Follow-up Report Research Articles

Twenty-four months long-term follow-up report on the effect of poly lactic-co-glycolic acid suspension suture in Asian with mild-moderate face laxity

Phoebe Kar Wai Lam, MBCHB (OTAGO), MRCS (EDIN), MSCPD (CARDIFF), Chi Pun Fung, MBBS, DFM, DPD, James Yui Lam, MBBS (HK), MRCSED, PGDIPCLINDERM (QMUL), Wang Lung Luk, MBBS, MSc, FCOHK, FCSHK, Alvin Ka Wai Lee, MBChB (CUHK), DCH (Sydney), Dip Derm (Glasgow), Ms Clin Derm (Cardiff), Ms PD (Cardiff), Cheuk Hung Lee, MBBS (HK), FHKAM (MED), FHKCP, MSc PD (Cardiff), MRCP (UK), DPD (Wales), Dip Derm (Glasgow), PG Dip Clin Derm (London), MRCP (London), Grad Dip Derm (NUS), Dip Med (CUHK), Paul Man Kei Tam, MBBS(HKU), MRCP (UK), FHKAM, FHKCP, DDME (CUHK), DPD, Edwin Kwan Chark Lau, MBBS (HK). J Cosmet Med 2022;6:8-12. https://doi.org/10.25056/JCM.2022.6.1.8

A prospective comparison of 3 hamstring ACL fixation devices—rigidfix, bioscrew, and intrafix—randomized into 4 groups with a minimum follow-up of 5 years

BackgroundACL (anterior cruciate ligament) reconstruction remains the gold standard surgical option for patients with ACL tears. There are many fixation devices available for ACL reconstruction. Recent ACL reconstruction strategies are aiming to reproduce the native anatomy and normal kinematics of the knee. This is a five years follow-up report of some of the new devices for graft fixation. A two years follow-up data was published previously.Methods120 patients were randomized into four different groups (30 each) for ACL reconstruction with hamstring tendons: group I femoral Rigidfix cross-pin and Intrafix tibial extension sheath with a tapered expansion screw; group II Rigidfix femoral and BioScrew interference screw tibial fixation; group III BioScrew femoral and Intrafix tibial fixation; group IV BioScrew fixation into both tunnels. The evaluation methods were clinical examination, knee scores, and instrumented laxity measurements.ResultsIn this 5 years follow-up there were 102/120 (85%) patients available, but only 77 (64,2%) attended the clinical examinations. No significant difference between the groups in the clinical results was detected. Between the 2 and 5 years follow-up there were 6 additional procedures in group I and one in group II. There was a significant difference in additional procedures between group I and the other groups (P = .041).ConclusionThere was a statistically significant difference in the additional procedures, most in group I (six). The ACL grafts were intact. Other statistically or clinically significant differences in the 5 years follow-up results were not found.Study designRandomized controlled clinical trial; Level of evidence, 1.Trial registration ISRCTN registry with study ID ISRCTN34011837. Retrospectively registered 17.4.2020.

Cardiovascular complications of Cushings syndrome: Impact on morbidity and mortality.

Cardiovascular complications of Cushings syndrome: Impact on morbidity and mortality.

Long-term outcomes following repair of nasal valve collapse with temperature-controlled radiofrequency treatment for patients with nasal obstruction.

Long-term outcomes following repair of nasal valve collapse with temperature-controlled radiofrequency treatment for patients with nasal obstruction.

Neutral lipid storage disease with myopathy: A 10-year follow-up case report.

Mutations in PNPLA2 gene encoding for adipose triglyceride lipase (ATGL), involved in triglyceride degradation, lead to an inborn error of neutral lipid metabolism. The disorder that results in abnormal storage of neutral lipid is known as neutral lipid storage disease with myopathy (NLSDM). We report the follow-up of a 30-year-old woman with NLSDM, asymptomatic until age 23. At the age of 18, a high level of CPK and neutral lipid abnormal accumulation in muscle and skin cells suggested NLSDM diagnosis, afterwards confirmed by PNPLA2 analysis. After 5 years, she developed weakness in the upper and lower extremities. She was put on a low-fat diet with medium-chain triglycerides (MCT) oil supplementation but, although her CPK level decreased, myopathy continued to progress. At present, she presents severe skeletal myopathy without cardiac involvement. In this patient, no beneficial effects on progressive skeletal muscle weakness were detected after the MCT diet, probably due to complete loss of PNPLA2 expression.

Prisoners regulating prisons: Voice, action, participation and riot.

Prisoners are a critical source of prison regulation around the world, but regulation by (rather than of) prisoners remains little analysed. In this article, we utilise the 1990 riots at HMP Strangeways (England), as a case study of prisoners (re)shaping imprisonment. We examine prisoners' roles in these riots and subsequent cross-sectoral regulatory activities. We innovatively use the four-phase process of translation from actor-network theory to guide document analysis of (1) Lord Woolf's official inquiry into the riots and (2) the voluntary organisation Prison Reform Trust's follow-up report. We explore how participatory approaches could inform prison regulation through (former) prisoners partnering with external regulators throughout the processes of identifying problems and solutions to establish broader alliances seeking social change.

Immediate ceramic implant in the molar region - a 3-year follow-up case report

Ceramic implants are considered to be a valid therapy in implant supported oral rehabilitation with short-term survival rates and osseointegration patterns similar to titanium. Immediate implant placement combined with the ceramic implant is a procedure with a short-term therapeutic prognosis where research validation is still needed. This case report with ceramic implants showed almost no radiographic and volumetric alterations over a 3-year post-rehabilitation period.

Long-term outcomes in patients with localized Ewing sarcoma treated with interval-compressed chemotherapy: A long-term follow-up report from Children’s Oncology Group study AEWS0031.

11505 Background: Children’s Oncology Group study AEWS0031 demonstrated superior 5-year event-free survival (EFS) in patients with localized Ewing sarcoma (ES) receiving interval-compressed (IC) chemotherapy (every 2 weeks) compared to standard timing (ST) chemotherapy (every 3 weeks). We assessed the long-term outcome of patients treated on AEWS0031 to determine whether the survival advantage of IC chemotherapy was maintained at 10 years. Methods: AEWS0031 enrolled 568 eligible patients with localized ES. Patients were stratified into four groups by age (<18 years and ≥ 18 years) and primary site (pelvic and non-pelvic), and randomized to receive 14 cycles of alternating vincristine-doxorubicin-cyclophosphamide and ifosfamide-etoposide given every 3 weeks (ST; Regimen A) vs. every 2 weeks (IC; Regimen B). For this updated report, one patient was excluded due to uncertainty of original diagnosis giving a total of 567 patients in this analysis. Data for tumor measurements and histologic response were collected retrospectively from institutional reports. EFS and overall survival (OS) were estimated using the Kaplan-Meier method and compared using the log-rank test and Gray’s test for cumulative incidence (CI). Results: The 10-year EFS for patients treated with IC chemo was 70% compared to 61% for ST chemo (p = 0.03), and the OS was 76% with IC chemo compared to 69% for ST chemo (p = 0.03). The 10-year CI of second malignant neoplasms (SMNs) for ST chemo was 4.2% [95% confidence interval: 2.4-7.5] compared to 3.2% (95% confidence interval: 1.6-6.3) for IC chemo (p = 0.5). There was a trend towards improved 10-year EFS in those receiving IC chemo both with non-pelvic (N = 477; 71% vs. 64%) and pelvic (N = 90; 67% vs. 43%) primary tumors. Similarly, the 10-year EFS was superior for patients treated with IC chemo in both the < 18 years (N = 500; 73% vs. 64%) and ≥ 18 years (N = 67; 53% vs. 37%) age groups. Among the 184 patients with available histologic response data, the 10-year EFS from the time of local control was 76% for those with < 10% viable tumor and 56% for those with ≥ 10% viable tumor (p = 0.01). Additional analysis comparing patients with any viable tumor vs. no viable tumor (NVT) by treatment regimen demonstrated that patients with NVT who received IC chemo had 10-year EFS and OS from local control of 91% and 97%, respectively. In the 210 patients for whom tumor volume calculations were possible, there was no difference in the 10-year EFS for patients with tumors < 200 mL vs. ≥ 200 mL. Conclusions: With longer term follow-up, IC chemotherapy for localized ES is associated with superior EFS and OS without an increase in SMNs. This study suggests patients ≥ 18 years with poor necrosis or pelvic primary tumors remain at high risk for relapse despite IC chemo, emphasizing the need for alternative treatment strategies to improve their outcomes. Clinical trial information: NCT00006734.

COVID-19 in pediatric kidney transplantation: a follow-up report of the Improving Renal Outcomes Collaborative.

BackgroundWe report follow-up data from an ongoing prospective cohort study of COVID-19 in pediatric kidney transplantation through the Improving Renal Outcomes Collaborative (IROC).MethodsPatient-level data from the IROC registry were combined with testing, indication, and outcomes data collected to describe the epidemiology of COVID testing, treatment, and clinical outcomes; determine the incidence of a positive COVID-19 test; describe rates of COVID-19 testing; and assess for clinical predictors of a positive COVID-19 test.ResultsFrom September 2020 to February 2021, 21 centers that care for 2690 patients submitted data from 648 COVID-19 tests on 465 patients. Most patients required supportive care only and were treated as outpatients, 16% experienced inpatient care, and 5% experienced intensive care. Allograft complications were rare, with acute kidney injury most common (7%). There was 1 case of respiratory failure and 1 death attributed to COVID-19. Twelve centers that care for 1730 patients submitted complete testing data on 351 patients. The incidence of COVID-19 among patients at these centers was 4%, whereas the incidence among tested patients was 19%. Risk factors to predict a positive COVID-19 test included age > 12 years, symptoms consistent with COVID-19, and close contact with a confirmed case of COVID-19.ConclusionsDespite the increase in testing and positive tests over this study period, the incidence of allograft loss or death related to COVID-19 remained extremely low, with allograft loss or death each occurring in < 1% of COVID-19-positive patients and in less than < 0.1% of all transplant patients within the IROC cohort.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information Supplementary InformationThe online version contains a graphical abstract available at 10.1007/s00467-022-05570-w.

ANALYSIS OF TEACHER PERFORMANCE IN TERMS OF WORK MOTIVATION AND IMPLEMENTATION OF ACADEMIC SUPERVISION IN TK NEGERI KAMPUNG RAKYAT DISTRICT, SOUTH LABUHANBATU REGENCY

This study aims to determine and analyze in depth the academic performance of the supervision carried out by the principal in improving the performance of teachers at the State Kindergarten in the Kampung Rakyat District. The research method uses qualitative data collection techniques, observations, interviews and conclusions. The results of the research Planning for academic supervision by the principal at the Kampung Rakyat State Kindergarten can be well structured. It can be seen that the supervision planning starts from compiling a supervision schedule, determining the purpose of supervision, implementing supervision, the techniques needed, the instruments to be used, and important things that support the implementation of good supervision. Giving motivation to teachers is able to provide encouragement to improve teacher performance. The role of the principal in fostering teacher work motivation by carrying out academic supervision. The implementation of academic supervision by the principal is carried out according to the planning stages of academic supervision and takes a humanist approach that creates comfort for teachers, even the teacher is used as a friend to discuss and agree on the implementation of follow-up supervision of academic supervision starting from face-to-face direct coaching, evaluation, and analyze and process the results of the evaluation which in the end prepare a follow-up report and carry out the follow-up. In connection there are principals who find teachers who have difficulty in carrying out learning evaluations, the principals try to overcome them.

A Multidisciplinary Approach for the Management of Iatrogenic Severe Periodontitis Following Orthodontic Treatment with a 12-Year Follow-up.

Orthodontic treatment aims to realign teeth in a functional and esthetic manner. When applied on an unhealthy periodontium, this may lead to advanced periodontal tissue breakdown. The present 12-year follow-up report describes the multidisciplinary management of a severe, iatrogenic, generalized periodontitis case that was caused/aggravated by orthodontic therapy on unhealthy periodontal tissues. Prompt therapy was applied through nonsurgical and surgical approaches, including soft and hard tissue grafting procedures combined with corrective orthodontic treatment on healthy tissues. This report is a clear demonstration that early disease detection and proper diagnosis combined with appropriate therapeutic approaches concomitant with strict supportive periodontal therapy could lead to long-term successful and maintainable outcomes, even in hopeless cases.

Effect of Early Infant Probiotic Supplementation on Eczema, Asthma, and Rhinitis at 7 Years of Age.

We previously reported the initial results of the Trial of Infant Probiotic Supplementation (TIPS) study to determine if daily administration of a probiotic, Lactobacillus rhamnosus GG (LGG), during the first 6 months of life to children at high risk for allergic disease because of asthma in a parent can decrease their cumulative incidence of eczema.1 To date, the TIPS study is the only of its type performed in the United States.urour initial report, when all children were at least 2 years of age, we noted no effect on the incidence of eczema. We now present additional results, with the participants at least 7 years of age, on the cumulative incidence of eczema, asthma, and rhinitis.The TIPS study is a randomized, double-masked, parallel-arm, controlled trial designed to evaluate the effectiveness of daily LGG supplementation for the first 6 months of life to decrease the incidence of eczema, a potential early marker of asthma.1 For this analysis, we used physician-diagnosed asthma and physician-diagnosed rhinitis as secondary outcomes.To determine the effects of LGG on cumulative incidence of study outcomes, we performed modified intention-to-treat analyses with all participants who received treatment in the study arm to which they had been randomly assigned. We used survival analysis approaches to estimate Kaplan-Meier curves for each treatment group. We used nonparametric log-rank tests to determine differences between treatment groups and failure plots to visualize the cumulative probability of experiencing each outcome during follow-up.We used separate Cox proportional hazards regression models to compare the incidence of each outcome between the intervention and control groups, adjusting for mode of delivery and breastfeeding duration. Breastfeeding duration (in months up to 12) was treated as a time-dependent covariate.All analyses were performed using SAS version 9.4 software (SAS Institute Inc, Cary, NC). P < .05 was set for statistical significance. The protocol was approved by the Albert Einstein College of Medicine Institutional Review Board.Over the 7-year follow-up, 49 (53%) of 92 intervention and 54 (59%) of 92 control participants remained in the study for an overall 56% retention rate. Eczema was diagnosed in 78 participants, asthma in 32, and rhinitis in 15. The mean follow-up time was 5.7 years (median, 7 years). Incidence of eczema was high during infancy but low thereafter. In contrast, incidence rates for asthma and rhinitis were constant during childhood. Although the initial cumulative incidence seemed to favor the intervention in the early years of life for eczema and asthma, this trajectory was not sustained. The results showed no difference in the primary or secondary outcomes (Fig 1). Main findings from the Cox proportional hazards regression model are presented in Table 1. Cesarean delivery was associated with a greater incidence of rhinitis, with a hazard ratio (HR) of 3.33 (95% confidence interval [CI], 1.21–9.21).This follow-up report reveals that early infant LGG supplementation does not affect the cumulative incidence of eczema, asthma, and rhinitis at 7 years of age. Kalliomäki et al2 reported that early LGG supplementation decreases the likelihood of eczema and wheezing; however, their LGG supplementation occurred through both postnatal infant and prenatal maternal supplementation. The effect of LGG supplementation may only be discernable in infants born into high-risk scenarios because of altered gastrointestinal microbiota development3,4 (eg, cesarean delivery, lack of breast milk exposure); however, few TIPS study infants were exclusively fed formula or were cesarean delivered. Although LGG supplementation in infants is associated with significant increases in the similarity of the infant gut microbiota and metabolome to that of an infant at low risk for allergic disease, it does so only for the 6-month period in which LGG is administered.5 It is possible that probiotic supplementation to the mother during pregnancy and/or the infant for a longer period may be more effective.The results presented in Table 1 reveal that breastfeeding may increase the risk of eczema (HR, 11.97); however, the CIs are extremely wide (95% CI, 6.81–21.02), suggesting an unstable estimate. In addition, the effect of breastfeeding is not consistent, as there is no association with asthma or rhinitis incidence; therefore, we cannot clearly interpret this result. There is the potential of a type II error, as the TIPS study was designed to have 80% power to detect an HR <0.66, corresponding with a 10% absolute reduction in the 2-year cumulative incidence of eczema.Despite these limitations of the results, we can build on our earlier report regarding eczema. For this population of infants at higher risk for allergic disease, we cannot support the use of early infant LGG probiotic supplementation for the prevention of eczema, asthma, or rhinitis.

Very Asymmetric Keratoconus: A Case Report of Long-term Follow-up

Very Asymmetric Keratoconus: A Case Report of Long-term Follow-up

Delayed large local reactions to Moderna COVID-19 vaccine: A follow-up report after booster vaccination

To the Editor: In the original phase 3 clinical trial of mRNA-1273 (Moderna) vaccine against SARS-CoV-2 reported in the New England Journal of Medicine, delayed injection site reactions were reported in 244 (0.8%) participants after the first dose and in 68 (0.2%) participants after the second dose.1 These reactions were characterized by erythema, induration, and tenderness; the onset was typically on or after day 8, with the resolution 4 to 5 days later. The first report of delayed large local reactions (DLLRs) in 12 patients who received the Moderna vaccine demonstrated a median onset on day 8 (range, 4-11) after dose 1, including 5 individuals with grade 3 (≥10 cm) plaques.

Deconstructing ADAURA: It is Time to Forgo Adjuvant Platinum-Based Chemotherapy in Resected IB-IIIA EGFR+ NSCLC (Except with RB Alterations?) When Adopting Adjuvant Osimertinib.

Adjuvant cisplatin-based chemotherapy is considered the standard of care for resected stage IB (tumor ≥ 4m)–IIIA non-small cell lung cancer (NSCLC). The ADAURA trial is a randomized placebo-controlled Phase III trial that demonstrated statistically significant improved disease-free survival (DFS) with the use of 3-years of adjuvant osimertinib in resected stage IB–IIIA NSCLC harboring epidermal growth factor receptor (EGFR) del 19 or L858R mutations. Subgroup analysis revealed that the DFS improvement with adjuvant osimertinib is independent of adjuvant chemotherapy in the primary analysis. A recent follow-up report suggested that adjuvant cisplatin-based chemotherapy provided no additional 2-year DFS improvement on top of adjuvant osimertinib regardless of stage (IB, II, or IIIA) and minimal numerical DFS benefit in stage II or IIIA resected EGFR+ NSCLC for those patients who did not receive adjuvant osimertinib. Here, we argue that if clinicians adopt the use of 3 years of adjuvant osimertinib in resected early-stage EGFR+ NSCLC, there is no role for adjuvant platinum-based chemotherapy. The use of adjuvant chemotherapy was balanced between the osimertinib and the placebo arms by stage even though adjuvant chemotherapy was not one of the three stratification factors (del 19 vs L858R; Stage IA vs II vs III; Asians versus non-Asian) in ADAURA. There may be a potential role of adjuvant cisplatin/vinorelbine in a small subgroup of EGFR+ NSCLC patients whose tumor harbors retinoblastoma (RB) gene alterations but requires further investigation.

Management of 3 Avulsed Permanent Teeth: Case Report of a 3-Year Follow-up

Dental avulsion is one of the most serious dental injuries. When the tooth is knocked out, the blood supply to the pulp is interrupted and the periodontal ligament cells are exposed to injuries caused by the external environment. In recent years, research findings have shown the possibility of complete healing under favorable conditions: replanting the tooth according to the criteria required by the guideline such as the extra oral time which should be very short, the time of pulp removal after replantation, and the appropriate storage medium. This set of criteria may lead to a slower progression of the phenomenon of resorption with a better prognosis over time; however, there is a high risk of complications such as external root resorption which lies in late replantation. The research results of many research-groups around the world have given us a better understanding of healing and complications. Nowadays, even teeth that are replanted after a delay can be saved. The dentist remains the key person in the case of dental trauma, namely, dental avulsion as his role is the management of the emergency situations. The objective of this case study is to present a successful management of 3 avulsed permanent incisors, replanted and remained with no complications for over a period of 3 years.

Hemodynamic analysis of hybrid treatment for thoracoabdominal aortic aneurysm based on Newtonian and non-Newtonian models in a patient-specific model

The accuracy of the Newtonian model used in retrograde visceral revascularization (RVR) of hybrid surgery for thoracoabdominal aortic aneurysm (TAAA) hemodynamic simulation remains unclear. Noting that an appropriate blood viscosity model is a significant factor to capture hemodynamic changes in numerical studies. Therefore, both Newtonian and non-Newtonian blood viscosity models were adopted in this study to investigate the importance of hemodynamics when non-Newtonian blood property was accounted for in a patient-specific RVR simulation. The results revealed that disturbed flow and unfavorable WSS distribution can be observed in the anastomosis region under both blood viscosity models due to the retrograde flow pattern in the RVR model. However, although the non-Newtonian blood model has negligible effect on flow pattern and pressure drop, there were of significance quantitative and qualitative difference of local normalized helicity and wall shear stress distribution under pulsatile flow condition. In particular, the unfavorable WSS indicators distribution was better matched with a patient-specific follow-up report when non-Newtonian blood viscosity was accounted for. To conclude, the use of a Newtonian blood model is a reasonable approximation to obtain the general features of the flow field under steady flow condition. However, to study the hemodynamic parameters within retrograde flow under pulsatile flow condition, a non-Newtonian model may be more appropriate.

Knee disarticulation following oncologic total knee arthroplasty: A 5-year follow-up case report

BackgroundThe present case report describes the 5-year follow-up results of an atypical knee disarticulation of a man previously treated with an oncologic total knee arthroplasty due to an Ewing sarcoma. MethodsThe patient presented an aseptic loosened tibial component of a tumor prosthesis system and requested final amputation, as he had previously suffered from five revision surgeries. To encourage the most functional outcome regarding an exoskeletal prosthesis, we decided to disarticulate the knee joint while retaining the currently fixed femoral component to create a full end-bearing stump. FindingsThe patient could be mobilized as a functional knee disarticulated amputee. Seven months after amputation, he showed a slightly less symmetrical gait compared to the preoperative status (preoperative mean Symmetry Index: 0.984 for kinematics and 0.940 for kinetics, 7-month postoperative Symmetry Index: 0.858 and 0.915). At the 5-year follow-up, the femoral component is still stably fixated and shows no loosening signs. In addition, the Symmetry Index increased to 0.908 and 0.949. InterpretationEven after 5 years, the presented amputation appears to be consistent with “conventional” knee disarticulation. The femoral component still withstands the altered loads and the patient shows a further improved gait pattern.

A five-year follow-up report on lung imaging and exercise endurance of a patient with paraquat poisoning

A patient with paraquat poisoning was followed up for five years, and it was showed that the interstitial lesion areas in chest CT of this patient gradually decreased after acute period of the poisoning and no significant changes were found six months later. After that the density of the lesions gradually reduced, while the cystic air cavities slowly increased. In addition, the patient's exercise endurance gradually improved over time, and the lung function was close to the normal level five years after poisoning. The follow-up report helps clinicians to have a deeper understanding of the long-term outcome of paraquat poisoning.

Lentigo Maligna on a Difficult Location of the Face Treated with 5% Imiquimod: A Case Report of 2-Year Follow-Up.

Topical imiquimod is an off-label alternative treatment for lentigo maligna used when surgery cannot be performed. Severe inflammatory response induced by this drug may generate many complaints and force patients to discontinue use. We present a case in which interval treatment with 5% topical imiquimod was implemented for severe inflammatory response. An 82-year-old Caucasian woman presented with a large, irregularly pigmented lesion on her left cheek within the scar of a previously excised melanocytic lesion diagnosed as junctional nevus. Based on dermatoscopical examination confirmed by histopathological description, lentigo maligna was diagnosed. Since the lesion was large and covered the lower left eyelid and due to the risk of disfigurement, the patient refused surgical excision. Therefore, treatment with imiquimod 5% once daily, five times per week, was offered. After 5 weeks, the treatment was stopped because of intense inflammatory reaction and ulceration. On the follow-up visit after 3 months, videodermatoscopical examination revealed changes in the pigmentation of the lentigo maligna including the presence of residual gray dots and fading of the previous dark brown and black colors. The inflammatory response had almost resolved. The second course of treatment with imiquimod five times a week was implemented again for 5 weeks, and after a 2-month interval the third course with the same regimen was started. Total clearance of the lesion was achieved, which was confirmed by videodermatoscopical examination. During the 2-year follow-up, no relapse was observed based on dermatoscopical examination. We propose interval treatment with topical imiquimod 5% lentigo maligna for severe inflammatory reactions in patients with contraindications to surgery. This could help patients overcome this typical response effect and decrease their cessation of treatment.