scholarly journals Understanding the evolution of epilepsy – the value of collecting longitudinal data in the setting of a first seizure clinic

2015 ◽  
Vol 42 (S1) ◽  
pp. S9-S10
Author(s):  
B Pohlmann-Eden ◽  
KT Legg ◽  
MH Schmidt ◽  
CE Crocker
Keyword(s):  
Longitudinal Data ◽  
Initial Assessment ◽  
Cross Sectional ◽  
Disease Evolution ◽  
Advanced Stages ◽  
Concepts Of Disease ◽  
Marijuana Consumption ◽  
New Perspective ◽  
Treatment Prognosis

Objective: Our knowledge of disease mechanisms in epilepsy is biased by findings originating from cross-sectional studies and advanced stages of epilepsy. We provide a new perspective by collecting systematically longitudinal data from patients who present in early stages (ES). Methods: The Halifax First Seizure Clinic, founded in 2008, uses a comprehensive multimodal data basis addressing clinical presentation, neuroimaging, EEG findings, genetics, cognition, comorbidities, social parameters, and life style. Follow-up visits are 6, 12 and 24 months. Results: Out of 575 patients we identified 3 subgroups 1) Strictly first seizure, n=187, 2) New-onset epilepsy (> 1 seizure < 12 months), n=149, and 3) Newly-diagnosed epilepsy (seizures > > 12 months), n=50. 189 patients were excluded (not proven seizure or other conditions e.g syncope etc.). Our interim analyses suggest: A) pharmacoresistance presents in highly diverse patterns and is rarer than expected in ES, B) Congenital malformations seem to have an excellent treatment prognosis in ES, C) Marijuana consumption is significantly more prevalent at initial assessment (comparison general population), D) Preceding psychiatric comorbidities associated with reduced amygdalar volume may be a predictor for seizure recurrence. Conclusions: The preliminary and illustrative findings of our pilot study challenge current concepts of disease evolution in epilepsy.

scholarly journals The Dynamics of Paid and Unpaid Activities Among People Aged 50–69 in Denmark, France, Italy, and England

2016 ◽  
Vol 39 (9) ◽  
pp. 1013-1038 ◽  
Author(s):  
Giorgio Di Gessa ◽  
Emily Grundy
Keyword(s):  
Longitudinal Data ◽  
Longitudinal Analyses ◽  
Paid Work ◽  
Current Policy ◽  
Cross Sectional ◽  
Negatively Associated ◽  
Working Lives ◽  
Productive Activities ◽  
The Relationship

In the context of the current policy emphasis on extending working lives, we investigate whether the relationship between participation in paid work, other formal, and informal activities among people aged 50–69 is complementary or competitive. We also investigate differences in associations between countries using comparable longitudinal data from Denmark, France, Italy, and England. We find positive associations between informal and formal engagement in cross-sectional and longitudinal analyses. Paid work was negatively associated with formal and informal engagement, and respondents who stopped working were more likely to be engaged in formal (Denmark and France) and informal activities (England and Italy) at follow-up than respondents who continued working. However, the strongest predictor of formal and informal engagement at follow-up was baseline engagement. In the context of policy aims to extend working lives and broaden older people’s participation in other productive activities, new balances between work and other forms of engagement are still to be found.

scholarly journals Prevalence and Longevity of SARS-CoV-2 Antibodies in Healthcare Workers: A Single Center Study

2020 ◽  
Author(s):  
Michael Brant-Zawadzki ◽  
Deborah Fridman ◽  
Philip A. Robinson ◽  
Matthew Zahn ◽  
Clayton Chau ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
First Responders ◽  
Analysis Data ◽  
Cross Sectional Study ◽  
Polymerase Chain Reaction Test ◽  
Initial Assessment ◽  
Antibody Prevalence ◽  
Cross Sectional ◽  
Hospital System

ABSTRACTUnderstanding SARS-CoV-2 antibody prevalence as a marker of prior infection in a spectrum of healthcare workers (HCWs) may guide risk stratification and enactment of better health policies and procedures.The present study reported on cross-sectional study to determine the prevalence and longevity of SARS-CoV-2 antibodies in HCWs at a regional hospital system in Orange County, California, between May and August, 2020.Data from HCWs (n=3,458) were included in the analysis. Data from first responders (n=226) were also analyzed for comparison. A blood sample was collected at study enrollment and 8-week follow-up. Information on job duties, location, COVID-19 symptoms, polymerase chain reaction test history, travel since January 2020, and household contacts with COVID-19 was collected. Comparisons to estimated community prevalence were also evaluated.Observed antibody prevalence was 0.93% and 2.58% at initial and 8-week follow-up, respectively, for HCWs, and 5.31% and 4.35% for first responders. For HCWs, significant differences (p < .05) between negative vs. positive at initial assessment were found for age, race, fever, and loss of smell, and at 8-week follow-up for age, race, and all symptoms. Antibody positivity persisted at least 8 weeks in this cohort. Among 75 HCWs with self-reported prior PCR-confirmed COVID-19, 35 (46.7%) were antibody negative. Significant differences between negative vs. positive were observed in age and frequency of symptoms.This study found considerably lower SARS-CoV-2 antibody prevalence among HCWs compared with prior published studies. This may be explained by better safety measures in the workplace, heightened awareness inside and outside of the workplace, possibly lower susceptibility due to innate immunity and other biological heterogeneity, and low COVID-19 prevalence in the community itself. HCWs with initial positive results had persistent positive serologies at 8 weeks. Further research is warranted to investigate factors influencing such lower prevalence in our HCWs.

scholarly journals Age, period and cohort effects on body weight and body mass index in adults: The Doetinchem Cohort Study

2009 ◽  
Vol 12 (6) ◽  
pp. 862-870 ◽  
Author(s):  
Astrid CJ Nooyens ◽  
Tommy LS Visscher ◽  
WM Monique Verschuren ◽  
A Jantine Schuit ◽  
Hendriek C Boshuizen ◽  
...  
Keyword(s):  
Body Weight ◽  
Cohort Study ◽  
Longitudinal Data ◽  
Adult Population ◽  
Age Groups ◽  
Cohort Effects ◽  
Cross Sectional ◽  
Educational Levels ◽  
General Adult Population

AbstractObjectiveTo study the development of body weight with ageing, in a general adult population, taking into account possible period and cohort effects.DesignA prospective cohort study with 11 years of follow-up. At baseline and after 6 and 11 years, body weight and height were measured.SettingThe Doetinchem Cohort Study, consisting of inhabitants of Doetinchem, a town in a rural area of The Netherlands.SubjectsIn total, 4070 healthy men and women aged 20–59 years at baseline.ResultsIncrease in BMI with ageing was less profound based on cross-sectional data than based on longitudinal data. More recent-born cohorts had a higher BMI at a given age than cohorts who were born earlier. Increase in mean BMI with ageing was observed in all age groups and was similar for groups with a different educational level. Highest increase in BMI over 11 years was observed in the youngest group, aged 20–29 years at baseline (2·2 [95 % CL 2·0, 2·3] kg/m2), and lowest increase in the oldest group, aged 50–59 years at baseline (1·1 [1·0, 1·3] kg/m2).ConclusionsFindings of the present study using longitudinal data suggest that increase in BMI with ageing is underestimated in all age groups by studying cross-sectional data only. Further, weight gain is present in all educational levels and does not stop at middle age.

The patient's perception of a (reliable) change in the Multiple Sclerosis Functional C omposite

2004 ◽  
Vol 10 (1) ◽  
pp. 55-60 ◽  
Author(s):  
E LJ Hoogervorst ◽  
N F Kalkers ◽  
G R Cutter ◽  
B MJ Uitdehaag ◽  
C H Polman
Keyword(s):  
Multiple Sclerosis ◽  
Longitudinal Data ◽  
Functional Impairment ◽  
Outpatient Clinic ◽  
Cross Sectional ◽  
Reliable Change ◽  
Perceived Disability ◽  
Disability Scale ◽  
Patient’S Perception

Objective: To prospectively character ize the relation between two-year changes in functional impairment as measured by the Multiple Sclerosis Functio nal C omposite (MSFC) and changes in patient perceived disability as measured by the Guy’s Neurological Disability Scale (GNDS). Methods: O ne hundred and eighty-eight patients with multiple sclerosis (MS) were recruited at our outpatient clinic. Impairment and disability were assessed using the MSFC and G NDS at baseline and follow-up. Longitudinal correlations were studied between changes in MSFC and GNDS and their corresponding components. We also studied changes in G NDS in relation to what can be classified as a reliable change in MSFC; for example, 20% change in each MSFC component or a change of 0.5 in total MSFC score. In addition, we studied the change in total number of GNDS subcategories with a score of 3 or higher in relation to the predefined MSFC changes, these subcategories being indicative of the requirement for help by another person. Results: Despite good cross-sectional correlations between MSFC and GNDS, no significant correlation was found between longitudinal changes in MSFC and GNDS. A nalysing the change in GNDS in relation to the predefined MSFC changes shows that G NDS changes are nicely rank ordered when more stringent definitions of reliable change were applied. In addition, analysing the number of G NDS subcategories scored 3 or higher indicate that there is a profile of worsening on the MSFC being associated with increase in the amount of help required from others. Conclusion: O ur longitudinal data suggest that a reliable change is associated with a likewise change in patient perceived disability, the smallest reliable change being identified by at least 20% change in each MSFC component.

scholarly journals Neuropsychiatric symptoms and subsyndromes in patients with different stages of dementia in primary care follow-up (NeDEM project): a cross-sectional study.

2021 ◽  
Author(s):  
Victoria García-Martín ◽  
M Canto de Hoyos-Alonso ◽  
Gloria Ariza-Cardiel ◽  
Rosalía Delgado-Puebla ◽  
Paula García-Domingo ◽  
...  
Keyword(s):  
Primary Care ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional Study ◽  
Psychotic Symptoms ◽  
Sectional Study ◽  
Global Deterioration Scale ◽  
Cross Sectional ◽  
Affective Symptoms ◽  
Advanced Stages

Abstract BackgroundThe objective was to describe the prevalence and intensity of Neuropsychiatric symptoms (NPSs) isolated and grouped into subsyndromes in patients with dementia in primary care (PC), to analyse their distribution based on stages of dementia and the relationship between them and the intensity of symptoms.MethodsDesign: Cross-sectional study. Setting and population: Patients with dementia, not institutionalized, in PC follow-up. Variables: Sociodemographic and clinical. Assessment instruments: The frequency and intensity of NPSs were measured with the Neuropsychiatric Inventory (NPI), and the stages of dementia with the Global Deterioration Scale (GDS). Statistical analysis: The number of NPSs per patient, mean NPI value, and prevalence and intensity of NPSs isolated and grouped into subsyndromes were calculated, as were their 95% CIs. The analyses were performed on an overall basis and by GDS. To analyse the association between NPI and GDS, multivariate analysis was performed with a generalized linear model.Results98.4% (95% CI 94.5;99.8) of the patients presented some type of NPS, with an average of five symptoms per patient. The most frequent symptoms were apathy [69.8% (95% CI 61.1;77.5)], agitation [55.8% (95% CI 46.8;64.5)] and irritability [48.8% (95% CI 39.9;57.8)]. The NPSs with greater intensity were apathy [NPI 3.2 (95% CI 2.5;3.8)] and agitation [NPI 3.2 (95% CI 2.5;4.0)]. For subsyndromes, hyperactivity predominated [86.0% (95% CI 78.8;91.5)], followed by apathy [77.5% (95% CI 69.3;84.4]). By phase of dementia, the most common isolated symptom was apathy (60.7%-75.0%). Affective symptoms and irritability predominated in the initial stages, and psychotic symptoms predominated in advanced stages. The mean NPI score was 24.9 (95% CI 21.5;28.4) and increased from 15.6 (95% CI 8.2;23.1) for GDS 3 to 28.9 (95% CI 12.6;45.1) for GDS 7. Patients with in the most advanced stages of dementia presented an NPI score of 7.6 (95% CI 6.8;8.3) points higher than mild dementia, adjusted for the other variables.ConclusionsThere is a high prevalence of NPSs in patients with dementia treated in PC. Symptoms change and increase in intensity as the disease progresses. Scales such as the NPI allow these symptoms to be identified, which could facilitate more stage-appropriate management.

State-of-the-art aortic imaging: Part II - applications in transcatheter aortic valve replacement and endovascular aortic aneurysm repair

VASA ◽  
2014 ◽  
Vol 43 (1) ◽  
pp. 6-26 ◽  
Author(s):  
Fabian Rengier ◽  
Philipp Geisbüsch ◽  
Paul Schoenhagen ◽  
Matthias Müller-Eschner ◽  
Rolf Vosshenrich ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Transcatheter Aortic Valve Replacement ◽  
Surgical Repair ◽  
Imaging Modality ◽  
Open Surgical Repair ◽  
Cross Sectional ◽  
Transcatheter Aortic Valve ◽  
Cross Sectional Imaging ◽  
Sectional Imaging

Transcatheter aortic valve replacement (TAVR) as well as thoracic and abdominal endovascular aortic repair (TEVAR and EVAR) rely on accurate pre- and postprocedural imaging. This review article discusses the application of imaging, including preprocedural assessment and measurements as well as postprocedural imaging of complications. Furthermore, the exciting perspective of computational fluid dynamics (CFD) based on cross-sectional imaging is presented. TAVR is a minimally invasive alternative for treatment of aortic valve stenosis in patients with high age and multiple comorbidities who cannot undergo traditional open surgical repair. Given the lack of direct visualization during the procedure, pre- and peri-procedural imaging forms an essential part of the intervention. Computed tomography angiography (CTA) is the imaging modality of choice for preprocedural planning. Routine postprocedural follow-up is performed by echocardiography to confirm treatment success and detect complications. EVAR and TEVAR are minimally invasive alternatives to open surgical repair of aortic pathologies. CTA constitutes the preferred imaging modality for both preoperative planning and postoperative follow-up including detection of endoleaks. Magnetic resonance imaging is an excellent alternative to CT for postoperative follow-up, and is especially beneficial for younger patients given the lack of radiation. Ultrasound is applied in screening and postoperative follow-up of abdominal aortic aneurysms, but cross-sectional imaging is required once abnormalities are detected. Contrast-enhanced ultrasound may be as sensitive as CTA in detecting endoleaks.

Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽  
2016 ◽  
Vol 37 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Danica W. Y. Liu ◽  
A. Kate Fairweather-Schmidt ◽  
Richard Burns ◽  
Rachel M. Roberts ◽  
Kaarin J. Anstey
Keyword(s):  
Risk Factors ◽  
Well Being ◽  
Current Status ◽  
Psychological Resilience ◽  
Cross Sectional ◽  
Life Project ◽  
Resilience Factors ◽  
First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

Theoretical and Methodological Problems of a 10-Year Follow-Up Program Evaluation Study

2002 ◽  
Vol 18 (3) ◽  
pp. 229-241 ◽  
Author(s):  
Kurt A. Heller ◽  
Ralph Reimann
Keyword(s):  
Program Evaluation ◽  
Evaluation Studies ◽  
Evaluation Study ◽  
Control Groups ◽  
Cross Sectional ◽  
Long Term Study ◽  
Partial Inclusion ◽  
Methodological Problems

Summary In this paper, conceptual and methodological problems of school program evaluation are discussed. The data were collected in conjunction with a 10 year cross-sectional/longitudinal investigation with partial inclusion of control groups. The experiences and conclusions resulting from this long-term study are revealing not only from the vantage point of the scientific evaluation of new scholastic models, but are also valuable for program evaluation studies in general, particularly in the field of gifted education.

Hearing Outcome of Stapes Surgery in NIENT, Bangladesh

2020 ◽  
Vol 26 (1) ◽  
pp. 31-36
Author(s):  
Md Zakaria Sarkar ◽  
AHM Ferdows Nur ◽  
Utpal Kumar Dutta ◽  
Muhammad Rafiqul Islam ◽  
Debabrota Roy ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cross Sectional Study ◽  
Surgical Trauma ◽  
Group 14 ◽  
Progressive Hearing Loss ◽  
Cross Sectional ◽  
Hearing Gain ◽  
Hearing Outcome

Objective: The aim of this study was to evaluate hearing outcome after stapedotomy in patients with Otosclerosis. Methods: This cross sectional study was carried out from July 2017 to January 2019 in National Institute of ENT, Unit V. About 22 patients with Otosclerosis were included in this study. Diagnosis of Otosclerosis was based on the history, medical status with Otoscopy, Tuning fork tests and Audiometric tests. We compiled data on the pre and post operative air-bone gap (ABG) at 0.5, 1, 2 KHZ. The ABG was Calculated using AC and BC thresholds on the same audiogram. Post operative hearing gain was then Calculated from the ABG before the operation minus the ABG of the last follow up examination Results: In this study most of the cases were age group 14-30 years (72.7%), female (54.5%). Most common symptoms was progressive hearing loss, tinnitus (77.8%).The average preoperative hearing loss in this study was (AC) was 48.31±7.68. The average post opt. hearing (AC) at follow up was 28.95±10.30 with an average hearing gain of 15.40±8.53 dB which was significant. The average pre-operative ABG was 28.99 dB ± 8.10. The average post opt. ABG was analyzed at 1 follow up showed ABG 13.18±8.09 dB which was found to be significant. Conclusion: Stapedotomy is an effective surgical procedure for the treatment of otosclerosis which leads to improvement in patient’s quality of life. A favorable hearing outcome can be obtained by the combination of experienced hands with minimal surgical trauma and appropriate surgical technique. Bangladesh J Otorhinolaryngol; April 2020; 26(1): 31-36

Profiles of Psychosocial and Clinical Functioning in Adolescence and Risk for Later Depression

2019 ◽  
Author(s):  
Thomas M Olino ◽  
Daniel Klein ◽  
John Seeley
Keyword(s):  
Psychosocial Functioning ◽  
Adolescent Depression ◽  
Depressive Disorders ◽  
Self Report ◽  
Initial Assessment ◽  
Predictive Utility ◽  
Regression Methods ◽  
History Of ◽  
History Of Depression

Background: Most studies examining predictors of onset of depression focus on variable centered regression methods that focus on effects of multiple predictors. In contrast, person-centered approaches develop profiles of factors and these profiles can be examined as predictors of onset. Here, we developed profiles of adolescent psychosocial and clinical functioning among adolescents without a history of major depression. Methods: Data come from a subsample of participants from the Oregon Adolescent Depression Project who completed self-report measures of functioning in adolescence and completed diagnostic and self-report measures at follow-up assessments up to approximately 15 years after baseline. Results: We identified four profiles of psychosocial and clinical functioning: Thriving; Average Functioning; Externalizing Vulnerability and Family Stress; and Internalizing Vulnerability at the baseline assessment of participants without a history of depression at the initial assessment in mid- adolescence. Classes differed in the likelihood of onset and course of depressive disorders, experience of later anxiety and substance use disorders, and psychosocial functioning in adulthood. Moreover, the predictive utility of these classes was maintained when controlling for multiple other established risk factors for depressive disorders. Conclusions: This work highlights the utility of examining multiple factors simultaneously to understand risk for depression.

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