Long-term Outcome Of Patients Research Articles

Chronic kidney disease as a predictor of long-term adverse cardiovascular outcomes in patients with aortoiliac disease: a prospective cohort study.

Aortoiliac disease poses a significant cardiovascular (CV) risk, especially in individuals with chronic kidney disease. This study aimed to assess the predictive role of chronic kidney disease in long-term major adverse CV events in patients submitted to aortoiliac revascularization due to severe aortoiliac atherosclerotic disease. From 2013 to 2023, patients who underwent aortoiliac revascularization for TASC II type D lesions, including those with chronic kidney disease, were selected from a prospective cohort study. Demographic, clinical, and postoperative data were collected. Prognostic factors were evaluated for their independent impact on outcomes using survival analysis with a multivariate Cox regression model. The study included 135 patients, 93.3% male, with a mean age of 62.39±9.20 years. Chronic kidney disease was associated with higher prevalence of short-term myocardial injury after noncardiac surgery (54.5%, P=0.014) and was a long-term predictor of acute heart failure (Hazard Ratio=4.884; 95% confidence interval 2.377-22.802; P=0.007), major adverse CV events (HR 2.992; 95% CI 1.498-5.975, P=0.002) and all-cause mortality (HR 3.296; 95% CI 1.626-6.682, P<0.001). The multivariable analysis revealed significant associations between major adverse CV events and the following predictors: chronic kidney disease (adjusted HR=2.416, 95% CI 1.171-4.984, P=0.017) and congestive heart failure (adjusted HR=2.633, 95% CI 1.233-5.623, P=0.012). Chronic kidney disease is a recognized CV risk factor and an independent predictor of long-term acute heart failure, major adverse CV events, and all-cause mortality. These findings underscore the importance of early identification of CV complications and stricter long-term follow-up for chronic kidney disease patients undergoing aortoiliac revascularization.

Ten-Year Implant Survivorship and Performance of Anatomic Total Shoulder Arthroplasty Patients with the Zimmer Biomet Comprehensive® Shoulder System - a Short Stemmed Humeral Implant and Hybrid Glenoid.

Anatomic total shoulder arthroplasty are highly successful procedures for treatment of glenohumeral arthritis to reduce pain, improve range of motion, and overall quality of life. However, the long-term survivorship of the implant systems is less widely documented in the existing literature. The purpose of this study was to establish the long-term patient outcomes and identify factors influencing the postoperative implant survivorship of total anatomic shoulder arthroplasty devices/procedures utilizing the short-stemmed prosthesis and hybrid glenoid components of the Comprehensive Shoulder System (Zimmer Biomet, Warsaw, IN, USA) at an average of ten years. Between 2007 and 2015, 159 shoulders in 128 unique patients were sequentially enrolled in the prospective, observational study following their anatomic total shoulder arthroplasty utilizing the Zimmer Biomet Comprehensive Shoulder System with the Mini Stem component and Modular Hybrid Glenoid component variation. Enrolled patients were clinically evaluated on an annual basis following their operation for up to ten years including a physical exam, radiographic evaluation, and patient outcomes via a modified Constant Score and satisfaction. The implant survival rate was 98.1% at ten years. The mean patient age was 70.4± 8.3 years (Range: 50.7-90.3 years) at the time of surgery. Average Constant Scores improved from preoperative to 6 months postoperative with an average of 81.55 ± 16.10 and 84.09 ± 15.12, respectively however there was a statistically significant longitudinal decline in Constant Score with increasing age for an average loss of 0.5 points per year. The overall revision rate for this cohort was 1.26% for a total of two revision cases secondary to external trauma and not implant system related. Anatomic total shoulder arthroplasty with the Comprehensive Shoulder System had a high survivorship rate at the ten-year follow-up with improved clinical results postoperative. Patients had comparable long-term clinical results to the current longitudinal literature regarding survivorship of other implant systems.

Observational Characterization of the Retreatment Course of Patients With Thyroid Eye Disease.

To characterize the retreatment course of patients with thyroid eye disease (TED), who had reactivation after initial therapy with teprotumumab. This was a single-center longitudinal cohort study of patients who received an initial course of teprotumumab for active TED and were followed for at least 6 months. Reactivation was defined as the increase of proptosis of 2 mm or more or an increase in Clinical Activity Score (CAS) of two points or more, as adapted from the Optic-X study. Data collection included patient age, sex, smoking status, history of thyroidectomy or radioactive iodine, proptosis measurements, clinical activity score (CAS) before initial infusion of teprotumumab, time interval to reactivation, diplopia assessment by the Bahn-Gorman scale, CAS at the time of reactivation, and CAS and proptosis measurements after completion of retreatment and retreatment modalities, including clinical monitoring, corticosteroids, teprotumumab, and/or surgery. Among the reactivated cohort, the treatment response of patients who received a second course of teprotumumab was compared with patients who were treated with intravenous (IV) steroids. Twenty-six percent (11/42) of patients experienced reactivation of TED with an average time to reactivation of 9 (SD:5) months (range: 2-20 months), average CAS at reactivation of 4 (SD:1) (range: 3-7), and average increase in proptosis of 3 (SD:1) mm (range: 2-6 mm). Of the 11 patients who reactivated, 4 received a second course of teprotumumab, while 6 received IV steroids. One patient elected to monitor. The patients who received a second course of teprotumumab had a mean (SD) posttreatment CAS score of 0 reduction in proptosis of 4 (2) mm (range: 3-6). The patients who received IV steroids had a mean (SD) posttreatment CAS of 2 (1) (range: 1-4) and a reduction in proptosis of 0 (1) mm (range: [-1] to [2]). Univariate analyses to look at predictors of reactivation found no correlation between factors such as age, sex, duration of TED, smoking status, presence of diplopia, previous treatment with radioactive iodine, history of periorbital surgery, and/or thyroidectomy after initial completion of teprotumumab between the 2 cohorts. We found a significant correlation between the CAS scores before initial treatment (P = 0.036) and thyroid hormone dysregulation (P = 0.006) in those who experienced reactivation. Patients with TED may experience reactivation of the disease after initial therapy with teprotumumab. Reactivated disease responds to repeat therapy with teprotumumab with higher previous CAS and thyroid hormonal dysregulation being the variables that were significantly associated with reactivation. These data underscore the importance of long-term monitoring and exploring underlying triggers for disease reactivation. Understanding these factors could help predict which patients may require retreatment or chronic dosing with teprotumumab. Further studies are essential to advance our understanding of the immunomodulatory effects of teprotumumab, duration of its therapeutic benefit, and potential retreatment strategies to improve long-term patient outcomes.

Long-term Outcomes of Endoscopic Radiofrequency Ablation versus Endoscopic Submucosal Dissection for Widespread Superficial Esophageal Squamous Cell Neoplasia.

Endoscopic radiofrequency ablation (ERFA) is a treatment option for superficial esophageal squamous cell neoplasia (ESCN), with a relatively low risk of stenosis; however, the long-term outcomes remain unclear. We aimed to compare the long-term outcomes of patients with widespread superficial ESCN who underwent endoscopic submucosal dissection (ESD) or ERFA. We retrospectively analyzed the clinical data of patients with superficial ESCN who underwent ESD or ERFA between January 2015 and December 2021. The primary outcome measure was recurrence-free survival. Ninety-two and 33 patients with superficial ESCN underwent ESD and ERFA, respectively. The en bloc, R0, and curative resection rates for ESD were 100.0%, 90.2%, and 76.1%, respectively. At 12 months, the complete response rate was comparable between the two groups (94.6% vs 90.9%, p=0.748). During a median follow-up of 66 months, recurrence-free survival was significantly longer in the ESD group than in the ERFA group (p=0.004), while no significant differences in overall survival (p=0.845) and disease-specific survival (p=0.494) were observed. Preoperative diagnosis of intramucosal cancer (adjusted hazard ratio, 5.55; vs high-grade intraepithelial neoplasia) was an independent predictor of recurrence. Significantly fewer patients in the ERFA group experienced stenosis compare to ESD group (15.2% vs 38.0%, p=0.016). The risk of recurrence was higher for ERFA than ESD for ESCN but overall survival was not affected. The risk of esophageal stenosis was significantly lower for patients who underwent ERFA.

Prognosis Associated with Complete Pathological Response Following Neoadjuvant Treatment for PancreaTic AdenOcarciNOma in the FOFLIRINOX Era: the Multicenter TONO Study.

The use of multiagent FOLFIRINOX chemotherapy for pancreatic adenocarcinoma in a neoadjuvant setting has been associated with an increased rate of complete pathological response (CPR) after surgery. This study investigated the long-term outcomes of patients with CPR in a multicenter setting to identify prognostic factors for overall survival (OS) and recurrence-free survival (RFS). This retrospective cohort study examined biopsy-proven pancreatic adenocarcinomas with CPR after neoadjuvant chemotherapy or chemoradiotherapy and surgery, between January 2006 and December 2023 across 22 French and 2 Belgian centers. Cox analyses were used to identify prognostic factors of OS and RFS. There were 101 patients with CPR after chemotherapy (n = 58, 57.4%) and chemoradiotherapy (n = 43, 42.6%) followed by surgery. Neoadjuvant FOLFIRINOX was used in 90% of patients. The median OS after surgery was 177 months (95% confidence interval (CI) 58.9-177 months) with 1-, 3-, 5-, and 10-year OS rates of 93%, 75%, 63%, and 51%, respectively. The median RFS was 67.8 months (95% CI:34.4-NR) with 1-, 3-, 5-, and 10-year RFS rates of 83%, 58%, 54%, and 49%, respectively. The multivariate Cox analysis of OS and RFS showed that preoperative radiotherapy was an independent negative prognostic factor for OS (hazard ratio (HR) 2.51; 95% CI 1.00-6.30; p = 0.03) and RFS (HR 2.62; 95% CI 1.27-5.41; p = 0.009). Complete pathologic response after neoadjuvant treatment is associated with remarkable long-term survival that is usually not seen after the resection of pancreatic adenocarcinomas. One-third of the patients still experienced disease recurrence, which was more common in those receiving preoperative chemoradiotherapy.

Importance of Post-Reduction CT Scans in Posterior and Transverse Posterior Wall Acetabular Fracture-Dislocations.

To report the frequency of patients with pre- and post-reduction computed tomography (CT) scans associated with acetabular fracture-dislocations and the change of associated intra-articular fragments occurring with joint reduction. Design: Retrospective case series. Regional Level 1 trauma center. Patients who sustained an OTA/AO 62A1 and 62B1 posterior wall or transverse posterior wall acetabular fracture-dislocations with pre- and post-reduction CT imaging from February 2020 until July 2023. Intra-articular fragments were identified and change in position (fossa to cranial, intra-articular to extra-articular, etc.) noted from pre- to post-reduction scans. Operative reports and post-operative CT scans were reviewed to determine the frequency of fragment retrieval. 119 out of 394 (30.2%) patients meeting fracture pattern inclusion received a CT scan prior to hip reduction. Of the 394 patients, 100 (25.9%) had pre- and post-reduction CT scans and were studied (average age of 35.5 years (range 16 - 87 years), 59 male). 45 of 100 patients (45%) had pre-reduction CT imaging demonstrating the presence of intra-articular fragment(s). 30 of 45 patients with a pre-reduction intra-articular fragment (66.7%) had an intra-articular fragment location change during the reduction. Of the 55 patients who did not have an intra-articular fragment on pre-reduction imaging, 28 of 55 (50.9%) had at least 1 intra-articular fragment on the post-reduction CT. Complete fragment retrieval was performed in 71.4% of patients. The study demonstrated 30.2% of patients with posterior wall and transverse posterior wall acetabular fracture-dislocations received a CT scan prior to hip reduction. It was common to find intra-articular fragments on the post-reduction CT in patients who did not have them on the pre-reduction CT. Obtaining and scrutinizing the post-reduction CT scan provided accurate knowledge of the location of all osseous fragments associated with the fracture-dislocations which facilitated thorough preoperative planning, intraoperative implementation, and hopeful long-term patient outcomes. Prognostic Level IV.

The impact of deep response to ursodeoxycholic acid in primary biliary cholangitis - should it be the new clinical standard?

This review explores the emerging concept of "deep response" in primary biliary cholangitis (PBC), defined by the normalization of biochemical markers, particularly alkaline phosphatase and bilirubin. It examines its potential as a new standard for disease management and its implications for long-term patient outcomes, health policies, and clinical decision-making. Recent studies suggest that achieving a deep response significantly improves long-term outcomes in some patients with PBC. In particular, a significant complication-free survival gain was observed among patients who at baseline were at high risk for disease progression. However, limitations in data and the variability in patient populations pose challenges for universal adoption of this standard. Deep biochemical response represents a promising new standard for optimizing PBC management, offering measurable goals for clinicians and potentially improved long-term outcomes for patients. However, further research is necessary to better define the appropriate biochemical thresholds, understand the risks of overprescribing, and identify patient subgroups that are most likely to benefit from this strategy. A balanced, patient-centered approach incorporating deep response into comprehensive management could improve care for high-risk PBC patients.

Patient-Reported Outcomes Following Total Knee Arthroplasty With Multiple Sclerosis Demonstrate Similar Functional Outcome Measures: A Propensity-Matched Analysis

Introduction: Multiple sclerosis (MS) may negatively influence the patient-reported outcomes measures (PROMs) when undergoing total knee arthroplasty (TKA). However, functional outcomes in this select population remains poorly characterized. This study aimed to compare clinical outcomes and rate of achieving Minimal Clinically Important Difference for Improvement (MCID-I) and Minimal Clinically Important Difference for Worsening (MCID-W) between MS and non-MS TKAs. Methods: We did a retrospective analysis of 61 TKAs in MS patients performed between 2015 and 2022 and it was propensity matched in a 3:1 ratio with 123 non-MS patients. Preoperative and postoperative assessments included Patient-Reported Outcomes Measurement Information System Global Health Mental and Physical, Patient-Reported Outcomes Measurement Information System Physical Function short form 10-a (PF-10a), and Knee injury and Osteoarthritis Outcome Score-Physical Function Short-form scores. Patients were categorized based on achieving MCID-I, MCID-W, or showing “no change” after TKA. Results: A total of 244 TKAs (61 MS and 183 matched non-MS) were analyzed. MS TKAs had similar length of stay but lower rate of home discharges (73.8% vs. 90.2%, P = 0.003) compared with non-MS patients. Notably, both cohorts had similar rates of achieving MCID-I and MCID-W among all four PROM scores. However, MS patients had a notable higher rate of 90-day postoperative complications (26.2% vs. 12.6%, P &lt; 0.001), revision surgeries (11.5% vs. 4.4%, P = .045), and revisions (6.6% vs. 0.5%, P = 0.004). Conclusion: Using MCID methodology, this study found that MS patients have similar rates of achieving MCID-I and MCID-W but have higher rate of postoperative complications, revision surgeries, and revisions when compared with non-MS patients. These findings highlight that despite the elevated risks of complications, MS patients can achieve similar improvements to their non-MS counterparts. Further investigations into the long-term outcomes of MS patients are warranted to the determine the effectiveness of this intervention.

Rise in Minimally Invasive Surgery for Colorectal Cancer Is Associated With Adoption of Robotic Surgery.

Minimally invasive surgery is associated with improved short-term outcomes and similar long-term oncologic outcomes for colorectal cancer patients compared with open surgery. Although the robotic approach has ergonomic and technical benefits, how it has impacted utilization of traditional laparoscopic surgery and minimally invasive surgery overall is unclear. Describe trends in open, robotic, and laparoscopic approaches for colorectal cancer resections and examine factors associated with minimally invasive surgery. Retrospective cohort study using data from the National Cancer Database from 2010 through 2020. Commission on Cancer-accredited U.S. facilities. Patients diagnosed with nonmetastatic colon or rectal adenocarcinoma. Surgical approach rates (open, robotic, laparoscopic). We identified 475,001 patients diagnosed with nonmetastatic colorectal adenocarcinoma, of whom 192,237 (40.5%) underwent open surgery, 64,945 (13.7%) underwent robotic surgery, and 217,819 (45.9%) underwent laparoscopic surgery. For colon cancer, laparoscopic minimally invasive surgery use steadily increased, with a peak prevalence of 54.0% in 2016, and total minimally invasive surgery (robotic + laparoscopic) was performed more often than open surgery from 2013 through 2020. For rectal cancer, laparoscopic minimally invasive surgery had a peak prevalence of 37.2% in 2014 and declined from 2014 through 2020; robotic surgery prevalence increased throughout the study period (5.5% in 2010, 24.7% in 2015, 48.8% in 2020). Minimally invasive surgery use increased in facilities performing robotic surgery every year during the study period. For both colon and rectal cancer, use of open surgery decreased across all facilities throughout the study period. Utilized National Cancer Database which may not be generalizable to non-Commission on Cancer institutions. Minimally invasive surgery steadily increased across all facilities from 2010 through 2020. Open resections declined, laparoscopic resections plateaued, and robotic resections increased for colon and rectal cancer. Minimally invasive surgery increases may be driven by increases in robot-assisted surgery. See Video Abstract.

Sex-Based Differences and Outcomes in Unselected Patients Undergoing Coronary Angiography.

Background: The study investigates sex-related differences and outcomes in unselected patients undergoing invasive coronary angiography (CA). Sex-based differences with regard to baseline characteristics and management of patients with cardiovascular disease have yet been demonstrated. However, their impact on long-term outcomes in unselected patients undergoing CA remains unknown. Methods: Consecutive patients undergoing invasive CA from 2016 to 2022 were included at one institution. Prognosis of male and female patients undergoing CA was investigated with regard to the primary endpoint of rehospitalization for heart failure (HF) at 36 months. Secondary endpoints comprised the risk of acute myocardial infarction (AMI) and coronary revascularization at 36 months, as well as in-hospital all-cause mortality. Statistical analyses included Kaplan-Meier analyses, as well as uni- and multivariable Cox proportional regression analyses. Results: From 2016 to 2022, 7691 patients undergoing CA were included (males: 65.1%; females: 34.9%). Males had a higher prevalence of coronary artery disease (CAD) (76.2% vs. 57.4%; p = 0.001), alongside a higher prevalence of 3-vessel CAD compared to females (33.9% vs. 20.3%; p = 0.001). The risk of rehospitalization for HF at 36 months was higher in males compared to females (22.4% vs. 20.3%; p = 0.036; HR = 1.127; 95% CI: 1.014-1.254; p = 0.027), which was no longer observed after multivariable adjustment. Male sex was associated with a higher risk of coronary revascularization (9.6% vs. 5.9%; p = 0.001; HR = 1.659; 95% CI: 1.379-1.997; p = 0.001), which was still evident after multivariable adjustment (HR = 1.650; 95% CI 1.341-2.029; p = 0.001). However, neither the risk of AMI at 36 months (8.1% vs. 6.9%; p = 0.077), nor the risk of in-hospital all-cause mortality (6.9% vs. 6.5%; p = 0.689) differed significantly between the two sexes. Conclusions: In consecutive patients undergoing coronary angiography, male sex was independently associated with an increased risk of coronary revascularization, but not HF-related rehospitalization.

Negative impact of self-reported executive problems in patients with functional/dissociative seizures: Results from a prospective long-term observational study.

Functional/dissociative seizures (FDS) are common and pose a considerable burden on both individual patients and healthcare systems. Cognitive complaints are frequent in patients with FDS. Previous studies on cognitive function in patients with FDS have yielded mixed results. We investigated executive function and its impact on long-term outcome in a prospective sample of patients with FDS. Thirty-three inpatients (age range: 16-62 years) who had been admitted to the National Centre for Epilepsy in Norway with FDS underwent neuropsychological assessment for both tested and self-reported executive function, using the Behavior Rating Inventory of Executive Function, at baseline. Participants were evaluated for their medical status at a mean of 5.5 years (SD 2.4, range 1.9-10.9 years) after inclusion. To determine potential predictors of achieving cessation of FDS by time of follow-up a multivariate logistic regression analysis was conducted. At follow-up, 14/33 (42 %) of the participants were FDS-free. Self-reported, but not tested, executive dysfunction was an independent risk factor for ongoing FDS at follow-up. Our findings indicate an association between greater self-reported executive problems and poorer long term outcomes in patients with FDS. Screening for executive dysfunction with a self-report questionnaire may yield relevant information that could be used to guide psychological interventions.

Impact of Updated Invasive Right Ventricular and Pulmonary Hemodynamics on Long-Term Outcomes in Patients With Mitral Valve Transcatheter Edge-to-Edge Repair

Right-sided cardiac catheterization (RHC) is selectively recommended in mitral valve transcatheter edge-to-edge (M-TEER) workup because right ventricle (RV) hemodynamic parameters predict adverse outcomes. This study examines the impact of RV hemodynamics and the prognostic value of the 2022 European Society of Cardiology (ESC) pulmonary hypertension definitions on outcomes after M-TEER. Of 152 patients treated with M-TEER for symptomatic severe mitral regurgitation (MR) between December 2014 and February 2024 at our tertiary center, 71 underwent elective RHC before the procedure. The primary outcomes assessed were all-cause mortality and a composite of heart failure hospitalization and death at the longest available follow-up. In a cohort of 152 mostly male patients (64%) with a median age of 79 years who were treated for symptomatic severe MR, 71 underwent elective RHC. The causes were categorized as degenerative (47%), functional ventricular (41%), and atrial (12%). Pulmonary hypertension (PH) was common, with 74% showing mean pulmonary artery pressure (mPAP) >20 mm Hg and 39% with pulmonary vascular resistance (PVR) >2 Wood Units. Success rates were high, with technical, device, and procedural success at 97%, 88%, and 84%, respectively. At a median follow-up of 681 days, all-cause mortality was 50%, and the composite outcome (death or heart failure hospitalizations) occurred in 61%. Key hemodynamic parameters, including mPAP, PVR, and the tricuspid annular plane systolic excursion/systolic pulmonary artery pressure ratio, were independently linked to mortality risk. Kaplan-Meier analysis found significant associations with mPAP >20 mm Hg and pulmonary capillary wedge pressure >15 mm Hg for long-term mortality, whereas the 2022 ESC PH thresholds showed greater sensitivity, correlating with increased mortality risk. In patients with severe MR who undergo M-TEER, most RV invasive hemodynamic parameters are linked to adverse long-term outcomes, with mPAP, PVR, and the tricuspid annular plane systolic excursion/systolic pulmonary artery pressure ratio identified as independent predictors of mortality. Despite the study's limited sample size, the updated ESC PH definitions enhance prognostic assessment.

Long-term Outcomes of Patients with Anal Canal Adenocarcinoma who Underwent Surgical Resection

Long-term Outcomes of Patients with Anal Canal Adenocarcinoma who Underwent Surgical Resection

Impact of Standardized Heart Failure Management Center Construction on the Management of Patients With Chronic Heart Failure.

Heart failure is extremely harmful to human health and social economics. The purpose of standardized heart failure management center (SHFMC) is to correct the non-standardization of heart failure treatment. SHFMC has a positive impact on the management and prognosis of patients with chronic heart failure (CHF). The SHFMC database of Jiaxing First Hospital was retrospectively analyzed. Two hundred sixty-three patients with CHF who were hospitalized in the cardiovascular medicine department of Jiaxing First Hospital in Zhejiang Province from January 2020 to December 2020 were identified as study subjects. The SHFMC opening day, July 1, 2020, was used as the dividing line around which the patients were divided into Group A (before the completion of SHFMC, n = 137) and Group B (after, n = 126). The baseline data, treatment standardization, long-term efficacy, 1-year all-cause mortality, and readmission rate of the two groups were compared. The use of angiotensin receptor enkephalinase inhibitors (ARNIs), β-blockers (β-Bs), and sodium-glucose cotransport protein 2 inhibitors (SGLT2is) increased significantly, and the long-term outcome, readmission rate, and 1-year all-cause mortality of patients improved in group B. The construction of SHFMC has been associated with consistent improvements in the standardization of CHF treatment, long-term patient outcomes, 1-year cumulative survival rates, and readmission rates.

النمذجة التنبؤية المعتمدة على الذكاء الاصطناعي في إدارة الأمراض المزمنة

By facilitating early detection, individualized therapy, and better patient outcomes, AI-driven predictive modeling holds the potential to completely transform the management of chronic diseases. Artificial intelligence (AI) algorithms are able to recognize complex patterns and forecast an individual's future health by evaluating massive datasets from several sources, such as wearable technology, electronic health records, and demographic data.aAI-powered predictive modeling represents a breakthrough in chronic disease management by enabling early detection, personalized treatment, and improved health outcomes for patients. Algorithms rely on analyzing massive datasets from multiple sources, with edge computing, data can be analyzed locally, reducing response time and accelerating decision-making quick decision-making, Therefore, the purpose of this study is to clarify the gaps resulting from the traditional management of chronic diseases by exploring the various roles of predictive modeling based on artificial intelligence. This will be done by enumerating some of these gaps and highlighting the reasons why AI-based methods may be useful in addressing them, particularly in providing more details regarding the latest developments aimed at enhancing long-term health outcomes for patients. To achieve this, a descriptive analytical approach was adopted to study and analyze the current technologies used, along with conducting an in-depth analysis of the impacts these technologies may have on health outcomes. Keywords: AI-driven healthcare, predictive analytics, chronic disease management, personalized treatment, data privacy.

Long-term outcome and social-intellectual ability of patients with basal ganglia germinoma

Long-term outcome and social-intellectual ability of patients with basal ganglia germinoma

DITTO: A Visual Digital Twin for Interventions and Temporal Treatment Outcomes in Head and Neck Cancer.

Digital twin models are of high interest to Head and Neck Cancer (HNC) oncologists, who have to navigate a series of complex treatment decisions that weigh the efficacy of tumor control against toxicity and mortality risks. Evaluating individual risk profiles necessitates a deeper understanding of the interplay between different factors such as patient health, spatial tumor location and spread, and risk of subsequent toxicities that can not be adequately captured through simple heuristics. To support clinicians in better understanding tradeoffs when deciding on treatment courses, we developed DITTO, a digital-twin and visual computing system that allows clinicians to analyze detailed risk profiles for each patient, and decide on a treatment plan. DITTO relies on a sequential Deep Reinforcement Learning digital twin (DT) to deliver personalized risk of both long-term and short-term disease outcome and toxicity risk for HNC patients. Based on a participatory collaborative design alongside oncologists, we also implement several visual explainability methods to promote clinical trust and encourage healthy skepticism when using our system. We evaluate the efficacy of DITTO through quantitative evaluation of performance and case studies with qualitative feedback. Finally, we discuss design lessons for developing clinical visual XAI applications for clinical end users.

Long-term clinical outcomes of asymptomatic patients with spontaneous type 1 Brugada electrocardiographic pattern undergoing electrophysiological study for risk stratification.

Long-term clinical outcomes of asymptomatic patients with spontaneous type 1 Brugada electrocardiographic pattern undergoing electrophysiological study for risk stratification.

Long-term outcomes of pediatric hepatoblastoma patients who present with metastasis and receive liver transplantation

Long-term outcomes of pediatric hepatoblastoma patients who present with metastasis and receive liver transplantation

Prevalence and factors influencing eating disorders among post-bariatric surgery patients in Saudi Arabia: A cross-sectional study.

To examine the occurrence and contributing factors of disordered eating patterns in individuals post-bariatric surgery. It also investigated the impact of these patterns on weight loss outcomes and long-term weight management, focusing on psychological and emotional factors. Additionally, the relationship between body image dissatisfaction and disordered eating patterns was explored. A cross-sectional study was conducted across multiple medical centers in Saudi Arabia, using self-administered questionnaires to evaluate the prevalence of eating disorders and self-esteem among patients who underwent bariatric surgery in the past five years. Out of 557 respondents, 452 met the inclusion criteria. The study found that 21.5% of participants experienced psychological disorders post-surgery. Notably, there was a significant improvement in mean self-esteem scores after surgery. Depression was the most frequently reported disorder (12.4%), followed by Generalized Anxiety Disorder (9.3%) and Eating Disorders (4.6%). The mean Rosenberg Self-esteem Scale score increased significantly from 28.17±6.2 pre-surgery to 31.7±5.3 post-surgery (p<0.001). The findings highlight a notable prevalence of psychological disorders among post-bariatric surgery patients, with depression being the most common. Despite this, significant improvements in self-esteem were observed. Understanding the psychological and emotional factors contributing to disordered eating patterns and body image dissatisfaction is crucial for improving long-term weight management and patient outcomes post-surgery.