Long-term follow-up of 246 adults with juvenile idiopathic arthritis: functional outcome

Abstract Objective: To investigate changes in the craniofacial skeleton in relation to the changes in condylar alterations that occur during long-term follow-up in patients with juvenile idiopathic arthritis. Materials and Methods: Temporomandibular joint (TMJ) involvement is defined as a condylar alteration that is observed on the orthopantomogram. Lateral cephalograms were used to determine linear and angular measurements. Results: Seventy of 97 patients from the initial study cohort were included, with a mean follow-up of 68 months. The overall prevalence of condylar alterations and posterior rotation of the mandible decreased; however, the prevalence of retrognathia remained the same. Patients showed improvement in the degree of retrognathia and posterior rotation (40% ANB, 51% OP-SN, and 44% GO-GN-SN). Improvement in the degree of retrognathia was seen more often in patients with improved condylar alterations than in patients with persistent alterations and in those without alterations (50%, 33%, and 28%, respectively). The degree of posterior rotation improved almost equally in patients without TMJ involvement and in patients with improved condylar alterations (57% and 50% by OP-SN, and 67% and 38% GO-GN-SN, respectively) and did not improve in patients with stable persistent alterations. Conclusion: Both condylar and craniofacial alterations can improve in patients with juvenile idiopathic arthritis.

Download Full-text

Abstract TP127: Mortality and Recurrence in Atherosclerotic Ischemic Stroke: Long-term Follow-up

Stroke ◽

10.1161/str.48.suppl_1.tp127 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Miguel A Barboza ◽

Rodrigo Uribe ◽

Fabiola Serrano ◽

Luis C Becerra-Pedraza ◽

D. K Mantilla-Barbosa ◽

...

Keyword(s):

Ischemic Stroke ◽

Functional Outcome ◽

Median Time ◽

Smoking History ◽

Stroke Recurrence ◽

Active Smoking ◽

Long Term Outcome ◽

Long Term Follow Up

Background and purpose: Atherosclerotic ischemic stroke is the second most frequent etiology of stroke in the adult population. Functional outcome, mortality and recurrence of stroke rates on the long-term follow-up are poorly studied. This study investigates long-term outcome among patients with ischemic stroke secondary to atherosclerotic causality, and identifies the main factors associated with poor outcome, recurrence, and death. Methods: We analyzed data from our consecutive acute ischemic stroke database, over a period of 25 years (1990-2015). The endpoints were: bad outcome (Modified Rankin Score ≥3), recurrence and mortality at discharge, and final follow-up. Multivariate Cox and Kaplan-Meier analysis were used to estimate the probability of death and recurrence. Results: A total of 946 consecutive atherosclerotic stroke patients were included (571 [60.4%] males, median age 65 years [interquartile range 57-73 years] for the entire population); dyslipidemia (64.2%), hypertension (63.3%), diabetes (35.0%), and active smoking history (31.8%) were the most prevalent risk factors.After a median follow-up of 38 months (IQR 12-75 months), 59.3% patients had a bad outcome at discharge. A result of 26.1% had stroke recurrence (median time until recurrence: 9 months [IQR 12-84 months], with 12.9% cases presenting ≥2 recurrences), and 24.1% were dead (median time to death: 18.5 months [IQR 11-74 months]) at the final follow-up period. After multivariate adjustment, hypertension (HR 4.2, CI 95% 2.8-6.1; p<0.001) was the strongest predictor of recurrence. Additionally, diabetes (HR 2.6, CI 95% 2.0-3.5; p<0.001), bad functional outcome after recurrence (HR 2.3, CI 95% 1.9-2.9; p<0.001), age ≥65 years (HR 2.2, CI 95% 1.7-2.9; p<0.001), and active smoking (HR 1.8, CI 95% 1.3-2.3; p<0.001) were the strongest predictors of mortality. Conclusions: Atherosclerotic ischemic stroke has a high rate of recurrence, associated mainly with hypertension. Mortality is predicted by diabetes, bad functional outcome at recurrence, and older age.

Download Full-text

Total Knee Replacement in Young, Active Patients. Long-Term Follow-up and Functional Outcome*

The Journal of Bone and Joint Surgery (American) ◽

10.2106/00004623-199704000-00015 ◽

1997 ◽

Vol 79 (4) ◽

pp. 575-82 ◽

Cited By ~ 355

Author(s):

DAVID R. DIDUCH ◽

JOHN N. INSALL ◽

W. NORMAN SCOTT ◽

GILES R. SCUDERI ◽

DAVID FONT-RODRIGUEZ

Keyword(s):

Total Knee Replacement ◽

Functional Outcome ◽

Knee Replacement ◽

Long Term Follow Up ◽

Total Knee ◽

Active Patients

Download Full-text

Pseudotumours, cobalt and clinical outcome in small head metal-on-metal versus conventional metal-on-polyethylene total hip arthroplasty

Hip International ◽

10.1177/1120700019832877 ◽

2019 ◽

Vol 30 (1) ◽

pp. 56-63

Author(s):

Hugo C van der Veen ◽

Inge HF Reininga ◽

Wierd P Zijlstra ◽

Martijn F Boomsma ◽

Sjoerd K Bulstra ◽

...

Keyword(s):

Total Hip Arthroplasty ◽

Functional Outcome ◽

Hip Arthroplasty ◽

Follow Up Study ◽

Metal On Metal ◽

Small Head ◽

Long Term Follow Up ◽

Serum Cobalt

Background: Metal-on-metal total hip arthroplasty (MoM THA) is associated with the formation of pseudotumours. Studies mainly concern pseudotumour formation in large head MoM THA. We performed a long-term follow-up study, comparing pseudotumour incidence in small head metal-on-metal (SHMoM) THA with conventional metal-on-polyethylene (MoP) THA. Predisposing factors to pseudotumour formation were assessed. Methods: From a previous randomised controlled trial comparing SHMoM (28 mm) cemented THA with conventional MoP cemented THA, patients were screened using a standardised CT protocol for the presence of pseudotumours. Serum cobalt levels and functional outcome were assessed. Results: 56 patients (33 MoP and 23 MoM) were recruited after mean follow-up of 13.4 years (SD 0.5). The incidence of pseudotumours was 1 (5%) in the SHMoM THA cohort and 3 (9%) in the MoP THA cohort. Prosthesis survival was 96% for both SHMoM and MoP THAs. Serum cobalt levels did not exceed acceptable clinical values (<5 µg/L) whereas no differences in cobalt levels were detected at follow-up between both groups. Oxford and Harris Hip Scores were good and did not differ between SHMoM and MoP THA. Conclusions: This long-term follow-up study shows a low incidence of pseudotumour formation and good functional outcome in cemented head-taper matched SHMoM and MoP THA.

Download Full-text

FUNCTIONAL OUTCOME FOLLOWING LATERAL PATELLAR RETINACULAR RELEASE: A LONG-TERM FOLLOW-UP.

Journal of Investigative Medicine ◽

10.1097/00042871-200401001-00469 ◽

2004 ◽

Vol 52 ◽

pp. S161

Author(s):

E. D. Griffin ◽

P. G. Gerbino ◽

L. J. Micheli ◽

C. C. Teitz ◽

D. Zurakowski

Keyword(s):

Functional Outcome ◽

Long Term Follow Up ◽

Lateral Patellar Retinacular Release

Download Full-text

Long-term Follow-up of Patients with Uveitis Associated with Juvenile Idiopathic Arthritis: A Cohort Study

Ocular Immunology and Inflammation ◽

10.1080/09273940802650398 ◽

2009 ◽

Vol 17 (2) ◽

pp. 104-108 ◽

Cited By ~ 45

Author(s):

Angelika Skarin ◽

Renate Elborgh ◽

Eva Edlund ◽

Elisabeth Bengtsson-Stigmar

Keyword(s):

Cohort Study ◽

Juvenile Idiopathic Arthritis ◽

Long Term Follow Up

Download Full-text

Long-term follow-up on effectiveness and safety of etanercept in juvenile idiopathic arthritis: the Dutch national register

Annals of the Rheumatic Diseases ◽

10.1136/ard.2007.087411 ◽

2008 ◽

Vol 68 (5) ◽

pp. 635-641 ◽

Cited By ~ 139

Author(s):

F H M Prince ◽

M Twilt ◽

R ten Cate ◽

M A J van Rossum ◽

W Armbrust ◽

...

Keyword(s):

Juvenile Idiopathic Arthritis ◽

Adverse Events ◽

Rheumatoid Factor ◽

Serious Adverse Events ◽

American College Of Rheumatology ◽

Systemic Jia ◽

Long Term Follow Up ◽

Remission Criteria

Objective:We undertook an observational study to obtain a complete overview of the long-term effectiveness and safety of etanercept in patients with different juvenile idiopathic arthritis (JIA) subtypes.Methods:At baseline we collected patient and disease characteristics of all Dutch patients with JIA who started treatment with etanercept. Disease activity was evaluated (at start of the study, after 3 months and then yearly) according to the JIA core set of the American College of Rheumatology paediatric definition for 30, 50 and 70% improvement (ACR Pedi 30, 50 and 70). Use of etanercept and concomitant drugs was monitored. Adverse events were recorded.Results:We included 146 patients with JIA with a median follow-up of 2.5 years per patient (range 0.3–7.3). JIA subtypes represented: 27% systemic, 8% polyarticular rheumatoid factor positive, 38% polyarticular rheumatoid factor negative, 19% oligoarticular extended, 3% enthesitis-related and 5% psoriatica. Most patients (77%) met the criteria of the ACR Pedi 30 in the first 3 months of treatment. For the majority of patients this improvement was sustained; 53 (36%) of all patients met the remission criteria. No other second-line agents were needed in 43 patients. Although patients with systemic JIA responded initially less to etanercept therapy than patients from other subtypes, those who did respond showed equal effectiveness in the long term. Serious adverse events rate was low (0.029 per patient year).Conclusions:Etanercept is effective and safe in JIA, even for a large proportion of the patients with systemic JIA. The greatest improvement occurred in the first 3 months of treatment, and was sustained for a long time in most patients (up to 75 months).

Download Full-text