilled the criteria, with a median age of 42 +/- 12 years (range, 16-79 yr), and with a mean follow-up of 9 +/- 3 years (range, 2-15 yr). The main manifestations included deep vein thrombosis in 62 patients (48%), arterial thrombosis in 63 (49%) patients, pregnancy loss in 177/320 (55%) cases, and pulmonary embolism in 37 (30%) patients. Other clinical manifestations were migraine in 51 (40%) patients, thrombocytopenia in 48 (38%), livedo reticularis in 47 (37%), and valvular disease in 27 (21%). Serologic findings were anticardiolipin antibodies (aCL) IgG positive in 110 (86%) patients, aCL IgM in 36 (39%), lupus anticoagulant in 71 (65%), antinuclear antibodies in 47 (37%), and positive Coombs test in 5 (4%) patients. During the follow-up and after a median disease duration of 8.2 years (range, 1-14 yr), 11 (8%) patients developed SLE, 6 (5%) developed lupus-like disease, and 1 (1%) developed myasthenia gravis. The remaining 110 patients (86%) continued to have primary APS. After the univariate analysis, a family history of lupus, the presence of Raynaud phenomenon

Time will tell: changes in risk perception and the processing of risk information about the Y2K-risk.

NARCIS (Netherlands)

Kuttschreuter, M.; Gutteling, Jan M.

2004-01-01

A field study was performed on the perceived risks related to the Y2K-problem. Two cross-sectional surveys were executed to study whether risk perception regarding the Y2K-problem, the perceived societal and personal capabilities to mitigate the risks, the attitude toward computers and the attitude

Efficacy and Safety of Drug-Eluting Stents in the Real World: 8-Year Follow-Up

Energy Technology Data Exchange (ETDEWEB)

Pellegrini, Denise Oliveira, E-mail: dennizmo@yahoo.com.br; Gomes, Vitor Osório; Lasevitch, Ricardo; Smidt, Luis; Azeredo, Marco Aurélio; Ledur, Priscila; Bodanese, Rodrigo; Sinnott, Leonardo; Moriguchi, Emílio; Caramori, Paulo [Hospital São Lucas PUC, Porto Alegre, RS (Brazil)

2014-09-15

Drug-eluting stents have been used in daily practice since 2002, with the clear advantages of reducing the risk of target vessel revascularization and an impressive reduction in restenosis rate by 50%-70%. However, the occurrence of a late thrombosis can compromise long-term results, particularly if the risks of this event were sustained. In this context, a registry of clinical cases gains special value. To evaluate the efficacy and safety of drug-eluting stents in the real world. We report on the clinical findings and 8-year follow-up parameters of all patients that underwent percutaneous coronary intervention with a drug-eluting stent from January 2002 to April 2007. Drug-eluting stents were used in accordance with the clinical and interventional cardiologist decision and availability of the stent. A total of 611 patients were included, and clinical follow-up of up to 8 years was obtained for 96.2% of the patients. Total mortality was 8.7% and nonfatal infarctions occurred in 4.3% of the cases. Target vessel revascularization occurred in 12.4% of the cases, and target lesion revascularization occurred in 8% of the cases. The rate of stent thrombosis was 2.1%. There were no new episodes of stent thrombosis after the fifth year of follow-up. Comparative subanalysis showed no outcome differences between the different types of stents used, including Cypher®, Taxus®, and Endeavor®. These findings indicate that drug-eluting stents remain safe and effective at very long-term follow-up. Patients in the 'real world' may benefit from drug-eluting stenting with excellent, long-term results.

Adolescents at clinical-high risk for psychosis: Circadian rhythm disturbances predict worsened prognosis at 1-year follow-up.

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Lunsford-Avery, Jessica R; Gonçalves, Bruno da Silva Brandão; Brietzke, Elisa; Bressan, Rodrigo A; Gadelha, Ary; Auerbach, Randy P; Mittal, Vijay A

2017-11-01

Individuals with psychotic disorders experience disruptions to both the sleep and circadian components of the sleep/wake cycle. Recent evidence has supported a role of sleep disturbances in emerging psychosis. However, less is known about how circadian rhythm disruptions may relate to psychosis symptoms and prognosis for adolescents with clinical high-risk (CHR) syndromes. The present study examines circadian rest/activity rhythms in CHR and healthy control (HC) youth to clarify the relationships among circadian rhythm disturbance, psychosis symptoms, psychosocial functioning, and the longitudinal course of illness. Thirty-four CHR and 32 HC participants were administered a baseline evaluation, which included clinical interviews, 5days of actigraphy, and a sleep/activity diary. CHR (n=29) participants were re-administered clinical interviews at a 1-year follow-up assessment. Relative to HC, CHR youth exhibited more fragmented circadian rhythms and later onset of nocturnal rest. Circadian disturbances (fragmented rhythms, low daily activity) were associated with increased psychotic symptom severity among CHR participants at baseline. Circadian disruptions (lower daily activity, rhythms that were more fragmented and/or desynchronized with the light/dark cycle) also predicted severity of psychosis symptoms and psychosocial impairment at 1-year follow-up among CHR youth. Circadian rhythm disturbances may represent a potential vulnerability marker for emergence of psychosis, and thus, rest/activity rhythm stabilization has promise to inform early-identification and prevention/intervention strategies for CHR youth. Future studies with longer study designs are necessary to further examine circadian rhythms in the prodromal period and rates of conversion to psychosis among CHR teens. Copyright © 2017. Published by Elsevier B.V.

Lack of gene-diuretic interactions on the risk of incident gout: the Nurses' Health Study and Health Professionals Follow-up Study.

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Bao, Ying; Curhan, Gary; Merriman, Tony; Plenge, Robert; Kraft, Peter; Choi, Hyon K

2015-07-01

Diuretic-induced gout might occur only among those with a genetic predisposition to hyperuricaemia, as suggested by a recent study with 108 self-reported gout cases. We examined the role of urate genes on the risk of diuretic-induced incident gout in 6850 women from the Nurses' Health Study (NHS) and in 4223 men from the Health Professionals Follow-up Study (HPFS). Two published genetic risk scores (GRSs) were calculated using urate-associated single-nucleotide polymorphisms for 8 (GRS8) and 29 genes (GRS29). Our analyses included 727 and 354 confirmed incident gout cases in HPFS and NHS, respectively. The multivariate relative risk (RR) for diuretic use was 2.20 and 1.69 among those with GRS8 0.20) and in our analyses limited to those with hypertension in both cohorts. SLC22A11 (OAT4) showed a significant interaction only among women but in the opposite direction to the recent study. In these large prospective studies, individuals with a genetic predisposition for hyperuricaemia are not at a higher risk of developing diuretic-induced gout than those without. 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.

{sup 18}F-FDG PET/CT to assess response and guide risk-stratified follow-up after chemoradiotherapy for oropharyngeal squamous cell carcinoma

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Bird, Thomas; Lei, Mary; Guerrero Urbano, Teresa [Guy' s and St Thomas' NHS Foundation Trust, Department of Clinical Oncology, London (United Kingdom); Barrington, Sally [King' s College, PET Imaging Centre at St Thomas' Hospital, London (United Kingdom); Thavaraj, Selvam [Guy' s and St Thomas' NHS Foundation Trust, Head and Neck Pathology Department, London (United Kingdom); Jeannon, Jean-Pierre; Lyons, Andrew; Oakley, Richard; Simo, Ricard [Guy' s and St Thomas' NHS Foundation Trust, Department of Head and Neck Surgery, London (United Kingdom)

2016-07-15

To evaluate the use of {sup 18}F-FDG PET/CT as the principal investigation to assess tumour response, to determine the need for further surgery and to guide follow-up following radical chemoradiotherapy for stage III/IV oropharyngeal squamous cell carcinoma (OPSCC). A retrospective analysis was undertaken in 146 patients treated at our centre with radical chemoradiotherapy for OPSCC and who had a PET/CT scan to assess response. According to the PET/CT findings, patients were divided into four groups and recommendations: (1) complete metabolic response (enter clinical follow-up); (2) low-level uptake only (follow-up PET/CT scan in 12 weeks); (3) residual uptake suspicious for residual disease (further investigation with or without neck dissection); and (4) new diagnosis of distant metastatic disease (palliative treatment options). The initial PET/CT scan was performed at a median of 12.4 weeks (range 4.3 - 21.7 weeks) following treatment. Overall sensitivity and specificity rates were 92.0 % (74.0 - 99.0 %) and 85 % (77.5 - 90.9 %). Of the 146 patients, 90 (62 %) had a complete response and had estimated 3-year overall and disease-free survival rates of 91.9 % (85.6 - 98.2 %) and 85.6 % (78.0 - 93.2 %), respectively, 17 (12 %) had residual low-level uptake only (with two having confirmed residual disease on subsequent PET/CT, both surgically salvaged), 30 (21 %) had suspicious residual uptake (12 proceeded to neck dissection; true positive rate at surgery 33 %). HPV-positive patients with reassuring PET/CT findings had an estimated 3-year progression-free survival rate of 91.7 % (85.2 - 98.2 %), compared with 66.2 % (41.5 - 90.9 %) of HPV-negative patients. A strategy of using PET/CT results alongside clinical examination to help select patients for salvage surgery appears successful. Despite a complete response on the 12-week PET/CT scan, HPV-negative patients have a significant risk of disease relapse in the following 2 years and further studies to assess whether

The metabolic syndrome and its components in 178 patients treated for craniopharyngioma after 16 years of follow-up.

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Wijnen, Mark; Olsson, Daniel S; van den Heuvel-Eibrink, Marry M; Hammarstrand, Casper; Janssen, Joseph A M J L; van der Lely, Aart-Jan; Johannsson, Gudmundur; Neggers, Sebastian J C M M

2018-01-01

Patients with craniopharyngioma are at an increased risk for cardio- and cerebrovascular mortality. The metabolic syndrome (MetS) is an important cardiometabolic risk factor, but barely studied in patients with craniopharyngioma. We aimed to investigate the prevalence of and risk factors for the MetS and its components in patients with craniopharyngioma. Cross-sectional study with retrospective data. We studied the prevalence of and risk factors for the MetS and its components in 110 Dutch (median age 47 years, range 18-92) and 68 Swedish (median age 50 years, range 20-81) patients with craniopharyngioma with ≥3 years of follow-up (90 females (51%); 83 patients with childhood-onset craniopharyngioma (47%); median follow-up after craniopharyngioma diagnosis 16 years (range 3-62)). In Dutch patients aged 30-70 years and Swedish patients aged 45-69 years, we examined the prevalence of the MetS and its components relative to the general population. Sixty-nine (46%) of 149 patients with complete data demonstrated the MetS. Prevalence of the MetS was significantly higher in patients with craniopharyngioma compared with the general population (40% vs 26% ( P  < 0.05) for Dutch patients; 52% vs 15% ( P  < 0.05) for Swedish patients). Multivariable logistic regression analysis identified visual impairment as a borderline significant predictor of the MetS (OR 2.54, 95% CI 0.95-6.81; P  = 0.06) after adjustment for glucocorticoid replacement therapy and follow-up duration. Age, female sex, tumor location, radiological hypothalamic damage, 90 Yttrium brachytherapy, glucocorticoid replacement therapy and follow-up duration significantly predicted components of the MetS. Patients with craniopharyngioma are at an increased risk for the MetS, especially patients with visual impairment. © 2018 European Society of Endocrinology.

Predictors of Standard Follow-Up Completion after Sexual Exposure to HIV: Five-Year Retrospective Analysis in a French HIV-Infection Care Center.

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Pierre Gantner

Full Text Available The care of exposed individuals to HIV remains a challenge regarding follow-up completion and HIV-testing of the partner. Identifying patients with risk of not fulfilling HIV-testing follow-up completion (FC, among patients demanding non-occupational post-exposure prophylaxis (nPEP, may improve clinical practice.A retrospective chart review was conducted in a single French HIV-infection care center. FC predictors were assessed in a multivariate logistic regression model (Likelihood ratios test.Between 2009 and 2013, 646 sexual exposures to HIV were evaluated for nPEP, of which 507 effectively received nPEP (78%. FC rate was 30% (194/646. In the multivariate analysis, FC rates rose with age of exposed individuals (OR, 1.04 [0.25-4.28]; p<0.001 and decreased with the year of sexual exposure (OR, 0.74 [0.65-0.85]; p<0.001. FC was associated with sexual encounter with a sex worker (OR, 4.07 [0.98-16.82]; p<0.001 and nPEP use (OR, 2.69 [2.37-3.06]; p<0.001. nPEP early discontinuation was associated with decreased FC rates (OR, 0.18 [0.08-0.39]; p<0.001. No documented nPEP failure was identified. However, five Men who have Sex with Men (MSM nPEP recipients for unprotected anal receptive intercourse subsequently seroconverted to HIV more than 6 months after nPEP. Seroconversion to HIV was associated with the lack of FC (p = 0.04 and multiple presentations for nPEP over the study period (p = 0.002.We identified significant predictors of not fulfilling sequential HIV-testing. They appear to be linked with a self-perceived HIV risk, especially in young adults recently exposed. Enhanced counseling in targeted individuals with high risk behaviors and using smartphone and internet-based strategies may be interesting retention in care options.

Development and evaluation of radiographer led telephone follow up following radical radiotherapy to the prostate. A report of a Macmillan Cancer Support Sponsored Pilot project at Mount Vernon Hospital

International Nuclear Information System (INIS)

Verma, R.; Treasure, P.; Hughes, R.

2015-01-01

Radiotherapy for localised prostate cancer is an effective and well tolerated treatment. Following radiotherapy, most men are followed up either in doctor or specialist nurse led hospital outpatient clinics. Attending clinics may be of little personal benefit as the majority of patients have few ongoing symptoms post radiotherapy and have very good cancer prognoses. Recognising the limitations outpatient clinic follow up, we developed a radiographer led model of remote telephone follow up of patients completing radiotherapy for low to intermediate risk prostate cancer. Standardised toxicity assessments were performed and patient satisfaction assessed. Radiographer led follow up detected similar levels of post radiotherapy GI, GU and sexual toxicity as outpatient clinic appointments, with a very high level of patient satisfaction compared to routine outpatient clinics. We believe that radiographer led telephone follow up provides an alternative model for long term follow up of men after prostate radiotherapy

Follow-up care for breast cancer survivors: improving patient outcomes

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Chopra I

2014-08-01

Full Text Available Ishveen Chopra,1 Avijeet Chopra2 1Department of Pharmacy Administration, Duquesne University, Pittsburgh, PA, USA; 2Department of Molecular and Cell Biology, University of Connecticut, Storrs, CT, USA Background: Appropriate follow-up care is important for improving health outcomes in breast cancer survivors (BCSs and requires determination of the optimum intensity of clinical examination and surveillance, assessment of models of follow-up care such as primary care-based follow-up, an understanding of the goals of follow-up care, and unique psychosocial aspects of care for these patients. The objective of this systematic review was to identify studies focusing on follow-up care in BCSs from the patient's and physician's perspective or from patterns of care and to integrate primary empirical evidence on the different aspects of follow-up care from these studies. Methods: A comprehensive literature review and evaluation was conducted for all relevant publications in English from January 1, 1990 to December 31, 2013 using electronic databases. Studies were included in the final review if they focused on BCS’s preferences and perceptions, physician's perceptions, patterns of care, and effectiveness of follow-up care. Results: A total of 47 studies assessing the different aspects of follow-up care were included in the review, with a majority of studies (n=13 evaluating the pattern of follow-up care in BCSs, followed by studies focusing on BCS's perceptions (n=9 and preferences (n=9. Most of the studies reported variations in recommended frequency, duration, and intensity of follow-up care as well as frequency of mammogram screening. In addition, variations were noted in patient preferences for type of health care provider (specialist versus non-specialist. Further, BCSs perceived a lack of psychosocial support and information for management of side effects. Conclusion: The studies reviewed, conducted in a range of settings, reflect variations in

High correlation between quantitative ultrasound and DXA during 7 years of follow-up

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Trimpou, Penelope [Section for Endocrinology, Department of Internal Medicine, Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, SE-41345 Goeteborg (Sweden)], E-mail: pinelopi.trimpou@vgregion.se; Bosaeus, Ingvar [Department for Clinical Nutrition, Sahlgrenska University Hospital, Goeteborg (Sweden)], E-mail: ingvar.bosaeus@nutrition.gu.se; Bengtsson, Bengt-Ake [Section for Endocrinology, Department of Internal Medicine, Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, SE-41345 Goeteborg (Sweden)], E-mail: bengt-ake.bengtsson@medic.gu.se; Landin-Wilhelmsen, Kerstin [Section for Endocrinology, Department of Internal Medicine, Sahlgrenska University Hospital at Sahlgrenska Academy, University of Gothenburg, SE-41345 Goeteborg (Sweden)], E-mail: kerstin.landin@sahlgrenska.se

2010-02-15

Ultrasound is a quick, cheap and non-radiating device for assessing bone quality. We wanted to validate the method for clinical and epidemiological use. Eighty women, aged 53-73 years, with osteoporosis and/or fractures were followed repeatedly during 7 years. Quantitative ultrasound (QUS) measurements (LUNAR Achilles) were compared with bone mineral density (BMD) and bone mineral content (BMC) estimated by DXA (LUNAR) in regions of interest. Changes in the speed of sound, broadband ultrasound attenuation and stiffness were positively correlated with changes in BMD and BMC in all regions measured with DXA (r = 0.20-0.53; p = 0.09 to <0.0001). The QUS t-score at the left heel was positively correlated with the t-score at the right heel (r = 0.90, p < 0.0001). The DXA t-score of the left vs. the right femur was also positively correlated (r = 0.72-0.86; p < 0.0001). A t-score < -2.5 S.D. was found in 70% and 56% at baseline, and 74% and 65% at follow-up measured with QUS and DXA, respectively. The mean sensitivity of QUS vs. DXA was 79% and the mean specificity 45% over a 7-year period. A QUS t-score of <-3.65 S.D. was consistent with a DXA t-score of <-2.5 S.D. In conclusion, QUS was well correlated with DXA in all regions over the 7-year period. QUS can be used in settings without access to DXA and in epidemiological studies. The sensitivity was high but the specificity was low, implicating that DXA, if available, is recommended before treatment for osteoporosis. However, treatment can be started without DXA at a QUS t-score < -3.65 S.D., and especially in the presence of fractures.

Forty-five-year follow-up on the renal function after spinal cord injury

DEFF Research Database (Denmark)

Elmelund, M; Oturai, P S; Toson, B

2016-01-01

rate (GFR) ⩽75% of expected according to age and gender) was 58%. The cumulative risk of severe renal deterioration (functional distribution outside 30-70% on renography or relative GFR⩽51%) was 29% after 45 years postinjury. Only dilatation of UUT and renal/ureter stone requiring removal significantly...... increased the risk of moderate and severe renal deterioration. CONCLUSION: Renal deterioration occurs at any time after injury, suggesting that lifelong follow-up examinations of the renal function are important, especially in patients with dilatation of UUT and/or renal/ureter stones....

Immunological follow-up of hydatid cyst cases

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Bulut Vedat

2001-01-01

Full Text Available Hydatid disease is caused by Echinococcus granulosus. In this study, we aimed to investigate the benefit of monitoring cases with hydatid cyst by means of immune components in patients in a long-term follow-up after surgery. Eighty-four preoperative and postoperative serum samples from 14 cases undergoing surgery for hydatid disease were evaluated in terms of immune parameters, such as total and specific IgE, IgG, IgM, IgA and complement. Total and specific IgE were determined by ELISA. Specific IgG levels were measured by indirect hemaglutination.Total IgG, IgM, IgA and complement (C3 and C4 were detected by nephelometry. Imaging studies were also carried out during the follow-up. In none of the patients hydatid cysts were detected during the follow-up. Total IgE levels in the sera of the patients decreased to normal six months after surgery. Although specific IgE against echinococcal antigens decreased one year after operation, levels were still significantly high. There were no changes in the levels of anti-Echinococcus IgG and total IgG in follow-up period. Additionally, other parameters, such as IgA, IgM, C3 and C4, were not affected.

[Hysteroscopic fallopian tube sterilization procedure: feasibility and one-year follow-up].

Science.gov (United States)

Gibon, E; Lopès, P; Linet, T; Martigny, H; Orieux, C; Philippe, H-J

2006-03-01

Hysteroscopic flexible micro-insert (Essure) is an ambulatory improvement of fallopian tube sterilization, which is a deliberated suppression of fertility. The aim of this study was an evaluation of feasibility (learning curve) and the first year outcome of this method. This prospective study, carried out between February 2002 and March 2003, included patients who were matching with manufacturer recommendations. One surgeon only realized all the device placements. Fifty patients were included (one year follow-up). Mean age was 41 (+/-3.3), mean parity was 2.7 (+/-0.8). Mean time needed for device placement was 26 minutes (+/-6.5) and was reduced with increased experience. Six failures of placement (12%) were related, because of submucus leiomyomas, proximal tubal stenotic disease or too retroverted uterus. Only 5 patients (11,4%) described intensive pelvic pain during the placement. The only case of device expulsion benefited from a successful second placement. The one-year follow-up showed no significant difference of body weight increasing, duration or quantity of menstruation, neither significant pelvic pain nor vaginal bleeding. Tolerance was rated at least at "somewhat satisfied". There have been no pregnancies reported in 670 woman-months of effectiveness. Our results agree in any point with those of larger studies. We think that hysteroscopy micro-insert placement is not only reserved to specialized centers but also to any gynecologist who is used to performing hysteroscopy because of its feasibility.

Structured nursing follow-up: does it help in diabetes care?

Science.gov (United States)

Shani, Michal; Nakar, Sasson; Lustman, Alex; Lahad, Amnon; Vinker, Shlomo

2014-01-01

In 1995 Clalit Health Services introduced a structured follow-up schedule, by primary care nurses, of diabetic patients. This was supplementary care, given in addition to the family physician's follow-up care. This article aims to describe the performance of diabetes follow-up and diabetes control in patients with additional structured nursing follow-up care, compared to those patients followed only by their family physician. We randomly selected 2,024 type 2 diabetic subjects aged 40-76 years. For each calendar year, from 2005-2007, patients who were "under physician follow-up only" were compared to those who received additional structured nursing follow-up care. Complete diabetes follow-up parameters including: HbA1c, LDL cholesterol, microalbumin, blood pressure measurements and fundus examination. The average age of study participants was 60.7 years, 52% were females and 38% were from low socioeconomic status (SES). In 2005, 39.5% of the diabetic patients received structured nursing follow-up, and the comparable figures for 2006 and 2007 were 42.1% 49.6%, respectively. The intervention subjects tended to be older, from lower SES, suffered from more chronic diseases and visited their family physician more frequently than the control patients. Patients in the study group were more likely to perform a complete diabetes follow-up plan: 52.8% vs. 21.5% (2005; p nursing follow-up care were more likely to perform complete diabetes follow-up protocol. Our results reinforce the importance of teamwork in diabetic care. Further study is required to identify strategies for channeling the use of the limited resources to the patients who stand to benefit the most.

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

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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.

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

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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

New methods for estimating follow-up rates in cohort studies

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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

99MTc - DMSA renal scintigraphy in the diagnosis and follow-up of acute pyelonephritis in children

International Nuclear Information System (INIS)

Wallin, L.

1997-06-01

The aim of the present thesis was to define and evaluate a strategy for identification of children who are at risk of developing progressive renal lesions after acute pyelonephritis. Qualitative and quantitative evaluation standards were elaborated to improve the interpretation of DMSA scintigraphy. The normal DMSA distribution pattern, the average background uptake, and scintigraphic kidney length according to age were assessed in 95 presumably healthy kidneys. Furthermore, typical DMSA distribution patterns in acute pyelonephritis were assessed on 65 kidneys in 38 children, and typical DMSA distribution patterns of 152 kidneys with VUR in 101 children with and without previous pyelonephritis. Measurement of scintigraphic kidney length, width and volume was validated in piglets and on a kidney phantom. The scintigraphic kidney length was found to be an accurate measure of renal size, whereas kidney width and volume were less reliable, at least on small kidneys. Criteria of kidney swelling in acute pyelonephritis were defined, and found to be beneficial for identifying reinfections in the absence of clinical symptoms. In 34 children with acute pyelonephritis quantitative and qualitative DMSA scintigraphic findings were correlated to clinical symptoms and laboratory data, in the acute stage and at follow up. We found that quantitative DMSA scintigraphy in the acute stage of pyelonephritis and again after one year will identify children who are at risk of developing progressive renal lesions. Qualitative assessment of DMSA distribution pattern is not reliable enough in this respect. 116 refs., 7 figs

Cardiac rehabilitation with a nurse case manager (GoHeart) across local and regional health authorities improves risk factors, self-care and psychosocial outcomes. A one-year follow-up study.

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Hansen, Vibeke Brogaard; Maindal, Helle Terkildsen

2014-01-01

In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR). The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM). A one-year follow-up study. A CR programme (GoHeart) was evaluated in a cohort at Lillebaelt Hospital Vejle, DK from 2010 to 2011. Consecutive patients admitted to CR were included. The inclusion criteria were the event of acute myocardial infarction or stable angina and invasive revascularization (left ventricular ejection fraction (LVEF) ≥45%). Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS)) were assessed at admission (phase IIa), at three months at discharge (phase IIb) and at one-year follow-up (phase III). Intention-to-treat and predefined subgroup analysis on sex was performed. Of 241 patients, 183 (75.9%) were included (mean age 63.8 years). At discharge improvements were found in total-cholesterol (p management (p < 0.001), Health status Short Form 12 version (SF12; physical; p < 0.001 and mental; p < 0.01) and in depression symptoms (p < 0.01). At one-year follow-up these outcomes were maintained; additionally there was improvement in body mass index (BMI; p < 0.05), and high density lipoprotein (HDL; p < 0.05). There were no sex differences. CR shared between local and regional health authorities led by a NCM (GoHeart) improves risk factors, self-care and psychosocial factors. Further improvements in most variables were at one-year follow-up.

Post-Flight Back Pain Following International Space Station Missions: Evaluation of Spaceflight Risk Factors

Science.gov (United States)

Laughlin, M. S.; Murray, J. D.; Wear, M. L.; Van Baalen, M.

2016-01-01

contribution to post-flight cases. Prior history of back pain included back pain recorded in the medical record within 3 years prior to launch. Landing vehicle was included in the model to discern if more astronauts experienced back pain or injury following a Shuttle or Soyuz landing. Onboard exercise countermeasures were noted for those astronauts who had a mission following 2009 deployment of the Advanced Resistive Exercise Device (aRED) (EXP 19 to 41). T-test and chi-squared tests were performed to evaluate the association between each individual risk factor and post-flight case. Logistic regression was used to evaluate the combined contribution of all the risk factors on post-flight cases. Separate models were calculated for cases reported by R + 45 and R + 1y. RESULTS During the study time period, there were 13 post-flight cases reported by R + 45 and an additional 5 reported by R + 1y. Most of these cases have been reported since EXP 19 with 10 cases by R + 45 and 4 by R + 1y. Individual risk factors of age, sex, landing vehicle, and prior military service were not significantly associated with post-flight cases identified at R + 45 or R + 1y (p greater than 0.05). Having back pain or injury within 3 years prior to launch significantly increased the likelihood of becoming a case by R + 1y (p = 0.041), but not at R+45 (p=0.204). Additionally, astronauts who experienced onboard exercise countermeasures that included aRED had a significantly increased risk of becoming a case at R + 45 (p = 0.024) and R + 1y (p=0.003). Multiple logistic regression evaluating all the risk factors for cases identified no significant risk factors at either the R + 45 or R + 1y time period (p greater than 0.05). Overall model fit was poor for both the R + 45 (R(exp 2) = 0.132) and R + 1y (R(exp 2) = 0.186) cases showing that there are risk factors not represented in our model. CONCLUSIONS Regardless of cause, post-flight cases are reported more often since aRED was deployed in 2009. This may

Comparing the effects of education using telephone follow-up and smartphone-based social networking follow-up on self-management behaviors among patients with hypertension.

Science.gov (United States)

Najafi Ghezeljeh, Tahereh; Sharifian, Sanaz; Nasr Isfahani, Mehdi; Haghani, Hamid

2018-03-05

Little is known about the benefits of social networks in the management of patients. The aim of this study was to compare the effects of self-management (SM) education using telephone follow-up and mobile phone-based social networking on SM behaviors among patients with hypertension. This randomized clinical trial was conducted with 100 patients. They were randomly allocated to four groups: (i) control, (ii) SM training without follow-up, (iii) telephone follow-up and (iv) smartphone-based social networking follow-up. The hypertension SM behavior questionnaire was used for data collection before and six weeks after the study. Those patients who underwent SM education training (with and without follow-up) had statistically significant differences from those in the control group in terms of SM behaviors (p social networking follow-up influenced SM behaviors among patients with hypertension.

Edad avanzada y factores de riesgo para infarto agudo de miocardio Risk factors for acute myocardial infarction in the elderly

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M. A. Ciruzzi

2002-12-01

Full Text Available Este estudio caso-control analizó en los sujetos añosos el rol de los factores de riesgo coronario en el desarrollo del infarto agudo de miocardio (IAM, estableció la naturaleza de esta asociación y el grado de riesgo. Los datos fueron obtenidos en una investigación que incluyó 1060 casos y 1071 controles, realizada en 35 unidades coronarias de centros médicos de Argentina entre noviembre de 1991 y agosto de 1994. Nuestro análisis se basó en la información de los sujetos mayores de 65 años. Los casos fueron 427 pacientes con un primer IAM. Los controles fueron 396 sujetos sin evidencias clinicas de enfermedad cardiovascular, seleccionados en los mismos centros que los casos. Los Odds Ratios (OR y su intervalo de confianza del 95% (IC 95% se obtuvieron mediante un análisis de regresión logística, incluyendo variables como la edad, educación, clase social, tabaquismo, antecedente de diabetes o hipertensión arterial, índice de masa corporal e historia familiar de enfermedad coronaria. Los factores de riesgo relacionados independientemente con IAM fueron los siguientes: hipercolesterolemia (colesterol sérico > 240 mg/dl: OR=1.76 (IC 95%: 1.25-2.49, tabaquismo: OR=1.6 (IC 95%: 1.06-2.4, hipertensión arterial: OR=2.05 (IC 95%: 1.51-2.73, diabetes OR=1.71 (IC 95%: 1.12-2.70, historia de un familiar con enfermedad coronaria: OR=1.36 (IC 95%: 0.93-1.97 y de dos o más familiares: OR=2.63 (IC 95%: 1.21-5.71. Este estudio, confirma en los sujetos de edad avanzada la importancia de la hipercolesterolemia, del tabaquismo, la hipertesión arterial, la diabetes y la historia familiar de enfermedad coronaria como factores de riesgo de IAMThis case-control study, analized the role of coronary risk factors in acute myocardial infarction (AMI in the elderly, and established the nature of this association and the degree of risk. Data were derived from an investigation (1060 cases and 1071 controls conducted in 35 coronary care units from clinical

Validity Assessment of Low-risk SCORE Function and SCORE Function Calibrated to the Spanish Population in the FRESCO Cohorts.

Science.gov (United States)

Baena-Díez, José Miguel; Subirana, Isaac; Ramos, Rafael; Gómez de la Cámara, Agustín; Elosua, Roberto; Vila, Joan; Marín-Ibáñez, Alejandro; Guembe, María Jesús; Rigo, Fernando; Tormo-Díaz, María José; Moreno-Iribas, Conchi; Cabré, Joan Josep; Segura, Antonio; Lapetra, José; Quesada, Miquel; Medrano, María José; González-Diego, Paulino; Frontera, Guillem; Gavrila, Diana; Ardanaz, Eva; Basora, Josep; García, José María; García-Lareo, Manel; Gutiérrez-Fuentes, José Antonio; Mayoral, Eduardo; Sala, Joan; Dégano, Irene R; Francès, Albert; Castell, Conxa; Grau, María; Marrugat, Jaume

2018-04-01