2-year Study Research Articles

The longitudinal incidence of pericarditis in 1.6 million patients: a 20-year study

The longitudinal incidence of pericarditis in 1.6 million patients: a 20-year study

Association between education and disability-free life expectancy among Japanese older people: The Ohsaki Cohort 2006 study

BackgroundHigher education level is associated with longer disability-free life expectancy (DFLE). However, evidence is scarce regarding factors that can contribute to eliminating inequality in DFLE according to education level. This study aimed to clarify the association between education and DFLE and estimate whether DFLE in people with lower education may increase to the same level as that in people with higher education through social participation. MethodsWe analyzed data from 13,849 Japanese people aged 65 years and older who participated in a 13-year prospective study. At baseline, we collected information on education levels (low, middle, or high) and social participation. DFLE was defined as the average duration people expect to live without disability. To calculate DFLE for each education level group, the multistate life table method was employed using a Markov model. ResultsAt the age of 65 years, DFLE (95 % confidence interval [CI]) in women with low education was 21.3 years (20.8–21.8) without social participation and 24.3 (23.8–24.9) with social participation. In the middle education group, DFLE was 22.1 (21.6–22.6) without social participation and 25.0 (24.6–25.5) with social participation. In the high education group, DFLE was 22.1 (21.5–22.8) without social participation and 25.5 (25.0–26.0) with social participation. Similar results were found for men. ConclusionsDFLE in people with low or middle education with social participation was almost the same as that in those with high education with social participation, suggesting the possibility that disparities in DFLE by education level could be offset by promoting social participation in older adults.

A prediction model for the progression of blepharospasm: A 4-year prospective cohort study

A prediction model for the progression of blepharospasm: A 4-year prospective cohort study

Age at menopause and risk of metabolic dysfunction-associated fatty liver disease: A 14-year cohort study

Backgrounds & aimsMenopause, characterized by a sudden decline in estrogen levels, has significant effects on women's health, especially when it occurs early. This study aimed to investigate the associations between menopausal age and incidence of metabolic dysfunction-associated fatty liver disease (MAFLD) using a large cohort and a long-term follow-up. MethodsMenopausal age was categorized into four groups (G1–4 [<40, 40–44, 45–49, and ≥50 years, respectively]). Cox proportional hazards regression analysis was used to assess the risk of developing MAFLD during the follow-up period according to the menopausal age categories. ResultsA total of 1,888 participants were included in the final analysis and followed for a median period of 12.3 years. The unadjusted hazard ratios (95 % CIs) for the incidence of new-onset MAFLD were 1.11 (0.93–1.32), 1.15 (0.90–1.47), and 1.52 (1.12–2.07) in G3, G2, and G1, respectively, compared with that in G4. After adjusting for confounders, the hazard ratio (95 % CIs) for the incidence of new-onset MAFLD was 1.40 (1.00–1.95) in G1 compared with that in G4. ConclusionThe risk of developing MAFLD was higher in women with premature menopause (<40 years) than in those with menopause aged ≥50 years.

Short- and mid-term morbidity and primary-care burden due to infant respiratory syncytial virus infection: A Spanish 6-year population-based longitudinal study.

The morbidity burden of respiratory syncytial virus (RSV) in infants extends beyond hospitalization. Defining the RSV burden before implementing prophylaxis programs is essential for evaluating any potential impact on short- to mid-term morbidity and the utilization of primary healthcare (PHC) and emergency services (ES). We established this reference data using a population-based cohort approach. Infants hospitalized for RSV from January 2016 to March 2023 were matched with non-hospitalized ones based on birthdate and sex. We defined the exposure as severe RSV hospitalization. The main study outcomes were as follows: (1) PHC and ES visits for RSV, categorized using the International Classification of Primary Care codes, (2) prescriptions for respiratory airway obstructive disease, and (3) antibacterial prescriptions. Participants were followed up from 30 days before hospitalization for severe RSV until the outcome occurrence or end of the study. Adjusted incidence rate ratios (IRRs) of the outcomes along with their 95% confidence intervals (CI) were estimated using Poisson regression models. Stratified analyses by type of PHC visit (nurse, pediatrician, or pharmacy) and follow-up period were undertaken. We defined mid-term outcomes as those taking place up to 24 months of follow-up period. The study included 6626 children (3313 RSV-hospitalized; 3313 non-hospitalized) with a median follow-up of 53.7 months (IQR = 27.9, 69.4). After a 3-month follow-up, severe RSV was associated with a considerable increase in PHC visits for wheezing/asthma (IRR = 4.31, 95% CI: 3.84-4.84), lower respiratory infections (IRR = 4.91, 95% CI: 4.34-5.58), and bronchiolitis (IRR = 4.68, 95% CI: 2.93-7.65). Severe RSV was also associated with more PHC visits for the pediatrician (IRR = 2.00, 95% CI: 1.96-2.05), nurse (IRR = 1.89, 95% CI: 1.75-1.92), hospital emergency (IRR = 2.39, 95% CI: 2.17-2.63), primary healthcare emergency (IRR: 1.54, 95% CI: 1.31-1.82), as well as with important increase in prescriptions for obstructive airway diseases (IRR = 5.98, 95% CI: 5.43-6.60) and antibacterials (IRR = 4.02, 95% CI: 3.38-4.81). All findings remained substantial until 2 years of post-infection. Severe RSV infection in infants significantly increases short- to mid-term respiratory morbidity leading to an escalation in healthcare utilization (PHC/ES attendance) and medication prescriptions for up to 2 years afterward. Our approach could be useful in assessing the impact and cost-effectiveness of RSV prevention programs.

Factors Associated With Repeat Surgery in Cervical Ossification of the Posterior Longitudinal Ligaments: Minimum 8-year Follow-up Study.

Single-center retrospective study. The objective of this study is to identify the factors leading to repeat surgery in patients with cervical ossification of the longitudinal ligament (OPLL) during a minimal 8-year follow-up after the initial surgery. The long-term effects of cervical OPLL are well known, but it's not always clear how many patients need to have surgery again because their neurological symptoms get worse. This study is included 117 patients who underwent surgery for cervical OPLL and had a follow-up of at least 8 years. OPLL type, surgical extent, surgical method, and sagittal radiological parameters were measured, and OPLL characteristics were analyzed. The average age of patients at the time of surgery was 53.2 years, with a male-to-female ratio of 78:39. The median follow-up duration was 122 months (96-170 mo). Out of the total, 20 cases (17.1%) necessitated repeat surgery, among which 8 cases required surgery at the same site as the initial operation. The highest rate of repeat surgery was observed in patients who underwent total laminectomy without fusion (TL), where 6 out of 21 patients (29%) needed a second surgery, and 5 of these (23%) involved the same surgical site. Patients who underwent repeat surgery at the same site exhibited a greater range of motion (ROM) one year postsurgery (16.4 ± 8.5° vs. 23.1 ± 12.7°, P =0.041). In addition, the ROM at 1 year was higher in patients who underwent TL compared with those who had laminoplasty. Furthermore, the recurrence rate for hill-shape OPLL was higher at 30.8% compared to 10% for plateau-shape OPLL ( P = 0.05). Larger cervical ROM 1 year after surgery is related to repeat surgery at the same level as previous surgery, especially in laminectomy without fusion surgery.

Autologous platelet-rich plasma as adjuvant treatment in patients with refractory endometrial growth: Preliminary results from a 2-year prospective study in a Spanish reference unit of assisted human reproduction

Autologous platelet-rich plasma as adjuvant treatment in patients with refractory endometrial growth: Preliminary results from a 2-year prospective study in a Spanish reference unit of assisted human reproduction

Descemet's membrane endothelial keratoplasty rejection after SARS-COV2 infection or vaccination: 2-year retrospective study

To assess the incidence of Descemet's membrane endothelial keratoplasty (DMEK) rejection potentially associated with coronavirus disease 2019 (COVID-19) infection or vaccination, and its association with known rejection risk factors during the first two years of the pandemic. This retrospective study included patients with DMEK rejection between January 2020 and December 2021. Diagnostic criteria were based on symptoms, visual acuity, and other clinical assessments. Risk factors for graft rejection were considered, and a telephone survey was conducted to identify possible preceding COVID-19 infection or vaccination. Of 58 patients, 44 were included. Six patients (14%) reported COVID-19 infection, with one immediate endothelial graft rejection (EGR) post-infection. After vaccine availability, 13 of 36 patients had EGR at an average of 2.7 months post-vaccination. Five (38%) had immediate EGR following vaccination, four of which had concomitant risk factors for rejection. Although the risk of endothelial graft rejection (EGR) associated with COVID-19 infection or vaccination appears to be extremely low, there may be a causative relationship, especially in patients with pre-existing risk factors for EGR. A temporary increase in anti-rejection treatment following COVID-19 infection or vaccination is recommended, especially in patients with pre-existing risk factors, along with closer monitoring during the subsequent 4 to 8 weeks.

The politics of sensemaking: Framing contests in border control during the EU “migration crisis”

Organizing an effective crisis response requires that actors collectively make sense of a situation by exchanging their interpretations and understandings. Current sensemaking studies predominantly adopt a short-term perspective on this process, focusing on how actors recognize and respond to deviant cues. This focus tends to obscure how organizational politics influences the sensemaking process. In this paper, we study how actors exert influence over sensemaking processes by analyzing how organizational members frame situations and challenge one another's understandings. Empirically, we focus on the response of Dutch Border Security Teams to the “migration crisis” at Chios, Greece, drawing from a 2-year multisite study consisting of two field visits and 47 interviews. Our analysis shows that organizational members used discursive, symbolic, and situated framing practices to influence one another's sensemaking. Based on these theoretical constructs, we are able to explain how frame hegemony emerged that entirely countered initial adaptive sensemaking at the frontline. We contribute to the sensemaking literature by theorizing the politics of sensemaking in turbulent environments.

Clinical presentation and outcomes of Mooren’s ulcer: a 2-year retrospective cohort study

Background: Mooren’s ulcer is a chronic, painful, unrelenting, peripheral ulcerative keratitis with atypical geographic presentation and distribution. This study aimed to retrospectively investigate the clinical presentation and outcomes of patients with Mooren’s ulcer over a 2-year period at the Evangelical Church Winning All (ECWA) Eye Hospital, Kano, Nigeria. Methods: The theatre records of 24 patients with Mooren’s ulcer were retrospectively reviewed, with a focus on those who had up to 2 years of follow-up. The surgical treatment followed a standard procedure of 3 ml of 2% xylocaine and 0.01% adrenaline were administered for peribulbar anaesthesia. The periorbital area was cleaned with 10% povidone iodine, draped, and a lid speculum was inserted to part the lids. The conjunctiva was excised 2 mm from the edge of the ulcer, and the area was lightly cauterized. This was followed by a combination of subconjunctival injection of 2 mg of dexamethasone and 20 mg of gentamycin and a drop of 0.3% of ciprofloxacin and 1% of atropine. Data were analyzed using a social science statistical package (IBM SPSS Inc. Chicago V 19.0) with 95% confidence. Results: The results revealed that Mooren’s ulcer was predominant in an age range of 11 and 30 years. A total number of 24 patients were seen in the two years of review, with an average age of 27.3±13.7 years. There were 19 male and 5 female patients, with a male-to-female ratio of 3.8:1. At presentation, patients had poor preoperative vision, with acuity values of less than 6/60–3/60 range. Postoperatively, 15 eyes had a borderline outcome (cannot see 6/18 but can see 6/60), 12 eyes had good vision (VA 6/18) and 4 eyes ended up with the same presenting vision (VA&lt;6/60) after treatment. One patient had iris prolapse and three patients had evisceration. Conclusions: This study provided the clinical characteristics of patients with Mooren’s corneal ulcer. A comparison of preoperative and postoperative visual acuity showed that early presentation and intervention improved visual outcomes. Although most eyes maintained or improved vision, nearly half demonstrated a borderline result that fell short of the target vision threshold. The retrospective nature of this study limited its ability to review complete patient information. The small sample size also constrained the analysis due to the low incidence of Mooren’s ulcer. Further research is needed to better understand increased susceptibility in younger populations. This will help inform prevention and treatment efforts to address this public health challenge.

Development of Upper-Extremity Morphological Asymmetries in Male and Female Elite Youth Tennis Players: A Longitudinal Study.

This 2-year longitudinal study examined the development of upper-extremity bone mineral density (BMD), bone mineral content (BMC), and lean mass (LM) asymmetry magnitudes in male and female youth tennis players. Dominant and nondominant upper-extremity BMD, BMC, and LM values of 49 male and 31 female players were measured yearly using dual X-ray absorptiometry. From these values, asymmetry magnitudes were calculated and expressed as a percentage. Maturity offset was estimated using anthropometric measurements. Linear mixed effect models examined the development of BMD, BMC, and LM asymmetry magnitudes according to players' maturity offset, sex, and training volume. Adjusted for sex and training volume, a 1-year increment in maturity offset was associated with a significant increase in BMD (1.3% [2.2%]; P < .001) and BMC (0.6% [2.4%]; P = .011) asymmetry magnitudes. Male players displayed significantly higher LM asymmetry magnitudes (Δ3.2% [8.4%]; P = .002) compared with their female counterparts. Training volume was not significantly associated with asymmetry magnitude development. In contrast to LM, male and female youth tennis players' upper-extremity bones are still responsive to mechanical loading with a significant increase in BMD and BMC asymmetry magnitudes according to maturity offset.

Hospitalization and mortality in Asian autoimmune bullous dermatosis patients: A 17-year retrospective study.

Limited data exist on the factors associated with hospitalization and mortality in Asian inpatients with autoimmune bullous dermatoses (AIBDs). This study aimed to elucidate the risk factors affecting hospitalization and mortality rates in Asian patients with AIBDs. A retrospective analysis of patients with AIBDs treated at Siriraj Hospital during a 17-year period was performed using the International Classification of Diseases 10th revision codes. The characteristics of inpatients and outpatients were compared, and mortality rates and associated factors were identified. The study included 360 AIBD patients (180 inpatients, 180 outpatients). Inpatients were significantly younger than outpatients. The identified risk factors for hospitalization were malignancy (odds ratio [OR] 2.83, 95% confidence interval [CI] 1.13-8.04; p = 0.034), moderate to severe disease (OR 2.52, 95% CI 1.49-4.34; p < 0.001), systemic corticosteroid use ≥15 mg/day (OR 2.27, 95% CI 1.21-4.41; p = 0.013) and oral cyclophosphamide treatment (OR 9.88, 95% CI 3.82-33.7; p < 0.001). Kaplan-Meier analysis revealed mortality rates of 26%, 36% and 39% for inpatients with pemphigus at 1, 3 and 5 years, respectively. For inpatients with pemphigoid, the corresponding rates were 28%, 38% and 47%. Infections, particularly pneumonia, were the predominant cause of death in both conditions. This study confirmed that both Asian ethnicity and healthcare disparities may be correlated with adverse outcomes in patients with AIBDs. Pemphigus mortality rates were substantially greater in Asian patients than in Caucasian patients. Continuous monitoring of factors contributing to hospitalization and mortality is imperative to improve treatment outcomes.

Associations Between Brain Structural Development and Onset of Depressive Disorder During Adolescence and Emerging Adulthood: Results From a 15-Year Longitudinal Study

Associations Between Brain Structural Development and Onset of Depressive Disorder During Adolescence and Emerging Adulthood: Results From a 15-Year Longitudinal Study

Suicide attempts of friends and family during adolescence and long-term suicidal ideation and attempts: Findings from the 25-year Add Health study

BackgroundSuicide is a significant global public health concern. However, previous studies have predominantly focused on individual-level risk factors. Against this backdrop, microsystem suicide propinquity, which encompasses suicidal thoughts and behaviors (STB) within families and peer groups, is significant in elucidating the development and perpetuation of STB in adolescents. MethodsThis study utilized data from the National Longitudinal Study of Adolescent to Adult Health (Add Health, 1994–2018). Adolescents who reported instances of suicide attempts among their friends and family members during Wave 1 were selected (N = 4826). Generalized estimation equations (GEE) and structural equation models (SEM) were employed. ResultsGEE analyses indicated that individuals with friends who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.57 [2.13, 3.11]) and suicide attempts (OR [95 % CI] = 2.47 [1.78, 3.42]). Also, individuals with family members who had attempted suicide exhibited higher risks for suicidal ideation (OR [95 % CI] = 2.37 [1.62, 3.46]) and attempts (OR [95 % CI] = 2.27 [1.17, 4.41]). However, friends' and family members' suicide attempts failed to show significant interactive effect. Besides, SEM analyses indicated that friends' and family members' suicide attempts were associated with one's long-term suicidal ideation and attempts via depressive symptoms. ConclusionSuicide attempts of friends and family during adolescence were long-term risk factors for suicidal ideation and attempts from adolescence to young adulthood. Moreover, depressive symptoms served as long-term mechanisms in these associations.

D36. Early Posterior Vault Distraction Osteogenesis is changing the Syndromic Craniosynostosis Treatment Paradigm: Outcomes of A 20-year Cohort Study

D36. Early Posterior Vault Distraction Osteogenesis is changing the Syndromic Craniosynostosis Treatment Paradigm: Outcomes of A 20-year Cohort Study

Evaluation of adherence to pharmacological treatments by undocumented migrants with chronic diseases: a 10-year retrospective cohort study

ObjectivesTo investigate the time course of medication adherence and some of the factors involved in this process in undocumented migrants with chronic diseases.DesignRetrospective cohort study.SettingA big non-governmental organisation in Milano,...

Outcomes following hip fracture surgery in adults with schizophrenia in Ontario, Canada: A 10-year population-based retrospective cohort study

ObjectiveTo understand immediate and long-term outcomes following hip fracture surgery in adults with schizophrenia. MethodsRetrospective population-based cohort study leveraging health administrative databases from Ontario, Canada. Individuals aged 40–105 years with hip fracture surgery between April 1, 2009 and March 31, 2019 were included. Schizophrenia was ascertained using a validated algorithm. Outcomes were: 30-day mortality; 30-day readmission; 1-year survival; and subsequent hip fracture within 2 years. Analyses incorporated Generalized Estimating Equation models, Kaplan-Meier curves, and Fine-Gray competing risk models. ResultsIn this cohort study of 98,126 surgically managed hip fracture patients, the median [IQR] age was 83[75–89] years, 69.2% were women, and 3700(3.8%) had schizophrenia. In Fine-Gray models, schizophrenia was associated with subsequent hip fracture (sdRH, 1.29; 95% CI, 1.09–1.53), with male patients with schizophrenia sustaining a refracture 50 days earlier. In age- and sex-adjusted GEE models, schizophrenia was associated with 30-day mortality (OR, 1.31; 95% CI, 1.12–1.54) and readmissions (OR, 1.40; 95% CI, 1.25–1.56). Kaplan-Meier survival curves suggested that patients with schizophrenia were less likely to be alive at 1-year. ConclusionsStudy highlights the susceptibility of hip fracture patients with schizophrenia to worse outcomes, including refracture, with implications for understanding modifiable processes of care to optimize their recovery.

Development and validation of a novel nomogram for predicting long-term rebleeding risk among patients with hemorrhagic moyamoya disease: a 10-year multicenter retrospective cohort study.

The aim of this study was to develop and validate a predictive nomogram model for long-term rebleeding events in patients with hemorrhagic moyamoya disease (HMMD). In total, 554 patients with HMMD from the Fifth Medical Center of the Chinese PLA General Hospital (5-PLAGH cohort) were included and randomly divided into training (390 patients) and internal validation (164 patients) sets. An independent cohort from the First Medical Center and Eighth Medical Center of Chinese PLA General Hospital (the 1-PLAGH and 8-PLAGH cohort) was used for external validation (133 patients). Univariate Cox regression analysis and least absolute shrinkage and selection operator (LASSO) regression algorithm were used to identify significant factors associated with rebleeding, which were used to develop a nomogram for predicting 5- and 10-year rebleeding. Intraventricular hemorrhage was the most common type of cerebral hemorrhage (39.0% of patients in the 5-PLAGH cohort and 42.9% of the 1-PLAGH and 8-PLAGH cohort). During the mean ± SD follow-up period of 10.4 ± 2.9 years, 91 (16.4%) patients had rebleeding events in the 5-PLAGH cohort. The rebleeding rates were 12.3% (68 patients) at 5 years and 14.8% (82 patients) at 10 years. Rebleeding events were observed in 72 patients (14.3%) in the encephaloduroarteriosynangiosis (EDAS) surgery group, whereas 19 patients (37.3%) experienced rebleeding events in the conservative treatment group. This difference was statistically significant (p < 0.001). We selected 4 predictors (age at onset, number of episodes of bleeding, posterior circulation involvement, and EDAS surgery) for nomogram development. The concordance index (C-index) values of the nomograms of the training cohort, internal validation cohort, and the external validation cohort were 0.767 (95% CI 0.704-0.830), 0.814 (95% CI 0.694-0.934), and 0.718 (95% CI 0.661-0.775), respectively. The nomogram at 5 years exhibited a sensitivity of 48.1% and specificity of 87.5%. The positive and negative predictive values were 38.2% and 91.3%, respectively. The nomogram at 10 years exhibited a sensitivity of 47.1% and specificity of 89.1%. The positive and negative predictive values were 48.5% and 88.5%, respectively. EDAS may prevent rebleeding events and improve long-term clinical outcomes in patients with HMMD. The nomogram accurately predicted rebleeding events and assisted clinicians in identifying high-risk patients and devising individual treatments. Simultaneously, comprehensive and ongoing monitoring should be implemented for specific patients with HMMD throughout their entire lifespan.

What Canadians search about asthma: a 10-year Google Trends study on asthma and related topics

BackgroundGoogle Trends (GTr) is now becoming an important tool in epidemiological studies to assess the trend of online searches by people of any geographical location. While previous studies assessed trends in searches for some allergic conditions, very few studies reported search patterns for asthma and asthma-related topics. MethodsWe took monthly Canadian GTr data for asthma-related keywords such as ‘asthma’, ‘shortness of breath’, ‘wheeze’, ‘asthma emergency’, ‘asthma hospital’, and ‘asthma medication’ between January 1, 2014, and December 31, 2023. We assessed the trend of yearly relative search volume (RSV) for the past 10 years. We also assessed the trend by influenza and wildfire seasons. ResultsWe observed a marginal increase in searches for some asthma-related topics such as ‘asthma’ ‘shortness of breath’, and ‘wheeze’ in Canada between 2014 to 2023 but not other topics such as ‘asthma emergency’, ‘asthma hospital’, and ‘asthma medication’. The pattern of searches for ‘asthma’, ‘shortness of breath’, and ‘wheeze’ did not change by influenza of wildfire seasons across the years. ConclusionOur study is the first to demonstrate searches for asthma and related topics by Canadians in the past 10 years and indicates GTr as an emerging tool in epidemiology that can be used in planning the implementation of public health policies.

Total lower eyelid reconstructions with septal chondromucosal graft and pedicled flap on the superficial temporal artery

BackgroundSubtotal and total lower eyelid tissue loss after tumour excision is a complex issue for reconstructive surgeons. The anterior and posterior flaps must be restored to avoid compromising the functional and aesthetic prognosis of the eye. This study used a septal chondromucosal graft for the posterior lamella and a fasciocutaneous flap pedicled on the temporal artery for the anterior lamella. MethodWe conducted a 10-year monocentric retrospective study, including 18 patients who were treated using a septal chondromucosal graft with a temporal artery pedicle flap following tumour excision. We collected demographic and medico-surgical data related to flap survival, absence of ectropion, lagophthalmos and other post-operative complications. The aesthetic outcome was judged using a grading scale during the last follow-up consultation. ResultsAll grafts and flaps survived, whereas 2 patients required early repeat surgery (1 for ectropion and 1 for graft site haematoma). None of the patients developed lagophthalmos. Two patients had distal flap injuries that healed with local care. All patients were satisfied with the aesthetic outcome at the last follow-up visit. ConclusionCombining a septal chondromucosal graft with a fasciocutaneous flap pedicled to the temporal artery for total lower eyelid reconstruction is a reliable method with satisfactory functional and cosmetic outcomes.