Blepharochalasis:Clinical and Epidemiological Characteristics, Surgical Strategy and Prognosis-- A Retrospective Cohort Study with 93 Cases

Retrospective Cohort ◽

Acute Attack ◽

Surgical Strategy ◽

Lacrimal Gland Prolapse ◽

The Mean ◽

Epidemiological Characteristics

Abstract Background: Blepharochalasis is a rare eyelid disorder but eventually leading to destructive eyelid deformation. Until now the clinical and epidemiological data is unavailable. This study aimed o report the manifestations, epidemiological characteristics and surgical strategy of a large series of blepharochalasis patients with long-term follow up, the prognosis of different clinical deformities was also investigated. Methods: This is a retrospective cohort study, included consecutive patients diagnosed with blepharochalasis in a single center. Blepharoplasty and other surgical approaches were scheduled according to the various manifestations, after a 2-year quiescent period with no recurrent attacks and exacerbation of lesions. Prognosis after surgery was recorded.Results: A total of 93 patients, with a mean follow-up of 5.29±2.07 (range: 3-10) years before surgery, and 2(range:1-4) years follow-up after surgery were included. Of all those 93 patients, 72.04% were females (67, P=0.02 ). The mean age of onset of blepharochalasis symptoms was 10.09±3.32 (range: 5-16) years, mostly (83.87%) consisted with the onset of the puberty. With the average of 5 times per year, the mean duration of each acute attack was 28.12±1.01 (rang: 2-192)hours. The mean duration from the onset of acute attack to the quiescent stage lasted for 7.33 ± 2.05 (range: 4-10) years. Most of the cases (88, 94.62%) had more than one manifestation at the end of the last follow-up before surgery. Ptosis (48.39%) was the most common deformity. Followed by lacrimal gland prolapse (44.09%), canthal angle deformity(29.04%), lower eyelid retraction(17.20%). After surgery, the functional and cosmetically acceptable results were achieved in all patients except for overcorrection in 5 (11.90%) patients with ptosis. The lacrimal gland prolapse recurred in two (4.00%) patients at 29 and 36 months after surgery. Conclusions: Blepharochalasis is rare but mostly occurred in adolescent females. The process from the onset to the stable stage usually lasted for about 7 years, might be associated with the onset of puberty. Surgical management of clinical manifestations after at least 2-year follow-up period of quiescence would be appropriate in order to observe a great plastic effect, low overcorrection and recurrence rate.

Blepharochalasis: clinical and epidemiological characteristics, surgical strategy and prognosis-- a retrospective cohort study with 93 cases

BMC Ophthalmology ◽

10.1186/s12886-021-02049-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Jinqiong Zhou ◽

Jingwen Ding ◽

Dongmei Li

Keyword(s):

Cohort Study ◽

Lacrimal Gland ◽

Retrospective Cohort ◽

Acute Attack ◽

Surgical Strategy ◽

Lacrimal Gland Prolapse ◽

The Mean ◽

Epidemiological Characteristics

Abstract Background Blepharochalasis is a rare eyelid disorder but eventually leading to destructive eyelid deformation. Until now the clinical and epidemiological data are unavailable. This study aimed to report the manifestations, epidemiological characteristics and surgical strategy of a large series of blepharochalasis patients with long-term follow-up. The prognosis of different clinical deformities was also investigated. Methods This was a retrospective cohort study, including consecutive patients diagnosed with blepharochalasis in a single center. Blepharoplasty and other surgical approaches were performed according to manifestations, after a 2-year quiescent period with no recurrent attacks and exacerbation of lesions. Prognosis after surgery was recorded. Results A total of 93 patients, with a mean age of 30.77 ± 14.04 (range: 9.00–70.00) years were included. Of all those 93 patients, 72.04% were females (67, P = 0.02). The mean follow-up was 5.29 ± 2.07 (range: 3–10) years before surgery, and 2.07 (range:1.54–4.22)years follow-up after surgery. The mean age of onset of blepharochalasis symptoms was 10.09 ± 3.32 (range: 5–16) years, and 83.87% patients got symptoms in puberty. With an average of 5 times per year, the mean duration of each acute attack was 28.12 ± 1.01 (rang: 2–192) hours. The mean duration from the onset of acute attack to the quiescent stage lasted for 7.33 ± 2.05 (range: 4–10) years. Most of the cases (88, 94.62%) had more than one manifestation at the end of the last follow-up before surgery. Ptosis (48.39%) was the most common deformity. Followed by lacrimal gland prolapse (44.09%), canthal angle deformity (29.04%), lower eyelid retraction (17.20%). After surgery, the functional and cosmetically acceptable results were achieved in all patients except for overcorrection in 5 (11.90%) patients with ptosis. The lacrimal gland prolapse recurred in two (4.00%) patients at 29 and 36 months after surgery. Conclusions Blepharochalasis is rare but mostly occurred in adolescent females. The process from the onset to the stable stage usually lasted for about 7 years, which might be associated with the onset of puberty. Surgical management of clinical manifestations after at least 2-year follow-up period of quiescence would be appropriate in order to observe a great plastic effect, low overcorrection and recurrence rate.

First Metatarsophalangeal Arthrodesis After Failed Distal Chevron Osteotomy for Hallux Valgus

Foot & Ankle International ◽

10.1177/1071100720968831 ◽

2020 ◽

pp. 107110072096883

Author(s):

Maria Tiscar Garcia-Ortiz ◽

Jose Juan Talavera-Gosalbez ◽

Lorena Moril-Peñalver ◽

Maria Dolores Fernandez-Ruiz ◽

Carolina Alonso-Montero ◽

...

Keyword(s):

Cohort Study ◽

Clinical Outcomes ◽

Hallux Valgus ◽

Retrospective Cohort ◽

Hallux Rigidus ◽

Primary Group ◽

Plate Removal ◽

Background: The purpose of this study was to compare the clinical outcomes after first metatarsophalangeal (MTP) joint arthrodesis for hallux rigidus between patients who underwent primary arthrodesis and those who had had a prior surgery for hallux valgus. Methods: Our design was a retrospective cohort study comparing 29 patients who underwent primary arthrodesis (primary group) and 34 patients with hallux rigidus after hallux valgus surgery (secondary group). The clinical assessment included the American Orthopaedic Foot & Ankle Society (AOFAS) score and a visual analog scale (VAS) for pain. Radiological evaluation was also performed. Overall, the mean postoperative follow-up was 3.4 (range, 2-5) years. Results: At final follow-up, AOFAS and VAS pain scores significantly improved in both groups ( P = .001). However, the mean AOFAS ( P = .001) and VAS pain ( P = .008) scores were significantly better in the primary group than in the secondary group. Radiologically, there were no significant differences between the groups in any angle after arthrodesis. Revision surgeries were not required in the primary group. In the secondary group, there was 1 revision due to deep infection, and 3 other patients required dorsal plate removal. Excluding plate removal, the Kaplan-Meier survival at 3 years was not significantly different between groups ( P = .775). Conclusion: Although arthrodesis of the first MTP joint was an effective procedure for hallux rigidus, the clinical outcomes in patients who had prior hallux valgus surgery were worse than those for patients who underwent primary surgery for hallux rigidus. Level of Evidence: Level III, retrospective cohort study.

Early weight gain after stopping smoking: a predictor of overall large weight gain? A single-site retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2018-023987 ◽

2018 ◽

Vol 8 (12) ◽

pp. e023987 ◽

Cited By ~ 1

Author(s):

Alexandra Pankova ◽

Eva Kralikova ◽

Kamila Zvolska ◽

Lenka Stepankova ◽

Milan Blaha ◽

...

Keyword(s):

Smoking Cessation ◽

Cohort Study ◽

Weight Gain ◽

Retrospective Cohort ◽

Receiver Operating Curve ◽

Large Weight ◽

Early Weight Gain ◽

ObjectivesMost people gain weight on stopping smoking but the extent of weight gain varies greatly. Interventions aimed at all quitters to prevent weight gain on cessation have proven unpopular but targeting people who have gained excess weight immediately after quitting may improve uptake and cost-effectiveness. We examined whether early large postcessation weight gain predicts overall large weight gain.DesignRetrospective cohort study.SettingPrimary care setting—smoking cessation centre in Prague, Czech Republic.ParticipantsOut of 3537 patients treated between 2005 and 2013, 1050 were continuous abstainers (verified by carbon monoxide measurement) at 1-year follow-up and formed the cohort of the current report. 48.7% were women (n=511) with the mean age of 46 (±14.4) years.MethodsIn this retrospective cohort study, all patients underwent usual tobacco dependence treatment using evidence-based methods. Weight was measured prior to smoking cessation and at each visit after quitting.ResultsThe mean weight gain in the first month (n=763) was 0.79% (±2.03%), in the second month (n=646) was 1.49% (±2.58%), for the third month (n=566) 2.33% (±3.44%) and 4.1% (±5.31%) after 1-year follow-up (n=1050). The regression coefficient per 1% rise in the first 3 months was +0.13% (95% CI −0.04% to 0.30%). A receiver operating curve analysis showed that patients gaining more than 0.98% of their baseline weight during first 3 months had a sensitivity of 66% and specificity of 44% for gaining 7% or more weight by 12 months. In addition, lower body mass index and an increase in appetite at 3 months after quitting were associated with greater weight gain, while using nicotine replacement therapy was associated with less weight gain at 1-year follow-up.ConclusionsPeople who stop smoking and gain a larger amount of weight early after quitting are not more likely to gain excessively at 1 year.

POS0805 TREATMENT OF GIANT CELL ARTERITIS WITH TOCILIZUMAB: A RETROSPECTIVE COHORT STUDY OF 119 PATIENTS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.1674 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 655.1-655

Author(s):

J. Rakholiya ◽

M. Koster ◽

H. Langenfeld ◽

C. S. Crowson ◽

A. Abril ◽

...

Keyword(s):

Cohort Study ◽

Clinical Practice ◽

Adverse Events ◽

Giant Cell Arteritis ◽

Giant Cell ◽

Retrospective Cohort ◽

Research Support ◽

Background:Giant cell arteritis (GCA) is an inflammatory condition of medium- and large-sized arteries. Prospective clinical trials have demonstrated the efficacy of tocilizumab (TCZ) for treatment of patients with GCA (1). However, there is a limited data on the use of TCZ in routine clinical practice.Objectives:To evaluate the efficacy and safety of TCZ in a retrospective cohort study of patients with GCA treated with TCZ.Methods:Patients with GCA treated with TCZ at 4 clinical centers of a single tertiary care institution (2000-2020) were identified. The diagnosis of GCA was confirmed by at least one of the following modalities: 1. Arterial biopsy 2. Large vessel imaging 3. Clinical diagnosis of GCA meeting ACR classification criteria and established by a rheumatologist. Patient demographics, clinical presentation, laboratory studies, treatment course and adverse events were abstracted from the medical record; only patients with at least 6 months of follow-up after TCZ initiation were included. Kaplan-Meier methods were used to estimate time to TCZ discontinuation and time to first relapse after TCZ discontinuation. Poisson regression models were used to compare relapse rates before and after TCZ initiation.Results:The study cohort included 119 patients [61% female; mean (SD) age at GCA diagnosis 70.3 (8.2) years]. The majority of patients (89%) had a biopsy-proven and/or imaging-based diagnosis of GCA, while 13 (11%) had a clinical diagnosis of GCA. In addition to glucocorticoids, 40 (34%) patients received other immunosuppressive agents prior to TCZ. The method of initial TCZ administration was subcutaneous (162mg/ml) weekly in 48 (41%), subcutaneous every other week in 20 (17%), monthly 4mg/kg infusions in 34 (29%), monthly 8mg/kg infusions in 14 (12%) and non-standard dosing in 3 remaining patients. The median (IQR) duration from GCA diagnosis to TCZ initiation was 4.8 (1.2-22.0) months and the median (IQR) duration of TCZ treatment was 18 (11-28) months. The mean (SD) dose of prednisone at TCZ initiation was 31 (19) mg/day and was reduced to a mean (SD) dose of 3.9 (6.7) mg/day at TCZ discontinuation/last follow-up visit. The relapse rate per year decreased 43% from 0.77 to 0.44 after the initiation of TCZ (RR=0.57; 95% CI: 0.44-0.75; p<0.001). The mean (SD) ESR and CRP decreased from 22 (20) mm/hour to 6 (9.2) mm/hour and from 19.1 (25) mg/L to 5.4 (16.6) mg/L, respectively from TCZ initiation to TCZ discontinuation/last follow-up visit. At 2 years of follow-up, 67% of patients had discontinued glucocorticoids. At last follow up, 46 patients had discontinued TCZ, only 14 of which were due to adverse events. The median time to TCZ discontinuation was 2.9 years. Only 17% (95%CI: 10-24%) had discontinued by 1 year after TCZ initiation and 38% (95% CI: 26-47%) had discontinued by 2 years. The most common adverse events were infections and cytopenias. While on TCZ, 1 patient developed new onset vision loss related to GCA and 1 patient, without history of diverticulitis, had bowel perforation. Among those discontinuing TCZ, 61% had relapsed at least once by 1 year after TCZ discontinuation.Conclusion:In this large single institution cohort of patients with GCA, TCZ use resulted in a significantly reduced relapse rate and reduction in glucocorticoid dosage. Overall, patients tolerated long-term use with only 12% discontinuing due to adverse events. However, over half of patients stopping TCZ had a subsequent flare; highlighting ongoing use may be required beyond two years in several patients with GCA to maintain remission.References:[1]Stone JH, et al. Trial of Tocilizumab in Giant-Cell Arteritis. N Engl J Med. 2017 Jul 27;377(4):317-328. doi: 10.1056/NEJMoa1613849. PMID: 28745999.[2]Calderón-Goercke M, et al. Tocilizumab in giant cell arteritis. Observational, open-label multicenter study of 134 patients in clinical practice. Semin Arthritis Rheum. 2019 Aug;49(1):126-135. doi: 10.1016/j.semarthrit.2019.01.003. Epub 2019 Jan 5. PMID: 30655091.Disclosure of Interests:Jigisha Rakholiya: None declared, Matthew Koster: None declared, Hannah Langenfeld: None declared, Cynthia S. Crowson: None declared, Andy Abril: None declared, Pankaj Bansal: None declared, Lester Mertz: None declared, Alicia Rodriguez-Pla: None declared, Rahul Sehgal: None declared, Benjamin Wang: None declared, Kenneth J Warrington Grant/research support from: Research support: Kiniksa, Eli Lilly

Distribution of Cancer cases and survival analysis results: A retrospective cohort study

European Journal of Public Health ◽

10.1093/eurpub/ckz185.123 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

E Pehlivan ◽

B Mete ◽

V Söyiler

Keyword(s):

Cohort Study ◽

Survival Analysis ◽

Retrospective Cohort ◽

World Health ◽

Cox Regression Analysis ◽

Risk Of Death ◽

Incidence Of Cancer ◽

Abstract Background Cancer was the second leading cause of death in Turkey. The aim of this study is to examine the changes in the incidence of cancer cases and survival analysis in a region. Methods This retrospective cohort study was carried out on data of 977 people had been diagnosed with cancer between the years 2013-2015 in Bingol province located in the east of Turkey. All cancer cases are included in the study. The data of the patients were obtained from the Ministry of Health Cancer Registry System and International Disease Classification Oncology (ICD-O) codes published by World Health Organization were used. Patients were evaluated topographically (tissue originating from the lesion) in 41 categories. Kruskal Wallis, Mann Whitney U test, Chi-square test and Cox regression analysis were used to analyze the data. Results The mean age of the patients was 58.73 ± 16.80 (min: 1-max: 107). It was observed that 28.7% of the patients died during the follow-up period and 71.3% of the patients were alive. 30% of the cancer cases digestive system, 11% respiratory system, 23% female breast- genitalia, 15% blood-lymph-thyroid, 11.8% muscle-bone, 15,4% other cancer species. In men, lung, stomach, colon, prostate; breast, thyroid and skin cancers are more common in women respectively. The incidence rate for all age groups was 97 per hundred thousand in 2013, 161 per hundred thousand in 2015. The increase trend did not differ by gender. The mean follow-up period of the patients who died was 388 days and 1541 days for the living patients. The risk of death is increased significantly in patients who cannot be operated (RR = 2.779, HR = 3.048). In patients not receiving chemotherapy, the risk of death is reduced significantly (RR = 0.656, HR = 0.340). Conclusions The incidence of cancer increases in the study area. Survival times vary according to treatment efficacy. Broad-based cohort studies evaluating the effects of treatment types on survival may be recommended. Key messages Cancer in the study area shows a significant increase from year to year. The average 5-year survival period of cancer patients was found is 71% as a good result.

Faculty Opinions recommendation of Evaluation of the economic burden of kidney stone disease in the UK: a retrospective cohort study with a mean follow-up of 19 years.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.737186277.793570254 ◽

2020 ◽

Author(s):

Walter Strohmaier

Keyword(s):

Cohort Study ◽

Economic Burden ◽

Kidney Stone ◽

Retrospective Cohort ◽

Stone Disease ◽

Kidney Stone Disease ◽

The Uk

Status and Determinants of Treatment Outcomes Among New Tuberculosis Patients in South Korea: A Retrospective Cohort Study

Asia Pacific Journal of Public Health ◽

10.1177/10105395211000529 ◽

2021 ◽

pp. 101053952110005

Author(s):

Hyunjin Son ◽

Jeongha Mok ◽

Miyoung Lee ◽

Wonseo Park ◽

Seungjin Kim ◽

...

Keyword(s):

Cohort Study ◽

South Korea ◽

Success Rate ◽

Treatment Outcomes ◽

Retrospective Cohort ◽

Health Care Facilities ◽

Tuberculosis Patients ◽

Lost To Follow Up

This is a retrospective cohort study using notification data in South Korea. We evaluated the nationwide status, regional differences, and the determinants of treatment outcomes among tuberculosis patients. Treatment success rate improved from 77.0% in 2012 to 86.0% in 2015. The lost to follow-up rate was higher among older people, males, and foreign nationals. Health care facilities designated for the Public-Private Mix (PPM) project showed higher success rate and lower rate of lost to follow-up. Moreover, municipalities with low regional deprivation index had higher PPM project coverage. Since there is a large regional difference in the coverage of the PPM project, an additional community-based support program should be implemented, especially for tuberculosis patients residing in region with low PPM project coverage.

Pioglitazone use and Parkinson’s disease: a retrospective cohort study in Taiwan

BMJ Open ◽

10.1136/bmjopen-2018-023302 ◽

2018 ◽

Vol 8 (8) ◽

pp. e023302 ◽

Cited By ~ 10

Author(s):

Hsiu-Feng Wu ◽

Li-Ting Kao ◽

Jui-Hu Shih ◽

Hui-Han Kao ◽

Yu-Ching Chou ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cohort Study ◽

Retrospective Cohort ◽

Asian Population ◽

Secondary Outcome ◽

Study Cohort ◽

Patients With Diabetes

ObjectivesMany researchers have expected pioglitazone to serve as an effective neuroprotective agent against Parkinson’s disease (PD). Therefore, we conducted this cohort study to investigate the association between pioglitazone use and PD by using a large Asian population-based dataset in Taiwan.DesignRetrospective cohort study.SettingTaiwan.Participants7906 patients with diabetes who had received pioglitazone were defined as the study cohort, and 7906 matched patients with diabetes who had not received pioglitazone were defined as the comparison cohort.Primary and secondary outcome measuresWe tracked each patient individually over a 5-year follow-up period to identify those diagnosed as having PD during this period. We performed Cox proportional hazard regression analyses to evaluate the HRs for PD between the study and comparison cohorts.ResultsThe findings indicated that among the sampled patients, PD occurred in 257 (1.63%): 119 (1.51%) pioglitazone users and 138 (1.75%) non-users. The adjusted HR for PD within the follow-up period was 0.90 (95% CI: 0.68 to 1.18) in the patients who had received pioglitazone compared with the matched patients who had not received pioglitazone. Moreover, this study revealed that pioglitazone use was not associated with PD incidence in men (HR: 1.06, 95% CI: 0.71 to 1.59) or women (HR: 0.84, 95% CI: 0.61 to 1.15).ConclusionsThis study did not find the relationship between pioglitazone use and PD incidence, regardless of sex, among an Asian population of patients with diabetes.