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PubMed1998

A longitudinal investigation of IgG and IgM antibody responses to the merozoite surface protein-1 19-kiloDalton domain of Plasmodium falciparum in pregnant women and infants: associations with febrile illness, parasitemia, and anemia.

This study was aimed at delineating characteristics of naturally acquired immunity against the merozoite surface antigen-1 (MSP-1) of Plasmodium falciparum, a candidate malaria vaccine antigen. A case/control study was performed on 75 case/control pairs of infants with febrile illness at the time of the first detected infection indicating a clinical case. The presence and level of antibodies at one month prior to the first infection and at the time of the first infection in the afebrile group was significantly higher than in the febrile group. Decreased parasite density and decreased infection-related loss of hemoglobin was seen in infants with anti-MSP-1(19kD) IgG antibodies. In addition, mothers who were positive for the presence of these antibodies conferred protection against placental infection and infection in their infants. In this study, development of anti-MSP-1(19kD) antibody responses in 24 infants were studied longitudinally using monthly serum samples collected from birth until approximately one year of age. In addition, umbilical cord blood sera and respective mothers' sera were analyzed. Longitudinal studies of antibody responses revealed several short-lived IgG and IgM peaks throughout an infant's first year that correlated with detection of parasitemia. The protection against parasitemia and febrile illness was observed in infants when anti-MSP-1(19kD) antibodies were present; when infants were negative for IgG, they had a 10-times greater risk of becoming parasitemic. These data from a longitudinal and prospective study of malaria suggest a protective role for anti-MSP-1(19kD) antibodies in infants and pregnant women.

Anemia↗
PubMed2003

A new longitudinal study of the health and wellbeing of Australian children: how will it help?

The Longitudinal Study of Australian Children (LSAC) is a major research endeavour to assess emerging health and developmental concerns and their determinants in children. Previous longitudinal studies of children in Australia and New Zealand have contributed significantly, but have had limitations, which LSAC will attempt to address. A new generation of longitudinal studies is needed to enable transnational and historical comparisons.

Adolescent↗
PubMed1998

Determining the feasibility of the Canadian First Nations and Inuit regional (longitudinal) health surveys.

The general framework recommended for the First Nations Regional Health Surveys can be summarized as follows: 1. Currently committed funding from Health Canada and Human Resources Development Canada should be used to develop a framework of regional cohort studies for First Nations and Inuit people in the 10 provinces to generate information on community health and the well-being of children. Indian and Northern Affairs should consider participating on an equal basis in this initiative, as long as program dollars are not compromised, in order to assist First Nations and Inuit communities in the documentation of socioeconomic conditions associated with health and the well-being of children. Representatives of these departments should work together with Métis representatives to secure funding for a similar initiative for Métis people in the provinces. 2. National First Nations and Inuit organizations and the major funding departments should be invited to appoint members to First Nations and Inuit National Steering Committees. These Committees will be responsible for the general supervision of the development of the regional cohort studies for their respective communities. 3. Regional (usually provincial) First Nations and Inuit political organizations should be invited to submit letters of intent indicating their interest in developing the longitudinal survey on behalf of all communities in their respective regions. 4. Regional organizations should be asked to propose a research group with which they wish to collaborate in the development of the survey. Research groups should be approved by the national steering committees. 5. National steering committees should appoint a "core questions research group" that will be responsible for the development of comparative "core questions" for the longitudinal surveys. 6. A national Aboriginal technical committee should be established consisting of members of the "core question" research group and one member from all other research groups involved in the longitudinal surveys. 7. National steering committees should approve grants to each regional organization/research group to develop and implement the survey. 8. This initiative should be developed at a pace which is suitable to Aboriginal organizations and communities. It is likely that the first wave of the survey in 1996 will be restricted to several pilot projects in different parts of the country. Other regions and communities may not be ready to participate until 1998.

Canada↗
PubMed1999

Mortality among US adult Asians and Pacific Islanders: findings from the National Health Interview Surveys and the National Longitudinal Mortality Study.

OBJECTIVES: To assess the mortality of the adult Asian and Pacific Islander population in the United States. METHODS: Cohort study using data from the National Health Interview Survey (1986 to 1994) and the National Longitudinal Mortality Study. Deaths were ascertained by matching the National Death Index with average follow-ups of 5.3 and 9 years, respectively, for the two studies. RESULTS: Respondents from the pooled National Health Interview Surveys included 532,794 non-Hispanic whites, 94,242 blacks, 52,725 Hispanics, and 16,936 Asians and Pacific Islanders, all of whom were at least 18 years of age at baseline. The National Longitudinal Mortality Study included 373,397 non-Hispanic whites, 41,262 blacks, 23,356 Hispanics, and 8,390 Asians and Pacific Islanders. Overall age-standardized mortality was the lowest in Asians/Pacific Islanders, whose risk of death was about 40% lower than whites'. Adjustment for differences in education levels had a minimal influence on the mortality advantage in Asians/Pacific Islanders. CONCLUSIONS: Longitudinal cohorts provide an important source of health status information on Asians and Pacific Islanders. These two studies from representative national samples suggest that overall mortality is substantially lower among Asians and Pacific Islanders than in all other major ethnic groups.

Adolescent↗
PubMed1999

[Analysis of longitudinal Gaussian data with missing data on the response variable].

BACKGROUND: Using an application and a simulation study we show the bias induced by missing data in the outcome in longitudinal studies and discuss suitable statistical methods according to the type of missing responses when the variable under study is gaussian. METHOD: The model used for the analysis of gaussian longitudinal data is the mixed effects linear model. When the probability of response does not depend on the missing values of the outcome and on the parameters of the linear model, missing data are ignorable, and parameters of the mixed effects linear model may be estimated by the maximum likelihood method with classical softwares. When the missing data are non ignorable, several methods have been proposed. We describe the method proposed by Diggle and Kenward (1994) (DK method) for which a software is available. This model consists in the combination of a linear mixed effects model for the outcome variable and a logistic model for the probability of response which depends on the outcome variable. RESULTS: A simulation study shows the efficacy of this method and its limits when the data are not normal. In this case, estimators obtained by the DK approach may be more biased than estimators obtained under the hypothesis of ignorable missing data even if the data are non ignorable. Data of the Paquid cohort about the evolution of the scores to a neuropsychological test among elderly subjects show the bias of a naive analysis using all available data. Although missing responses are not ignorable in this study, estimates of the linear mixed effects model are not very different using the DK approach and the hypothesis of ignorable missing data. CONCLUSION: Statistical methods for longitudinal data including non ignorable missing responses are sensitive to hypotheses difficult to verify. Thus, it will be better in practical applications to perform an analysis under the hypothesis of ignorable missing responses and compare the results obtained with several approaches for non ignorable missing data. However, such a strategy requires development of new softwares.

Data Interpretation, Statistical↗
PubMed2000

Longitudinal evaluation of early Alzheimer's disease using brain perfusion SPECT.

UNLABELLED: The aim of this SPECT study was to determine the initial abnormality and longitudinal changes in regional cerebral blood flow (rCBF) in early Alzheimer's disease (AD) using statistical parametric mapping (SPM). METHODS: rCBF was noninvasively measured using (99m)Tc-ethyl cysteinate dimer SPECT in 32 patients complaining of mild cognitive impairment, with a Mini-Mental State Examination score more than 24 at the initial study, and 45 age-matched healthy volunteers. All patients satisfied the diagnostic criteria of AD during the follow-up period of at least 2 y. Follow-up SPECT studies were performed on the patients at a mean interval of 15 mo. We used the raw data (absolute rCBF parametric maps) and the adjusted rCBF images of relative flow distribution (normalization of global cerebral blood flow [CBF] for each subject to 50 mL/100 g/min with proportional scaling) to compare these groups with SPM. RESULTS: In the baseline study, the adjusted rCBF was significantly and bilaterally decreased in the posterior cingulate gyri and precunei of patients compared with healthy volunteers. In the follow-up study, selected reduction of the adjusted rCBF was observed in the left hippocampus and parahippocampal gyrus. These areas showed the most prominent reduction in absolute rCBF on each occasion. Moreover, further decline of the absolute rCBF was longitudinally observed in extensive areas of the cerebral association cortex. CONCLUSION: SPM analysis showed the characteristic early-AD rCBF pattern of selective decrease and longitudinal decline, which may be overlooked by a conventional region-of-interest technique with observer a priori choice and hypothesis. This alteration in rCBF may closely relate to the pathophysiologic process of this disease.

Aged↗
PubMed2000

[Roaming through methodology. XXII. Application of techniques for longitudinal data analysis].

Longitudinal studies are characterised by repeated measurements of the outcome variable on the same individuals. This implicates that observations are correlated and that statistical techniques, such as linear regression analysis cannot be used. Special longitudinal techniques correct for the dependency in repeated observations by analysing the development of a certain individual in time. Depending on the research question, the distribution of the outcome variable, and the number of repeated measurements, a certain technique should be chosen. Sophisticated longitudinal techniques like generalized estimating equations and random-coefficient models are most recommendable.

Data Interpretation, Statistical↗
PubMed2000

[Roaming through methodology. XXVII. Problems with longitudinal studies: confounding of the relationship between age, time of measurement and birth cohort].

Nowadays, age-related research questions are investigated using longitudinal study designs where measurements are repeated over time in the same subjects. Cross-sectional studies are used less often for this purpose, as they provide measurements at only one point in time thus making it more difficult to establish relationships between variables and outcomes. However, longitudinal measurements also have drawbacks, even in investigations that, for example, are aimed at age-related changes in physical and psychosocial characteristics during growth and development in young people. In the study of age-related trends, several types of confounding may occur: birth cohort effects, time-of-measurement effects, and test-and-learning effects. If control measurements are carefully collected, for example, in a multiple longitudinal design, or by not repeatedly measuring a control group, the confounding may be quantified and the study results corrected accordingly.

Age Factors↗
PubMed2001

Burnout and inequity among human service professionals: a longitudinal study.

In a composite sample of human service professionals (N = 245), longitudinal relations across 1 year were tested between equity in the professional-recipient relationship and burnout (i.e., emotional exhaustion, depersonalization, and reduced personal accomplishment). The 1st research question was whether inequity influenced burnout across time. The 2nd research question was whether longitudinal relations between equity and burnout were curvilinear, as predicted by equity theory. The results confirmed that inequity affects the central component of burnout (i.e., emotional exhaustion) and that this relation is curvilinear. Feeling more deprived and feeling more advantaged resulted in higher future emotional exhaustion levels. No indication was found for a longitudinal relation between inequity and depersonalization. A synchronous relation was found suggesting that personal accomplishment influences equity.

Adult↗
PubMed2001

Gene-environment interaction in patterns of adolescent drinking: regional residency moderates longitudinal influences on alcohol use.

BACKGROUND: Drinking frequency escalates rapidly during adolescence. Abstinence declines markedly, and drinking monthly or more often becomes normative. Individual differences in adolescent drinking patterns are large, and some patterns are predictive of subsequent drinking problems; little, however, is known of the gene-environment interactions that create them. METHODS: Five consecutive and complete birth cohorts of Finnish twins, born 1975-1979, were enrolled sequentially into a longitudinal study and assessed, with postal questionnaires, at ages 16, 17, and 18.5 years. The sample included 1786 same-sex twin pairs, of whom 1240 pairs were concordantly drinking at age 16. Maximum likelihood models were fit in longitudinal analyses of the three waves of drinking data to assess changes in genetic and environmental influences on alcohol use across adolescence. Secondary analyses contrasted twin pairs residing in rural versus those in urban environments to investigate gene-environment interactions. RESULTS: Longitudinal analyses revealed that genetic factors influencing drinking patterns increased in importance across the 30-month period, and effects arising from common environmental influences declined. Distributions of drinking frequencies in twins residing in urban and rural environments were highly similar, but influences on drinking varied between the two environments. Genetic factors assumed a larger role among adolescents residing in urban areas, while common environmental influences were more important in rural settings. Formal modeling of the data established a significant gene-environment interaction. CONCLUSIONS: The results document the changing impact of genetic and environmental influences on alcohol use across adolescence. Importantly, the results also reveal a significant gene-environment interaction in patterns of adolescent drinking and invite more detailed analyses of the pathways and mechanisms by which environments modulate genetic effects.

Adolescent↗
PubMed2000

[Relation among early maturation, body mass index and the longitudinal behavior of systolic blood pressure].

In the Caracas Longitudinal Study, 53 girls- 8 to 11 years of age- who had been classified as early, average and late maturers were analyzed longitudinally with respect to Body Mass Index (BMI) and Systolic Blood Pressure (SBP). A longitudinal principal component analysis was used to summarize trends or intraindividual changes in BMI and SBP. A first component was identified for BMI, this component accounted for most of its total variance (94.65%). Girls were classified as normal in weight or at risk of overweight on the basis of this component. Three principal components were identified for SBP, that accounted for 91.83% of the total variance of this variable. The first component represented a measure of position across the whole age period, a "canalization pattern"; this component accounted for most of the total variance (45.65%). The second component revealed an unidirectional change in relative position of the values of the variable, a "decanalization pattern", and a third pattern summarized deviations around a position level: "recanalization pattern". Girls who showed a canalization pattern for SBP were those identified as early maturers and at risk of overweight.

Blood Pressure↗
PubMed2001

[Longitudinal follow-up evaluation of pulmonary emphysema using high-resolution Computed Tomography (HRCT) study and pulmonary function tests].

PURPOSE: To evaluate the usefulness of HRCT in the identification of longitudinal progression of emphysema and to establish the sensitivity of HRCT compared with functional tests. MATERIAL AND METHODS: 15 ex-smokers with chronic obstructive lung disease were studied, using two consecutive HRCT examinations (t1 and t2); emphysema was evaluated by HRCT visual score and, at the same time, pulmonary function tests. RESULTS: As a whole, the extension of emphysema with HRCT presented a good correlation with Tiffeneau index (IT). At t1 a significant correlation between HRCT and IT was almost reached; it was achieved between HRCT and PaCO2, FEV1 and IT. At t2, there was a significant correlation between HRCT and IT, FEV1 and IT, FEV1 and PaO2, FEV1 and PaCO2, IT and PaO2. In the interval between t1 and t2 there was a significant worsening of HRCT visual score and IT, with no modification of FEV1, PaO2 and PaCO2. The change in HRCT visual score had a significant correlation with FEV1. DISCUSSION AND CONCLUSIONS: HRCT is able not only to identify and quantify anatomic emphysema, but also to evaluate progression of the disease. In the middle-short term anatomic emphysema worsens significantly and visual score HRCT is more sensitive than functional tests for longitudinal evaluation because emphysematous destruction is faster than decline in function. Furthermore emphysematous destruction in smokers progresses even after smoking cessation. The usefulness of combining HRCT with functional tests in the follow-up remains to be established. Longitudinal examination by HRCT could allow us to identify the smokers that tend to develop earlier and more seriously the symptoms of chronic obstructive lung disease.

Female↗
PubMed2001

Hematologic and blood biochemical variables of captive chimpanzees: cross-sectional and longitudinal analyses.

Hematologic and blood biochemical variables are of great importance in medical and veterinary practice. In addition, these analytes may have significance as potential biomarkers of aging. Previous reports on normative values of these variables in the chimpanzees are based on cross-sectional studies that did not include individuals of advanced age. To address this omission, we performed cross-sectional and longitudinal analyses of hematologic and blood biochemical data collected from chimpanzees over a 9-year period. One-hundred forty-six females and 106 males of ages representing the entire life span of the species were studied. We derived normative cross-sectional values of 14 commonly measured hematologic and 20 blood biochemical variables, which should provide a useful reference for clinical blood studies in chimpanzees. In addition, we found in a cross-sectional regression analysis of our data that most analytes varied significantly between males and females, and that they varied markedly with age. Most variables had year-to-year consistency within the same individuals, as indicated by statistically significant intra-year correlation coefficients. Finally, we performed a longitudinal analysis of the analytes in chimpanzees by calculating the slopes and intercepts of the best-fitting trend line for each individual. The resulting slopes were analyzed by sex and by decade of age of subjects to determine whether trends were consistent. Consistent trends detected in the longitudinal analysis were usually restricted to the first decade of life, and thus represented maturational processes. The overall lack of within-animal trends covering all or most of the period from early adulthood through old age in this 9-year study suggests that a longer period of follow-up than used here may be required to document senescence-related changes.

Aging↗
PubMed2002

Delivery of preventive health services for breast cancer control: a longitudinal view of a randomized controlled trial.

OBJECTIVE: To develop a longitudinal model to characterize the delivery of mammography services using repeated observations of mammography referral rates during a randomized controlled trial (RCT) of physician mammography reminders. DATA SOURCES/STUDY SETTING: Administrative records of a health department and observational data on mammography appointment scheduling. STUDY DESIGN: The design was a longitudinal study of month-specific referral rates during a 1-year RCT. A retrospective case-control study was used to investigate differences between women with timely and delayed (or absent) mammography referral assessed at the end of the intervention year. DATA COLLECTION/EXTRACTION METHODS: Month-specific indicators for referrals and missed clinical opportunities, that is, months when clinic visitors were due for a mammogram and not referred, were constructed using administrative and observational data. FINDINGS: In the unadjusted analysis, the effectiveness of the reminder declined over time. However, in a multivariate analysis that controlled for the number of missed opportunities, the effectiveness was constant over time. On a monthly basis, physician reminders were significantly associated with higher referral rates among clinic visitors newly due for mammography (adjusted OR = 2.8, 95 percent CI = 1.3, 5.8) or who had one previously missed clinical opportunity (adjusted OR = 3.0, 95 percent CI = 1.6, 5.3) but were not for those with two or more missed clinical opportunities (adjusted OR = 1.2, 95 percent CI = 0.7, 2.3). Factors independently associated with delayed referral were age over 65, presence of more than one chronic illness, and the absence of a physician mammography reminder. CONCLUSIONS: Longitudinal models that examine rates of referral over time and include information about outcomes on previous visits can enhance our understanding of how intervention strategies work in practice.

Adult↗
PubMed2002

Radicular compression by lumbar intraspinal epidural gas pseudocyst in association with lateral disc herniation. Role of the posterior longitudinal ligament.

Among unusual abnormalities of the lumbar spine reported since the introduction of Computed Tomography (CT), the presence of gas lucency in the spinal canal, known as vacuum phenomenon, is often demonstrated. On the contrary, epidural gas pseudocyst compressing a nerve root in patients with a lateral disc herniation has rarely been reported. We report a case of a 44-year-old man who experienced violent low back pain and monolateral sciatica, exacerbated by orthostatic position, one week before admission. A lumbosacral spine CT showed the presence of vacuum phenomenon associated with a degenerated disc material and a capsulated epidural gas collection with evidence of root compression. A microsurgical interlaminar approach was carried out and, before the posterior longitudinal ligament was entered, a spherical "bubble" compressing the nerve roots was observed. The capsulated pseudocyst was dissected out, peeled off and excised en bloc. A large part of the posterior longitudinal ligament and the lateral disc herniation were removed. Postoperatively the patient was completely free of symptoms. The mechanism of exacerbation of pain was probably due to the increased radicular compression in the upright posture and, besides the presence of a lateral disc herniation, could be related to a pneumatic squeezing of gas from the intervertebral space into the well capsulated sac by the solicitated L4-L5 motion segment. Histological study of the wall of the pseudocyst showed the presence of fibrous tissue identical to the ligament. We conclude that, in case of a lumbar disc herniation, it is recommended to perform a complete microdiscectomy and an accurate removal of the involved portion of posterior longitudinal ligament in order to prevent pseudocystic formations.

Adult↗
PubMed2003

Laminectomy and posterior cervical plating for multilevel cervical spondylotic myelopathy and ossification of the posterior longitudinal ligament: effects on cervical alignment, spinal cord compression, and neurological outcome.

OBJECTIVE: Multilevel anterior decompressive procedures for cervical spondylotic myelopathy or ossification of the posterior longitudinal ligament may be associated with a high incidence of neurological morbidity, construct failure, and pseudoarthrosis. We theorized that laminectomy and stabilization of the cervical spine with lateral mass plates would obviate the disadvantages of anterior decompression, prevent the development of kyphotic deformity frequently seen after uninstrumented laminectomy, decompress the spinal cord, and produce neurological results equal or superior to those achieved by multilevel anterior procedures. METHODS: We retrospectively reviewed the records of 38 patients who underwent laminectomy and lateral mass plating for cervical spondylotic myelopathy or ossification of the posterior longitudinal ligament between January 1994 and November 2001. Seventy-six percent of patients had spondylosis, 18% had ossification of the posterior longitudinal ligament, and 5% had both. Clinical presentation included upper extremity sensory complaints (89%), gait difficulty (70%), and hand use deterioration (67%). Spasticity was present in 83%, and weakness of one or more muscle groups was seen in 79%. Spinal cord signal abnormality on sagittal T2-weighted magnetic resonance imaging (MRI) was seen in 68%. Neurological evaluation was performed using a modification of the Japanese Orthopedic Association Scale for functional assessment of myelopathy, the Cooper Scale for separate evaluation of upper and lower extremity motor function, and a five-point scale for evaluation of strength in individual muscle groups. Lateral cervical spine x-rays were analyzed using a curvature index to determine maintenance of alignment. Each surgically decompressed level was graded on a four-point scale using axial MRI to assess the adequacy of decompression. Late follow-up was conducted by telephone interview. RESULTS: Laminectomy was performed at a mean 4.6 levels. Follow-up was obtained at a mean of 30.2 months after the procedure. The score on the modified Japanese Orthopedic Association scale improved in 97% of patients from a mean of 12.9 preoperatively to 15.58 postoperatively (P < 0.0001). In the upper extremities, function measured by the Cooper Scale improved from 1.8 to 0.7 (P < 0.0001), and in the lower extremities, function improved from 1.0 to 0.4 (P < 0.0002). There was a statistically significant improvement in strength in the triceps (P < 0.0001), iliopsoas (P < 0.0002), and hand intrinsic muscles (P < 0.0001). X-rays obtained at a mean of 5.9 months after surgery revealed no change in spinal alignment as measured by the curvature index. There was a decrease in the mean preoperative compression grade from 2.46 preoperatively to 0.16 postoperatively (P < 0.0001). There was no correlation between neurological outcome and the presence of spinal cord signal change on T2-weighted MRI scans, patient age, duration of symptoms, or preoperative medical comorbidity. CONCLUSION: Multilevel laminectomy and instrumentation with lateral mass plates is associated with minimal morbidity, provides excellent decompression of the spinal cord (as visualized on MRI), produces immediate stability of the cervical spine, prevents kyphotic deformity, and precludes further development of spondylosis at fused levels. Neurological outcome is equal or superior to multilevel anterior procedures and prevents spinal deformity associated with laminoplasty or noninstrumented laminectomy.

Adult↗
PubMed2003

[Clinical and radiological study of ossification of the anterior longitudinal ligament in the cervical spine].

Twenty-seven patients with ossification of the anterior longitudinal ligament (OALL) in diffuse idiopathic skeletal hyperostosis (DISH) in the cervical region were diagnosed among 2000 individuals during 10 months and analyzed clinically and radiologically by two neurosurgeons. Sex distribution was 20 men and 7 women with ages ranging from 57 to 82 years (average: 72.3 y.o.). Main signs and symptoms were dysesthesia of the upper extremities, stiff neck, dizziness and dysphagia (33%). Three patients had diabetes mellitus, 14 had hypertension, and 15 had hyperuremia. Ossification of the posterior longitudinal ligament (OPLL) co-existed in 18 patients (66%). Number of vertebral bodies with cervical OALL ranged from 4 to 6 (average: 4.8) and thickness of ossification of the anterior longitudinal ligament was from 2 to 6 (average: 3.1) mm. Originally we divided OALL in the cervical region into 3 types, nodular-type; 16 cases, continuous-type; 7 cases, and mixed-type; 4 cases. Small OPLL can be diagnosed by either cervical CT or myelo-CT. DISH is thought to be a benign clinical entity, but patients with OALL in DISH, accompanied by OPLL and those accompanied by dysphasia are frequently encountered and sometimes may be treated surgically.

Aged↗
PubMed2003

Does perceived discrimination affect health? Longitudinal relationships between work discrimination and women's physical and emotional health.

This study uses longitudinal data to examine the causal relationships between perceived work discrimination and women's physical and emotional health. Using data on 1,778 employed women in the National Longitudinal Survey of Mature Women, we investigate the structural and individual characteristics that predict later perceptions of discrimination and the effects of those perceptions on subsequent health. We find that perceptions of discrimination are influenced by job attitudes, prior experiences of discrimination, and work contexts, but prior health is not related to later perceptions. However, perceptions of discrimination do impact subsequent health, and these effects remain significant after controlling for prior emotional health, physical health limitations, discrimination, and job characteristics. Overall, the results provide even stronger support for the health impact of workplace discrimination and suggest a need for further longitudinal analyses of causes and consequences of perceived discrimination.

Adult↗