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Prospective Follow-up Study (prospective + follow-up_study)
Selected AbstractsA 5-Year Prospective Follow-Up Study of Implant-Supported Fixed Prostheses in Patients Subjected to Maxillary Sinus Floor Augmentation with an 80:20 Mixture of Bovine Hydroxyapatite and Autogenous BoneCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 2 2004Mats Hallman DDS ABSTRACT Background: Prospective long-term follow-up studies evaluating the use of bone substitutes to enable dental implant placement and integration are rare. Purpose: This study was undertaken to evaluate the survival rate of dental implants placed 6 months after maxillary sinus floor augmentation using a mixture of 80% bovine hydroxyapatite (BH) and 20% autogenous bone (AB). Material and Methods: Twenty patients subjected to 30 maxillary sinus floor grafting procedures using fibrin glue and an 80:20 mixture of BH and AB to enable placement of dental implants 6 months later were followed for 5 years of functional loading. Clinical and radiographic examinations of the grafts and implants were performed. Results: After 5 years of functional loading with fixed bridges, 15 of 108 implants had been lost, giving a cumulative survival rate of 86%. The mean marginal bone loss after 5 years was 1.3 ± 1.1 mm. Conclusion: Grafting of the maxillary sinus with a mixture of BH and AB and later placements of turned implants could be performed with predictable long-term results. All but one of the patients who were observed had functional fixed bridges after 5 years of functional loading. [source] Prospective Follow-Up Study of 95 Patients with Edentulous Mandibles Treated According to the Branemark Novum ConceptCLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2003Per Engstrand DDS ABSTRACT Background: The long-term predictability reported with the traditional two-staged Brånemark method has led to developments aimed at simplifying the technique and reducing healing time. Results from a pilot study using the Brånemark Novum concept are promising, and it has been shown possible to fabricate and deliver an implant-supported fixed prosthesis to the patient on the day of surgery. Purpose: The objective of this study is to report clinical and radiographic outcomes in a group of patients treated according to the Brånemark Novum concept. Materials and Methods: Ninety-five patients with edentulous mandibles were consecutively included in the study. Three specially designed fixtures were placed in each patient (285 fixtures in total) using drilling templates. The fixtures were immediately splinted with a prefabricated substructure, and fixed prostheses were delivered the same day in 67% of the patients. For the rest, prosthesis delivery ranged from 1 to 40 days (mean 5.6 d). Clinical and radiographic examinations were performed after 3 months, 6 months, 1 year, and then annually. The follow-up time was 1 to 5 years (mean 2.5 yr). Results: The cumulative prosthesis survival rate was 99%. Eighteen fixtures (6.3%) failed in 13 patients. Kaplan-Meier survival estimates demonstrated a probability implant survival at 1 year of 95.0% (94 patients), at 3 years of 93.3% (47 patients), and at 5 years of 93.3% (9 patients). The mean bone loss was 0.73 mm between the examinations at 3 months and 1 year, 0.16 mm during the second year, and 0.13 mm annually during years 3 to 5. Conclusions: Comparable results, related to continuous prosthesis stability, were shown for the Novum approach compared with the traditional two-staged procedure. Survival of individual fixtures is lower when immediate loading is applied. [source] Short-term outcomes after brief ambulatory opioid detoxification with buprenorphine in young heroin usersADDICTION, Issue 4 2003Devang H. Gandhi Abstract Aims, This study examines the outcomes at 1, 3 and 6 months after a very brief outpatient detoxification with buprenorphine in 18,25-year-old heroin users. Design, Prospective follow-up study. Setting, Outpatient drug treatment clinic, providing brief detoxification in downtown Baltimore, Maryland, USA. Participants, One hundred and twenty-three subjects between 18 and 25 years old; 56% male; 95% Caucasian; seeking detoxification; living in Baltimore City and five surrounding counties. Intervention, Detoxification with buprenorphine over 3 days. Follow-up at 1, 3 and 6 months. Measurements, Drug use history, the Addiction Severity Index at baseline and follow-up, urine drug screens, evaluation of the detoxification experience. Findings, By self-report, 37% of the total sample were not currently using heroin at 1 month, 32% at 3 months and 29% at 6 months, and 6.7%, 10.1% and 11.8% had an opioid negative urine test at 1, 3 and 6 months, respectively. There was a significant reduction from the baseline in mean Addiction Severity Index drug use composite score, as well as the mean number of days of heroin and cocaine use during past 30 days, that was sustained over the three follow-up points. Engagement in aftercare was generally poor. Conclusions, The findings show a reduced frequency and intensity of drug use, suggesting a possible role for brief outpatient detoxification in reducing the severity of dependence for some younger heroin users who may not yet be ready to engage in long-term abstinence-oriented or opioid substitution treatments. [source] Serum Calcium and Cognitive Function in Old AgeJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 11 2007Miranda T. Schram PhD OBJECTIVES: To determine whether serum calcium is associated with cognitive function in elderly individuals in the general population. DESIGN: Prospective follow-up study of two independent, population-based cohorts. SETTING: The Rotterdam Study (median follow-up 11 years) and the Leiden 85-plus Study (median follow-up 5 years). PARTICIPANTS: Three thousand nine hundred ninety-four individuals, mean age 71, from the Rotterdam Study and 560 individuals, all aged 85, from the Leiden 85-plus Study. MEASUREMENTS: Global cognitive function was assessed in both cohorts using the Mini-Mental State Examination; attention, psychomotor speed, and memory function were assessed in the Leiden 85-plus Study only. Linear regression and linear mixed models were used for statistical analyses. RESULTS: In the Rotterdam Study, high serum calcium was associated with worse global cognitive function at baseline (P<.05) and a faster rate of decline in cognitive function during follow-up (P=.005) in individuals aged 75 and older but not in younger individuals. In the Leiden 85-plus Study, high serum calcium was associated with worse global cognitive function from age 85 through 90 (P<.001). This observation also held for the specific cognitive domains tested (all P<.01). These results did not change when individuals with serum calcium levels greater than normal (>2.55 mmol/L) were excluded from the analyses. CONCLUSION: In the general population, high serum calcium levels are associated with faster decline in cognitive function over the age of 75. [source] Prediction of recurrence after treatment for high-grade cervical intraepithelial neoplasia: the role of human papillomavirus testing and age at conisationBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 11 2006J Verguts Objectives, The aim of this study was to examine the accuracy of the presence of high-risk human papillomavirus (HR-HPV) DNA (HR-HPV DNA test) postconisation as prediction of recurrent or residual cervical intraepithelial neoplasia (CIN) after treatment of high-grade cervical intraepithelial lesions (CIN2+) in a prospective study and to compare this with follow-up cytology and the marginal status of the excised tissue. Design, Prospective follow-up study. Setting, Unselected women presenting at colposcopy clinic of University Hospital Gasthuisberg, Leuven. Population, Seventy-two women treated with conisation for CIN2 or CIN3. Methods, Women were followed by HR-HPV DNA test (Hybrid Capture II test of Digene®) every 3 to 6 months. The same vial was used for cytology and the HR-HPV DNA test (SurePathÔ). All women were further followed by colposcopy and cytology for 24 months at 6-month intervals. The outcome of the study was presence of >CIN2, proven with colposcopy-directed biopsy occurring within 24 months after treatment. HR-HPV status was correlated with recurrent or residual CIN2+. Main outcome measures, Sensitivity, specificity, predictive values and diagnostic odds ratios to predict treatment failure or cure were computed for HR-HPV testing, marginal status and follow-up cytology. HR-HPV status was also correlated with section margins postconisation and with the first cervical smear. Results, In 6 of the 72 treated women (8%), residual or recurrent CIN occurred. Women with recurrence were significantly older than women without a recurrence (51.5 ± 9.6 versus 39.8 ± 12.2 years, P= 0.007). All six women with recurrence were HR-HPV positive, four had a positive follow-up smear (,atypical squamous cells of uncertain significance = ASCUS+) and only two had involved section margins. Among the 66 cured women, 15 were HR-HPV positive, 6 had an abnormal smear and 12 had positive section margins. Sensitivity of cytology, positive section margins and HR-HPV DNA positivity was 66.7, 33.3 and 100% to predict treatment failure. Specificity of the three tests was, respectively, 90.9, 81.8 and 77.3%. Women with HR-HPV DNA at 3 to 6 months showed recurrent or residual CIN in 15% (2/13) if they had normal follow-up Pap smears and in 50% (4/8) if they had abnormal Pap smears. Margin status was not statistically significantly associated with human papillomavirus status. Conclusion, Persistence or clearance of HR-HPV DNA is an early valid prognostic marker of failure or cure after treatment for CIN2+ and is more accurate than cytology or section margin status at the time of conisation. The absence of HR-HPV DNA has a 100% negative predictive value. Higher age at conisation may be a previously unrecognised risk factor for recurrence. [source] Pregnancy-associated plasma protein A in a large cohort of Type 1 diabetic patients with and without diabetic nephropathy,a prospective follow-up studyDIABETIC MEDICINE, Issue 12 2007A. S. Astrup Abstract Aim Pregnancy-associated plasma protein A (PAPP-A) has been implicated in the aetiology of acute coronary syndromes and carotid and peripheral artherosclerosis. Diabetic nephropathy is characterized by increased cardiovascular risk. We investigated the prognostic value of PAPP-A in a large cohort of Type 1 diabetic patients. Methods In a prospective observational follow-up study, 197 Type 1 diabetic patients with diabetic nephropathy and a matched group of 178 patients with normoalbuminuria were followed for 10.1 (0,10.3) years. PAPP-A was determined at baseline. Results In patients with diabetic nephropathy, plasma PAPP-A was elevated 3.6 (0.4,51.1) mIU/l [median (range)] vs. 2.1 (0.4,46.6) mIU/l in normoalbuminuric patients, P < 0.0001. For acute coronary syndromes, a PAPP-A threshold of 10 mIU/l has been suggested. Thirty-seven patients were above the threshold and of these 13 patients (35%) died, compared with 60 of 338 patients (18%) below the threshold; log rank test P = 0.007. PAPP-A significantly predicted mortality after adjustment for presence of nephropathy; hazard ratio for dying when PAPP-A was above the threshold 2.1 (95% CI 1.13,3.9); P = 0.019. After adjusting for traditional risk factors, the results were attenuated. When only patients with nephropathy were analysed, PAPP-A was significantly predictive of all-cause mortality [P = 0.008; 2.43 (1.26,4.67)] in unadjusted analysis. After adjustment, the predictive value of PAPP-A for all-cause mortality was attenuated (P = 0.064). Conclusion We find PAPP-A to be associated with increased mortality in Type 1 diabetic patients with nephropathy in unadjusted analysis. After adjustment for traditional risk factors, the prognostic value of PAPP-A was no longer significant. [source] Do premorbid impairments predict emergent ,prodromal' symptoms in young relatives at risk for schizophrenia?EARLY INTERVENTION IN PSYCHIATRY, Issue 3 2009Matcheri S. Keshavan Abstract Aims: Individuals at risk for developing schizophrenia (SZ) in the future frequently exhibit subtle behavioural and neurobiological abnormalities in their childhood. A better understanding of the role of these abnormalities in predicting later onset of ,prodromal' symptoms or psychosis may help in early identification of SZ. Methods: In an ongoing prospective follow-up study of young genetically at-risk relatives of patients with SZ, we studied the prevalence of problems in premorbid social adjustment and childhood psychopathology and examined their relationship with the presence and progression of ,prodromal' symptoms of SZ. Results: Growth curve analyses showed that ,prodromal' symptoms, as measured by the Scale of ,Prodromal' Symptoms, increased during follow-up. Premorbid maladjustment and childhood behavioural disturbances were cross-sectionally correlated broadly with ,prodromal' symptomatology scores. Longitudinal analyses revealed that behavioural disturbances, but not childhood maladjustment at baseline, significantly predicted increases in ,prodromal' symptomatology during the 2-year study period. Conclusion: Premorbid behavioural disturbance and maladjustment may predict the later emergence of ,prodromal' symptoms. ,Prodromal' symptoms in young at-risk relatives may define a subgroup worthy of follow-up into the age of risk for psychosis in order to cost-effectively characterize the predictors of psychotic symptoms and SZ. [source] Bilateral ankle arthritis with mediastinal lymphadenopathy: a clinician's perspectiveINTERNATIONAL JOURNAL OF RHEUMATIC DISEASES, Issue 3 2006Lalit DUGGAL Abstract Aim:, This study is a clinician's perspective of the association of bilateral ankle arthritis with mediastinal lymphadenopathy. Method:, Forty-three patients with bilateral ankle arthritis with mediastinal lymphadenopathy were included in a 14-month prospective follow-up study in our hospital. Complete history, examination and investigations were carried out. Result:, There were 27 female and 16 male patients. Ankle arthritis with tuberculous mediastinal lymphadenopathy was associated in 58.13%, sarcoidosis in 32.5% and 9.3% were non-specific. The patients were clustered in the spring-summer months. Erythema nodosum was found in 14.3%, polyarticular presentation in 25%. Thirteen out of 43 patients (28.2%) had biopsy/fine needle aspiration (FNA), of which 69.23% had histopathological evidence of tuberculosis. Conclusion:, The aetiology of bilateral ankle arthritis associated with mediastinal lymphadenopathy may be tuberculosis as opposed to sarcoidosis. There is a seasonal clustering of these cases. FNA of mediastinal lymphadenopathy is a fairly safe procedure and should be carried out when feasible, for confirmation of diagnosis. [source] Bone turnover markers and prediction of fracture: A prospective follow-up study of 1040 elderly women for a mean of 9 yearsJOURNAL OF BONE AND MINERAL RESEARCH, Issue 2 2010Kaisa K Ivaska Abstract Osteoporosis is characterized by compromised bone mass and strength, predisposing to an increased risk of fracture. Increased bone metabolism has been suggested to be a risk factor for fracture. The aim of this study was to evaluate whether baseline bone turnover markers are associated with long-term incidence of fracture in a population-based sample of 1040 women who were 75 years old (Malmö OPRA study). Seven bone markers (S-TRACP5b, S-CTX-I, S-OC[1,49], S-TotalOC, S-cOC, S-boneALP, and urinary osteocalcin) were measured at baseline and 1-year follow-up visit. During the mean follow-up of 9.0 years (range 7.4,10.9), 363 women sustained at least one fracture of any type, including 116 hip fractures and 103 clinical vertebral fractures. High S-TRACP5b and S-CTX-I levels were associated with increased risk of any fracture with hazard ratios [HRs (95% confidence interval)] of 1.16 (1.04,1.29) and 1.13 (1.01,1.27) per SD increase, respectively. They also were associated with increased risk of clinical vertebral fracture with HRs of 1.22 (1.01,1.48) and 1.32 (1.05,1.67), respectively. Markers were not associated with risk for hip fracture. Results were similar when we used resorption markers, including urinary osteocalcin, measured at the 1-year visit or an average of the two measurements. The HRs were highest for any fracture in the beginning of the follow-up period, 2.5 years from baseline. For vertebral fractures, the association was more pronounced and lasted for a longer period of time, at least for 5 years. In conclusion, elevated levels of S-TRACP5b, S-CTX-I, and urinary osteocalcin are associated with increased fracture risk for up to a decade in elderly women. © 2010 American Society for Bone and Mineral Research [source] Fc, receptor polymorphisms and periodontal status: a prospective follow-up studyJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 10 2006D. L. Wolf Abstract Aims: The aims of this study were to assess: (i) the distribution of Fc, receptor polymorphisms among patients with chronic periodontitis ("cases") and control subjects with no/minimal loss of periodontal tissue support in a Caucasian population; (ii) whether these polymorphisms can serve as severity markers for periodontitis; and (iii) whether they have any bearing on the response to periodontal therapy. Methods: The study sample consisted of 132 cases and 73 controls of comparable age and gender. Full-mouth periodontal status was assessed. Subgingival plaque (PL) samples and blood samples were obtained and analysed with respect to 19 bacterial species and homologous serum immunoglobulin G titres. Polymorphisms in the Fc, receptor IIa (131R/H) and IIIb (NA1/NA2) were assessed by polymerase chain reaction. Patients underwent periodontal therapy and were followed up at 4 and 30 months. Results: Neither polymorphism showed a skewed distribution among cases and controls. At baseline, periodontitis patients with Fc, RIIa-H/H131 genotype had more PL and deeper pockets than patients in other genotype groups (p<0.05). Both bacterial levels and antibody titres were unrelated to genotype. The longitudinal analysis failed to detect an association between genotype and response to periodontal therapy. Conclusions: The present data failed to demonstrate a clinically relevant relationship between the Fc, receptor IIa (131R/H) or IIIb (NA1/NA2) polymorphism and periodontal status. [source] Changes in professional conceptions of suicide prevention among psychologists: using a conceptual modelJOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY, Issue 2 2002Maila Upanne Abstract This prospective follow-up study monitored the evolution of psychologists' conceptions of suicide prevention over the course of their participation in psychological autopsy studies that constituted the first phase of the National Suicide Prevention Project in Finland. Another purpose of the study was to consider the feasibility of an earlier suicide prevention model. Ideas on prevention were compared in two different situations and items were categorized using descriptive and conceptual criteria of prevention. They could be classified into a typology of four categories: care approach, cultural-educational approach, conditions approach, and critical approach. The follow-up suggested that the model is a feasible method for analysing conceptions of suicide prevention, and that it was possible to interpret conceptions in a theoretically adequate manner. In addition, ideas could be compared with certain known theoretical models of prevention. The model could thus be used in further research and for practical purposes. Experiences of psychological autopsy studies definitely had an impact on the psychologists' views; conceptions altered towards emphasizing the care approach and individual risk factors. Nonetheless, the overall structure of the prevention paradigm remained multifactorial, stressing multistage influencing. Surprisingly, the priority of acute suicide risk as a preventive target did not increase. Promotive aims remained the most important aim category. Copyright © 2002 John Wiley & Sons, Ltd. [source] Evolving patterns of tobacco use in northern SwedenJOURNAL OF INTERNAL MEDICINE, Issue 6 2003B. Rodu Abstract., Rodu B, Stegmayr B, Nasic S, Cole P, Asplund K (University of Alabama at Birmingham, Birmingham, AL, USA; Umeå Hospital, Umeå, Sweden). Evolving patterns of tobacco use in northern Sweden. J Intern Med 2003; 253: 660,665. Background and objectives., Cross-sectional data from northern Sweden suggest that the increased use of Swedish moist snuff (snus) may have contributed to a decline in the prevalence of smoking, especially amongst men. This study describes the evolving patterns of tobacco use in this population over the period 1986,1999. Design., This is a prospective follow-up study of 1651 men and 1756 women, aged 25,64 years, who were enrolled in the northern Sweden MONICA project (entry in 1986, 1990, 1994) and who were followed-up in 1999. Information on tobacco use at entry and at follow-up was used to describe the stability of tobacco use over a period of 5,13 years ending in 1999. Results., Snus was the most stable form of tobacco use amongst men (75%); only 2% of users switched to cigarettes and 20% quit tobacco altogether. Smoking was less stable (54%); 27% of smokers were tobacco-free and 12% used snus at follow-up. Combined use (smoking and snus) was the least stable (39%), as 43% switched to snus and 6% switched to cigarettes. Former users of both products were much less stable than former users of either cigarettes or snus. The stability of smoking amongst women was 69%, which was higher than that amongst men (P < 0.05). Conclusions., The use of snus played a major role in the decline of smoking rates amongst men in northern Sweden. The evolution from smoking to snus use occurred in the absence of a specific public health policy encouraging such a transition and probably resulted from historical and societal influences. [source] Clinical features of gastric cancer discovered after successful eradication of Helicobacter pylori: results from a 9-year prospective follow-up study in JapanALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2005T. Kamada Summary Background :,Eradication of Helicobacter pylori is expected to prevent the development of gastric cancer. However, gastric cancer is sometimes discovered after successful eradication of H. pylori. Aim :,To conduct a prospective study to determine the clinical features of patients who underwent successful eradication and were later diagnosed with gastric cancer. Methods :,A total of 1787 patients (1299 males and 488 females; mean age, 58.2 years; range: 15,84) who underwent successful eradication therapy between April 1994 and March 2001 were our study subjects. Results :,Gastric cancer occurred at a rate of 1.1% (20 of 1787) during the follow-up period. Gastric cancer comprises six of 105 (5.7%) with early gastric cancer after endoscopic resection, 12 of 575 (2.1%) with gastric ulcer and two of 453 (0.4%) with atrophic gastritis. Gastric cancer did not develop in any patient with duodenal ulcer. All patients with gastric cancer had baseline severe atrophic gastritis in the corpus. Conclusion :,Careful endoscopic examination is necessary even after successful eradication of H. pylori in patients with early gastric cancer or gastric ulcer with severe mucosal atrophy in the corpus. [source] Glycated albumin levels predict long-term survival in diabetic patients undergoing haemodialysisNEPHROLOGY, Issue 4 2008KOUSUKE FUKUOKA SUMMARY: Aim: Glycated albumin (GA) is recognized as a reliable marker for monitoring glycemic control particularly in patients with end-stage renal disease (ESRD). Here, we investigated the impact of GA levels on long-term survival in diabetic patients with ESRD. Methods: We enrolled ESRD patients with diabetic nephropathy into our single-centre prospective follow-up study (n = 98, 66 men and 32 women; age 68.2 12.3 years) with a mean follow-up period of 47.7 months. All patients had started haemodialysis between December 1992 and November 2003. They were categorized into two groups according to their GA levels at the initiation of haemodialysis; GA < 29% (low-GA group; n = 54) and GA 29% (high-GA group; n = 44). Results: Between low-GA and high-GA groups, there were no significant differences in various clinical parameters except GA and HbA1c levels. The cumulative survival rate of low-GA group was significantly higher than that of high-GA group (P = 0.034, log,rank test). After adjustment for age, sex, total cholesterol, C-reactive protein and albumin, high-GA was a significant predictor of survival (hazard ratio 1.042 per 1.0% increment of GA, 95% CI 1.014,1.070, P < 0.05), but not in the case with HbA1c. Cox proportional hazard model demonstrated that high-GA group was a significant predictor for cardiovascular death (hazard ratio 2.971 (1.064,8.298), P = 0.038). Conclusion: We conclude that poor glycemic control (GA 29%) before starting haemodialysis is associated with increased cardiovascular morbidity and shortened survival in diabetic patients with ESRD. [source] Long-Term Outcomes of Continuous Intrathecal Baclofen Infusion for Treatment of Spasticity: A Prospective Multicenter Follow-Up StudyNEUROMODULATION, Issue 3 2008Elmar M. Delhaas MD ABSTRACT Long-term outcomes of 115 patients treated with continuous intrathecal baclofen infusion are reported. A prospective follow-up study was conducted in eight centers. Patients were followed up over a 12-month period. The follow-up scores on the three spasticity scales (Ashworth, spasm, and clonus scales) were significantly lower at every follow-up visit in comparison to the intake score, except for the clonus scale scores at 12 months. Improvements in health-related quality of life (EQ-5D) and functionality (SIP-68, functional independence measure) were small and nonsignificant. A significant reduction in severity of self-reported personal problems rating scale was observed. Sixty-six patients had no adverse events. Types of adverse events reported were wound complications (22%), catheter problems (36%), cerebrospinal fluid leakage (25%), and other complications (17%). Intrathecal baclofen reduces spasticity and severity of patient-reported problems but its effect on quality of life and functionality is less apparent. Improvements are desired in selection criteria, design of spinal catheters, and outcome scales. [source] Adult asthma after non-respiratory syncytial virus bronchiolitis in infancy: Subgroup analysis of the 20-year prospective follow-up studyPEDIATRICS INTERNATIONAL, Issue 2 2007EIJA PIIPPO-SAVOLAINEN Abstract Background: Recent studies have stressed the influence of other viruses than respiratory syncytial virus (RSV) in the development of asthma in later childhood after bronchiolitis in infancy. However, the virus-specific prognosis until adulthood has remained obscure, due to lack of sufficiently long follow-up studies. The aim of the present study was to evaluate adult respiratory morbidity after bronchiolitis in infancy, focused on cases not caused by RSV. Methods: A total of 54 children hospitalized for bronchiolitis at age <2 years were re-studied at median age 19 years; 22 with RSV bronchiolitis and 22 with non-RSV bronchiolitis outside RSV epidemic were included. RSV etiology was studied by antigen and antibody assays on admission. Adult asthma was defined by two ways, based on written questionnaire, clinical examination and home peak expiratory flow monitoring. Lung function was evaluated by flow-volume spirometry (FVS), bronchial reactivity by methacholine inhalation challenge (MIC), and atopy by skin prick tests (SPT). Results: In the non-RSV group, asthma by two definitions was present in 41,50% (vs 18,27% in RSV group). In logistic regression, adjusted for gender, age on admission, current atopy and smoking, non-RSV etiology of bronchiolitis, compared with RSV etiology, increased asthma risk by both strict (odds ratio [OR], 8.34; 95% confidence interval [CI], 1.18,58.69) and less strict (OR, 7.93; 95% CI, 1.14,55.41) criteria. An abnormal result in FVS was present in 32,41% and in MIC in 48,52% of cases in non-RSV and RSV groups, respectively. Conclusions: Infants with non-RSV bronchiolitis requiring treatment in hospital are at an increased risk for subsequent asthma in adulthood. [source] Airway hyperresponsiveness: the usefulness of airway hyperresponsiveness testing in epidemiology, in diagnosing asthma and in the assessment of asthma severityTHE CLINICAL RESPIRATORY JOURNAL, Issue 1 2007Celeste Porsbjerg MD Abstract The present PhD thesis was conducted at the Respiratory Research Unit at the Pulmonary Department L in Bispebjerg Hospital, Copenhagen, Denmark and describes airway hyperresponsiveness in asthma patients in four studies. The first study concerned risk factors for the development of asthma in young adults in a 12-year prospective follow-up study of a random population sample of 291 children and adolescents from Copenhagen, who were followed up from the age of 7,17 years (1986) until the age of 19,29 years (1998). During follow-up, 16.1% developed asthma, and in these subjects, the most important predictor of asthma development was airway hyperresponsiveness to histamine at baseline. Airway hyperresponsiveness is associated with more severe asthma and a poorer prognosis in terms of more exacerbations and less chance of remission of the disease. The second study described the relation between airway hyper-responsiveness to methacholine and the quality of life in 691 asthma patients: In asthma patients with airway hyperresponsiveness to methacholine, the quality of life measured with a validated questionnaire (Junipers Asthma Quality of Life Questionnaire) was significantly reduced compared to asthma patients who did not respond to bronchial provocation with methacholine. Airway hyperresponsiveness is not uncommonly observed in non-asthmatics, and the response to bronchial provocation with methacholine is therefore relatively non-specific. The mannitol test is a relatively new bronchial provocation test that acts indirectly on the smooth airway muscle cells through the release of mediators from inflammatory cells in the airways; the mannitol could consequently be a more specific test compared with methacholine. The third study showed that out of 16 non-asthmatics with airway hyperresponsiveness to methacholine, 15 did not respond to bronchial provocation with mannitol Because of the mechanism of action of mannitol, it seems plausible that the response to mannitol is more closely correlated to airway inflammation in asthma compared with the response to methacholine. The fourth study showed that in 53 adult asthma patients, who did not receive treatment with inhaled steroids, there was a positive correlation between the degree of airway inflammation and the degree of airway responsiveness to mannitol as well as to methacholine. The mannitol does, however, have the advantage of being a faster and simpler test to perform, requiring no additional equipment apart from a spirometer. Conclusions:, Airway hyperresponsiveness in children and in adolescents without asthma predicts asthma development in adulthood. Asthma patients with airway hyperresponsiveness to methacholine have a poorer quality of life as well as more severe disease and a poorer prognosis compared with asthma patients without airway hyperresponsiveness. Bronchial provocation with mannitol as well as with methacholine were useful for evaluating the severity of asthma and the degree of airway inflammation, and accordingly for determining the need for steroid statement. The mannitol test does, however, have practical advantages over the methacholine test that make it preferable for clinical use. [source] Role of Albumin Coating of Tympanostomy Tubes: Long-Term Clinical EvaluationTHE LARYNGOSCOPE, Issue 12 2007Teemu J. Kinnari MD Abstract Objective: Our previous work has shown that albumin coating of tympanostomy tubes prevented adhesion of proteins or bacteria on the tube surface in vitro and in a 9-month prospective follow-up study. This study was continued until all tubes were extruded. Study Design: A prospective, clinical trial. Methods: The randomized, double-blind clinical trial had 149 patients. The randomization was revealed after the follow-up period of 9 months. The number of tube sequelae in ears with human serum albumin (HSA)-coated titanium tympanostomy tubes was compared with the contralateral ears with uncoated, otherwise identical titanium tubes. The follow-up continued until all tubes were extruded, followed by evaluation of each tympanostomized patient. Results: No significant difference between the two tube types emerged after the 9-month follow-up. Among the patients younger than 2 years, one of the three typical bacteria causing acute otitis media (AOM), Streptococcus pneumoniae, Haemophilus influenzae, or Moraxella catarrhalis, was found in 45% of all bacterial cultures taken during AOM. However, among patients older than 2, one of these bacteria appeared in 17% of all the bacterial cultures and in 8% of cultures taken during the summer. Conclusions: After the first 9 follow-up months, no difference was found in the sequelae related to uncoated and HSA-coated tubes. The typical bacteria causing AOM were found less frequently among patients older than 2 years. A profile of tympanostomy patients in Finland will be given. [source] 20-year prospective follow-up study of specialized treatment for adolescents who offended sexually,BEHAVIORAL SCIENCES & THE LAW, Issue 1 2010C.Psych., James R. Worling Ph.D. Most follow-up investigations of the effectiveness of specialized treatment for adolescents who have offended sexually have not included a comparison group. Furthermore, the average length of most previous studies is approximately 5 years. This investigation is a 10-year extension of our prospective, 10-year follow-up study of specialized treatment (Worling & Curwen, 2000). Recidivism data (criminal charges) were collected from a national database for 148 adolescents who had offended sexually. Adolescents were between 12 and 19 years of age (M,=,15.5; SD,=,1.5) at assessment, and the follow-up interval spanned from 12 to 20 years (M,=,16.23; SD,=,2.02). Relative to the comparison group (n,=,90), adolescents who participated in specialized treatment (n,=,58) were significantly less likely to receive subsequent charges for sexual, nonsexual violent, and nonviolent crimes. These data add to the growing body of research supporting the effectiveness of specialized treatment for individuals who have offended sexually. Copyright © 2009 John Wiley & Sons, Ltd. [source] Twelve-month neurodevelopmental outcome in preterm infants with and without intrauterine growth restrictionACTA PAEDIATRICA, Issue 10 2010Nelly Padilla Abstract Aim:, To evaluate the neurodevelopmental outcome at 12 months' corrected age in preterm infants with and without severe intrauterine growth restriction. Methods:, This prospective follow-up study included 37 infants with severe intrauterine growth restriction and 36 appropriate-for-gestational-age infants born between 26 and 34 weeks. Neonatal and infant data were prospectively recorded. Infants were assessed at 12 ± 2 months' corrected age with the Hammersmith Infant Neurological Examination and the Bayley Scale for Infant Development version-II. Results:, Both groups were similar in demographic characteristics and perinatal status. No significant differences in neurodevelopmental performance were found. The mental development index was 98.8 (SD 9.0) vs 98.4 (SD 13.1) (p = 0.9) and the psychomotor development index was 91.7 (SD 9.9) vs 95.5 (SD 13.4) (p = 0.2) for the study and reference groups respectively. Neurological assessment showed no significant differences between the two groups. Conclusion:, Although the study group showed a non-significant trend towards a lower score in the psychomotor development index than the reference group, significant differences at 12 months could not be demonstrated. IUGR infants continued to have significantly lower weight, length and head circumference at 1 year. [source] | |||||||||||||