Prospective Follow-up Study Research Articles

Family Health Care Needs in a Pediatric Population 6 Months After Moderate and Severe Physical Trauma

Background: Traumatic injury is a leading cause of death and disability in children and young adults. There is a lack of evidence-based literature and guidelines on supporting families after severe child injury. This study aimed to assess the family needs and factors associated with those needs. Methods: A prospective multicenter follow-up study conducted at two Norwegian trauma centers involving children (aged 0–18 years) who sustained a moderate or severe traumatic injury with a New Injury Severity Score > 9. Sociodemographic and injury variables were recorded at baseline. The Family Needs Questionnaire—Paediatric Version, ranging from one (not at all met) to five (completely met) was completed by parents to assess the family needs at the 6-month follow-up. Bivariate logistic regression analyses were conducted to identify the factors associated with the family needs at 6 months post-injury. Results: Of the 63 children included, 38 (68% boys) with a mean age of 9.9 years (SD = 5.8) were available for follow-up. At 6 months, 82% reported needs for health information with a mean score of 3.8 (SD = 1.0), and involvement with care with a mean of 3.7 (SD = 1.2). Additionally, 71% reported emotional support needs (mean score 2.6, SD = 1.3). A higher number of injuries and a lower age of the child were significantly associated with increased odds of having more family needs. Conclusions: After moderate to severe pediatric traumatic injury, families report a need for health information, involvement in care, and emotional support. Paying attention to the number of injuries and the child’s age could help to identify families in need of information and support.

Early remission of deliberate self-harm predicts emotion regulation capacity in adulthood: 12.4 years follow-up of a randomized controlled trial of adolescents with repeated self-harm and borderline features

AbstractEmotion regulation capacity, critical for adult functioning and mental health, develops strongly during adolescence in healthy individuals. Deficits in emotion regulation is often referred to as emotion dysregulation [ED] and is associated with various mental health problems, including repeated deliberate self-harm [DSH] which peaks in adolescence. Dialectical Behaviour Therapy for adolescents [DBT-A] systematically targets ED through strategies such as changing coping behaviours and has previously been shown to effectively induce DSH remission in adolescents. However, whether such remission is associated with improved emotion regulation capacity in adulthood, and whether this effect is mediated by changes in use of coping strategies has not been previously studied. Prospective long-term follow-up study of an RCT comparing DBT-A with enhanced usual care [EUC] for adolescents presenting to community child and adolescent psychiatric outpatient clinics with borderline personality features and repeated self-harm. Assessments included both structured interviews and self-report at baseline and 1.6, 3.1 and 12.4 years follow-up. In the final follow-up, adult ED was measured and data were collected for 61 (80%) of the original 77 participants. DSH remission was assessed at 1.6 years follow-up, and use of coping strategies at 3.1 and 12.4 years follow-ups. A mediation analysis was conducted within a causal inference framework. Both treatment groups increased their use of functional coping skills from adolescence to adulthood, while only DBT-A was associated with decreases in dysfunctional coping. There was a direct effect of DSH remission 1 year after treatment on adult ED, particularly for participants who did not receive DBT-A. There was a negative association between reductions in dysfunctional coping and adult ED, however this did not mediate the effect of DSH remission. This is the first study to report that early DSH remission in adolescence predicted lower ED in adulthood. These results highlight the importance of early DSH remission and provides new insight into the long-term relationship between DSH and ED. Clinical trial registration information: “Treatment for Adolescents with Deliberate Self-harm”; http://ClinicalTrials.gov/;NCT00675129

Characteristics of adolescents with acute alcohol intoxication in Belgium

Abstract Background Binge drinking and acute alcohol intoxication (AAI) are common in Belgian adolescents, posing a risk of serious health consequences. To develop cost-effective preventive measures for problematic alcohol use in adolescents in Belgium, more insight into the background of this group is necessary. Methods To gain more insight into the prevalence, medical characteristics and context of AAI, a retrospective multicentre hospital chart study was performed on adolescents aged 10 to 18 years with AAI in Antwerp, Belgium from 2015-2021. Furthermore, a prospective intervention study for adolescents with AAI in Antwerp was set up in 2023, of which the first results were not yet known at the time of submission. However, these results will be presented at the conference, if available. Results Over the study period, a total of 1032 admissions related to alcohol intoxication occurred in 1016 patients, with a median age of 16.6 years old and a median blood alcohol intoxication (BAC) of 1.95 g/L. There was combined drug use in 10% of the cases. Only 17% of the patients received additional care after admission. These findings did not significantly change over the study period. Multiple linear regression analyses indicated that after correcting for covariates, higher age, no combined drug use and decreased consciousness at admission were associated with more severe AAI cases (higher BAC). Conclusions AAI is prevalent among Belgian adolescents. Therefore, better-targeted preventive measures and policies are needed. Our findings could be taken into account when developing preventive measures. However, data addressing the demographics and context of AAI were mostly missing. Therefore, a prospective follow-up study was set up in Antwerp, which started in 2023 and is still ongoing. Furthermore, this study will investigate the feasibility and effectiveness of a follow-up intervention for this group of patients.

Associations between biomarkers and P-wave indices in patients with heart failure

Abstract Background Atrial structural abnormalities linked to the risk of atrial fibrillation (AF), as indicated by P-wave indices on surface ECG, are associated with the fibrotic transformation of the atrial myocardium. To what extent incident AF can be predicted by ECG characteristics in patients with advanced atrial structural remodeling, such as patients with heart failure (HF), is less well studied. Purpose To evaluate the association between P-wave indices and biomarkers implicated in cardiac fibrosis, and incident AF in patients with HF. Methods Patients with new-onset or worsening of HF were prospectively recruited in a observational study (n=501) and followed-up for 5 years. Blood samples were collected for analysis using proximity extension assay that included a subset of biomarkers that were associated with fibrosis development (TIMP-2, MMP-2, MMP-3, MMP-9, ST-2, GDF-15, Gal-3). All ECGs ever recorded in the hospital catchment area were exported in digital format and processed using Glasgow algorithm for calculation of the P-wave indices (P-wave duration [PWD], P-wave terminal force in V1 [PTFV1] and P-wave axis [Paxis]) and rhythm identification. AF diagnosis was ascertained by manual ECG review. Only patients who did not have AF reported or ECG documented at enrolment were included in the analysis. Of those subjects, 121 patients also had biomarkers of fibrosis analyzed. Cox-regression analyses were used to assess biomarkers’ and p-wave indices’ associations with incident AF. Results After exclusion of patients with prevalent AF (n=317), 184 patients comprised the study group (mean age of 71 years, 33.2% women, 121 patients with biomarker data available). During follow-up, incident AF was observed in 39 patients. At enrolment, PWD>120 ms was observed in 38.7%, abnormal PTFV1>40 mm*ms in 24.5% and Paxis<0° in 5.4%. Among the seven biomarkers assessed, five demonstrated significant associations with incident AF in adjusted analyses: TIMP4 (HR 1.78; 95%CI 1.03-3.05; p=0.037); MMP2 (HR 1.97; 95%CI 1.03-3.80; p=0.042), MMP3 (HR 1.39; 95%CI 1.03-1.88; p=0.031); ST2 (HR 1.91; 95%CI 1.29-2.83; p=0.001) and GDF-15 (HR 2.56; 95%CI 1.50-4.35; p=0.001) (Figure 1). However, none of the tested P-wave variables (P-wave duration, P-wave terminal force, and P-wave axis) were associated to incident AF. Conclusions In this prospective long-term follow-up study of patients admitted for acute HF, biomarkers with proven associations to fibrosis were strongly associated with incident AF. P-wave indices used for prediction of AF in epidemiological cohorts appear to have limited value in patients with HF who have high prevalence of ECG atrial abnormalities at baseline.

Sustained Symptomatic Remission and Recovery and Their Loss Among Patients With Borderline Personality Disorder and Patients With Other Types of Personality Disorders: A 24-Year Prospective Follow-Up Study.

Sustained Symptomatic Remission and Recovery and Their Loss Among Patients With Borderline Personality Disorder and Patients With Other Types of Personality Disorders: A 24-Year Prospective Follow-Up Study.

Associations between Kidney Disease Progression and Metabolomic Profiling in Stable Kidney Transplant Recipients-A 3 Year Follow-Up Prospective Study.

Background: kidney transplant recipients are exposed to multiple pathogenic pathways that may alter short and long-term allograft survival. Metabolomic profiling is useful for detecting potential biomarkers of kidney disease with a predictive capacity. This field is still under development in kidney transplantation and metabolome analysis is faced with analytical challenges. We performed a cross-sectional study including stable kidney transplant patients and aimed to search for relevant associations between baseline plasmatic and urinary metabolites and relevant outcomes over a follow-up period of 3 years. Methods: we performed a cross-sectional study including 72 stable kidney transplant patients with stored plasmatic and urinary samples at the baseline evaluation which were there analyzed by nuclear magnetic resonance in order to quantify and describe metabolites. We performed a 3-year follow-up and searched for relevant associations between renal failure outcomes and baseline metabolites. Between-group comparisons were made after classification by observed estimated glomerular filtration rate slope during the follow-up: positive slope and negative slope. Results: The mean estimated GFR (glomerular filtration rate) was higher at baseline in the patients who exhibited a negative slope during the follow-up (63.4 mL/min/1.73 m2 vs. 55.8 mL/min/1.73 m2, p = 0,019). After log transformation and division by urinary creatinine, urinary dimethylamine (3.63 vs. 3.16, p = 0.027), hippuric acid (7.33 vs. 6.29, p = 0.041), and acetone (1.88 vs. 1, p = 0.023) exhibited higher concentrations in patients with a negative GFR slope when compared to patients with a positive GFR slope. By computing a linear regression, a significant low-strength regression equation between the log 2 transformed plasmatic level of glycine and the estimated glomerular filtration rate was found (F (1,70) = 5.15, p = 0.026), with an R2 of 0.069. Several metabolites were correlated positively with hand grip strength (plasmatic tyrosine with r = 0.336 and p = 0.005 and plasmatic leucine with r = 0.371 and p = 0.002). Other urinary metabolites were found to be correlated negatively with hand grip strength (dimethylamine with r = -0.250 and p = 0.04, citric acid with r = -0.296 and p = 0.014, formic acid with r = -0.349 and p = 0.004, and glycine with r = -0.306 and p = 0.01). Conclusions: some metabolites had different concentrations compared to kidney transplant patients with negative and positive slopes, and significant correlations were found between hand grip strength and urinary and plasmatic metabolites.

Mandibular Implant-Supported Overdentures Using Telescopic Crowns and Immediate Loading Protocol: A 2-Year Prospective Follow-up Study.

Implant-supported overdentures have been an effective treatment method for edentulous mandibles. However, the loading time after implant placement is still controversial. The purpose of this study was to evaluate the outcome of implant-supported overdentures using telescopic crowns for the treatment of edentulous patients with immediate loading protocol. This study was conducted on 22 edentulous mandibular patients visiting the Department of High Technique, National Hospital of Odonto - Stomatology, Ho Chi Minh City, Vietnam for prosthodontic rehabilitation. Each patient received four interforaminal implants. Immediate loading protocol was applied, and Ankylos Syncone copings systems was used to connect the prosthesis and the implants. The survival rate of implants and prostheses, as the primary outcome, were evaluated at 6 months, 01 year, and 02 years post-surgery. Peri-implant tissue condition, peri-implant bone loss, and patient satisfaction were the secondary outcomes. The implant survival rate was 98.9% with 01 failed implant. The peri-implant bone loss changes after 6 months, 01 year, and 02 years were 0.07 ± 0.22 mm, 0.12 ± 0.3 mm, and 0.15 ± 0.2 mm, respectively. No gingival hyperplasia was recorded. The prosthesis survival rate was 86.4% with 1 fractured overdenture, 1 overdenture relining and 1 abutment fracture. Mandibular rehabilitation using implant-supported overdenture with telescopic crowns and immediate loading protocol showed high survival rates of both implant and prosthesis in 2-year follow-up.

Prospective study of restless legs syndrome in a blood donors' sample.

Blood donation is suggested to increase the risk of Restless Legs Syndrome (RLS). This study aims to assess the prevalence of RLS in Spanish blood donors and determined its potential correlation with iron metabolism parameters. Prospective cohort study of 129 blood donors (54.3% men, 39.44 years ± 11.0) that underwent a physical examination, blood analysis (hemoglobin, ferritin, transferrin saturation index and soluble transferrin receptor) and a RLS screening questionnaire followed by a prospective follow-up study including a clinical phone interview. A multivariate logistic regression model was performed to examine the association between RLS and other variables. Eighty-four (65.1%) participants were repeat blood donors (mean of 2.11 donations/year) at inclusion and 61 (47.4%) at follow-up (mean of 2.09 donations/year). Non-anemic iron deficiency (ferritin < 50 µg/L) was high in women p < 0.001 and in repeat donors (p = 0.003). The prevalence of RLS was 14.1% at inclusion increasing prospectively (19.5%; p = 0.065). On multivariate analysis, gender was the only variable significantly associated with a RLS diagnosis, being higher in women (OR 5.1; 95% CI 1.71-15.3; p = 0.003). Despite the high prevalence of non-anemic iron deficiency there was no association between ferritin, soluble transferrin receptor concentration values and RLS diagnosis. Gender was associated with RLS diagnosis regardless of other variables.

A prospective study on the cardiorespiratory effects of air pollution among residents of the Tibetan Plateau

The Tibetan Plateau is characterized by high ozone concentration which poses a significant public health concern. However, the causal evidence linking ozone pollution to adverse cardiopulmonary health impacts, as well as the understanding of its underlying biological mechanisms, remains limited. Additionally, exposure levels to particulate and other gaseous air pollutants along with their associated health effects in this region are largely unknown. To address these gaps, we conducted a prospective follow-up study in Tibet from May 2021 to November 2021. In consideration of the potential synergistic effects of chronic hypobaric hypoxia, two Tibetan cities with different altitudes, Lhasa (3650 m) and Nyingchi (3000 m), were chosen to implement atmospheric monitoring and health measurement. We employed cutting-edge, high-precision instruments at stationary monitoring sites to measure ambient air pollution and collected particle samples. Portable devices were used to monitor personal exposure levels of ozone and black carbon. A total of 212 healthy Tibetan college students participated in up to four clinical visits, yielding 774 visits in total, during which functional endpoints were measured and biological samples were collected. The primary aim of this study is to evaluate the cardiorespiratory effects of ambient ozone under hypoxic conditions, where its impact may be amplified due to the region's unique environmental characteristics. The secondary aim is to provide a comprehensive assessment of other air pollutants, including their exposure levels, sources, and health effects. By addressing these aims, the study offers valuable insights into air quality and its health implications in this unique high-altitude setting. This paper outlines the research motivation, measurement framework, and preliminary findings.

Prospective Follow-Up Study on Anti-Tpo Antibodies and Anti-Tg Antibodies in Euthyroid Subjects

Prospective Follow-Up Study on Anti-Tpo Antibodies and Anti-Tg Antibodies in Euthyroid Subjects

The Chinese visceral adiposity index: a novel indicator more closely related to cardiovascular disease than other abdominal obesity indices among postmenopausal women

BackgroundSeveral abdominal obesity indices including waist circumference (WC), waist–hip ratio (WHR), visceral adiposity index (VAI), lipid accumulation product (LAP), and Chinese visceral adiposity index (CVAI) were considered effective and useful predictive markers for cardiovascular disease (CVD) in general populations or diabetic populations. However, studies investigating the associations between these indices among postmenopausal women are limited. Our study aimed to investigate the associations of the five indices with incident CVD and compare the predictive performance of CVAI with other abdominal obesity indices among postmenopausal women.MethodsA total of 1252 postmenopausal women without CVD at baseline were analyzed in our investigation based on a 10-year follow-up prospective cohort study. Link of each abdominal obesity index with CVD were assessed by the Cox regression analysis and the Kaplan–Meier curve. The receiver operating characteristic (ROC) curves were drawn to compare the predictive ability for CVD.ResultsDuring the median follow-up of 120.53 months, 121 participants newly developed CVD. Compared to quartile 1 of LAP and CVAI, quartile 4 had increased risk to develop CVD after fully adjusted among postmenopausal women. When WC, VAI and CVAI considered as continuous variables, significant increased hazard ratios (HRs) for developing CVD were observed. The areas under the curve (AUC) of CVAI (0.632) was greatly higher than other indices (WC: 0.580, WHR: 0.538, LAP: 0.573, VAI: 0.540 respectively).ConclusionsThis study suggested that the abdominal obesity indices were associated with the risk of CVD excluded WHR and highlighted that CVAI might be the most valuable abdominal obesity indicator for identifying the high risk of CVD in Chinese postmenopausal women.

Anthropometric recovery of children 6-59 months with complicated severe acute malnutrition, treated in public hospitals of Sana’a City

Background: The management of severe acute malnutrition (SAM) in inpatient therapeutic feeding centers (TFCs) is a life-saving intervention for children 6-59 months in Yemen. Aims: To evaluate the anthropometric recovery of children admitted to the TFCs and transferred to complete treatment in outpatient programs (OTPs) of Sana’a City Public Hospitals. Methods: A prospective follow-up study for children admitted to TFCs from September 2023 to April 2024 was conducted. The anthropometry measurements of the Weight-for-Height Z score (WHZ) and Mid-Upper Arm Circumference (MUAC) were calculated and used to follow the progression in recovery until the discharge from OTPs. Results: Of the total 150 children admitted to TFCs, 48 (32%) were males, and 75 (50%) were aged 6-&lt;12 months; 99 (66%) had both WHZ &lt;-3 and MUAC &lt;11.5); 25 (17%) had WHZ &lt;-3; and 26 (17%) had MUAC&lt;11.5 cm. At the point of transfer from TFCs, 72% (108) were with SAM, and 28% (42/150) with Moderate Acute Malnutrition (MAM). At discharge from OTP, 19% (28/150) were with non-acute malnutrition (NAM); the progression to NAM was among 48% (20/42) and 7% (8/108) of children transferred with MAM and SAM, P value (&lt;0.001). In conclusion, 88% (132/150) of children transferred from TFCs were discharged as cured from OTP, 21% (28/132) of them were anthropometrically recovered, and 79% were prematurely discharged.

Effect of various active reminders via mobile phone on cooperation of orthodontic teenage patients regarding oral hygiene and ClassII elastics use : Athree-month follow-up prospective cohort study.

The purpose of this prospective cohort study was to assess the impact of reminders via mobile phone, such as text messages or video/multimedia images, on orthodontic patients' cooperation with regard to oral hygiene and the use of ClassII intermaxillary elastics. The study included 124 orthodontic patients aged 12-20years (mean age14.06 ± 2.0 years, 63females and 61males). The patients were divided into two groups: group1 (n = 56) was evaluated for oral hygiene, while group2 (n = 68) was evaluated for the use of ClassII intermaxillary elastics. Each main group was divided into three subgroups: text message group, video message group, and control group. Specific messages were sent to the participants in the study groups twice aweek for 12weeks. Data were collected at the beginning of the study (T0), after 6weeks (T1), and 12weeks (T2) and compared to determine the impact of the reminders. Oral hygiene was evaluated using plaque and gingival index scores, and the use of ClassII elastics was evaluated using digital model measurements. Between-subject comparisons were performed using Kruskal-Wallis or one-way analysis of variance (ANOVA). For within-subject comparisons (T0-T1, T1-T2, and T0-T2 time intervals), one-way repeated measures ANOVA or Friedman test was performed. There was no significant difference between the control group (1.49 ± 0.22) and the message groups (video: 1.58 ± 0.34 and text: 1.51 ± 0.28) in terms of plaque index scores and gingival index (control: 1.56 ± 0.26, text: 1.51 ± 0.36, video: 1.52 ± 0.26) scores. However, in the intragroup comparison, it was observed that both plaque index scores and gingival index scores at T0, T1, and T2 increased for both the study and control groups. While there was no difference between the subgroups in overjet measurement at T0 (control: 3.46 ± 1.20, video: 3.34 ± 1.20, text: 2.73 ± 1.03; p = 0.51), there was asignificant difference at T2 (control: 2.62 ± 0.85, video: 2.32 ± 1.41, text: 1.48 ± 0.72, p < 0.01). Mobile active reminders had no effect on improving oral hygiene. Despite repeated reminders, hygiene worsened over time. The use of ClassII elastics seemed to have increased as aresult of the mobile reminders.

The Impact of Ambient Air Pollution on Allergic Rhinitis Symptoms: A Prospective Follow-Up Study.

Air pollution has become a serious public health problem and there is evidence that air pollution affects the incidence of allergic rhinitis. To further investigate the effect of ambient air pollutants on the severity of allergic rhinitis symptoms, a prospective follow-up study in patients with allergic rhinitis was conducted. A total of 167 allergic rhinitis patients with a mean age of 35.4 years, who were visiting the hospital, were enrolled. The daily symptom severity of allergic rhinitis and the concentrations of six air pollutants, including PM2.5, PM10, SO2, CO, O3 and NO2, were collected through follow-up investigations. The impact of ambient air pollutants on symptom severity was assessed via multi-pollutant models. Among several typical ambient air pollutants, we observed correlations of allergic rhinitis symptoms with PM2.5, PM10, CO, SO2 and NO2, whereas O3 showed no such correlation. Specifically, PM2.5 and PM10 were significantly associated with sneezing and nasal blockage. NO2 was significantly correlated with symptoms of rhinorrhea, itchy nose and itchy eyes. CO was significantly linked to sneezing and nasal blockage symptoms. These air pollutants not only had a direct impact on allergic rhinitis symptoms but also exhibited a lagging effect. This study indicates that short-term exposure to air pollutants is associated with exacerbation of nasal symptoms in patients with allergic rhinitis, leading to a decline in their quality of life.

A prospective 10-year follow-up study after sublobar resection for ground-glass opacity-dominant lung cancer

This single-arm multi-institutional prospective study aimed to evaluate the 10-year outcomes of sublobar resection for small-sized ground-glass opacity-dominant lung cancer. Among 73 patients prospectively enrolled from 13 institutions between November 2006 and April 2012, 53 ground-glass opacity-dominant lung cancer patients underwent sublobar resection with wedge resection as the first choice. The inclusion criteria were maximum tumor size of 8–20 mm; ≥ 80% ground-glass opacity ratio on high-resolution computed tomography; lower 18F-fluorodeoxyglucose accumulation than the mediastinum; intraoperative pathological diagnosis of adenocarcinoma in situ; and no cancer cells on intraoperative cut margins. The primary endpoint was a 10-year disease-specific survival. The 53 eligible patients had a mean tumor size of 14 ± 3.4 mm and a mean ground-glass opacity ratio of 95.9 ± 7.2%. Wedge resection and segmentectomy were performed in 39 and 14 patients, respectively. The final pathological diagnoses were adenocarcinoma in situ in 47 patients (88.7%) and adenocarcinoma with mixed subtype in 6 patients (11.3%). The 10-year disease-specific survival and overall survival were 100% and 96.2%, respectively, during a median follow-up period of 120 months (range, 37–162 months). Ground-glass opacity-dominant small lung cancer is cured by sublobar resection when patients are strictly selected by the inclusion criteria of this study.

Quality of life and abdominal wall functionality after abdominal wall reconstruction: A prospective single center follow-up study

BackgroundFascial breakdown with the occurrence of an incisional hernia (IH) is an important and challenging complication of any laparotomy. For a long time, the success of the abdominal wall reconstruction (AWR) was measured only from the surgeon’s perspective by defining outcome measures such as wound morbidity and recurrence. The understanding that complete recovery is difficult to assess without considering patients has shifted the paradigm of optimal outcomes to Patient Reported Outcome Measures (PROMS) and Quality of Life (QoL), which are pivotal to evaluate the success and efficacy of AWR.MethodsWe conducted a prospective follow-up study of 91 patients undergoing mesh-augmented abdominal wall reconstruction for primary or recurrent incisional hernia between January 2021 and December 2023. Demographic data, comorbidities, and hernia characteristics were recorded. All patients were evaluated preoperatively by a native abdomino-pelvic CT scan to assess the characteristics of hernia (length, width, surface, and volume of the incisional hernia sac and of peritoneal cavity), the presence of mesh (if previously inserted), and abdominal wall muscles status. All intervention were performed by the same surgical team according to the techniques described by Rives – Stoppa (RS), Ramirez (ACS), and Novitsky (PCS). Abdominal wall function was assessed using trunk raising (TR) and double leg lowering (DLL) measurements performed preoperatively, 1 month, 6 months, and 1 year postoperatively. At the same time, pre- and post-operative quality of life was analysed using the EQ-5D score.ResultsMean age of 59.42 ± 12.28 years and a male/female ratio of 35/56 were recorded, most of them being obese. There were 36 (42%) patients with defects larger than 10 cm. The distribution of the type of surgical intervention was: RS 35 patients, ACS 13 patients, and PCS 43 patients. The mean value of combined score for the preoperative abdominal wall functionality was 4.41 ± 1.67 (2–8) while the mean value of preoperative EQ-5D index was 0.652 ± 0.026 (-0.32–1.00). QoL was poor and very poor for 48% (44) of the patients who recorded index values less than 0.56 (50% percentile). Preoperative EQ-5D index was highly correlated with Combined AWF score (r = 0.620; p < 0.0001) and the correlation was specific (AUC = 0.799; p < 0.0001; asymptotic 95%CI = 0.711–0.923). At 12 months, the AWF score increased to 8.13 ± 2.58 (1–10) and the QoL total score to 0.979 ± 0.007 (0.71–1). Good and very good total scores for QoL were recorded for 47 patients (84%) compared to 33 (36%) in the preoperative evaluation (χ2 with Yates continuity correction for two degrees of liberty = 46.04; p < 0.00001).ConclusionOur results suggest that patients can expect to see a significant overall improvement in all five components of QoL measured with the help of Eq. 5D questionnaire. This improvement is dependent by hernia size, and some individual patient’s factors (diabetes, cardiovascular diseases, and age over 60 years).

Kawasaki Disease Diagnosis and Treatment in over 1000 Patients: A Continuum of Dysregulated Inflammatory Responses.

Kawasaki disease (KD) is a pediatric vasculitis, leading to coronary artery aneurysms (CAAs) in ~4-14%. Attention to the etiology and course of KD was generated by the close mimic of a SARS-CoV-2-induced phenotype, called multisystem inflammatory syndrome in children (MIS-C). A total of 1179 cases were collected from 2012 with ~50% of cases retrospectively included. Clinical characteristics were described and risk factors for CAA (persistence) were investigated. Phenotypic patterns of the prospectively included KD patients were evaluated. These patterns were also compared to the seronegative KD and seropositive MIS-C cases identified during the SARS-CoV-2 pandemic. KD mostly affected boys and children < 5 years. IVIG resistance, CAAs, and giant CAAs occurred in 24.5%, 21.4%, and 6.6%, respectively. Giant CAAs were significantly more likely to normalize to a normal Z score in patients that were younger than 2.5 years old at the time of initial giant CAA (χ2 test p = 0.02). In our prospective (SARS-CoV-2-seronegative) KD series, there was a diminishing male predominance over time, whereas the proportions of incomplete presentations (p < 0.001) and patients with circulatory shock (p = 0.04) increased since the COVID-19 pandemic. Pre- and post-pandemic KD cases presented with different levels of C-reactive protein, thrombocyte counts, and hemoglobin levels over the years. Compared to pandemic KD, SARS-CoV-2-seropositive MIS-C patients were older (p < 0.001), and more often required intensive care admission (p < 0.001), with a gradual decrease over time between 2020 and 2022 (p = 0.04). KD carried a substantial risk of CAA development in contrast to MIS-C. the phenotypic changes seen over the last twelve years of our prospective follow-up study suggest a spectrum of hyperinflammatory states with potentially different triggering events within this clinical entity.

Number of Teeth and Dementia-free Life Expectancy: A 10-Year Follow-Up Study from the Japan Gerontological Evaluation Study

ObjectivesPrevious studies have reported that tooth loss is associated with an increased risk of dementia; however, few have explored the association between number of teeth and dementia-free and total life expectancies. We investigated whether having more teeth is associated with longer dementia-free and total life expectancies. DesignA 10-year follow-up prospective cohort study from 2010 to 2020. Setting and ParticipantsFunctionally independent older adults aged ≥65 years living in 9 municipalities in Japan. MethodsThe exposure was the number of teeth (≥20, 10–19, 1–9, and 0). Dementia onset and mortality within the 10-year follow-up were used as the outcome. Dementia-free and total life expectancies according to the number of teeth were derived from multistate modeling estimates. ResultsA total of 44,083 participants were included (men: 46.8%). The mean age was 73.7 years [standard deviation (SD) = 6.0]. During follow-up, 17.3% and 21.4% of the participants experienced the onset of dementia and death, respectively. Having fewer teeth was associated with dementia [hazard ratio (HR), 1.14; 95% confidence interval (CI), 1.07–1.22, 10–19 teeth; HR, 1.15; 95% CI, 1.08–1.22, 1–9 teeth; HR, 1.13; 95% CI, 1.05–1.21, 0 teeth] and death (HR, 1.13; 95% CI, 1.05–1.22, 10–19 teeth; HR, 1.27; 95% CI, 1.19–1.37, 1–9 teeth; HR, 1.47; 95% CI, 1.36–1.59, 0 teeth) compared with having ≥20 teeth. Dementia-free life expectancies at the age of 65 years were 16.43 years and 18.88 years with ≥20 teeth, and 14.40 years and 17.12 years with 0 teeth for men and women, respectively. The total life expectancies at the age of 65 were 17.84 years and 22.03 years with ≥20 teeth, and 15.42 years and 19.79 years with 0 teeth for men and women, respectively. Conclusions and ImplicationsHaving more teeth was associated with longer dementia-free and total life expectancies.

A Study of Quality of Life of Elderly Live Kidney Donors—An Interview-Based Prospective Follow-Up Study

Quality of life (QoL) is a vital aspect of postdonation amongst donors, especially elderly donors. There is a limited study from India assessing the QoL amongst young live donors (YLD), and no study has been done on the elderly sub-group. This study was undertaken to determine the donors' sociodemographic and essential clinical characteristics, as well as to study the QoL of the live kidney donors and compare the QoL of elderly and young donors. Baseline demographic characters taken from the RTR registration register and SF-36 questionnaire were used to assess the QoL at baseline, discharge post-transplant, 1 month, 3 months, 6 months, and 12 months through an interview. We found that the QoL of the elderly donors in postkidney donation returns to baseline at the end of 6 months in all dimensions of the QoL amongst the North Indian population. The physical function is better amongst elderly donors at the end of 3 and 6 months than among young donors. The study's findings must be propagated to increase the donation of kidneys to older people. This is the first of its kind from India, necessitating further multicentric study.

The Association between Dietary Inflammatory Patterns and the Incidence of Frailty and Its Reversal in Older Adults: A Community-Based Longitudinal Follow-Up Study in Taiwan.

Dietary patterns related to inflammation have garnered great interest in disease prevention. The aims of this study were to evaluate whether a proinflammatory diet affects the incidence of frailty and its reversal in a prospective follow-up study. Data were taken from 5663 community-dwelling individuals ≥ 55 years old in Taiwan. The energy-adjusted dietary inflammatory index (DII) and the Empirical Dietary Inflammatory Patterns-Healthy Aging Longitudinal Study in Taiwan (EDIP-HALT) at baseline were calculated using a food frequency questionnaire. Frailty was assessed with Fried's criteria in 2008-2013 and 2013-2020. Associations with changes in frailty status were assessed with multinominal logistic regressions and adjusted for major confounders. Higher EDIP-HALST scores (proinflammatory) were associated with higher odds of frailty among baseline robust participants in men (OR = 2.44, 95% CI = 1.42-4.21, p-trend < 0.01) and broadline associated in women (OR = 1.96, 95% CI = 0.96-3.98, p-trend = 0.05), but associated with lower odds of reversing back to robust among baseline prefrail participants. However, the later association was only observed in women, and the relationships were stronger in the middle tertile (second vs. first tertile, OR = 0.40, 95% CI = 0.25-0.65). A pro-inflammatory diet pattern was associated with higher odds of frailty onset in baseline robust participants and lower odds of reversal in baseline prefrail female participants.