Long-term Cognitive Outcome of Children With Parenchymal Neurocysticercosis: A Prospective Observation Study

2018 ◽  
Vol 33 (7) ◽  
pp. 468-473 ◽  
Author(s):  
Pratibha Singhi ◽  
Prabhjot Malhi ◽  
Renu Suthar ◽  
Brijendra Deo ◽  
N. K. Khandelwal
Keyword(s):  
Socioeconomic Status ◽  
Cognitive Assessment ◽  
Cognitive Outcome ◽  
Lower Socioeconomic Status ◽  
Observation Study ◽  
Lower Socioeconomic ◽  
Scholastic Performance ◽  
Poor Memory

To study the cognitive profile and scholastic performance of children with parenchymal neurocysticercosis. A total of 500 children with a diagnosis of neurocysticercosis and epilepsy registered in our pediatric neurocysticercosis clinic between January 1996 and December 2002 were enrolled. Patients were evaluated for their scholastic performance using their school grades. Cognitive assessment was done using Parental interview and the “Draw-a-Man” test. Poor scholastic performance was seen in 22.2% (111) children. Draw-a-Man test was done in 148 children; 18.2% (27/148) had scores equivalent to IQ <70. Intermittent headache, behavior problems, and poor memory were reported in 40% (201) children. Multiple lesions, lower socioeconomic status, and calcified lesions on follow-up were associated with academic underachievement ( P < .05). About a fourth of children with neurocysticercosis had cognitive impairment during follow-up. This was mostly seen in children from lower socioeconomic status and in those with multiple-lesion neurocysticercosis.

Risk factors for incidence of trachomatous scarring in a cohort of women in low endemic district

2018 ◽  
Vol 102 (4) ◽  
pp. 419-423 ◽  
Author(s):  
Rabia Karani ◽  
Meraf Wolle ◽  
Harran Mkocha ◽  
Beatriz Muñoz ◽  
Sheila K West
Keyword(s):  
Socioeconomic Status ◽  
Logistic Regression ◽  
Demographic Factors ◽  
Bivariate Analysis ◽  
Fire Exposure ◽  
Lower Socioeconomic Status ◽  
Multivariable Logistic Regression Model ◽  
Lower Socioeconomic ◽  
Endemic District

Background/aimsTo determine the incidence of scarring in women in a trachoma low endemic district of rural Tanzania and to determine the effects of lifetime cooking fire exposure and markers of lower socioeconomic status on incidence of scarring in these women.MethodsA prospective cohort study was conducted over a 3.5-year period from 2013 to 2016 in 48 villages in Kongwa, Tanzania where trachoma at baseline was 5.2% in children. A random sample of 2966 women aged 15 and older who were at risk for incident scarring were eligible for follow-up. Data on demographic factors, cooking fire exposure and trachomatous scarring were gathered at baseline and follow-up. An index of lifetime exposure to cooking fire exposure was created and bivariate analysis, age-adjusted logistic regression and multivariable logistic models were used to look for associations of demographic factors and cooking fire exposure with incident trachomatous scarring.ResultsThe cumulative incidence of scarring was 7.1% or 2.0% per year. Incidence of scarring increased with age and exposure to markers of lower socioeconomic status. A multivariable logistic regression model adjusting for confounding factors did not find an association between lifetime cooking fire exposure and incidence of scarring (OR=0.92; 95% CI 0.68 to 1.24, P=0.58).ConclusionsThere was still incident scarring in women in Tanzania despite low rates of active trachoma. There was no association between exposure to cooking fires and incident scarring. More research is needed to understand the factors that contribute to new scarring in these women.

Abstract 17079: Lower Socioeconomic Status Portends Higher Long Term Mortality Following Isolated Mitral Valve Surgery

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Mark R Helmers ◽  
William Patrick ◽  
Cody Fowler ◽  
Amit Iyengar ◽  
Jason J Han ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Mitral Valve ◽  
Census Block ◽  
Lower Socioeconomic Status ◽  
Term Survival ◽  
Lower Socioeconomic ◽  
Address Data ◽  
Block Groups ◽  
Long Term Mortality

Introduction: Lower socioeconomic status (SES) has been associated with worse outcomes in patients undergoing cardiac surgery; however, this has not been fully elucidated in mitral valve (MV) surgery. We sought to determine the effect of SES on short-term outcomes and long-term mortality following MV surgery. Hypothesis: Lower SES is associated with higher mortality following isolated MV surgery. Methods: Retrospective analysis of our institution’s MV database was performed between November 1998 and March 2019 for all adult patients undergoing isolated MV surgery in our state and 4 neighboring states. Patients for whom address data was missing were excluded. SES was determined by the Area Deprivation Index (ADI). The ADI uses 17 social determinants of heath to estimate the average SES for all US Census Block Groups (mean 1500 people). This score is then nationally indexed from 1 to 100, with lower SES represented by higher scores. Patients were stratified by ADI quartiles. Baseline characteristics and postoperative outcomes were compared between quartiles. Results: Overall, 3,860 surgeries met inclusion criteria during the study period. Of these, 1,795 (46.5%) patients fell into the lowest ADI quartile, 1,216 (31.5%) in the second quartile, 476 (12.3%) in the third quartile, and 344 (8.9%) in the highest quartile. 30-day mortality was not significantly different between ADI quartiles and ADI was not a significant determinate of 30-day survival in a multivariable logistical regression. Figure 1 show the distribution of patient addresses within Census Block Groups as well as 10-year survival by Kaplan-Meier estimates, stratified by ADI quartiles. Cox proportional hazards model revealed that lower SES as determined by ADI was associated with increased 10-year mortality (P = 0.008). Conclusions: Lower SES is associated with worse long-term survival in patients undergoing isolated MV surgery. Social interventions to bridge this survival gap are warranted.

The Social Construction of a Gentrifying Neighborhood

2015 ◽  
Vol 52 (1) ◽  
pp. 98-128 ◽  
Author(s):  
Jackelyn Hwang
Keyword(s):  
Socioeconomic Status ◽  
Social Construction ◽  
Cultural History ◽  
Cognitive Maps ◽  
Lower Socioeconomic Status ◽  
Socially Constructed ◽  
Lower Socioeconomic ◽  
The Social ◽  
Shed Light

This study draws upon cognitive maps and interviews with 56 residents living in a gentrifying area to examine how residents socially construct neighborhoods. Most minority respondents, regardless of socioeconomic status and years of residency, defined their neighborhood as a large and inclusive spatial area, using a single name and conventional boundaries, invoking the area’s Black cultural history, and often directly responding to the alternative way residents defined their neighborhoods. Both long-term and newer White respondents defined their neighborhood as smaller spatial areas and used a variety of names and unconventional boundaries that excluded areas that they perceived to have lower socioeconomic status and more crime. The large and inclusive socially constructed neighborhood was eventually displaced. These findings shed light on how the internal narratives of neighborhood identity and boundaries are meaningfully tied to a broader structure of inequality and shape how neighborhood identities and boundaries change or remain.

scholarly journals Lower socioeconomic status is associated with increased long‐term mortality after sudden cardiac arrest

2019 ◽  
Vol 42 (8) ◽  
pp. 735-740
Author(s):  
Ankit N. Medhekar ◽  
Shubash Adhikari ◽  
Ahmed S. Abdul‐Al ◽  
Sayna Matinrazm ◽  
Krishna Kancharla ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Cardiac Arrest ◽  
Sudden Cardiac Arrest ◽  
Lower Socioeconomic Status ◽  
Lower Socioeconomic ◽  
Long Term Mortality

Effect modifiers for patient-reported outcomes in operatively and nonoperatively treated patients with adult symptomatic lumbar scoliosis: a combined analysis of randomized and observational cohorts

2020 ◽  
Vol 33 (1) ◽  
pp. 17-26
Author(s):  
Elizabeth L. Yanik ◽  
Michael P. Kelly ◽  
Jon D. Lurie ◽  
Christine R. Baldus ◽  
Christopher I. Shaffrey ◽  
...  
Keyword(s):  
Mental Health ◽  
Socioeconomic Status ◽  
Operative Treatment ◽  
Nonoperative Treatment ◽  
Lower Socioeconomic Status ◽  
Effect Modifier ◽  
Lumbar Scoliosis ◽  
Lower Socioeconomic ◽  
High Bmi

OBJECTIVEAdult symptomatic lumbar scoliosis (ASLS) is a common and disabling condition. The ASLS-1 was a multicenter, dual-arm study (with randomized and observational cohorts) examining operative and nonoperative care on health-related quality of life in ASLS. An aim of ASLS-1 was to determine patient and radiographic factors that modify the effect of operative treatment for ASLS.METHODSPatients 40–80 years old with ASLS were enrolled in randomized and observational cohorts at 9 North American centers. Primary outcomes were the differences in mean change from baseline to 2-year follow-up for the SRS-22 subscore (SRS-SS) and the Oswestry Disability Index (ODI). Analyses were performed using an as-treated approach with combined cohorts. Factors examined were prespecified or determined using regression tree analysis. For each potential effect modifier, subgroups were created using clinically relevant cutoffs or via regression trees. Estimates of within-group and between-group change were compared using generalized linear mixed models. An effect modifier was defined as a treatment effect difference greater than the minimal detectable measurement difference for both SRS-SS (0.4) and ODI (7).RESULTSTwo hundred eighty-six patients were enrolled and 256 (90%) completed 2-year follow-up; 171 received operative treatment and 115 received nonoperative treatment. Surgery was superior to nonoperative care for all effect subgroups considered, with the exception of those with nearly normal pelvic incidence−lumbar lordosis (PI–LL) match (≤ 11°). Male patients and patients with more (> 11°) PI–LL mismatch at baseline had greater operative treatment effects on both the SRS-SS and ODI compared to nonoperative treatment. No other radiographic subgroups were associated with treatment effects. High BMI, lower socioeconomic status, and poor mental health were not related to worse outcomes.CONCLUSIONSNumerous factors previously related to poor outcomes with surgery, such as low mental health, lower socioeconomic status, and high BMI, were not related to outcomes in ASLS in this exploratory analysis. Those patients with higher PI–LL mismatch did improve more with surgery than those with normal alignment. On average, none of the factors considered were associated with a worse outcome with operative treatment versus nonoperative treatment. These findings may guide future prospective analyses of factors related to outcomes in ASLS care.

scholarly journals Socioeconomic Disparities in Surveillance and Follow-Up of Patients with Thoracic Aortic Aneurysm

2021 ◽  
Author(s):  
Michael Shang ◽  
Gabe Weininger ◽  
Makoto Mori ◽  
Arianna Kahler-Quesada ◽  
Ellelan Degife ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Aortic Aneurysm ◽  
Competing Risks ◽  
Thoracic Aortic Aneurysm ◽  
Surgical Intervention ◽  
Aortic Aneurysms ◽  
Lower Socioeconomic Status ◽  
Lower Socioeconomic ◽  
Surveillance Imaging

Background: Thoracic aortic aneurysm is a significant risk factor for aortic dissection and rupture. Guidelines recommend referral of patients to a cardiovascular specialist for periodic surveillance imaging with surgical intervention determined primarily by aneurysm size. We investigated the association between socioeconomic status and surveillance practices in patients with ascending aortic aneurysms. Methods: We retrospectively reviewed records of 465 consecutive patients diagnosed between 2013-2016 with ascending aortic aneurysm ≥4cm on computed tomography scans. Primary outcomes were clinical follow-up with a cardiovascular specialist and aortic surveillance imaging within 2 years following index scan. We stratified patients into quartiles using the area deprivation index (ADI), a validated percentile measure of 17 variables characterizing socioeconomic status at the census block group level. Competing risks analysis was used to determine interquartile differences in risk of death prior to follow up with a cardiovascular specialist. Results: Lower socioeconomic status was associated with significantly lower rates of surveillance imaging and referral to a cardiovascular specialist. On competing risks regression, the ADI quartile with lowest socioeconomic status had lower hazard of follow-up with a cardiologist or cardiac surgeon prior to death (HR 0.46 [0.34, 0.62], p<0.001). Though there were no differences in aneurysm size at time of surgical repair, patients in the lowest socioeconomic quartile were more frequently symptomatic at surgery than other quartiles (92% vs 23-38%, p<0.001). Conclusion: Patients with lower socioeconomic status receive less timely follow-up imaging and specialist referral for thoracic aortic aneurysms, resulting in surgical intervention only when alarming symptoms are already present.

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