scholarly journals MON-307 Prospective, Longitudinal Study of Glucose-Suppressed GH Levels in 87 Acromegaly Patients with IGF-1 Normalization After Surgical Therapy: Prognostic Value of Nadir GH Levels for Long-Term Remission or Recurrence

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Pamela Freda ◽  
Jeffrey N Bruce ◽  
Carlos Reyes-Vidal ◽  
Yessica De Leon ◽  
Zhezhen Jin ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Prognostic Value ◽  
Relevant Information ◽  
Oral Glucose ◽  
Surgical Removal ◽  
Prospective Longitudinal Study ◽  
Normal Ranges ◽  
Prospective Longitudinal

Abstract Surgical removal of the GH-secreting tumor is the initial treatment of choice for acromegaly. Outcome of surgery is assessed by measuring IGF-1 and glucose-suppressed GH levels. IGF-1 normalization is an essential biochemical criterion for remission. The cut-off for nadir GH after oral glucose that signifies remission, however, is debated. It also remains unclear whether GH levels provide additional prognostic or clinically relevant information when IGF-1 results are definitive. To address this question, we examined how initial postoperative glucose-suppressed GH levels change over time on serial testing in patients who achieve initial remission as defined by IGF-1 normalization. We studied 87 acromegaly patients (48M, 39F) who achieved a normal IGF-1 level after surgery alone longitudinally from 1996 to 2019. All had GH measured before and 60, 90 and 120 minutes after 75 or 100 mg oral glucose (OGTT) at ≥ 3 months after surgery and GH and IGF-1 repeated ≥ 1 year later. GH was by measured by sensitive, 22KDa GH specific assays, either a IRMA (DSL, International Reference Standard (IRS) 88/624) or a chemiluminescence immunoassay (IDS-iSYS, IRS 98/574). OGTT Nadir GH levels were also measured in healthy subjects; n=46 (26 M, 20 F, ages 19-71 yr.) by DSL and n=46 (29 M, 17 F; ages 20-66 yr.) by IDS-iSYS. Nadir GH levels in acromegaly patients were compared to the 95%CI of healthy subjects’ mean and categorized relative to healthy subjects’ 97.5 percentile, which was 0.14 µg/L for both assays. IGF-1 levels were compared to age and gender adjusted normal ranges. Subjects were grouped based on initial nadir GH ≤ or > 0.14 µg/L and the patterns of change in nadir GH and IGF-1 at last follow up or until IGF-1 became elevated (i.e. recurrence). Follow up durations are given as median(range). In follow up, 73 patients remained in remission (normal IGF-1) and 14 had a recurrence (elevated IGF-1). Of the 73 in remission, 55 had initial nadir GH ≤ 0.14 µg/L that persisted to 10 yr.(1-22yr.) of follow up, 5 had initial GH ≤ 0.14 µg/L that rose to > 0.14 µg/L by 9(3-21)yr., 10 had GH > 0.14 µg/L that persisted at 5.5(2-22)yr., and 3 had GH > 0.14 µg/L that fell to ≤ 0.14 µg/L at 5(4-7)yr. of follow up. Of the 14 that recurred, 11 had an initial and persistent GH > 0.14 µg/L and developed an elevated IGF-1 level after 6(1-23) yr.. The 3 other patients that recurred had an initial GH ≤ 0.14 µg/L that rose to > 0.14 µg/L by 1-6 years later and subsequently developed an elevated IGF-1 level by 14-16 years of follow up. In summary, we found that the pattern of normal IGF-1 along with nadir GH > 0.14 µg/L on initial testing or developing with time, was associated with recurrence in 14/32 patients. We also found that initial nadir GH ≤ 0.14 µg/L was highly predictive of long-term persistent remission: 60/63 such patients remained in remission. In conclusion, glucose-suppressed GH levels are of prognostic value in acromegaly patients with normal IGF-1 after surgery.

Early Exposure to Direct Instruction and Subsequent Juvenile Delinquency: A Prospective Examination

2002 ◽  
Vol 69 (1) ◽  
pp. 85-96 ◽  
Author(s):  
Paulette E. Mills ◽  
Kevin N. Cole ◽  
Joseph R. Jenkins ◽  
Philip S. Dale
Keyword(s):  
Early Childhood ◽  
Juvenile Delinquency ◽  
Direct Instruction ◽  
Preschool Education ◽  
Prospective Longitudinal Study ◽  
Young Children With Disabilities ◽  
Long Term Impact ◽  
Prospective Longitudinal

In a widely cited follow-up study of disadvantaged preschool attendees, Schweinhart, Weikart, and Larner (1986a) found that graduates of an early childhood program using direct instruction (DI) methods exhibited higher rates of juvenile delinquency at age 15 than did graduates of two other preschool education models. The present research examined juvenile delinquency outcomes for young children with disabilities in a prospective longitudinal study that tracked the long-term impact of two preschool models—one using DI, the other using a cognitively oriented, child-directed model. We followed 171 children who had been randomly assigned to the two early childhood models. At age 15, the groups did not differ significantly in their level of reported delinquency. Analyses suggest that gender differences in delinquent behavior may provide a more parsimonious explanation than program effects for the earlier Schweinhart et al. findings.

scholarly journals Long-term outcomes of rotating gamma knife for vestibular schwannoma: A 4-year prospective longitudinal study of 89 consecutive patients in Vietnam

2021 ◽  
Vol 12 ◽  
pp. 585
Author(s):  
Hung Dinh Kieu ◽  
Duong Ngoc Vuong ◽  
Khoa Trong Mai ◽  
Phuong Cam Pham ◽  
Tam Duc Le
Keyword(s):  
Longitudinal Study ◽  
Gamma Knife ◽  
Trigeminal Nerve ◽  
Vestibular Schwannoma ◽  
Tumor Control ◽  
Prospective Longitudinal Study ◽  
Nerve Preservation ◽  
Prospective Longitudinal

Background: Microsurgical total removal of vestibular schwannoma (VS) is the definitive treatment but has a high incidence of postoperative neurological deficits. Rotating Gamma Knife (RGK) is a preferred option for a small tumor. This study aims to evaluate long-term neurological outcomes of RGK for VS. Methods: This prospective longitudinal study was conducted at the Nuclear Medicine and Oncology Center, Bach Mai Hospital, Hanoi, Vietnam. Eighty-nine consecutive patients were enrolled from October 2011 to October 2015 and followed up to June 2017. RGK was indicated for VS measuring <2.2 cm, while RGK for tumors measuring 2.2–3 cm was considered in patients with severe comorbidities, high-risk surgery, and who denied surgery. Concurrently, VS consisted of newly diagnosed, postoperative residual, and recurrent tumors. Patients with neurofibromatosis type 2 were excluded from the study. Primary outcomes were radiological tumor control rate, vestibulocochlear functions, facial and trigeminal nerve preservation. Stereotactic radiosurgery was performed by the Rotating Gamma System Gamma ART 6000. Results: The tumors were measured 20.7 ± 5.6 mm at pre treatment and 17.6 ± 4.1 mm at 3-year post treatment. The mean radiation dose was 13.5 ± 0.9 Gy. Mean follow-up was 40.6 ± 13.3 months. The radiological tumor control rate was achieved 95.5% at 5-year post treatment. The hearing and vestibular functions were preserved in 70.3% and 68.9%, respectively. The facial and trigeminal nerve preservation rates were 94.4% and 73.3%, respectively. Conclusion: RGK is an effective and safe treatment for VS measuring ≤3 cm with no significant complications during long-term follow-up.

scholarly journals The fall in antibody response to SARS-CoV-2: a longitudinal study of asymptomatic to critically ill patients up to 10 months after recovery

2021 ◽  
Author(s):  
Maddalena Peghin ◽  
Maria De Martino ◽  
Martina Fabris ◽  
Alvisa Palese ◽  
Erica Visintini ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Antibody Response ◽  
Seroconversion Rate ◽  
Disease Onset ◽  
Acute Onset ◽  
Serological Response ◽  
Prospective Longitudinal Study ◽  
Prospective Longitudinal

Background. The aim was to assess long-term dynamics and factors associated with the serological response against the Severe Acute Respiratory Syndrome Coronavirus 2 after primary infection. Methods. A prospective longitudinal study with monthly serological follow-up during the first 4 months, and then at 6, 8 and 10 months after the disease onset of all recovered adult in- and out-patients with Coronavirus Disease 2019 (COVID-19) attending Udine Hospital (Italy) during the first wave (from March to May 2020). Results. 542 individuals were included (289 female, mean age 53.1 years), mostly with mild COVID-19 (370, 68.3%). Patients were followed for a median of 302 days (Interquartile Range, 186-311). Overall seroconversion rate within two months was 32% for IgM and 90% for IgG. Seroreversion was observed in 90% of patients for IgM at 4 months and in 47% for IgG at 10 months. older age, number of symptoms at acute onset, severity of acute COVID-19, were all independent predictors of long-term immunity both for IgM (β, linear regression coefficient, 1.10, p=0.001; β 5.15 p=0.014; β 43.84 p=0.021, respectively) and for IgG (β 1.43 p<0.001; β 10.46 p<0.001; β 46.79 p<0.001, respectively), whereas the initial IgG peak was associated only with IgG duration (β 1.12, p <0.001). Conclusions. IgM antibodies disappeared at four months and IgG antibodies declined in about half of patients 10 months after acute COVID-19. These effects varied depending on the intensity of the initial antibody response, age and burden of acute COVID-19.

scholarly journals Older Sepsis Survivors Suffer Persistent Disability Burden and Poor Long-Term Survival

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 138-139
Author(s):  
Robert Mankowski ◽  
Stephen Anton ◽  
Gabriela Ghita ◽  
Christiaan Leeuwenburgh ◽  
Lyle Moldawer ◽  
...  
Keyword(s):  
Performance Status ◽  
Middle Aged ◽  
Term Survival ◽  
Prospective Longitudinal Study ◽  
Discharge Disposition ◽  
Sepsis Survivors ◽  
Persistent Disability ◽  
Prospective Longitudinal

Abstract As in-hospital sepsis mortality has decreased, more “sepsis survivors” are progressing into poorly characterized long-term outcomes. The purpose of this study was to describe the current epidemiology of sepsis in older adults compared to middle-aged and young adults. Design: Prospective longitudinal study with patients categorized into young (≤ 45 years), middle-aged (46-64 years) and older (≥ 65 years) patient groups. 328 sepsis patients were characterized by a) baseline demographics and predisposition factors, b) septic event, c) hospital outcomes and discharge disposition, d) 12-month mortality and e) Zubrod Performance status, physical function and cognitive function at three, six and 12-month follow-up. Follow-up visits were not completed due to death (in 68) and withdrawal of consent (in 32). Compared to young and middle-aged patients, older patients had: 1) significantly more comorbidities at presentation (example chronic renal disease 6% vs 12 % vs 21%), intra-abdominal infections (14% vs 25% vs 37%), septic shock (12% vs 25% vs 36%) and organ dysfunctions, 2) higher 30 day mortality (6% vs 4% vs 17%) and fewer ICU free days (median 25 vs 23 vs 20), 3) more progression into CCI (22%, vs 34% vs 42%) with higher poor disposition discharge to non-home destinations (19% vs 40% vs 62%), 4) worse 12-month mortality (11% vs 14 % vs 33%) and, 5) poorer Zubrod Performance status and objectively-measured physical and cognitive functions with slight improvement over 12 month follow-up. Conclusion: Compared to younger patients, older sepsis survivors suffer with both a higher persistent disability burden and 12-month mortality.

Immediate and Long-Term Mental Health Outcomes in Adolescent Female Rape Survivors

2016 ◽  
Vol 35 (1-2) ◽  
pp. 252-267 ◽  
Author(s):  
Yewande Oshodi ◽  
Muiruri Macharia ◽  
Anusha Lachman ◽  
Soraya Seedat
Keyword(s):  
Psychological Impact ◽  
Cape Town ◽  
Child And Adolescent ◽  
Adolescent Female ◽  
Prospective Longitudinal Study ◽  
Rape Survivors ◽  
Child And Adolescent Trauma ◽  
Prospective Longitudinal

Rape is considered a stressful trauma and often has long-lasting health consequences. Compared with adult females, limited data exist on the psychological impact of rape in adolescents. The aim of this study was to assess the prevalence and associated factors of emotional distress in a cohort of adolescent rape survivors in Cape Town. Participants in this prospective longitudinal study were 31 adolescent female rape survivors recruited from a rape clinic in Cape Town and assessed within 2 weeks of the assault. Assessment measures included a sociodemographic questionnaire and initial screening with the Child and Adolescent Trauma Survey (CATS), the patient-rated Children’s Depression Inventory (CDI), and the Multidimensional Anxiety Scale for Children (MASC). The CATS, CDI, and MASC were repeated at 1, 3, 6, 9, and 12 months post enrollment. Psychiatric diagnoses were made with the clinician-administered Mini International Neuropsychiatric Interview–Child and Adolescent version (MINI-Kid). At baseline, on the MINI-Kid, a definitive diagnosis of major depressive episode was endorsed in 22.6% of the participants. Stress-related disorders were found in 12.9%, whereas 16.1% had anxiety disorders. There was no diminution of symptoms on self-reported psychopathology measures at follow-up assessment over the five follow-up time points, suggesting persistent psychopathology over a 1-year period despite repeated clinical assessments and supportive counseling. Symptoms of anxiety, depression, and posttraumatic stress disorder in this sample of adolescent female rape survivors were high at enrollment and found to be persistent, underlining the need for long-term support, screening, and evidence-based follow-up care.

Abstract MP04: 25 year Physical Activity Trajectories and Development of Subclinical Coronary Artery Disease as Measured by Coronary Artery Calcium: the CARDIA Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jamal S Rana ◽  
Rosenda Murillo ◽  
Charles P Quesenberry ◽  
Michael E Sorel ◽  
Barbara Sternfeld ◽  
...  
Keyword(s):  
Physical Activity ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Middle Age ◽  
Subclinical Atherosclerosis ◽  
Prospective Longitudinal Study ◽  
Men And Women ◽  
Prospective Longitudinal

Background: Physical activity (PA) has been shown to be protective against the development of clinical cardiovascular disease. There is paucity of data regarding the association of long term PA patterns and development of subclinical atherosclerosis, as measured by coronary artery calcium (CAC). Studies so far are limited by evaluation of PA only at baseline. The goal of this study was to identify 25 year patterns of PA from young to middle age and its association with development of CAC. Methods: CARDIA is a prospective longitudinal study of black and white men and women, ages 18-30 years at baseline in 1985-86, with up to 7 follow-up exams over 25 years of follow-up. PA was determined at each exam by a questionnaire that assessed typical PA during the past 12 months for 13 types of activities. Men and women who had at least 3 measures of PA during the 25 years of follow up and CAC assessment at the Year 25 exam were included (N= 3178). CARDIA Physical Activity Score > 300 units is approximately equivalent to >150 min/week of moderate or vigorous physical activity and was considered as meeting PA guidelines (MPAG). Latent class modeling was used to identify unique trajectories of PA. Odds ratios for CAC were estimated from a multivariable logistic model controlling for age, sex, ethnicity, hypertension, diabetes, BMI, smoking status and education. Results: Our analyses showed 5 unique PA trajectories (figure). 1. Maintaining-not MPAG (46.5%); 2. maintaining-MPAG (35.6%); 3 increasing-MPAG (8.5%); 4. decreasing-MPAG (6.5%), and 5. maintaining- > 3 fold MPAG (2.4%). Compared with the maintaining-not MPAG, the multivariable adjusted odds ratio for presence of CAC (non-zero CAC score) was 1.02 (95% CI, 0.84-1.24) for maintaining-MPAG, 1.07 (95% CI, 0.78-1.44) for increasing-MPAG , 1.01(95% CI, 0.72- 1.41) for decreasing-MPAG , and 1.37 (95% CI, 0.82-2.27) for maintaining- > 3 fold MPAG. Conclusion: Long-term trajectories for levels of PA through young adulthood are not associated with development of subclinical atherosclerosis by middle age.

733: The Prognostic Value of E-Cadherin, Alpha-, and Beta-Catenin in Invasive Bladder Cancer Patients: Long Term Follow-Up Study

2004 ◽  
Vol 171 (4S) ◽  
pp. 194-195
Author(s):  
Kyoichi Tomita ◽  
Haruki Kume ◽  
Keishi Kashibuchi ◽  
Satoru Muto ◽  
Shigeo Horie ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Prognostic Value ◽  
Invasive Bladder Cancer ◽  
Beta Catenin ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
E Cadherin

scholarly journals Hidradenoma papilliferum of the hymen: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ozer Birge ◽  
Mehmet Sait Bakır ◽  
Ceyda Karadag ◽  
Zivar Eldarova ◽  
Tayup Simsek
Keyword(s):  
Benign Neoplasm ◽  
Surgical Removal ◽  
Apocrine Glands ◽  
Sexually Transmitted ◽  
Anogenital Region ◽  
Hidradenoma Papilliferum ◽  
Anogenital Area ◽  
Slow Growing

Abstract Background Hidradenoma papilliferum is a rare benign neoplasm arising from apocrine glands. It occurs commonly on the anogenital region of middle-aged women. It usually presents as a slow growing, solitary asymptomatic, skin colored or red nodule less than 1 cm in diameter. Case presentation The case is a 38-year-old, white woman who presented with a painful nodule occurring within a month in the himenal region of the posterior vaginal introitus. The nodule was excisied and the histology revealed a hidradenoma papilliferum. The diagnosis and treatment of hidradenoma papilliferum is possible with surgical removal and histopathological evaluation of nodules. Conclusion When an adult woman presents with a noduler lesion in the anogenital area, sexually transmitted diseases and other benign and malignant vulvar lesions, as well as malignant transformation is very rare but,should be kept in mind; however because it has been reported and long-term clinical follow-up is suggested

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