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There are few prospective data about the use of surveillance colonoscopy and the risk of recurrent neoplasia in first degree relatives (FDRs) of colorectal cancer (CRC) patients. We examined the use and yield of surveillance colonoscopy in a population-based screening program (Trentino, Italy) METHODS: 1252 FDRs have been included in this study. We calculated compliance (percentage of FDRs who underwent surveillance colonoscopy among those eligible), appropriateness of colonoscopy (appropriate if performed within 6 months of the guidelines recommended interval) and diagnostic yield for neoplasia. We compared these data with those of 765 individuals without a family history (FH) of CRC who underwent screening colonoscopy in the same period (controls).Compliance and appropriateness were higher in FDRs than in controls (93.0% vs. 48.0%; p 0.001; 59.6% vs. 18.8%; p 0.0001, respectively). Younger age, female sex, FH of CRC and both non-advanced adenomas (nAA) and advanced adenomas (AA) at screening colonoscopy were predictors of appropriate surveillance. The cumulative incidence of nAA and AA was similar in FDRs and controls (31.7% and 4.9% in FDRs, including three invasive cancers; 32.4% and 5.8% in controls, respectively).FH does not increase the risk of AA in a 5-year follow-up; appropriate surveillance practices in FDRs could be highly expected in an organized screening program.

Prior stroke plays an important role in the development of cognitive impairment (CI), the prevention of which requires detailed study. Patients and methods . A total of 350 patients (mean age, 65±17.7 years; 49% men) who had experienced a stroke with a small degree of neurological deficit were followed up. Cognitive functions were evaluated using the Mini-Mental State Examination (MMSE), Mattis dementia rating scale, the clock drawing test, the test on memorizing 12 words, and the Schulte table. During 5 years of follow-up, 61 (17.4%) patients died, including 45 (12.8%) from recurrent stroke; 89 recurrent strokes developed. Results . The first examination did not reveal CI in 59 (17%) patients; 73 (21%) were found to have marked CI (mild or moderate dementia). After 1, 3, and 5years of follow-up, the proportion of patients with marked CI increased up to 23.2, 29.5, and 34.5%, respectively. Within 5 years, there was an average decline of 2 MMSE scores. The maximum decrease in cognitive functions was seen in patients who had experienced a recurrent stroke, but this also occurred in the absence of a stroke. Cognitive functions were substantially better in a group of patients with blood pressure (BP) normalization. Conclusion . The 5-year follow-up has shown that post-stroke CI gradually progresses, which is associated with the progression of both vascular disease and a concomitant neurodegenerative process. BP normalization during antihypertensive therapy contributes to the prevention of progressive post-stroke CI.

Aims: The purpose of this retrospective, non-interventional, open cohort study is to report on short implants (8 mm’s and less) as used to treat severe atrophic ridges in absence of bone graft. Materials and Methods: Retrospectively all Straumann implant implants of length 6 and 8 mm that were placed in the posterior mandible with no bone graft were evaluated (N= 720). Implant restorations were all splinted together. Bone levels were evaluated at 12 months then at 1-2 year intervals up to 5 years. Results: Among the 720 implants placed, the overall 5-year survival rate was 100%. The overall cumulative success rate of all implants was 95.8% at 3 years and 93.4% at 5 years, respectively. Success rates of the 6 mm implants were 92.3% and 90.5% at 3 and 5 years, respectively. Success rates for the 8 mm implants were found to be 97.2% and 94.6% at 3 and 5 years, respectively. There was no statistically significant difference in the success rates of 6 and 8 mm implants. Conclustion: Short multiple splinted implants are an effective treatment modality in the resorbed mandible and may provide alternative to bone grafting or nerve transposition.

Autologous chondrocyte implantation (ACI) is an established surgical procedure that has provided satisfactory results. The aim of the present study was to correlate the clinical outcomes of a series of 20 patients treated by ACI at a 7-year follow-up examination with the magnetic resonance imaging (MRI) T2-mapping 5-year follow-up findings. We evaluated 20 patients using the American Orthopaedic Foot and Ankle Society (AOFAS) score preoperatively and the established follow-up protocol until 87.2 ± 14.5 months. MRI T2-mapping sequences were acquired at the 5-year follow-up examination. At the MRI examination (60 ± 12 months), the mean AOFAS score improved from 58.7 ± 15.7 to 83.9 ± 18.4. At the final follow-up examination at 87.2 ± 14.5 months, the AOFAS score was 90.9 ± 12.7 (p = .0005). Those patients who experienced an improvement between 5 and 7 years after surgery had a significant greater percentage of T2-map value of 35 to 45 ms (hyaline cartilage) compared with those patients who did not improve (p = .038). MRI T2 mapping was shown to be a valuable tool capable of predicting reproducible clinical outcomes after ACI even 7 years after surgery. The quality of the regenerated tissue and the degree of defect filling became statistically significant to the clinical results at the final follow-up examination.

Background We present 5‑year follow-up data for tinnitus-specific and comorbid depressive symptoms as well as stress-related outcome variables of an intensive multimodal 7‑day tinnitus therapy. Method Tinnitus burden (Tinnitus Questionnaire), stress (Perceived Stress Questionnaire), and depressive symptomatology (General Depression Scale) were measured at the 5‑year follow-up after a multimodal intensive 7‑day intervention. In all, 94 patients participated in the study. Results All outcome variables showed significant improvement at the end of the 7‑day intensive treatment. These effects remained significant after 5 years. Conclusion The results of the present study support the effectiveness of the 7‑day multimodal intensive therapy for tinnitus. Posttreatment improvements were related to both tinnitus burden as well as stress and depressive symptoms and were maintained at the 5‑year follow-up.

Breakfast eating (BE) seems to be cross-sectionally associated with fruit and vegetable intake (FVI). To date, gender differences in any codevelopment between BE and FVI, as well as their associated factors, have not been examined. The objectives of this study were (1) to identify dual trajectories of BE and FVI among economically disadvantaged boys and girls; and (2) to examine potential associated factors of identified dual trajectories by gender. Children from economically disadvantaged families were enrolled in this prospective multicity study of the Taiwan Database of Children and Youth in Poverty between July 6 and October 31, 2009 and followed up biannually (2009, 2011, and 2013). One thousand one children (50.2% girls, mean ages at each time point being 9.1, 11.2 and 13.1 years, respectively; 49.8% boys, 9.0, 11.0 and 13.0 years) who completed at least two of the three assessments were included. Dual trajectories of BE and FVI over a 5-year follow-up period were identified as the outcome variables of interest by using mainly group-based dual trajectory modeling. Nine potential associated factors were then examined using logistic regression models. Two distinct dual trajectories of BE and FVI were identified among the girls: longitudinally irregular (68.8%) and shift to irregular (31.2%). Two distinct dual trajectories of BE and FVI were identified among the boys: longitudinally irregular (90.2%) and consistently regular (9.8%). Age was the significantly associated factor for boys. The findings confirmed a heterogeneous codevelopment between BE and FVI that may indicate different underlying mechanisms. Most children with a longitudinally irregular BE pattern had a similar pattern of FVI. Future research should comprehensively explore the gender differences in the determinants of codevelopment between BE and FVI.

Seronegative myasthenia gravis (MG) is a generalized form of MG that is diagnosed on the basis of clinical symptoms, electrophysiological testing, and pharmacological responses, in the absence of a seropositive status for anti-acetylcholine receptor (AChR) antibodies. Generalized MG that is seronegative for anti-AChR, anti-muscle-specific kinase (MuSK), and anti-low density lipoprotein receptor related protein 4 (Lrp4) antibodies is known as triple-seronegative MG. We here describe a case of triple-seronegative MG in an 8-year-old boy. His first symptom was dysphagia, at 3 years of age, and he subsequently developed ptosis, rhinolalia, and a waddling gait. A genetic analysis was conducted to exclude the possibility of congenital myasthenia syndrome due to the patient's resistance to steroid therapy. His condition was successfully managed with tacrolimus therapy over a 5-year follow-up period. Recently, several studies have reported the therapeutic utility of tacrolimus in juvenile seropositive MG; in contrast, a few reports have described tacrolimus treatment in cases of seronegative MG. Our findings suggest that tacrolimus therapy is a safe and effective option for the treatment of juvenile seronegative MG.

Background Mindfulness-based intervention (MBI) may offer a novel means of preventing excess weight gain in adolescents, theoretically by decreasing stress-eating through altering executive functioning (EF) and food-reward sensitivity. Methods N = 54 12–17y girls and boys at-risk for excess weight gain (i.e., BMI ≥70th percentile or two biological parents with reported obesity [BMI ≥30 kg/m2]) participated in a 1.5-year follow-up of a pilot randomized controlled trial comparing 6-week/6-session MBI (n = 29) and a health education (HE) control (n = 25). Laboratory stress-eating, food-reward sensitivity, EF, perceived stress, and BMI/adiposity were re-assessed at 1.5-years with validated measures. Changes from baseline to 1.5-year follow-up were explored with ANCOVA, accounting for the respective baseline outcome, age, and sex. Results Compared to MBI (M = −21, SE = 59), HE had greater increases in stress-eating from baseline to 1.5-years (M = 194, SE = 63, Cohen's d = 0.59, p = .01). There were no other between-condition differences. Discussion MBI may prevent worsening stress-eating for adolescents at-risk for excess weight gain. The potential for MBI as an intervention for stress-eating and ultimately, weight stabilization warrants testing in an adequately-powered trial.

BACKGROUND Compressive optic neuropathy is the most common indication for transsphenoidal surgery for pituitary adenomas. Optical coherence tomography (OCT) is a useful visual assessment tool for predicting postoperative visual field recovery. OBJECTIVE To analyze visual parameters and their association based on long-term follow-up. METHODS Only pituitary adenoma patients with abnormal visual field defects were selected. A total of 188 eyes from 113 patients assessed by visual field index (VFI) and 262 eyes from 155 patients assessed by mean deviation (MD) were enrolled in this study. Postoperative VFI, MD, and retinal nerve fiber layer (RNFL) thickness were evaluated and followed up. After classifying the patients into normal (>5%) and thin (

Several studies have reported incidence and risk factors for the development of proximal junctional kyphosis (PJK) in patients with adolescent idiopathic scoliosis (AIS). However, there is little information regarding long-term follow-up after pedicle screw instrumentation (PSI) with rod derotation (RD) and direct vertebral rotation (DVR). Sixty-nine AIS patients who underwent deformity correction using PSI with RD and DVR were retrospectively analyzed in two groups according to the occurrence of PJK, with a minimum five-year follow-up, including a non-PJK group (n = 62) and PJK group (n = 7). Radiological parameters were evaluated at preoperative, postoperative, and last follow-up. Incidence for PJK was 10.1% (7/69 patients), with a mean 9.4-year follow-up period. The thoracolumbar/lumbar curve (TL/L curve) was proportionally higher in the PJK group. The proximal compensatory curve was significantly lower in the PJK group than in the non-PJK group preoperatively (p = 0.027), postoperatively (p = 0.001), and at last follow-up (p = 0.041). The development of PJK was associated with the TL/L curve pattern, lower preoperative proximal compensatory curve, and over-correction of the proximal curve for PSI with RD and DVR. Therefore, careful evaluation of compensatory curves as well as of the main curve is important to prevent the development of PJK in the treatment of AIS.

Background We assessed the 5-year risk of being diagnosed with significant prostate cancer following a low-suspicion biparametric magnetic resonance imaging result. Methods The study population was derived from a prospective database used to assess the diagnostic accuracy of biparametric magnetic resonance imaging for significant prostate cancer detection in 1020 biopsy-naïve men. Significant prostate cancer was defined as any core with Gleason grade group ≥3 or a maximum cancerous core length greater than 50% of Gleason grade group 2. A secondary definition of significant prostate cancer was also included: any core with prostate cancer Gleason grade group ≥2. Of the 1020 men, 305 had a low-suspicion biparametric magnetic resonance imaging result (Prostate Imaging Reporting and Data System score of 1 or 2) but four men were excluded from follow-up. Thus, the final study population consisted of 301 men, who were clinically followed-up from inclusion (November 2015 to June 2017) until 1 June 2021. Findings Overall, 1·7% (5/301) of the study population had significant prostate cancer diagnosed within 5 years (median 1480 days, Interquartile Range (1587–1382)) of their low-suspicion result and corresponding set of biopsies. When the secondary definition of significant prostate cancer was applied, this increased to 5% (15/301) of the study population. Interpretation The 5-year risk of being diagnosed with significant prostate cancer after a prebiopsy low-suspicion prebiopsy biparametric magnetic resonance imaging result was 1·7%., Biparametric MRI; Multiparametric MRI; Prostate cancer.

[This corrects the article DOI: 10.1371/journal.pone.0251260.].

This retrospective study investigated 5-year results of primary arthroscopic operation for anterior glenohumeral instability (AI) with special interest in patients aged25 years and gender.Recurrence of AI is higher in male patients aged25 years than older patients or females.Primary arthroscopic Bankart repair was performed between January 2009 and December 2015 on 156 shoulders [154 patients, 104/156 (67%) males]. The mean follow-up was 5.6 (SD 2.1, range 0.4-8.9) years. Outcome measures, including re-dislocation, fear of dislocation, Western Ontario instability index, Subjective shoulder value and pain Numerical rating scale scores, the number of revision surgeries and satisfaction with the result of surgical treatment, were assessed for 130 shoulders [82/130 (63%) males]. AI recurrence was defined as a dislocation or a fear of such.The Kaplan-Meier analysis estimates for the cumulative survival of stable shoulders were 28% at 8.8 years for patients aged25 years (SE 0.4, CI 95% 5.5-7.2) and 53% at 8.9 years for patients aged ≥25 years (SE 0.2, CI 95% 7.2-8.0; p=0.005). The Kaplan-Meier estimates for the cumulative survival of stable shoulders were 50% at 8.9 years for males (SE 0.3, CI 95% 6.8-7.8) and 37% at 8.6 years for females (SE 0.3, CI 95% 6.5-7.7; p=0.8). Mean time to revision was 2.4 (SD 1.7, range 0.4-5.3) years.Recurrence of AI was higher in the patients aged25 years (p=0.005), but gender was not a risk factor. Re-operation rate due to recurrent AI was 10% in this 5-year follow-up.III; case-control study.

The aim of this study was to (1) investigate whether radiographic and clinical parameters, which influence how stresses during sporting activities act on the proximal femur, are associated with cam morphology or (2) precede cam morphology development.Young male football players participated at baseline (n = 89, 12-19 years of age), 2.5-year (n = 63) and 5-year follow-up (n = 49). Standardized anteroposterior pelvic and frog-leg lateral radiographs were obtained at each time-point. Cam morphology was quantified by an alpha angle ≥ 60°, and large cam morphology ≥ 78°. The neck-shaft angle (NSA), epiphyseal extension (EE), lateral center-edge angle (LCEA) and hip internal rotation (IR) were also measured. Cross-sectional associations between NSA, EE, LCEA and IR and (large) cam morphology were studied at all time-points. To study whether these variables preceded cam morphology development, hips without cam morphology at baseline were studied prospectively.A lower NSA, a higher EE and limited IR were consistently associated with cam morphology at all three time-points. These differences were more pronounced in hips with large cam morphology. No association between cam morphology and the LCEA was found. None of the parameters studied preceded cam morphology development.Cam morphology developed simultaneously with a varus orientation, growth plate extension towards the femoral neck and limited hip internal rotation. These parameters did not precede cam morphology development. The hip parameters studied cannot be used to identify individuals at risk of developing cam morphology.Level II.

The extraosseous/peripheral odontogenic fibroma (E/POF) is a benign mesenchymal odontogenic tumour found on the gingival surface with clinical characteristics identical to those of reactive lesions. A histopathological analysis is the only method for determining the difference between reactive lesions and these neoplastic lesions, whose recurrence potential varies between 38.9% and 50%, highlighting the importance of correct diagnosis. The following report describes an E/POF case with a clear cells component, as well as a long-term follow-up treatment, which we emphasise due to its potential for recurrence.

It was reported imperative on cervical sagittal alignment reconstruction after anterior multilevel procedures with self-locked stand-alone cage (SSC) or anterior cage-with-plate (ACP) system multilevel while there was little knowledge about the relationship on cervical alignment and clinical outcomes. To identify the importance of cervical sagittal alignment after 3-level anterior cervical discectomy and fusion on cervical spondylotic myelopathy with SSC and ACP system. Seventy-seven patients with SSC system (SSC group) and 52 cases with ACP system (ACP group) from February 2007 to September 2013 were enrolled with well-matched demographics. Cervical alignment included C2–7 lordosis (CL), operated-segment cervical lordosis (OPCL), upper and lower adjacent-segment cervical lordosis, range of motion of upper and lower adjacent segment at preoperation, immediate postoperation, and the final follow-up. Clinical outcomes contained the neck disability index (NDI), the Japanese Orthopaedic Association (JOA) score, visual analogous scale (VAS) of arm and neck and adjacent segment degeneration (ASD). Patients were then divided into CL improved subgroup (IM subgroup) and non-improved subgroup (NIM subgroup). There were improvements on CL and OPCL in both groups. The change of CL and OPCL larger in ACP group (P

Introduction: External cervical resorption (ECR) is a physiological or pathological event usually detected on radiographic examination, since there are no symptoms in its initial and intermediate phases. Objectives: This case is an important finding because the early detection of this lesion allowed an effective multidisciplinary approach to be carried out. Case Report: Radiography was taken in a 55-year-old male and revealed a radiolucent area on the distal surface of the permanent mandibular left first molar, suggesting ECR with impaired pulpal vitality. Based on the clinical and radiographic examinations, a multidisciplinary approach was established involving endodontic treatment, periodontal surgery and indirect restoration that provided an option for preserve the affected tooth. The early diagnosis of ECR was essential for the successful treatment in order to maintain the satisfactory function for five-year follow-up. Conclusion: Despite the procedures performed, the idiopathic etiology of the lesion contributed to the appearance of recurrences; however, monitoring and maintenance of the affected tooth proved to be important for the longevity of the treatment. Introducción: La reabsorción cervical externa (ECR) es un evento fisiológico o patológico que generalmente se detecta en el examen radiográfico, ya que no presenta síntomas en sus fases inicial e intermedia. Objetivos: Este caso es un hallazgo importante porque la detección precoz de esta lesión permitió realizar un abordaje multidisciplinar eficaz. Caso clínico: La radiografía se tomó en un varón de 55 años y reveló el área radiotransparente en la superficie distal del primer molar inferior izquierdo permanente, sugiriendo una ECR con vitalidad pulpar deteriorada. Con base en los exámenes clínicos y radiográficos, se estableció un abordaje multidisciplinario que involucró tratamiento endodóntico, cirugía periodontal y restauración indirecta que brindó una opción para preservar el diente afectado. El diagnóstico temprano de RCE fue esencial para un tratamiento exitoso con el fin de mantener la función dental durante un seguimiento de cinco años. Conclusión: A pesar de los procedimientos realizados, la etiología idiopática de la lesión contribuyó a la aparición de recidivas; sin embargo, el seguimiento y mantenimiento del diente afectado resultó ser importante para la longevidad del tratamiento. Introdução: A reabsorção cervical externa (RCE) é um evento fisiológico ou patológico geralmente detectado no exame radiográfico, uma vez que não apresenta sintomas em suas fases inicial e intermediária. Objetivo: Este caso é um achado importante porque a detecção precoce desta lesão permitiu uma abordagem multidisciplinar eficaz por um longo período de tempo. Relato de Caso: A radiografia foi feita em um homem de 55 anos e revelou uma área radiolúcida na superfície distal do primeiro molar permanente inferior esquerdo, sugerindo um RCE com vitalidade pulpar prejudicada. Com base em exames clínicos e radiográficos, foi estabelecida uma abordagem multidisciplinar que envolveu tratamento endodôntico, cirurgia periodontal e restauração indireta que forneceu uma opção para preservar o dente afetado. O diagnóstico precoce de RCE foi essencial para o sucesso do tratamento, a fim de manter a função do dente ao longo de um acompanhamento de cinco anos. Conclusão: Apesar dos procedimentos realizados, a etiologia idiopática da lesão contribuiu para o aparecimento de recividas; no entanto, o acompanhamento e a manutenção do dente afetado mostraram-se importantes para a longevidade do tratamento.

Jianjun Zhang, Tongsheng Ma, Yuan Peng, Guangfeng Huang, Fengli Liu Department of Neonatal Surgery, Xuzhou Children’s Hospital, Xuzhou, China Objective: To investigate different outcomes and long-term efficacy of transanal Soave or Swenson surgery in treatment for neonates with Hirschsprung’s disease (HD).Methods: In the present study, a total of 29 neonatal patients were included, with 20 patients undergoing the Soave procedure and nine patients undergoing the Swenson procedure. Data collected from the patients included basic demographics, age and weight at the time of operation, pathological typing, type of operation, operative time, blood loss, length of hospital stay, bowel function, and complications. The follow-up lasted for 5 years for all patients via the outpatient clinics or by telephone. Results were statistically analyzed using SPSS version 18.0.Results: The age, weight, and pathological type of patients with different surgical approaches showed no significant difference. The operation time and blood loss of patients who underwent Swenson procedure were significantly lower than those who underwent Soave procedure; P0.05. Bowel function (Rintala score) and postoperative complications in the two groups also showed no significant difference when evaluated 3 months after the surgery; P>0.05. Patients were followed-up for a 5-year period at 3 months, 6 months, 2 years, and 5 years after surgery, respectively. Results showed that complications and bowel function recovery during the 5-year follow-up showed no significant difference between the two methods.Conclusion: The operation time and blood loss of the transanal Swenson pull-through procedure was lower than transanal Soave method; however the long-term outcomes of the two methods showed no significant difference. These results may give more clinical evidence in this field. Keywords: Hirschsprung’s disease, follow-up, transanal Soave, transanal Swenson, pull-through

Background:The technique of hip arthroscopic surgery is advancing and becoming more commonly performed. However, most current reported results are limited to short-term follow-up, and therefore, the durability of the procedure is largely unknown.Purpose:To perform a multicenter analysis of mid-term clinical outcomes of arthroscopic hip labral repair and determine the risk factors for patient outcomes.Study Design:Cohort study; Level of evidence, 3.Methods:Prospectively collected data of primary hip arthroscopic labral repair performed at 4 high-volume centers between 2008 and 2011 were reviewed retrospectively. Patients were assessed preoperatively and postoperatively with the visual analog scale (VAS), modified Harris Hip Score (mHHS), and Hip Outcome Score–Sports-Specific Subscale (HOS-SSS) at a minimum of 5 years’ follow-up. Factors including age, body mass index (BMI), Tönnis grade, and cartilage grade were analyzed in relation to outcome scores, and revision rates were determined. Failure was defined as subsequent ipsilateral hip surgery, including revision arthroscopic surgery and open hip surgery.Results:A total of 303 patients (101 male, 202 female) with a mean age of 32.0 years (range, 10.7-58.9 years) were followed for a mean of 5.7 years (range, 5.0-7.9 years). Patients achieved mean improvements in VAS of 3.5 points, mHHS of 20.1 points, and HOS-SSS of 29.3 points. Thirty-seven patients (12.2%) underwent revision arthroscopic surgery, and 12 (4.0%) underwent periacetabular osteotomy, resurfacing, or total hip arthroplasty during the study period. Patients with a BMI >30 kg/m2had a mean mHHS score 9.5 points lower and a mean HOS-SSS score 15.9 points lower than those with a BMI ≤30 kg/m2( P < .01). Patients aged >35 years at surgery had a mean mHHS score 4.5 points lower and a HOS-SSS score 6.7 points lower than those aged ≤35 years ( P = .03). Patients with Tönnis grade 2 radiographs demonstrated a 12.5-point worse mHHS score ( P = .02) and a 23.0-point worse HOS-SSS score ( P < .01) when compared with patients with Tönnis grade 0.Conclusion:Patients demonstrated significant improvements in VAS, mHHS, and HOS-SSS scores after arthroscopic labral repair. However, those with Tönnis grade 2 changes preoperatively, BMI >30 kg/m2, and age >35 years at the time of surgery demonstrated significantly decreased mHHS and HOS-SSS scores at final follow-up.

The incidence of proximal junctional kyphosis (PJK) ranges from 5% to 46% following adult spinal deformity surgery. Approximately 66% to 76% of PJK occurs within 3 months of surgery. A subset of these patients, reportedly 26% to 47%, develop proximal junctional failure (PJF) within 6 months postoperatively. To date, there are no studies evaluating the impact of prophylactic vertebroplasty on PJK and PJF incidence at long-term follow-up.The purpose of this study is to evaluate the long-term radiographic and clinical outcomes, and incidence of PJK and PJF, after prophylactic vertebroplasty for long-segment thoracolumbar posterior spinal fusion (PSF).This is a prospective cohort study.Thirty-nine patients, of whom 87% were female, who underwent two-level prophylactic vertebroplasty at the upper instrumented and supra-adjacent vertebrae at the time of index PSF were included in this study.Clinical outcomes were assessed using the Scoliosis Research Society-22 (SRS-22), and Short-Form (SF) 36 questionnaires, and the Oswestry Disability Index (ODI). Radiographic parameters including PJK angle, and coronal and sagittal alignment, were calculated, along with relevant perioperative complications and revision rates.Of the 41 patients who received two-level prophylactic vertebroplasty at the upper instrumented and supra-adjacent vertebrae at the time of index PSF, and comprised a cohort with previously published 2-year follow-up data, 39 (95%) completed 5-year follow-up (average: 67.6 months). Proximal junctional kyphosis was defined as a change in the PJK angle ≥10° between the immediate postoperative and final follow-up radiograph. Proximal junctional failure was defined as acute proximal junctional fracture, fixation failure, or kyphosis requiring extension of fusion within the first 6 months postoperatively.Thirty-nine patients with a mean age of 65.6 (41-87) years were included in this study. Of the 39 patients, 28.2% developed PJK (11: 7.7% at 2 years, 20.5% between 2 and 5 years), and 5.1% developed acute PJF. Two of the 11 PJK patients required revision for progressive worsening of the PJK. There were no proximal junctional fractures. There was no significant difference in preoperative, immediate postoperative, and final follow-up measurements of thoracic kyphosis, lumbar lordosis, and coronal or sagittal alignment between patients who developed PJK, PJF, or neither (p.05). There was no significant difference in ODI, SRS-22, or SF-36 scores between those with and without PJK or PJF (p.05).This long-term follow-up demonstrates that prophylactic vertebroplasty may minimize the risk for junctional failure in the early postoperative period. However, it does not appear to decrease the incidence of PJK at 5 years.

Objectives: The aim of this study was to assess calcium growth with fused grayscale intravascular ultrasound (IVUS), IVUS–virtual histology, and optical coherence tomography (OCT) from base...

SummaryBackground In 2011, a multicentre study was conducted in order to determine how hair dye manufacturers instructed consumers to perform a self-test prior to dyeing their hair, in order to identify individuals who are likely to react upon subsequent hair dyeing. A number of concerns were raised concerning the variability in instructions between products and producers, and the safety and validity of this tool. Objectives To perform a 5-year follow-up study in order to determine whether manufacturers still recommend a self-test, and if so, whether the procedures have been changed. Methods During March 2016, a total of 40 oxidative hair dye products from 21 different manufacturers were bought in retail stores in 8 European countries. Results The consumers were instructed to perform a self-test prior to hair dyeing for 39 of the products; however, the procedures varied greatly regarding the method of application, the amount of hair dye applied, the location and size of the application area, the number of applications, whether or not rinsing was performed after application, the reading times, and how a positive reaction was defined. Conclusions Self-testing is still recommended by almost all manufacturers of permanent hair dyes. There are major variations in the instructions, even in products from the same manufacturer. The previously raised concerns regarding safety and validity still remain.

Pelvic fractures are uncommon in children and account for between 0.3 and 7.5% of all pediatric injuries. Open pelvic fractures only account for up to 12.9% of all pediatric pelvic fractures. An unusual case of open complete anterior sacro-iliac joint dislocation in a 4-year-old boy is presented with a long-term follow-up. The multidisciplinary approach is reported with review of the current literature. A 4-year-old male presented to our institution in January 2012 after having been run over by a tractor. He presented with gross hemodynamical instability, MISS of 25, and an unstable lateral compression type III pelvic fracture with complete anterior dislocation of the left hemipelvis and a groin wound extending into the left thigh. The patient was managed in accordance with the ATLS and open fracture guidelines. Reduction in the dislocated SI joint was achieved via a posterior approach to the SI joint, followed by fixation with 2K wires in S1 and S2 sacral segments, with an anterior external fixator. Pelvic asymmetry post-reduction was 0.9 cm, compared to 16 cm post-injury, and asymmetry persisted till final follow-up at 5 years. At 5 years, patient regained full function, including recreational sport activities. Patients scored a 96/96 on the Majeed score (after excluding 4 points for sexual function). We believe that posterior reduction in an anteriorly dislocated SI joint in the pediatric population is a viable option. A coordinated, multidisciplinary approach and restoration of pelvic ring stability can lead to optimal outcome.

Aim To investigate the fees charged by Swedish dentists for root fillings, coronal restorations and further dental interventions during a follow-up period of 5-6 years. Methodology A total of 248,299 root fillings were linked with the tooth, the patient and the provider and entered into the Swedish Social Insurance Agency register in 2009. The data register also recorded the subsidy-based (scheduled) fee and the fee actually charged for the root fillings. Fees charged for direct or indirect coronal restorations and additional interventions during the follow-up period were also recorded. One-way ANOVA and T-test were used for statistical analysis. Results The mean overall fee charged for a root filling was approximately 332 Euro and differed only marginally (13 Euro) from the scheduled fee. The total mean fee for preservation of a root filled tooth was 717 Euro, which included the root canal treatment, the coronal restoration and any additional interventions during the follow-up period. The fees for indirectly restored root filled teeth were significantly higher (1,105 Euro) than for directly restored teeth (610 Euro), despite further additional treatment (P< 0.001). The mean fee for teeth which were subsequently extracted was higher (769 Euro) than for the retained teeth (711 Euro) (P< 0.001). Conclusions Fees charged by Swedish dentists for root canal treatment were in accordance with the scheduled fees. The overall mean fee was significantly higher for root filled teeth with indirect restorations than for teeth with direct coronal restorations. However, prospective clinical cost-effectiveness studies are needed to analyse the total costs. This article is protected by copyright. All rights reserved.

Background We wanted to identify in children with epilepsy the factors associated with seizure control and recurrence after a 2-year remission. Methods We did a 5-year follow-up of epileptic children whose antiepileptic medication had been stopped. Bivariate and multivariate analyses were used to compare features of electroencephalograms (EEGs) and clinical findings. In this study, 43 patients with and 64 without a seizure recurrence (SR) were enrolled. Results Clinical features strongly associated with SR in the univariate analysis included a symptomatic etiology for seizures, a history of status epilepticus, treatment duration before stopping antiepileptic drugs, and abnormal EEG findings at the time of stopping antiepileptic drugs. Conclusion We found that a history of status epilepticus, symptomatic partial epilepsy, treatment duration before stopping antiepileptic drugs, and an abnormal EEG when the medication was stopped are important predictors of SR. The risk factors of SR after discontinuing antiepileptic drugs have been investigated in several studies. However, a history of status epilepticus as a predictive factor is rarely mentioned.

Purpose The aims of this study were to describe and compare diagnoses, symptoms, and care needs in palliative cancer patients in two medium-sized hospitals in a county council with no specialized palliative care available 24/7; to analyze the relationships between diagnosis and symptoms/care needs; and to compare results and trends from two datasets (from 2007 and 2012). Methods The study was population-based with a cross-sectional design and was conducted at two acute care hospitals. We performed 142 one-day inventories (n = 2972) in 2007 and 139 in 2012 (n = 2843) to register symptoms, care needs, and diagnosis based on a questionnaire. Multiple logistic regression models were used in the analysis. Results During 2007 and 2012 combined, 10% (n = 589) of hospitalized patients were assessed as having cancer in a palliative phase. Prostate (12%) and colorectal (12%) cancers were most common. Pain (42%) and deterioration (42%) were the most prevalent symptoms and were associated with pancreas cancer in our regression models (p = 0.003 and p = 0.019, respectively). Other cancers had different associations: hematologic malignancies were associated with infections and blood transfusions (p

Highlights • Although sclerosing angiomatoid nodular transformation (SANT) of the spleen is a new entity defined as a benign pathologic lesion, it is very difficult for ruling out the malignancy in preoperative imaging studies. • Even when accumulation of fluorodeoxyglucose increased slightly during the follow-up period and suggested the possibility of malignant diseases, it is necessary to make a diagnosis of splenic SANT comprehensively., Introduction Sclerosing angiomatoid nodular transformation (SANT) of spleen is a new entity defined as a benign pathologic lesion. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) shows weak accumulation, thereby ruling out the malignancy in preoperative diagnosis is difficult. Herein, we reported a case of shrinking SANT with increased FDG accumulation during a 5-year follow-up period, which was treated by laparoscopic splenectomy. Presentation of case A 64-year-old female had been referred to our hospital for the evaluation of a splenic tumor. Initial contrast-enhanced computed tomography (CT) showed a well-defined, and ovoid hypoattenuating lesion, measuring 52 mm in diameter in the spleen. Initial PET/CT revealed accumulation of FDG in the tumor (maximum standardized uptake value [SUVmax]: 2.8). The mass was diagnosed as SANT, and the patient was followed-up every 6–12 months for 5 years. Follow-up PET/CT revealed increased accumulation of FDG (SUVmax: 3.5). As it was suspicious considering the differential diagnosis, including malignant lymphoma and inflammatory pseudotumor, she underwent laparoscopic splenectomy. The pathological results showed three types of vessels including capillaries, ectatic small veins, and sinusoids-like vessels, consistent with the features of SANT. Discussion A SANT may have features that resemble those of malignancy, including the growing mass and the increase of FDG accumulation. Conclusion Although the preoperative diagnosis of SANT is difficult, it is necessary to make a diagnosis of SANT comprehensively, even when accumulation of FDG increased slightly during the follow-up period and suggested the possibility of malignant diseases.

Background: Latinas have the highest incidence rates of cervical cancer in the United States, and Latinas in the United States are less likely to utilize cervical cancer screening. We used secondary data analysis of a nonclinical convenience sample (n = 316 women at baseline; n = 285 at 5-year follow-up) to examine correlates of cervical cancer screening among adult Latina women. Univariate and multiple logistic regression models using generalized estimated equations (GEE) algorithm were utilized to assess the influence of the independent variables. Women who reported their main health-care source as community health clinics, women who were sexually active, and women who reported that a health-care provider discussed HIV prevention with them were more likely to report having had a cervical cancer screening (aOR = 2.06; CI = 1.20, 3.52). The results suggest a need for continued efforts to ensure that medically underserved women (e.g., Latina women) receive counseling and education about the importance of preventive cervical cancer screening.

Background Previous studies were conflicting regarding the associations between HPV vaccination, cervical cancer risk perceptions, high-risk sexual behaviors and STIs. This study compared the HPV-vaccinated and non-vaccinated young women in Uganda regarding cervical cancer risk perceptions, high-risk sexual behaviors, syphilis and HIV infections 5 years after vaccine implementation. Methods This was a population-based comparative cross-sectional survey conducted in Uganda. The 438 participants were sexually active young women aged 15–24 years and mean age was 18.6 (SD 1.4). The majority (53.0%) were HPV-vaccinated in 2008 without assessment of sexual activity prior to HPV vaccination. Upon verbal assessment of sexual activity at the time of follow-up, data were collected using a questionnaire and laboratory testing of blood samples for syphilis and HIV infections. Results There were no significant differences between the HPV-vaccinated and non-vaccinated groups regarding the prevalence of high-risk sexual behaviors, syphilis and HIV infections. Cervical cancer risk perceptions and age at sexual debut were nonetheless significantly lower among the vaccinated group compared to their non-vaccinated counterparts. However, HPV vaccination was not significantly associated to cervical cancer risk perceptions and early age at sexual debut in multivariate logistic regression analysis. Conclusions We found no associations between HPV vaccination, cervical cancer risk perceptions, high-risk sexual behaviors, syphilis and HIV infections among young women in Uganda 5 years after vaccine implementation. Young girls in the study population were found to be sexually active at a young age, affirming the importance of targeting girls of younger age for HPV vaccination. Electronic supplementary material The online version of this article (doi:10.1186/s12905-017-0394-y) contains supplementary material, which is available to authorized users.

Background Alcohol-use disorders (AUDs), including alcohol dependence and alcohol abuse defined according to specific DSM-IV and ICD-X criteria, can be potentially lethal, since they are associated with several medical and psychiatric conditions. This study aims to describe the causes of hospitalization of a large cohort of subjects with alcohol dependence (alcoholics) enrolled in Florence (Italy) over a 5-year follow-up period and to evaluate the effect of hospitalization on overall survival. Methods Eleven-hundred-thirty (1,130) alcoholics, newly diagnosed from 1997-2001, were linked to the Regional Mortality Registry for update of vital status as of December 31, 2006 and to the Hospital Discharge electronic archives of the Regional Health System of Tuscany to verify hospital admissions during the 5-year post cohort enrollment follow-up. Kaplan-Meier survival and Cox regression analyses were performed to evaluate any association of hospital admission with overall survival. Results A total of 3,916 new hospitalizations occurred during the 5-year follow-up. Most alcoholics (70.6%) reported at least 1 new hospitalization, with a first hospitalization rate of 61.7 per 100 person-years in the first year of follow-up. The mean number of hospitalizations per admitted subject was 4.87 (SD:7.4) and mean length of hospital stay was 8.5 days (SD:11.3). The main causes of hospitalization were mental disorders and diseases of the digestive system, as well as accidents or violence. Among those alcoholics alive after 1 year of follow-up, a significantly increased risk of dying in the following years could be predicted by early hospitalization in the 12 months preceding (HR 1.73; 95% CI 1.15-2.60) or following (HR 3.59; 95% CI 2.31-5.61) enrollment in the cohort. Conclusions Our results confirm the association of AUDs with several serious medical conditions. This fact may be responsible for a high impact on health resource utilization and high social costs. Early hospitalization significantly predicts vital status at 5 years. This article is protected by copyright. All rights reserved.

Evidence regarding the effect of n-3 long-chain polyunsaturated fatty acid (LCPUFA) supplementation during pregnancy on offspring's neurodevelopment is not conclusive.In this analysis, the effect of a reduced n-6:n-3 LCPUFA ratio in the diet of pregnant/lactating women (1.2 g n-3 LCPUFA together with an arachidonic acid (AA)-balanced diet between 15th wk of gestation-4 months postpartum vs control diet) on child neurodevelopment at 4 and 5 years of age was assessed. A child development inventory (CDI) questionnaire and a hand movement test measuring mirror movements (MMs) were applied and the association with cord blood LCPUFA concentrations examined.CDI questionnaire data, which categorizes children as 'normal', 'borderline' or 'delayed' in different areas of development, showed no significant evidence between study groups at 4 (n=119) and 5 years (n=130) except for the area 'letters' at 5 years of age (P=0.043). Similarly, the results did not strongly support the hypothesis that the intervention has a beneficial effect on MMs (for example, at 5 years: dominant hand, fast: adjusted mean difference, -0.08 (-0.43, 0.26); P=0.631). Children exposed to higher cord blood concentrations of docosahexaenoic acid, eicosapentaenoic acid and AA, as well as a lower ratio of n-6:n-3 fatty acids appeared to show beneficial effects on MMs, but these results were largely not statistically significant.Our results do not show clear benefits or harms of a change in the n-6:n-3 LCPUFA ratio during pregnancy on offspring's neurodevelopment at preschool age. Findings on cord blood LCPUFAs point to a potential influence on offspring development.

Immediate implant placement followed by an immediate restoration has proven to be a viable technique in the anterior maxillary region.This prospective study evaluated the mid-long term (2-5 years) tissue changes around immediately placed and restored implants in the anterior maxilla using flapless surgery and simultaneous hard tissue augmentation.Thirty AstraTech implants were immediately placed in 30 patients, followed by the delivery of an immediate provisional restoration on the same day. All participating 30 patients underwent the same treatment strategy that involved flapless removal of a failing maxillary anterior tooth, immediate implant placement, simultaneous augmentation with a deproteinized particulate xenograft, followed by the connection of a screw-retained provisional restoration. Radiographs and photographs were used to measure hard and soft tissue changes. Aesthetic evaluation was performed using the Pink Esthetic Score (PES).All implants remained osseointegrated during the follow up period of 2-5 years (mean 47 ± 15 months). Twelve of the thirty patients completed the 5 year follow up. Radiographic evaluation revealed average gains in bone levels of 0.18 and 0.34 mm mesially and distally, respectively. Soft tissue evaluation showed a mean tissue loss of 0.05 ± 0.64 mm and 0.16 ± 0.63 mm at the mesial and distal papillae, respectively, while mid-facial mucosal recession was 0.29 ± 0.74 mm. A significant improvement in the Pink Esthetic Scores was seen at the final follow-up (mean PES 11.50), as compared to the baseline (mean PES 10.27) (P = .001).In addition to a favorable implant success rate and peri-implant bony response, the soft tissue levels and overall aesthetics around single immediately placed and restored implants can also be maintained in the mid-long term.

A substantial portion of the older adult population suffers from frequent feelings of loneliness, but a large proportion remains relatively unscathed by loneliness. To date, research examining both protective and risk factors for loneliness has not included data from the United States. The present study used the first two waves of data from the National Social Life, Health, and Aging Project to examine sociodemographic, structural, and functional factors thought to be associated with loneliness in older adults. Functional limitations and low family support were associated with an increase in loneliness frequency (as were more strained friendships) and with transitioning from nonlonely to lonely status. Better self-rated health, higher levels of socializing frequency, and lower family strain were associated with transitioning from lonely to nonlonely status. Interventions that target these factors may be effective in preventing and reducing loneliness and its effects on health and well-being in older adults.

Both rotating-platform (RP) mobile-bearing and medial-pivot (MP) fixed-bearing prostheses allow axial femorotibial rotation using a highly conforming polyethylene insert. However, limited comparative data are available between the 2 designs. This study was performed to compare the midterm clinical outcomes and patient-reported outcome measures (PROMs) of RP and MP prostheses.We retrospectively reviewed the records of 52 total knee arthroplasties using RP mobile-bearing prosthesis and 49 total knee arthroplasties using MP fixed prosthesis with a minimum follow-up period of 5 years. Clinical and radiological outcomes, failure rates, and PROMs, including the Western Ontario and McMaster Universities Osteoarthritis Index score and satisfaction, were compared.There was no difference in clinical or radiographic outcomes (P.1 for all comparisons), with the exception of the larger flexion contracture (FC) in the MP group (0.3° in RP vs 2.3° in MP, P.01). No failure in either group was recorded during the study period. PROMs were comparable (P.1 in all comparisons), with the exception of higher satisfactions in the RP group while performing light household duties (P.01) and leisure or recreational activities (P = .014) in patients without FC.The midterm clinical results with both the RP mobile-bearing and MP fixed-bearing prostheses were satisfactory. Although both prostheses provided comparable PROMs, patients with an RP prosthesis were more satisfied than those with an MP prosthesis for highly demanding activities that are strongly associated with the presence of postoperative FC.

The purpose of this study was comparison of clinical and radiographic outcomes of immediate post-extraction implants with or without the use of pure platelet-rich plasma (P-PRP) in the short- and medium-term follow-up. A retrospective analysis was performed to assess soft tissue healing, implant and prosthesis survival, marginal bone level changes and biological complications. A total of 109 partially edentulous patients with 126 implants were included in this analysis. At 4–5 years after loading, cumulative survival rate in test group was 97.4% and in control group was 97.8%, with no significant differences. After 5 years of function, marginal bone loss (MBL) in test group was 0.8 ± 0.35 and 1.02 ± 0.27 mm for immediate and delayed loading, respectively, and in control group was 0.6 ± 0.16 and 0.8 ± 0.89 mm for immediate and delayed loading, respectively. No significant differences in MBL were observed intragroups and intergroups at any time point considered. Soft tissue healing score was significantly higher in test group compared to the control at 3 and 7 days after surgery, with significant differences. P-PRP implant group showed a better soft tissue management and wound healing in the first 7 days after surgery compared to non-P-PRP implant group. In the medium-term follow-up, comparable clinical and radiographic outcomes were noticed between two groups.

Background This prospective cohort study reports the medium-term clinical and radiographic results of 113 hips treated with a hybrid total hip replacement (THR) with a new cemented tapered cobalt-chrome (Co-Cr) stem with a titanium (Ti) modular neck (ProfemurXm®). Method Between October 2008 and December 2010 we performed 115 consecutive hybrid THR with the ProfemurXm® in 105 patients. Results Survivorship of the implant (stem and modular neck) at a mean of 6.5 years (min 5-max 8) was 100% with the endpoint revision for any reason. No implant was at risk for revision or showed signs of loosening. The mean Harris Hip Score was 89/100, mean Oxford Hip Score was 43/48, mean WOMAC was 91/100. No patient had thigh pain, no patient reported squeaking. There were no dislocations in this cohort. No implant showed development of radiolucent lines (RLL), either at the stem-cement or cement-bone interface. No hip showed osteolysis or calcar resorption. The mean femoral subsidence of the stem within the cement mantel was 0.31 mm (range 0-0.6 mm) after 6.5 years. With the use of this modular stem, 93% of hips showed no measurable leg length difference after THR, and leg length could be restored within a 5-mm limit in 99% of hips. Conclusions The mid-term results of this new polished stem were excellent, without adverse effects from the use of modularity.

Background and aims We aimed to determine changes in oxidative stress, lipoprotein-associated phospholipase A 2 (Lp-PLA 2 ) activity and arterial stiffness in subjects with persistent prehypertensive symptoms during a 3.5-year follow-up period. Methods We divided 254 subjects with prehypertension according to their blood pressure (BP) status at 3.5 years of follow-up into three groups: reversed normotensive, persistent prehypertensive and developed hypertensive group. BP, serum lipid profile, oxidized LDL (ox-LDL), Lp-PLA 2 activity and brachial-ankle pulse wave velocity (ba-PWV) were measured at baseline and the 3.5-year follow-up. Results The reversed normotensive group showed a significant reduction in average BP (14.7/10.1 mmHg), whereas the developed hypertensive group showed a significant increase in average BP (15.2/11.5 mmHg). The persistent prehypertensive group showed increases in serum lipid profiles, circulating levels of Lp-PLA 2 activity, ox-LDL and arterial stiffness as measured by ba-PWV at 3.5 years. The persistent prehypertensive and developed hypertensive groups showed greater increases in ox-LDL than the reversed normotensive group. The developed hypertensive group showed greater increases in Lp-PLA 2 , 8- epi -PGF 2α , and ba-PWV than those observed in the reversed normotensive and persistent prehypertensive groups. In all subjects, changes (Δ) in systolic blood pressure (SBP) positively correlated with Δ Lp-PLA 2 , Δ ox-LDL, Δ urinary 8- epi -PGF 2α and Δ ba-PWV. Conclusions This study indicates that in persistent prehypertension, increased ox-LDL hydrolysis by Lp-PLA 2 enhances arterial stiffness without an age-related increase in BP.

Ribbing disease, or multiple diaphyseal sclerosis, is a rare diaphyseal sclerosis of unknown etiology. Patients with this pathology usually present with asymmetric pain limited to the lower extremities. Though all efforts are made to relieve the progressive pain associated with Ribbing disease, no medical or surgical treatments have been established yet. In this case report, we followed up a Ribbing case with sclerotic bone fenestration for 5 years. The radiological changes and the clinical effects are described, and the different Ribbing treatments are then briefly reviewed.

IntroductionThe aim of this prospective study was to evaluate the association between serum magnesium (Mg) and mortality, in particular the cause-specific mortality of Mg and other risk factors in hemodialysis (HD) patients.MethodsWe studied a cohort of 185 HD patients receiving thrice-weekly HD treatment, on a dialysate Mg concentration of 0.5 mmol/L. We stratified 3 patient groups according to the level of Mg: lower (1.3 mm/L).ResultsDuring the 5-year follow-up, 60 patients died, with cardiovascular (CV) disease as the predominant cause (73.3%). Hazard ratio (HR) for all-cause and CV mortality were 2.55 and 2.67 in the lower versus intermediate Mg group, but there was no significant association between the higher and intermediate Mg group. Univariate Cox regression analysis showed that Mg 1,200 pg/mL However, in the multivariate analysis only CRP ≥10 mg/L with HR 3.89 was a significant predictor of mortality. Subgroup analyses showed that among patients with CRP >10 mg/L, HR for all-cause and CV mortality of the lower versus intermediate Mg group were 1.96 and 2.39, respectively, not reaching significance for the higher versus intermediate Mg group. Conversely, there was no association between Mg level and all-cause and CV mortality within these 3 groups among patients with CRP ConclusionsLower serum Mg level was significantly associated with an increased all-cause and cardiovascular mortality in HD patients, especially in inflamed patients.

Objective To compare the effectiveness of tension-free vaginal tape (TVT) and tension-free obturator tape (TOT) in treatment of genuine stress urinary incontinence and study the related complications. Materials and methods About 150 cases with complaints of stress urinary incontinence were taken during 5-year period, and they were confirmed urodynamically. Exclusion criteria included patients with diabetes mellitus, neurological disorders, other forms of incontinence, uterovaginal prolapse, urinary tract infection, and pregnancy. Out of 150 cases, 70 underwent TVT procedure and 80 were taken up for TOT. The outcome was studied at the end of 5 years. Results The cure rate in the TOT group was 94%, which was slightly higher than the TVT group, which came out to be 90%. The failure rate in the TVT group was 1.1%, but no failure was encountered in the TOT group. However, the improvement rates were similar in each group. Comparing the complications in each group, the rate of bladder perforation and postoperative retention of urine was much higher in the TVT group. Postoperative voiding difficulties were also noticeably less in TOT group compared with TVT group. However, none of the cases in either group had de novo urgency. Conclusion Both the procedures are a safe and effective method of curing stress incontinence; however, owing to slightly higher improvement rates and lower complications rate, TOT should be preferred over TVT. How to cite this article Bhadana P, Mittal P, Bachani S. Tension-free Vaginal Tape vs Tension-free Obturator Tape for Treatment of Genuine Stress Urinary Incontinence: A 5-year Follow-up. J South Asian Feder Obst Gynae 2017;9(2):89-93.

BACKGROUND CONTEXT For adolescent idiopathic scoliosis (AIS) Lenke Type 1-4C curves, controversy exists whether selective thoracic fusion (STF) is sufficient or non-selective fusion (NSF) should be used to treat the associated lumbar curves. PURPOSE In this multicenter study with minimum 5-year follow-up, we performed propensity score matching to compare patients treated with selective thoracic fusion and non-selective fusion for Lenke 1-2C curves vs 3-4C curves. STUDY DESIGN/SETTING Retrospective analysis of multicenter, prospectively collected data using propensity score matching PATIENT SAMPLE A total of 74 patients with Type 1-2C curves and 36 patients with 3-4C curves OUTCOME MEASURES Radiographic parameters (such as main thoracic and compensatory lumbar Cobb angles) and SRS-22 scores METHODS A prospective, multicenter database was queried for Lenke 1-4C curves (min 5-yr follow up). Patients were dichotomized to STF (fusion L1 or above) vs NSF (fusion below L1). We analyzed two subgroups: 1) non-structural lumbar curves (1-2C), and 2) structural lumbar curves (3-4C). After propensity score matching within each subgroup for age and preop thoracic and lumbar Cobb angles, we conducted within and between group comparisons of radiographic data and SRS-22 scores. RESULTS Of 124 patients with 1-2C curves, 74 matched (37 STF, 37 NSF). At 5 years postop, both STF and NSF led to improvement in main thoracic (MT) and compensatory lumbar (CL) Cobb angles as well as coronal balance (C7-CSVL), but NSF values were better than STF (p CONCLUSIONS In propensity score matched patients treated for Lenke Type 1-2C curves, STF results in slightly less radiographic correction but similar patient reported outcomes as NSF at 5 years. In contrast, matched patients treated for Lenke Type 3-4C curves with NSF have both better radiographic and patient reported outcomes when compared to STF. FDA DEVICE/DRUG STATUS This abstract does not discuss or include any applicable devices or drugs.