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PubMed1995

A longitudinal analysis of accelerated weight gain in preschool children.

The purpose of the current investigation was to determine the dietary, physical activity, family history, and demographic predictors of relative weight change in a cohort of 146 children over a 3-year period. Results indicated that boys of normal-weight parents or who had only one parent overweight showed decreases in their body mass index (BMI) while those with two parents overweight showed increases. Girls with an overweight father showed BMI increases while others experienced decreases in BMI. Additionally, baseline intake of kilocalories from fat as well as decreases in fat intake were related to decreases in BMI. At higher levels of baseline aerobic activity, subsequent changes in BMI decreased. There was also a trend for changes in leisure activity--increases in children's leisure activity was associated with decreases in subsequent weight gain. Modifiable variables (ie, dietary intake, physical activity) accounted for more of the variance in changes in child BMI change than nonmodifiable variables (eg, number of parents obese). These results strongly suggest that encouragement of heart healthy dietary intake patterns and participation in physical activity can decrease accelerated weight gain and obesity, even in preschool children.

Body Mass Index↗
PubMed2005

Serum erythropoietin and aging: a longitudinal analysis.

OBJECTIVES: To determine the changes in serum erythropoietin with age in patients with and without anemia and to assess the importance of certain comorbidities on changes in erythropoietin level and the development of anemia. DESIGN: Clinical history, hematological parameters, and serum erythropoietin levels were examined at 1- to 2-year intervals for 8 to 30 years. SETTING: Baltimore Longitudinal Study on Aging (BLSA), National Institute on Aging. PARTICIPANTS: One hundred forty-three BLSA participants. MEASUREMENTS: Complete blood count and serum chemistries were performed at the time of each visit, and archived serum samples were used for erythropoietin level. RESULTS: Although all subjects were healthy and without anemia at the time of initial evaluation, some developed chronic illness-most notably hypertension and diabetes mellitus. Erythropoietin levels rose significantly for the group as a whole, and the slope of the rise was found to be greater for those who did not have associated diabetes mellitus or hypertension. During the subsequent years, subjects who developed anemia but did not have hypertension or diabetes mellitus had the greatest slope in erythropoietin rise over time, whereas those with hypertension or diabetes mellitus and anemia had the lowest erythropoietin slope. CONCLUSION: The increase in serum erythropoietin with aging may be compensation for subclinical blood loss, increased red blood cell turnover, or increased erythropoietin resistance of red cell precursors. It is suspected that, with very advanced age, or in those with compromised renal function (e.g., diabetes mellitus or hypertension), the compensatory mechanism becomes inadequate and anemia results.

Adult↗
PubMed2000

Longitudinal analysis of the effects of the aging process on neuropsychological test performance in the healthy young-old and oldest-old.

A sample of 33 young-old (ages 65 to 74) and 20 oldest-old (ages 84 to 93) healthy elderly without dementia were assessed with neuropsychological tests annually over a 4-year period to examine longitudinal changes in cognitive functioning. Significant age-group differences existed at baseline in participants' performances on tests of immediate memory and visuospatial skills. There were no age-group differences in the rate of change over the 4-year interval on any neuropsychological tests. Within each age-group, the amount of change over time was minimal for most tests though some practice effects were apparent, and on some tests mild decline was observed. Results suggest that healthy old adults, including the oldest-old, do not experience measurable declines in cognitive functioning over a 4-year period.

Age Factors↗
PubMed2000

Longitudinal analysis of maternal plasma leptin concentrations during normal pregnancy and pre-eclampsia.

Leptin concentrations have been found to be elevated in cross-sectional studies of established pre-eclampsia. Circulating concentrations of leptin were measured in a cross-sectional study to confirm these findings (19 women with pre-eclampsia and 13 normal pregnant controls) and in a longitudinal study to establish the timing of the increase in leptin concentrations (samples obtained at 16, 20, 24, 28, 32, 36 and 38 weeks gestation from eight women who went on to develop pre-eclampsia and seven normal pregnant controls). In the cross-sectional study, plasma leptin concentrations were significantly greater in women with pre-eclampsia than in normal controls (P: = 0.001). In the longitudinal study, it was found that circulating leptin concentrations rose gradually to 32 weeks and thereafter declined slightly in normals. The concentrations in women destined to develop pre-eclampsia were consistently higher from 20 weeks gestation (P: = 0.04-0.003) and, in contrast to the normal controls, rose markedly from 32 weeks as pre-eclampsia developed. This study confirms that plasma leptin concentrations are increased in established pre-eclampsia and reports for the first time that leptin concentrations are elevated before pre-eclampsia is clinically evident.

Adult↗
PubMed1996

Longitudinal analysis of soluble intercellular adhesion molecule 1 in retinal vasculitis patients.

Increased levels of soluble intercellular adhesion molecule 1 (sICAM-1) in serum have been demonstrated in several human disease conditions. We have previously shown, in a point-prevalence study, a positive correlation between sICAM-1 levels and disease relapse in patients with idiopathic retinal vasculitis. We now report a longitudinal study over 1 year in which sICAM-1 levels were compared with clinical disease status in order to determine this relationship further. Serum samples from 11 patients with idiopathic retinal vasculitis were tested for the presence of sICAM-1 by enzyme linked immunosorbent assay. Eight control subjects were also tested. Five out of 11 patients presented with relapse and had raised sICAM-1 levels compared with quiescent periods of their disease. Five out of 11 patients showed no relapse over 1 year and also no increase in sICAM-1 levels. One patient showed increased levels of sICAM-1, but no clinical signs of relapse. These results indicate that sICAM-1 is associated with disease activity in retinal vasculitis patients and could indicate dysfunction of the blood-retina barrier.

Adult↗
PubMed2026

Longitudinal analysis of circulating tumor DNA and CA19-9 dynamics in predicting disease relapse and monitoring treatment response in stage I-III pancreatic ductal adenocarcinoma: An interim analysis of a prospective observational study.

INTRODUCTION: Postoperative recurrence is the leading cause of mortality in resected pancreatic ductal adenocarcinoma (PDAC), yet reliable tools for early relapse detection and treatment response assessment remain lacking. METHODS: In a prospective cohort of 136 patients with resected stage I-III PDAC receiving adjuvant chemotherapy, we evaluated circulating tumor DNA (ctDNA) and CA19-9 as longitudinal biomarkers across multiple postoperative time windows. RESULTS: ctDNA consistently outperformed CA19-9 as an independent prognostic factor; ctDNA positivity at on-treatment and surveillance assessments achieved a positive predictive value of 91.7%, while persistent negativity identified the lowest-risk patients. Integrating CA19-9 with ctDNA resolved the ctDNA-alone gap in distinguishing treatment clearance from conversion, improving discrimination of responders from non-responders (HR 3.72; P = .008). A time-weighted dynamic ctDNA risk score (MinerVa-dynamic) further stratified ctDNA-negative patients into clinically distinct prognostic subgroups, achieving an area under the curve of 0.87 and 0.82 for one- and two-year disease-free survival prediction, respectively. CONCLUSIONS: These findings support a dual-biomarker longitudinal monitoring framework as a practical, individualized approach to postoperative surveillance and early therapeutic decision-making in PDAC.

CA19-9↗
PubMed1997

A 2-year longitudinal analysis of the relationships between violent assault and substance use in women.

Women experience alarming levels of physical and sexual assault, which may lead to escalation of substance use. Reciprocally, evidence from cross-sectional studies indicates that substance use may increase risk of assault. To date, directionality of this relationship remains unclear. This issue is addressed by the present 3-wave longitudinal study in which a national probability sample of 3,006 women were followed for 2 years. Dependent measures were obtained at each wave of the study and included questions about lifetime and new assault status, alcohol abuse, and drug use. Wave 1 use of drugs, but not abuse of alcohol, increased odds of new assault in the subsequent 2 years. Reciprocally, after a new assault, odds of both alcohol abuse and drug use were significantly increased, even among women with no previous use or assault history. For illicit drug use, findings support a vicious cycle relationship in which substance use increases risk of future assault and assault increases risk of subsequent substance use.

Adolescent↗
PubMed2000

Age and emotional response to the Northridge earthquake: a longitudinal analysis.

Cross-sectional studies have found older adults to have lower levels of emotional distress after natural disasters. The maturation hypothesis suggests that older adults are less reactive to stress events, whereas the inoculation hypothesis argues that prior experience with disaster is protective. One hundred and sixty-six adults aged 30 to 102 were interviewed regarding the 1994 Northridge earthquake. Longitudinal data were available on depressed mood before and after the earthquake. The maturation hypothesis was generally not supported. The young-old were least depressed; however, this age difference was present prior to the earthquake. The old-old showed lowest levels of earthquake-specific rumination, but age did not buffer the relationship between damage exposure and rumination. The inoculation hypothesis was supported for depressed mood. Prior earthquake experience was related to lower postearthquake depression scores.

Adult↗
PubMed2004

Retrospective, longitudinal analysis of serum human herpesvirus-8 viral DNA load in AIDS-related Kaposi's sarcoma patients before and after diagnosis.

Human herpesvirus 8 (HHV-8) is detected more often in patients progressing towards Kaposi's sarcoma (KS) than in patients who do not develop the disease, suggesting that the level of viremia might be associated with Kaposi's sarcoma disease and progression. Longitudinal serum samples from 19 AIDS-Kaposi's sarcoma patients, ranging from 2 years before KS till 2 years after KS diagnosis were tested. No correlation was found between viral load and progression to KS, or disease stage.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Outcomes of open cholecystectomy in the elderly: a longitudinal analysis of 21,000 cases in the prelaparoscopic era.

OBJECTIVE: We sought to obtain unbiased estimates of open cholecystectomy outcomes in a population-based cohort of elderly patients during the immediate prelaparoscopic era. METHODS: Medicare claims data were used to identify 21,131 patients aged 65 years or more who underwent open cholecystectomy in Pennsylvania between 1986 and 1989 and to develop longitudinal histories of hospitalizations and physician services utilization for these patients. Study patients were divided into three groups: simple cholecystectomy, cholecystectomy with intraoperative cholangiography (IOC) alone, and cholecystectomy with common bile duct exploration (CBDE). Outcomes examined included 30- and 90-day postoperative mortality rates and postoperative complications. RESULTS: Postoperative mortality rates in all patients was 2.1% at 30 days and 3.6% at 90 days. Patients in the CBDE group had a significantly higher mortality rate than those in the simple cholecystectomy or IOC groups; adjusted for differences in case mix, the mortality rate in the CBDE group was 47% higher at 30 days and 29% higher at 90 days. Rates of retained or recurrent common duct stones, bile duct stricture, and recurrent biliary tract surgery by 42 to 60 months after cholecystectomy were 2.8%, 0.4%, and 1.0%, respectively. CBDE was a strong risk factor for these complications. In contrast, the IOC group had a significantly lower risk of having clinically manifest retained or recurrent common duct stones develop by 42 months after operation. CONCLUSIONS: This study provides an unbiased assessment of open cholecystectomy outcomes necessary for future comparisons of open and laparoscopic cholecystectomy in elderly patients. Estimates of the excess mortality rates associated with CBDE provide a benchmark for assessing the outcomes of alternative strategies for managing common duct stones during laparoscopic cholecystectomy. Findings regarding the rates of retained or recurrent common bile duct stones in patients undergoing simple cholecystectomy and IOC challenge widespread beliefs about the limited clinical importance of unsuspected common duct stones, at least in the elderly population, and are relevant to the debate about routine IOC.

Aged↗
PubMed2002

Peripheral blood lymphocyte subsets in adolescents: a longitudinal analysis from the REACH project.

Flow cytometry analysis of lymphocyte subset markers was performed for a group of sexually active, human immunodeficiency virus (HIV)-negative adolescents over a 2-year period to establish normative data. Data were collected in the REACH Project (Reaching for Excellence in Adolescent Care and Health), a multicenter, longitudinal study of HIV-positive and high-risk HIV-negative adolescents. Two- and three-color flow cytometry data were collected every 6 months for these subjects. We determined the effects of gender, race, and age on the following lymphocyte subset markers: total CD4(+) cells, CD4(+) naïve cells, CD4(+) memory cells, all CD8(+) cells, CD8(+) naïve cells, CD8(+) memory cells, CD16(+) natural killer cells, and CD19(+) B cells. Gender was the demographic characteristic most frequently associated with differences in lymphocyte subset measures. Females had higher total CD4(+) cell and CD4(+) memory cells counts and lower CD16(+) cell counts than males. Age was associated with higher CD4(+) memory cell counts as well as higher CD8(+) memory cell counts. For CD19(+) cells, there was an interaction between age and gender, with males having significantly lower CD19(+) cell counts with increasing age, whereas there was no age effect for females. Race and/or ethnicity was associated with differences in total CD8(+) cell counts and CD8(+) memory cell counts, although both of these associations involved an interaction with gender.

Adolescent↗
PubMed1993

A longitudinal analysis of burnout in the health care setting: the role of personal dispositions.

Burnout is frequently interpreted as a situationally induced stress reaction. However, the long-term stability of burnout scores and their correlations with subjective well-being measures suggest that burnout may also reflect enduring qualities of the individual. To assess the contribution of personality to the experience of burnout, an exploratory longitudinal study was done. At Time 1, 36 occupational therapists (32 women, 4 men) from two hospitals completed the Maslach Burnout Inventory (MBI; Maslach, 1982) and the NEO Personality Inventory (NEO-PI; Costa & McCrae, 1985; a measure of the five-factor model of personality). At Time 2, the MBI was again given along with the Work Environment Scale (Moos, 1981) to 29 of the original therapists. Moderately strong correlations were found between burnout scores and measures of the five factors both concurrently and longitudinally. Even when situational variables were controlled, personality continued to account for a significant portion of the variance in burnout scores. The implications of these findings are discussed.

Adult↗
PubMed2003

Longitudinal analysis of serum insulin-like growth factor-I and insulin-like growth factor binding protein-1 in antiphospholipid syndrome and in healthy pregnancy.

OBJECTIVE: The purpose of this study was to determine the concentrations of serum insulin-like growth factor-I and insulin-like growth factor binding protein-1 in pregnancies that are complicated with primary antiphospholipid syndrome. STUDY DESIGN: Longitudinal blood samples were collected from 8 weeks of gestation in 28 women with treated primary antiphospholipid syndrome and 19 control women. Serum insulin-like growth factor-I and insulin-like growth factor binding protein-1 were measured by immunoradiometric assay. RESULTS: Three antiphospholipid syndrome pregnancies miscarried, four pregnancies had intrauterine growth restriction and preeclampsia, six pregnancies had a thrombotic event, and one pregnancy had abruptio placentae. Mean (+/-SD) birth weight in antiphospholipid syndrome group was 2867 +/- 914 g (control, 3492 +/- 527 g; P =.02), and the mean gestation at delivery was 36.5 +/- 5.2 weeks (control, 40.3 +/- 0.7 weeks; P =.002). Insulin-like growth factor binding protein-1 and insulin-like growth factor-I concentrations increased with gestational age in both groups (2.8% and 2.4% per week), but insulin-like growth factor binding protein-1 was 61% higher in the antiphospholipid syndrome group (95% CI, 16%-122%; P =.004). Insulin-like growth factor-I was not significantly different (8% higher in antiphospholipid syndrome; 95% CI, -10% to 30%; P =.41). CONCLUSION: Serum concentrations of insulin-like growth factor binding protein-1 are abnormal in the antiphospholipid syndrome group and may reflect abnormalities in trophoblast invasion.

Abortion, Spontaneous↗
PubMed2004

The impact of job strain on social isolation: a longitudinal analysis of French workers.

Numerous studies have shown that work may have an impact on social identity and social functioning in the community. Since work organisation in our society has gone through some profound changes in the last few decades, it is important to study the effect of these new constraints on the social life of people and, thereby, on their health. Using data from a French longitudinal cohort study on work, health and ageing (ESTEV), this paper analyses the impact of job strain on social isolation, in a sample of 16,950 individuals who were working in 1990 and 1995. The results show that low-decision latitude was associated with a significantly higher level of social isolation in both men and women. When compared with low job strain, active work (high-psychological demand and high-decision latitude) and high job strain were associated among men with a significantly higher level of social isolation. This study shows that a change in psychosocial work conditions (demand and control) had an impact on social isolation and that this impact may be more significant in male workers than in female workers.

Cohort Studies↗
PubMed2003

Primary care, income inequality, and stroke mortality in the United States: a longitudinal analysis, 1985-1995.

BACKGROUND AND PURPOSE: The goal of this study was to test whether primary care reduces the impact of income inequality on stroke mortality. METHODS: This study used pooled time-series cross-sectional analysis of 11 years of state-level data (n=549). Analyses controlled for education levels, unemployment, racial/ethnic composition, and percent urban. Contemporaneous and time-lagged covariates were modeled. RESULTS: Primary care was negatively associated with stroke mortality in models including all covariates (P<0.0001). The impact of income inequality on stroke mortality was reduced in the presence of primary care (P<0.0001) but disappeared with the addition of covariates (P>0.05). CONCLUSIONS: In the absence of social policy that addresses sociodemographic determinants of health, primary care promotion may serve as a palliative strategy for combating stroke mortality and reducing the adverse impact of income inequality on health.

Cross-Sectional Studies↗
PubMed2006

Sexual scripts of women: a longitudinal analysis of participants in a gender-specific HIV/STD prevention intervention.

Project FIO (The Future Is Ours) was a three arm randomized controlled HIV prevention intervention trial carried out with heterosexually-active women in a high seroprevalence area of New York City. The trial was effective and women in the eight-session intervention arm were significantly more likely to report decreased unsafe sex or no unsafe sex compared to controls at one month and one year post-intervention. The current investigation was a qualitative analysis of women's sexual scripts at baseline and one year follow-up for a randomly selected subsample of participants in Project FIO. We examined the domains of sexual initiation, pace setting, sexual decision-making, communication about sexual needs, and the timing of condom introductions in the experimental and control arms at baseline and one year follow-up. At one year follow-up, among both the experimental and control arms, results showed changes away from male-dominated and toward female-dominated sexual initiation and sexual decision-making. Among both the experimental and control arms, results also showed that trial participants shifted from a late condom introduction (right before intercourse) toward much earlier mention of condoms (e.g. during a date). The fact that shifts in sexual scripts at one year follow-up occurred in both groups is likely reflective of the degree to which a lengthy assessment interview facilitated comfort with discussing and imagining new sexual behaviors, even for control group participants who did not receive the intervention. The value of empirically assessing sexual scripts in HIV/AIDS prevention and doing so longitudinally is assessed in light of the goals of HIV prevention interventions.

Adult↗
PubMed1995

Longitudinal analysis of parotid and submandibular salivary flow rates in healthy, different-aged adults.

BACKGROUND: Early studies suggested that salivary gland dysfunction was a normal sequela of aging. Recent research on healthy, different-aged adults has led to a revision of these former conclusions. Parotid gland function appears to be age-stable, yet there is no consensus on submandibular/sublingual output. To date, there have only been two longitudinal studies utilizing healthy individuals examining parotid function, and no published longitudinal studies on submandibular/sublingual output. The purpose of this study was to examine unstimulated and stimulated major salivary gland flow rates in unmedicated, essentially healthy subjects, over a 3-year period. METHODS: Thirty-seven males and females, aged 26-90 years of age, were examined twice over a 3-year period at the Clinical Center of the National Institutes of Health. All were healthy, community-dwelling adults, without systemic diseases, and not taking any medications. Unstimulated and 2% citrate-stimulated parotid and submandibular/sublingual salivary gland flow rates were assessed at both visits, and changes over time were evaluated according to the subject's age at initial visit. RESULTS: There were no significant flow rate differences over a 3-year time period for unstimulated and stimulated parotid and submandibular/sublingual flow rates. CONCLUSIONS: Major salivary gland output is aged-stable in healthy persons over a 3-year period. The data from this study suggest that salivary gland dysfunction in an older person should not be considered a normal process of aging.

Adult↗