Years In Patients Research Articles

Cladribine tablets as therapy for advanced relapsing-remitting multiple sclerosis: a 4-year follow-up real-world, multi-center, retrospective, cohort study

IntroductionCladribine tablets (CladT) are a high-efficacy disease-modifying therapy recommended for the treatment of relapsing–remitting multiple sclerosis (RRMS) particularly in early disease. This study is aimed to evaluate the long-term efficacy of CladT in population of Polish RRMS patients, with more advanced disease.MethodsThis retrospective observational study included patients with RRMS who started CladT treatment between December 2019 and November 2023. Collected data included prior treatments, annualized relapse rate (ARR), magnetic resonance imaging (MRI) activity, Expanded Disability Status Scale (EDSS) score, no evidence of disease activity (NEDA-3), lymphocyte counts, and safety outcomes were collected.ResultsOf the 230 patients (8.3% treatment-naïve, mean disease duration 9.2 years), follow-up data were available up to year 1 for 222 patients, year 2 for 154 patients, year 3 for 87 patients and year 4 for 31 patients. The ARR decreased from 1.42 at baseline to 0.26, 0.22, and 0.36 in years 1, 2, and 3, respectively. The proportion of relapse-free patients increased from 13.9% at baseline to 76.8% in year 1, 82% in year 2 and 75.4% in year 3 with no relapses reported in year 4. The proportion of patients with active MRI lesions declined from 90.4% at baseline to 36.3% in year 1, 25.2% in year 2, 45.9% in year 3 and 8.3% in year 4. Stable or improved EDSS was observed in 85.9% of patients in year 1, 80.8% in year 2, 73.7% in year 3 and 88.9% in year 4. NEDA-3 status was achieved in 47.4% of patients in year 1, 51.0% in year 2, 40.4% in year 3 and 71.4% in year 4. Adverse events were reported in 16.7% of patients in years 1–2 and in 6.3% of patients in year 3.DiscussionThe results indicate that CladT is effective and safe in Polish patients with RRMS, characterized by high disease activity, delayed treatment initiation, and multiple number of prior therapies.

Multimodal profiling of proinflammatory protease activity identifies caspase-1 as a target for lung cancer interception.

The systemic inhibition of IL-1b, a key mediator of pulmonary inflammation, has been shown to reduce the incidence of lung cancer in patients in years following treatment, but knowledge gaps surrounding its activation and role in the tumor microenvironment are hindering approaches for cancer interception. We developed a suite of activity-based technologies to probe inflammation in early lung cancer and identified a translational target candidate. We designed probes sensitive to various IL-1b-activating proteases and applied them to a murine model of inflammatory lung cancer, Kras/Trp53 -mutant with SIINFEKL expression (KPS). Our nanosensors revealed reduced cleavage of a caspase-1 reporter in the lungs of KPS mice treated with IL-1b antibody, as well as elevated caspase-1 expression and activity in naïve tumor tissue sections, highlighting the importance of caspase-1 processing of IL-1b during cancer development. We conducted a pre-clinical trial of a novel combination intervention by administering both IL-1b blockade and caspase-1 inhibition shortly after tumor induction. Following treatment, we observed significant reduction in lung cancer formation, including complete ablation of tumor incidence in nearly 20% of KPS mice. Our approach to understand the interplay of protease activity and cytokine activation supports development of new strategies to mitigate inflammation and intercept lung cancer progression.

Impact of timing of diagnosis and breastfeeding on postpartum breast cancer outcomes.

e12537 Background: Pregnancy-associated and postpartum breast cancers (PABC/PPBC) have a worse prognosis than other breast cancers. We hypothesized that patients diagnosed earlier postpartum and those breastfeeding (BF) at diagnosis would have inferior outcomes compared to patients diagnosed later or non-BF patients. Methods: We identified PPBC patients diagnosed at our institution 2 years (2-year PP) or 2-5 years (2-5 year PP) following a live birth. Clinicopathologic details, BF status at diagnosis, mastitis in the 6 months prior to diagnosis, and whether symptoms of PPBC were initially attributed to BF or lactational change by the patient or a provider were ascertained via chart review. Characteristics were compared between groups using chi-square or Kruskall-Wallis tests. Kaplan-Meier analysis was used to assess overall survival (OS) and metastasis-free survival (MFS). Results: From 2002 to 2024, 60 2-year PP patients and 101 2-5 year PP patients were identified. The 2-5 year PP group was older (median age 39.6 vs 37.4 years, p<.001) and less likely to be BF (7% vs 60%, p<.001) at the time of diagnosis. Patients in the 2-5 year PP group were diagnosed at a lower clinical T-stage (50% vs 20% T1, 36 vs 17% T3-4, p<.001) and N-stage (61% vs 37% N0, 11% vs 29% N2-3, p=.01) compared to the 2-year PP group. There was a trend toward decreased metastasis (3% vs 12%, p=.06) and lower grade (13% vs 5% Grade 1, 55% vs 65% Grade 3, p=.2) at diagnosis for 2-5 year PP vs 2-year PP patients. Estrogen and progesterone receptor positivity and triple negative disease did not differ between groups, but HER2+ disease was more common among 2-year PP patients (36% vs 17%, p=.01). Among 2-year PP patients, BF at diagnosis showed a trend toward increased clinical nodal involvement (71% vs 50%, p=.17), metastasis at diagnosis (17% vs 4%, p=.3), and HER2 positivity (44% vs 22%, p=.13). BF patients were significantly more likely to have a diagnosis of mastitis in the 6 months preceding PPBC diagnosis (31% vs 4%, p=.03) and to have their PPBC symptoms initially attributed to BF or lactational change (58% vs 4%, p<.001). There was no difference in months postpartum at diagnosis between BF and non-BF patients (median 11.8 vs 13.5 months, p=.7). Median follow-up was 54 months. The 2-year PP group had inferior OS (5-year OS 79% [95% CI 67-93] vs 97% [95% CI 93-100], p<.001) and MFS (5-year MFS 74% [95% CI 60-90] vs 93% [95% CI 87-99], p=.003) compared to 2-5 year PP patients. Among the 2-year PP group, there was a trend toward worse OS (5-year OS 74% [95% CI 59-93] vs 86% [95% CI 70-100], p=.08) and significantly worse MFS (5-year MFS 62% [95% CI 45-86] vs 91% [95% CI 75-100], p=.032) for those BF vs not BF at diagnosis. Conclusions: Breast cancer diagnosed in the first two years postpartum has a worse prognosis compared to later PPBC. Breastfeeding at diagnosis is associated with inferior outcomes and may lead to delayed diagnosis due to misattribution of symptoms to lactational change.

Impact analysis of expanded access to ketamine for treatment-resistant depression

Aim:This study aimed to estimate the economic impacts of expanded access to ketamine relative to electroconvulsive therapy (ECT) by offering intravenous ketamine to US patients with nonpsychotic treatment-resistant depression (TRD) and moderate-to-severe depression.Materials & methods:A population-level Markov simulation model with key parameters from a randomized trial was used to simulate the economic impacts of managing TRD with intravenous ketamine versus ECT over a 5-year horizon. Health states included response of depression in the acute treatment phase and continued treatment and relapse in the maintenance phase. The model estimated costs associated with healthcare utilization (direct costs) and time loss (indirect costs) from patient, caregiver, payer and societal perspectives. Model uncertainty was assessed with one-way sensitivity, probabilistic sensitivity and scenario analyses.Results:In year 1, our model included 350,000 eligible patients. In years 2 through 5, our model added 11,296 eligible patients annually. Expanded access to ketamine to manage TRD was projected to increase the number of patients receiving treatment by 75,000 patients in year 1 and 4292 patients annually in subsequent years. Over 5 years, expanded access to ketamine would result in a net positive societal savings of $828.2 million annually ($95.3 million to patients and $743.7 million to payers). However, expanded ketamine access would impose an additional $10.8 million burden on caregiver time annually.Conclusion:For US patients with TRD and moderate-to-severe depression, ketamine may be a noninferior treatment relative to ECT to improve depression symptoms. Expanded access to ketamine treatment would result in net savings to the patients, payers and society.

Multi-modal radiomics features to predict overall survival of locally advanced esophageal cancer after definitive chemoradiotherapy

PurposeTo establish prediction models to predict 2-year overall survival (OS) and stratify patients with different risks based on radiomics features extracted from magnetic resonance imaging (MRI) and computed tomography (CT) before definite chemoradiotherapy (dCRT) in locally advanced esophageal squamous cell carcinoma (ESCC).MethodsPatients with locally advanced ESCC were recruited. We extracted 547 radiomics features from MRI and CT images. The least absolute shrinkage and selection operator (LASSO) for COX algorithm was used to obtain features highly correlated with survival outcomes in the training cohort. Based on MRI, CT, and the hybrid image data, three prediction models were built. The predictive performance of the radiomics models was evaluated in the training cohort and verified in the validation cohort using AUC values.ResultsA total of 192 patients were included and randomized into the training and validation cohorts. In predicting 2-year OS, the AUCs of the CT-based model were 0.733 and 0.654 for the training and validation sets. The MRI radiomics-based model was observed with similar AUCs of 0.750 and 0.686 in the training and validation sets. The AUC values of hybrid model combining MRI and CT radiomics features in predicting 2-year OS were 0.792 and 0.715 in the training and validation cohorts. It showed significant differences in 2-year OS in the high-risk and low-risk groups divided by the best cutoff value in the hybrid radiomics-based model.ConclusionsThe hybrid radiomics-based model demontrated the best performance of predicting 2-year OS and can differentiate the high-risk and low-risk patients.

The Multimodal MRI Features of Deteriorative MCI Patients-A 2-Year Follow-up Study.

To explore the magnetic resonance imaging (MRI) features of the 2-year follow-up patients with deteriorative mild cognitive impairment (MCI). A number of 105 MCI-afflicted patients underwent multimodal MRI sequences in 2019 and 2021, respectively. The brain image was segmented into 116 regions, and the apparent diffusion coefficient (ADC) value, fractional anisotropy (FA) value, and cerebral blood flow (CBF) value of each brain region were extracted by the deep learning algorithm. They were divided into the deteriorative MCI group and the non-deteriorative MCI group according to the cognitive function 2 years later. With the FA values analyzed, we found the characteristics in nine brain regions as follows: In both 2019 and 2021, the FA value was significantly lower in the deterioration group (DG) than in the non-deterioration group (NDG) (P < 0.001). In the DG, the FA value was significantly lower in 2021 than in 2019 (P < 0.001), while in the NDG, no significant difference was found in the FA value between 2019 and 2021 (P > 0.05). In terms of the ADC value, we found the characteristics in middle frontal gyrus-orbital part region as follows: In both 2019 and 2021, the ADC value was significantly higher in the DG than in the NDG (P < 0.001). In the DG, the ADC value was significantly higher in 2021 than in 2019 (P < 0.001). The decrease of the FA value in nine brain regions and the increase of the ADC value in one brain region could be the warning characteristics of the deterioration of MCI.

THROMBOCYTOPENIA AS A SURROGATE FOR CIRRHOSIS AND A MARKER FOR THE IDENTIFICATION OF PATIENTS AT HIGH RISK FOR HEPATOCELLULAR CARCINOMA

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality, primarily arising in patients with cirrhosis due to chronic hepatitis B (HBV) or hepatitis C (HCV) infections. The global epidemiology of HCC is influenced by viral hepatitis prevalence, metabolic disorders, and liver fibrosis progression. Thrombocytopenia has emerged as a potential surrogate marker for cirrhosis and an early indicator of HCC risk. Identifying a reliable platelet cutoff value may improve the early diagnosis and risk stratification of patients prone to liver malignancy. Objective: To evaluate thrombocytopenia as a surrogate marker for cirrhosis and assess platelet count as a diagnostic indicator for advanced HCC in patients with chronic liver disease. Methods: A cross-sectional hospital-based study was conducted over six months (January–June 2022) at a tertiary care hospital. A total of 40 cirrhosis patients (20 males, 20 females) aged 30–65 years were enrolled. Blood serum samples were collected in glass vials containing 20% EDTA to prevent coagulation. Sociodemographic data were obtained following written informed consent. Statistical analysis was performed using SPSS (version 22). Sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), and Kaplan-Meier analysis were applied to determine platelet cutoff values for cirrhosis and HCC risk prediction. Results: The platelet cutoff value was determined as 150 × 10³/mm³ for HBV (sensitivity 79.5%, specificity 82.4%, accuracy 85.1%, PPV 39.4%, NPV 98.5%) and 170 × 10³/mm³ for HCV (sensitivity 86.5%, specificity 60.8%, accuracy 67.6%, PPV 44.9%, NPV 92.8%). Thrombocytopenia (&lt;145 × 10³/mm³) was observed in 15% of HBsAg-positive, anti-HCV-negative patients in year 1 and 5% in year 2. Among HCC patients, 60% were thrombocytopenia suspects, with 45% confirmed cases. A significant reduction in platelet count was noted in cirrhosis patients progressing to HCC. Conclusion: Thrombocytopenia strongly correlates with cirrhosis and serves as an early, cost-effective marker for identifying patients at risk of developing HCC. Implementing platelet count assessment in routine clinical practice may improve early detection and timely management of liver disease progression.

DOP018 Etrasimod for the treatment of Ulcerative Colitis: Up to 4 years of safety data from the global clinical programme

Abstract Background Etrasimod is an oral, once-daily, selective sphingosine 1-phosphate (S1P)1,4,5 receptor modulator for the treatment of moderately to severely active ulcerative colitis (UC). The long-term safety, tolerability and efficacy of etrasimod are being evaluated in an ongoing open-label extension (OLE) study.1 We report an updated cumulative safety analysis from the etrasimod UC clinical programme with a maximum of 4 years of exposure. Methods Patients who received etrasimod in completed phase 2 (OASIS; OASIS OLE), phase 3 (ELEVATE UC 52; ELEVATE UC 12) and ongoing ELEVATE UC OLE (data cutoff 30 Aug 2023) and ES101002 OLE (data snapshot 30 Aug 2022) studies were included. Treatment-emergent adverse event (TEAE) frequency and exposure-adjusted incidence rates (IRs) per 1 patient-year (PY) were analysed. Results A total of 1196 patients received ≥1 dose of etrasimod 1 mg or 2 mg once daily with a mean (standard deviation) exposure of 70.66 (54.36) weeks, and 1619.5 PYs of total exposure. Demographics and baseline characteristics are reported in Table 1. Most TEAEs were nonserious and rarely led to discontinuation. The IRs of TEAEs of interest were generally low (Table 2). Serious infections and herpes zoster infections were infrequently reported (all IR ≤0.02). Three patients experienced four nonserious events of macular oedema (0.3%, IR &amp;lt;0.01), including one event leading to discontinuation that resolved. One patient experienced two nonserious events of cystoid macular oedema (&amp;lt;0.1%; IR &amp;lt;0.01) that resolved. Malignancies were uncommon and included five patients with serious events (0.4%), two patients with squamous cell carcinomas and one with basal cell carcinoma. Eleven patients (0.9%) had alanine aminotransferase (ALT) levels &amp;gt;3 times the upper limit of normal (ULN) at two consecutive post-baseline visits. Notably, no patients exhibited &amp;gt;3× ULN in either ALT or aspartate aminotransferase and &amp;gt;2× ULN in total bilirubin (laboratory criteria for Hy’s law). TEAEs leading to death were reported in three patients (all deemed unrelated to treatment). No serious adverse events of hypertension or bradycardia were reported. No events of second-degree Mobitz type 2 atrioventricular (AV) block or third-degree AV block occurred. Conclusion Etrasimod remains well tolerated in patients with moderately to severely active UC, with a favourable safety profile that has not changed with longer-term treatment exposure for up to 4 years.

Sutureless Bioprostheses for Aortic Valve Replacement: An Updated Systematic Review with Long-Term Results.

Background: In recent years, in case of aortic valve replacement (AVR), a significant increase in the use of bioprostheses has been observed. The Perceval sutureless bioprosthesis has proven to be safe and reliable in the short and mid-term, with limited but promising long-term results. An updated systematic review with the long-term results of patients who underwent a sutureless bioprosthesis implantation with a Perceval biological valve is herewith presented. Methods: Studies published between 2015 and 2024, including the long-term outcomes-with clinical as well as echocardiographic information for up to five years-of patients who underwent a Perceval implantation for AVR were selected from the published literature. The Cochrane GRADE system was used to assess the study quality, and the risk of bias in non-randomized studies (ROBINS-I) tool was used to evaluate studies. Results: Ten studies were selected with an overall number of 5221 patients. The long-term survival ranged from 64.8 to 87.9%, freedom from structural valve degeneration (SVD) from 96.1 to 100%, freedom from significant paravalvular leak from 98.5 to 100%, freedom from prosthetic endocarditis from 90.7 to 99%, and freedom from reintervention from 94 to 100%. The long-term mortality ranged from 6.5 to 27.4%. SVD was observed in 0-4.8% patients. Significant paravalvular leak was observed in 0-3.4% patients, and infective endocarditis was observed in 0-3.4%. A bioprosthesis-related reintervention at long-term follow-up was required for 0-4.3% of patients, and 1.7-7.1% of patients required a late new pacemaker implantation. The transprosthetic mean pressure gradient ranged from 9 to 14.7 mmHg, peak pressure gradient ranged from 17.8 to 26.5 mmHg, and EOA ranged from 1.5 to 1.7 cm2. Conclusions: This systematic review shows that there is still a paucity of data about sutureless bioprostheses. Nevertheless, the clinical results from prospective studies or retrospective series are encouraging. Medium- and long-term results seem to support the increasing use of this type of prosthesis.

Long-Lasting AML-Specific Antibody Responses after Allogeneic Hematopoietic Progenitor Cell Transplantation

Long-Lasting AML-Specific Antibody Responses after Allogeneic Hematopoietic Progenitor Cell Transplantation

Lower Risk of Postoperative Complications and Rotator Cuff Retear Associated With Semaglutide Use in Patients with Type II Diabetes Mellitus Undergoing Arthroscopic Rotator Cuff Repair

Lower Risk of Postoperative Complications and Rotator Cuff Retear Associated With Semaglutide Use in Patients with Type II Diabetes Mellitus Undergoing Arthroscopic Rotator Cuff Repair

IL6 and WNK2 polymorphisms and prognosis in patients with intracerebral hemorrhage receiving edaravone

IL6 and WNK2 polymorphisms and prognosis in patients with intracerebral hemorrhage receiving edaravone

Exploring the association between phytopharmaceutical use and antibiotic prescriptions in upper respiratory infections: results from a German cohort study evaluating the impact of naturopathy qualifications of general practitioners using routine data.

Antibiotic resistance is a significant global health threat, exacerbated by inappropriate prescribing practices, particularly for upper respiratory infections that are predominantly viral. Complementary and Integrative Medicine (CIM), including the use of phytopharmaceuticals, offers a potential strategy to reduce antibiotic prescriptions. This study aimed to describe the impact of General Practitioners' (GPs) naturopathy (NP) qualifications and phytopharmaceutical prescriptions on the rate of antibiotic prescribing for upper respiratory infections (RTI). We conducted a retrospective cohort study using routine data from the CONTinuous morbidity registration Epidemiologic NeTwork (CONTENT), which includes over 200,000 patients across four federal states in Germany. The study included data from n = 36 GPs who recorded at least one ICD-10 diagnosis of RTI. Antibiotic and phytopharmaceutical prescriptions were identified and analyzed through mixed-effects logistic regression models to explore the influence of GPs' naturopathy qualifications and phytopharmaceutical use on antibiotic prescribing patterns. The study included 40,344 patients managed by 36 GPs. Prescriptions of phytopharmaceuticals significantly reduced the likelihood of antibiotic use (OR 0.48, 95% CI 0.45-0.52). Additionally, holding a naturopathy qualification was associated with lower rates of antibiotic prescriptions (OR 0.73, 95% CI 0.69-0.78). The interaction between naturopathy qualification and phytopharmaceutical prescriptions also showed a significant effect (OR 1.43, 95% CI 1.27-1.62). Patient's year of birth influenced prescribing patterns indicating a reduction of antibiotic prescriptions for younger patients, while patients' gender did not reveal a significant effect. Prescriptions of phytopharmaceuticals were significantly associated with a decrease antibiotic prescriptions among GPs, especially when combined with naturopathy qualifications. Training in naturopathic approaches could enhance antibiotic stewardship efforts in primary care settings, suggesting that broader integration of CIM elements into medical training could be beneficial in mitigating antibiotic resistance.

Long-term persistence of carrier-bound fibrin sealant (TachoSil®) following abdominal surgery: a decade-long follow-up study.

This study analyzed the long-term effects of carrier-bound fibrin sealant (CBFS) following abdominal surgery by tracking patients for years post-application. From 2006 to 2022, patients who underwent this procedure were contacted via telephone. Those who died due to underlying diseases, natural causes, or refused the check-up were excluded from the study. After 11years of follow-up, CBFS was observed in different forms on computed tomography scans in four patients. Our findings indicate that CBFS can persist for years after the procedure. While we cannot confirm any secondary effects, it appears that CBFS sponges are not resorbed within 12weeks and can remain for many years post-implantation.

Parichay Patient Support Program: Useful Tool for Improving Compliance in Kidney Transplant Recipients

Parichay Patient Support Program: Useful Tool for Improving Compliance in Kidney Transplant Recipients

The First Observational Study of Acute Medical Unit in Qatar.

Background Acute medical unit (AMU) is a dedicated facility to treat patients with acute medical conditions requiring a short hospital stay (< 72 hours) with the support of a multidisciplinary team led by a medical consultant. We aim to present a study of the AMU model of care from Qatar to provide insight into its effects on patient care and management. Methods Retrospective data from AMU facility at Hamad General Hospital (HGH), Doha, Qatar, was collected from January 2019 to December 2020 from the electronic patient record. The data were analyzed for demographic characteristics of the patients, length of stay (LOS), readmission rate, and postdischarge follow-up. The effectiveness of the AMU system was studied closely from this data. An extensive literature search was also performed for comparative results analysis in other AMU facilities outside Qatar. Results Total admissions under the AMU facility were 8,371 from january2019 to December 2020. The 28 days readmission rate was 10.25 and 9.9% in 2019 and 2020, respectively. The average LOS was approximately 3.2 days. Around 88.7% of the patients were discharged home, 7.8% were admitted to medical wards due to longer stays, and 0.5% left against medical advice. Most of the patients admitted under AMU were 18 to 60 years old. The top primary diagnoses of admissions were minor stroke, transient ischemic attack, chest infection, urinary tract infections, and gastrointestinal and liver diseases. The most common comorbidities were hypertension, diabetes, acute kidney injury, and chronic kidney disease. A total of 2,858 patients were booked for a follow-up visit in the postdischarge clinic on discharge from the AMU for the year 2019 and 2020. The analysis of these followed up patients showed 73% of patients were discharged from clinic after first visit while the readmission from clinic was on only 1% (28 patients for year 2019 and 2020). Conclusion Attentive patient care under AMU with a designated multidisciplinary medical team led by an internal medicine consultant is the cornerstone for the success of the AMU unit. This unit has proven very helpful for the smooth disposition of patients from the emergency department with reduced LOS, readmission rate, and overall mortality.

Resurgence of Kawasaki Disease Following Relaxation of Coronavirus Disease 2019 Pandemic Restrictions in Japan

Resurgence of Kawasaki Disease Following Relaxation of Coronavirus Disease 2019 Pandemic Restrictions in Japan

Time to Dementia Diagnosis Among Veterans with Comorbid Insomnia and Depressive Episodes.

Older adults with heart failure are at elevated risk of Alzheimer's disease and related dementias (AD/ADRD). Research suggests that insomnia and depressive episodes contribute somewhat dissociable impacts on risk for AD/ADRD in this patient population, although the temporal ordering of effects is unknown. This study examined time to dementia diagnosis among patients with comorbid insomnia and/or depressive episodes in an epidemiological sample. Secondary data analyses were conducted using a cohort study of 203,819 Veterans with a primary admission diagnosis of heart failure in 129 VA Medical Centers. Patients with diagnoses of both insomnia and depressive episodes had the shortest time to a dementia diagnosis at both 1-year (Hazard ratio = 1.43, 95% CI [1.36, 1.51]) and 3-year follow-up time points (Hazard ratio = 1.40, 95% CI [1.34, 1.47]) versus patients with one or neither comorbidity. Individuals with both comorbidities had the shortest time to dementia onset. Screening for these comorbidities may help to identify patients at elevated risk of dementia who could benefit from enhanced monitoring or early intervention strategies for more rapid detection and management of dementia symptoms.

Examining autocorrection of concurrent cervical malalignment following thoracolumbar deformity surgery.

The aim of the study was to assess preoperative radiographic parameters predictive of cervical deformity (CD) autocorrection in patients undergoing thoracolumbar deformity (ASD) surgery. This was a retrospective cohort study. Inclusion criteria were operative ASD patients with complete baseline (BL) and 2-year radiographic data. Patients with cervical fusion during index surgery, revision involving cervical fusion, and those who developed proximal junctional kyphosis by 2-year postoperative were excluded from the study. If patients met CD criteria at BL but not at 6 weeks or 2 years postoperatively, they were considered autocorrected (AC). Descriptive and univariate analysis, binominal logistic regression, and multivariable backward stepwise regression. Two hundred and twenty ASD patients were included. 51.4% of patients had preoperative CD. By 6-week postoperative, 32.7% achieved AC. At 2 years, 24.8% of preoperative CD patients obtained AC. 2-year AC patients had lower BL sacral slope, lumbar lordosis (LL), T1 slope, cervical lordosis (CL), and C2-T3, and T2-T12 kyphosis (all P < 0.05). Patients with BL-unmatched Roussouly types are corrected postoperatively and are more likely to experience autocorrection at 1 year (45.2% vs. 19.0%; P = 0.042) and at 2 years (31% vs. 4.8%; P = 0.018). Multivariable analysis revealed that patients with BL-mismatched Roussouly types were corrected postoperatively and showed a significant increase in likelihood of AC at 1 year (odds ratio [OR]: 18.72; P = 0.029) and 2 years (OR: 8.5; P = 0.047). Similarly, BL LL (OR: 0.772; P = 0.003) and CL (OR: 0.829; P = 0.005) exhibited significant predictive value for autocorrection at 1 year and 2 years (OR: 0.927; P = 0.004 | OR: 0.942; P = 0.039; respectively). Autocorrection is more likely in patients with postoperatively corrected Roussouly types, those with lower BL cervical, and LL. Given these findings, it may not be necessary to routinely extend reconstruction into the cervical spine for ASD patients with similar characteristics to those in this study.

Deep learning detection of diabetic retinopathy in Scotland’s diabetic eye screening programme

Background/AimsSupport vector machine-based automated grading (known as iGradingM) has been shown to be safe, cost-effective and robust in the diabetic retinopathy (DR) screening (DES) programme in Scotland. It triages screening...