Long‐Term Outcomes in Juvenile Idiopathic Arthritis: Eighteen Years of Follow‐Up in the Population‐Based Nordic Juvenile Idiopathic Arthritis Cohort

Background: Neonatal arterial ischemic stroke (NAIS) is a leading cause of brain injury and cerebral palsy. Diffusion-weighted imaging (DWI) has revolutionized NAIS diagnosis and outcome prognostication. Diaschisis refers to changes in brain areas functionally connected but structurally remote from primary injury. We hypothesized that acute DWI can demonstrate cerebral diaschisis and evaluated associations with outcome. Methods: Subjects were identified from a prospective, population-based research cohort (Calgary Pediatric Stroke Program). Inclusion criteria were unilateral middle cerebral artery NAIS, DWI MRI within 10 days of birth, and >12-month follow-up (Pediatric Stroke Outcome Measure, PSOM). Diaschisis was quantified using a validated software method. Diaschisis-scores were corrected for infarct size and compared to outcomes (Mann-Whitney). Results: From 20 eligible NAIS, 2 were excluded for image quality. Of 18 remaining, 16 (89%) demonstrated diaschisis. Thalamus (88%) was most often involved. Age at imaging was not associated with diaschisis. Long-term outcomes available on 13 (81%) demonstrated no association between diaschisis score and PSOM categories. Conclusion: Cerebral diaschisis occurs in NAIS and can be quantified with DWI. Occurrence is common and should not be mistaken for additional infarction. Determining additional clinical significance will depend on larger samples with long-term outcomes.

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Long-term outcomes for patients with limited-stage follicular lymphoma: update of a population-based study

Blood ◽

10.1182/blood.2019004588 ◽

2020 ◽

Vol 136 (8) ◽

pp. 1006-1010 ◽

Cited By ~ 4

Author(s):

Andrea C. Lo ◽

Belinda A. Campbell ◽

Tom Pickles ◽

Christina Aquino-Parsons ◽

Laurie H. Sehn ◽

...

Keyword(s):

Follicular Lymphoma ◽

Population Based ◽

Long Term Outcomes ◽

Population Based Study ◽

Limited Stage ◽

Primary Radiotherapy

With a median follow-up of 16.6 years, Lo and colleagues report excellent long-term outcomes with primary radiotherapy for limited-stage follicular lymphoma in this month’s CME article.

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Preliminary Results of first Belgian Cohort of Juvenile Idiopathic Arthritis: Where Do we Stand in Terms of Quality of Care and Remission?

10.21203/rs.3.rs-133374/v1 ◽

2020 ◽

Author(s):

Céline La ◽

Phu Quoc Lê ◽

Alina Ferster ◽

Laurence Goffin ◽

Bernard Lauwerys ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Quality Of Care ◽

Long Term Outcomes ◽

Disease Characteristics ◽

French Speaking ◽

Das28 Remission ◽

The Mean

Abstract BackgroundJuvenile idiopathic arthritis (JIA) represents a very heterogeneous disease, and our objectives were to describe the first Belgian cohort of children with JIA, assess their disease characteristics and outcome and identify potential markers of prognosis.MethodsThe CAP48 cohort is a multicentric observational study of children with a recent or well-established diagnosis of JIA (naïve or not to treatment at baseline), evaluated every 6 months during a follow-up of 5 to 10 years.ResultsThere were 125 children included in the cohort, composed of 25 naïve and 100 established patients. The patients had a median age of 6.2 and 4.2 years at onset in the naïve and established cohort respectively, with a predominance of female. All subtypes of JIA were represented in both cohorts. The mean DAS28-CRP and JADAS10-CRP at baseline in naïve patients was 2.52 and 6.0 respectively. Uveitis occurred in 19% of patients and was strongly associated with presence of antinuclear antibodies (odds ratio of 6). Fifty-five percent of naïve patients were in remission at 12 months of follow-up according to the ACR criteria and JADAS10 scores, in contrast with 100% achieving DAS28 remission. ConclusionThis first cohort study in Belgium allowed to compare its data to other existing cohorts and to evaluate quality of care in Belgian French-speaking hospitals. Additionally, it highlighted a superiority of JADAS10 over DAS28 to monitor and evaluate remission in JIA. This study also underlined a need for more accurate markers of prognosis to improve treatment and long-term outcomes.

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Abstract 179: The correlation between Insurance Coverage and Long-term Outcomes in patients presenting with ACS: An ACAP-PAIN Registry Analysis

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.6.suppl_1.a179 ◽

2013 ◽

Vol 6 (suppl_1) ◽

Author(s):

Chaithanya K Pamidimukala ◽

Emad F Aziz ◽

Balaji Pratap ◽

Joseph H Bastawrose ◽

Shuaib Mohamed ◽

...

Keyword(s):

Insurance Coverage ◽

Composite Endpoint ◽

Medical Insurance ◽

Population Based ◽

Long Term Outcomes ◽

Population Based Study ◽

Confounding Variables ◽

Registry Analysis

BACKGROUND: To look for the association between Insurance coverage (IC) and Long term Outcomes (O) after discharge following ACS admission from ACAP-PAIN (AP) registry. METHODS: The AP registry had 5526 hospitalized patients admitted with a diagnosis of ACS enrolled between 2006-2010. Long-term outcomes (composite of death, AMI, and ACS readmission) were evaluated during a Follow-up period of 4 yrs. Patients were stratified into 5 medical insurance groups: Government (Gov) (n = 2571), Managed Government (MGov) (n = 1229), HMO (n = 630), Commercial (Com) (n = 863), and other (O) (n = 233). RESULTS: Composite endpoint at the end of the follow up was seen in 29%, 23%, 16%, 15%, and 12%, (p <0.0001), and all-cause mortality was seen in 6.5%, 6.2%, 3.9%, 3.1%, and 1.2%, (p<0.001), of the 5 medical insurance groups, respectively. Patients with Gov and MGov care coverage were older, with higher incidence of CAD, hypertension and diabetes. After adjusting for confounding variables, the multivariable-adjusted odds for composite endpoint was 1.73 (95% confidence interval [CI], 0.56-1.36) for Gov patients, 1.07 (95% CI, 0.93-1.24) for MGov patients, 0.56 (95% CI, 0.45-0.70) for HMO patients, 0.55 (95% CI, 0.46-0.67) for Com patients, and, 0.42 (95% CI, 0.29-0.63) for O patients. (See Graph) CONCLUSIONS: The results of this population-based study demonstrate that ACS patients with any government insurance status have an increased long term morbidity and mortality. This may be explained at least partially by the patients’ characteristics.

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Incidence, Risk Factors, and Outcomes of Neonatal Renal Vein Thrombosis in Ontario: Population-Based Cohort Study

Kidney360 ◽

10.34067/kid.0000912019 ◽

2020 ◽

Vol 1 (7) ◽

pp. 640-647 ◽

Cited By ~ 1

Author(s):

Allison C. Ouellette ◽

Elizabeth K. Darling ◽

Branavan Sivapathasundaram ◽

Glenda Babe ◽

Richard Perez ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Renal Vein Thrombosis ◽

Population Based ◽

Long Term Outcomes ◽

Vein Thrombosis ◽

Increased Risk ◽

Neonatal Renal Vein Thrombosis

BackgroundThere are limited data at a population level on the burden, risk factors, and long-term outcomes of neonatal renal vein thrombosis (nRVT). We conducted a population-based cohort study to understand the epidemiology and outcomes of nRVT over a 25-year period in Ontario.MethodsUsing linked administrative health databases, all hospitalized neonates ≤28 days born in Ontario between 1992 and 2016 with nRVT were identified. The primary outcome was to calculate the incidence of nRVT and trend over time in Ontario. We also determined the risk factors associated with nRVT as well as the risk of long-term outcomes after nRVT, including CKD, ESKD, all-cause mortality, and hypertension (HTN) compared with the healthy neonatal population without nRVT.ResultsThe annual incidence rate of nRVT was 2.6 per 100,000 live births (n=85). Presence of respiratory distress syndrome (OR, 8.01; 95% CI, 4.90 to 13.1), congenital heart disease (OR, 9.1; 95% CI, 5.05 to 16.4), central venous catheterization (OR, 3.9; 95% CI, 1.89 to 7.93), maternal preeclampsia (OR, 2.8; 95% CI, 1.6 to 4.79), and maternal diabetes (OR, 2.36; 95% CI, 1.36 to 4.07) conferred the highest risk for nRVT. Over a median follow-up of 15 years and after adjusting for confounders, neonates with nRVT versus the comparator cohort had a 15.5-fold risk of CKD, HTN, or death (n=49 [58%] versus n=90,050 [3%]; 95% CI, 11.7 to 20.6); 12.3-fold increased risk of CKD or death (n=39 [46%] versus n=32,016 [1%]; 95% CI, 8.9 to 16.8); and a 15.7-fold increased risk of HTN (n=33 [39%] versus n=64,458 [2%]; 95% CI, 11.1 to 21.1). None of the nRVT cohort developed ESKD. The median time to composite outcome of CKD, HTN, or death was 11.1 years.ConclusionsPatients with a history of nRVT remain at higher risk than the general population for long-term morbidity or mortality, indicating the need for long-term follow-up.

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DISEASE MODIFYING TREATMENTS IN MS: INDUCTION OR ESCALATION?

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2015-312379.29 ◽

2015 ◽

Vol 86 (11) ◽

pp. e4.117-e4 ◽

Cited By ~ 1

Author(s):

Owain H Williams ◽

Katharine E Harding ◽

Mark Willis ◽

Trevor Pickersgill ◽

Mark Wardle ◽

...

Keyword(s):

Treatment Strategies ◽

Population Based ◽

Post Treatment ◽

Long Term Outcomes ◽

Term Outcome ◽

Long Term Outcome ◽

Patient Groups ◽

Selection Of

BackgroundIt is currently unclear whether aggressive induction or stepwise escalation of DMTs provides optimum long term outcomes for patients with MS.ObjectiveCompare clinical outcomes in clinical practice amongst unmatched patient groups receiving either initial monoclonal induction, injectable DMT only or escalation from injectable DMT.MethodsA subset of a population-based cohort identified 268 patients, with a median follow up post treatment of 5.4 years. Time to disability end points (EDSS) were examined using survival analysis.ResultsMonoclonals (25%) pre and post treatment annual relapse rate reduced from 2.28 (±1.92) to 0.28 (±0.42) 88% reduction; injectables (62%) from 1.08 (±0.97) to 0.4 (±1.03), 63% reduction; escalation (13%) had elevated rates of 1.72 (±2.04) to 0.64 (±0.54), only 63% reduction. Time to EDSS4 was shorter for monoclonal against injectable and escalation strategies: 5.7 vs 12 vs 6.8 years, p=0.0002. Time to EDSS6 was similar for the treatment strategies respectively: 14.6 vs 16.4 vs 13.3 years, p=0.13.ConclusionsPatients requiring escalation had relatively worse outcomes, and could be identified as having higher disease activity on treatment initiation. This data suggest that initial selection of DMT class does not significantly affect long term outcome to EDSS6, or conversely, aggressive induction slows the rate of disability progression to EDSS6.

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Parental Grief After Losing a Child to Cancer: Impact of Professional and Social Support on Long-Term Outcomes

Journal of Clinical Oncology ◽

10.1200/jco.2006.10.0743 ◽

2007 ◽

Vol 25 (22) ◽

pp. 3307-3312 ◽

Cited By ~ 127

Author(s):

Ulrika C. Kreicbergs ◽

Patrizia Lannen ◽

Erik Onelov ◽

Joanne Wolfe

Keyword(s):

Social Support ◽

Population Based ◽

Care Staff ◽

Health Care Staff ◽

Parental Grief ◽

Long Term Outcomes ◽

Swedish Population ◽

Population Based Study

Purpose It is still uncertain whether or not parents can ever come to terms with the loss of a child and whether professional or social support facilitate the long-term grief process. Methods A Swedish population-based study, which sent an anonymous, mail-in questionnaire to parents who had lost a child to a malignancy 4 to 9 years earlier, gained the participation of 449 (80%) of 561 parents. Parents were asked whether, and to what extent, they had worked through their grief. Questions were also asked regarding those who provided parents with support. We examined candidate factors to determine their associations with greater likelihood of working through parental grief. Results Overall, most parents (74%) stated that they had worked through their grief “a lot” or “completely” at the time of the follow-up. Parents who had shared their problems with others during the child's illness (fathers: relative risk [RR], 3.0; 95% CI, 1.8 to 5.0; mothers: RR 1.9; 95% CI, 1.2 to 2.8) and who had access to psychological support during the last month of their child's life (fathers: RR 1.4; 95% CI, 1.0 to 1.8; mothers: RR 1.3; 95% CI, 1.1 to 1.6) were more likely to have worked through their grief. In cases where health care staff offered parents counseling during the child's last month, the parents were more likely to have worked through their grief (fathers: RR 1.5; 95% CI, 1.2 to 1.8; mothers; RR 1.2; 95% CI, 1.1 to 1.4). Conclusion Most parents eventually work through the grief associated with losing a child to cancer. In the long term, sharing the emotional burden with others facilitates the grieving process.

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Preliminary Results of first Belgian Cohort of Juvenile Idiopathic Arthritis: Where Do we Stand in Terms of Quality of Care and Remission?

10.21203/rs.3.rs-133374/v2 ◽

2021 ◽

Author(s):

Céline La ◽

Phu Quoc Lê ◽

Alina Ferster ◽

Laurence Goffin ◽

Bernard Lauwerys ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Quality Of Care ◽

Age At Onset ◽

Long Term Outcomes ◽

Disease Characteristics ◽

French Speaking ◽

Das28 Remission

Abstract IntroductionJuvenile idiopathic arthritis (JIA) represents a very heterogeneous disease. As such, it has been a challenge to describe the disease activity of JIA cohorts. Our objective was to describe the first Belgian cohort of children with JIA by assessing their disease characteristics, outcomes, and potential markers of prognosis.MethodsThe CAP48 cohort is a multicentric observational study of children with recent or well-established diagnosis of JIA (naïve or not to treatment at baseline), evaluated every 3 to 6 months during a follow-up of 10 years.ResultsThere were 125 children included, composing of 25 naïve and 100 established patients. Their median age at onset was 6.2 and 4.2 years in the naïve and established cohort respectively, with a predominance of female. All subtypes of JIA were represented in both cohorts. The mean DAS28-CRP and JADAS10-CRP at baseline in naïve patients was 2.52 and 6.0 respectively. Uveitis occurred in 19% of patients and was strongly associated with presence of antinuclear antibodies (odds ratio of 6). Among naïve patients, 55% were in remission at 12 months according to ACR criteria and JADAS10 scores, in contrast with 100% achieving DAS28 remission. ConclusionThis first cohort study in Belgium allowed to compare its data to other existing cohorts and to evaluate quality of care in Belgian French-speaking hospitals. Additionally, it highlighted a superiority of JADAS10 over DAS28 to monitor and evaluate remission in JIA. This study also underlined a need for more accurate markers of prognosis to improve treatment and long-term outcomes.

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P405 Comparison of long-term outcomes of infliximab vs. adalimumab in 1488 biologic-naive Korean patients with Crohn’s disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjz203.534 ◽

2020 ◽

Vol 14 (Supplement_1) ◽

pp. S374-S374

Author(s):

Y S Jung ◽

M Han ◽

S Park ◽

J H Cheon

Keyword(s):

Crohn’S Disease ◽

Crohn's Disease ◽

Population Based ◽

Long Term Outcomes ◽

Population Based Study ◽

Korean Patients ◽

Asian Patients ◽

Significant Difference

Abstract Background Data on the comparative effectiveness of infliximab (IFX) or adalimumab (ADA) in patients with Crohn’s disease (CD) are rare, particularly for Asian patients. We compared the clinically key outcomes (surgery, hospitalisation, and corticosteroid use) of these two drugs in biologic-naive Korean patients with CD. Methods Using National Health Insurance claims, we collected data on patients who were diagnosed with CD and exposed to IFX or ADA between 2010 and 2016. Results We included 1488 new users of biologics (1000 IFX users and 488 ADA users). Over a median follow-up of 2.1 years after starting biological therapy, there were no significant differences in the risk of surgery (ADA vs. IFX; adjusted hazard ratio [aHR], 1.30; 95% confidence interval [CI], 0.86–1.95), hospitalisation (aHR, 1.05; 95% CI, 0.84–1.32), and corticosteroid use (aHR, 0.84; 95% CI, 0.58–1.22) between IFX and ADA users. These results were unchanged even when only patients who used biologics for over 6 months were analysed (aHR [95% CI]; surgery: 1.41 [0.88–2.26], hospitalisation: 1.06 [0.83–1.35], and corticosteroid use: 0.82 [0.56–1.21]). Additionally, these results were stable in patients treated with biological monotherapy or combination therapy with immunomodulators. Conclusion In this nationwide population-based study, there was no significant difference in the long-term effectiveness of IFX and ADA in the real-world setting of biologic-naive Korean patients with CD. In the absence of trials to directly compare IFX and ADA, our study supports that the choice of one of these two biologics may be allowed to be determined by the preference of patients and/or physicians.

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