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Objective Despite the existence of several follow-upstudies of children with ADHD followedup into adulthood, there is limited information on whether patterns of persistence and remission in ADHD can be predicted over the long-term. The main aim of this study was to evaluate predictors of persistence of ADHD in a large sample of boys with and without ADHD followed prospectively for 11years into young adulthood. Method Subjects were Caucasian, non-Hispanic boys with (N=110) and without (N=105) ADHD who were 6 to 17 years old at the baseline assessment (mean age 11years) and 15 to 31 years old at the follow-up assessment (mean age 22 years). Subjects were comprehensively and blindly assessed with structured diagnostic interviews and assessments of cognitive, social, school, and family functioning. Results At the 11-yearfollow-up, 78% of children with ADHD continued to have a full (35%) or a partial persistence (subsyndromal (22%), impaired functioning (15%), or remitted but treated (6%)). Predictors of persistence were severe impairment of ADHD, psychiatric comorbidity, and exposure to maternal psychopathology at baseline. Conclusions These findings prospectively confirm that persistence of ADHD over the long term is predictable from psychosocial adversity and psychiatric comorbidity ascertained 11years earlier.
Biederman, Joseph; Petty, Carter R.; Clarke, Allison; Lomedico, Alexandra; Faraone, Stephen V.
Participant attrition and attendance at follow-up were examined in a multicenter, randomized, clinical trial. The Lung Health Study (LHS) enrolled a total of 5, 887 adults to examine the impact of smoking cessation coupled with the use of an inhaled bronchodilator on chronic obstructive pulmonary disease (COPD). Of the initial LHS 1 volunteers still living at the time of enrolment in LHS 3 (5,332), 4,457 (84%) attended the LHS 3 clinic visit, a follow-up session to determine current smoking status and lung function. The average period between the beginning of LHS 1 and baseline interview for LHS 3 was 11years. In univariate analyses, attenders were older, more likely female, more likely to be married, smoked fewer cigarettes per day, and were more likely to have children who smoked at the start of LHS 1 than non-attenders. Attenders were also less likely to experience respiratory symptoms, such as cough, but had decreased baseline lung function compared with non-attenders. Volunteers recruited via mass mailing were more likely to attend the long-term follow-up visit. Those recruited by public site, worksite, or referral methods were less likely to attend. In multivariate models, age, gender, cigarettes smoked per day, married status, and whether participants’ children smoked were identified as significant predictors of attendance versus non-attendance at LHS 3 using stepwise logistic regression. Treatment condition (smoking intervention or usual care) was not a significant predictor of attendance at LHS 3. Older females who smoked less heavily were most likely to participate. These findings may be applied to improve participant recruitment and retention in future clinical trials.
Snow, Wanda M.; Connett, John E.; Sharma, Shweta; Murray, Robert P.
The aim of this study was to estimate the prevalence of sedentary behavior and investigate associated factors in adolescents 11years of age from the 1993 birth cohort in Pelotas, Rio Grande do Sul State, Brazil. Sedentary behavior was investigated with a questionnaire, and was defined as spending more than two hours per day watching television, playing videogames, or using the computer. Of the 4,452 adolescents interviewed, 98% reported watching television, 44% playing videogames, and 22% using the computer. The average time spent on each of these electronic media was 197, 36, and 17 minutes per day, respectively. Prevalence of sedentary behavior was 79.7% (95%CI: 78.6; 80.9) and showed a positive association with socioeconomic level and nutritional status and a negative association with well-being. These 11-year-olds spent extensive time at TV viewing, videogames, and the computer. Special attention should be given to the most exposed groups of adolescents, including the more affluent, overweight, and those with limited schooling. PMID:20963290
Dumith, Samuel C; Hallal, Pedro C; Menezes, Ana M B; Araújo, Cora Luiza
This study investigated the association between individual and area socioeconomic status (SES) and leading causes of unintentional injury mortality in Canadian adults. Using the 1991-2001 Canadian Census Mortality Follow-upStudy cohort (N=2,735,152), Cox proportional hazard regression was used to calculate hazard ratios and 95% confidence intervals for all-cause unintentional injury, motor vehicle collision (MVC), fall, poisoning, suffocation, fire/burn, and drowning deaths. Results indicated that associations with SES differed by cause of injury, and were generally more pronounced for males. Low education was associated with an elevated risk of mortality from all-cause unintentional injury and MVC (males only) and poisoning and drowning (both sexes). Low income was strongly associated with most causes of injury mortality, particularly fire/burn and poisoning. Having no occupation or low occupational status was associated with higher risks of all-cause injury, fall, poisoning and suffocation (both sexes) and MVC deaths among men. Associations with area deprivation were weak, and only areas with high deprivation had elevated risk of all-cause injury, MVC (males only), poisoning and drowning (both sexes). This study reveals the importance of examining SES differentials by cause of death from a multilevel perspective. Future research is needed to clarify the mechanisms underlying these differences to implement equity-oriented approaches for reducing differential exposures, vulnerability or consequences of injury mortality. PMID:22269490
Migraine with aura is associated with an increased incidence of stroke and cardiovascular disease, but the biological mechanisms are poorly understood. This study examined the incidence of metabolic syndrome and its relationship to migraine with and without aura and to nonmigraine headache. In the population-based the Nord-Trøndelag Health Study (HUNT), 19,895 individuals were followed for the development of metabolic syndrome, with a median follow-up time of 11.3 years. Headache diagnoses were based on a validated headache questionnaire, and metabolic syndrome was based on a modified version of the National Cholesterol Education Program's Adult Treatment Panel (ATP) III criteria, using objective anthropometric measurements and blood biochemistry. Using the Poisson regression model, migraine with aura was associated with an increased risk for developing metabolic syndrome. The effect was modified by smoking, with an adjusted incident risk ratio (IRR) among smokers of 2.10 (95% CI 1.53-2.89) and among nonsmokers of 1.39 (95% CI 1.03-1.86), when compared to headache-free controls. A moderate risk increase was seen for migraine without aura (IRR 1.26, 95% CI 1.12-1.42) and nonmigraine headache (IRR 1.22, 95% CI 1.13-1.32), not modified by smoking. The results suggest that traditional risk factors may be one of the mechanisms through which migraine with aura is linked to an increased risk for cardiovascular disease. A heightened vigilance concerning cardiovascular risk factors in this patient group may be warranted. PMID:23726372
Objective To determine whether educational level and overweight/obesity was associated with the development of diabetes among Chinese adult men and women. Methods A cohort (2000–2011) of 10 704 participants aged 18–59 years (8 238 men, 2 466 women) in Qingdao Port Health Study (QPHS) were recruited in this study. The personal lifestyle, height, weight, waist circumference, resting heart rate, blood pressure, fasting blood glucose, total cholesterol, triglycerides and plasma uric acid were collected annually in a comprehensive health checkup program. Cox proportional hazards regression models were used to estimate the association of factors and incidence of diabetes. Results During 110 825 person-years of follow-up, 1 056 new onset cases (9.5 per 1 000 person-years) of diabetes were identified. With normal weight as reference, the multiple-adjusted hazard ratio (HR) (95%CI) of diabetes was 1.69(1.38–2.09) for overweight and 2.24(1.66–3.02) for obesity among men, which was 1.81(1.12–2.92) and 2.58(1.37–4.86) among women, respectively. Compared with the participants with high educational level, those with low educational level had a higher risk of diabetes (multiple-adjusted HR (95%CI): 1.43(1.11–1.86)) among men. The association was not found among women and the adjusted HR (95%CI) of diabetes was 1.56(0.89–2.76). The increased risks of low educational level were independent of mediators among men, through normal weight (P for trend?=?0.0313) and overweight (P for trend?=?0.0212) group but not obesity group (P for trend?=?0.0957). Conclusion Baseline overweight/obesity was an independent risk factor for diabetes for both men and women. Low educational level was adversely associated with incidence of diabetes through normal weight, overweight and obesity groups, with the association being substantially attenuated by mediating factors only in the obesity group among men. The association was not found among women.
The purpose of the study was to investigate to what extent the physical activity pattern in adulthood can be predicted by physical characteristics, performance and activity in adolescence. A group of 62 men and 43 women completed a questionnaire concerning physical activity during their leisure time at the ages of 16 and 27 years. An activity index produced from the
The purpose of this case report was to describe the clinical long-term outcome, 11years after periodontal therapy, of 2 siblings diagnosed with Papillon-Lefèvre syndrome. Sibling 1 was a 14-year-old boy with severe periodontal bone loss in his permanent dentition. Sibling 2 was a 7-year-old girl with mixed-dentition and also suffering from periodontal disease. Both were treated with a combination of nonsurgical and antimicrobial therapy. Annual re-evaluations were performed for 11years. Both siblings improved their periodontal status, but a low level of compliance with treatment over time by sibling 1 resulted in further tooth loss and recurrent periodontal disease. Sibling 2 experienced good periodontal healing in her primary and, later, permanent teeth due in part to proper compliance with oral hygiene instructions. Periodontal health was achieved, and no tooth loss occurred during follow-up. Papillon-Lefèvre syndrome subjects can be successfully treated with nonsurgical/antimicrobial therapy, but treatment outcome could be related to age at diagnosis and compliance with oral hygiene procedures. PMID:23265160
AimTo study longitudinal changes in optic nerve head (ONH) topography in healthy volunteers.MethodsOne eye each of 36 healthy volunteers was prospectively followed for 11 (7–13) years with the Heidelberg Retina Tomograph I (HRT I). All eyes had normal visual fields, non-glaucomatous ONHs, no defects on red-free nerve fibre layer photographs and intraocular pressure (IOP) <22 mm Hg. During the follow-up,
Mika Harju; Leena Kurvinen; Jukka Saari; Eija Vesti
Context: The floating shoulder (FS) is an uncommon injury, which can be managed conservatively or surgically. The therapeutic option remains controversial. Aims: The goal of our study was to evaluate the long-term results and to identify predictive factors of functional outcomes. Settings and Design: Retrospective monocentric study. Materials and Methods: Forty consecutive FS were included (24 nonoperated and 16 operated) from 1984 to 2009. Clinical results were assessed with Simple Shoulder Test (SST), Oxford Shoulder Score (OSS), Single Assessment Numeric Evaluation (SANE), Short Form-12 (SF12), Disabilities of the Arm Shoulder and Hand score (DASH), and Constant score (CST). Plain radiographs were reviewed to evaluate secondary displacement, fracture healing, and modification of the lateral offset of the gleno-humeral joint (chest X-rays). New radiographs were made to evaluate osteoarthritis during follow-up. Statistical Analysis Used: T-test, Mann-Whitney test, and the Pearson's correlation coefficient were used. The significance level was set at 0.05. Results: At mean follow-up of 135 months (range 12-312), clinical results were satisfactory regarding different mean scores: SST 10.5 points, OSS 14 points, SANE 81%, SF12 (50 points and 60 points), DASH 14.5 points and CST 84 points. There were no significant differences between operative and non-operative groups. However, the loss of lateral offset influenced the results negatively. Osteoarthritis was diagnosed in five patients (12.5%) without correlation to fracture patterns and type of treatment. Conclusions: This study advocates that floating shoulder may be treated conservatively and surgically with satisfactory clinical long-term outcomes. However, the loss of gleno-humeral lateral offset should be evaluated carefully before taking a therapeutic option.
Pailhes, ReI gis; Bonnevialle, Nicolas; Laffosse, JeanMichel; Tricoire, JeanLouis; Cavaignac, Etienne; Chiron, Philippe
Background\\/Aims: Liver transplantation (LTx) is the only established treatment in patients with end-stage primary biliary cirrhosis (PBC). Although short-term survival after LTx in this group of patients is usually good, few data exist on the long-term survival. The optimal timing of transplantation is difficult. Thus, the aims of this study were to assess the long-term survival of patients with PBC
Christian Rust; Horst Rau; Alexander L. Gerbes; Gerd R. Pape; Mathias Haller; Hans-Jörg Krämling; Friedrich W. Schildberg; Gustav Paumgartner; Ulrich Beuers
Forty-six of 47 patients diagnosed as having chronic fatigue and offered treatment four years previously were followedup. Twenty-nine patients were interviewed, three patients refused an interview, and information on the remaining 14 was obtained from their general practitioners. All the instruments used at interview had been used in the initial study. The long-term prognosis for patients with chronic fatigue
The aim is to assess socio-occupational (SO) class differences in incident coronary and stroke. Methods. In a prospective fixed-cohort study 2959 35-74 year old men free from coronary (CHD) and stroke events were recruited in four population-based cohorts from 1986 to 1994 and followed-up until the end of 2002 to ascertain first CHD and stroke events. At baseline, major cardiovascular risk factors were investigated according to a standardised protocol. SO classes were based on current or last employment. Age-adjusted and multi-factors-adjusted risk ratios (RR) and 95% CI were calculated from Poisson regression models. Results. In 11-year median follow-up, the cohorts accumulated 33,926 person-years and generated 168 first major CHD events and 56 stroke events. Non-manual workers showed the lowest incident rates of both endpoints, and were considered as the reference category. Higher relative risks of CHD events were foundfor lower administrators and professionals, unskilled manual workers (UMW) and self-employed. Higher relative risks of stroke were found for skilled manual workers and UMW. Higher relative risks of CVD (either CHD or stroke) were found for lower administrators and professionals, skilled and unskilled manual workers and self-employed. Adjustments for major risk factors (cholesterol, systolic blood pressure, cigarette smoking, diabetes) did not modify the RRs. Conclusion. The higher risk of major cardiovascular events among lower SO classes is confirmed. Higher relative risks of CHD among lower administrators and professionals, and self-employers were also found. Further studies are needed to assess the etiologic role of job stress conditions. PMID:16240572
Ferrario, M; Veronesi, G; Corrao, G; Fomari, C; Sega, R; Borchini, R; Battaini, E; Corda, R; Cesana, G
A follow-up, retrospective classification and heredofamilial study on affective psychosis is reported. Since 1958 704 cases (1.2% of the total admissions) of affective psychosis have been encountered, with 595 cases followedup for 11years in average. In...
|Bakersfield City College reports on a followup study done to evaluate their Food Service Management Program. The program offers courses in three areas: certification and skill updating for those already employed in school cafeteria work, an A.A. degree program, and avocational courses for extended day students. Identical questionnaires were sent…
Background:This study investigated physical activity and dietary intake of children aged 9–11years, and the influence of peers on these behaviours over a 2-year period.Methods:A total of 106 (64 girls; 42 boys) children were investigated annually, over 2 years. Measures included physical activity (sealed pedometer), self-report measures of dietary intake and physical activity, and a peer influence questionnaire. Anthropometric measures
T Coppinger; Y M Jeanes; J Dabinett; C Vögele; S Reeves
|This article offers systematic procedures for designing and conducting follow-upstudies of teacher education graduates. Also offered are recommendations for formulating instrument questions and scales, determining questionnaire length and appearance, writing the cover letter, planning the follow-up reminder procedures, and comparing respondents…
Lifestyle-related health behaviours such as screen time, physical activity, sleep duration, and food intake tend to change into non-favourable directions when children become young adolescents. Cross-sectional studies show that family characteristics are important determinants for children's health behaviours. This study examined whether family characteristics such as parenting practices at meals and family involvement predict a more favourable change in children's lifestyle-related health behaviours during an 18-month follow-up. 745 children in school grades 4 and 5 (response rate 65%) filled in a baseline questionnaire in the autumn of 2006. A follow-up was conducted in the spring of 2008 (91%). Several health behaviours had changed in a non-favourable direction. Baseline parenting practices at meals and family involvement predicted some of the changes in the lifestyle-related health behaviours in 2008. Parenting practices at meals predicted a smaller increase in TV, DVD viewing time, and a smaller decrease in fruit intake. Amongst family involvement determinants, less time alone at home after school predicted a smaller increase in screen time, a smaller decrease in sleep duration, and a smaller increase in soft drink intake. For conclusion several family characteristics predicted favourable changes in children's lifestyle-related health behaviours. PMID:22056489
SUMMARY Twenty-two cases who fulfilled the criteria of having atypical manifestation at any stage of illness and had minimum followup of three years were studied in detail. Their family history and followup was analysed. The findings of the present study suggest that the cases showing admixture of schizophrenic and affective symptoms are probably a variant of affective disorders although a possibility of their being a third independent psychosis cannot be ruled out.
A follow-upstudy of 16 schizo-affectives (part of a group of 57 children originally diagnosed as schizophrenic) is reported. All 57 patients were under 14 years. They were reinvestigated after an average follow-up period of 16 years (range 6 to 40 years). Of the 57 psychoses 28% had a typical schizoaffective character. In contrast to purely schizophrenic psychoses, we found
This confirmatory study aims at investigating the long term determinants of mobility limitation among late middle aged and elderly in a physically less active population. Five thousand four hundred and sixty-four participants aged 50-97 in 1996 enrolled the Taiwan Longitudinal Study on Aging (TLSA) for four waves of interview during 11years. Social and health-related determinants were collected in each interview. Mobility limitation was enquired level of difficulty in eight movement tasks, including lifting 11kg weight, squatting, running 20-30m, standing for 15min, walking 200-300m, climbing up two to three floors, raising arms up and grasping with fingers. According to the mixed models with repeated measurements, more frequent gardening and longer time for each exercise predicted subsequent better mobility function in Taiwanese elderly while controlling demographics and current comorbidities. The protective effect of gardening was robust in all models. Frequent alcohol consumption was harmful to future mobility function, but less as harmful when participants aged. Besides, the depression-related somatic complaints were predictive to future mobility limitation among those without limitation at baseline. It shall be worthy to explore the dosage as well as the mechanism of these protective factors, especially the most significant but the least explored factor, gardening. Additionally, efforts should be made to understand the relationship between depression-related somatic complaints and mobility decline and so as the relevant interventions. PMID:23608344
Objectives To study health problems, quality of life, functional status, and memory after intensive care. Setting Adult patients ( n=346) discharged from a university hospital ICU. Design and methods Prospective cohort study. Follow-up patients were found using the ICU database and the Peoples Registry. Quality of life (QOL) was measured with the Short Form 36 (SF-36) 6 months after ICU discharge.
We investigated the results of 31 hips in 26 patients with nontraumtic (n = 20) and steroid-induced (n = 6) avascular necrosis of the femoral head (ANFH) treated with vascularized iliac pedicle bone graft (PBG). The average age at operation was 38.3 years. Three were women and 23 men. The average follow-up was 8.0 years. The Harris hip score prior
Y. Hasegawa; H. Iwata; S. Torii; T. Iwase; K. Kawamoto; S. Iwasada
The second phase of the project -Peat production follow-up and studies- has been carried through during the 1984 production season. As in the earlier phase this project is co-financed by the Swedish Peat Research Foundation and National Energy Administrat...
In 1990, a follow-upstudy was conducted of former students of Lane Community College (LCC) and their employers. The survey targeted three groups of former LCC students: all 1988-89 graduates who earned degrees or certificates, all no-formal-award leavers with 70 or more credits, and all early leavers who had earned less than 70 credits while…
Results of a follow-upstudy of the graduates of Hagerstown Junior College during its existence (1948-1973 inclusive) are provided. During the 26-year period, 1,797 people received either a degree or a one-year certificate from the college. Questionnaires were mailed to all graduates, and 1,359 (77%) were returned. The data are tabulated as to…
In fall 1994, Owens Community College (OCC), in Ohio, conducted a follow-upstudy of all 956 graduates from 1993-94 to determine their level of educational satisfaction, employment status, and other background information. Completed surveys were returned by 664 of the graduates, for a response rate of 70%. Survey results included the following:…
|A follow-upstudy of the Early Childhood Education Project (ECEP) was conducted in Richmond, Virginia to determine the effects of preschool experiences on selected aspects of pupil performance at the beginning and completion of grade 1. EPEC is a Head Start type program organized for the regular school year. The sample was divided into three…
The psychological and social consequences of having a diagnosis of cancer can continue beyond the initial year of diagnosis. However, very few empirical studies examine the long-term adjustment of cancer survivors and the factors that promote survivors' well-being. This paper presents an 18 month follow-upstudy of 26 women who were treated for various types of cancer at a major
In this follow-up to our earlier study (Toller, Suter, & Trautman, Gender role identity and attitudes towards feminism, Sex Roles, 51, 85–90, 2004) we examine the interrelationships among gender role, support for feminism, and willingness to self-label as feminist. Ten percent of college students previously surveyed participated in qualitative interviews, which elicited characterizations of feminists, whether students self-identified as feminist,
|The study guide and follow-up activities were designed primarily to give students a feeling of Ute life in the San Luis Valley in Colorado. The unit begins with six Southern Ute stories about the wolf and coyote, the race between the skunk and the coyote, the frog and the eagle, why the frog croaks, the bear (Que Ye Qat), and the two Indian…
Although conversion of an osteochondroma to chondrosarcoma is a well-described rare occurrence, it is usually associated with syndromes such as multiple hereditary exostoses and is much more common after maturity. We present here a rare case of secondary pelvic chondrosarcoma arising from a solitary exostosis in a pediatric patient. An 11-year-old, otherwise healthy, female was referred to our clinic for evaluation of a pelvic mass detected on a radiograph. The radiographs obtained by the referring physician demonstrated a large lesion arising from the right superior pubic ramus, which was visible but not identified on an abdominal radiograph several years prior. Histopathologic analysis showed chondrosarcoma which was supported by an additional opinion to rule out chondroblastic osteosarcoma. The patient was treated with wide resection without adjuvant therapy and is doing well with no evidence of recurrence five years post-operatively. There have been only a few small case series describing chondrosarcoma in the pediatric patient. Even rarer are descriptions of secondary chondrosarcoma with only occasional cases reported as part of larger case series. Chondrosarcoma is a rare and difficult diagnosis in the pediatric patient. There is often considerable debate between chondrosarcoma and chondroblastic osteosarcoma, and the treatment implications of differentiating these diagnoses are of paramount importance. PMID:24027486
Nystrom, Lukas M; Deyoung, Barry R; Morcuende, Jose A
Introduction: The most common reason patients seek medical attention is pain. However, there may be significant delays in initiating prehospital pain therapy. In a 2001 quality improvement (QI) study, we demonstrated improvement in paramedic knowledge, perceptions, and management of pain. This follow-upstudy examines the impact of this QI program, repeated educational intervention (EI), and effectiveness of a new pain management standard operating procedure. Methods: 176 paramedics from 10 urban and suburban fire departments and two private ambulance services participated in a 3-hour EI. A survey was performed prior to the EI and repeated one month after the EI. We reviewed emergency medical services (EMS) runs with pain complaints prior to the EI and one month after the EI. Follow-up results were compared to our prior study. We performed data analysis using descriptive statistics and chi-square tests. Results: The authors reviewed 352 surveys and 438 EMS runs with pain complaints. Using the same survey questions, even before the EI, 2007 paramedics demonstrated significant improvement in the knowledge (18.2%; 95% CI 8.9%, 27.9%), perceptions (9.2%; 95% CI 6.5%, 11.9%), and management of pain (13.8%; 95% CI 11.3%, 16.2%) compared to 2001. Following EI in 2007, there were no significant improvements in the baseline knowledge (0%; 95% CI 5.3%, 5.3%) but significant improvements in the perceptions of pain principles (6.4%; 95% CI 3.9%, 9.0%) and the management of pain (14.7%; 95% CI 11.4%, 18.0%). Conclusion: In this followupstudy, paramedics’ baseline knowledge, perceptions, and management of pain have all improved from 6 years ago. Following a repeat educational intervention, paramedics further improved their field management of pain suggesting paramedics will still benefit from both initial and also ongoing continuing education on the topic of pain management.
Objectives: To decide if cold calling was ethically justifiable and, if so, to set guidelines for researchers. Design: The study was a cohort study of patients with neurotic disorder treated initially for 10 weeks in a randomised controlled trial. Findings: At followup by a research medical practitioner 18 of the 210 patients had died and of the remaining 192 patients 186 (97%) were seen or had a telephone interview. Four patients refused and two others did not have interviews but agreed to some data being obtained. However, only 104 patients (54%) responded to letters inviting them to make an appointment or to refuse contact and the remainder were followedup by cold calling, with most patients agreeing readily to the research interview. The findings illustrate the dilemma of the need to get the maximum possible data from such studies to achieve scientific validity (and thereby justify the ethics of the study) and the protection of subjects' privacy and autonomy. Conclusions: More attention needs to be paid to consent procedures if cold calling is to be defended on ethical grounds but it is unreasonable to expect this to be obtained at the beginning of a research study in a way that satisfies the requirements for informed consent. A suggested way forward is to obtain written consent for the research at the time that cold calling takes place before beginning the research.
To determine whether the effects of low-level lead exposure persist, we reexamined 132 of 270 young adults who had initially been studied as primary school-children in 1975 through 1978. In the earlier study, neurobehavioral functioning was found to be inversely related to dentin lead levels. As compared with those we restudied, the other 138 subjects had had somewhat higher lead
Herbert L. Needleman; Alan Schell; David Bellinger; Alan Leviton; Elizabeth N. Allred
To determine whether the effects of low-level lead exposure persist, we reexamined 132 of 270 young adults who had initially been studied as primary school-children in 1975 through 1978. In the earlier study, neurobehavioral functioning was found to be inversely related to dentin lead levels. As compared with those we restudied, the other 138 subjects had had somewhat higher lead levels on earlier analysis, as well as significantly lower IQ scores and poorer teachers' ratings of classroom behavior. When the 132 subjects were reexamined in 1988, impairment in neurobehavioral function was still found to be related to the lead content of teeth shed at the ages of six and seven. The young people with dentin lead levels greater than 20 ppm had a markedly higher risk of dropping out of high school (adjusted odds ratio, 7.4; 95 percent confidence interval, 1.4 to 40.7) and of having a reading disability (odds ratio, 5.8; 95 percent confidence interval, 1.7 to 19.7) as compared with those with dentin lead levels less than 10 ppm. Higher lead levels in childhood were also significantly associated with lower class standing in high school, increased absenteeism, lower vocabulary and grammatical-reasoning scores, poorer hand-eye coordination, longer reaction times, and slower finger tapping. No significant associations were found with the results of 10 other tests of neurobehavioral functioning. Lead levels were inversely related to self-reports of minor delinquent activity. We conclude that exposure to lead in childhood is associated with deficits in central nervous system functioning that persist into young adulthood.
Needleman, H.L.; Schell, A.; Bellinger, D.; Leviton, A.; Allred, E.N. (Univ. of Pittsburgh, PA (USA))
To study the evolution of cytogenetic damage from past exposure to high concentrations of benzene and its health significance, chromosome aberrations (CA) in lymphocytes were reinvestigated after approximately 20 years in four subjects with past severe hemopathy and in seven controls studied in the late 1960s. Increased chromosome-type aberrations were still present up to 30 years after benzene toxicity, but blood counts were normal. The vital status at the end of 1993 was ascertained for 32 subjects with a history of benzene toxicity and for 31 controls studied for CA from 1965 to 1970, who differed significantly for CA rates. Of the 32 benzene-exposed subjects, 1 was lost to follow-up, 20 were still alive, and 11 had died at ages 36 to 83, between 1 and 20 years after the last CA study. Five deaths were from neoplasia (acute erythroleukemia, brain tumor, cancer of lung, paranasal cavity, esophagus). The decreased subjects had significantly higher rates of chromosome-type aberrations than those alive, and those who died of neoplasia had the highest rates of these aberrations in the last study before death or diagnosis of cancer. Out of the 31 controls, 12 had died from 4 to 23 years after the CA study. Three deaths were from neoplasia (two lung cancer, one brain tumor). Even if this is a small sample, the results suggest a higher risk of cancer for the benzene-exposed cohort, who had persistently high CA rates in lymphocytes.
A cohort study has been carried out of 2167 subjects employed between 1941 and 1983 at an asbestos cement factory in England. The production process incorporated the use of chrysotile asbestos fibre only, except for a small amount of amosite during four months in 1976. Measured airborne fibre concentrations available since 1970 from personal samplers showed mean levels below 1 fibre/ml, although higher levels had probably occurred previously in certain areas of the factory. No excess of lung cancer was observed in the mortality followup by comparison with either national or local death rates, and analyses of subgroups of the workforce by job, exposure level, duration of employment, duration since entry, or calendar years of employment gave no real suggestion of an asbestos related excess for this cause of death. There was one death from pleural mesothelioma and one with asbestosis mentioned as an associated cause on the death certificate, but neither is thought to be linked to asbestos exposure at this factory. Other suggested asbestos related cancers, such as laryngeal and gastrointestinal, did not show raised risks. Although the durations of exposure were short in this study, the findings are consistent with two other studies of workers exposed to low concentrations of chrysotile fibre in the manufacture of asbestos cement products which reported no excess mortality.
Gardner, M J; Winter, P D; Pannett, B; Powell, C A
Twenty-seven (77.1%) of the thirty-five 1977 graduates of the South Georgia Colleges' Division of Nursing responded to a follow-up survey, producing the following information: (1) 17 were employed full-time, two were employed part-time, and eight were unemployed; (2) 88.9% agreed they were prepared adequately for the state board examination; (3)…
Although 1,3-butadiene (BD) has been classified as an animal carcinogen, epidemiologic research has reported inconsistent results on the relationship between BD and lymphopoietic and other cancers in humans. This study evaluated the mortality experience of 15649 men employed for at least 1 year at any of eight North American styrene-butadiene rubber (SBR) plants. About 75% of the subjects were exposed to BD; 83% were exposed to styrene (STY). During 1943-1991, the cohort had a total of 386172 and an average of 25 person-years of follow-up, with 3976 deaths observed compared to 4553 deaths expected based on general population mortality rates (standardized mortality ratio (SMR) = 87, 95% confidence interval (CI) = 85-90). More than expected leukemia deaths occurred in the overall cohort (48 observed/37 expected, SMR = 131, CI = 97-174) and among ever hourly subjects (45/32, SMR = 143, CI = 104-191). The excess was concentrated among ever hourly subjects with 10+ years worked and 20+ years since hire (28/13, SMR = 224, CI = 149-323) and among subjects in polymerization (15/6.0, SMR = 251, CI = 140-414), maintenance labor (13/4.9, SMR = 265, CI = 141-453) and laboratories (10/2.3, SMR = 431, CI = 207-793), three areas with potential for relatively high exposure to BD or STY monomers. Some cohort sub-groups had slight increases in deaths from lymphopoietic cancers other than leukemia, but mortality patterns by race, years worked and process group within the SBR industry did not indicate a causal association with occupational exposures. These results indicate that exposures in the SBR industry cause leukemia. PMID:8901897
Delzell, E; Sathiakumar, N; Hovinga, M; Macaluso, M; Julian, J; Larson, R; Cole, P; Muir, D C
Background Acute?disseminated encephalomyelitis (ADEM) is a demyelinating disorder of the central nervous system, whose epidemiology, clinical presentations and functional outcome are incompletely understood in Asian populations. Objective To assess the clinical presentations, predisposing factors and functional outcome of ADEM in Taiwan. Methods 50 patients initially diagnosed with ADEM (male, 19; female, 31) were enrolled from 1991 to 2005. Diagnosis of ADEM or multiple sclerosis was established during a follow?up period of 2–120?months. 8 adult patients were noted to have taken the immunomodulatory drug, levamisole, within 3?months before onset of symptoms. The remaining 42 patients (male, 17; female, 25) were categorised by age as children (<16?years, n?=?12), young adults (16–49?years, n?=?21) and elderly adults (?50?years, n?=?9). The clinical manifestations, predisposing factors and radiological findings were compared between different age groups and adult patients with or without levamisole use. Functional outcome was compared by a log?rank test. Results Preceding upper respiratory tract infection was evident in 21 (50%) patients and only one young?adult patient had received Rubella vaccine immunisation. The frequency of fever was higher in children (p?=?0.04) and psychiatric symptoms were more prevalent in elderly patients (p?=?0.03). Functional recovery was faster in children than in adults (p?=?0.002). Initial Expanded Disability Status Scale score (odds ratio (OR) 1.9, p?=?0.03) and no fever (OR 0.04, p?=?0.06) were associated with poor outcome (modified Rankin scale ?2). After a mean (SD) follow?up of 31.8 (9.9)?months, 4 (9.5%) patients developed multiple sclerosis (3 (25%) children, 1 (4.7%) young adult, p?=?0.03). The neurological disability, radiological and cerebrospinal fluid findings did not differ between patients with and without levamisole use. One elderly adult patient previously receiving levamisole developed multiple sclerosis of relapse?remitting type after a mean follow?up period of 36.9?months. Conclusion The clinical presentations, functional outcome and risk of developing multiple sclerosis differed between different age groups. Functional recovery was faster in children than in adults. Poor functional outcome was related to initial high Expanded Disability Status Scale score and absence of fever.
The authors prospectively followed patients with treatment-resistant obsessive-compulsive disorder (OCD). Between 1988 and 1995, 56 patients with a history of inadequate response to oral clomipramine received 14 infusions of intravenous clomipramine. The follow-up period ranged from 4 to 11years after treatment. Of the 44 subjects interviewed at follow-up, 70.5% had current OCD and 29.5% had sub-threshold OCD. Almost half reported feeling much improved or very much improved compared to their state prior to treatment with intravenous clomipramine. PMID:19196930
Ross, Stephen; Fallon, Brian A; Petkova, Eva; Feinstein, Suzanne; Liebowitz, Michael R
This study is the fifth assessment in an 18-year longitudinal study begun in 1986 to follow a group of Montessori students who attended the Franciscan Montessori Earth School in Portland, Oregon. Participating were 45 students with an average age of 18 years, about half of whom were in high school and half in college. Students completed an online…
The primary objective of the study was to determine what effects, if any, the Behavior Modification School had upon the lives of its graduates. BMS, one of five treatment methods within the Rehabilitation Countermeasure, is designed for the problem drinke...
In spring 1987, a study was conducted at Monroe Community College (MCC) to determine the factors which influence attrition and retention, with particular focus on the reasons why students who have not graduated fail to return for succeeding semesters. Questionnaires were mailed to 452 former students, requesting information on students' rankings…
Although hundreds of thousands of women in this country have had augmentation mammaplasty, little is known about long-term effects. Clinical studies have documented a decreased ability to detect breast lesions in women with implants, leading to concerns regarding breast cancer risk. There is also anecdotal evidence that implants might have effects on a variety of immune conditions. More recently, concern
Louise A. Brinton; Paolo Toniolo; Bernard S. Pasternack
|Objective: In the intent-to-treat analysis of the Multimodal Treatment Study of Children With ADHD (MTA), the effects of medication management (MedMgt), behavior therapy (Beh), their combination (Comb), and usual community care (CC) differed at 14 and 24 months due to superiority of treatments that used the MTA medication algorithm (Comb+MedMgt)…
Jensen, Peter S.; Arnold, L. Eugene; Swanson, James M.; Vitiello, Benedetto; Abikoff, Howard B.; Greenhill, Laurence L.; Hechtman, Lily; Hinshaw, Stephen P.; Pelham, William E.; Wells, Karen C.; Conners, C. Keith; Elliott, Glen R.; Epstein, Jeffery N.; Hoza, Betsy; March, John S.; Molina, Brooke S. G.; Newcorn, Jeffrey H.; Severe, Joanne B.; Wigal, Timothy; Gibbons, Robert D.; Hur, Kwan
|In spring 1987, a study was conducted at Monroe Community College (MCC) to determine the factors which influence attrition and retention, with particular focus on the reasons why students who have not graduated fail to return for succeeding semesters. Questionnaires were mailed to 452 former students, requesting information on students' rankings…
The purpose of this work assignment was to add to our knowledge of the issues that will affect recruitment and retention of pregnant women into the National Children's Study by conducting 14 focus groups comprised of pregnant women, couples, and parents of young chi...
Seventeen cases of collodion baby are reported. Clinical aspects, complications, treatment, final outcome and family history were studied. We did not observe any clinical features in the collodion baby that could serve as a clue in predicting the final diagnosis. Infections were observed in nine, hypothermia in five and hypernatraemic dehydration in four cases. Skin infection mainly occurred in babies treated with emollients (petrolatum, lanolin and cetomacrogolis cream were used). We therefore recommend treating the collodion baby in a humidified incubator, if necessary with intravenous rehydration, but not to use emollients. The final outcome of these study patients was erythrodermic autosomal recessive lamellar ichthyosis in seven cases (41%), non-erythrodermic autosomal recessive lamellar ichthyosis in three cases (18%), Sjögren-Larsson in one case (6%), epidermolytic hyperkeratosis in one case (6%), acute neonatal variant of Gaucher disease in one case (6%) and normal skin in four cases (24%). PMID:12428840
Van Gysel, D; Lijnen, R L P; Moekti, S S; de Laat, P C J; Oranje, A P
? Abstract Background: There are several studies that deal with the evolution of patients with occupational rhinitis\\/asthma as a result of immunoglobulin (Ig) E-mediated allergy to latex. However, none have focused on the course of this illness in non-occupational settings. Objective: To ascertain patient compliance in individuals diagnosed with latex allergy with respect to following avoidance measures, as well as
Although 1,3-butadiene (BD) has been classified as an animal carcinogen, epidemiologic research has reported inconsistent results on the relationship between BD and lymphopoietic and other cancers in humans. This study evaluated the mortality experience of 15649 men employed for at least 1 year at any of eight North American styrene-butadiene rubber (SBR) plants. About 75% of the subjects were exposed
Elizabeth Delzell; Nalini Sathiakumar; Mary Hovinga; Maurizio Macaluso; Jim Julian; Rodney Larson; Philip Cole; David C. F. Muir
Objective:In the intent-to-treat analysis of the Multimodal Treatment Study of Children With ADHD (MTA), the effects of medication management (MedMgt), behavior therapy (Beh), their combination (Comb), and usual community care (CC) differed at 14 and 24 months due to superiority of treatments that used the MTA medication algorithm (Comb+MedMgt) over those that did not (Beh+CC). This report examines 36-month outcomes,
PETER S. JENSEN; L. EUGENE ARNOLD; JAMES M. SWANSON; BENEDETTO VITIELLO; HOWARD B. ABIKOFF; LAURENCE L. GREENHILL; LILY HECHTMAN; STEPHEN P. HINSHAW; WILLIAM E. PELHAM; KAREN C. WELLS; C. KEITH CONNERS; GLEN R. ELLIOTT; JEFFERY N. EPSTEIN; BETSY HOZA; JOHN S. MARCH; BROOKE S. G. MOLINA; JEFFREY H. NEWCORN; JOANNE B. SEVERE; TIMOTHY WIGAL; ROBERT D. GIBBONS; KWAN HUR
Objective: To examine recent figures on major laparoscopic complications in Finland.Methods: This was a nationwide record-linkage study from January 1995 through December 1996 including all Finnish hospitals performing gynecologic laparoscopies. Data files of the National Patient Insurance Association and the Finnish Hospital Discharge Register were used. Data were compared with previous results from 1990 to 1994.Results: Among 32,205 gynecologic laparoscopies,
Aims: Observations of high-energy ?-rays recently revealed a persistent source in spatial coincidence with the binary system ? Carinae. Since modulation of the observed ?-ray flux on orbital time scales has not been reported so far, an unambiguous identification was hitherto not possible. Particularly the observations made by the Fermi Large Area Telescope (LAT) posed additional questions regarding the actual emission scenario. Analyses show two energetically distinct components in the ?-ray spectrum, which are best described by an exponentially cutoff power-law function (CPL) at energies below 10 GeV and a power-law (PL) component dominant at higher energies. Methods: The increased exposure in conjunction with the improved instrumental response functions of the LAT now allow us to perform a more detailed investigation of location, spectral shape, and flux time history of the observed ?-ray emission. Results: We detect a weak but regular flux decrease over time. This can be understood and interpreted in a colliding-wind binary scenario for orbital modulation of the ?-ray emission. We find that the spectral shape of the ?-ray signal agrees with a single emitting particle population in combination with significant absorption by ?-? pair production. Conclusions: We are able to report on the first unambiguous detection of GeV ?-ray emission from a colliding-wind massive star binary. Studying the correlation of the flux decrease with the orbital separation of the binary components allows us to predict the behaviour up to the next periastron passage in 2014.
Reitberger, K.; Reimer, O.; Reimer, A.; Werner, M.; Egberts, K.; Takahashi, H.
We report results of surgical treatment of ten knees affected by patellar dislocation in six children with Down syndrome.\\u000a Four knees showed a dislocatable patella (grade III according to Dugdale), two a dislocated reducible patella (grade IV) and\\u000a four a dislocated irreducible patella (grade V). Symptoms included frequent falls, limping and pain. In all the cases a Roux–Goldthwait–Campbell\\u000a procedure was
As it remains unproven that hypermobility of the first tarsometatarsal joint (TMTJ-1) is a significant factor in hallux valgus deformity, the necessity for including arthrodesis of TMTJ-1 as part of a surgical correction of a hallux valgus is questionable. In order to evaluate the role of this arthrodesis on the long-term outcome of hallux valgus surgery, a prospective, blinded, randomised study with long-term follow-up was performed, comparing the Lapidus procedure (which includes such an arthrodesis) with a simple Hohmann distal closing wedge metatarsal osteotomy. The study cohort comprised 101 feet in 87 patients: 50 feet were treated with a Hohmann procedure and 51 with a Lapidus procedure. Hypermobility of TMTJ-1 was assessed pre-operatively by clinical examination. After a mean of 9.25 years (7.25 to 11.42), 91 feet in 77 patients were available for follow-up. There was no difference in clinical or radiological outcome between the two procedures. Also, there was no difference in outcome between the two procedures in the subgroup clinically assessed as hypermobile. This study does not support the theory that a hallux valgus deformity in a patient with a clinically assessed hypermobile TMTJ-1 joint requires fusion of the first tarso-metatarsal joint. Cite this article: Bone Joint J 2013;95-B:1222-6. PMID:23997136
The concept of "successful aging" has become widely accepted in gerontology, yet continues to have no common underlying definition. Researchers have increasingly looked to older individuals for their lay definitions of successful aging. The present analysis is based on responses to five questionnaires administered to surviving participants of the male Manitoba Follow-upStudy cohort (www.mfus.ca) in 1996, 2000, 2002, 2004, and 2006 (n = 2,043 men were alive at a mean age of 78 years in 1996). One question on each survey asked: "What is YOUR definition of successful aging?" Applying content analysis to the 5,898 narratives received over the 11years, we developed a coding system encompassing 21 main themes and 86 sub-themes defining successful aging. We quantitatively analyzed trends in prevalence of themes of successful aging prospectively over time. Our findings empirically support colleagues' past suggestions to shift from defining successful aging in primarily biomedical terms, by taking lay views into account. PMID:23855184
Objectives: Adults with ADHD experience considerable functional impairment. However, the extent to which comorbid Axis II personality disorders contribute to their difficulties and whether such comorbidities are associated with the childhood condition or the persistence of ADHD into adulthood remains unclear. Methods: This study examined the presence of personality disorders in a longitudinal sample of adolescents diagnosed with ADHD when they were 7 – 11years-old, as compared to a matched, never-ADHD, control group. Participants were 16-26 years old at follow-up. Based on a psychiatric interview, the ADHD group was subdivided into those with and without persistent ADHD. Axis II symptoms were assessed using the SCID-II. Data were analyzed using logistic regression and odds ratios (OR) were generated. Results: Individuals diagnosed with childhood ADHD are at increased risk for personality disorders in late adolescence, specifically Borderline (OR = 13.16), Antisocial (OR = 3.03), Avoidant (OR = 9.77), and Narcissistic (OR = 8.69) personality disorders. Those with persistent ADHD were at higher risk for Antisocial (OR = 5.26) and Paranoid (OR = 8.47) personality disorders when compared to those in whom ADHD remitted, but not the other personality disorders. Conclusion: Results suggest that ADHD portends risk for adult personality disorders, but the risk is not uniform across disorders, nor is it uniformly related to child or adult diagnostic status.
In summer 1994, a long-term follow-upstudy was conducted of 1989-90 graduates of career programs at Johnson County Community College (JCCC) in Kansas. A survey was mailed to 536 graduates, certificate holders, and students who left JCCC with marketable skills to assess their satisfaction with JCCC and their jobs. With telephone follow-up, a…
Johnson County Community Coll., Overland Park, KS. Office of Institutional Research.
|This study is the first follow-up assessment of the RETHINK Parenting and Anger Management Program. Parent participants (N = 168) reduced their anger, violence, and family conflict levels from posttest to follow-up, on average, at 2.5 months on 13 of 15 dependent variables. Current findings are consistent with a small, albeit growing body of…
Fetsch, Robert J.; Yang, Raymond K.; Pettit, Matthew J.
This study is the first follow-up assessment of the RETHINK Parenting and Anger Management Program. Parent participants (N = 168) reduced their anger, violence, and family conflict levels from posttest to follow-up, on average, at 2.5 months on 13 of 15 dependent variables. Current findings are consistent with a small, albeit growing body of…
Fetsch, Robert J.; Yang, Raymond K.; Pettit, Matthew J.
The Japan Collaborative Cohort Study for Evaluation of Cancer Risk (JACC Study) was established in the late 1980s to evaluate the risk impact of lifestyle factors and levels of serum components on human health. During the 20-year follow-up period, the results of the study have been published in almost 200 original articles in peer-reviewed English-language journals. However, continued follow-up of the study subjects became difficult because of the retirements of principal researchers, city mergers throughout Japan in the year 2000, and reduced funding. Thus, we decided to terminate the JACC Studyfollow-up at the end of 2009. As a final point of interest, we reviewed the population registry information of survivors. A total of 207 (0.19%) subjects were ineligible, leaving 110 585 eligible participants (46 395 men and 64 190 women). Moreover, errors in coding date of birth and sex were found in 356 (0.32%) and 59 (0.05%) cases, respectively, during routine follow-up and final review. Although such errors were unexpected, their impact is believed to be negligible because of the small numbers relative to the large total study population. Here, we describe the final cohort profile at the end of the JACC Study along with selected characteristics of the participants and their status at the final follow-up. Although follow-up of the JACC Study participants is finished, we will continue to analyze and publish study results.
Objective: The aim of this prospective study was to investigate predictors of 1-year changes in sick leave in workers with asthma.\\u000a Methods: The initial cohort consisted of 111 workers with asthma. One-hundred and one participants completed the follow-up after\\u000a 1 year. Self-reported sick leave over the past 12 months was reported at baseline and at follow-up. At the start of this study,
Cécile R. L. Boot; Jan H. M. M. Vercoulen; Karin H. Orbon; Jos M. Rooijackers; Chris van Weel; Hans Th. M. Folgering
This paper reports the results of a long-term follow-upstudy of 112 alcoholic patients admitted to an intensive 1-month residential programme. Outcomes at the 6-month and 1-year stages were reported in an earlier paper (G. K. Shaw et al. (1990) British Journal of Psychiatry 157, 190-196). The length of the follow-up period in this study was an average of 9
G. K. SHAWf; S. WALLER; C. J. LATHAM; G. DUNN; A. D. THOMSON
Nineteen moderately impaired patients with clinically definite multiple sclerosis and an initially relapsing-remitting course were included in a neuropsychological and magnetic resonance imaging (MRI) follow-upstudy. The average test\\/re-test interval was about 2 years. The neuropsychological findings were indicative of a very mild overall impairment; the patients, as a group, showed no evidence of cognitive deterioration in the follow-up period.
C. Mariani; E. Farina; S. F. Cappa; G. P. Anzola; L. Faglia; L. Bevilacqua; R. Capra; F. Mattioli; L. A. Vignolo
BACKGROUND: The purpose of this study was to assess the impact of drug abuse treatment in Peru that used the therapeutic community (TC) model. Program directors and several staff members from all study treatment facilities received two to eight weeks of in-country training on how to implement the TC treatment model prior to the follow-upstudy. METHODS: This outcome study
Knowlton Johnson; Zhenfeng Pan; Linda Young; Jude Vanderhoff; Steve Shamblen; Thom Browne; Ken Linfield; Geetha Suresh
Background Ensuring successful follow-up is essential when conducting a prospective cohort study. Most existing literature reviewing\\u000a methods to ensure a high response rate is based on experience in developed nations.\\u000a \\u000a \\u000a \\u000a \\u000a Findings We report our 4-year follow-up success for a national cohort study examining the health transition underway in Thailand. We\\u000a began the cohort study in 2005 with a baseline postal questionnaire sent
Sam-ang Seubsman; Matthew Kelly; Adrian Sleigh; Janya Peungson; Jaruwan Chokkanapitak; Duangkae Vilainerun
Background Depressive symptoms are common in patients with first episode psychosis (FEP) and have serious consequences for them. The main aims of this study were to examine the course of depression in FEP patients and explore whether any patient characteristics at baseline predicts depressive symptoms after one year. Method A total of 198 FEP patients with schizophrenia spectrum disorders were assessed for depressive symptoms with Calgary Depression Scale for Schizophrenia (CDSS) at baseline and 127 were followed for one year. A CDSS score [greater than or equal to] 6 was used as a cut-off score for depression. Results Approximately 50% of the patients were depressed (CDSS[greater than or equal to]6) at baseline. At follow-up approximately 35% had depression. The course of depressive symptoms varied, 26% was depressed at both baseline and follow-up, 9% became depressed during the follow-up, 22% remitted from depression during the 12 months and 43% was neither depressed at baseline nor at follow-up. Poor childhood social functioning, long duration of untreated psychosis (DUP) and depressive symptoms at baseline predicted depression at 12 months follow-up. Conclusion Depressive symptoms are frequent in the first year after onset of psychosis. Patients with poor social functioning in childhood, long DUP and depressive symptoms at baseline are more prone to have depressive symptoms after one year. These patients should be identified and proper treatment provided.
This is the first prospective study to investigate psychosocial adjustment in male and female former child soldiers (n=156, 12% female). The study began in Sierra Leone in 2002 and was designed to examine both risk and protective factors in psychosocial adjustment. Over the two-year period of followup, youth who had wounded or killed others during the war demonstrated increases in hostility. Youth who survived rape had higher levels of anxiety and hostility, but also demonstrated greater confidence and prosocial attitudes at followup. Of the potential protective resources examined, improved community acceptance was associated with reduced depression at followup and improved confidence and prosocial attitudes regardless of levels of violence exposure. Retention in school was also associated with greater prosocial attitudes.
Betancourt, Theresa Stichick; Borisova, Ivelina Ivanova; Williams, Timothy Philip; Brennan, Robert T.; Whitfield, T. Hatch; de la Soudiere, Marie; Williamson, John; Gilman, Stephen E.
Reports on a follow-upstudy of the relationship between managerial quality, administrative performance and citizens’ trust in government and in public administration systems. The study was based on a survey of 502 Israeli citizens conducted during 2002 and was compared with a similar study that was conducted during 2001 among 345 Israeli citizens. The research tried to validate and replicate
A clinical follow-upstudy (mean follow-up period 16.8 ± 6.4 years) of 278 patients with juvenile-onset endogenous episodic\\u000a psychosis (Endogenous Psychosis Episodic Type, EPET – ICD-10 F20.03, F20.23, F25) with first episodes in 1984–1995 was performed.\\u000a The period of the most intense occurrence of repeated episodes occurred during the first five years from the initial episode\\u000a (almost all repeat episodes
Objective: To assess the risk of death associated with various patterns of alcohol intake. Design: Prospective study of mortality in realtion to alcohol consumption at recruitment, with active annual followup. Setting: Four small, geographically defined communities in Shanghai, China. Subjects: 18 244 men aged 45-64 years enrolled in a prospective study of diet and cancer during January 1986 to
Jian-Min Yuan; Ronald K. Ross; Yu-Tang Gao; Brian E. Henderson; Mimi C. Yu
This Field Note presents a follow-up to a pilot study that explored pre-field placement anxiety for 1st-year MSW students. Previous studies report that students experience significant anxiety as they anticipate their field placement, and research indicates that anxiety has the potential to affect learning. A sample of 204 students reported…
|This is the first prospective study to investigate psychosocial adjustment in male and female former child soldiers (ages 10-18; n = 156, 12% female). The study began in Sierra Leone in 2002 and was designed to examine both risk and protective factors in psychosocial adjustment. Over the 2-year period of follow-up, youth who had wounded or killed…
Betancourt, Theresa Stichick; Borisova, Ivelina Ivanova; Williams, Timothy Philip; Brennan, Robert T.; Whitfield, Theodore H.; de la Soudiere, Marie; Williamson, John; Gilman, Stephen E.
Background In Italy, a large cohort study (VEdeTTE1) was conducted between 1998–2001 to evaluate the effectiveness of treatments in reducing mortality and increasing treatment retention among heroin addicts. The follow-up of this cohort (VEdeTTE2) was designed to evaluate the effectiveness of treatments on long-term outcomes, such as rehabilitation and social re-integration. The purpose of this paper is to describe the protocol of the VEdeTTE2 study, and to present the results of the pilot study carried out to assess the feasibility of the study and to improve study procedures. Methods The source population for the VEdeTTE2 study was the VEdeTTE1 cohort, from which a sample of 2,200 patients, traced two or more years after enrolment in the cohort, were asked to participate. An interview investigates drug use; overdose; family and social re-integration. Illegal activity are investigated separately in a questionnaire completed by the patient. Patients are also asked to provide a hair sample to test for heroin and cocaine use. Information on treatments and HIV, HBV and HCV morbidity are obtained from clinical records. A pilot phase was planned and carried out on 60 patients. Results The results of the pilot phase pointed out the validity of the procedures designed to limit attrition: the number of traced subjects was satisfactory (88%). Moreover, the pilot phase was very useful in identifying possible causes of delays and attrition, and flaws in the instruments. Improvements to the procedures and the instruments were subsequently implemented. Sensitivity of the biological test was quite good for heroin (78%) but lower for cocaine (42.3%), highlighting the need to obtain a hair sample from all patients. Conclusion In drug addiction research, studies investigating health status and social re-integration of subjects at long-term follow-up are lacking. The VEdeTTE2 study aims to investigate these outcomes at long-term follow-up. Results of the pilot phase underline the importance of the pilot phase when planning a follow-upstudy.
In epidemiologic cohort studies of chronic diseases, such as heart disease or cancer, confounding by age can bias the estimated effects of risk factors under study. With Cox proportional-hazards regression modeling in such studies, it would generally be recommended that chronological age be handled nonparametrically as the primary time scale. However, studies involving baseline measurements of biomarkers or other factors frequently use follow-up time since measurement as the primary time scale, with no explicit justification. The effects of age are adjusted for by modeling age at entry as a parametric covariate. Parametric adjustment raises the question of model adequacy, in that it assumes a known functional relationship between age and disease, whereas using age as the primary time scale does not. We illustrate this graphically and show intuitively why the parametric approach to age adjustment using follow-up time as the primary time scale provides a poor approximation to age-specific incidence. Adequate parametric adjustment for age could require extensive modeling, which is wasteful, given the simplicity of using age as the primary time scale. Furthermore, the underlying hazard with follow-up time based on arbitrary timing of study initiation may have no inherent meaning in terms of risk. Given the potential for biased risk estimates, age should be considered as the preferred time scale for proportional-hazards regression with epidemiologic follow-up data when confounding by age is a concern. PMID:22517300
Cologne, John; Hsu, Wan-Ling; Abbott, Robert D; Ohishi, Waka; Grant, Eric J; Fujiwara, Saeko; Cullings, Harry M
As part of an evaluation of the effectiveness of its nursing program, William Rainey Harper College (WRHC) in Illinois conducted a follow-upstudy of program graduates from 1994. One year after their graduation, questionnaires were sent to all 114 graduates from 1994, soliciting information on their employment status, future educational plans, and…
|A follow-upstudy and evaluation were done on the effect of an annual 4-week academically intensive program for 50 St. Louis (Missouri) area high school junior and senior students. The program consists of two summers, the first offering general scientific experience and education, and the second providing students with the chance to conduct…
The identity status, narcissism, and use of defense mechanisms of 89 college seniors who had previously been assessed as they entered college (Cramer, 1995) was determined. As compared to earlier follow-upstudies, fewer students were found in the Foreclosed status, and more students remained in Moratorium. Support was found for the previously made predictions that change in identity status would
The long term effects of a preschool intervention program for an experimental group of high-risk, black, low income children were assessed and compared to a high-risk placebo control group and low-risk "normal" controls. Seventy first grade children were involved in this 2-year follow-upstudy. Of these children, 42 were involved in the preschool…
A total of 126 children with chronic idiopathic thrombocytopenic purpura, including 35 splenectomized cases, were investigated in a long-term follow-upstudy, with regard to residual hematologic and immunologic abnormalities, complications and physical growth. Such hemorrhagic symptoms as petechiae, ecchymosis and epistaxis were still observed in about 22% – 28% of the patients with a period of morbidity ranging from 3
A group of 41 registered nursing graduates of the 1974 class at Bakersfield College was surveyed in the summer of 1974 as part of a nursing education follow-upstudy. In the summer of 1975, the same group was surveyed again in order to compare the perceptions and aspirations reported by the graduates one year after graduation with those reported…
INTRODUCTION: UK policy recommendations advocate the use of intensive care unit (ICU) follow-up services to help detect and treat patients' physical and emotional problems after hospital discharge and as a means of service evaluation. This study explores patients' perceptions and experiences of these services. METHODS: Thirty-four former ICU patients were recruited throughout the UK, using maximum variation sampling to achieve
A long term followupstudy is presented of 73 patients with myasthenia gravis, living in Amsterdam between 1926 and 1965. In the period 1961-65 the annual incidence was 3.1, the prevalence 53 per million. Maximum severity of the disease occurred during the first seven years after onset in 87%. Eighteen (29%) patients died, of whom eight had a thymoma
A multicentre retrospective study was carried out on the characteristics and course of myasthenia gravis (MG) in Italy. Data from 1152 patients, fairly representative of the myasthenic population seeking medical advice, were analysed for diagnostic criteria, clinical aspects and therapeutic approaches. Mean follow-up was 4.9 years. The disease was correctly diagnosed within 2 years of the onset in 80% of
R. Mantegazza; E. Beghi; D. Pareyson; C. Antozzi; D. Peluchetti; A. Sghirlanzoni; V. Cosi; M. Lombardi; G. Piccolo; P. Tonali; A. Evoli; E. Ricci; A. P. Batocchi; C. Angelini; G. F. MicaglioS; G. Marconi; R. Taiuti; L. Bergamini; L. Durelli; F. Cornelio
This manual has been produced to familiarize data users with the procedures followed for data collection and processing for the base year and first follow-up of the Education Longitudinal Study of 2002 (ELS:2002). It also provides the necessary documentat...
D. J. Pratt E. S. Stutts J. E. Rogers P. H. Siegel S. J. Ingels
|In a 1991 Gallup poll, 6 percent of American adolescents admitted to suicide attempts. This follow-upstudy focused on the suicidal behavior before and after admission to a private psychiatric hospital of adolescent inpatients (N=25) who were part of an original sample of 150 inpatients. Compared to the non-respondent group, the respondent group…
|In 1990, a follow-upstudy of nursing program graduates was conducted at William Rainey Harper College (WRHC) in Palatine, Illinois, to examine their employment patterns, further education plans, and evaluate particular aspects of their WRHC experience. All 98 nursing students who earned 48 credit hours in 1990 were mailed questionnaires 1 year…
BACKGROUND: Many western nations continue to have high rates of teenage pregnancies and births, which can result in adverse outcomes for both mother and child. This study identified possible antecedents of teenage pregnancy using linked data from administrative sources to create a 14-year follow-up from a cross-sectional survey. METHODS: Data were drawn from two sources - the 1993 Western Australian
Jennifer Gaudie; Francis Mitrou; David Lawrence; Fiona J Stanley; Sven R Silburn; Stephen R Zubrick
Objective: To describe the clinical course of attention-deficit/hyperactivity disorder (ADHD) symptom severity and diagnosis from ages 3 to 5 up to 9 to 12 years during a 6-year follow-up after the original Preschool ADHD Treatment Study (PATS). Method: A total of 207 participants (75% male) from the original PATS, assessed at baseline (mean age,…
Riddle, Mark A.; Yershova, Kseniya; Lazzaretto, Deborah; Paykina, Natalya; Yenokyan, Gayane; Greenhill, Laurence; Abikoff, Howard; Vitiello, Benedetto; Wigal, Tim; McCracken, James T.; Kollins, Scott H.; Murray, Desiree W.; Wigal, Sharon; Kastelic, Elizabeth; McGough, James J.; dosReis, Susan; Bauzo-Rosario, Audrey; Stehli, Annamarie; Posner, Kelly
|A group of 41 registered nursing graduates of the 1974 class at Bakersfield College was surveyed in the summer of 1974 as part of a nursing education follow-upstudy. In the summer of 1975, the same group was surveyed again in order to compare the perceptions and aspirations reported by the graduates one year after graduation with those reported…
The association between gout and nephrolithiasis in men: The Health Professionals' Follow-UpStudy. Approximately 10 million adults in the United States have experienced the passage of a kidney stone, and up to 5 million have been diagnosed with gout by a physician. Previous reports have suggested that gout increases the risk for the development of kidney stones, but there are
Holly J. Kramer; Hyon K. Choi; Karen Atkinson; Meir Stampfer; Gary C. Curhan
|Strategies are presented for analyzing longitudinal research designs with many waves of data using hierarchical linear modeling. The approach defines well-focused parameters that yield meaningful effect size estimates and significance tests. It is illustrated with data from the Boys Town Follow-UpStudy. (SLD)|
This long-term follow-upstudy, conducted in the summer of 1998 by Johnson County Community College (JCCC, Kansas) focused on graduates, certificate recipients, and students identified by career program administrators as leaving with marketable skills in 1993-94. Since first administering this type of survey in 1989, JCCC has gained a broader…
In summer 1996, a long-term follow-upstudy was conducted of 1991-92 graduates of career programs at Johnson County Community College (JCCC), in Kansas. Questionnaires were mailed to 646 graduates, certificate holders, and students who left JCCC with marketable skills to assess their satisfaction with their educational experiences and their…
BACKGROUND: Childhood asthma has risen dramatically not only in the western societies and now forms a major and still increasing public health problem. The aims of this study were to followup at the age of ten the patterns of asthma symptoms and associations among children with a clinically diagnosed asthma in a sizeable urban-rural community and to in compare
Eduardo Roel; Åshild Faresjö; Olle Zetterström; Erik Trell; Tomas Faresjö
A four-year follow-upstudy of underachieving college freshmen measured changes in the self-concept of those still in college and those who had dropped out. Significant differences generally favored college seniors. Findings also indicate that dropping out of college may be a positive experience. (Author)
This follow-upstudy presents findings from 11 structured interv iews that were conducted with principals engaged in a conv ersion from a large comprehensiv e high school to six small schools. Key findings are (a) the greatest barrier to improv ement was entrenched instructional patterns and (b) goals of college readiness and social\\/ emotional dev elopment, espoused by principals, only
In spring 1987, a follow-upstudy of nursing program graduates was conducted at William Rainey Harper College (WRHC) to examine employment patterns, further education plans, and graduates' evaluation of particular aspects of their WRHC experience. Questionnaires were mailed to 112 nursing students who graduated with an associate degree in 1986.…
|This paper reports the follow-up of a randomised control trial study of the ABRACADABRA web-based literacy intervention that contrasted synthetic versus analytic phonics (Comaskey, Savage & Abrami, 2009) in kindergarten children from urban low-SES backgrounds. Participants who received a "synthetic" phonics+phoneme awareness training (n = 26) or…
Di Stasio, Maria Rosaria; Savage, Robert; Abrami, Philip C.
This paper reports on a 14-year follow-upstudy of two developmentally retarded Japanese children, a brother and sister, who had been kept shut up in a small shack before being rescued (at ages 5 and 6 respectively). Following birth they consistently suffered malnutrition, maternal deprivation, social isolation from adults, language deprivation,…
A brief review of the English and Japanese literature as to the past use of thorium dioxide-containing media is presented. Physical and laboratory findings including roentgenography in a follow-upstudy of 23 cases who received such contrast material for ...
W. J. Russell F. Hattori L. B. Morrow H. Yoshinaga T. Kogure
The purpose of this study was to review the 12-year visual outcomes of patients who underwent surgical removal for subfoveal choroidal neovascularization (CNV) attributable to pathologic myopia. This retrospective study included 14 patients, with a mean age of 45.8 years, high myopia (>6 D) and classic subfoveal CNV. They were treated with pars plana vitrectomy and surgical removal of CNV. All patients were followedup every 3 months for 2 years, with visual acuity (VA), fundus examination, and fluorescein angiography and then every year for 5 years. Ten patients underwent a final visit with VA and fundus examination after a minimum 12-year follow-up. The main outcome measurement was VA and the secondary outcome measurement was the lesion size. After 12 years of follow-up, the mean VA did not significantly change over time, with a mean gain of 0.22 logMAR at 1 year, and 0.18, 0.12 and 0.05 at 2, 5 and 12 years, respectively. The anatomical evolution was characterized by a significant enlargement of the lesion size at 5 years. This study showed that final VA after surgical treatment with 12 years of follow-up was poor, due to the significant CNV scar enlargement over time. These results should prompt a prospective randomized study of other medical treatments, particularly anti-vascular endothelial growth factor therapy. PMID:23539478
Families and children who participated in a primary prevention experiment called Home Oriented Preschool Education (HOPE) were assessed during a follow?upstudy approximately ten years following the experiment. Home environment and social class were assessed for families, and children's ability and achievement test scores and grade point averages were obtained from school records. Home environment was shown to be only
|During 1980, Black Hawk Community College conducted a follow-upstudy of the 92 students who had graduated with an Associate in Liberal Arts (ALS) degree since 1973. The degree differs from the college's more traditional degrees in emphasizing less restrictive residency requirements, opportunities to develop a personalized course of instruction,…
This studyfollows-up with beginning teachers who were involved in the Inquiry Learning Forum (ILF) during their pre-service education. The ILF is an online professional development community for teachers built on the theoretical foundations of situated cognition (Lave & Wenger, 1991) and communities of practice (Wenger, 1998). Online communities would appear to have great potential to connect new teachers into
A follow-up was carried out into the study of schistosomal colonic polyposis reported in the last article. Eighteen patients with schistosomal colonic polyposis were treated with oxamniquine and their progress was evaluated for 2-3 weeks after treatment, ...
N. A. El-Masry Z. Farid S. Bassily M. E. Kilpatrick R. H. Watten
|This research studyfollowsup on previous investigations of the ongoing curriculum reform in China and its repercussions (actual and potential) on the effectiveness of the teacher evaluation process there (Liu & Teddlie, 2004, 2005). With the full implementation of the new curriculum reform throughout the country, teacher evaluation is becoming…
Recent follow-up analyses of the previous findings from the Women's Health Initiative and the Women's Health Initiative Memory Study confirmed some health benefits of estrogen- containing hormone therapy (HT) in women within 10 years from the onset of menopause. However, the potential risks associated with long-term administration of HT, such as breast cancer and stroke, remain a concern for therapy
Objectives The present study attempts to identify appropriate elements that may contribute to clarify the broad clinical features (diagnosis, care, complication and prognosis) of Takotsubo-like cardiomyopathy for improving its management. Design study Observational study. Setting Primary level of care referred to the emergency department of Vannini Hospital, Rome, Italy. Participants The study population consisted of 75 patients, 72 of the them were women and 3 were men with a mean age of 71.9±9.6?years. Methods From February 2004 to November 2010, prospectively included 84 consecutive patients diagnosed for suspected Takotsubo-like cardiomyopathy. To be eligible, patients had to meet all the Mayo clinic criteria in the absence of neurological trauma or intracranial haemorrhage. Moreover, those patients that at follow-up still presented alteration of acute phase at ECG and echocardiogram were excluded. Thus, 75 patients comprised the study population. To follow-up 19 patients were lost. Results None of 75 patients died in acute phase. All patients were promptly discharged (8.4±4.4?days), since they recovered their normal functional status without symptoms. Follow-up information was available for 56 patients. At a mean follow-up time of 2.2±2?years (range, 0.1–6.8?years) two octogenarian patients (2.6%) died because of sudden cardiac death and pulmonary embolism, respectively. The Takotsubo-like cardiomyopathy recurred in one patient. Conclusions The results of this study support the previous reports about the good prognosis, also in critically ill patients, of Takotsubo-like cardiomyopathy. Further assessment will be needed to determine a careful and sustained follow-up for choosing the best care and foreseeing the recurrences of this emerging condition.
BACKGROUND: Concerns about the possible toxic effects of workplace exposures in the synthetic rubber industry have centered on 1,3-butadiene (BD), styrene and dimethyldithiocarbamate (DMDTC). Our previous mortality studies of over 17,000 male synthetic rubber workers found an excess of leukemia that may be due to BD or BD plus other chemicals. Experimental studies have shown that BD produces mammary tumors in female mice and rats and ovarian tumors in female mice. AIM: This paper presents the methods of a follow-upstudy that evaluates the mortality experience of women employed in the North American synthetic rubber industry. METHODS: Women employed for at least 1 day at any of eight North American styrene-butadiene rubber plants were followedup from 1943 to 2002. Identifying and work history information were obtained from personnel records. Estimated quantitative exposure to BD, styrene and DMDTC, developed for our previous study of men, were used in this study. External analyses use the standardized mortality ratios (SMRs) to compare the cohort's cause-specific mortality rates to the rates of the female general population of the states or the province where the plants are located. Internal analyses use the Poisson regression and Cox proportional hazards models to examine specific cancer mortality rates in relation to BD, styrene and DMDTC exposure, by comparing an exposed cohort subgroup with the rate of unexposed cohort members. PMID:17229413
BACKGROUND: The most documented complication of scabies has been reported to be infection by group A streptococci, which has in turn been suggested to contribute to the development of glomerulonephritis. OBJECTIVE: This study aimed to investigate the risk of chronic kidney disease (CKD) subsequent to scabies utilizing a population-based dataset in Taiwan. METHODS: This retrospective matched-cohort study included 5071 subjects with scabies and 25 355 randomly selected comparison subjects. We individually tracked each subject for a 5-year period to identify those who subsequently received a diagnosis of CKD during the follow-up period. Stratified Cox proportional hazards regressions were performed to compute the hazard ratio (HR) of CKD during the 5-year follow-up period. RESULTS: The incidence rate of CKD during the 5-year follow-up period was 9.66 (8.51-10.93) per 1,000 person-years and 6.24 (5.82-6.69) per 1000 person-years for subjects with and without scabies respectively. The HR for CKD during the 5-year follow-up period for subjects with scabies was 1.34 (95% CI = 1.15-1.56) that of comparison subjects after adjusting for monthly income, hypertension, diabetes, obesity, stroke, coronary heart disease, chronic obstructive pulmonary disease, tobacco use disorder, hyperlipidemia and alcohol abuse during the 5-year follow-up period. Male subjects with scabies were 1.40 (95% CI = 1.14-1.71) times more likely than comparison subjects to suffer from subsequent CKD, and female study subjects were 1.27 (95% CI = 1.05-1.61) times more likely. CONCLUSIONS: We concluded that there was an increased risk for CKD among patients suffering from scabies. PMID:23374101
The aim of this follow-upstudy was to assess the long-term development of symptoms and their social consequences among patients referred for diagnosis and treatment of symptoms believed to be related to dental-restorative materials. A questionnaire was sent to 614 such patients containing questions on civil status, present health, changes between baseline and follow-up, current employment situation, and consequences of the problems. The results showed that patients with complex symptoms at baseline had a worse prognosis (i.e. more symptoms remaining) at follow-up than patients with local symptoms only. Replacement of dental materials seemed to have the largest impact on the alleviation of the symptoms reported. Those with remaining complex symptoms had more often stopped working or had decreased their work hours because of their symptoms. Only one-sixth of the patients were symptom-free at the follow-up. Our results indicate a relationship between patients with complex symptoms and social consequences in daily life. Therefore, social factors must be taken into consideration when examining the patients. Dental, medical, and social factors have to be considered simultaneously when examining a patient with symptoms that they relate to dental materials, in order to recommend appropriate care-management programs for this group of patients. PMID:18705804
Tillberg, Anders; Mårell, Lena; Berglund, Anders; Eriksson, Nils
A pilot study conducted to measure the effects of art therapy with prison inmates (Gussak, 2004) demonstrated marked improvement in mood. The results of this study encouraged a quantitative follow-upstudy the following year. This study used the Formal Elements Art Therapy Scale (FEATS) and the Beck Depression Inventory-Short Form (BDI-II) as pre and post-test assessments to assess the effects
Background and Purpose—No previous study has investigated the incidence or risk of cerebrovascular diseases developing after the sudden sensorineural hearing loss (SSNHL). This study sets out to estimate the risk of stroke development among SSNHL patients during a 5e-year follow-up period after hospitalization for acute episodes of SSNHL. Methods—Our study design features a study cohort and a comparison cohort. The
Objective To examine whether diabetes mellitus increases the risk of pneumonia mortality among seniors in the U.S. general population. Methods & Results The NHANES III follow-upstudy data were used. After excluding individuals from other minorities, being hospitalized with pneumonia in the previous year at baseline, or death of pneumonia during the first year of follow-up, a total of 3,707 subjects aged 65 years or older (1,794 men and 1,913 women) who had no missing information on variables for the analysis were included. Approximately 16% of seniors at baseline were diabetics, which was defined as either having been diagnosed by a physician, currently taking pills/insulin lowering blood glucose, or HbA1c higher than 6.4%. During an average 11years of follow-up, a total of 98 deaths due to pneumonia were recorded (ICD-10: J12–J18). Cox-regression models were used to estimate the risk association between pneumonia mortality and diabetes mellitus. After adjustment for the covariates at baseline, the hazard ratios of pneumonia death were 1.30 (95% CI: 0.64–2.70) for pre-diabetics and 2.28 (95% CI: 1.18–4.39) for diabetics, respectively. Among those covariates, only age (HR (95% CI); 1.16 (1.13–1.20)), gender as female (0.35 (0.22–0.61)) and physical fitness measured as having no problem walking 1+ mile during the previous month (0.38 (0.20–0.67)) reached statistical significance. Conclusions The results suggest that diabetes mellitus is a strong risk predictor of pneumonia mortality and the evaluation of physical fitness may also be useful in the risk prediction of pneumonia mortality for seniors.
Several links between aspects of executive functioning and the development of social competence have been established. The\\u000a present study investigates the relation between executive inhibitory control and cooperative\\/non-cooperative behavior, in\\u000a an ecological setting, and from a longitudinal perspective. Elementary school children (n=195) of three age groups (7, 9, 11years, initially) were measured at two consecutive time points, at a
Silvia Ciairano; Laura Visu-Petra; Michele Settanni
Szrmmary.-This studyfollowsup one in which was derived a nvo-item screening questionnaire for pathological gambling. In the previous study, the nvo-item screening questionnaire had sensitivity of .99 and specificity of .91. In this study, testing 295 men (116 pathological gamblers and 179 controls) and 128 women (30 pathological gamblers and 98 controls). sensitivity was 1.00 and specificity .85. In
Longitudinal studies observing working conditions and weight gain are rare. We aimed to study whether weight gain can be predicted\\u000a by working conditions or changes in them in a 28-year follow-up. The study population consisted of working-aged industrial\\u000a employees (n = 449). Data on height and weight were collected in clinical examinations in 1973, 1983 and 2001, and information on working\\u000a conditions
Tea Lallukka; Sirpa Sarlio-Lähteenkorva; Leena Kaila-Kangas; Janne Pitkäniemi; Ritva Luukkonen; Päivi Leino-Arjas
Delirium usually occurs during hospitalisation. The aims of this study were to evaluate the incidence of delirium in “hospital-at-home”\\u000a compared to a traditional hospital ward and to assess mortality, hospital readmissions and institutionalisation rates at 6-month\\u000a follow-up in elderly patients with intermediate\\/high risk for delirium at baseline according to the criteria of Inouye. We\\u000a performed a prospective, non-randomised, observational study
Gianluca Isaia; Marco A. Astengo; Vittoria Tibaldi; Mauro Zanocchi; Benedetta Bardelli; Rossella Obialero; Alessandra Tizzani; Mario Bo; Corrado Moiraghi; Mario Molaschi; Nicoletta Aimonino Ricauda
BACKGROUND: This report details a follow-upstudy of the parent-child relationship and the child's psychosocial development after IVF. The pilot study compared 31 IVF families and 31 families with a naturally conceived child when the children were aged 2 years. Twenty-seven IVF and 23 control families participated again when the children were aged 8-9 years. METHODS: Fathers and mothers completed
Background and objective. Sexual dysfunction severely affects the quality of life of patients, but longitudinal studies of sexual function in multiple sclerosis are lacking. We performed a study on a group of patients with multiple sclerosis to evaluate the change in sexual function and to examine the relationship between sexual dysfunction and other clinical variables over time.Methods. A 2-year follow-up
M Zorzon; R Zivadinov; L Monti Bragadin; R Moretti; R De Masi; D Nasuelli; G Cazzato
Background: The aim of this study was to examine the course of poststroke fatigue in a cohort of first-time stroke patients compared to the general population, and to identify clinically relevant features of post-stroke fatigue. Methods: We performed a follow-upstudy of 165 patients with first-time stroke admitted to acute stroke units at the Aarhus University Hospital, Denmark. A reference
Health factors have the power to prevent and postpone diseases and death; however, studies using the same methodology in both\\u000a men and women are sparse. We aimed to study the ability of health factors to prevent mortality in a population-based, 26-year\\u000a follow-up of Swedish men and women. During 1969–70, a health-screening programme was offered to a stratified sample of 3,064
Independent replication of linkage in previously studied pedigrees is desirable when genetic heterogeneity is suspected or when the illness is very rare. When the likelihood of the new data in this type of replication study is computed as conditional on the previously reported linkage results, it can be considered independent. The authors describe a simulation method using the SLINK program in which the initial data are fixed and newly genotyped individuals are simulated under [theta] = .01 and [theta] = .50. These give appropriate lod score criteria for rejection and acceptance of linkage in the follow-upstudy, which take into account the original marker genotypes in the data. An estimate of the power to detect linkage in the follow-up data is also generated. 13 refs., 1 fig., 1 tab.
Gershon, E.S.; Goldin, L.R. (National Institute of Mental Health, Bethesda, MD (United States))
Background Physical inactivity is associated with several diseases, but studies evaluating the association between chronic musculoskeletal complaints (MSCs) and physical exercise have shown conflicting results. The aim of this large-scale prospective population-based study was to investigate the association between self-reported physical exercise at baseline and the prevalence of chronic musculoskeletal complaints (MSCs) 11years later. Methods The results are based upon two consecutive public health studies conducted within the county of Nord-Trøndelag, Norway (The HUNT studies). A total of 39,520 (83%) out of 47,556 adults who participated in HUNT 1 and HUNT 2 responded to questions about physical exercise at baseline in 1984–86, and to questions about musculoskeletal complaints 11years later (1995–97). Chronic MSCs was defined as MSCs ? 3 months during the past year, and chronic widespread MSCs such as pain ? 15 days during the last month from the axial region, above the waist, and below the waist. Associations were assessed using multiple logistic regression, estimating prevalence odds ratio (OR) with 95% confidence intervals (CIs). All the final analyses were adjusted for age, gender, body mass index, smoking and education level. Results At follow-up 20,223 (51%) reported chronic MSCs, and among these 2,318 (5.9%) reported chronic widespread MSCs. Individuals who exercised at baseline were less likely to report chronic MSCs 11years later (OR 0.91, 95% CI 0.85–0.97) than inactive persons. Among individuals who exercised more than three times per week, chronic widespread MSCs were 28% less common (OR 0.72, 95% CI 0.59–0.88) compared to inactive individuals. Conclusion In this large-scale population-based study, physical exercise was associated with lower prevalence of chronic MSCs, in particular chronic widespread MSCs. Future studies should try to clarify whether chronic MSCs are a cause or a consequence of inactivity.
Holth, Helene Sulutvedt; Werpen, Hanne Kine Buchardt; Zwart, John-Anker; Hagen, Knut
A nationwide neonatal sreening program for phenylketonuria (PKU), maple syrup urine disease (MSUD), homocystinuria, histidinemia and galactosemia was started in Japan in 1977. The total number of infants screened had reached 6,311,754 by March, 1982. A follow-upstudy revealed the incidence of the disease in Japan: 1\\/108,823 for PKU; 1\\/450,840 for hyperphenylalaninemia (HPA); 1\\/1,577,939 for biopterin deficiency; 1\\/525,980 for MSUD;
K. Tada; H. Tateda; S. Arashima; K. Sakai; T. Kitagawa; K. Aoki; S. Suwa; M. Kawamura; T. Oura; M. Takesada; Y. Kuroda; F. Yamashita; I. Matsuda; H. Naruse
BackgroundInformation on outcome of patients with occlusion of the internal carotid artery (ICA) is limited by the short duration of follow-up and lack of haemodynamic studies on the brain.MethodsThe authors prospectively investigated 117 consecutive patients with transient or moderately disabling cerebral or retinal ischaemia associated with ICA occlusion between September 1995 and July 1998, and followed them until June 2008.
Suzanne Persoon; Merel J A Luitse; Gert Jan de Borst; Albert van der Zwan; Ale Algra; L Jaap Kappelle; Catharina J M Klijn
This study documents how teachers who participated in a professional development program on understanding the development of students’ mathematical thinking continued to implement the principles of the program 4 years after it ended. Twenty-two teachers participated in follow-up interviews and classroom observations. All 22 teachers maintained some use of children’s thinking and 10 teachers continued learning in noticeable ways. The
Megan Loef Franke; Thomas P. Carpenter; Linda Levi; Elizabeth Fennema
Speech recognition (SR), available since the 1980s, has only recently become sufficiently reliable to allow utilization in\\u000a medical environment. This study measured the effect of SR for the radiological dictation process and estimated differences\\u000a in report turnaround times (RTTs). During the transition from cassette-based reporting to SR, the workflow of 14 radiologists\\u000a was periodically followedup for 2 years in a
Alexithymic features are often associated with depression, which is the most important risk factor for suicidal behaviors. Nevertheless, little is known about the associations between alexithymia and suicidality. In this 12-month follow-upstudy we investigated the relationship between alexithymia and suicidal ideation in a sample of the general population (N = 1,563) using the 20-item Toronto Alexithymia Scale (TAS-20) and
Jukka Hintikka; Kirsi Honkalampi; Heli Koivumaa-Honkanen; Risto Antikainen; Antti Tanskanen; Kaisa Haatainen; Heimo Viinamäki
Objectives: To examine the effects of exercise training on paediatric obesity immediately after training and at a one year followup and to provide recommendations for future research.Methods: Studies that met the following criteria were included in a meta-analysis: (a) at least six subjects per group; (b) subject groups consisting of children in the 4–17 year age range; (c) pre-test
M T Maziekas; L M LeMura; N M Stoddard; S Kaercher; T Martucci
The aim of this study was to describe the indication, planning, technique, rehabilitation, and clinical results after cryopreserved allograft meniscus transplantation. Forty consecutive patients, 33 men and 7 women (mean, 37.3 years of age), were evaluated at 1-year follow-up post surgery. Symptoms, patient satisfaction, ROM (range of motion), surgical time, blood loss, and surgical history were evaluated. Thirty-eight (95%) patients
Kazumasa Fukushima; Nobuo Adachi; Joon Y. Lee; Vladimir Martinek; Mark Urquhart; Junnosuke Ryu; Freddie H. Fu
Summary OBJECTIVE To evaluate the impact of maternal hypo- thyroxinaemia during early gestation (fT4 below the lowest tenth percentile and TSH within the reference range: 0·15-2·0 mIU\\/l) on infant development, together with any subsequent changes in fT4 during gestation. DESIGN A prospective 3-year follow-upstudy of pre- gnant women and their children up to the age of 2 years. MEASUREMENTS
Victor J. Pop; Evelien P. Brouwers; Huib L. Vader; Thomas Vulsma; Baar van A. L; Vijlder de J. J. M
Objective: In this study we sought to develop a comparative cost evaluation between conventional and new media, e.g. web, mobile communication technology and digital television, and near patient testing supported anticoagulant (ac) treatment follow-up in a primary health care setting. Method: The comparison was done for two patient groups, self-care and home-care patients, on oral ac treatment in the primary
Samuli Niiranen; Heikki Lamminen; Kirsi Niemi; Heikki Mattila; Seppo Kalli
The aim of the present study was to evaluate the impact of empowerment group education on type 2 diabetes patients’ confidence in diabetes knowledge, self-efficacy, satisfaction with daily life, BMI and glycaemic control compared with the impact of routine diabetes care on the same factors at a 1-year follow-up. In this randomized controlled trial, conducted at 7 primary care centres
Eva Thors Adolfsson; Marie-Louise Walker-Engström; Bibbi Smide; Karin Wikblad
In order to facilitate comparisons across follow-upstudies that have used different measures of effect size, we provide a table of effect size equivalencies for the three most common measures: ROC area (AUC), Cohen's d, and r. We outline why AUC is the preferred measure of predictive or diagnostic accuracy in forensic psychology or psychiatry, and we urge researchers and practitioners to use numbers rather than verbal labels to characterize effect sizes. PMID:16254746
A follow-upstudy was made of 207 boys who as ten-year-olds in 1948 had been the subjects of complaints to the Detroit police. Only 43 of this group had been in trouble with the police during 1950. The items recorded at the time of the first contact which proved predictive of repeating were (a) having 2 or more brothers, (b)
This study provided information on the natural histories of 25 girls with gender identity disorder (GID). Standardized assessment data in childhood (mean age, 8.88 years; range, 3–12 years) and at follow-up (mean age, 23.24 years; range, 15–36 years) were used to evaluate gender identity and sexual orientation. At the assessment in childhood, 60% of the girls met the Diagnostic and
Kelley D. Drummond; Susan J. Bradley; Michele Peterson-Badali; Kenneth J. Zucker
Especially in the presence of agoraphobia and comorbid conditions, panic disorder causes significant impairment in life quality. Although there are several studies about epidemiology and clinical features, subthreshold symptoms and courses of comorbidity have not been studied sufficiently in panic disorder. The current study assessed the courses of panic disorder and subthreshold panic symptoms in consideration of the major and subthreshold comorbid conditions. Patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-diagnosed panic disorder were assessed using the panic disorder follow-up questionnaire, Panic and Agoraphobia Scale, Hamilton Depression Rating Scale, and State-Trait Anxiety Inventory. Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders was used to determine comorbidity, and all participants were received to 1-year follow-up. Comorbidity assessment showed that the threshold comorbidity decreased, while the subthreshold comorbidity increased at 1-year follow-up. Panic disorder symptom severity was decreased, but subthreshold panic symptoms continued to be present within the course of the illness. Presence of agoraphobia and duration of disease were significantly related with higher Panic and Agoraphobia Scale scores in the second assessment, and these relationships were independent from the treatment process. Even if the comorbidity and the severity of panic decrease with treatment, subthreshold panic and comorbid symptoms may still resist in panic disorder. PMID:22425529
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 population. Methods As part of the Copenhagen City Heart Study, 8045 men and women aged 30–60?years with normal lung function at baseline were followed for 25?years. Lung function measurements were collected and mortality from COPD during the 25?year observation period was analysed. Results The percentage 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 followup period, decreased the risk of developing COPD substantially compared with continuous smoking. During the followup 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 of the followup period. Conclusion The absolute risk of developing COPD among continuous smokers is at least 25%, which is larger than was previously estimated.
Background Most outpatient orthopedic follow-up visits for patients who had total joint arthroplasty are routine among those with well-functioning implants. The technology and resources now exist to enable patient assessment without requiring attendance in hospital. We tested an electronic clinic for routine follow-up in a small cohort of arthroplasty patients. Methods We randomly assigned primary arthroplasty patients scheduled for routine annual outpatient review into 2 groups: group A completed a Web-based assessment 4 weeks after the clinical assessment, whereas group B completed the Web-based assessment first. Standard clinical questionnaires were included. We also collected radiographic data and information on assessment duration and cost. Results Forty patients participated in the study. The average age of participants was 58 years. There were 12 men and 8 women in each of the 2 groups. The average total time spent by patients on an outpatient visit was 115 minutes, compared with 52 minutes for the electronic assessment. Participants reported the electronic assessment to be more convenient and less costly. Conclusion This pilot study supports the practical use of an electronic clinic for the follow-up of arthroplasty patients. Further studies examining the complex interaction of factors involved in patient clinics are needed.
Wood, Gavin; Naudie, Douglas; MacDonald, Steve; McCalden, Richard; Bourne, Robert
The purpose of this SOP is to define the coding strategy for the FollowUp Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the "Border" study. Household and individual follow-up data were combined in a single Follow-up Questionnaire data...
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 differential diagnosis.
Background The purpose of this study was to assess the impact of drug abuse treatment in Peru that used the therapeutic community (TC) model. Program directors and several staff members from all study treatment facilities received two to eight weeks of in-country training on how to implement the TC treatment model prior to the follow-upstudy. Methods This outcome study involved 33 TC treatment facilities and 509 former clients in Lima and other cities in five providences across Peru. A retrospective pre-test (RPT) follow-up design was employed in which 30-day use of illegal drugs and alcohol to intoxication was measured at baseline retrospectively, at the same time of the six-month follow-up. In-person interview data were collected from directors of 73 percent of the eligible TC organizations in January and February 2003 and from former 58 percent of the eligible TC former clients between October 2003 and October 2004. Drug testing was conducted on a small sample of former clients to increase the accuracy of the self-reported drug use data. Results Medium to large positive treatment effects were found when comparing 30-day illegal drug and alcohol use to intoxication before and six months after receiving treatment. As a supplemental analysis, we assumed the 42 percent of the former clients who were not interviewed at the six month assessment had returned to drugs. These results showed medium treatment effects as well. Hierarchical Generalized Linear Modeling (HGLM) results showed higher implementation fidelity, less stigma after leaving treatment, and older clients, singly or in combination are key predictors of treatment success. Conclusion This study found that former clients of drug and alcohol treatment in facilities using the TC model reported substantial positive change in use of illegal drugs and alcohol to intoxication at a six-month follow-up. The unique contribution of this study is that the results also suggest attention should be placed on the importance of implementing the TC drug abuse treatment model with fidelity. Further, the results strongly suggest that TC drug abuse treatment programs should incorporate follow-up activities that attempt to neutralize community negative reactions (perceived stigma) independent of other factors.
Background: The non-response rates in surveys are increasing which is problematic as it means that a progressively smaller proportion of the population represents the majority, and it is uncertain how health survey results are affected. This follow-up was performed on the non-responders to the postal questionnaire in the public health survey Life and Health, conducted in Örebro County Council, Sweden, where large differences in response rates had been found between different socio-demographic groups and geographical areas. The main objective was to analyse non-response bias regarding self-rated health. Methods: This follow-upstudy was conducted as a census to all non-responders in the area that had the lowest response rate and, in one other geographical area used as a control. It was carried out by telephone interviews, 49.3% (580 individuals) answered the follow-up. The outcome variable was self-rated health, a main variable in public health surveys. Differences in response patterns between responders and initial non-responders were approximated by prevalences with confidence intervals and adjusted odds ratios. Results: Poor health was more common in the initial non-response group than among the responders, even with consideration given to sex, age, country of birth and education. However, good health was equally common among responders and initial non-responders. Conclusions: Public health surveys can be biased due to certain groups being under-represented or not represented at all. For this reason, in repeated public health surveys, we recommend selective follow-ups of such groups at regular intervals.
Background More than 6 million Americans have undiagnosed diabetes. Several national organizations endorse screening for diabetes by physicians, but actual practice is poorly understood. Our objectives were to measure the rate, the predictors and the results of glucose testing in primary care, including rates of follow-up for abnormal values. Methods We conducted a retrospective cohort study of 301 randomly selected patients with no known diabetes who received care at a large academic general internal medicine practice in New York City. Using medical records, we collected patients' baseline characteristics in 1999 and followed patients through the end of 2002 for all glucose tests ordered. We used multivariate logistic regression to measure associations between diabetes risk factors and the odds of glucose testing. Results Three-fourths of patients (78%) had at least 1 glucose test ordered. Patient age (?45 vs. <45 years), non-white ethnicity, family history of diabetes and having more primary care visits were each independently associated with having at least 1 glucose test ordered (p < 0.05), whereas hypertension and hyperlipidemia were not. Fewer than half of abnormal glucose values were followedup by the patients' physicians. Conclusion Although screening for diabetes appears to be common and informed by diabetes risk factors, abnormal values are frequently not followedup. Interventions are needed to trigger identification and further evaluation of abnormal glucose tests.
Kern, Lisa M; Callahan, Mark A; Brillon, David J; Vargas, Maryelena; Mushlin, Alvin I
Objective: To prospectively assess the early results of surgical treatment of chronic Achilles tendinopathy. Methods: This seven month prospective followupstudy assessed the short term results of surgical treatment of chronic Achilles tendinopathy and compared the subjective and functional outcome of patients with Achilles tendinopathy without a local intratendinous lesion (group A) with that of similar patients with such a lesion (group B). Forty two of the initial 50 patients were examined before surgery and after the seven month followup. Evaluation included an interview, subjective evaluation, clinical tests, and a performance test. Results: At the followup, physical activity was fully restored in 28 of the 42 patients (67%), and 35 patients (83%) were asymptomatic or had only mild pain during strenuous exercise. In clinical tests, significant improvements were observed in climbing up and down stairs and the rising on the toes test. Surgical treatment also seemed to be successful from the total test score, which was excellent or good in 35 patients, compared with before surgery when it was excellent or good in one patient only. Patients in group A fared better than those in group B, whether evaluated by recovery of physical activity after surgery (88% v 54%) or the complication rate (6% v 27%). Conclusions: Surgical treatment of chronic Achilles tendinopathy gives good and acceptable short term results. A lower complication rate and a trend to better recovery was observed in patients with peritendinous adhesions only than in those with peritendinous adhesions combined with an intratendinous lesion.
Paavola, M; Kannus, P; Orava, S; Pasanen, M; Jarvinen, M
Customer relationship management research is utilized to explain the need for a more patient-oriented support in patient care. This article presents a European study on how various hospital units of a single healthcare organization have utilized a patient relationship management system--in particular a patient treatment follow-up system--and how it affects patient care and the knowledge work performed by the medical staff. Eight physicians were interviewed at a university hospital on whether patient treatment was improved through a follow-up system that had been in use in the case organization for three years. The interviewees represented various hospital units, and all of them had used the system at their own unit. The results indicate that it is possible to improve patient care through more personalized treatment. The follow-up treatment system seems to be a tool to create and maintain better communication with the patients rather than just a technological solution. It may help better understand and analyze both individual patients and patient groups. For individual physicians it provides a way to reflect professional skills. The system was lacking in its support for one-to-one communication with patients. Nevertheless, the system is an example of patient relationship management which may help healthcare units to move towards a more patient-oriented care. PMID:19267028
Oinas-Kukkonen, Harri; Räisänen, Teppo; Hummastenniemi, Niko
Nonalcohol-induced fatty liver is widely believed to be a benign condition with little or no risk of disease progression. There have been occasional reports of progression to cirrhosis but none in the absence of preexisting fibrosis on the index biopsy specimen even when co-existing hepatitis was present (steatohepatitis). From our histological database (1978 to 1985), we identified 161 patients with fatty liver seen at our institution and traced the case notes of 156. One hundred five patients were initially excluded as having an alcohol-induced cause, and the remaining 51 either were seen in the clinic (37) or had died, in which cases copies of their death certificates were obtained (14). A further 7 patients were excluded after clinic attendance gave evidence of alcohol excess and another 4 after review of their initial biopsy showed the presence of fibrosis or steatohepatitis. The apparent cause of the steatosis in the 40 included patients with strictly nonalcohol-induced pure fatty liver was obesity in 12, diabetes in 4 (1 obese patient), and cachexia associated with extrahepatic malignancy in 6. Four of the remaining 19 had serological evidence of an autoimmune disorder, but none of these had any clinical or histological features of autoimmune liver disease. Nine patients had evidence of hyperlipidemia, 3 of whom were also obese. At a median follow-up of 11years (7 to 16), 12 of 26 living patients had abnormal results of liver blood tests and had repeat liver biopsies performed. None had progressed to steatohepatitis or cirrhosis; 1 obese patient had developed mild fibrosis 9.8 years after her index biopsy.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7489979
Teli, M R; James, O F; Burt, A D; Bennett, M K; Day, C P
The Follow-up Questionnaire data set provides information concerning the activities within the household during the sampling week. The information is from 201 Follow-up Questionnaires for 91 households. Medication and supplemental dietary information is provided. The Follow-up...
Background In 1987, a prospective study of an Australian Aboriginal Birth Cohort was established focusing on the relationships of fetal and childhood growth with the risk of chronic adult disease. However as the study is being conducted in a highly marginalized population it is also an important resource for cross-sectional descriptive and analytical studies. The aim of this paper is to describe the processes of the third followup which was conducted 20 years after recruitment at birth. Methods Progressive steps in a multiphase protocol were used for tracing, with modifications for the expected rural or urban location of the participants. Results Of the original 686 cohort participants recruited 68 were untraced and 27 were known to have died. Of the 591 available for examination 122 were not examined; 11 of these were refusals and the remainder were not seen for logistical reasons relating to inclement weather, mobility of participants and single participants living in very remote locations. Conclusion The high retention rate of this follow-up 20 years after birth recruitment is a testament to the development of successful multiphase protocols aimed at overcoming the challenges of tracing a cohort over a widespread remote area and also to the perseverance of the study personnel. We also interpret the high retention rate as a reflection of the good will of the wider Aboriginal community towards this study and that researchers interactions with the community were positive. The continued follow-up of this life course study now seems feasible and there are plans to trace and reexamine the cohort at age 25 years.
Objective To examine the association between total antioxidant capacity (TAC) intake and colorectal cancer incidence.\\u000a \\u000a \\u000a \\u000a Methods TAC intake was assessed in 1986 and every 4 years thereafter in the Health Professionals Follow-upStudy, a prospective cohort\\u000a study of 47,339 men. Between 1986 and 2004, 952 colorectal cancer cases were diagnosed. Cox proportional hazards regression\\u000a models were used to estimate relative risks (RR) and
Rania A. MekaryKana; Kana Wu; Edward Giovannucci; Laura Sampson; Charles Fuchs; Donna Spiegelman; Walter C. Willett; Stephanie A. Smith-Warner
Purpose To describe postoperative complications encountered in the Tube Versus Trabeculectomy (TVT) Study during 5 years of follow-up. Design Multicenter randomized clinical trial. Methods Settings Seventeen clinical centers. Study Population Patients 18 to 85 years of age who had previous trabeculectomy and/or cataract extraction with intraocular lens implantation and uncontrolled glaucoma with intraocular pressure (IOP) ?18 mm Hg and ?40 mm Hg on maximum tolerated medical therapy. Interventions Tube shunt (350-mm2 Baerveldt glaucoma implant) or trabeculectomy with mitomycin C (MMC 0.4 mg/mL for 4 minutes). Main Outcome Measures Surgical complications, reoperations for complications, visual acuity, and cataract progression. Results Early postoperative complications occurred in 22 patients (21%) in the tube group and 39 patients (37%) in the trabeculectomy group (P = .012). Late postoperative complications developed in 36 patients (34%) in the tube group and 38 patients (36%) in the trabeculectomy group during 5 years of follow-up (P = .81). The rate of reoperation for complications was 22% in the tube group and 18% in the trabeculectomy group (P = .29). Cataract extraction was performed in 13 phakic eyes (54%) in the tube group and 9 phakic eyes (43%) in the trabeculectomy group (P = .43). Conclusions A large number of surgical complications were observed in the TVT Study, but most were transient and self-limited. The incidence of early postoperative complications was higher following trabeculectomy with MMC than tube shunt surgery. The rates of late postoperative complications, reoperation for complications, and cataract extraction were similar with both surgical procedures after 5 years of follow-up.
Gedde, Steven J.; Herndon, Leon W.; Brandt, James D.; Budenz, Donald L.; Feuer, William J.; Schiffman, Joyce C.
A follow-up EEG study was conducted on a subject with 50 years of experiences in Qigong. Resting EEG at present showed frontally dominant alpha-1 as compared to occipitally dominant alpha-2 described in 1962. During the Qigong practice alph-1 enhanced quickly and became far more prominent than 50 years ago. Compared with baseline, these activities remained to be higher at rest after the Qigong practice. These results suggest that extended practice in meditation may change the EEG pattern and its underlying neurophysiology. It remains to be explored as to what biological significance and clinical relevance do these physiological changes might mean. PMID:19229721
Qin, Zhen; Jin, Yi; Lin, Shin; Hermanowicz, Neal S
Background The relationship between weight and dementia risk has not been investigated in populations with relatively low body mass index (BMI) such as the Yoruba. This study set out to achieve this objective using a prospective observational design. Methods The setting was Idikan Ward in Ibadan City, Nigeria. The participants were all aged 65 years or older and were enrolled in the Indianapolis-Ibadan Dementia Project. Repeated cognitive assessments and clinical evaluations were conducted to identify participants with dementia or MCI during 10 years of follow-up (mean duration: 5.97 years). BMI measures, information on alcohol, smoking history, cancer, hypertension, diabetes, heart attack, stroke and depression were collected at each follow-up evaluation. Mixed effect models adjusted for covariates were used to examine the differences in BMI among participants who developed dementia or MCI and those who remained cognitively normal during the follow-up. Results This analysis included 1559 participants who had no dementia at their first BMI measurements. There were 136 subjects with incident dementia, 255 with MCI and 1168 with normal cognition by the end of the study. The mean BMI at baseline was higher for female participants (22.31; SD = 4.39) than for male (21.09; SD = 3.61, p < 0.001). A significantly greater decline in BMI was found in those with either incident dementia (p < 0.001) or incident MCI (p < 0.001) compared to normal subjects. Conclusion Decline in BMI is associated with incident MCI and dementia in elderly Yoruba. This observation calls for close monitoring of weight loss in elderly individuals which may indicate future cognitive impairment for timely detection and tailored interventions.
Ogunniyi, Adesola; Gao, Su; Unverzagt, Frederick W.; Baiyewu, Olusegun; Gureje, Oyewusi; Nguyen, James Tat; Smith-Gamble, Valerie; Murrell, Jill R.; Hake, Ann M.; Hall, Kathleen S.; Hendrie, Hugh C.
This prospective study investigated the effectiveness of a three-tier modularized out- and inpatient multidisciplinary integrated headache care program. N = 204 patients with frequent headaches (63 migraine, 11 tension-type headache, 59 migraine + tension-type headache, 68 medication-overuse headache and 3 with other primary headaches) were enrolled. Outcome measures at baseline, 6- and 12-month follow-ups included headache frequency, Migraine Disability Assessment (MIDAS), Hospital Anxiety and Depression Scale (HADS), standardized headache diary and a medication survey. Mean reduction in headache frequency was 5.5 ± 8.5 days/month, p < 0.001 at 6 months' follow-up and 6.9 ± 8.3 days/month, p < 0.001 after 1 year. MIDAS decreased from 53.0 ± 60.8 to 37.0 ± 52.4 points, p < 0.001 after 6 months and 34.4 ± 53.2 points, p < 0.001 at 1 year. 44.0 % patients demonstrated at baseline an increased HAD-score for anxiety and 16.7 % of patients revealed a HAD-score indicating a depression. At the end of treatment statistically significant changes could be observed for anxiety (p < 0.001) and depression (p < 0.006). The intake frequency of attack-aborting medication decreased from 10.3 ± 7.3 days/month at admission to 4.7 ± 4.1 days/month, p < 0.001 after 6 months and reached 3.8 ± 3.5 days/month, p < 0.001 after 1 year. At baseline 37.9 % of patients had experience with non-pharmacological treatments and 87.0 % at 12-month follow-up. In conclusion, an integrated headache care program was successfully established. Positive health-related outcomes could be obtained with a multidisciplinary out- and inpatient headache treatment program. PMID:22790281
Patients suffering facial pain that does not fit with the traditional diagnostic criteria and which does not respond to dental treatment constitute a clinical problem. These patients lack a proper diagnosis and are frequently exposed to excessive and inadequate invasive treatment. The aim of this investigation was to study the long-term development of pain and the result of treatment in a cohort of patients suffering chronic idiopathic facial pain. The 74 patients referred to the Facial Pain Diagnostic Group at the Karolinska Institute School of Dentistry between 1981 and 1992 were invited to take part in a follow-upstudy. As 16 subjects were unwilling or unable to take part in the study and 13 had died, the remaining 45 were interviewed either in accordance with a standard protocol or by filling out a questionnaire mailed to them. The interview revealed that 10 were free of orofacial pain, but only 2 were totally free of pain. Over the 9-19 years' follow-up period the relationship between facial pain and pain in the rest of the body had changed substantially. Of 14 patients and more than 100 extractions, permanent pain relief was felt by only 3 patients. It is concluded that a diagnosis was given in only 2 cases. The distribution of the pain has changed dramatically. The low success rate of invasive treatments suggests that such therapeutic methods are to be considered contraindicated in patients suffering from idiopathic orofacial pain. PMID:15198384
Background Work-related musculoskeletal disorders (MSDs) are an important cause of functional impairments and disability among construction workers. An improved understanding of MSDs in different construction occupations is likely to be of value for selecting preventive measures. This study aimed to survey the prevalence of symptoms of MSDs, the work-relatedness of the symptoms and the problems experienced during work among two construction occupations: bricklayers and supervisors. Methods We randomly selected 750 bricklayers and 750 supervisors resident in the Netherlands in December 2009. This sample was surveyed by means of a baseline questionnaire and a follow-up questionnaire one year later. The participants were asked about complaints of the musculoskeletal system during the last six months, the perceived work-relatedness of the symptoms, the problems that occurred during work and the occupational tasks that were perceived as causes or aggravating factors of the MSD. Results Baseline response rate was 37%, follow-up response was 80%. The prevalence of MSDs among 267 bricklayers and 232 supervisors was 67% and 57%, respectively. Complaints of the back, knee and shoulder/upper arm were the most prevalent among both occupations. Irrespective of the body region, most of the bricklayers and supervisors reported that their complaints were work-related. Complaints of the back and elbow were the most often reported among the bricklayers during work, whereas lower arm/wrist and upper leg complaints were the most often reported among the supervisors. In both occupations, a majority of the participants perceived several occupational physical tasks and activities as causes or aggravating factors for their MSD. Recurrent complaints at follow-up were reported by both bricklayers (47% of the complaints) and supervisors (31% of the complaints). Participants in both occupations report that mainly back and knee complaints result in additional problems during work, at the time of follow-up. Conclusions A substantial number of the bricklayers and the supervisors report musculoskeletal disorders, mainly back, knee and shoulder/upper arm complaints. The majority of the bricklayers and half of the supervisors believe that their complaints are work-related. Irrespective of occupation, participants with MSDs report substantial problems during work. Workplace intervention measures aimed at occupational physical tasks and activities seem justified for both occupations.
Background We carried out a three months follow-upstudy on the efficacy of metadoxine in a cohort of alcoholics admitted to the Alcohol misuse Long-term Treatment (ALT) Unit – University of Pisa (Italy). We analyzed the clinical data, psychometric tests and blood tests of 160 alcoholics on admission and after 3 months of treatment. We compared 58 pts treated with metadoxine (MET) with 102 pts who did not receive (NULL) any drug as an adjunct to the psycho-educational interventions provided by the ALT Unit. Results At follow-up, the patients in treatment with metadoxine showed a significant improvement in the rate of complete abstinence (44.8% vs. 21.6%; chi square: 8.45, df = 1, p < 0.0037). Furthermore, the number of drop-outs at three months of treatment was also significantly lower in the MET than in the NULL group (17% vs. 57%; chi square of 23.22, df = 1, p < 0.001). Conclusion Our findings support the use of metadoxine in the management of alcohol dependence. However, randomized clinical trials are necessary to confirm and replicate them. This study raises the importance of identifying new pharmacological compounds effective on the outcome of alcoholism in order to help patients to best adhere to treatment programs and to prevent the development of mental and physical complications due to chronic and heavy use of alcohol.
Guerrini, Irene; Gentili, Claudio; Nelli, Gloria; Guazzelli, Mario
Background—It has been suggested that Mycobacterium paratuberculosis is the cause of Crohn's disease. In a previous report the immediate effect of two years treatment with antituberculous chemotherapy showed no clinical benefit. ?Aims—To assess both the immediate and longer term effect of treatment on the disease. ?Methods—Patients were followed for five years from their date of entry to the study. One hundred and thirty patients entered the initial study, and of these 111 (81%) were followed regularly. ?Results—Overall, there was no evidence of consistent benefit or disadvantage from antituberculous chemotherapy in any of the assessments made, including the number of acute relapses, surgical episodes, hospital admissions, disease activity, blood tests, or medication required for Crohn's disease during the followup period. ?Conclusion—The absence of any benefit at the end of the initial two year trial period, and during the three year subsequent followup, fails to support the hypothesis that mycobacteria play an important part in the pathogenesis of Crohn's disease, or that antituberculous chemotherapy may be of benefit. ?? Keywords: Crohn's disease; mycobacteria; antituberculus chemotherapy
Semantics, phonology, and syntax are essential elements of aphasia diagnosis and treatment. Until now, these linguistic components have not been specifically addressed in follow-upstudies of aphasia recovery after stroke. The aim of this observational prospective follow-upstudy was to investigate semantic, phonological, and syntactic recovery in aphasic stroke patients. In addition, we investigated the recovery of verbal communication and of aphasia severity. We assessed 147 aphasic patients at 1, 2, and 6 weeks, 3 and 6 months, and 1 year after stroke with the ScreeLing, a screening test for detecting deficits on the three main linguistic components, the aphasia severity rating scale (ASRS), a measure of verbal communication, and the Token test, a measure of aphasia severity. We investigated the differences in scores between the six time points with mixed models. Semantics and syntax improved up to 6 weeks (p < 0.001) after stroke, and phonology up to 3 months (p ? 0.001). ASRS improved up to 6 months (p < 0.05) and the Token test up to 3 months (p < 0.001). We conclude that in aphasia after stroke, various linguistic components have a different recovery pattern, with phonology showing the longest period of recovery that paralleled aphasia severity, as measured with the Token test. The improvement of verbal communication continues after the stabilization of the recovery of the linguistic components. PMID:22820721
El Hachioui, Hanane; Lingsma, Hester F; van de Sandt-Koenderman, Mieke E; Dippel, Diederik W J; Koudstaal, Peter J; Visch-Brink, Evy G
The basic objective of this third research phase was to verify and further delineate factors that are constant and valid contributors to the success of postsecondary occupational students enrolled in developmental programs. Follow-up research on a longitudinal basis was conducted on nontraditional students at six New York colleges. Of…
State Univ. of New York, Ithaca. Coll. of Agriculture and Life Sciences at Cornell Univ.
The predictive value of blood pressure (BP), heart rate (HR), and catecholamines in terms of any subsequent development of cardiovascular disease was investigated. Systolic (S) and diastolic (D) BP, HR, epinephrine (E) and norepinephrine (NE) were measured three times a year in 1980, 1984, and 1989 on 20 clinically healthy subjects, 18 patients with ‘essential hypertension’, and 22 patients with angina pectoris. Of the 22 patients in the latter group, 15 died during a 2-year follow-up (1990–1991). Each individual data series was analyzed by single cosinor to assess the circannual variation. Results were summarized by population-mean cosinor for each group. Parameter tests were used to compare the circannual rhythm characteristics among the different patient groups. A circannual rhythm was invariably demonstrated on a group basis (P < 0.05). Differences in MESOR and/or circannual amplitude were found among the different groups. In particular, patients with angina pectoris who will die within the 2-year follow-up differ in terms of their E and NE from all other patient groups, a difference already detected at the beginning of the study, more than 10 years before they die. A similar separation is not achieved in terms of BP or HR.
Prikryl, P.; Cornelissen, G.; Otsuka, K.; Halberg, F.
To assess the effect of interim clean-up measures on the current health of a community, we conducted a follow-up survey of 193 residents living near the McColl waste disposal site and a comparison area located approximately 5 miles from the site. Results from this survey were compared with results from a similar survey conducted 7 years earlier. Odors were detected at least once per week by 32.7% of "high-exposed" respondents in 1988 compared with 68.5% in 1981, but prevalence odds ratios (PORs) comparing symptom reporting between "high-exposed" and comparison-area respondents were greater than that of the 1981 survey for 89% of symptoms. PORs comparing symptom reporting between these two areas were greater than 2.0 for 64% of symptoms assessed in the current survey. Symptoms reported in excess did not represent a single organ system or suggest a mechanism of response. PORs comparing respondents who were very worried about the environment and those reporting no worry were greater than 2.0 for 86% of symptoms. These finding, along with environmental data from the area, suggest that living near the waste disposal site and being very worried about the environment, rather than a toxicologic effect of chemical from the site, explain excess symptom reporting found in this follow-upstudy.
Lipscomb, J A; Goldman, L R; Satin, K P; Smith, D F; Vance, W A; Neutra, R R
PURPOSE: The aims of the present study were to investigate whether being subjected to bullying and witnessing bullying at the workplace was associated with concurrent sleep difficulties, whether frequently bullied/witnesses have more sleep difficulties than occasionally bullied/witnesses, and whether there were associations between being subjected to bullying or witnessing bullying at the workplace and subsequent sleep difficulties. METHODS: A total of 3,382 respondents (67 % women and 33 % men) completed a baseline questionnaire about their psychosocial work environment and health. The overall response rate was 46 %. At follow-up 2 years later, 1671 of those responded to a second questionnaire (49 % of the 3,382 respondents at baseline). Sleep difficulties were measured in terms of disturbed sleep, awakening problems, and poor quality of sleep. RESULTS: Bullied persons and witnesses reported more sleep difficulties than those who were neither bullied nor witnesses to bullying at baseline. Frequently bullied/witnesses reported more sleep difficulties than respondents who were occasionally bullied or witnessing bullying at baseline. Further, odds ratios for subsequent sleep difficulties were increased among the occasionally bullied, but not among witnesses. However, the associations weakened when adjusting for sleep difficulties at baseline. CONCLUSION: Being subjected to occasional bullying at baseline was predictive of subsequent sleep difficulties. Witnessing bullying at baseline did not predict sleep difficulties at follow-up. PMID:23460184
Hansen, Ase Marie; Hogh, Annie; Garde, Anne Helene; Persson, Roger
Background The purpose of this retrospective follow-upstudy is to evaluate the prevalence of patients with thyroid eye disease presenting with apparent unilateral proptosis and determine the occurrence of exophthalmos in contralateral non-proptotic eye over the time. Associated features with this event were evaluated. Methods A cohort of 655 consecutive patients affected by thyroid eye disease with a minimum follow-up of 10 years was reviewed. Exophthalmos was assessed by using both Hertel exophthalmometer and computed tomography (CT). The influence of age, gender, hormonal status and of different therapies such as corticosteroids, radiotherapy and surgical decompression on this disease progression was evaluated. Results A total of 89 patients (13.5%) (95% confidence interval [CI] 15%-10%) had clinical evidence of unilateral exophthalmos at the first visit. Among these, 13 patients (14%) (95% CI 22%-7%) developed subsequent contralateral exophthalmos. The increase of protrusion ranged from 2 to 7 mm (mean of 4.2). The time of onset varied from 6 months to 7 years (mean time: 29 months). Smoking status, young age and surgical decompression are significantly associated with development of contralateral proptosis (p< .05). Conclusions Asymmetric thyroid eye disease with the appearance of unilateral exophthalmos at the initial examination is a fairly frequent event, while subsequent contralateral proptosis occurs less commonly. However, physicians should be aware that young patients, particularly if smokers, undergoing orbital decompression in one eye may need further surgery on contralateral side over time.
The grant provides for continued follow-up for and research on the Health Professionals Follow-upStudy (HPFS) of 51,529 men who completed an extensive dietary questionnaire first in 1986 and again in 1990, 1994,1998, 2002, 2006, and 2010. The program project grant also supports the food composition database and nutrient analysis system used by the Nurses' Health Study, Nurses' Health Study II, and many other studies.
Several serological techniques may be used for the detection of HIV infection, however, in the case of infants, there are no methods that are effective prior to the loss of maternal antibodies. Thus, in such cases, a completed series of serological and virological assay of HIV antibodies should be performed in follow-upstudies. Twenty children living in Modena (Italy) were studied since 1985. Seven of these children were of ages ranging from 3 to 10 years. Only one of them was found to be seropositive for HIV. The remaining 13 children were studied from birth. Six had lost maternal antibodies to HIV at a median age of 15.1 months. Four showed decreasing levels of the anti-body by Western blotting. HIV antigen was detected in serum samples from 2 children. The data reported stress the need for longitudinal studies that could lead to reliable methods of diagnosing HIV infections in newborns. PMID:2491302
De Rienzo, B; Borghi, V; Cocchi, I; Frigeri, G; Cavazzuti, G B; Pecorari, M; Pietrosemoli, P; Lami, G; Squadrini, F
The value of routine follow-up with frequent visits to a breast cancer specialist—both in terms of detection of recurrence and patient satisfaction—has been questioned.The aim of this study was to compare nurse-led follow-up on demand versus physician follow-up after breast cancer treatment with regards to patients’ well-being, satisfaction, access to medical care and medical safety.Two hundred and sixty-four consecutively selected
I.-L Koinberg; B Fridlund; G.-B Engholm; L Holmberg
The evidence obtained from prospective studies to support the hypothesis that fish consumption may improve mental status remains limited. The current study prospectively assessed a low frequency of fish consumption as a risk factor for depressed mood. Included were 5068 adults aged 25-74 years examined in 1971-1975 as the baseline of the First National Health and Nutrition Examination Survey Follow-upStudy. Frequency of eating fish at baseline was obtained using a 3-month food frequency questionnaire. Severely depressed mood (SDM) was defined as the Center for Epidemiologic Studies Depression Scale scores ?22 or taking anti-depressants. After an average of 10.6 years of follow-up, among men (n=2039), the percentage of individuals with SDM was 11.7%. Compared with frequent consumers (more than once a week), the odds ratios (ORs) were 1.43 (95%CI=0.66-3.11) and 2.08 (1.08-4.09) respectively for the men eating fish once a week and less than once a week (p for trend=0.03). Among women (n=3029), the percentage of individuals with SDM was 17.89%. The ORs were 1 (reference), 0.91 (0.68-1.22) and 1.15 (0.83-1.59) respectively for the women eating fish more than once, once, and less than once a week. These estimates were obtained after adjustment for indicators of social deprivation and major physical diseases. The study concluded that independently from social deprivation and physical diseases, low fish consumption was a risk factor for SDM among men. Further studies are needed to confirm these findings and elucidate mechanisms for the difference between men and women. PMID:21628074
Risk follow-up by probabilistic safety assessment (PSA) provides a systematic method to analyze incidents. Events can be evaluated from the safety point of view to get feedback from operating experience, for the identification of risk contributors and for the verification of PSA models. This paper is concerned with the risk follow-up methodology, which is based on a marked point process
The Food Follow-up Questionnaire data set provides information on the eating patterns and the food identification and preparation methods that occurred during the period the food sample was taken. The information is for 86 Food Follow-up Questionnaires for 86 households. In the...
Background Recruitment and retention of adolescent research participants presents unique challenges and considerations when conducting epidemiological studies. Purpose To describe the use of the social networking website in the re-recruitment and tracking of adolescent girls into a follow-upstudy of the Trial of Activity for Adolescent Girls (TAAG) at the University of Maryland field site. Methods 730 girls were recruited as 8th graders into TAAG. Re-recruitment efforts were conducted when they were 11th graders (TAAG 2). Traditional methods, including mailings and school visits, were conducted. A TAAG 2 Facebook site was created to search for girls not found through traditional recruitment methods. Chi-square and t-tests were conducted to identify differences in characteristics between those found and “friended” through Facebook and through traditional recruitment methods. Results There were 175 girls we were unable to locate using traditional recruitment methods. Of these, 78 were found on Facebook, 68 responded to our friend request, and 43 girls (6% of the girls previously recruited) participated in the study. Demographic data were similar for those who friended us on Facebook and traditional methods. 8th grade body mass index and percent body fat were lower for those recruited from Facebook (p = 0.03 and 0.04, respectively). Number of daily minutes of moderate-to-vigorous physical activity tended to be lower among the TAAG 2 Facebook friends (19 ± 11 vs 21 ± 11, p = 0.06). Conclusions Loss to follow-up was minimized by contacting potential participants through Facebook. Social networking websites are a promising method to recruit adolescents.
Jones, Lindsey; Saksvig, Brit I.; Grieser, Mira; Young, Deborah Rohm
Background Laparoscopic gastric bypass (LGB) surgery markedly increases percent excess weight loss (%EWL) and obesity-related co-morbidities.\\u000a However, poor study quality and minimal exploration of clinical, behavioral, and psychosocial mechanisms of weight loss have\\u000a characterized research to date.\\u000a \\u000a \\u000a \\u000a \\u000a Methods We conducted a comprehensive assessment of n=100 LGB patients surveyed 2–3 years following surgery using standardized measures.\\u000a \\u000a \\u000a \\u000a \\u000a Results Mean %EWL at follow-up was 59.1±17.2%. This
Garry Welch; Cheryl Wesolowski; Sofija Zagarins; Jay Kuhn; John Romanelli; Jane Garb; Nancy Allen
Background Although the duration of untreated psychosis (DUP) plays an important role in the short-term prognosis of patients with schizophrenia, their long-term prognosis generally is not determined by DUP alone. It is important to explore how other clinical factors in the early stage are related to DUP and consequent disease courses. Methods A total of 664 patients with untreated psychosis were surveyed for this study. At the first examination, we divided them into the severe positive symptoms cases (SC) or the less severe cases (NonSC) and compared the prognosis among the two groups after a 10-year follow-up. In all, 113 patients in the SC group and 43 patients in the NonSC group were follow-up completers. Results Whereas DUP was not different between the two groups, patients with nonacute onset in both groups had significantly longer DUP than those in patients with acute onset. For all clinical measures, there was no difference in prognosis between the two groups or among the four groups classified by mode of onset (MoO) and initial severity of positive symptoms. However, the degree of improvement of global assessment of functioning (GAF) was significantly smaller in the NonSC-nonacute group than in the SC-acute and SC-nonacute groups. Conclusions These results suggest that neither DUP nor MoO alone necessarily affects the initial severity of positive symptoms. Moreover, it is possible that patients with low impetus of positive symptoms onset within long DUP experience profound pathologic processes. Therefore, the current study results indicated that long DUP and nonacute onset were related to poor long-term prognosis, regardless of initial positive symptoms.
Background: Gestational hypertension (GH) is a newly recognized risk factor for adverse cardiovascular events later in life. Sleep disordered breathing (SDB) is an established risk factor for adverse cardiovascular events. Recent research has suggested that women with GH may have an increased rate of SDB during pregnancy, but it is not known if this higher rate of SDB persists into the postpartum state. Objective: To assess whether women with GH continue to have an increased rate of SDB compared to healthy pregnant women, after the physiologic changes of pregnancy resolve. Methods: We previously studied women with GH and uncomplicated pregnancies with sleep questionnaires and level 1 polysomnography. Participants were invited to participate in repeat testing 1-2 years postpartum. Respiratory disturbance index (RDI) differences were assessed. Results: Eighteen subjects (11 GH and 7 healthy) had complete follow-up data available for comparison with antepartum data. This group was representative of the initial antepartum cohort. Women with GH experienced a decrease in mean RDI from antepartum to postpartum (12.0 ± 12.3 vs 2.9 ± 2.9; P = 0.02). Healthy women did not experience the same change (2.8 ± 5.3 vs 2.1 ± 3.2; P = 0.81). Postpartum comparisons showed the mean RDI of women with GH had decreased to be similar to that of healthy women (P = 0.75). Conclusions: SDB in women with gestational hypertension improved in the postpartum state to levels indistinguishable from our healthy subjects. This suggests that the physiologic effects of pregnancy may have had a pathologic role in the development of antepartum SDB in women with GH. Citation: Reid J; Glew RA; Skomro R; Fenton M; Cotton D; Olatunbosun F; Gjevre J; Guilleminault C. Sleep disordered breathing and gestational hypertension: postpartum follow-upstudy. SLEEP 2013;36(5):717-721.
Background and Purpose Chronic pain is increasingly recognized as a consequence of stroke. This study aimed to describe the prevalence and pain types of new onset chronic pain (“novel pain”) in patients with stroke compared with a randomly selected reference group from the general population and to identify factors associated with pain development in stroke patients. Methods In a population-based follow-up design, development of chronic pain after stroke was assessed by a questionnaire sent to consecutive stroke patients, registered in a Danish national stroke database, two years after their stroke. A randomly selected sex- and age-matched reference group from the same catchment area received a similar questionnaire about development of new types of chronic pain in the same time period. A total of 608 stroke patients and 519 reference subjects were included in the study. Results Development of novel pain was reported by 39.0% of stroke patients and 28.9% of reference subjects (OR 1.57, CI 1.21-2.04), and was associated with low age and depression in a multivariate model. Daily intake of pain medication for novel pain was reported by 15.3% and 9.4% of the stroke and reference population, respectively. Novel headache, shoulder pain, pain from increased muscle stiffness, and other types of novel pain were more common in stroke patients, whereas joint pain was equally common in the two groups. Conclusions Development of chronic pain is more common in stroke patients compared with sex- and age-matched reference subjects. Evaluation of post-stroke pain should be part of stroke follow-up.
|The main objective of this follow-upstudy is to explore factors influencing the success or failure of women in reintegrating after their release from prison. Female drug users in five European cities were tracked after being released from prison. Out of 234 female prisoners contacted in prisons, 59 were included in the follow-upstudy.…
Background Each follow-up during the course of tuberculosis treatment currently requires two sputum examinations. However, the incremental yield of the second sputum sample during follow-up of different types of tuberculosis patients has never been determined precisely. Objectives To assess the incremental yield of the second sputum sample in the follow-up of tuberculosis patients under the Revised National Tuberculosis Control Programme (RNTCP) in Chhattisgarh, India. Methodology A record review of tuberculosis (TB) patients registered in 2009 using a structured proforma from two sources, Tuberculosis and Laboratory Register, was undertaken in the six districts of Chhattisgarh, India. Results In smear positive cases, of 10,048 follow-up examinations, 45 (0.5%) were found to be smear positive only on the second sputum when the result of the first sample was negative. In smear negative pulmonary and extra pulmonary TB patients, of 6,206 follow-up smear examinations, 11(0.2%) were found to be smear positive. Conclusions The incremental yield of a second smear examination was very low, indicating that examination of one sputum sample is enough during follow-up among TB patients. There is insufficient yield to support sputum smear microscopy for monitoring smear negative pulmonary TB and extra pulmonary TB patients. These results indicate that the follow-up smear microscopy can be substantially simplified with favourable resource implications.
Kundu, Debashish; M. V. Kumar, Ajay; Satyanarayana, Srinath; Dewan, Puneet Kumar; Achuthan Nair, Sreenivas; Khaparde, Kshitij; Nayak, Priyakanta; Van den Bergh, Rafael; Manzi, Marcel; Enarson, Donald A.; Deshpande, Madhav Rao; Chandraker, Sachin
High endothelial cell density (ECD) is essential for the corneal graft clarity. We evaluated ECD loss in 120 eyes that underwent penetrating keratoplasty (PK) in Eye Clinic Svjetlost in a one year followup period. Patients were divided into 3 groups of high (N = 35), intermediate (N = 31) and low risk (N = 54) for graft failure. Postoperative central endothelial density, coefficient of variation in cell area (polymegathism), percentage of hexagonal cells (pleomorphism) in comparison to preoperative donor cell measurements were determined in the following postoperative time-points of 1, 2, 3, 6, 9 and 12 months. There were no significant differences in the preoperative ECD values, storage time, donor age or surgical procedures between groups. Throughout all time points intermediate group had the greatest statistically significant ECD loss as compared to high and low risk groups. There were no significant differences between high and low risk group. After 12 month post PK, intermediate risk group had 28.38% ECD loss as compared to 24.07% in high and 23.03% ECD loss in low risk group. Coefficient of variation in cell area (CV) was for high risk group 0.34, intermediate 0.40 and low risk 0.31 which was not significantly different between groups. Percentage of plemorphism in high risk was 54%, intermediate 58% and in low risk 48% which was significantly different as compared to other two groups. Our study showed that corneal pathology is among others, very important prognostic factor for ECD after PK. However, longer followup period is needed. PMID:22220396
|Objective: To study childhood predictors for late adolescence criminality. Method: The follow-up sample included 2,713 Finnish boys born in 1981. Information about the 8-year-old boys' problem behavior was obtained from parents, teachers, and the children themselves. The follow-up information about criminal offenses was based on the national…
Objective: To study childhood predictors for late adolescence criminality. Method: The follow-up sample included 2,713 Finnish boys born in 1981. Information about the 8-year-old boys' problem behavior was obtained from parents, teachers, and the children themselves. The follow-up information about criminal offenses was based on the national…
Prospective follow-upstudy of 70 males with Asperger syndrome (AS), and 70 males with autism more than 5 years after original diagnosis. Instruments used at follow-up included overall clinical assessment, the Diagnostic Interview for Social and Communication Disorders, Wechsler Intelligence Scales, Vineland Adaptive Behavior Scales, and Global…
Cederlund, Mats; Hagberg, Bibbi; Billstedt, Eva; Gillberg, I. Carina; Gillberg, Christopher
|Prospective follow-upstudy of 70 males with Asperger syndrome (AS), and 70 males with autism more than 5 years after original diagnosis. Instruments used at follow-up included overall clinical assessment, the Diagnostic Interview for Social and Communication Disorders, Wechsler Intelligence Scales, Vineland Adaptive Behavior Scales, and Global…
Cederlund, Mats; Hagberg, Bibbi; Billstedt, Eva; Gillberg, I. Carina; Gillberg, Christopher
By followingup on some prior respondents to solar surveys, solar energy purchase intentions are related to actual purchase behavior. Also examined is the relationship between attitudinal and demographic variables and trends in intention variables. Two se...
The hypothesis of the study was that social contacts to close friends and relatives and perceived social integration was able to delay mortality in general and cardiovascular mortality in particular. Altogether 1752 males and females, aged 70-100 years were interviewed by trained nurses in 1972 to 1974. The study group was based upon a random sample of all elderly in the town of Odense, Denmark. More than 80% participated in the survey which included data collection on social networks and health at the time of interviewing. By means of linking the study group to national registries on mortality and causes of mortality practically all in the cohort were traced until 1987. During follow-up 1501 persons died. Most of the association between social networks and mortality were weak and statistically insignificant but had the expected sign. After adjusting for initial health status only the interviewer's assessment of the quality of the network was statistically significant associated with longevity. A feeling of loneliness was found to be associated with cardiovascular mortality, especially for males. PMID:1767289
Olsen, R B; Olsen, J; Gunner-Svensson, F; Waldstrøm, B
Periods of recovery were examined in patients with and without deficit syndrome schizophrenia. Fifty-six patients with schizophrenia were studied, 39 of whom were divided into deficit and nondeficit syndrome schizophrenia subtypes using a proxy method. We also studied 39 nonpsychotic depressive comparison patients. Patients were evaluated as part of the Chicago Follow-upStudy, which prospectively examined patients at regular intervals over a 20-year period. Using standardized instruments, patients were evaluated for the deficit syndrome, global recovery, rehospitalization, social dysfunction, occupational disability, and symptom presentation. Recovery was examined at 6 time points measured at 2-, 4.5-, 7.5-, 10-, 15-, and 20-year postindex hospitalization. Cumulatively, over the 20-year period, 13% of patients classified as meeting criteria for the deficit syndrome showed 1 or more 1-year periods of global recovery, in comparison to 63% of nondeficit schizophrenia patients and 77% of depressed patient controls. Results indicate that the deficit syndrome represents a persistently impaired subsample of schizophrenia patients, with continuous social, occupational, and symptom impairment. In contrast, nondeficit syndrome schizophrenia patients showed at least some periods of remission or recovery, with the likelihood of these periods increasing as they became older. Findings provide further support for the validity of the deficit syndrome concept and suggest that deficit status is characterized by a more persistently impaired course of illness and particularly poor long-term prognosis. PMID:19095758
Strauss, Gregory P; Harrow, Martin; Grossman, Linda S; Rosen, Cherise
In this paper 4 studies on the course of delusional disorders of midlife, partly diagnosed as 'late schizophrenias' in the sense of M. Bleuler, published up to the 70s and 3 studies on the same topic which were published in the 80s, all European, are analysed with regard to differences in their results in order to find out factors operating on these differences and to propose standards to be followed in such studies. Four such factors are stressed: different follow-up times leading to different rates of loss of probands by death, unreliable use of diagnostic terms and, probably more influential, unreliable use of terms describing the course, and different preconditions of the recruiting process by differences in the care systems the probands are collected in. Four conclusions are derived from this finding: the need for comprehensive and valid information, for reliable use of terms describing the course, for information about the care system the patients come from as an important precondition of the process of recruiting probands, and probably for the further development of a 'language' for the description of course. PMID:1784706
Background: Among the various treatment modalities, family intervention is the most notable current advance in the area of psychosocial treatment of alcoholism. Aim: To assess the impact of family intervention therapy as an adjuvant to pharmacotherapy in alcohol-dependent subjects in a case-control study design. Materials and Methods: Thirty patients who satisfied DSM-IV Criteria for alcohol dependence syndrome were given the right package of family intervention therapy. Thirty age-, sex- and ‘marital status’-matched patients who satisfied the same diagnostic criteria were given only brief supportive psychotherapy. Both groups were assessed at base line, six months and at one year using Michigan Alcohol Screening Test, Motivation Scale, Rotter's Locus of Control, Family Intervention Pattern Scale and Presumptive Stressful Events Scale. Primary efficacy variable was cumulative abstinence duration, and secondary efficacy variables were relapse rate and time to first drink. Results: Family intervention therapy significantly reduced the severity of alcohol intake, improved the motivation to stop alcohol and changed the locus of control from external to internal in the study group. Control group experienced more severe stressful life events than the study group during the follow-up periods. Drop-out rate was comparable in both groups. Conclusion: Combining pharmacological treatment with appropriate psychosocial therapies focusing on the specific problem of the patient provides better outcome than either of these therapies given alone.
Objective: To examine the course of pain, physical function, and other health dimensions after a comprehensive inpatient rehabilitation intervention in patients with osteoarthritis (OA) of the hip or knee. Methods: An observational, prospective cohort study with assessments at baseline (entry into clinic), 1 (discharge from inpatient rehabilitation), 3, 6, 9, 12, and 24 months after baseline. Consecutively referred patients to an inpatient rehabilitation centre fulfilling the inclusion criteria were studied. 3–4 week comprehensive rehabilitation intervention, including strengthening exercise, flexibility training, endurance training, relaxation strategies, and consultations for preventive measures, was carried out. Individual home rehabilitation programmes were taught. Generic health status was measured using the SF-36, condition specific health was measured with the WOMAC questionnaire. Effects were analysed with sensitivity statistics (effect size, ES) and non-parametric tests. Results: Data from 128 patients with complete followup data were analysed. Both pain and physical function improved moderately (WOMAC pain: ES = 0.56, WOMAC function ES = 0.44) until discharge. Although the effect in pain reduction remained significant by month 24 (WOMAC: ES = 0.26), physical function deteriorated close to baseline values after 12 months. Conclusions: Comprehensive inpatient rehabilitation of patients with OA of the hip or knee may improve pain and physical function in the mid-term, and pain in the long term.
Weigl, M; Angst, F; Stucki, G; Lehmann, S; Aeschlimann, A
This follow-upstudy compares the accuracy of the HESI Exit Exam (E) in predicting NCLEX success for the academic years 1996-97 (N = 2,809) and 1997-98 (N = 3,752) and is designed to replicate the study of Lauchner et al and to implement recommendations suggested by the authors for further research. The E was again found to be highly predictive of licensure success, regardless of the type of program tested: associate degree, baccalaureate degree, diploma, or practical nurse programs. The predictive accuracy of the E was 98.27% for the RN group and 99.34% for the PN group. The E was again found to be significantly more accurate when administration of the exam was monitored than when it was not monitored (P = 0.05). In the 1997-98 academic year, NCLEX success of low-scoring E students was examined. Significantly more (P = 0.001) of the low-scoring E students failed the licensure exam than high-scoring E students. However, significantly fewer (p = 0.05) of these low-scoring E students failed the licensing exam when the E was used as a benchmark or guide for remediation. PMID:18791385
Sprinters are advised to include additional protein sources in their diet. Basal metabolism and vigorous physical activities generate hydrogen ions that need to be buffered. The present follow-upstudy estimates the dietary potential renal acid load (PRAL) and net endogenous acid production (NEAP) in adolescent sprint athletes. Seven-day food diaries and anthropometrics of 60 adolescent sprint athletes (mean age at start 14.7 ± 1.9 years) were collected every six months over a three year period. Comparisons were made between athletes with a negative (PRAL(?)) versus positive PRAL (PRAL(+)). For the entire sample, mean PRAL values of up to 6 mEq/day were slightly positive despite a relatively high protein intake of around 1.5 g/kg. The NEAP ranging between 42 and 46 mEq/day remained stable during the study period. Athletes with a PRAL(?) (?8 to ?10 mEq/day) consumed significantly more fruit and fruit juice than athletes with a PRAL(+) (+9 to 14 mEq/day). Athletes with a PRAL(+) did not consume more meat, fish and poultry than athletes with a PRAL(?). Grains and dairy products were only discriminative between the two groups on one measurement occasion. Lowering the PRAL can be obtained by increasing the consumption of potatoes, fruits, vegetables and vegetable soup.
Aerenhouts, Dirk; Deriemaeker, Peter; Hebbelinck, Marcel; Clarys, Peter
The objective of the study was to ascertain whether involvement in bullying increases the risk for subsequent suicidal ideation. A total of 2,070 Finnish girls and boys aged 15 were surveyed in the ninth grade (age 15) in schools, and followedup 2 years later in the Adolescent Mental Health Cohort Study. Involvement in bullying was elicited at age 15 by two questions focusing on being a bully and being a victim of bullying. Suicidal ideation was elicited by one item of the short Beck Depression Inventory at age 17. Baseline depressive symptoms and externalizing symptoms, age and sex were controlled for. Statistical analyses were carried out using cross-tabulations with Chi-square/Fisher's exact test and logistic regression. Suicidal ideation at age 17 was 3-4 times more prevalent among those who had been involved in bullying at age 15 than among those not involved. Suicidal ideation at age 17 was most prevalent among former victims of bullying. Being a victim of bullying at age 15 continued to predict subsequent suicidal ideation when depressive and externalizing symptoms were controlled for. Being a bully at age 15 also persisted as borderline significantly predictive of suicidal ideation when baseline symptoms were controlled for. Findings indicate adolescent victims and perpetrators of bullying alike are at long-term risk for suicidal ideation. PMID:23053774
Commercial broilers were raised in a 5-week period and a detailed clinicochemical follow-up was carried out, to characterise a flock selected for one-sided muscle mass production. Blood samples were drawn at the ages of 1 day, 1, 2, 3, 4 and 5 weeks, and plasma enzyme activities, metabolite and ion concentrations were determined. Early increases were found for all plasma nitrogenous compounds (total protein, albumin, creatinine and urate). Triglyceride showed a posthatch peak with a significant effect of age. Plasma total cholesterol was characterised by a marked post-hatch concentration peak, while during the first week its concentration decreased markedly. Plasma AST showed an increase during the rearing, while a one-magnitude increment was found for creatine kinase activity during the study. The main results of the study outlined a typical precocial bird (post-hatch triglyceride peak; decreasing cholesterol and early peaking plasma protein and urate concentrations) with very quick skeletal muscle mass growth (increasing creatine kinase and AST activities, slight hyperkalaemia). PMID:18277704
Abstract Conclusion: Early intervention may change the natural course of allergic rhinitis, preventing the progression to asthma. In particular, immunotherapy guarantees remission of local symptoms and valid protection against local and bronchial complications. Symptomatic treatment represents a valid alternative; it is always to be preferred to abstention from any treatment. Objectives: Data emerging from various studies on the increase of the prevalence of allergic rhinitis in recent decades appear to be widely dishomogeneous. Another point that needs clarification is the relationship between allergic rhinitis and lower airways pathologies such as asthma or bronchitis. Methods: We followed the evolution of allergic rhinitis in a group of patients for the last 30 years to highlight the efficacy of different treatments in the prevention of complications, specifically asthma. After 32 years (1980-2012), 46/73 (63%) patients completed the follow-up. Results: Symptomatic drugs exhibited maximum efficacy from the third to the eighth year, with 13 of 15 patients reporting an improvement of symptoms; immunotherapy achieved the best efficacy starting from the sixth to the tenth year (8 of 10 patients recovered). Subsequently, improvements decreased in the two groups, to a steady level of 11 of 15 and 6 of 10 recovered patients. Asthma developed in 3 of 46 patients and only among patients that were not treated. PMID:24125190
Passali, Giulio Cesare; Bellussi, Luisa Maria; De Corso, Eugenio; Passali, Francesco Maria; Passali, Desiderio
An 8 to 14-year follow-upstudy of 51 surgically-treated patients with idiopathic scoliosis was performed to determine the impact upon their total life styles, and the differences in comparable but non-surgically-treated patients. Forty-nine per cent were already married and raising families and 70 per cent had been educated beyond high school. Ninety-four per cent were actively employed although 20 per cent had met with some type of job discrimination. None of the unemployed was rejected because of back symptoms. Eighty-six per cent of the patients experienced either no back symptoms or just an annoying but nonrestrictive type of low back pain. Most of the patients experiencing significant back pain were found to have tight hamstrings. Only 4 per cent of the patients required hospitalization for back symptoms and another 4 per cent relied on the use of a lumbar corset to relieve their back strain. Seventy-eight per cent of the patients were quite active in sports and other strenuous activities. Fifty-one per cent of the patients were motivated for cosmetic reasons to undergo the corrective surgery. Postoperatively, 33 per cent were still self-conscious of their scar and 43 per cent were bothered with a residual deformity. Only 10 per cent, however, expressed an overall dissatisfaction with the total result. PMID:1277665
Grouw, A V; Nadel, C I; Weierman, R J; Lowell, H A
Although otherwise extensively researched, one aspect of social functioning in older people that has received less attention is its association with staying at home for as long as possible. This 10-year follow-up examines factors of social functioning that support older people's independent living in their own homes and that reduce the risk of mortality. The data were collected in 1991 by a postal questionnaire that was sent to all residents of Turku, Finland, born in 1920. A physical examination was also conducted. Ten years later, in 2001, the mortality rate of this population was determined. The data were examined statistically. Female gender reduced the risk of mortality. In addition, daily outdoor activities, and not needing help (from different sources) were associated with a reduced risk of mortality. No need for help and a more positive attitude towards life reduced the risk of mortality of women. There were found only non-significant trends for men. Having plans for the future also reduced the risk of mortality. The findings of this study offer useful clues for planning the services provided by home health care personnel. In planning these services it is important that home health care workers take into account the differences between women and men customers: men may need and want different things from the home health care service than women do. PMID:18207580
Arve, Seija; Lavonius, Sirkku; Savikko, Niina; Lehtonen, Aapo; Isoaho, Hannu
This study examined the predictors of longevity among 40 late adolescent romantic couples (mean age males=17.71 years; mean age females=17.18 years). Subjects were given a revealed differences task where they were asked to solve their disagreements. The joint task was recorded, transcribed and analysed by two raters. At 3, 6, 9, 12, 18, and 24 months after this procedure, partners were contacted by telephone and asked whether their relationship was still intact. A cluster analysis was performed on couples' interaction indices and yielded three distinctive conflict resolution patterns. The Downplaying pattern was characterized by a high tendency to minimize the conflict. The relationships of the adolescents displaying this pattern stayed intact for a period of 9 months. Half of them were still together after 24 months. The adolescents displaying the Integrative pattern, which shows a good ability to negotiate differences tended to stay together over a period of 24 months. Those showing the Conflictive pattern, characterized by a confrontative interaction, were separated by the 3 months follow-up. Results are discussed within the context of developmental perspectives of conflict resolution tendencies and adolescent romance. PMID:16198410
OBJECTIVE: To investigate the contribution of neuroleptic drugs to cognitive decline in dementia. DESIGN: Two year prospective, longitudinal study consisting of interviews every four months, with necropsy followup. SETTING: Community settings in Oxfordshire. SUBJECTS: 71 subjects with dementia, initially living at home with informant. MAIN OUTCOME MEASURES: Cognitive function (score from expanded minimental state examination); behavioural problems (physical aggression, hallucinations, persecutory ideas, and disturbance of diurnal rhythm); and postmortem neuropathological assessment (cortical Lewy body pathology). RESULTS: The mean (SE) decline in cognitive score in the 16 patients who took neuroleptics was twice that in the patients who did not (20.7 (2.9) v 9.3 (1.3), P = 0.002). An increased rate of decline was also associated with aggression, disturbed diurnal rhythm, and persecutory ideas. However, only use of neuroleptics and severity of persecutory ideas were independently associated with more rapid cognitive decline when all other variables were adjusted for. The start of neuroleptic treatment coincided with more rapid cognitive decline: median rate of decline was 5 (interquartile range 8.5) points per year before treatment and 11 (12) points per year after treatment (P = 0.02). Cortical Lewy body pathology did not account for association between neuroleptic use and more rapid decline. CONCLUSIONS: Neuroleptic drugs that are sometimes used to treat behavioural complications of dementia may worsen already poor cognitive function. Randomised controlled trials are needed to confirm a causal relation.
Among 44 patients with acute post-infectious GN, we found 11 cases (10 male, 1 female) displaying an immunohistologically and electron microscopically characteristic "garland pattern". Numerous sub-epithelial deposits of the "hump" type with characteristic patchiness correspond in the electron micrograph to densely packed deposits (IgG, always combined with C3, more rarely also with IgM) demonstrable immunohistologically on the peripheral loops. On the other hand, sub-endothelial, mesangial and intramembranous deposits are less prominent. Clinically, the patients have a strikingly high proteinuria. Follow-upstudies have revealed that in a proportion of the patients both the clinical and the morphological findings can regress after a month long course. These are mainly younger patients. On the other hand, in another group of cases (mainly older patients) both the clinical and the morphological findings persist even after months. Within acute post-infectious GN, the "garland type" appears to form a particular group in which a large proteinuria (with or without nephrotic syndrome) and a tendency to chronicity or at least to a protracted course is present in a relatively high percentage. PMID:6883817
Sorger, K; Balun, J; Hübner, F K; Köhler, H; Olbing, H; Schulz, W; Seybold, D; Thoenes, G H; Thoenes, W
Although the research indicates that patients and family members are not fully satisfied with the counselling they receive, little is known about the quality of counselling in more detail. The purpose of the study was to describe patients' and their family members' experiences about counselling in emergency department, and follow how these experiences possibly change after the educational intervention for the whole nursing staff of the ED ward. The pre-test-post-test follow-up design was implemented including online continuing education for ED staff. The data were collected via questionnaires from patients and their family members in two phases and analyzed statistically. After online education of staff, experiences of patients and family members concerning counselling were better than before the education. Especially, family members' satisfaction had increased. However, our results also indicated that patients and family members desire more information for example, regarding medications. Care practices had developed towards family-centeredness, which patients and family members appreciate. Online education proved also in some degree its usefulness in educating ED staff, by offering the same education to a staff which works in shifts. Furthermore, family presence and participation practices should be developed by offering possibilities for families to stay with each other on ED ward.
A long-term follow-upstudy of maxillary clefts operated on primarily with the maxillary periosteal flap (67 patients) and the free tibial periosteal graft (23 patients) showed a definite bone bridge in 64 versus 85 percent of the patients. Still, secondary bone grafting was indicated in both in over 70 percent. Lateral crossbite was observed in all and anterior crossbite (mostly dental) was seen in over 80 percent of both groups. There were no statistically significant differences in the cephalometric angular measurements between the groups. Inside the maxillary periosteal flap group the maxillary growth was more retarded in unilateral and especially bilateral complete clefts than in alveolar clefts only. The maxillary growth seemed to be on average better than in primarily bone-grafted materials. The primary use of periosteum had been abandoned in our unit already in 1974, because it did not fulfill the expectations of prevention of maxillary collapse, lesser need for secondary bone grafting, and better midfacial growth. PMID:2909063
Browlift for patients with irreversible paralysis of the frontalis muscle was evaluated in a review of 40 patients who had undergone follow-upstudies for durations of more than 3 years. The procedure consists of a lazy S-shaped excision above the upper border of the eyebrow and upward fixation of the lower skin margin. The results were as follows: (1) The percentage of patients for whom symmetrical positioning of the eyebrow was achieved was 65%. (2) The greater the preoperative severity of ptosis, the more often did recurrence occur. (3) Recurrence progressed rapidly during the first postoperative year, but thereafter recurrence was seen only in those patients in whom the affected eyebrow was still in a position higher than its counterpart. (4) No relationship could be seen between age at the time of surgery and postoperative position of eyebrow. (5) Improvement in contraction of the visual field was seen in 85% of patients postoperatively, and complaints were eliminated in 50%. (6) Careful preservation of the sensory nerve is required. (7) The postoperative scar was acceptable. This procedure is a simple and effective method of correction of paralytic ptosis. Although a degree of skill is required to obtain satisfactory results and a surgical scar remains at the upper border of the eyebrow, the advantages of the procedure surpass its disadvantages. It is believed that this method should be used more often in the treatment of facial paralysis. PMID:8192367
Background Substance use in general has been shown to predict criminal recidivism. The present study aimed to examine potential predictors of criminal recidivism, including substance-specific substance use patterns, in prisoners with substance use. Methods A cohort of prisoners with substance use problems (N?=?4,152) were assessed with the Addiction Severity Index (ASI) in the Swedish criminal justice system. Clients were followed for an average of 2.7?years. Criminal recidivism was defined as any return to the criminal justice system. Results During follow-up, 69 percent (n?=?2,862) returned to the criminal justice system. Recidivism was associated with amphetamine and heroin use, with an additive risk for injectors, and with polysubstance use. Also, recidivism was negatively associated with alcohol, other opioids than heroin/methadone and with hallucinogenic drugs, and positively associated with previous psychiatric in-patient treatment, violent behaviour, and with a shorter index sentence. Associations remained when controlling for type of crime. Conclusions Even when controlling for type and severity of crime, and for psychiatric problems, risk of criminal relapse was increased by substance use variables, including amphetamine, heroin and polysubstance use, and an additional risk was shown for injection drug users. These findings have implications for the need for substance abuse treatment after release from prison.
The document is the manual of procedures for the Phase II follow-upstudy of cryotherapy for retinopathy of prematurity. It details the rationale, design, current status, and procedures used in the study.
Background: The association of all-cause mortality and cardiovascular outcomes with air pollution exposures has been well established in the literature. The number of studies examining chronic exposures in cohorts is growing, with more recent studies conducted among women finding risk estimates of greater magnitude. Questions remain regarding sex differences in the relationship of chronic particulate matter (PM) exposures with mortality and cardiovascular outcomes. Objectives: In this study we explored these associations in the all-male Health Professionals Follow-UpStudy prospective cohort. Methods: The same spatiotemporal exposure estimation models, similar outcomes, and biennially updated covariates were used as those previously applied in the female Nurses’ Health Study cohort. Results: Among 17,545 men residing in the northeastern and midwestern United States, there were 2,813 deaths, including 746 cases of fatal coronary heart disease (CHD). An interquartile range change (4 µg/m3) in average exposure to PM ? 2.5 µm in diameter in the 12 previous months was not associated with all-cause mortality [hazard ratio (HR) = 0.94; 95% confidence interval (CI), 0.87–1.00] or fatal CHD (HR = 0.99; 95% CI, 0.87–1.13) in fully adjusted models. Findings were similar for separate models of exposure to PM ? 10 µm in diameter and PM between 2.5 and 10 µm in diameter and for copollutant models. Conclusions: Among this cohort of men with high socioeconomic status living in the midwestern and northeastern United States, the results did not support an association of chronic PM exposures with all-cause mortality and cardiovascular outcomes in models with time-varying covariates. Whether these findings suggest sex differences in susceptibility or the protective impact of healthier lifestyles and higher socioeconomic status requires additional investigation.
Despite decades of use, the long-term safety of breast implants in women remains a concern. While the incidence of breast cancer among women has increased dramatically in the past decade, the implant-related risk of carcinoma of the breast only recently has received widespread attention. An additional concern is that the presence of the implant may delay tumor detection. This study allows examination of breast cancer risk and detection issues among patients with long-term exposure. We conducted a record linkage cohort study of cosmetic breast implant patients. We abstracted the records of the private practices of 35 broad-certified plastic surgeons in Los Angeles County, California. We included 3182 white women who received cosmetic breast implants between 1953 and 1980. Spanish-surnamed women, nonresidents of Los Angeles County, and patients with prior subcutaneous mastectomy or breast cancer were excluded. Cancer outcomes through 1991 have been ascertained through record linkage with the Los Angeles County Cancer Surveillance Program. With a median follow-up of 14.4 years, 31 breast cancer cases were observed, compared with 49.2 expected, based on Los Angeles County population-based incidence rates (standardized incidence ratio = 63.0 percent; 95 percent confidence limits: 42.8 and 89.5 percent). The distribution of stage of disease at diagnosis among women with implants did not differ from that of all similar breast cancer patients in Los Angeles County. In Los Angeles County, augmentation mammaplasty patients experience a significantly lower than expected risk of breast cancer and no delay in breast cancer detection after an average of 14.4 years of exposure. While the linkage methodology allows the possibility of failing to detect diagnosed cancer cases and does not permit collection of some pertinent risk factors, the six other published epidemiologic studies on the topic also report breast cancer risk to be at or below the expected rate. PMID:9105362
Objective This study examines if overweight in midlife increases dementia risk later in life. Methods In 1963 Body Mass Index was assessed in 1152 participants of The Swedish Twin Registry, then at the age of 45 to 65 years. These participants were later screened for dementia in a prospective study with up to 40 years follow-up. A total of 312 participants were diagnosed with dementia. Results Logistic regression analyses, adjusted for demographic factors, smoking and alcohol habits, indicated that men and women categorized as overweight in their midlife had an elevated risk of dementia (OR = 1.59; 95% CI: 1.21 to 2.07, p = .002), Alzheimer’s disease (OR = 1.71; 95% CI: 1.24 to 2.35, p = .003), and vascular dementia (OR = 1.55; 95% CI: 0.98 to 2.47, p = .059). Further adjustments for diabetes and vascular diseases did not substantially affect the associations, except for vascular dementia (OR = 1.36; 95% CI: 0.82 to 2.56, p = .116), reflecting the significance of diabetes and vascular diseases in the aetiology of vascular dementia. There was no significant interaction between overweight and APOE ?4 status, indicating that having both risk factors does not have a multiplicative effect concerning dementia risk. Conclusions This study gives further support to the notion that overweight in midlife increases later risk of dementia. The risk is increased for both Alzheimer’s disease and vascular dementia, and follows the same pattern for men and women.
Hassing, Linda B.; Dahl, Anna K.; Thorvaldsson, Valgeir; Berg, Stig; Gatz, Margaret; Pedersen, Nancy L.; Johansson, Boo
Background Studies on factors which may predict the risk of diabetes are scarce. This prospective cohort study was conducted to determine the association between adiponectin and type 2 diabetes among Korean men and women. Methods A total of 42,845 participants who visited one of seven health examination centers located in Seoul and Gyeonggi province, Republic of Korea between 2004 and 2008 were included in this study. The incidence rates of diabetes were determined through December 2011. To evaluate the effects of adiponectin on type 2 diabetes, the Cox proportional hazard model was used. Results Of the 40,005 participants, 959 developed type 2 diabetes during a 6-year follow-up. After the adjustment for age, body mass index (BMI), and waist circumference, the risks for type 2 diabetes in participants with normoglycemia had a 1.70-fold (95% confidence interval [CI], 1.21 to 2.38) increase in men and a 1.83-fold (95% CI, 1.17 to 2.86) increase in women with the lowest tertile of adiponectin when compared to the highest tertile of adiponectin. For participants with impaired fasting glucose (IFG), the risk for type 2 diabetes had a 1.46-fold (95% CI, 1.17 to 1.83) increase in men and a 2.52-fold (95% CI, 1.57 to 4.06) increase in women with the lowest tertile of adiponectin. Except for female participants with normoglycemia, all the risks remained significant after the adjustment for fasting glucose and other confounding variables. Surprisingly, BMI and waist circumference were not predictors of type 2 diabetes in men or women with IFG after adjustment for fasting glucose and other confounders. Conclusion A strong association between adiponectin and diabetes was observed. The use of adiponectin as a predictor of type 2 diabetes is considered to be useful.
Ahn, Chul Woo; Park, Jong Suk; Park, Chang Gyu; Kim, Hyon-Suk; Lee, Sang-Hak; Park, Sungha; Lee, Myoungsook; Lee, Chang Beom; Park, Hye Soon; Kimm, Heejin; Choi, Sung Hee; Sung, Jidong; Oh, Seungjoon; Joung, Hyojee; Kim, Sung Rae; Youn, Ho-Joong; Kim, Sun Mi; Lee, Hong Soo; Mok, Yejin; Choi, Eunmi; Yun, Young Duk; Baek, Soo-Jin; Jo, Jaeseong; Huh, Kap Bum
The current study was designed to trace changes in the relationship between non-word reading and irregular word reading on the one hand, and between phonological awareness and non-word reading on the other, through a follow-upstudy of a group of individuals with Down syndrome. Twelve individuals with Down syndrome, whose data were originally reported in Roch and Jarrold (2008), were seen four years later, and were given the same tasks as in the previous study evaluating phonological awareness, non-word reading and irregular word reading. After four years, an improvement was observed in all the skills of interest. Furthermore, the pattern of relationships among the three skills was observed to change considerably across the four year period. At the first time point, a weak association between non-word and irregular word reading was found, but there was a strong association between these two measures at the second time point. In contrast, a strong relationship was found at Time 1 between non-word reading and phonological awareness, which became weaker at Time 2. Longitudinal associations between the three skills were also examined in order to explain this changing pattern of associations. The results indicated that the ability to decode non-words plays a marginal role on later irregular word reading. In contrast, irregular word reading is a longitudinal predictor of later non-word reading. Phonological awareness was not longitudinally related to non-word reading. The results indicate that developing word knowledge can facilitate later non-word reading in Down syndrome, perhaps by a process of reading by visual analogy to known lexical items. Learning outcomes: Readers will be able to (a) explain the development of word reading, non-word reading and phonological awareness in Down syndrome; (b) explain the longitudinal changes in the relationships among the three skills; (c) explain the relevance for education of the influence of word reading for the improvement in non-word reading. PMID:22176835
Follow-up data from school records, teacher ratings, and parent ratings were obtained for a sample of 86 handicapped children who had been enrolled during 1973-1979 in a preschool program organized by the Rural Champaign County Special Education Cooperative and the University of Illinois. Results indicate that, in general, these children made a successful transition into elementary school. Only 20% were
Merle B. Karnes; Allan M. Schwedel; George F. Lewis; Darryl A. Ratts; D. Ruth Esry
The long-term results of 325 consecutive Charnley total hip arthroplasties (THAs) were assessed at an average of 62 and 140 months (five-year and ten-year follow-up examinations) postoperatively. Cases developing deep infection during the first five years were not included. Pain, walking ability, and mobility were rated as advocated by Charnley. The results were then graded as excellent, good, fair (clinically successful), and failure. At the five-year follow-up evaluation, 77 hips were excluded; 92% (228/248) of the results were successful. At the ten-year follow-up examination, interest was focused on the 228 hips graded as successful after five years. Sixty-six were excluded, one that had not been included at the five-year evaluation was traced, and 92% (150/163) were again clinically successful. The failure rate owing to mechanical causes during the first five years and between the five-year and ten-year follow-up examinations was 6.9% and 6.7%, respectively. The clinical results were considered highly satisfactory because only 50% of the hips judged successful at the ten-year examination had roentgenographically intact components. There is good reason to have great confidence in the Charnley THA. PMID:3370865
Followingup on the transition to university and university persistence, 119 (44 males; 75 females) students who had not graduated (within seven years) from a large, commuter Canadian university were interviewed. "Leavers" were not a homogenous group but could be divided into categories of departure: transferred to another university (29.4%),…
|In an attempt to measure the efficacy of a college parallel program, a follow-up of 204 community college students was conducted. Grades earned by those students at both colleges correlated +.65. GPA dropped during the first semester after transfer, indicating the effects of transfer shock. (Author)|
Chest radiographs and spirometric tests were performed on 81 patients who had silicosis from two granite quarries in 1975, 73 of whom were followedup for two to 10 (mean 7.2) years. Each patient's initial and most recent chest radiographs were assessed independently by three experienced readers, and the yearly declines in forced expiratory volume in one second and forced
Considers how communication audits are typically presented as one-shot events, whose impact is not measured. Employs a follow-up audit to track the effects of an initial audit upon a major health care organization. Illustrates how the audit can play a useful role in an organization's communication strategy. (SG)
|Considers how communication audits are typically presented as one-shot events, whose impact is not measured. Employs a follow-up audit to track the effects of an initial audit upon a major health care organization. Illustrates how the audit can play a useful role in an organization's communication strategy. (SG)|
Objective: To describe loss to follow-up (LTFU) in a longitudinal community-based study on urogenital tract dysfunction in older men. Patients and Methods: A cohort study of men recruited from a Dutch municipality was performed. A baseline study and two follow-up rounds – all with questionnaires and additional measurements – were performed with, on average, 2.1-year intervals. Baseline characteristics were compared
Marco H. Blanker; Jennie Prins; J. L. H. Ruud Bosch; Boris W. V. Schouten; Roos M. D. Bernsen; Frans P. M. J. Groeneveld; Arthur M. Bohnen
Context: Studies have revealed high morbidity and mortality among agate stone workers of Shakarpur due to silicosis. Besides the fatal disease, the workers also suffer from debilitating co-morbidities especially tuberculosis and under nutrition. Aims: The present study describes few co-morbidities and their influence in mortality in cases of silicosis that were followed for 30 months at Shakarpur. Settings and Design: Shakarpur, Khambhat of Gujarat. Materials and Methods: Spirometry for lung function, chest X-ray, anthropometry, body fat % measurement, record of tuberculosis status and ILO classification of pneumoconiosis were done among 53 chest symptomatic patients above 15 years of age who were followed for 30 months. Results: Out of 53 participants (35 men), with an average duration of exposure to free silica of 16.8 years, more than half of the male workers were underweight (BMI<18.5 kg/m2) at enrollment. Thirteen participants died in less than 3 years of followup. While 11 of them were silicosis positive out of which 10 had tuberculosis. The odds ratio for association between silicosis and tuberculosis was 2.75. A majority (81.1%) of the 37 silicosis positive cases showed a mixed pattern in spirometry suggesting co-existence of restrictive and obstructive pathology. On regression analysis, TB and nutritional status were found to have strong influence on mortality. Conclusions: Screening for early diagnosis of silicosis as well as co-morbid conditions and managing them would go a long way in prolonging the lives of the agate stone workers who are prone to die early due to silicosis.
The assessment of stroke survivors' quality of life (QoL) is essential for planning poststroke therapy strategies. This study aimed to assess, compare, and identify predictors of unsatisfactory QoL in different dimensions of stroke survivors at 1 month and 3 months poststroke. A total of 125 stroke survivors were recruited from 4 public hospitals under the auspices of the Department of Medical Services, Bangkok Metropolitan Administration, Thailand, and followed for 3 months. QoL was assessed using the self-administered SF-36 Health Survey, version 2.0. Six specific dimensions of QoL-physical function, role-physical, bodily pain, general health, vitality, and role-emotional-were significantly improved at 3 months poststroke; however, 2 dimensions-social function and mental health-were not. Multiple logistic regression analysis revealed that at 1 month poststroke, significant predictors of unsatisfactory QoL were being dependent (Barthel Index score <80), severe cognitive impairment (Canadian Neurological Scale score <7), right hemisphere lesions, being single or widowed, age ?60 years, and being unemployed poststroke. At 3 months poststroke, significant predictors of unsatisfactory QoL were being dependent (Barthel Index score <80), severe cognitive impairment (Canadian Neurological Scale score <7), being single or widowed, being unemployed poststroke, and self-supporting/other support for treatment fees. This follow-upstudy demonstrated a significant improvement in QoL from 1 month to 3 months poststroke. Predictors of QoL varied both over time poststroke and over the specific dimensions of QoL being considered. PMID:22749628
Objectives The death of a sibling can trigger grief and depression. Sibling deaths from external causes may be particularly detrimental, since they are often sudden. We aimed to examine the association between the death of an adult sibling from external causes and the risk of suicide among surviving siblings up to 18?years after bereavement. We adjusted for intrafamily correlation in death risks, which might occur because of shared genetics and shared early-life experiences of siblings in the same family. Design A follow-upstudy between 1981 and 2002 based on the total population. Setting Sweden. Participants Swedes aged 25–64?years (n=1?748?069). Primary and secondary outcome measures Suicide from the Swedish cause of death register. Results An increased risk of mortality from suicide was found among persons who had experienced the death of a sibling. In women, the suicide risk was 1.55 times that of non-bereaved persons (95% CI 0.99 to 2.44), and in men it was 1.28 times higher (95% CI 0.93 to 1.77). If one sibling committed suicide, the risk of the remaining sibling also committing suicide was 3.19 (95% CI 1.23 to 8.25) among women and 2.44 (95% CI 1.34 to 4.45) among men. Associations with other main causes of death—such as external other than suicide, cardiovascular diseases or cancer—were generally much smaller and statistically not significant in either sex. We found no clear support for a specific time pattern according to time since a sibling's death. Conclusions Our study provided evidence for suicide risk associated with the death of a sibling at adult age, revealing that bereaved persons’ risk of suicide is higher when siblings die from suicide, even when adjusting for intrafamily correlation in death risks.
Objective To define better the adult phenotype and natural history of Noonan syndrome. Design A prospective observational study of a large cohort. Results Data are presented for 112 individuals with Noonan syndrome (mean age 25.3 (range 12–71)?years), who were followedup for a mean of 12.02?years. Mutations in PTPN11 were identified in 35% of probands. Ten subjects died during the study interval; three of these deaths were secondary to heart failure associated with hypertrophic cardiomyopathy. Pulmonary stenosis affected 73 (65%) subjects; 42 (58%) required no intervention, nine underwent balloon pulmonary valvuloplasty (three requiring further intervention) and 22 surgical valvuloplasty (three requiring further intervention). Hypertrophic cardiomyopathy affected 21 (19%) patients, which had remitted in two cases, but one subject required cardiac transplant. No subjects died suddenly or had symptoms suggestive of arrhythmia. The mean final adult height was 167.4?cm in males and 152.7?cm in females. Feeding problems in infancy were identified as a predictor of future outcome. The mean age of speaking in two?word phrases was 26?months for those with no feeding difficulties, compared with 39?months for those with severe problems requiring nasogastric feeding. Attendance at a school for children with special needs for the same groups was 12.5% and 58%, respectively. A statement of special educational need had been issued in 44% overall; however, academic achievement was broadly similar to that of the general population. Implications Although the morbidity for some patients with Noonan syndrome is low, early predictors of poorer outcome have been identified, which will help ascertain those most in need of intervention.
Shaw, A C; Kalidas, K; Crosby, A H; Jeffery, S; Patton, M A
Aims: To estimate the one year cumulative incidence and persistence of upper extremity (UE) soft tissue disorders, in a fixed cohort of automotive manufacturing workers, and to quantify their associations with ergonomic exposures. Methods: At baseline and at followup, cases of UE musculoskeletal disorders were determined by interviewer administered questionnaire and standardised physical examination of the upper extremities. The interview obtained new data on psychosocial strain and updated the medical and work histories. An index of exposure to ergonomic stressors, obtained at baseline interview, was the primary independent variable. Cumulative incidence and persistence of UE disorders (defined both by symptoms and by physical examination plus symptoms) were analysed in relation to baseline ergonomic exposures, adjusting for other covariates. The incidence of new disorders was modelled using multivariate proportional hazards regression among workers who were not cases in the first year and the prevalence on both occasions was modelled by repeated measures analysis. Results: A total of 820 workers (69% of eligible cohort members) was examined. Followup varied slightly by department group but not by baseline exposure level or other characteristics. Among the non-cases at baseline, the cumulative incidence of UE disorders was 14% by symptoms and 12% by symptoms plus examination findings. These rates increased with index of physical exposures primarily among subjects who had the same jobs at followup as at baseline. Increased exposure during followup increased risk of incidence. The persistence of UE disorders from baseline to followup examination was nearly 60% and somewhat associated with baseline exposure score. Conclusions: These longitudinal results confirm the previous cross sectional associations of UE musculoskeletal disorders with exposure to combined ergonomic stressors. The exposure-response relation was similar for incident cases defined by symptoms alone and those confirmed by physical examination.
|Details language, memory, and reading information gathered for a five year followupstudy of 30 children and adolescents with Down syndrome. Concludes that early learning skills may be significant predictors of mean length of utterance five years later. (PM)|
... funded study examines frequency of follow-up bone mineral density tests in older adults What Osteoporosis is ... care professionals have long known that low bone mineral density (BMD) is an important risk factor for ...
Recent follow-up analyses of the previous findings from the Women's Health Initiative and the Women's Health Initiative Memory Study confirmed some health benefits of estrogen-containing hormone therapy (HT) in women within 10 years from the onset of menopause. However, the potential risks associated with long-term administration of HT, such as breast cancer and stroke, remain a concern for therapy recipients, underlying the need for an alternative treatment that is functionally equivalent but with a greater safety profile. Owing to their structural and functional resemblance to mammalian estrogens and lack of evident adverse effects, research interest in plant-derived phytoestrogens has increased in the past decade. While multiple health-promoting benefits of phytoestrogens have been proposed from basic science, the clinical data remain inconclusive. This review provides a comparative analysis of human studies on the effects of soy-based isoflavones on cognition. Of the eight studies published in 2000-2007, seven were conducted in postmenopausal women, four of which revealed a positive impact of isoflavones on cognitive function. Multiple factors could have contributed to the discrepant outcomes across studies, such as variation in the composition of phytoestrogen interventions and the heterogeneous characteristics of the study population. Thus, a well-designed clinical study based on a standardized stable formulation in a well-characterized study population is required in order to reach a clinical consensus. A formulation composed of select estrogen receptor beta-selective phytoestrogens with a rationally designed composition would avoid the potential antagonism present in a mixture and thus enhance therapeutic efficacy. In addition, inclusion of equol in a study formulation offers a potential synergistic effect from equol in both equol-producing and nonproducing individuals, as well as added benefits for men. With respect to the design of study population, a clinically consistent effect could potentially be achieved by stratifying populations based on genotype, age, hormonal history and even diets. Development of an effective phytoestrogen formulation would benefit both women and men to prevent or treat hormone-dependent conditions and, most of all, to improve neurological health and reduce the risk of Alzheimer's disease. PMID:17997703
Purpose To determine whether higher physical activity after prostate cancer (PCa) diagnosis decreases risk of overall and PCa-specific death. Patients and Methods We evaluated physical activity in relation to overall and PCa mortality among 2,705 men in the Health Professionals Follow-UpStudy diagnosed with nonmetastatic PCa observed from 1990 to 2008. Proportional hazards models were used to evaluate physical activity and time to overall and PCa-specific death. Results Among men who lived at least 4 years after their postdiagnosis physical activity assessment, we documented 548 deaths, 20% of which were a result of PCa. In multivariable analysis, men who were physically active had lower risk of all-cause mortality (Ptrend < .001) and PCa mortality (Ptrend = .04). Both nonvigorous activity and vigorous activity were associated with significantly lower overall mortality. Those who walked ? 90 minutes per week at a normal to very brisk pace had a 46% lower risk of all-cause mortality (hazard ratio [HR] 0.54; 95% CI, 0.41 to 0.71) compared with shorter durations at an easy walking pace. Men with ? 3 hours per week of vigorous activity had a 49% lower risk of all-cause mortality (HR, 0.51; 95% CI, 0.36 to 0.72). For PCa-specific mortality, brisk walking at longer durations was suggestively inverse but not statistically significant. Men with ? 3 hours per week of vigorous activity had a 61% lower risk of PCa death (HR, 0.39, 95% CI, 0.18 to 0.84; P = .03) compared with men with less than 1 hour per week of vigorous activity. Men exercising vigorously before and after diagnosis had the lowest risk. Conclusion In men with PCa, physical activity was associated with lower overall mortality and PCa mortality. A modest amount of vigorous activity such as biking, tennis, jogging, or swimming for ? 3 hours a week may substantially improve PCa-specific survival.
Kenfield, Stacey A.; Stampfer, Meir J.; Giovannucci, Edward; Chan, June M.
This study examined relative hazards for mortality and functional limitations according to poor self-ratings of health using prospective data from the NHANES I Epidemiologic Follow-upStudy, a representative sample of US adults aged 25-74 years that has been followed since the First National Health and Nutrition Examination Survey (NHANES I) was conducted in 1971-1975. Follow-up data were taken from death
A group of 52 patients presenting at an outpatient unit for anxiety disorders were included consecutively in a prospective 2-year follow-upstudy. Patients were administered to a structured interview for DSM-III-R diagnoses, a follow-up interview (LIFE), and various other ratings. Sociodemographic and illness-history characteristics, levels of anxiety and depressive symptoms, as well as psychosocial impairment, were evaluated at baseline and
A prospective study of 1431 patients admitted to a general surgery department were followedup for a median of 6.2 years after discharge (7679 person-years of follow-up). We collected information on underlying conditions, including severity of illness, and healthcare-related variables. Relative rates of death and their 95% confidence interval (CI) were estimated using person-years as the denominator. Multiple-risk factors adjusted
A Cosano; M. Á Mart??nez-González; M Medina-Cuadros; G Mart??nez-Gallego; S Palma; M Delgado-Rodr??guez
The current study evaluated the outcome of family-based treatment for female adolescents with anorexia nervosa (N?=?32), at the Anorexia-Bulimia Outpatient Unit in Göteborg, Sweden. Patients\\/parents were assessed pre-treatment, at 18- and 36-month follow-ups concerning eating disorder symptoms, general psychopathology, family climate and BMI. At the 36-month follow-up, 75% of the patients were in full remission with reduction in eating disorder
Gunilla Paulson-Karlsson; Ingemar Engström; Lauri Nevonen
In the Swiss Childhood Cancer Survivor Study, we aimed to assess the proportion of long-term survivors attending follow-up care, to characterise attendees and to describe the health professionals involved. We sent a questionnaire to 1252 patients, of whom 985 (79%) responded, aged in average 27years (range 20–49). Overall, 183 (19%) reported regular, 405 (41%) irregular and 394 (40%) no follow-up.
Cornelia E. Rebholz; Nicolas X. von der Weid; Gisela Michel; Felix K. Niggli; Claudia E. Kuehni
Longitudinal studies can be hampered by poor follow-up rates, seriously reducing generalizability of the findings. Understanding the barriers, as well as approaches to overcome and adapt to these impediments, resulted in a 96.6% 18 month follow-up rate of 479 drug abusers enrolled in an NIDA funded demonstration project aimed at reducing HIV transmission among St. Louis' most vulnerable drug-using population.
Linda B. Cottler; Wilson M. Compton; Arbi Ben-Abdallah; Malaika Horne; Daniel Claverie
BACKGROUND: Little is known about the care process after patients have contacted a GP cooperative for out-of-hours care. The objective of this study was to determine the proportion of patients who seek follow-up care after contact with a GP cooperative for out-of-hours care, and to gain insight into factors that are related to this follow-up care. METHODS: A total of
Caro JT van Uden; Paul J Zwietering; Sjoerd O Hobma; Andre JHA Ament; Geertjan Wesseling; Harry FJM Crebolder
Follow-up weights were obtained from 149 participants from two worksite weight control programs 1 year after the end of treatment. These participants regained, on average, 75% of the weight they had lost during treatment. Only 21% of this population maintained their post-treatment weight or continued to lose. We conclude that worksites do not appear to offer special advantages over clinic settings in aiding weight-loss maintenance. PMID:3362799
Background. The influence of residency training on use of smoking cessation intervention (SCI) in future practice is unexamined.Methods. We surveyed 291 physicians who participated in SCI research during residency between 1986 and 1996. Half received SCI training; half did not. Best practice included: (1) identifying smokers; (2) advising cessation; (3) assisting with a plan; (4) arranging follow-up.Results. Forty-two percent of
Katherine E Hartmann; Amy Espy; Melissa McPheeters; Linda S Kinsinger
Patients with generalized anxiety disorder (GAD) without concurrent depression (n = 11) and normal controls (n = 17) were tested twice, about 2 months apart, on a modified Stroop colour-naming task, which presented anxiety-related, depression-related and neutral words in masked and unmasked exposure conditions. GAD patients received cognitive behaviour therapy in the test-retest interval, and were also retested at follow-up,
Karin Mogg; Brendan P. Bradley; Neil Millar; Jim White
A follow-up survey was conducted on 201 young adults with autism who were 18 or older (mean age, 21.5). All had participated previously in intensive therapeutic camping or had therapeutic involvement at medical consultation agencies to evaluate their outcome. Their social outcome was better than that previously reported in Japan. Although 31.5% had shown marked deterioration during adolescence, 43.2% had
One-hundred-and-forty-nine motor vehicle collision trauma victims were interviewed one year after discharge from a Regional Trauma Unit. Follow-up data indicated major post trauma problems such depression, anxiety, family stress, financial problems and driving fears. Almost 40% reported drinking driving after the crash with a greater proportion of alcohol (blood alcohol content) positive drivers engaging in drinking driving than blood alcohol
Evelyn Vingilis; Edward Larkin; Gina Stoduto; Adele Parkinson-Heyes; Barry McLellan
Background: The factors that cause children to become smokers in adolescence remain unclear. Although parental smoking and peer pressure may play a role, physiological factors such as lung volume have also been identified. Methods: To investigate these and other possible childhood pre- dictors of teenage smoking, we gathered follow-up data on 191 Montréal schoolchildren, aged 5-12 years (average 9.2 yr)
Margaret R. Becklake; Heberto Ghezzo; Pierre Ernst
Objective To examine the contribution of premorbid function, duration of untreated psychosis (DUP), age of onset, severity of symptoms at presentation, and number of subsequent hospitalisations to the outcome of early onset schizophrenia (EOS; onset before 17th birthday). Method Twenty-three EOS patients (mean age at onset 15.16 ± 1.39 years) were re-assessed after a mean interval of 4 ± 1.08 years. At baseline and follow-up clinical
OBJECTIVE: To investigate the risk of enzyme sensitisation and clinical allergy in workers exposed to enzymes at Novo Nordisk A/S. METHODS: The study was a retrospective followupstudy based on medical history and test data originally collected at routine screenings for enzyme allergy by the Occupational Health Service (OHS) of Novo Nordisk A/S during the period 1970-92. Workers were exposed to proteases, lipases, cellulases, and carboxyhydrases. Medical records of 3815 subjects were registered in the OHS database. According to criteria including possible enzyme exposure, allergy tests at the time of engagement, and participation in the allergy screening programme 1064 were selected for the present study. Outcomes were allergy symptoms, specific IgE test (radioallergosorbent test (RAST)) to enzymes, skin test reactions to common allergens and enzymes, forced expiratory volume in one second (FEV1), and forced vital capacity (FVC). Potential risk factors were smoking habits, workplace, type of job, age, and sex. RESULTS: Sensitisation occurred to all types of enzymes handled in the plant, most often in production areas and laboratories; 8.8% developed clinical enzyme allergy during the first three years of employment. The risk declined during the period. The frequency of enzyme sensitisation, expressed as RAST values > 0.5 SU, was 36%, and the frequency of significant RAST values > or = 2 SU was 8%. Ranking diagnoses of enzyme allergy by severity, the frequency of asthma was 5.3%, rhinitis 3.0%, and urticaria 0.6%. Half of the cases occurred within the first 15 months of exposure. Smoking was an independent risk factor for clinical enzyme allergy (odds ratio (OR) = 2.3 (95% exact confidence interval (95% CI) 1.4 to 3.9), measurable RAST > or = 0.5 SU (OR = 1.5 (95% CI 1.1 to 2.1)), and RAST > or = 2 SU (OR = 4.5 (95% CI 2.2 to 8.4)). Atopic predisposition at the time of engagement was not a significant risk factor for enzyme allergy. This could be due to various selection mechanisms.
Johnsen, C R; Sorensen, T B; Ingemann Larsen, A; Bertelsen Secher, A; Andreasen, E; Kofoed, G S; Fredslund Nielsen, L; Gyntelberg, F
Over an eight-year period up to 1983, a total of 322 consecutive patients had operations for ankle fractures; 176 were Weber type B and 128 type C. We were able to review 230 of these patients after a mean follow-up of six years (1 to 11) including 128 with Weber B and 102 with Weber C fractures. We used an ankle score which combined symptoms and clinical and radiological findings, with a maximum score of 100 points. The mean score for all 230 was 92 (68 to 100). Fifteen of these patients had developed a distal synostosis between the tibia and fibula, three after a Weber B and 12 after a Weber C fracture. In 13 of these 15 ankles the synostosis had been visible radiologically within three months of the operation. In the other two there had been radiologically visible calcification at the three-month follow-up. In 1993, we were able to review nine of the 15 patients with synostosis using the same scoring system. At a mean follow-up of 14 years (12 to 18) the mean score for those with synostosis was 91 (71 to 100), much the same as this group's previous score and the mean score of the whole group of operated patients. We conclude that distal tibiofibular synostosis after ankle fracture usually causes few symptoms and does not generally require any treatment. PMID:8666636
Albers, G H; de Kort, A F; Middendorf, P R; van Dijk, C N
With improvements in the ballistic physics, patient evacuation, imaging, neurosurgical management and intensive care facilities, there has been overall improvement in the survival of patients with missile injuries of the brain. Patients with retained intracranial fragments have been followedup and the sequelae of such fragments were analysed. We present our observations in 43 such patients who had survived low velocity missile injuries of the brain during military conflicts and had retained intracranial fragments. Over a followup period of 2 to 7 years, suppurative sequelae (brain abscess, recurrent meningitis) were seen in 6 patients, two of these progressing to formation of brain abscess. Three patients developed hydrocephalus and one seizures. Patients with orbitocranial or faciocranial wound of entry had a higher incidence of suppurative complications (3 out of 4), while those with skull vault entry had a lower incidence of such sequelae (7 out of 30). Nine patients were lost to followup. Other determinants of suppurative complications were postoperative CSF leak and intraventricular lodgement of the fragment. PMID:11303238
Objective To investigate the relationship between disturbed lung function and large-artery hemodynamics in school-age children born extremely preterm (EP) (at 25 completed weeks of gestation or less). Study design This was a cross-sectional study of participants from the EPICure study, now aged 11years (n = 66), and 86 age- and sex-matched term-born classmates. Spirometry parameters (including forced expiratory volume in 1 second), blood pressure, and augmentation index (AIx, a composite of arterial stiffness and global wave reflections) were measured. Results Compared with their classmates, the EP children had significantly impaired lung function, particularly those with neonatal bronchopulmonary dysplasia. Peripheral blood pressure did not differ significantly between the 2 groups, but AIx values were on average 5% higher (95% CI, 2%-8%) in the preterm infants, remaining significant after adjustment for potential confounders. Neonatal bronchopulmonary dysplasia status was not related to AIx. Lung function and maternal smoking were independently associated with AIx; AIx increased by 2.7% per z-score reduction in baseline forced expiratory volume in 1 second and by 4.9% in those whose mothers smoked during pregnancy. Conclusion The independent association between impaired lung function and cardiovascular physiology in early adolescence implies higher cardiovascular risk for children born EP, and suggests that prevention of chronic neonatal lung disease may be a priority in reducing later cardiovascular risk in preterm infants.
Bolton, Charlotte E.; Stocks, Janet; Hennessy, Enid; Cockcroft, John R.; Fawke, Joseph; Lum, Sooky; McEniery, Carmel M.; Wilkinson, Ian B.; Marlow, Neil
Background Little is known about the incidence and risk of seizures after stroke in young adults. Especially in the young seizures might dramatically influence prognosis and quality of life. We therefore investigated the long-term incidence and risk of post-stroke epilepsy in young adults with a transient ischemic attack (TIA), ischemic stroke (IS) or intracerebral hemorrhage (ICH). Methods and Findings We performed a prospective cohort study among 697 consecutive patients with a first-ever TIA, IS or ICH, aged 18–50 years, admitted to our hospital between 1-1-1980 till 1-11-2010. The occurrence of epilepsy was assessed by standardized questionnaires and verified by a neurologist. Cumulative risks were estimated with Kaplan-Meier analysis. Cox proportional hazard models were used to calculate relative risks. After mean follow-up of 9.1 years (SD 8.2), 79 (11.3%) patients developed post-stroke epilepsy and 39 patients (5.6%) developed epilepsy with recurrent seizures. Patients with an initial late seizure more often developed recurrent seizures than patients with an initial early seizure. Cumulative risk of epilepsy was 31%, 16% and 5% for patients with an ICH, IS and TIA respectively (Logrank test ICH and IS versus TIA p<0.001). Cumulative risk of epilepsy with recurrent seizures was 23%, 8% and 4% respectively (Logrank ICH versus IS p?=?0.05, ICH versus TIA p<0.001, IS versus TIA p?=?0.01). In addition a high NIHSS was a significant predictor of both epilepsy and epilepsy with recurrent seizures (HR 1.07, 95% CI 1.03–1.11 and 1.08, 95% CI 1.02–1.14). Conclusions Post-stroke epilepsy is much more common than previously thought. Especially patients with an ICH and a high NIHSS are at high risk. This calls upon the question whether a subgroup could be identified which benefits from the use of prophylactic antiepileptic medication. Future studies should be executed to investigate risk factors and the effect of post-stroke epilepsy on quality of life.
Arntz, Renate; Rutten-Jacobs, Loes; Maaijwee, Noortje; Schoonderwaldt, Hennie; Dorresteijn, Lucille; van Dijk, Ewoud; de Leeuw, Frank-Erik
Background Limited data exist documenting the degree to which travelers are inconvenienced by travelers' diarrhea (TD). We performed a prospective follow-upstudy at the travel clinic of Leiden University Medical Center in The Netherlands to determine the degree of inconvenience and to determine how experiencing TD affects travelers' perception. Methods Healthy adults who intended to travel to the (sub)tropics for less than two months were invited to take part. Participants filled out a web-based questionnaire before departure and after returning home. TD was defined as three or more unformed stools during a 24-hour period. Results 390 of 776 Eligible travelers completed both questionnaires. Participants' median age was 31 years and mean travel duration 23 days. Of 160 travelers who contracted TD (incidence proportion 41%, median duration of TD episode 2.5 days) the majority (107/160, 67%) could conduct their activity program as planned despite having diarrhea. However, 21% (33/160) were forced to alter their program and an additional 13% (20/160) were confined to their accommodation for one or more daylight days; 53 travelers (33%) used loperamide and 14 (9%) an antibiotic. Eight travelers (5%) consulted a physician for the diarrheal illness. When asked about the degree of inconvenience brought on by the diarrheal illness, 39% categorized it as minor or none at all, 34% as moderate and 27% as large or severe. In those who regarded the episode of TD a major inconvenience, severity of symptoms was greater and use of treatment and necessity to alter the activity program were more common. Travelers who contracted travelers' diarrhea considered it less of a problem in retrospect than they had thought it would be before departure. Conclusion Conventional definitions of TD encompass many mild cases of TD (in our study at least a third of all cases) for which treatment is unlikely to provide a significant health benefit. By measuring the degree of inconvenience brought on by TD, researchers and policy makers may be able to better distinguish 'significant TD' from mild TD, thus allowing for a more precise estimation of the size of the target population for vaccination or stand-by antibiotic prescription and of the benefit of such measures.
BACKGROUND AND PURPOSE: The long-term fate of coiled intracranial aneurysms is largely unknown, and prolonged imaging follow-up has been advocated. The yield of follow-up imaging in coiled aneurysms adequately occluded at 6 months is unknown. In such patients, we performed time-of-flight MR angiography (MRA) to assess the incidence and therapeutic consequences of reopening 5-11years after coiling. MATERIALS AND METHODS:
M. E. Sprengers; J. Schaafsma; W. J. van Rooij; M. Sluzewski; G. J. E. Rinkel; B. K. Velthuis; J. C. van Rijn; C. B. Majoie
An 11-year lysimeter study was established to monitor the movement of Pu through vadose zone sediments. Sediment Pu concentrations as a function of depth indicated that some Pu moved upward from the buried source material. Subsequent numerical modeling suggested that the upward movement was largely the result of invading grasses taking up the Pu and translocating it upward. The objective of this study was to determine if the Pu of surface sediments originated from atmosphere fallout or from the buried lysimeter source material (weapons-grade Pu), providing additional evidence that plants were involved in the upward migration of Pu. The (240)Pu/(239)Pu and (242)Pu/(239)Pu atomic fraction ratios of the lysimeter surface sediments, as determined by Thermal Ionization Mass Spectroscopy (TIMS), were 0.063 and 0.00045, respectively; consistent with the signatures of the weapons-grade Pu. Our numerical simulations indicate that because plants create a large water flux, small concentrations over multiple years may result in a measurable accumulation of Pu on the ground surface. These results may have implications on the conceptual model for calculating risk associated with long-term stewardship and monitored natural attenuation management of Pu contaminated subsurface and surface sediments. PMID:20227801
Kaplan, D I; Demirkanli, D I; Molz, F J; Beals, D M; Cadieux, J R; Halverson, J E
Objectives This report provides an update of the mortality experience of a cohort of South Carolina asbestos textile workers. Methods A cohort of 3072 workers exposed to chrysotile in a South Carolina asbestos textile plant (1916–77) was followedup for mortality through 2001. Standardised mortality ratios (SMRs) were computed using US and South Carolina mortality rates. A job exposure matrix provided calendar time dependent estimates of chrysotile exposure concentrations. Poisson regression models were fitted for lung cancer and asbestosis. Covariates considered included sex, race, age, calendar time, birth cohort and time since first exposure. Cumulative exposure lags of 5 and 10 years were considered by disregarding exposure in the most recent 5 and 10 years, respectively. Results A majority of the cohort was deceased (64%) and 702 of the 1961 deaths occurred since the previous update. Mortality was elevated based on US referent rates for a priori causes of interest including all causes combined (SMR 1.33, 95% CI 1.28 to 1.39); all cancers (SMR 1.27, 95% CI 1.16 to 1.39); oesophageal cancer (SMR 1.87, 95% CI 1.09 to 2.99); lung cancer (SMR 1.95, 95% CI 1.68 to 2.24); ischaemic heart disease (SMR 1.20, 95% CI 1.10 to 1.32); and pneumoconiosis and other respiratory diseases (SMR 4.81, 95% CI 3.84 to 5.94). Mortality remained elevated for these causes when South Carolina referent rates were used. Three cases of mesothelioma were observed among cohort members. Exposure?response modelling for lung cancer, using a linear relative risk model, produced a slope coefficient of 0.0198 (fibre?years/ml) (standard error 0.00496), when cumulative exposure was lagged 10 years. Poisson regression modelling confirmed significant positive relations between estimated chrysotile exposure and lung cancer and asbestosis mortality observed in previous updates of this cohort. Conclusions This study confirms the findings from previous investigations of excess mortality from lung cancer and asbestosis and a strong exposure?response relation between estimated exposure to chrysotile and mortality from lung cancer and asbestosis.
Hein, Misty J; Stayner, Leslie T; Lehman, Everett; Dement, John M
Background Coffee contains many biologically active compounds, including caffeine and phenolic acids, that have potent antioxidant activity and can affect glucose metabolism and sex hormone levels. Because of these biological activities, coffee may be associated with a reduced risk of prostate cancer. Methods We conducted a prospective analysis of 47 911 men in the Health Professionals Follow-upStudy who reported intake of regular and decaffeinated coffee in 1986 and every 4 years thereafter. From 1986 to 2006, 5035 patients with prostate cancer were identified, including 642 patients with lethal prostate cancers, defined as fatal or metastatic. We used Cox proportional hazards models to assess the association between coffee and prostate cancer, adjusting for potential confounding by smoking, obesity, and other variables. All P values were from two-sided tests. Results The average intake of coffee in 1986 was 1.9 cups per day. Men who consumed six or more cups per day had a lower adjusted relative risk for overall prostate cancer compared with nondrinkers (RR = 0.82, 95% confidence interval [CI] = 0.68 to 0.98, Ptrend = .10). The association was stronger for lethal prostate cancer (consumers of more than six cups of coffee per day: RR = 0.40, 95% CI = 0.22 to 0.75, Ptrend = .03). Coffee consumption was not associated with the risk of nonadvanced or low-grade cancers and was only weakly inversely associated with high-grade cancer. The inverse association with lethal cancer was similar for regular and decaffeinated coffee (each one cup per day increment: RR = 0.94, 95% CI = 0.88 to 1.01, P = .08 for regular coffee and RR = 0.91, 95% CI = 0.83 to 1.00, P = .05 for decaffeinated coffee). The age-adjusted incidence rates for men who had the highest (?6 cups per day) and lowest (no coffee) coffee consumption were 425 and 519 total prostate cancers, respectively, per 100 000 person-years and 34 and 79 lethal prostate cancers, respectively, per 100 000 person-years. Conclusions We observed a strong inverse association between coffee consumption and risk of lethal prostate cancer. The association appears to be related to non-caffeine components of coffee.
Kasperzyk, Julie L.; Rider, Jennifer R.; Kenfield, Stacey; van Dam, Rob M.; Stampfer, Meir J.; Giovannucci, Edward; Mucci, Lorelei A.
Thirty-eight cases of suspected yersinia arthritis occurring in southern Sweden in 1975-6 were reviewed four to five years later. In 31 cases the diagnosis was confirmed. At follow-up three of the patients had definite ankylosing spondylitis, three radiologically confirmed sacroiliitis, three extensor tenosynovitis, five isolated articular joint disease, and 10 localised arthralgias; one patient had developed seropositive rheumatoid arthritis. Only six of the 31 patients were free of joint symptoms. These results suggest that although the acute symptoms of yersinia arthritis disappear within 12 months, the long-term prognosis may be less favourable than previously thought.
In 125 early breast cancer patients who underwent multiple bone marrow aspirates, there was no significant difference in terms of disease-free and overall survival after a median follow-up of 163 months between the patients with or without micrometastasis at the time of primary surgery. However, when the time-dependent evolution of the bone marrow aspirates was taken into account, some evidence for a longer disease-free and overall survival was found for the patients with negative bone marrow
Molino, Annamaria; Giovannini, Monica; Micciolo, Rocco; Auriemma, Alessandra; Fiorio, Elena; Santo, Antonio; Cetto, Gian Luigi
Purpose: To analyze the long-term survival and tumor control outcomes after stereotactic body radiotherapy (SBRT) for metastases limited in number and extent. Methods and Materials: We prospectively analyzed the long-term overall survival (OS) and cancer control outcomes of 121 patients with five or fewer clinically detectable metastases, from any primary site, metastatic to one to three organ sites, and treated with SBRT. Freedom from widespread distant metastasis (FFDM) was defined as metastatic disease not amenable to local therapy (i.e., resection or SBRT). Prognostic variables were assessed using log-rank and Cox regression analyses. Results: For breast cancer patients, the median follow-up was 4.5 years (7.1 years for 16 of 39 patients alive at the last follow-up visit). The 2-year OS, FFDM, and local control (LC) rate was 74%, 52%, and 87%, respectively. The 6-year OS, FFDM, and LC rate was 47%, 36%, and 87%, respectively. From the multivariate analyses, the variables of bone metastases (p = .057) and one vs. more than one metastasis (p = .055) were associated with a fourfold and threefold reduced hazard of death, respectively. None of the 17 bone lesions from breast cancer recurred after SBRT vs. 10 of 68 lesions from other organs that recurred (p = .095). For patients with nonbreast cancers, the median follow-up was 1.7 years (7.3 years for 7 of 82 patients alive at the last follow-up visit). The 2-year OS, FFDM, and LC rate was 39%, 28%, and 74%, respectively. The 6-year OS, FFDM, and LC rate was 9%, 13%, and 65%, respectively. For nonbreast cancers, a greater SBRT target volume was significantly adverse for OS (p = .012) and lesion LC (p < .0001). Patients whose metastatic lesions, before SBRT, demonstrated radiographic progression after systemic therapy experienced significantly worse OS compared with patients with stable or regressing disease. Conclusions: Select patients with limited metastases treated with SBRT are long-term survivors. Future research should address the therapeutic benefit of SBRT for these patients.
Milano, Michael T., E-mail: MTMilano@yahoo.com [Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY (United States); Katz, Alan W.; Zhang Hong [Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY (United States); Okunieff, Paul [Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY (United States); Department of Radiation Oncology, University of Florida, Gainesville, FL (United States)
We have updated our experience concerning eight families (24 patients) with FPC, 11 of whom had FPC with carcinoma and 13, FPC only. The importance of biopsy to prove the presence of an adenoma (tubular, villous or tubulovillous) was emphasized. Although we prefer total colectomy with ileorectal anastomosis as definitive treatment, total proctocolectomy also has been recommended. The value of careful follow-up examination to detect carcinoma in the retained rectal segment and the periampullary region has been stressed. No racial differences were noted. PMID:6635909
Leffall, L D; Chung, E B; Nagel, S; Levette, A; Cornwell, E E; DeWitty, R L
AIM: To evaluate the long-term natural history of the gastroduodenal lesions secondary to extrahepatic embolization with Ytrium 90 (90Y) spheres. METHODS: From September 2003 to January 2012, 379 procedures of liver radioembolization (RE) using resin microspheres loaded with 90Y were performed in our center. We have retrospectively compiled the data from 379 RE procedures performed in our center. We report a comprehensive clinical, analytical, endoscopic and histologic long-term follow-up of a series of patients who developed gastroduodenal lesions after the treatment. RESULTS: Six patients (1.5%) developed gastrointestinal symptoms and had gastrointestinal lesions as shown by upper endoscopy in the next 12 wk after RE. The mean time between RE and the appearance of symptoms was 5 wk. Only one patient required endoscopic and surgical treatment. The incidence of gastrointestinal ulcerations was 3.75% (3/80) when only planar images were used for the pre-treatment evaluation. It was reduced to 1% (3/299) when single-photon emission computed tomography (SPECT) images were also performed. The symptoms that lasted for a longer time were nausea and vomiting, until 25 mo after the treatment. CONCLUSION: All patients were free from severe symptoms at the end of follow-up. The routine use of SPECT has decreased the incidence of gastrointestinal lesions due to unintended deployment of 90Y particles.
Rodriguez-Lago, Iago; Carretero, Cristina; Herraiz, Maite; Subtil, Jose C; Betes, Maite; Rodriguez-Fraile, Macarena; Sola, Jesus J; Bilbao, Jose I; Munoz-Navas, Miguel; Sangro, Bruno
The validity of Cariogram in relation to caries increment over a 2-year period was evaluated. In 2007, the caries risk profile in a group of Sardinian schoolchildren (957) aged 7-9 years was assessed using the Cariogram software. A re-examination using the same criteria was performed 2 years later on 861 individuals from the original sample (drop-out 10.0%). The possible correlated variables were analyzed using the principal component analysis (PCA). The performances of Cariogram in predicting caries increment were evaluated by receiver operating characteristic (ROC) analysis. At follow-up examination, 54.4% of the sample had developed new carious lesions (mean DFS 1.6, 95% CI 1.5-1.8). The mean caries increment (?DFS) was 0.5, 95% CI 0.4-0.5. PCA showed that Cariogram, gingival status and dietary sugar frequency, both at baseline and at follow-up, tend to form a separate cluster (goodness of fit ?0.75). Sensitivity and specificity measured by ROC analysis were 0.83 and 0.85, respectively, so the gain in certainty was 1.68, while the area under the ROC curve was 0.93. A strong correlation between caries risk profiles at baseline and caries incidence in the permanent teeth after 2 years was found. The validity of Cariogram was confirmed, the software fulfilling the criteria for a good risk assessment model: precision, accuracy and ease of use. PMID:22222621
Campus, G; Cagetti, M G; Sale, S; Carta, G; Lingström, P
Clinical and biological evidence of liver disease was found in 99 out of 242 (40%) patients hospitalized with acute manifestations of the Spanish toxic oil syndrome. No patient was alcoholic. According to the severity of liver involvement, patients were classified in 3 groups and followedup for at least 30 months. Group I included 65 patients with a transient increase of serum aminotransferase activity as the only evidence of liver disease. This abnormality disappeared within 2 months in all these patients. Group II included 18 patients with raised aminotransferases and alkaline phosphatase. At the end of follow-up, liver tests remained slightly abnormal in 4 patients of this group (22%) and a liver biopsy revealed minor changes in 3 of them. Group III included 16 patients with raised aminotransferases, alkaline phosphatase and bilirubin. Thirty months after the acute episode, liver function tests remained abnormal in 8 patients (50%); a liver biopsy, performed in 5 cases, showed changes suggesting chronic biliary disease in 2, and fibrosteatosis, chronic hepatitis and minimal changes in each of the remaining 3. Pulmonary, cutaneous, vascular, neuromuscular and other extra-hepatic disturbances were noted in a large number of patients but no relationship was observed between the degree of hepatic disfunction and the presence and severity of systemic manifestations of the toxic oil syndrome. PMID:3745885
Velicia, R; Sanz, C; Martinez-Barredo, F; Sánchez-Tapias, J M; Bruguera, M; Rodés, J
We studied the effect of sensory education on taste and odor awareness and food ratings in school children. Second and fifth graders (n=244, 7–11years at the baseline) from two schools in Helsinki area participated in the study. At the completion of the study at two years, the groups consisted of 96 (education, school one) and 79 (control, school two)
Longitudinal studies are often considered to be a gold standard for research, but the operational management of such studies is not often discussed in detail; this paper describes strategies used to track and maintain high levels of participation in a longitudinal study involving annual personal interviews with a cohort of 1,253 undergraduates (first-time, first-year students at time of enrollment) at a large public mid-Atlantic university. PMID:22247739
Vincent, Kathryn B; Kasperski, Sarah J; Caldeira, Kimberly M; Garnier-Dykstra, Laura M; Pinchevsky, Gillian M; O'Grady, Kevin E; Arria, Amelia M
The results of follow-upstudies in 77 dogs with clinical signs of large bowel disease are presented. In 32 dogs colonic and/or rectal biopsy follow-upstudies were done, combined with necropsy in seven dogs. In 45 dogs a follow-up necropsy only was done. The time between the first and the last series of biopsies varied from three to 729 days and between the first series of biopsies and necropsy from one to 980 days. Colitis found in 45 dogs in the initial biopsies was still present in 29 cases in the follow-up biopsy studies and/or at necropsy. Eleven cases showed hystiocytic ulcerative colitis. In general, adenoma, carcinoma and lymphosarcoma were confirmed in the follow-up examination, except for one adenoma, which appeared to be a carcinoma at necropsy. In cases in which the differential diagnosis was adenoma or carcinoma, the necropsy diagnosis was always carcinoma and in cases of a differential diagnosis of lymphosarcoma and/or colitis, lymphosarcoma was always diagnosed at necropsy. Several dogs without colonic changes in the initial biopsies had other gastric or small intestinal lesions at necropsy such as gastritis and enteritis of the small intestine, or tumors, in these areas.
All mothers (n = 79) in the county of Stockholm who gave birth to a child during 1976-77 and were also hospitalised for the first time in a psychiatric clinic were followedup after a mean interval of 15 years. The sample was classified according to the Research Diagnostic Criteria. Comparisons were made with matched obstetric controls. Five patients had died. The recurrence rate was 51% and 7. 3% relapsed after a subsequent childbirth. No difference was found between psychotic and non-psychotic mothers regarding mean sick-leave days per year. The majority of the women with a depressive disorder at index admission suffered from a minor depressive disorder. The women in the group with an unspecified functional psychosis showed a less severe course of illness than the women in the schizophrenia group. PMID:9730784
A group of alcoholics treated by partially reinforced electrical escape conditioning were found to have a significantly better outcome on follow-up than a selected control group, who showed a parallel level of motivation, and were treated by conventional methods. No sex differences in outcome were found for either group. In the experimental group, better prognosis was associated with higher social class and older age, and poorer prognosis with single marital status. There were no variations in outcome for age in the control group. In the age range 20-40 aversion therapy showed no better results than conventional therapies, but with subjects above this age range it was very significantly superior. The results are discussed with reference to the application of aversion therapy to alcoholism. PMID:843777
77 individuals convicted of a drinking and driving (DUI) offense were screened for recidivism approximately 12 years following their first offense. At the time of the initial DUI conviction, participants were administered the MAST and the MMPI-2. Participants' drinking history and driving history and arrest at the time of screening and at a 12-year follow-up were also reviewed. The results indicate that, among DUI recidivists, on average 6 years elapsed between their first and second DUI offenses. Driving history prior to the first DUI offense was predictive of later recidivism. The only significant finding from the MAST and MMPI results was that repeat offenders tended to have higher scores on the L and K validity scales of the MMPI. These results are discussed in the context of Jessor's Problem-Behavior Theory and as well their clinical implications for screening and treatment decisions involving first time DUI offenders. PMID:16876960
Cavaiola, Alan A; Strohmetz, David B; Abreo, Sandra D
Follow-up testing was conducted to better understand the excessive hydrogen generation seen in the initial Sludge Batch 4 (SB4) qualification Sludge Receipt and Adjustment Tank/Slurry Mix Evaporator (SRAT/SME) simulation in the Savannah River National Laboratory (SRNL) Shielded Cells. This effort included both radioactive and simulant work. The initial SB4 qualification test produced 0.59 lbs/hr hydrogen in the SRAT, which was just below the DWPF SRAT limit of 0.65 lbs/hr, and the test produced over 0.5 lbs/hr hydrogen in the SME cycle on two separate occasions, which were over the DWPF SME limit of 0.223 lbs/hr.
Pareizs, J; David Koopman, D; Dan Lambert, D; Cj Bannochie, C
AIM: To identify the incidence and etiology of anemia after gastrectomy in patients with long-term follow-up after gastrectomy for early gastric cancer. METHODS: The medical records of those patients with early gastric adenocarcinoma who underwent curative gastrectomy between January 2006 and October 2007 were reviewed. Patients with anemia in the preoperative workup, cancer recurrence, undergoing systemic chemotherapy, with other medical conditions that can cause anemia, or treated during followup with red cell transfusions or supplements for anemia were excluded. Anemia was defined by World Health Organization criteria (Hb < 12 g/dL in women and < 13 g/dL in men). Iron deficiency was defined as serum ferritin < 20 ?g/dL. Vitamin B12 deficiency was defined as serum vitamin B12 < 200 pg/mL. Iron deficiency anemia was defined as anemia with concomitant iron deficiency. Anemia from vitamin B12 deficiency was defined as megaloblastic anemia (mean cell volume > 100 fL) with vitamin B12 deficiency. The profile of anemia over 48 mo of follow-up was analyzed. RESULTS: One hundred sixty-one patients with gastrectomy for early gastric cancer were analyzed. The incidence of anemia was 24.5% at 3 mo after surgery and increased up to 37.1% at 48 mo after surgery. The incidence of iron deficiency anemia increased during the followup and became the major cause of anemia at 48 mo after surgery. Anemia of chronic disease and megaloblastic anemia were uncommon. The incidence of anemia in female patients was significantly higher than in male patients at 12 (40.0% vs 22.0%, P = 0.033), 24 (45.0% vs 25.0%, P = 0.023), 36 (55.0% vs 28.0%, P = 0.004), and 48 mo (52.0% vs 31.0%, P = 0.022) after surgery. Patients with total gastrectomy showed significantly higher incidence of anemia than patients with subtotal gastrectomy at 48 mo after surgery (60.7% vs 31.3%, P = 0.008). The incidence of iron deficiency was significantly higher in female patients than in male patients at 6 (35.4% vs 13.3%, P = 0.002), 12 (45.8% vs 16.8%, P < 0.001), 18 (52.1% vs 22.3%, P < 0.001), 24 (60.4% vs 20.9%, P < 0.001), 36 (62.5% vs 29.2%, P < 0.001), and 48 mo (66.7% vs 34.7%, P = 0.001) after surgery. CONCLUSION: Anemia was frequent after gastrectomy for early gastric cancer, with iron deficiency being the major cause. Evaluation for anemia including iron status should be performed after gastrectomy and appropriate iron replacement should be considered.
Lim, Chul-Hyun; Kim, Sang Woo; Kim, Won Chul; Kim, Jin Soo; Cho, Yu Kyung; Park, Jae Myung; Lee, In Seok; Choi, Myung-Gyu; Song, Kyo-Young; Jeon, Hae Myung; Park, Cho-Hyun
Aims: To examine the association between 2-methoxyethanol (2-ME) exposure and haematological effects, as well as the recovery from these haematological effects with continuous reduction in exposure to 2-ME. Methods: Twenty nine exposed and 90 non-exposed workers were recruited. Haematological parameters, eight hour full shift personal exposure to 2-ME, and urinary 2-methoxyacetic acid (MAA) were repeatedly measured in three consecutive surveys within six months. Results: Results of haematological examination in the first exposure survey showed that haemoglobin, packed cell volume, and red blood cell count in the male exposed workers were significantly lower than those in the comparison workers. The frequency of anaemia in the exposed group (42%) was significantly higher than that in the comparison group (3%). The haematological effects were significantly associated with the urinary MAA of exposed workers. The haematological effects had returned to normal in the first followup survey 2.5 months later, when a reduction in 2-ME exposure was noted. Haematological results of the second followup examination six months later remained normal. The mean airborne exposure of 2-ME in the three surveys dropped from 35.7 to 2.65, then to 0.55 ppm. The mean urinary MAA of exposed workers in the three surveys was reduced from 57.7 to 24.6, then to 13.5 mg/g creatinine (n = 29). The reduction in exposure through both inhalation and potential dermal contact with 2-ME might account for the haematological recovery. Conclusion: 2-ME is a haematological toxin which leads to anaemia in exposed workers. However, the toxic haematological effects of 2-ME persist for only a short period of time after cessation or reduction of exposure.
The purpose of this long-term follow-upstudy was twofold-firstly, to assess prevalence of relapse after treatment of deep bite malocclusion and secondly, to identify risk factors that predispose patients with deep bite malocclusion to relapse. Sixty-one former patients with overbite more than 50% incisor overlap before treatment were successfully recalled. Clinical data, morphometrical measurements on plaster casts before treatment, after treatment and at long-term follow-up, as well as cephalometric measurements before and after treatment were collected. The median follow-up period was 11.9 years. Patients were treated by various treatment modalities, and the majority of patients received at least a lower fixed retainer and an upper removable bite plate during retention. Relapse was defined as increase in incisor overlap from below 50% after treatment to equal or more than 50% incisor overlap at long-term follow-up. Ten per cent of the patients showed relapse to equal or larger than 50% incisor overlap, and their amount of overbite increase was low. Among all cases with deep bite at follow-up, gingival contact and palatal impingement were more prevalent in partially corrected noncompliant cases than in relapse cases. In this sample, prevalence and amount of relapse were too low to identify risk factors of relapse. PMID:23197574
Danz, J C; Greuter, C; Sifakakis, L; Fayed, M; Pandis, N; Katsaros, C
Objective: The aim of this study was to quantify the efficacy of three different surgical techniques for entropion repair in a 3-year follow-upstudy: (1) the Fox procedure, (2) everting sutures and (3) a modified technique of lower lid retractor plication. Methods: We included in our study 32 eyelids of 32 consecutive patients with involutional lower lid entropion; 10 lids
Michele Altieri; Michele Iester; Francesca Harman; Roberta Bertagno; Paolo Capris; Davide Venzano; Franco Baldi; Gianguido Altieri
OBJECTIVE—To assess the prognosis of patients with sicca symptoms and to identify the clinical and immunological factors that most sensitively predict the later development of primary Sjögren's syndrome (SS) or other connective tissue diseases.?METHODS—Eighty seven patients (72 female, 15 male) with sicca symptoms were re-evaluated after a median followup time of 11years (range 8-17). The clinical examination included ophthalmological examination (Schirmer's test, break up time and Rose-Bengal staining). Labial salivary gland biopsy was performed and histological findings graded according to the Chisholm-Mason scale. The immunoserological tests included determination of rheumatoid factor (RF), antinuclear antibodies (ANA), anti-extractable nuclear antigen-antibodies (ENA), serum immunoglobulins IgA, IgG, and IgM, and serum ?2-microglobulin (?2m).?RESULTS—At followup 31 patients (36%) fulfilled modified Californian criteria (salivary flow measurements were not performed and Chisholm-Mason grades 3-4 were regarded as diagnostic histological findings) for possible or definite SS. Likewise, a significant progression of the histological findings was observed. Labial salivary gland re-biopsy was performed in 42 patients with grade 0-2 findings at baseline, progression to grades 3-4 being observed in 21 (50%) at followup. The patients who later developed SS were at baseline significantly older (mean (SD) 52 (9) v 44 (14) years, p?0.005) compared with those not fulfilling the SS criteria at followup; they also had significantly higher serum ?2m (p?0.0005) and IgG concentrations (p?0.005), and they had positive ANA more frequently (p?0.01).?CONCLUSION—These results suggest that high age, increased values of serum ?2m, ANA positivity and increased concentrations of serum IgG, might be useful indicators for the subsequent development of SS in patients with sicca symptoms. The prognosis of patients with these symptoms was favourable, and the clinical course was benign even in the 36% of patients who developed SS. No cases of lymphoma were observed.??
Pertovaara, M.; Korpela, M.; Uusitalo, H.; Pukander, J.; Miettinen, A.; Helin, H.; Pasternack, A.
Morphologic changes of small-sized post-stent malapposition have not been sufficiently evaluated. We investigated serial changes\\u000a of minimal post-stent malapposition with a follow-up optical coherence tomography (OCT) study. Post-stent OCT and intravascular\\u000a ultrasound (IVUS) and follow-up OCT were performed in 26 patients with minimal post-stent malapposition. Serial changes of\\u000a number and percent of malapposition struts, and mean extra-stent malapposition area were
Won Ho Kim; Byoung Kwon Lee; Sahng Lee; Jae-Min Shim; Jung-Sun Kim; Byoung-Keuk Kim; Young-Guk Ko; Donghoon Choi; Yangsoo Jang; Myeong-Ki Hong
Background A retrospective study concerning patients presenting with patella instability, treated using a Roux-Elmslie-Trillat reconstruction\\u000a operation and followedup for 10 years following surgery, is presented.\\u000a \\u000a \\u000a \\u000a \\u000a Methods Pre-operative and follow-up radiographic evaluation included the weight-bearing anteroposterior and merchant views. Evaluation\\u000a was carried out using the Insall-Salvati index, sulcus and congruence angle. The Roux-Elmslie-Trillat reconstruction operation\\u000a was performed on 18 patients. The clinical
Background: This study aimed to assess laparoscopic dissection of uterine vessels (LDUV) for symptomatic fibroids in women. Methods: A total of 69 women entered the study between March 2000 and June 2003. In this case series, 68 consecutive women underwent LDUV using ultrasonically activated sheers or electrosurgery for the treatment of fibroids over 3 years (median follow-up period, 14.5 months).
Z. Holub; A. Jabor; J. Lukac; L. Kliment; Š. Urbanek
BACKGROUND: The aim of this study was to assess the frequency of use of dietary supplements (DS) among large sample of elite Finnish athletes and to describe possible changes in dietary supplement use between the years 2002 and 2009. METHODS: A prospective follow-upstudy was conducted on Olympic athletes. The first survey was conducted on Olympic athletes in 2002 (N
Anni Heikkinen; Antti Alaranta; Ilkka Helenius; Tommi Vasankari
: In the absence of a universally agreed-upon definition of successful aging, researchers increasingly look to older adults for layperson views of aging and definitions of successful aging. To use lay definitions in studies of aging, however, researchers must address the definitionsâ€™ consistency. In 2004, surviving members of the Manitoba Follow-upStudy male cohort (mean age: 83 years) were asked
Robert B. Tate; Brenda L. Loewen; Dennis J. Bayomi; Barbara J. Payne
In the absence of a universally agreed-upon definition of successful aging, researchers increasingly look to older adults for layperson views of aging and definitions of successful aging. To use lay definitions in studies of aging, however, researchers must address the definitionsâ€™ consistency. In 2004, surviving members of the Manitoba Follow-upStudy male cohort (mean age: 83 years) were asked twice
We report the long-term outcome in 80 patients who had undergone extended anterior cervical decompression without fusion for cervical nerve root or spinal cord compression. Follow-up ranged from 2 years 4 months to 13 years. Five patients had died from causes unrelated to the original pathology or the surgery. Of the remaining 75 patients, 66 (88%) were symptom free or clearly improved, eight (10%) were unchanged and one patient (1.5%) was worse. Sixty-eight patients (91%) were satisfied with the outcome of treatment. Nineteen patients (25%) had some degree of residual neck pain, but in none was this a major problem. Three patients had required subsequent surgery for cervical disc protrusions at levels adjacent to the first operation, while two patients had developed foraminal stenosis at the level of the surgery and had undergone foraminotomy. One patient had developed a symptomatic flexion deformity. Radiological assessment revealed bony fusion in 71%, some degree of flexion deformity in 13% and some degree of foraminal stenosis in 38%. Our results suggest that the initial good results of extended anterior cervical decompression without fusion are maintained long-term. Although a small number of patients eventually develop problems that might be avoided by an initial spacing procedure/formal fusion, these are no greater than the immediate problems associated with the harvesting and insertion of a bone graft. PMID:10627778
Between 1999 and 2001, 90 patients underwent total hip replacement using the same uncemented acetabular and femoral components with a 28 mm metallic femoral head but with prospective randomisation of the acetabular liner to either Durasul highly cross-linked polyethylene or nitrogen-sterilised Sulene polyethylene. We assessed 83 patients at a minimum follow-up of ten years. Linear penetration of the femoral head was estimated at six weeks, six and 12 months and annually thereafter, using the Dorr method, given the non-spherical shape of the acetabular component. There was no loosening of any component; only one hip in the Sulene group showed proximal femoral osteolysis. The mean penetration of the femoral head at six weeks was 0.08 mm (0.02 to 0.15) for the Durasul group and 0.16 mm (0.05 to 0.28) for the Sulene group (p = 0.001). The mean yearly linear penetration was 64.8% lower for the Durasul group at 0.05 mm/year (sd 0.035) for the Sulene group and 0.02 mm/year (sd 0.016) for the Durasul (p < 0.001). Mean linear femoral head penetration at ten years was 61% less in the Durasul than Sulene group. Highly cross-linked polyethylene gives excellent results at ten years. PMID:23450015
The risk of overwhelming sepsis in splenectomized patients is well known and autotransplantation of splenic tissue might be considered as a prophylactic approach. Little is known, however, of the success of grafting in man. In six patients with autologous grafts after emergency splenectomy the ''trapping function'' (TF) was measured by sequential scintigraphy with heat damaged red cells every third month. To correlate TF with blood flow and histology, different experiments were done in pigs: ligation of the splenic artery or partial splenectomy or total splenectomy with grafting of fragments either subfascially or in the greater momentum. TF, blood flow with Rb-86 and immune response was measured at different times after surgery. Remnants left at the main vessels did not grow, while splenic tissue left at smaller vessels increased in size. There were great differences in blood flow per gram splenic tissue, but a significant correlation between TF and blood flow. All experimental grafts showed a normal function both of the white and the red pulp. In patients there was a growth of grafts in four, while in two no TF could be measured. TF is an indicator of relative blood flow to splenic grafts and therefore useful in the followup of grafted patients.
The value of routine follow-up with frequent visits to a breast cancer specialist-both in terms of detection of recurrence and patient satisfaction-has been questioned. The aim of this study was to compare nurse-led follow-up on demand versus physician follow-up after breast cancer treatment with regards to patients' well-being, satisfaction, access to medical care and medical safety. Two hundred and sixty-four consecutively selected women with newly diagnosed breast cancer, classified as UICC stage I or stage II, were randomised to follow-up at two hospitals in Sweden, either by routine medical follow-up, the physician group (PG, n=131), or on demand by a specialist nurse, the nurse group (NG, n=133). Measures were done at baseline and twice a year over a period of 5 years by means of a questionnaire containing the Hospital Anxiety and Depression Scale (HAD), and the Satisfaction and Accessibility (SaaC) scale. Number of contacts with the health care services, number of diagnostic procedures, and time to recurrence or death were monitored. The ratings of HAD and SaaC did not show any statistically significant differences between the groups. The levels of anxiety and depression were generally low and levels of patient satisfaction high. There were no differences between the groups concerning time to recurrence or death. This study indicates that women with breast cancer in stages I to II can be followedup by a specialist nurse with high patient satisfaction and good medical safety. PMID:15171968
Koinberg, I-L; Fridlund, B; Engholm, G-B; Holmberg, L
Objective This study examined the clinical significance of loss of control over eating (LOC) in bariatric surgery over 24 months of prospective multi-wave follow-ups. Method Three-hundred sixty-one gastric bypass surgery patients completed a battery of assessments before surgery and at 6, 12, and 24 months following surgery. In addition to weight loss and LOC, the assessments targeted eating disorder psychopathology, depression levels, and quality of life. Results Prior to surgery, 61% of patients reported LOC; post-surgery, 31% reported LOC at 6-month follow-up, 36 % reported LOC at 12-month follow-up, and 39% reported LOC at 24-month follow-up. Preoperative LOC did not predict post-operative outcomes. In contrast, mixed models analyses revealed that post-surgery LOC was predictive of weight loss outcomes: patients with LOC post-surgery lost significantly less weight at 12-month (34.6 vs. 37.2% BMI loss) and 24-month (35.8 % vs. 39.1 % BMI loss) post-surgery follow-ups. Similarly, post-surgery LOC significantly predicted eating-disorder psychopathology, depression, and quality of life at 12- and 24-month post-surgery follow-ups. Conclusions Pre-operative LOC does not appear to be a negative prognostic indicator for post-surgical outcomes. Postoperative LOC, however, is a prospective predictor of significantly poorer post-surgical weight and psychosocial outcomes at 12- and 24- month following surgery. Since LOC following bariatric surgery significantly predicts attenuated post-surgical improvements, it represents an important target for clinical attention.
White, Marney A.; Kalarchian, Melissa A.; Masheb, Robin M.; Marcus, Marsha D.; Grilo, Carlos M.
This study examines the process and effects of using facebook (FB) to locate and re-contact study participants targeted for followup in a longitudinal study of adult methamphetamine users (N = 649). A follow-up interview was conducted in 2009–11 approximately 8 years after previous study participation. Our paper describes re-contact efforts involving FB, including IRB regulatory issues and the effectiveness of using FB compared to mailings and phone calls. A total of 48 of the 551 surviving non-incarcerated participants who agreed to be contacted for followupstudies were contacted via FB, of whom 11 completed the follow-up interview. Those contacted through FB were more likely to be younger, female, relocated out-of-state, and reported somewhat higher rates of anxiety and cognitive problems compared to those not located on FB. Although participants contacted through FB are likely to differ demographically from those contacted by phone or mail, FB provides a potentially effective means to expand conventional methods of correspondence for contacting hard to reach participants.
Primary progressive aphasia has been clinically defined as a progressive language deficit leading to the dissolution of almost all language functions with relative preservation of other cognitive functions until late in the course of the disease. Two types of language impairment have been described for primary progressive aphasia, which differ with respect to the degree of fluency of spontaneous speech. Whereas some authors have emphasized non-fluency as a defining characteristic of primary progressive aphasia, others have proposed that phonemic rather than semantic paraphasias in naming, both in the fluent and the non-fluent subtype, should be used as a criterion to distinguish primary progressive aphasia from slowly progressive aphasia in other forms of degenerative brain disease. Patients with fluent speech and semantic dementia, as typically seen in Alzheimer's disease, produce semantic paraphasias and circumlocutions rather than phonemic errors in naming. This paper reports the long-term follow-up of a patient with fluent aphasic speech, whose language profile over a decade was similar to that of patients with semantic dementia. Neuropathological examination revealed no evidence of Alzheimer's disease. Pick's disease or Pick variant, but showed spongiform changes of cortical layers (II and III) in temporal and, less severely, in frontal gyri. The present case indicates that semantic dementia is not a reliable indicator of probable Alzheimer's disease and supports the notion that there are different subtypes of primary progressive aphasia which cannot be defined by fluency or by the presence of phonemic paraphasia. Progress in identifying the neuropathological correlates of these subtypes in cases with lobar atrophy and spongiform changes should be expected from hereditary variants of progressive disorder. PMID:9549492
Introduction We report on the adherence experience of a group of people living with HIV on ART over six years in Uganda. Methods Between 2005 and 2009, we followedup 41 participants who were also part of a clinical trial comparing home and facility based delivery of ART in Jinja, eastern Uganda. We conducted qualitative in-depth interviews at enrolment, 3, 6, 18 and 30 months to capture experiences with adherence over time. In 2011 we returned to these participants to find out how they were fairing with long term adherence. We managed to retrace 24 participants and interviewed them about their experience. We thematically analysed the data and compared findings over time. Results Initially there were few barriers to adherence and many followed the adherence guidance closely. By year six, relaxation of these rules was noticeable although self-reported adherence continued to be high. Alcohol consumption was more common than before. Some relatives of the participants who had died claimed that some deaths were a result of alcohol. While participants reported that ART had allowed them to reclaim independence and return to work the changes in work and social routines created new challenges for adherence. Side effects like lipodystrophy were not only causing some stigma but for some tested their faith in the drugs. Many participants reported resumption of sexual lives but apart from those who selected same status partners, disclosure to new partners was minimal. Conclusion Good adherence practice to ART wanes over the long-term, and people who may have disclosed at initiation find it difficult to do so to new partners once they are healthy. Further adherence interventions and support with disclosure over the course of therapy may need to be considered. (Words: 283)
|Introduction: The study presented here examined the learning outcomes of graduate students in visual impairment who were enrolled in an assistive technology course in three university programs. Methods: The students' perceptions of learning were evaluated using pre- and posttests administered during the course. A follow-up questionnaire was…
Kamei-Hannan, Cheryl; Howe, Jon; Herrera, Robyn Rene; Erin, Jane N.
|This population-based 24-year follow-upstudy evaluated the association of occupational physical activity (OPA) with overweight and mortality in 47,405 men and women, healthy at baseline, and reporting OPA as sedentary (reference), light, moderately heavy, or heavy. The adjusted odds ratio for overweight was slightly less than 1 for all…
|Conducted follow-upstudy to test concurrent validity of stress-vulnerability model of suicidal ideation and behavior. College students (N=202) completed self-report measures of life stress, loneliness, depression, dysfunctional cognitions, reasons for living, hopelessness, current suicide ideation, and predictions of future suicide probability.…
This report describes the methods and procedures used for the full-scale data collection effort of the Beginning Postsecondary Students Longitudinal Study First Follow-Up 1996-98 (BPS:96/98). These students, who started their postsecondary education during the 1995-96 academic year, were first interviewed during 1996 as part of the National…
Wine, Jennifer S.; Whitmore, Roy W.; Heuer, Ruth E.; Biber, Melissa; Pratt, Daniel J.
In order to provide information for the 1989-90 program review at William Rainey Harper College (WRHC) and to fulfill American Bar Association accreditation guidelines, a long-term, follow-upstudy was conducted of all Legal Tech program alumni who graduated between 1984 and 1988. A telephone survey generated usable responses from 106 (73%) of the…
|In order to evaluate the efficacy of the college parallel program at Southern West Virginia Community College (SWVCC), a follow-upstudy was conducted of all students who had attended SWVCC between 1967 and 1972 and had subsequently transferred to Marshall University. Each of the 204 students in the sample had earned at least 30 semester credit…
This 2001 follow-upstudy conducted in the spring of 2001 and reported in the fall of 2001,targeted 2 groups of former Lane Community College (LCC) (Oregon) students. Surveys were mailed to all 1990-2000 graduates (students who earned a degree or certificate). The second group contacted were students who had achieved no formal award (NFA). These…
In 1989, a follow-upstudy of non-returning students who had attended Johnson County Community College (JCCC) during fall 1985, spring 1986, or summer 1986 was conducted to assess the former students' achievement of their educational goals. A target population of 7,910 long-term leavers was surveyed regarding their opinions and perceptions of…
Johnson County Community Coll., Overland Park, KS. Office of Institutional Research.
Objectives: Hand-arm vibration syndrome (HAVS) consists of vascular and neurological component. Musculoskeletal component has not been delineated yet. In the present follow-upstudy, we evaluated the prevalence of HAVS and the cumulative exposure to vibration among a cohort of forestry workers. Special interest was given to numbness and musculoskeletal disorders of upper extremity and neck in forestry workers. Methods: A
Päivi Sutinen; Esko Toppila; Jukka Starck; Anthony Brammer; Jing Zou; Ilmari Pyykkö
A four?year follow?upstudy comparing gifted achievers and underachievers examined college attendance, academic performance, involvement in campus activities, type of institution attended, number of declared majors, career direction, and satisfaction with life developments since high school. All achievers attended college, were more sure of career direction, completed more years of college, and were more involved in campus activities than were
BACKGROUND AND OBJECTIVES: Occipital neuralgia is a paroxysmal nonthrobbing, stabbing pain in the area of the greater or lesser occipital nerve caused by irritation of these nerves. Although several therapies have been reported, no criterion standard has emerged. This study reports on the results of a prospective trial with 6 months of follow-up in which pulsed radiofrequency treatment of the
Pascal Vanelderen; T. P. H. Rouwette; Pieter De Vooght; Martine Puylaert; René Heylen; Kris Vissers; Jan Van Zundert
|The temporal stability of obsessive-compulsive symptom dimensions was studied in a nonclinical student sample. The Obsessive-Compulsive Inventory--Revised was administered twice to 132 undergraduate students during a 2-year period. There were no significant changes in symptom dimension scores between the baseline and follow-up, except for the…
BACKGROUND & AIMS: Few data are available concerning the long-term prognosis of chronic liver disease associated with hepatitis C virus infection. This study examined the morbidity and survival of patients with compensated cirrhosis type C.METHODS: A cohort of 384 European cirrhotic patients was enrolled at seven tertiary referral hospitals and followedup for a mean period of 5 years. Inclusion
G Fattovich; G Giustina; F Degos; F Tremolada; G Diodati; P Almasio; F Nevens; A Solinas; D Mura; JT Brouwer; H Thomas; C Njapoum; C Casarin; P Bonetti; P Fuschi; J Basho; A Tocco; A Bhalla; R Galassini; F Noventa; SW Schalm; G Realdi
|In order to ascertain the effect of open admissions by investigating the graduation rate of basic skills students, a follow-upstudy was conducted of the 1,728 students who entered Queensborough Community College in fall 1970 and who were assigned to remedial reading and/or writing. Of a total enrollment of 3,230, 24% or 774 students were…
Hand exercise is recommended for hand osteoarthritis (OA) management, but few efficacy studies have been published. The purpose of the study was to determine the effects of two years of whole body strength training and gripper exercise on hand strength, pain, and function in adults with radiographic evidence of hand OA. Older adults (N=55; 71.5+/-6.5 years; 80% female) participated in a two-year, three times per week strength training regimen. Bilateral gripper exercise weight (i.e., isotonic grip strength), isometric grip strength, pain, and self-reported hand, and finger function were recorded at baseline and 24 months. Isotonic grip strength increased 1.94 kg (20.14 kg baseline, 22.09 kg follow-up; p<0.0003). Right and left isometric grip increased 3.62 kg (25.83 kg baseline, 29.45 kg follow-up; p<0.002) and 2.95 kg (22.73 kg baseline, 25.65 kg follow-up; p<0.0005), respectively. Hand pain decreased from 4.77 to 2.62 (p<0.006). Hand and finger function scores showed minimal dysfunction at baseline and follow-up. Results suggest strength training safely increases dynamic and static grip strength and reduces pain in older persons with hand OA. PMID:17658418
Objective To describe upper body structures associated with upper limb reduction deficiency and the development of these structures over time, to examine the presence of physical complaints in this population, and to compare body structures and complaints between groups based on prosthesis use. Design Prospective cohort study with a follow-up period of 24 years, with matched able-bodied controls. Subjects Twenty-eight patients with unilateral below-elbow reduction deficiency fitted with myoelectric prostheses, aged 8–18 years at inclusion. Method Measurements of upper arm, trunk and spine were performed and study-specific questionnaires were answered at baseline and follow-up; the Brief Pain Inventory and the Quick Disability of Arm, Shoulder, and Hand questionnaires were answered at follow-up. Results Both at baseline and follow-up, within-subjects differences in structures of the arm and trunk were shown in patients but not in controls. Spinal deviations, although small, were greater in patients compared to controls. Self-reported disability was higher in patients compared to controls. Differences in back pain and effect of prostheses use could not be shown. Conclusions Patients with unilateral below-elbow reduction deficiency have consistent differences in upper body structures. Deviations of the spine, probably of functional origin, do not progress to clinically relevant scoliosis.
Postema, Sietke G.; van der Sluis, Corry K.; Waldenlov, Kristina; Norling Hermansson, Liselotte M.
Background The purpose of this study was to evaluate the visual outcome of photorefractive keratectomy (PRK) in patients with mild to moderate stable keratoconus and to assess the risk of progression of the disease after the excimer laser procedure. Methods In this prospective study, carried out at the Clemenceau Medical Center, an affiliate of Johns Hopkins International, in Beirut, Lebanon, 119 eyes from 72 patients with grade 1–2 keratoconus (Amsler–Krumeich classification) underwent PRK. Forty-seven patients had both eyes treated and 25 patients had one eye treated. The procedure was done using the Wavelight Eye Q Excimer laser. Uncorrected and best-corrected visual acuity, corneal topography, and pachymetry were assessed before the procedure and 3, 6, 12, 36, and 60 months after the procedure. Results Mean uncorrected visual acuity showed a statistically significant improvement (P < 0.05) at one, 3, and 5 years follow-up. One hundred and seventeen eyes (98.3%) showed no progression while two eyes (1.7%) showed progression of the disease at 5 years follow-up, as documented by corneal topography and pachymetry. These two eyes were treated with corneal collagen crosslinking. Conclusion PRK in mild to moderate keratoconus is a safe and effective procedure for improving uncorrected vision in patients with mild refractive errors. However, close follow-up of patients is needed to detect any progression of the disease. Longer follow-up is needed to assess the overall effect of this procedure on progression of the disease.
Chelala, Elias; Rami, Hala El; Dirani, Ali; Fadlallah, Ali; Fakhoury, Omar; Warrak, Elias
Objective:Limited data are available regarding longitudinal changes in body weight. Here, we describe changes in the prevalences of overweight and obesity and calculated the incidence of these indices during a 10-year follow-up period for a large-scale cohort study in Japan.Design:Longitudinal analysis of data from a population-based cohort study, the Japan Public Health Center (JPHC) Study.Participants:A total of 65 095 Japanese
Y Matsushita; Y Takahashi; T Mizoue; M Inoue; M Noda; S Tsugane
Study objective: To examine the effect of baseline body mass index (BMI) and skinfold thickness (ST) on fatal coronary heart disease (CHD) and all cause mortality after 30 years of followup.Design: Prospective cohort study.Setting: Northwick Park heart study (NPHS) designed to investigate the role of haemostatic variables on CHD.Participants: 1511 men and 691 women enrolled in NPHS aged 40
The objective of this study was to evaluate long-term oncological outcomes of laparoscopic management of endometrial carcinoma\\u000a (EC) in a large series of consecutive patients from two referral cancer centres. The study is a large retrospective study\\u000a with 15-year follow-up. The clinical records of 207 consecutive women with clinical stage I EC managed by laparoscopy between\\u000a 1990 and 2005 were
Benoit Rabischong; Demetrio Larraín; Guillaume Le Bouëdec; Michel Canis; Christophe Pomel; Kris Jardon; Fabrice Kwiatkowski; Jean-Louis Achard; Jacques Dauplat; Gerard Mage
This article presents the results of an 11-year longitudinal study of the impact of America's Choice comprehensive school reform (CSR) design on student learning gains in Rochester, New York. A quasi-experimental interrupted time-series approach using Bayesian hierarchical growth curve analysis with crossed random effects is used to compare the…
|This article presents the results of an 11-year longitudinal study of the impact of America's Choice comprehensive school reform (CSR) design on student learning gains in Rochester, New York. A quasi-experimental interrupted time-series approach using Bayesian hierarchical growth curve analysis with crossed random effects is used to compare the…
Objective To describe differences in trajectories of self reported health in an ageing cohort according to occupational grade.Design Prospective cohort study of office based British civil servants (1985-2004).Participants 10 308 men and women aged 35-55 at baseline, employed in 20 London civil service departments (the Whitehall II study); follow-up was an average of 18 years.Main outcome measures Physical component and
Tarani Chandola; Jane Ferrie; Amanda Sacker; Michael Marmot
Recent calcium supplementation trials in chil- dren have confirmed a positive but moderate effect of calcium intake on bone mineral accretion. However, the lasting effect of a higher bone mineral mass after calcium-supplement withdrawal is not known. This is an I 8-mo follow-upstudy conducted after an I 8-mo controlled calcium supplementation trial to study the per- sistent effect of
Objectives To study the duration of depression, recovery over time, and predictors of prognosis in an older cohort (?55 years) in primary care.Design Longitudinal cohort study, with three years’ follow-up.Setting 32 general practices in West Friesland, the Netherlands.Participants 234 patients aged 55 years or more with a prevalent major depressive disorder.Main outcome measures Depression at baseline and every six months
E Licht-Strunk; H W J Van Marwijk; T Hoekstra; J W R Twisk; M De Haan; A T F Beekman
The purpose of this study was to determine whether the thickness of the intimal hyperplasia (IH) layer that accumulates within Palmaz-Schatz stents is dependent on stent size. Intravascular ultrasound (IVUS) and quantitative angiographic (QCA) studies were performed after stent implantation and at follow-up (5.4 ± 3.8 months) in 161 patients with 177 lesions treated with 221 Palmaz-Schatz stents. Stent and
Rainer Hoffmann; Gary S. Mintz; Augusto D. Pichard; Kenneth M. Kent; Lowell F. Satler; Martin B. Leon
We report on the histological results of in-vivo animal follow-upstudies on refractive femtosecond laser surgery. Non-invasive flap-free intrastromal ablation as well as flap generation has been performed with MHz nanojoule near infrared femtosecond laser pulses. In particular, the dynamics of corneal wound healing have been studied. Wound-healing effects could be detected up to 90 days post-operation in the case of lasermediated flap generation. The flap-free intrastromal cavity was identified until the 28th day post-treatment. Interestingly, eosinophil granulocytes were observed. The follow-upstudies confirmed that the near infrared femtosecond laser at near-nanojoule pulse energy is a highly precise and an attractive tool for intraocular refractive surgery, especially for flap-free intrastromal surgery.
|Iran was one of the major contributors to the international student population in the United States. For some years, the number of Iranian students studied in America mounted such that there were more Iranians studying at colleges and universities in the United States than from any other foreign country. This study examined the satisfaction of…
Background: Work-related musculoskeletal disorders (WMSDs) have a significant impact on physical therapists, but few studies have addressed the issue. Research is needed to determine the scope of the problem and the effects of specific risk factors. Objectives: The objectives of this study were: (1) to determine the 1-year incidence rate of WMSDs in physical therapists and (2) to determine the effects of specific risk factors. Design: This was a prospective cohort study with 1-year follow-up. Methods: Subjects were randomly selected American Physical Therapy Association members (N=882). Exposure assessment included demographic data, physical risk factors, job strain, and specific physical therapy tasks. The primary outcome was WMSDs, with a severity rating of at least 4/10 and present at least once a month or lasting longer than a week. Results: The response rate to the baseline questionnaire was 67%. Ninety-three percent of the subjects who responded to the baseline questionnaire responded to the follow-up questionnaire. The 1-year incidence rate of WMSDs was 20.7%. Factors that increased the risk for WMSDs included patient transfers, patient repositioning, bent or twisted postures, joint mobilization, soft tissue work, and job strain. Limitations: The primary limitation of this study was the number of therapists who had a change in their job situation during the follow-up year. Conclusions: Work-related musculoskeletal disorders are prevalent in physical therapists. Physical therapy exposures, patient handling, and manual therapy, in particular, increase the risk for WMSDs.
Purpose: To describe patterns of prescribed drug use over time among primiparous women in Denmark. Methods: Through the Danish Medical Birth Registry, we identified all primiparous women giving live birth or stillbirth at ? 22 gestational weeks in northern Denmark, from 1999 to 2009. From the Aarhus University Prescription Database we obtained information on the women’s prescriptions for reimbursed drugs filled from 30 days before conception until delivery. Results: Among 85,710 primiparous women, 47,982 (56.0%) redeemed at least one prescription from 30 days before conception until delivery. Women aged 35 years and older had the highest overall prevalence of prescription drug use (61.1%). Age-standardized prevalence of drug use was 54.7% in 1999 and 61.2% in 2009, prevalence ratio (PR) of 1.13 (95% confidence interval 1.10; 1.16), adjusted for age and smoking. Conclusion: Over the 11-year period from 1999 to 2009, we found a modest increase in overall use of drugs by primiparous women in Denmark. This increase was not, however, explained by an increasing proportion of older first-time mothers. We noted changes in patterns of use of anti-infective drugs and antidepressants.
Bj?rn, Anne-Mette Bay; N?rgaard, Mette; Hundborg, Heidi Holmager; Nohr, Ellen Aagaard; Ehrenstein, Vera
Background: Few long-term follow-upstudies have evaluated the response to psychotherapeutical interventions in anorexia nervosa (AN). The effectiveness of individual cognitive-behavioral therapy (CBT) and the possible predictors of outcome in outpatients suffering from threshold and subthreshold AN (s-AN) were evaluated. Methods: At the beginning (T0) and at the end of treatment (T1), and 3 years after the end of treatment
Valdo Ricca; Giovanni Castellini; Carolina Lo Sauro; Edoardo Mannucci; Claudia Ravaldi; Francesco Rotella; Carlo Faravelli
Purpose: The aim of this multicenter study was to evaluate the clinical outcome of anterior cruciate ligament (ACL) reconstruction by use of the Ligament Advanced Reinforcement System (LARS) artificial ligament (Surgical Implants and Devices, Arc-sur-Tille, France) with 3- to 5-year follow-up. Methods: From August 2004 to July 2006, 159 patients with ACL rupture underwent arthroscopic ACL recon- struction with LARS
Kai Gao; Shiyi Chen; Lide Wang; Weiguo Zhang; Yifan Kang; Qirong Dong; Haibin Zhou; Linan Li
The present study reports a two-year follow-up of psychological effects of predictive testing for Huntington's disease. Questionnaires assessing depression, general health, well-being, self injurious behavior, life satisfaction, and lifestyle were completed by 35 carriers and 58 non-carriers before the predictive test, and 2, 6, 12, and 24 months afterwards. Both carriers and non-carriers showed high suicidal ideation before the predictive
Maria U. Larsson; Mary A. Luszcz; Tarja-Brita Robins Wahlin
Summary This study examined effect of a new intervertebral cervical disc prosthesis in relieving the neurological symptoms and signs,\\u000a improving the patients’ ability to perform daily activities, reducing pain, and maintaining the stability and segmental motion.\\u000a From December 2003 to October 2004, 12 patients, who had received 14 replacements of cervical artificial discs, were followed-up\\u000a for 2 to 8 months (with
Shuhua Yang; Yong Hu; Jijun Zhao; Xianfeng He; Yong Liu; Weihua Xu; Jingyuan Du; Dehao Fu
Background Relatively little information is available on the incidence of secondary cancer in non-Hodgkin's lymphoma. The aim of this long-term follow-upstudy was to determine the incidence, the time free of second tumors, and risk factors for developing secondary cancer in a homogeneous group of patients with non-Hodgkin's lymphoma. Design and Methods We evaluated a total of 563 patients with
Stefano Sacchi; Luigi Marcheselli; Alessia Bari; Raffaella Marcheselli; Samantha Pozzi; Stefano Luminari; Marco Lombardo; Gabriele Buda; Antonio Lazzaro; Paolo G. Gobbi; Caterina Stelitano; Fortunato Morabito; Giovanni Quarta; Maura Brugiatelli; Orsola Ciarcia; Caterina Mammi
This is a three-year follow-upstudy on the results from the Deinstitutionalization Project of the Leros PIKPA asylum regarding job-related fears of care staff of the institution as well as their attitudes towards people with learning disabilities. We expected that changes in staff would occur in a way congruent with previously published findings indicating that after a year of intervention
John Tsiantis; Stavroula P. Diareme; Gerasimos Kolaitis
This follow-upstudy to van Kraayenoord and Schneider (1999) examined the performance in reading, metacognition and motivation\\u000a related to reading of students in Grades 7 and 8. Results showed significant correlations between all of the variables. A\\u000a multivariate analysis of variance showed that “good” and “poor” readers differed in reading self-concept and metacognitive\\u000a measures related to reading and memory. A
Annette Roeschl-Heils; Wolfgang Schneider; Christina E. van Kraayenoord
Rationale: A large body of epidemiologic literature has found an association of increased fine particulate air pollution (PM2.5) with acute and chronic mortality. The effect of improvements in particle exposure is less clear. Objectives: Earlier analysis of the Harvard Six Cities adult cohort study showed an association between long-term ambient PM2.5 and mortality between enrollment in the mid-1970s and follow-up
Francine Laden; Joel Schwartz; Frank E. Speizer; Douglas W. Dockery
Objective: To evaluate the long term prognosis of patients with stable angina pectoris.Design: Registry based followup (median 9.1 years) of patients participating in the APSIS (angina prognosis study in Stockholm), which was a double blind, single centre trial of antianginal drug treatment.Patients: 809 patients (31% women) with stable angina pectoris < 70 (mean (SD) 59 (7) years at inclusion)
P Hjemdahl; S V Eriksson; C Held; L Forslund; P Na?sman; N Rehnqvist
Given the limited knowledge on the long-term outcome of adolescents who receive electroconvulsive therapy (ECT), the study aimed to follow-up adolescents treated with ECT for severe mood disorder. Eleven subjects treated during adolescence with bilateral ECT for psychotic depression (n = 6) or mania (n = 5), and ten psychiatric controls matched for sex, age, school level, and clinical diagnosis, completed at least 1
O. Taieb; M.-F. Flament; S. Chevret; P. Jeammet; J.-F. Allilaire; P. Mazet; D. Cohen
Background: Although angiotensin-converting enzyme inhibitors (ACEIs) have been shown to prolong life in patients with congestive heart failure (CHF), the prognosis of these patients remains poor.Objective: The purpose of the study was to reevaluate a cohort of patients with CHF after 7 years of follow-up with cilazapril therapy to assess the renin-angiotensin system (RAS), anatomic and functional capacity of the
?eref Demirel; Osman Erk; Mehmet Ünal; Sezai Vatansever; Hüseyin Oflaz; ?lker Yücesir; Nursal Florinal?; Kamil Adalet
This longitudinal study set out to examine the changes that took place in parents’ evaluations of their child’s school in\\u000a the course of the child’s complete 9-year-long compulsory education. Over the follow-up period, academically educated and\\u000a vocationally educated mothers and fathers (N?=?326) were asked to indicate their degree of satisfaction with aspects of their child’s school every 2 years. It was
A retrospective multicentre study of 341 children with persistent\\/recurrent, isolated haematuria is described. The haematuria was isolated for at least 6 months at the beginning of observation. The duration of follow-up was 2–5 years in 201, 5–10 years in 119, 10–15 years in 19, and over 15 years in 2 cases. Of these patients 47.8% became symptom-free. In 18.4% the
S. Túri; M. Visy; Á. Vissy; V. Jfiszai; Zs. Czirbesz; I. Haszon; Zs. Szelid; I. Ferkis
We examined the relation of dietary diversity to subsequent all-cause mortality by using data from the First National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-upStudy, 1982- 1987. The analytic co- hort consisted of 4 160 men and 6264 women (including 2556 deaths), 25-74 y at baseline ( 197 1- 1975). Twenty-four-hour di- etary recalls were evaluated for
This study aimed to evaluate the long-term course of obsessive–compulsive disorder (OCD) in patients treated with serotonin reuptake inhibitors (SRIs) and to identify predictors of clinical outcome. Seventy-nine patients fulfilling DSM-IV criteria for OCD were followed prospectively for 3 years. Baseline information was collected on demographic and clinical characteristics, using standardized instruments. During the follow-up period, the clinical status of
Francesco Catapano; Francesco Perris; Mariangela Masella; Flavia Rossano; Marco Cigliano; Lorenza Magliano; Mario Maj
This study examined the outcome of youth previously diagnosed with psychotic disorders at a public-sector tertiary care hospital. Of 95 children and adolescents retrospectively identified, follow-up information (mean interval 3.9 years) was obtained on 24 subjects with an outcome diagnosis of schizophrenia, 9 with psychotic mood disorders, 5 with personality disorders (antisocial or borderline), and 1 with schizo-affective disorder. The
X-STOP is the first interspinous process decompres- sion device that was shown to be superior to nonoperative therapy in patients with neurogenic intermittent claudication secondary to spinal stenosis in the multicenter randomized study at 1 and 2 years. We present 4-year follow-up data on the X-STOP patients. Patient records were screened to identify potentially eligible subjects who underwent X-STOP implanta-
Dimitriy G. Kondrashov; Matthew Hannibal; Ken Y. Hsu; James F. Zucherman
Objectives: To investigate the relationship between purpose in life and depression and, in a five-year follow-up investigate whether purpose in life, adjusted for different background characteristics, can prevent very old men and women from developing depression.Methods: A cross-sectional study included 189 participants (120 women and 69 men) 85–103 years of age living in a county in northern Sweden. Those who
Pia Hedberg; Yngve Gustafson; Lena Alèx; Christine Brulin
ObjectivesTo assess the risk of autism spectrum disorders (ASD) in children born after assisted conception compared with children born after natural conception.DesignPopulation-based follow-upstudy.SettingAll children born alive in Denmark 1995–2003.Participants588 967 children born in Denmark from January 1995 to December 2003. Assisted conception was defined as in vitro fertilisation (IVF) with or without intracytoplasmic sperm injection and ovulation induction (OI)
D. Hvidtjorn; J. Grove; D. Schendel; L. A. Schieve; C. Svaerke; E. Ernst; P. Thorsen
BACKGROUND: Skeletal muscle consists of type-I (slow-twitch) and type-II (fast-twitch) fibers, with proportions highly variable between individuals and mostly determined by genetic factors. Cross-sectional studies have associated low percentage of type-I fibers (type-I%) with many cardiovascular risk factors. METHODS: We investigated whether baseline type-I% predicts left ventricular (LV) structure and function at 19-year follow-up, and if so, which are the
Jouko Karjalainen; Heikki Tikkanen; Miika Hernelahti; Urho M Kujala
BACKGROUND: An evaluation of homeopathic treatment and the outcomes in patients suffering from sinusitis for ?12 weeks in a usual care situation. METHODS: Subgroup analysis including all patients with chronic sinusitis (ICD-9: 473.9; ?12 weeks duration) of a large prospective multicentre observational study population. Consecutive patients presenting for homeopathic treatment were followed-up for 2 years, and complaint severity, health-related quality
The levels of smoking of 1st and 2nd year students at Faculty of Medicine and Manisa School of Health at Celal Bayar University were investigated in 2006-2007. This study is carried out in order to see if there is a change in the same students' level of smoking while they are in 3rd and 4th year. In addition, the study aimed to examine the factors affecting the level of use and attitudes towards the law effectuated in July 19, 2009. This is a follow-upstudy with 80.42% return rate. A 26-item structured questionnaire was administered. The participants filled out the questionnaires under supervision of the researchers in their classrooms. The University Institutional Review Board approved the study. The total of participants (263) of the follow-upstudy included 189 female and 74 male. The rate of experimenting with smoking was 49% with the mean age of 15.7 (SD= 4.01 years). The mean age of experimenting with smoking was the earliest on male students studying at faculty of medicine. The level of smoking was found to be the most on females, studying at faculty of medicine and staying at the dormitory, with smoking parents (p< 0.05). The most important reason to begin smoking was curiosity (55.2%) while bad breath and yellowing of teeth were the reasons to quit (91.7%). 83.3% of the students thought that the law will be effective on quit smoking. The level of both experimenting and use of smoking has been increased over time. It is suggested that medical students' awareness about the danger of smoking should be raised at earlier grades. In addition, lectures should be offered to students at School of Health and they should be encouraged to unite in order to fight with smoking. PMID:22233305
This thesis is based on the findings of the FuPro-Stroke study (the Stroke section of the Functional Prognostification and disability study on neurological disorders), which is a multicentre, prospective cohort study among patients with stroke, who were included during inpatient rehabilitation. The aim of the research reported on in the present thesis was to investigate the long-term prognosis of chronic
Few studies have examined the stability of major psychiatric disorders in pediatric psychiatric clinical populations. The\\u000a objective of this study was to examine the long-term stability of anxiety diagnoses starting with pre-school age children\\u000a through adolescence evaluated at multiple time points. Prospective cohort study was conducted of all children and adolescents\\u000a receiving psychiatric care at all pediatric psychiatric clinics belonging
Juan J. CarballoEnrique; Enrique Baca-Garcia; Carlos Blanco; M. Mercedes Perez-Rodriguez; Miguel A. Jimenez Arriero; Antonio Artes-Rodriguez; Moira Rynn; David Shaffer; Maria A. Oquendo
STUDY OBJECTIVE—To test the hypothesis that the association between socioeconomic status and mortality rates cuts across the major causes of death for middle aged and elderly men.?DESIGN—25 year followup of mortality in relation to employment grade.?SETTING—The first Whitehall study.?PARTICIPANTS—18 001 male civil servants aged 40-69 years who attended the initial screening between 1967 and 1970 and were followedup for at least 25 years.?MAIN OUTCOME MEASURE—Specific causes of death.?RESULTS—After more than 25 years of followup of civil servants, aged 40-69 years at entry to the study, employment grade differences still exist in total mortality and for nearly all specific causes of death. Main risk factors (cholesterol, smoking, systolic blood pressure, glucose intolerance and diabetes) could only explain one third of this gradient. Comparing the older retired group with the younger pre-retirement group, the differentials in mortality remained but were less pronounced. The largest decline was seen for chronic bronchitis, gastrointestinal diseases and genitourinary diseases.?CONCLUSIONS—Differentials in mortality persist at older ages for almost all causes of death.???Keywords: mortality; socioeconomic factors; cause of death.
van Rossum, C. T M; Shipley, M.; van de Mheen, H.; Grobbee, D.; Marmot, M.
Background The association between overtime work and depression is still unclear. This study examined the association between overtime work and the onset of a major depressive episode (MDE). Methodology/Principal Findings Prospective cohort study with a baseline examination of working hours, psychological morbidity (an indicator of baseline depression) and depression risk factors in 1991–1993 and a follow-up of major depressive episode in 1997–1999 (mean follow-up 5.8 years) among British civil servants (the Whitehall II study; 1626 men, 497 women, mean age 47 years at baseline). Onset of 12-month MDE was assessed by the Composite International Diagnostic Interview (CIDI) at follow-up. In prospective analysis of participants with no psychological morbidity at baseline, the odds ratio for a subsequent major depressive episode was 2.43 (95% confidence interval 1.11 to 5.30) times higher for those working 11+ hours a day compared to employees working 7–8 hours a day, when adjusted for socio-demographic factors at baseline. Further adjustment for chronic physical disease, smoking, alcohol use, job strain and work-related social support had little effect on this association (odds ratio 2.52; 95% confidence interval 1.12 to 5.65). Conclusions/Significance Data from middle-aged civil servants suggest that working long hours of overtime may predispose to major depressive episodes.
Virtanen, Marianna; Stansfeld, Stephen A.; Fuhrer, Rebecca; Ferrie, Jane E.; Kivimaki, Mika
The effects of prolonged treatment with intranasally applied budesonide was studied in twenty-four patients with perennial allergic or non-allergic rhinitis. Patients on continuous treatment were followedup for 5.5 years. At entry and follow-up visits, rhinoscopic findings, nasal symptom scores, blood chemistry, haematology, urine analysis and determination of plasma cortisol levels, before and after stimulation with ACTH (Synacthen, Ciba-Geigy AG, Basel, Switzerland), were registered. Biopsies of the nasal mucosa were taken before entry into the study, after 1 year of treatment, and after varying time intervals ranging from 2.5 to 5.5 years during the treatment. The biopsy specimens were examined blindly by an independent pathologist. The analyses revealed no histopathological changes in the nasal mucosa. All nasal symptom parameters assessed by the patients were significantly reduced from the baseline during the entire follow-up period. No clinically significant changes in the haematological and blood chemistry parameters were observed. Plasma cortisol analyses before and after challenge with ACTH revealed no influence on the hypothalamic pituitary adrenal (HPA) axis. The present study suggests that intranasal budesonide in the dose of 200-400 micrograms/day is also a safe treatment for prolonged treatment of perennial rhinitis. PMID:3396194
Pipkorn, U; Pukander, J; Suonpää, J; Mäkinen, J; Lindqvist, N
The purpose of this SOP is to define the coding strategy for the FollowUp Questionnaire. This questionnaire was developed for use in the Arizona NHEXAS project and the Border study. Household and individual follow-up data were combined in a single Follow-up Questionnaire data f...
Background: Many studies have looked at sources of stress in psychiatrists, yet the role played by different factors in the causation of burnout in psychiatrists remains unclear. We had two aims, first, to develop a predictive model for the onset of burnout. Second, we aimed to study the differences in the perception of what caused stress between psychiatrists who rated
Shailesh Kumar; Simon Hatcher; Gaelle Dutu; Jesse Fischer; Etuini Mau
|The purpose of the study was to explore students' alternative conceptions and their associative thinking regarding internal transport in plants through administration of a refined diagnostic test. Questions of associative thinking and explanation were added to form a third tier of the previous two-tier test. The study found three terms related to…
|This document reports a comprehensive followup study to describe postservice life status of former vocational rehabilitation clients and to develop an empirical index of postservice adjustment to spinal cord injury. Significant findings, conclusions, and implications are found at the beginning. The introduction section summarizes followup studies…
|The Baccalaureate and Beyond Longitudinal Study (B&B:93) tracks the experiences of a cohort of recent college graduates, those who received the baccalaureate degree during the 1992-93 academic year and were first interviewed as part of the National Postsecondary Student Aid Study. The experiences of this group in the areas of academic enrollment,…
|This study provides results regarding the effectiveness of the Bounce Back Retention Program (BBRP), a semester-long voluntary course for students on academic probation (AP). This is the first phase of a longitudinal study of spring 2007 freshmen at San Diego State University (SDSU). Results were analyzed for three samples: 1) "AP BBRP-Credit"…
|This study presents data that extend an earlier analysis of predictors of academic performance from one to three years. None of the adjustment and other psychosocial variables (help-seeking, academic motivation, self-esteem, perceived stress and perceived academic overload) could predict success at university at the end of three years of study.…
This document reports a comprehensive followup study to describe postservice life status of former vocational rehabilitation clients and to develop an empirical index of postservice adjustment to spinal cord injury. Significant findings, conclusions, and implications are found at the beginning. The introduction section summarizes followup studies…
We report the medium-term outcomes of the Rotaglide mobile bearing total knee arthroplasty (RTK). Between 1994 and 1999, 357 RTK prostheses were implanted at our institution. Of 150 knees attending for follow-up, none had needed revision. Mean American Knee Society Score (AKSS), Oxford knee score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at 8 years were 153.6, 23.1 and 16.5, respectively. Radiological analysis revealed no prosthesis with signs of impending failure requiring revision. Survivorship was 100% in those attending. However, we are aware of two failures requiring revision, both of which were due to infection. We have no reported failures requiring revision due to aseptic loosening. This may be a result of the implant design. Limitations of the study include loss to follow-up and radiological analysis. The RTK gives good to excellent medium-term results and we support its continued use.
Objectives To describe loss to follow-up (LTFU) at all stages of the HIV programme. Design A retrospective cohort study. Setting The HIV clinic at Hospital National Simão Mendes in Bissau, Guinea-Bissau. Participants A total of 4080 HIV-infected patients. Outcome measures Baseline characteristics, percentages and incidence rates of LTFU as well as LTFU risk factors at four different stages: immediately after HIV diagnosis (stage 1), after the first CD4 cell count and before a follow-up consultation (stage 2), after a follow-up consultation for patients not eligible for antiretroviral treatment (ART; stage 3) and LTFU among patients on ART (stage 4). Results Almost one-third of the patients were lost to the programme before the first consultation where ART initiation is decided; during the 7-year observation period, more than half of the patients had been lost to follow-up (overall incidence rate=51.1 patients lost per 100 person-years). Age below 30?years at inclusion was a risk factor for LTFU at all stages of the HIV programme. The biggest risk factors were body mass index <18.5?kg/m2 (stage 1), male gender (stage 2), HIV-2 infection (stage 3) and CD4 cell count <200 cells/?L (stage 4). Conclusions In this study, LTFU constituted a major problem, and this may apply to other similar ART facilities. More than half of the patients were lost to follow-up shortly after enrolment, possibly implying a high mortality. Thus, retention should be given a high priority.
H?nge, Bo Langhoff; Jespersen, Sanne; Nordentoft, Pernille Bejer; Medina, Candida; da Silva, David; da Silva, Zacarias Jose; ?stergaard, Lars; Laursen, Alex Lund; Wejse, Christian
An appendix to a study (May 1965-April 1968) of mentally ill clients of the California Department of Vocational Rehabilitation 2 years after case closure reproduces abbreviated copies of the two principal research instruments, a case record schedule and a...
This study aimed to assess short-term (12 weeks) and long-term (12 months) gender differences in the outcomes of patients\\u000a experiencing an episode of mania in the course of bipolar disorder. European Mania in Bipolar Longitudinal Evaluation of Medication\\u000a was a 2-year, prospective, observational study of the outcomes of patients with a manic or mixed episode conducted in 14 European\\u000a countries. Data were
Laia Miquel; Judith Usall; Catherine Reed; Jordan Bertsch; Eduard Vieta; Ana González-Pinto; Jules Angst; Willem Nolen; Inge van Rossum; Josep Maria Haro
This study contributes a Canadian perspective to a growing body of international studies examining suicide among cohorts\\u000a of suicide attempters, and a much more limited literature on the epidemiology of suicide in Canada. We evaluated the 13-year\\u000a mortality experience of a regional cohort of 876 first-ever inpatient hospital admissions for a suicide attempt admitted between\\u000a 1979 and 1981. Compared to
Background The epidemiology of suicidal ideation has remained a relatively unstudied area. The aim of this study was to investigate\\u000a the incidence, prevalence and persistence of and recovery from suicidal ideation in a sample of the Finnish general population.\\u000a Methods Postal questionnaires including the Beck Depression Inventory (BDI) were mailed to the study subjects (n = 1,593) at baseline\\u000a and
J. Hintikka; T. Pesonen; P. Saarinen; A. Tanskanen; J. Lehtonen; H. Viinamäki
This three-wave 35-year prospective study used the Job Demands-Resources model and life course epidemiology to examine how life conditions in adolescence (1961–1963) through achieved educational level and working conditions in early adulthood (1985) may be indirectly related to job burnout 35 years later (1998). We used data (N = 511) from the Finnish Healthy Child study (1961–1963) to investigate the
Jari J. Hakanen; Arnold B. Bakker; Markku Jokisaari
Few studies examine whether and how parental attitudes towards genetic testing change over time. In this study we interviewed\\u000a parents of 14 children with newly identified hearing loss at two time points: after referral to genetics and 1 year later.\\u000a Qualitative analyses of parental narratives indicate that parental attitudes did not change significantly over this time.\\u000a Parents who perceived genetic testing
Girija Kaimal; Annie G. Steinberg; Sara Ennis; Sue Moyer Harasink; Rachel Ewing; Yuelin Li
Objectives. To study the outcome at 2-year corrected age of infants who participated in a double-blind controlled trial of early (<12 hours) dexa- methasone therapy for the prevention of chronic lung disease (CLD). Methods and Materials. A total of 133 children (70 in the control group, 63 in the dexamethasone-treated group) who survived the initial study period and lived to
S. Hsieh; Yu J. Lien; Tsu F. Yeh; Yuh J. Lin; Chao C. Huang; Yung J. Chen; Chyi H. Lin; Hong C. Lin
Self-reports continue to be the most commonly used method in studies on the effectiveness of treatments for drug addiction. Nevertheless, the validity of this procedure has been called into question, so that subjects' reports are often compared with data from other sources. This study compares the data collected from the self-reports of 207 subjects that had participated in a drug-free
Roberto Secades-Villa; José Ramón Fernández-Hermida
We describe the case of an 11-year-old, previously healthy, pre-puberal, right-handed girl with acquired aphasia following an extensive cerebral hemorrhage into a left hemisphere brain tumor. A 3-year follow-up evaluation of the girl's communicative performance showed an incomplete recovery of linguistic abilities with a good recovery of comprehensive components, but persisting severe impairment in expressive language. At the end of
Although many studies focus on the how contrast effects can impact cognitive evaluations, the question of whether emotions are regulated by such contrast effects is still the subject of considerable debate, especially in the study of loss-related decisions. To address this gap in the literature, we designed three decision making loss conditions: (i) both losses are trivial (TT), (ii) one loss is trivial and the other loss is vital (TV), or (iii) one loss is trivial and the other loss is routine (TR). In study 1, which compared the difference between the negative emotion ratings in TT and TV, we found that negative emotions were affected by the contrast effects. In study 2, which compared the difference between the importance of trivial options in TT and TV, we found that the contrast effects differentially changed the importance of trivial options in the two conditions, which in turn down-regulated negative emotions. In study 3, the impact of decision difficulty was controlled by predetermining the items to be lost. In this study, we found that, when comparing the differences between the negative emotions of losing trivial options in TV and TR, the contrast effects still modulated the loss-related emotions. We concluded that the contrast effects could down-regulate emotions. To our knowledge, this is the first demonstration that contrast effects can alleviate negative affect in loss-related decision making. This study will enrich and extend the literature on emotion regulation theory, and it will provide a new cost-effective mitigation strategy for regulating negative emotions.
Background: Chronic exposure to arsenic is associated with skin lesions. However, it is not known whether reducing arsenic exposure will improve skin lesions. Objective: We evaluated the association between reduced arsenic exposures and skin lesion recovery over time. Methods: A follow-upstudy of 550 individuals was conducted in 2009–2011 on a baseline population of skin lesion cases (n = 900) previously enrolled in Bangladesh in 2001–2003. Arsenic in drinking water and toenails, and skin lesion status and severity were ascertained at baseline and follow-up. We used logistic regression and generalized estimating equation (GEE) models to evaluate the association between log10-transformed arsenic exposure and skin lesion persistence and severity. Results: During the study period, water arsenic concentrations decreased in this population by 41% overall, and 65 individuals who had skin lesions at baseline had no identifiable lesions at follow-up. In the adjusted models, every log10 decrease in water arsenic and toenail arsenic was associated with 22% [odds ratio (OR) = 1.22; 95% CI: 0.85, 1.78] and 4.5 times (OR = 4.49; 95% CI: 1.94, 11.1) relative increase in skin lesion recovery, respectively. In addition, lower baseline arsenic levels were significantly associated with increased odds of recovery. A log10 decrease in toenail arsenic from baseline to follow-up was also significantly associated with reduced skin lesion severity in cases over time (mean score change of –5.22 units; 95% CI: –8.61, –1.82). Conclusions: Reducing arsenic exposure increased the odds that an individual with skin lesions would recover or show less severe lesions within 10 years. Reducing arsenic exposure must remain a public health priority in Bangladesh and in other regions affected by arsenic-contaminated water.
Approximately 50% of individuals with HIV report cognitive deficits that can affect social or occupational functioning. The present study used a longitudinal design (1 year) to examine the relationship between cognitive factors and incidental functional deficits in medication management and driving ability among a cohort of 101 HIV+ participants. Participants were classified into groups of functionally "stable" and "disabled" for each laboratory-based functional task (i.e., Medication Management Task-Revised, MMT-R, and PC-based driving simulator). We hypothesized that participants who exhibited a functional deficit in either MMT-R or driving at follow-up assessment would demonstrate significantly poorer baseline cognitive performance at study entry than participants who remained functionally stable. As hypothesized, participants who demonstrated significantly lower baseline performance in learning/memory and executive functioning also demonstrated functional disability on the MMT-R at follow-up when compared to functionally stable participants. Poor baseline performance in speed of information processing was associated with a deficit in driving ability at follow-up assessment. Our results suggest that lower baseline cognitive functioning predicts downstream functional disability, and that deficits in learning/memory and information processing speed are particularly predictive of deficits in medication management and driving ability. PMID:23237014
Thames, April D; Arentoft, Alyssa; Rivera-Mindt, Monica; Hinkin, Charles H
Background A retrospective study concerning patients presenting with patella instability, treated using a Roux-Elmslie-Trillat reconstruction operation and followedup for 10 years following surgery, is presented. Methods Pre-operative and follow-up radiographic evaluation included the weight-bearing anteroposterior and merchant views. Evaluation was carried out using the Insall-Salvati index, sulcus and congruence angle. The Roux-Elmslie-Trillat reconstruction operation was performed on 18 patients. The clinical evaluation at follow-up was performed using the Knee-Society-Score (KSS) and Tegner-Score. Results Subjective results of the operation were classed as excellent or good in 16 of the 18 patients ten years after surgery; persistent instability of the patella was recorded in only one of the 18 patients. The majority of patients returned to the same level of sporting activity after surgery as they had participated in before injury. Conclusions The Roux-Elmslie-Trillat procedure could be recommended in cases presenting with an increased q-angle, trochlea dysplasia or failed soft tissue surgery. In the present study the majority of patients report a return to previous sporting activity ten years after surgery.
Objective Family studies have suggested that postpartum mood symptoms might have a partly genetic etiology. The authors used a genome-wide linkage analysis to search for chromosomal regions that harbor genetic variants conferring susceptibility for such symptoms. The authors then fine-mapped their best linkage regions, assessing single nucleotide polymorphisms (SNPs) for genetic association with postpartum symptoms. Method Subjects were ascertained from two studies: the NIMH Genetics Initiative Bipolar Disorder project and the Genetics of Recurrent Early-Onset Depression. Subjects included women with a history of pregnancy, any mood disorder, and information about postpartum symptoms. In the linkage study, 1,210 women met criteria (23% with postpartum symptoms), and 417 microsatellite markers were analyzed in multipoint allele sharing analyses. For the association study, 759 women met criteria (25% with postpartum symptoms), and 16,916 SNPs in the regions of the best linkage peaks were assessed for association with postpartum symptoms. Results The maximum linkage peak for postpartum symptoms occurred on chromosome 1q21.3-q32.1, with a chromosome-wide significant likelihood ratio Z score (ZLR) of 2.93 (permutation p=0.02). This was a significant increase over the baseline ZLR of 0.32 observed at this locus among all women with a mood disorder (permutation p=0.004). Suggestive linkage was also found on 9p24.3-p22.3 (ZLR=2.91). In the fine-mapping study, the strongest implicated gene was HMCN1 (nominal p=0.00017), containing four estrogen receptor binding sites, although this was not region-wide significant. Conclusions This is the first study to examine the genetic etiology of postpartum mood symptoms using genome-wide data. The results suggest that genetic variations on chromosomes 1q21.3-q32.1 and 9p24.3-p22.3 may increase susceptibility to postpartum mood symptoms.
Introduction Psychological adjustment following cancer occurrence remains a key issue among the survivors. This study aimed to investigate\\u000a psychological distress in patients with breast cancer following completion of breast cancer treatments and to determine its\\u000a associated factors.\\u000a \\u000a \\u000a \\u000a \\u000a Materials and methods This was a prospective study of anxiety and depression in breast cancer patients. Anxiety and depression were measured using\\u000a the Hospital Anxiety
Mariam Vahdaninia; Sepideh Omidvari; Ali Montazeri
Background Nucleoplasty is a minimally invasive percutaneous intradiscal coblation therapy option in patients with chronic discogenic\\u000a low back pain. The purpose of this prospective study was to assess the effectiveness of nucleoplasty in our patients up to\\u000a 1 year after treatment.\\u000a \\u000a \\u000a \\u000a Method All patients included in this study suffered from established back pain and\\/or radiating pain in the lower extremities. Age,\\u000a gender, weight,
Ferass Al-Zain; Johannes Lemcke; Tim Killeen; Ullrich Meier; Andreas Eisenschenk
|Recent evidence on amusia suggests that our ability to perceive music might be based on the same neural resources that underlie other higher cognitive functions, such as speech perception and spatial processing. We studied the neural correlates of acquired amusia by performing extensive neuropsychological assessments on 53 stroke patients with a…
Sarkamo, Teppo; Tervaniemi, Mari; Soinila, Seppo; Autti, Taina; Silvennoinen, Heli M.; Laine, Matti; Hietanen, Marja
A study is reported of the longer term impact of high intensity training, 7 to 12 months after completion, particularly as to the wages of HIT trained workers who left the organization in which they had been trained; the educational experience was obtaine...
|We report the impact of case management services on drug use and self-reported delinquency for youths involved in a clinical trial of the Juvenile Arbitration program. The project evaluated an innovative intervention service providing 16 weeks of intensive case management services to youths and their families. The present study examines interview…
Dembo, Richard; Wareham, Jennifer; Poythress, Norman G.; Cook, Brittany; Schmeidler, James
Dietary exposure to the ochratoxin A (OTA) occurring in Portugal is characterized by a high frequency of contamination of the consumed foodstuffs, although at low levels. The exposure bears significance for the total food consumed, and not for a particular one. Biomonitoring studies are thus fundamental in simplifying the evaluation of exposure, with no need to examine the entire range of consumed foodstuffs. Biomonitoring studies further allow the identification of host factors as predictors of OTA exposure in epidemiologic studies, the results of which are merited for targeting intervention strategies by public health authorities and advising official regulatory decisions. Using a longitudinal approach, this study examined factors related to OTA exposure in the adult population over a one-year period. Anthropometric measures, season of the year and region were the selected factors correlated with OTA exposure biomarker. Urine samples from 95 inhabitants from six Portuguese main geographical areas were assayed through spectrofluorimetric detection. Exposure to OTA proved to markedly increase in winter, and gender differences were observed only in summer, which might be related to different dietary patterns not only between seasons, but also between genders. The same rationale may also serve the observed statistically significant differences between some regions. No other strong association upon the remaining determinants under testing was observed. These observations reinforce the need for OTA exposure evaluation, possibly specifically targeting the staple foods or dietary habits that sustain potential predictors or determinants of exposure. PMID:22237049
|The Student/Teacher Achievement Ratio (STAR) Project first investigated the effect of small class size on student achievement with over 6,000 Tennessee primary students in 1985 through 1989. The study found a consistent and significant benefit of small classes for all students, with the greatest advantages for minority, inner-city students from…
Pate-Bain, Helen; Boyd-Zaharias, Jayne; Cain, Van A.; Word, Elizabeth; Binkley, M. Edward
|Examined changes in physical fitness of middle-aged adults with mental retardation over 13 years. The subjects had participated in a physical fitness study in 1983. They were re-evaluated for cardiovascular endurance, muscular strength, muscular endurance, flexibility, and body composition. Fitness levels declined over the 13 years and were low…
The current study tested parent alcoholism effects on growth curves of adolescent substance use and examined whether parent and peer influences, temperamental emotionality and sociability, and stress and negative affect could explain parent alcoholism effects. Longitudinal latent growth curve modeling showed that adolescents with alcoholic fathers, boys, and adolescents with drug-using peers had steeper growth in substance use over time
Laurie Chassin; Patrick J. Curran; Andrea M. Hussong; Craig R. Colder
Developmental disabilities are a heterogeneous group of chronic conditions that may result in substantial activity limitations. The type and number of limitations may vary by impairment characteristics. Economic and social constraints may impact activity limitations beyond those attributable to their impairment. Using the International Classification of Functioning (ICF), Disability, and Health conceptual framework, this study tests the hypothesis that activity
Kim Van Naarden Braun; Marshalyn Yeargin-Allsopp; Donald Lollar
Lit tie fol low-up data has been pub lished on in di vid u als with dissociative iden tity dis or der (DID). In this study, DID was di agnosed in 25 pa tients by two sea soned dissociative dis or der clinician\\/researchers be ginning in 1986. The initial evaluationin cludedacomprehensive med i cal and psy chi at ric eval
Objective: To examine factors associated with bullying and victimization from age 8 to 16.Method: An 8-year longitudinal study included questions about bullying and victimization at age 8 and 16. Children were evaluated with Rutter scales by parents and teachers and with the Child Depression Inventory filled in by the children at age 8. When the children were at the age
Andre Sourander; Leila Helstelä; Hans Helenius; Jorma Piha
Allergy to bovine meat and Bovine serum albumin (BSA) is exceptional, especially in the adult life. BSA is considered a minor allergen in cow's milk allergy, but there is little information about this antigen in reactions produced by other beef products as meat. To our knowledge, evolutive studies of beef's allergic patients have not been reported. Objective. To present one
V. Fuentes Aparicio; I. Sánchez Marcén; A. Pérez Montero; M. L. Baeza; M. de Barrio Fernández
This study examined the predictors of longevity among 40 late adolescent romantic couples (mean age males=17.71 years; mean age females=17.18 years). Subjects were given a revealed differences task where they were asked to solve their disagreements. The joint task was recorded, transcribed and analysed by two raters. At 3, 6, 9, 12, 18, and 24…
|Comprehensive School Reform (CSR) programs were implemented in 1998 in five states working with the Southwest Educational Development Laboratory (SEDL). SEDL's five-state region includes Arkansas, Louisiana, New Mexico, Oklahoma, and Texas. This study examined the implementation status of CSR programs since funding ended. Two hundred and…
Southwest Educational Development Lab., Austin, TX.
This paper presents empirical findings from a 10-year longitudinal study of the educational and occupational socialization of 445 participants who were about 7 years old when first tested, and about 17 years old at the fourth time of measurement. In addition to collecting psychological measurements from the participants, behavioral reports were collected from significant others, specifically parents and teachers. Findings
Joaquim Armando Ferreira; Eduardo J. R. Santos; António C. Fonseca; Richard F. Haase
Background:Since the introduction of atrial switch operation, the outlook for patients with complete transposition of the great arteries (TGA has improved dramatically. However, many survivors are afflicted with postoperative complications and continue to demand medical attention. We therefore performed the study for the evaluation of the clinical course in the patients with complete TGA after atrial switch operation. Methods:We analyzed
This study investigates how adult students aged 25 or older at the time of leaving the two?year University of Wisconsin Centers compare to younger students in terms of their goals, where they go on to school, or the barriers to going on.More than 450 former Center students who left the Centers after the Spring 1979 or Spring 1980 semesters with
|The purpose of this study was to determine if the students who graduated from Ferris State University (Michigan) with a bachelor's degree in criminal justice were satisfied with their education and career choices. A questionnaire was mailed to all graduates of Ferris State University's Bachelor's program in criminal justice between 1991 and 1994.…
|Background: The natural history of thyroid function in adults with Down syndrome (DS) is unknown. Method: This study investigated annual thyroid function tests in 200 adults with DS over a 10-year period. Results: Transient and persistent thyroid dysfunction was common. The 5- and 10-year incidence of definite hypothyroidism was 0.9%-1.64% and…
A study (May 1965-April 1968) of 307 mentally ill clients 2 years after case closure found that, in general, the services were useful, especially for those who had received pre-release treatment and whose cases had been closed rehabilitated; 70% of these ...
|Based on data from a three-year longitudinal study, we assess the effect, according to gender, of emotional psychopathology in preadolescence on anthropometric and body composition parameters in adolescence (N = 229). Psychopathology was assessed using the "Screen for Childhood Anxiety and Related Emotional Disorders, the Children's Depression…
Aparicio, Estefania; Canals, Josefa; Voltas, Nuria; Hernandez-Martinez, Carmen; Arija, Victoria
Recent evidence on amusia suggests that our ability to perceive music might be based on the same neural resources that underlie other higher cognitive functions, such as speech perception and spatial processing. We studied the neural correlates of acquired amusia by performing extensive neuropsychological assessments on 53 stroke patients with a…
Sarkamo, Teppo; Tervaniemi, Mari; Soinila, Seppo; Autti, Taina; Silvennoinen, Heli M.; Laine, Matti; Hietanen, Marja
|This report provides information from graduates of selected occupational programs regarding the effectiveness of their Illinois community college experience. The study surveyed a pool of 2,190 occupational program graduates, which yielded a usable response rate of 58.6%. The majority of graduate respondents (64.5%) came from programs in four…
Since the original stop-arm violation study completed in February 1996, the Florida Department of Education (DOE) and Florida's 67 school districts have been involved in various efforts to educate the motoring public about Florida's school bus stop law (F...
This study investigates the question how the quality of students' learning motivation changes within a period of 3 years. Of special interest is which conditions of the learning environment are responsible for the stability or respectively the change of learning motivation. Deci and Ryan's (2002) self-determination theory (SDT) provides the theoretical foundation of this paper. It allows a differentiated analysis
Workers at an electronics recycling plant have previously been shown to have elevated serum levels of polybrominated diphenyl ethers (PBDEs) compared to referents without occupational PBDE exposure. Subsequent structural changes and industrial hygiene measures at the plant were applied to improve the work environment. The present study aims to assess the impact of these work environment changes on the occupational
Kaj Thuresson; Åke Bergman; Klaus Rothenbacher; Thomas Herrmann; Sverker Sjölin; Lars Hagmar; Olaf Päpke; Kristina Jakobsson
PHASE ONE OF THIS STUDY IS A FOLLOWUP, BEGINNING MARCH 1968, OF GRADUATES OF OCCUPATIONAL CURRICULUMS. OF THE 429 GRADUATES QUESTIONED, 211 (49.18 PERCENT) REPLIED. INFORMATION WAS SOUGHT ON THE JOBS THEY TOOK, THE SALARY RANGES, THE KIND OF FIRMS HIRING THEM, HOW MANY WENT ON TO 4-YEAR SCHOOLS, WHICH SCHOOLS THEY WENT TO, AND WHETHER ON A FULL-…
Blackfoot disease is an endemic peripheral vascular disease found among the inhabitants of a limited area on the southwest coast of Tai wan, where artesian well water with a high concentration of arsenic has been used for more than eighty years. The natural history of blackfoot dis ease, based on a prospective study of 1,300 patients, is presented. The overall
This investigation was conducted to test the hypothesis that exposure of pregnant women to chemicals increases the risk of spontaneous abortion. The chemical risk factors under study to which dental assistants, factory workers, painters, and gardening workers were exposed were nitrous oxide, inorganic mercury, organic solvents, and pesticides. The study was carried out within the Danish county of Funen. It included all dental assistants employed in private or public dentistry. A comparable reference group was made up by employees less exposed to chemicals. Further study groups included all women painters within the county, women factory workers from selected factories, and about 50% of the women gardening workers within the county. Shop assistants and packers formed their control group. Information was obtained through a postal questionnaire study in May 1980 and from hospital records. Only among factory workers and painters was the odds ratio of spontaneous abortion found to be significantly increased. Neither among these women nor among dental assistants and gardening workers, however, was the reported exposure to any single chemical during pregnancy associated with a significantly increased odds ratio of spontaneous abortion. PMID:6747515
The intake of fluorides with water, food, dental fluoride preparations, or in particular fluoride supplements, such as NaF tablets, may lead to dental fluorosis. In the present study conducted in a nonfluoridated area in Germany, developmental enamel defects were examined using the Modified Developmental Defects of Enamel Index (Mod DDE Index), which subdivides enamel defects into the categories demarcated (Mod
Study subjects were participants in the Breast Cancer Detection Demonstration Project (BCDDP), a breast cancer screening program conducted between 1973 and 1980. Sponsored by the American Cancer Society and the NCI, the BCDDP provided up to five annual breast examinations to 283,222 women at 29 screening centers in 27 cities throughout the United States.
In 1991, a study was conducted at Johnson County Community College (JCCC), in Kansas, of "leavers," those students who were once enrolled at JCCC, but did not graduate, transfer to another institution, or complete a career program. Questionnaires were mailed to 1,860 students identified as leavers who had been enrolled at JCCC during fall 1990,…
Background\\/Aims: Spirituality and religiousness have been shown to be highly prevalent in patients with psychosis. Yet the influence of religious denomination as it affects coping methods and\\/or as an explanatory model for illness and treatment remains to be determined. This study aims (1) to investigate if religious denomination is associated with explanatory models, (2) to assess the evolution over time
P. Huguelet; S. Mohr; C. Gilliéron; P.-Y. Brandt; L. Borras
|Earlier research has associated early puberty with emotional and behavioral symptoms particularly among girls, while among boys, findings have been contradictory as to whether risks are associated with early or late pubertal timing. We studied the association between pubertal timing and substance use behaviors in middle adolescence in a 2-year…
Kaltiala-Heino, Riittakerttu; Koivisto, Anna-Maija; Marttunen, Mauri; Frojd, Sari
Deep brain stimulation (DBS) is associated with significant improvement of motor complications in patients with severe Parkinson's disease after some 6-12 months of treatment. Long-term results in a large number of patients have been reported only from a single study centre. We report 69 Parkinson's disease patients treated with bilateral DBS of the subthalamic nucleus (STN, n= 49) or globus
M. C. Rodriguez-Oroz; J. A. Obeso; A. E. Lang; J.-L. Houeto; P. Pollak; S. Rehncrona; J. Kulisevsky; A. Albanese; J. Volkmann; M. I. Hariz; N. P. Quinn; J. D. Speelman; J. Guridi; I. Zamarbide; A. Gironell; J. Molet; B. Pascual-Sedano; B. Pidoux; A. M. Bonnet; Y. Agid; J. Xie; A.-L. Benabid; A. M. Lozano; J. Saint-Cyr; L. Romito; M. F. Contarino; M. Scerrati; V. Fraix; N. Van Blercom
BACKGROUND: The developmental outcomes of children born after ICSI are still a matter of concern. The purpose of the present study was to investigate psychological outcomes for 5-year-old children born after ICSI and compare these with outcomes for children born after spontaneous conception (SC). METHODS: Three hundred singleton children born after ICSI in Belgium, Sweden and the USA were matched
I. Ponjaert-Kristoffersen; T. Tjus; J. Nekkebroeck; J. Squires; D. Verte; M. Heimann
A study was made of 363 patients 11 to 18 years after initial biopsies and gastric secretory findings. Investigation of the cause of death revealed the development of gastric carcinoma in 13% of the cases which had prior findings of atrophic gastritis. Statistical analysis of the cases led to additional evidence that atrophic gastritis may constitute a predisposition for the
We performed a clinical and magnetic resonance (MR) longitudinal study in 19 patients with benign multiple sclerosis (MS) to achieve a better definition of the nature of disability in MS. Patients with higher lesion volumes on conventional T2-weighted images at entry were those with more frequent relapses (p = 0.0004) and more new MR lesions (p = 0.003) during the
Massimo Filippi; Adriana Campi; Vittorio Martinelli; Bruno Colombo; Giuseppe Scotti; Giancarlo Comi
|The success of rehabilitative nursing homes has been measured by their ability to return patients to their homes. The rates of reinstitutionalization after discharge are less studied but are basic to the role of alternative levels of care. This research examines the relationship of predischarge factors with long term outcomes of patients…
|Describes a study that investigated whether cooperative editing had lasting benefits for remedial freshman composition students. Reports that students who had been taught the application of standard written grammar made significantly higher mean grades in freshman composition than students who had been taught using only textbooks, discussion, and…
BACKGROUND Few data on atrial fibrillation (AF) progression from the first paroxysmal episode are available. OBJECTIVE The purpose of this study was to assess the progres- sion of AF not due to potentially reversible causes in patients treated according to current guidelines recommendations that also include catheter ablation. METHODS Among 402 screened patients with first AF, 106 pa- tients (mean
Carlo Pappone; Andrea Radinovic; Francesco Manguso; Gabriele Vicedomini; Giuseppe Ciconte; Stefania Sacchi; Patrizio Mazzone; Gabriele Paglino; Simone Gulletta; Simone Sala; Vincenzo Santinelli
Erythema nodosum leprosum (ENL) or type 2 lepra reactions complicate lepromatous leprosy and borderline lepromatous leprosy. We report an 11-year retrospective case record analysis of 481 outpatients with borderline lepromatous and lepromatous leprosy at the Dhoolpet Leprosy Research Center in Hyderabad, India.. The overall prevalence of ENL was 24%, 49.4% among cases of lepromatous leprosy (LL) and 9% among cases of borderline lepromatous (BL) leprosy. Logistic regression analysis identified LL (odds ratio [OR] = 8.4, 95% confidence interval [CI] = 4.6-15.4, P < 0.001) and BL with a bacterial index > or = 4+ (OR = 5.2, 95% CI = 2.1-12.9, P = 0.001) as major risk factors. The average patient with ENL was male, 34.7 years of age, and had multiple episodes of ENL (mean = 3.1) over an 18.5-month period. Three types of ENL were identified: single acute ENL, multiple acute ENL (repeated discrete episodes), and chronic ENL (continuous episodes). Acute single ENL is rare, accounting for only 8% of cases. Chronic ENL accounted for 62.5% of the cohort. Chronic ENL was of longer duration and more severe. An age > or = 35 years was a risk factor for developing chronic ENL. Patients with chronic ENL were more compliant with multi-drug therapy, especially during the first six doses of multi-drug therapy. Distinguishing these different types of ENL would be useful for patient management and developing improved treatment of these debilitating reactions. Improved strategies for treatment and management of these reactions need to be developed. PMID:16687695
The aim of this study was to test the hypothesis that atopic conditions at 15\\/16 years of age affect both internalized and\\u000a externalized mental health problems 3 years later. Combined school and postal survey was conducted in urban and rural settings.\\u000a A total of 3,674 adolescents (70.1% response rate) were followed at two time points and interviewed with similar questionnaires\\u000a at baseline
Lars Lien; Kristian Green; Magne Thoresen; Espen Bjertness
Background The incidence of incisional hernia after midline laparotomies ranges from 10 to 20%. The recurrence rate after this hernia\\u000a surgery varies from 25 to 52% using autogenous tissue. The use of prosthetic meshes can decrease the postoperative hernia\\u000a recurrence by up to 10%. The aim of this prospective randomized clinical study was to analyze and compare the results of three
OBJECTIVE--To assess the five year prognostic significance of transient myocardial ischaemia on ambulatory monitoring after a first acute myocardial infarction, and to compare the diagnostic and long term prognostic value of ambulatory ST segment monitoring, maximal exercise testing, and echocardiography in patients with documented ischaemic heart disease. DESIGN--Prospective study. SETTING--Cardiology department of a teaching hospital. PATIENTS--123 consecutive men aged under
H. Mickley; J. R. Nielsen; J. Berning; A. Junker; M. Møller
. Local recurrence after curative surgery of rectal cancer indicates failure of the initial treatment. In recent years reported\\u000a local recurrence rates have steadily decreased. In this study 364 patients treated for rectal cancer were analyzed retrospectively\\u000a to determine if it is still justified to treat this disease in small nonspecialized hospitals. An overall local recurrence\\u000a rate of 9.7% was
BACKGROUND: Alteration in menstrual cycle function is suggested among rhesus monkeys and humans exposed to polybrominated biphenyls (PBBs) and structurally similar polychlorinated biphenyls (PCBs). The feedback system for menstrual cycle function potentially allows multiple pathways for disruption directly through the hypothalamic-pituitary-ovarian axis and indirectly through alternative neuroendocrine axes. METHODS: The Michigan Female Health Study was conducted during 1997–1998 among women
Stephanie I Davis; Heidi Michels Blanck; Vicki S Hertzberg; Paige E Tolbert; Carol Rubin; Lorraine L Cameron; Alden K Henderson; Michele Marcus
We examined the impact of school performance measured in terms of grade point averages (GPAs) in early and middle adolescence\\u000a (ages 9, 12, and 15), and the impact of school performance throughout the different school stages on adult obesity. The participants\\u000a were 732 healthy women and men derived from a population-based Cardiovascular Risk in Young Finns Study. GPAs were measured
Saija AlatupaLaura; Laura Pulkki-Råback; Mirka Hintsanen; Niklas Ravaja; Olli T. Raitakari; Risto Telama; Jorma S. A. Viikari; Liisa Keltikangas-Järvinen
PURPOSE: This study tested whether: (1) the survival rate of cast post-and-core restorations is better than the survival of direct post-and-core restorations and post-free all-composite cores; and (2)the survival of these buildup restorations is influenced by the remaining dentin height after preparation. MATERIALS AND METHODS: In a clinical trial, 18 operators made 319 core restorations in 249 patients. The restorations
N. H. J. Creugers; A. G. B. Mentink; W. A. Fokkinga; C. M. Kreulen
Macronutrient intake, height, weight, and body composition of 60 adolescent sprint athletes were estimated every 6 months over 3 years. Seven-day food records were analysed based on the Belgian and Dutch food databanks. The age of participants at the start of the 3-year study was 14.8 ± 1.6 years for female athletes and 14.7 ± 1.9 years for male athletes. Girls and boys gained
Dirk Aerenhouts; Peter Deriemaeker; Marcel Hebbelinck; Peter Clarys
A total of 21 immediate resin-bonded bridges were inserted under controlled and standardized clinical conditions and evaluated over a period of 35 months. During the evaluation period, two bridges debonded (9.5%). The debonded bridges were re-cemented successfully. This low incidence of debonding indicates that this simple alternative procedure for the immediate replacement of a single unsaveable tooth was satisfactory. The subjects included in this study expressed their satisfaction with this form of treatment. PMID:15125604
Background Displacement of jejunal feeding tubes is a major problem in enteral feeding. Although endoscopic clips have been used to\\u000a prevent migration of the tube during placement, the long-term effect of the clips on tube displacement is unknown. Objectives The purpose of this study was to examine the long-term effect of endoscopic clips on preventing displacement of the jejunal\\u000a feeding
Maureen Onyinyechukwu Udorah; Michael Wayne Fleischman; Vanitha Bala; Qiang Cai
A retrospective study was performed to determine factors associated with the outcome of pulmonary multidrug-resistant tuberculosis (MDR-TB) in Taipei, Taiwan. All patients newly diagnosed with pulmonary MDR-TB in a referral centre from 1992-1996 were enrolled and their outcome over the subsequent 6 yrs was determined. A total of 299 patients were identified, comprising 215 (71.9%) males and 84 (28.1%) females
C. Y. Chiang; D. A. Enarson; M. C. Yu; K. J. Bai; R. M. Huang; C. J. Hsu; J. Suo; T. P. Lin
A previous study by the author of 35 titles in Elsevier's Earth and Planetary Sciences digital back file package revealed that 73.6% of the 6,038 issues published before digital format was available had at least one figure with unacceptable quality. During 2006–2009 Elsevier conducted a rescanning project to improve the quality of the images in their backfile packages for issues
The association between serum ferritin level and coronary heart disease (CHD) and stroke events was evaluated in a long-term Western Australia prospective study in 1981-1998. The cohort consisted of the 1,612 men and women aged 40-89 years who participated in the 1981 Busselton Health Survey and who were free of cardiovascular disease at that time. Serum ferritin levels were obtained
M. W. Knuiman; M. L. Divitini; J. K. Olynyk; D. J. Cullen; H. C. Bartholomew
The aim of the study was to further determine the pathophysiology, clinical course, MRI-features and response to therapy of\\u000a chronic lymphocytic inflammation with pontine perivascular enhancement responsive to steroids (CLIPPERS), which has recently\\u000a been proposed as a rare chronic inflammatory central nervous system disorder responsive to immunosuppressive therapy. Three\\u000a patients with this rare entity underwent serial clinical and bimonthly MRI
The aim of the present study was to investigate children’s achievement goal orientations and their relations to math achievement in the primary grades. The sample consisted of 179 children who were in the 2nd and 3rd grades during the first measurement and in the 3rd and 4th grades during the second measurement. Children’s self?ratings were obtained on their goal orientations,
This prospective study reports the results of stereotactic limbic leucotomy at a mean of 17 months following surgery. Clinical improvement had occurred in twenty-four (80%) of the patients, fifteen (50%) of them being symptom free or much improved. Fourteen of sixteen patients suffering from obsessional neurosis were improved, as were five of seven with chronic anxiety and the degree of improvement at 17 months was superior to that at 6 weeks. Psychometric scores of anxiety, obsessions and neuroticism were all significantly reduced at 17 months. The mean depression scores were also significantly reduced and this result was superior to that reported in a previous study of ‘free-hand’ operations. Adverse effects were not a problem following limbic leucotomy. Emotional blunting, disinhibition, post-operative epilepsy and excessive weight gain were not encountered, and intelligence was unaffected by the operation. Limbic leucotomy is a much more limited and precise procedure than older ‘free-hand’ operations which we have studied, but its therapeutic effects are comparable and in obsessional neurosis, superior.
The "Health Management Plan"(HMP) for caring diabetic patient was begun by the National Health Insurance (NHI) in Taiwan in order to maximize the effectiveness of limited medical resources. This study describes the clinical experience of the nurse-directed diabetic HMP program and analyzes factors associated with the outcome. One hundred and thirty-six patients, all of whom had participated in the diabetic HMP program at least 5 times, were enrolled in the study. The effect of the HMP was evaluated by comparing hemoglobin A1C status before and after %) maintained their hemoglobin A1C status over the course of HMP participation. Diabetic patients with regular exercise habits showed a 2.8-fold increased chance of outcome improvement compared with those who did not exercise regularly. The chance of outcome improvement in patients with complications was found to be one-third that of patients who had no complications (Odds ratio: 0.3, 95% CI: 0.1-1.0). This study found that specially trained nurses, following agreed upon protocols and algorithms and collaborating with medical team members, can effectively concentrate on providing comprehensive and effective diabetes care. PMID:16372236
Aims The ECOST trial examined prospectively the long-term safety and effectiveness of home monitoring (HM) of implantable cardioverter defibrillators (ICD). Methods and results The trial's primary objective was to randomly compare the proportions of patients experiencing ?1 major adverse event (MAE), including deaths from all causes, and cardiovascular, procedure-related, and device-related MAE associated with HM (active group) vs. ambulatory follow-ups (control group) in a sample of 433 patients. The 221 patients assigned to the active group were seen once a year, unless HM reported an ICD dysfunction or a clinical event requiring an ambulatory visit, while the 212 patients in the control group underwent ambulatory visits every 6 months. The characteristics of the study groups were similar. Over a follow-up of 24.2 months, 38.5% of patients in the active and 41.5% in the control group experienced ?1 MAE (P < 0.05 for non-inferiority). The overall number of shocks delivered was significantly lower in the active (n = 193) than in the control (n = 657) group (P < 0.05) and the proportion of patients who received inappropriate shocks was 52% lower in the active (n = 11) than in the control (n = 22) group (P < 0.05). At the end of the follow-up, the battery longevity was longer in the active group because of a lower number of capacitor charges (499 vs. 2081). Conclusion Our observations indicate that long-term HM of ICD is at least as safe as standard ambulatory follow-ups with respect to a broad spectrum of MAE. It also lowered significantly the number of appropriate and inappropriate shocks delivered, and spared the device battery. Clinical trials registration NCT00989417.
The cause of progressive supranuclear palsy (PSP) is not known and has been little studied. The one previous controlled epidemiologic survey, performed at our center in 1986, found small-town experience and greater educational attainment as PSP risks, but, in retrospect, these results may have been produced by ascertainment bias. Since that time, several anecdotal reports have implicated heredity and various environmental exposures in the cause of some cases of PSP. To clarify the results of the previous study and to evaluate the more recently implicated candidate factors in a controlled fashion, we mailed a validated 69-item questionnaire to 91 personally examined patients with PSP and 104 unmatched controls with other neurologic conditions for which they had been referred to our tertiary neurologic center. We were able to match 75 subjects from each group by year of birth, sex, and race and subjected them to a separate matched-pair analysis. We allowed surrogates to supply any or all of the responses. Questions concerned hydrocarbon, pesticide, and herbicide exposure; urban/rural living; auto repair and other occupations; head trauma; educational attainment; maternal age; and family history of PSP, parkinsonism, dementia, and other neurologic conditions. A statistically significant finding was that patients with PSP were less likely to have completed at least 12 years of school (matched odds ratio = 0.35, 95% CI = 0.12-0.95, p = 0.022; unmatched odds ratio = 0.44, 95% CI = 0.21-0.89, p = 0.020). We hypothesize that this result may be a proxy for poor early-life nutrition or for occupational or residential exposure to an as-yet unsuspected toxin. Future studies should examine these potential risk factors in PSP. PMID:8710069
Golbe, L I; Rubin, R S; Cody, R P; Belsh, J M; Duvoisin, R C; Grosmann, C; Lepore, F E; Mark, M H; Sachdeo, R C; Sage, J I; Zimmerman, T R
The in vivo performance of 250 retrieved internal fixation plates was evaluated. The corrosion characteristics and metallurgical properties of each implant were assessed and correlated with respective clinical performance. Screw-plate interface corrosion and screw surface corrosion were graded; Rockwell hardness, grain size, thin inclusion content, and heavy inclusion content measurements were made. The devices studied included 169 bone plates, 59 Richards type hip screw-plates and 22 Jewett type hip nail-plates. The devices remained in situ for an average of 26.3 months, with in situ periods ranging from 1 to 192 months. The majority of the plates (50.4%) were removed due to cause-related reasons, while the remaining devices (49.6%) were removed on a routine asymptomatic basis. The primary symptomatic removal reasons consisted of implant related pain, nonunion or malunion, infection, loosening and implant breakage. Upon stereomicroscopic examination, 89% of all plates exhibited some degree of interface crevice corrosion, and 88% of all screws exhibited some degree of surface corrosion. Statistical analysis of corrosion gradings and metallurgical data revealed significant correlations between the two. As was suggested in our previous study of a limited number of implants, this study demonstrates that stricter manufacturing standards for metallurgical properties would serve to enhance corrosion resistance and improve the in vivo performance of stainless steel internal fixation devices. It is also suggested that the routine removal of all internal fixation plates after fracture healing has been achieved would reduce the occurrence of symptomatic complications, such as implant breakage, implant loosening and implant related pain. PMID:3607150
Cook, S D; Thomas, K A; Harding, A F; Collins, C L; Haddad, R J; Milicic, M; Fischer, W L
Thirty-five subjects with occupational asthma due to toluene diisocyanate (TDI) exposure were examined. All the subjects were studied with inhalation challenges with TDI and with methacholine. TDI asthma was documented by a positive inhalation challenge to low levels of TDI. Airway responsiveness to methacholine was in the range of asthmatic patients at the time of diagnosis. After an average follow-up interval of 10 months, all the subjects were re-examined. Of the 35 subjects examined, 30 subjects (85.7%) left the workplace, and 5 remained in the same job. Twenty-seven subjects (77.1%) continued to have asthmatic attacks requiring medication for relief of symptoms. At follow-up examination, TDI asthma was documented by a positive inhalation challenge to TDI in 27 subjects. Of these 27 TDI reactors, 22 subjects were removed from occupational exposure to TDI. The TDI reactors had persistent respiratory symptoms and airway hyperresponsiveness to methacholine. At follow-up visit, 8 subjects (22.9%) lost sensitization to TDI; 5 subjects (62.5%) in this group had also normal airway responsiveness to methacholine after removal from exposure. Only 1 subject among the TDI nonreactors complained of mild respiratory symptoms. At diagnosis, there were no significant differences between subjects who recovered and those who did not with regard to age, smoking habits, atopy, duration of exposure to isocyanates, duration of symptoms, baseline FEV1 (% pred), and baseline airway responsiveness to methacholine.
Mapp, C.E.; Corona, P.C.; De Marzo, N.; Fabbri, L.
We prospectively studied parental mental health after suddenly losing a son in a military training accident. Parents (N = 32) were interviewed at 1, 2 and 23 years after the death of their son. The General Health Questionnaire and Expanded Texas Inventory of Grief were self-reported at 1, 2, 5, and 23 years; the Inventory of Complicated Grief was self-reported at 23 years. We observed a high prevalence of psychiatric disorders at 1- and 2-year follow-ups (57% and 45%, respectively), particularly major depression (43% and 31%, respectively). Only one mental disorder was diagnosed at the 23-year follow-up. Grief and psychological distress were highest at 1- and 2-year follow-ups. Spouses exhibited a high concordance of psychological distress. Mothers reported more intense grief reactions than did fathers. The loss of a son during military service may have a substantial impact on parental mental health particularly during the first 2 years after death. Spouses' grief can be interrelated and may contribute to their psychological distress. PMID:22210364
A follow-upstudy was performed in 33 patients with proven (ictal EEG-CCTV) psychogenic, non-epileptic seizures (PNES). These patients received a questionnaire to evaluate seizures, treatment and rehabilitation. The response group consisted of 21 females (80% response) and seven males (100% response). Follow-up after diagnosis varied from 23-67 months. Seven patients (25%) reported that seizures had ceased and of the patients not seizure-free seven did report a seizure-free period after diagnosis of an average 6.7 months. Eight patients were on antiepileptic drugs again. Of 13 patients referred for psychotherapy, who also did receive treatment, six became free of seizures and seven did not. Of seven patients also referred, but who did not receive psychotherapy, all continued to have seizures. On a self-rating scale to compare "overall function" at the time of diagnosis and follow-up, 75% considered themselves to have "improved", but no improvement could be detected in psychosocial functioning. PMID:10356370
Jongsma, M J; Mommers, J M; Renier, W O; Meinardi, H
This study documents changes in clinical and magnetic resonance imaging (MRI) characteristics in a large cohort of patients with primary and transitional progressive multiple sclerosis (PP and TPMS) over 2 years. Patients with PPMS and TPMS were recruited from six European centres and underwent clinical and MRI examination at three time points: baseline, year one and year two. Of the 190 patients recruited clinical data were available on 125 patients (66%, five centres) and MRI data were available on 113 patients (59%, four centres) at 2 years. Significant increases were seen in T2 load and T1 hypointensity, while brain and cord volume decreased. In PPMS significantly higher lesion loads were found in those who presented with non-cord syndromes when compared to cord presentation and there was a trend to greater brain atrophy in those who deteriorated clinically over the course of the study compared to those who remained stable. Significant cord atrophy was only seen in those with a cord presentation. Measurable changes in MRI parameters can be detected in PPMS patients over a relatively short period of time. MRI quantification is likely to be useful in elucidating disease mechanisms in PPMS and in the execution of clinical trials. PMID:11990866
Ingle, G T; Stevenson, V L; Miller, D H; Leary, S M; Rovaris, M; Barkhof, F; Brochet, B; Dousset, V; Filippi, M; Montalban, X; Kalkers, N F; Polman, C H; Rovira, A; Thompson, A J
The high-frequency hearing loss (3-8 kHz) in 230 male and 238 female subjects (age 16) was compared concerning their habits of listening to portable cassette players (PCPs). In the group that listened to PCPs daily, we found fewer subjects with high-frequency hearing loss compared to the group that never listened to PCPs. In a temporary threshold shift (TTS) study, three groups of subjects with different listening habits to music were exposed to 1/3 octave band noise (2 kHz). These groups participated in a TTS study on another occasion, on which they listened to music from PCPs at a high but comfortable level for 1 hour. Together with the music exposure, the sound pressure level (SPL) was measured in the external auditory canal with a probe-provided mini-microphone (MMP). There was no significant difference in TTS between groups from the noise exposure. There were significant differences in listening levels and in the resulting TTS between groups. The noise exposure resulted in significantly higher TTS than the music exposure at comparable exposure levels.
Abstract Objective: The purpose of this article is to identify, from a long-term perspective, stroke survivors' self-identity, their views of any associated disabilities and how they manage their lives after stroke. Methods: The interviews and analyses were conducted using a phenomenological qualitative method. A total of 10 men and 5 women, aged 42-84, participated. All had suffered first-time stroke 5 years earlier. Results: After 5 years, participants had greater acceptance of their situation compared with immediately after participating in the rehabilitation programme. However, they described how they still had to deal with the consequences of stroke. They had suffered further illnesses and additions to side effects of the stroke. In dealing with their disabilities and changes to self-identity and life patterns, they seemed to be in a continuous process of change that never truly stabilised. They coped with this continuous process in at least two different ways, including resignation or personal growth. Conclusion: Stroke survivors suffered considerable ongoing and changing difficulties in relation to disability, self-perception and to coping with a new life. This continuous process of change could be seen to drain their energy. The study shows that many survivors live a more home-centred life with fewer social relations and less active participation in their community. This can entail the risk of depression and loneliness. The study also shows, however, that adopting an optimistic approach to life can lead to continued learning about abilities and limitations, to the development of new skills and to the fashioning of a new self-identity. Implications for Rehabilitation This study suggests that stroke survivors should be offered individualised rehabilitation programmes that address not only physical activities but also psychological circumstances and existential issues. It is recommended that the interventions offered to the stroke survivor are unfolded through a pedagogical approach, so the individuals do not feel alienated or need to struggle in isolation. The programme should promote the individual's motivation, the sense of being able to cope and an optimistic view of life. There is a need for further research focusing on identifying the factors that facilitate the individual's positive approach to life and optimism. There is also the need to examine a variety of approaches to rehabilitation that emphasise empowerment and self-efficacy for stroke individuals in a variety of phases of rehabilitation and with various degrees of disability. PMID:23631656
All visits to physicians in the Orivesi Region Federation of Municipalities for Public Health Work in Finland paid due to symptomatic osteoarthrosis of the knee joint were prospectively recorded over a period of one year. Two hundred and thirty four visits were made, accounting for 0.63% of all visits. The prevalence of knee osteoarthrosis was 1.11% (men 0.45%, women 1.72%), and the incidence was 0.60%. The disease occurred almost twice as often in the right knee than in the left. The study provides basic information about patients needing medical help because of symptomatic knee osteoarthrosis. The results can be used as an aid to the planning of examination and treatment resources and in assessment of the need for such services.
Kannus, P; Jarvinen, M; Kontiala, H; Bergius, L; Hyssy, E; Salminen, E; Tuomi, A; Unkila, T; Valtanen, I
This paper updates single risk factors identified by the Northern Finland 1966 Birth Cohort Study up to the end of year 2001 or age 34. Impaired performance (e.g., delayed motor or intellectual development) or adverse exposures (e.g., pregnancy and birth complications, central nervous system diseases) are associated with an increased risk for schizophrenia. However, upper social class girls and clever schoolboys also have an increased risk to develop schizophrenia, contrasted to their peers. Individuals who subsequently develop schizophrenia follow a developmental trajectory that partly and subtly differs from that of the general population; this trajectory lacks flexibility and responsiveness compared to control subjects, at least in the early stages. We propose a descriptive, lifespan, multilevel systems model on the development and course of schizophrenia.
The aim of the present study was to clinically and radiographically evaluate Mineral Trioxide Aggregate (MTA) as an agent for pulpotomy in primary teeth and to compare it with that of formocresol (FC) pulpotomy. Nineteen children between the ages of 6 to 8 years with 40 carious primary molars were treated with pulpotomy using either FC or MTA. All the molars were evaluated clinically and radiographically at regular intervals over a twenty four month period. The observations were tabulated and statistically analyzed. Eighty five percent success was observed with FC pulpotomy whereas MTA showed 95% success. MTA showed a higher clinical and radiographic success rate than FC. MTA may be a favorable material for pulpotomy in primary teeth whose pulps have been compromised by a carious or mechanical pulp exposure. PMID:19725237
Subramaniam, Priya; Konde, Sapna; Mathew, Somy; Sugnani, Sony
The aim of this study was to evaluate work ability among college educators before and after an intervention at the workplace. An administrative restructuring in the workplace started to be implemented in 2005. The work ability index (WAI) was administered to 154 educators before the restructure in 2004 and to 60 educators following the restructure in 2006. A t-test comparing the WAI score of the 60 educators who took part in both phases showed a trend of improving work ability (p=0.06; mean WAI in 2004 was 41.7 and 43.3 in 2006). The results suggest that the intervention led to an improvement in psychosocial factors, which in turn positively influenced work ability. PMID:18377866
Marqueze, Elaine C; Voltz, Gustavo P; Borges, Flávio N S; Moreno, Claudia R C
Purpose Evaluating homeopathic treatment for dysmenorrhea.\\u000a \\u000a \\u000a \\u000a Methods Prospective multicenter observational study in primary care, using standardized questionnaires to record for 2 years diseases,\\u000a quality of life, medical history, consultations, all treatments, other health services use.\\u000a \\u000a \\u000a \\u000a Results Fifty-seven physicians treated 128 women (age 32.4 ± 7.5 years, mean ± SD) and 11 girls (13.7 ± 4.0). Women had dysmenorrhea\\u000a for 11.6 ± 9.0 (girls 3.1 ± 1.5) years. Patients received 7.5 ± 6.5 (5.9 ± 3.7) homeopathic prescriptions. Diagnoses and
Health selection, as one of the several possible explanations for social inequities in health, has been receiving more attention recently but few researchers turn the issue into a question of discrimination. The aim of the study was to analyse the impact of health in young age for social position in adult age and to discuss health selection in terms of discrimination from a gender-theoretical perspective. A prospective cohort study was conducted, in which all pupils (N = 1083) in the last year of compulsory school in a middle-sized municipality in northern Sweden were followed for 14 years. The response rate was high, with 96.6% still participating after 14 years. The data were collected through repeated comprehensive self-administered questionnaires as well as through teacher interviews and register data. Health selection was analysed in a multiple logistic regression model, with working-class position at age 30 as a dependent variable and different measures of health/health behaviour at age 16 and 21 as independent variables. Overall, the impact of early health/health behaviour on future socioeconomic position was small or non-existent. However, even after correction for possible mediating and moderating mechanisms, being overweight at age 16 and at age 21 was related to future working-class position among women only. Possible mediating mechanisms were feeling looked down upon, not being active in associations and not reading cultural/political events in daily newspapers. Early menarche together with early motherhood and low education could not explain the correlations. Our results indicate that overweight girls and young women are exposed to gendered discrimination which probably occurs in many arenas, based on the societal norms for female bodies in our society. There is a need to redirect research on health selection into gender research in order to further explore the subject as well as the possible mechanisms of gendered discrimination. PMID:16099575
Cleft lip/palate comprises a large fraction of all human birth defects, and is notable for its significant lifelong morbidity and complex etiology. Several studies have shown that genetic factors appear to play a significant role in the etiology of cleft lip/palate. Human chromosomal region 9q21 has been suggested in previous reports to contain putative cleft loci. Moreover, a specific region (9q22.3-34.1) was suggested to present a ?45% probability of harboring a cleft susceptibility gene. Fine mapping of fifty SNPs across the 9q22.3-34.11 region was performed to test for association with cleft lip/palate in families from United States, Spain, Turkey, Guatemala, and China. We performed family-based analysis and found evidence of association of cleft lip/palate with STOM (rs306796) in Guatemalan families (P=0.004) and in all multiplex families pooled together (P=0.002). This same SNP also showed borderline association in the US families (P=0.04). Under a nominal value of 0.05, other SNPs also showed association with cleft lip/palate and cleft subgroups. SNPs in STOM and PTCH genes and nearby FOXE1 were further associated with cleft phenotypes in Guatemalan and Chinese families. Gene prioritization analysis revealed PTCH and STOM ranking among the top fourteen candidates for cleft lip/palate among 339 genes present in the region. Our results support the hypothesis that the 9q22.32-34.1 region harbors cleft susceptibility genes. Additional studies with other populations should focus on these loci to further investigate the participation of these genes in human clefting.
Letra, Ariadne; Menezes, Renato; Govil, Manika; Fonseca, Renata F.; McHenry, Toby; Granjeiro, Jose M.; Castilla, Eduardo E.; Orioli, Ieda M.; Marazita, Mary L.; Vieira, Alexandre R.
Many frontline chemotherapeutic agents produce robust neuropathy as a dose-limiting side effect; however, the persistence of chemotherapy-related sensory disturbances and pain are not well-documented. We have previously investigated the qualities of bortezomib-induced pain, and now seek to determine the ongoing nature of this pain. Twenty-six control subjects and eleven patients who had previously been treated with bortezomib and who were experiencing ongoing pain consented to recurring quantitative sensory testing. A pilot immunohistochemistry study of skin innervation was also performed on patient obtained biopsies. Psychophysical testing in patients revealed persistent changes including decreased skin temperature in the area of pain, diminished touch and sharpness detection, increased pegboard completion times, and decreased sensitivity to skin heating. Additionally, the intensity of pain, as captured by the use of a visual analog scale and pain descriptors, was reported by patients to be unchanged during the retest despite similar morphine equivalent daily doses. The patient skin biopsies displayed a marked decrease in the density of epidermal nerve fibers and Meissner’s corpuscles. These results signify a persistent and severe impairment of A?, A?, and C fibers in patients with chronic bortezomib-induced chemoneuropathy. Further, this study reports a loss of both epidermal nerve fibers and Meissner’s corpuscles. Perspective The results of this article indicate a persistent, painful peripheral neuropathy in patients treated with bortezomib. Pilot data indicates a loss of nerve fibers innervating the area of pain. This is the first paper to address the persistence, and potential contributing factors, of bortezomib chemoneuropathy.
Boyette-Davis, Jessica A.; Cata, Juan P.; Zhang, Haijun; Driver, Larry C.; Wendelschafer-Crabb, Gwen; Kennedy, William R.; Dougherty, Patrick M.
Purpose To assess longitudinal changes in parapapillary atrophy in the adult population of Greater Beijing. Methods The population-based Beijing Eye Study 2006 included 3251 subjects who had participated in the Beijing Eye Study 2001 and returned for re-examination. The mean age was 60.4±10.1 years. Using optic disc photographs, we measured parapapillary atrophy which was divided into alpha zone and beta zone. Results Overall progression rate of alpha zone was seen in 0.6±0.1% (95% confidence interval (CI):0.3,0.9) of the subjects and of beta zone in 8.2±0.5% (95%CI:7.2,9.1) of the subjects. In binary regression analysis, rate of progression of alpha zone was significantly associated higher age (P?=?0.04) and the co-progression of zone Beta (P<0.001). Rate of progression of beta zone was significantly associated with higher age (P<0.001; odds ratio (OR):1.11;95%CI:1.10,1.14), higher intraocular pressure (P<0.001;OR:1.10;95%CI:1.05,1.14), higher myopic refractive error (P<0.001;OR:0.71; 95%CI:0.67,0.75), rural region of habitation (P?=?0.002;OR: 0.58; 95%CI:0.41,0.82), presence of glaucomatous optic nerve damage (P<0.001;OR:2.89; 95%CI:1.62,5.14), co-progression of alpha zone (P<0.001;OR:7.13;95%CI:2.43,20.9), absence of arterial hypertension (P?=?0.03;OR: 0.70; 95%CI:0.51,0.96), and thicker central corneal thickness (P?=?0.02;OR:1.01;95%CI:1.00,1.01). Subjects with a non-glaucomatous optic nerve damage (n?=?22) as compared to the remaining subjects did not vary in the progression rate of alpha zone (0.0% versus 0.6±0.1%; P?=?1.0) and beta zone (8.2±0.5% versus 6.3±0.6%;P?=?1.0). Conclusions In adult Chinese in Greater Beijing, the 5-year progression rate of beta zone of parapapillary atrophy (seen in 8.2±0.5% of subjects) was significantly correlated with higher age, rural region of habitation, absence of arterial hypertension, higher intraocular pressure, higher myopic refractive error, thicker central corneal thickness, and presence of glaucoma. It was not associated with non-glaucomatous optic nerve damage.
Guo, Yin; Wang, Ya Xing; Xu, Liang; Jonas, Jost B.
Planimetric analysis of argyrophilic (reticulin) fibers of the bone marrow was performed on 17 patients (7 males, 10 females, median age 52 years) with acute myeloid leukemia (AML). Trephine biopsies were investigated at presentation and during the course of chemotherapy. Density of reticulin was determined by examining the total marrow area as well as the hematopoietic tissue. In about half of the patients with FAB-subtypes M4, M5 an increased amount of fibers was recognizable on admission in comparison with age-matched controls. Two to five bone marrow biopsies (total 81) of each patient were obtained at intervals ranging mostly between three and seven weeks after cytotoxic treatment. The following results could be demonstrated: in several patients with a normal or elevated fiber count at onset, partial and complete remission was characterized by an increase in reticulin in the regenerative hematopoietic tissue. On the other hand, a relapse was most frequently heralded by a reduction of the formerly increased amount of fibers. Because of the inverse relationship between the density of argyrophilic fibers and the amount of fat cells, these findings were observable only by considering the hematopoietic tissue and not the total marrow area, as has been done in previous studies. For this reason a significant decrease in reticulin fibers in the areas of regenerative hematopoiesis may be suggestive of an impending relapse of AML. PMID:1883746
Since 1995, the Caruso Project used an Ecosystem Approach to Human Health to examine mercury (Hg) exposure in fish-eating communities in the Brazilian Amazon and develop interventions to maximise nutrition from traditional