scholarly journals Effect of Leflunomide on Pegloticase Response Rate in Patients with Uncontrolled Gout: A Retrospective Study

Author(s):  
Karim Richard Masri ◽  
Lissa Padnick-Silver ◽  
Kevin Winterling ◽  
Brian LaMoreaux
2019 ◽  
Vol 160 (5) ◽  
pp. 810-817 ◽  
Author(s):  
Ashley M. Nassiri ◽  
James W. Pichert ◽  
Henry J. Domenico ◽  
Mitchell B. Galloway ◽  
William O. Cooper ◽  
...  

Objectives To analyze unsolicited patient complaints (UPCs) among otolaryngologists, identify risk factors for UPCs, and determine the impact of physician feedback on subsequent UPCs. Methods This retrospective study reviewed UPCs associated with US otolaryngologists from 140 medical practices from 2014 to 2017. A subset of otolaryngologists with high UPCs received peer-comparative feedback and was monitored for changes. Results The study included 29,778 physicians, of whom 548 were otolaryngologists. UPCs described concerns with treatment (45%), communication (19%), accessibility (18%), concern for patients and families (10%), and billing (8%). Twenty-nine (5.3%) otolaryngologists were associated with 848 of 3659 (23.2%) total UPCs. Male sex and graduation from a US medical school were statistically significantly associated with an increased number of UPCs ( P = .0070 and P = .0036, respectively). Twenty-nine otolaryngologists with UPCs at or above the 95th percentile received peer-comparative feedback. The intervention led to an overall decrease in the number of UPCs following intervention ( P = .049). Twenty otolaryngologists (69%) categorized as “responders” reduced the number of complaints an average of 45% in the first 2 years following intervention. Discussion Physician demographic data can be used to identify otolaryngologists with a greater number of UPCs. Most commonly, UPCs expressed concern regarding treatment. Peer-delivered, comparative feedback can be effective in reducing UPCs in high-risk otolaryngologists. Implications for Practice Systematic monitoring and respectful sharing of peer-comparative patient complaint data offers an intervention associated with UPCs and concomitant malpractice risk reduction. Collegial feedback over time increases the response rate, but a small proportion of physicians will require directive interventions.


2020 ◽  
Vol 60 (1) ◽  
Author(s):  
Juliana Delfino ◽  
Thiago Alberto F. G. dos Santos ◽  
Thelma L. Skare

Abstract Background Nephritis occurs frequently in systemic lupus erythematosus (SLE) and may worsen disease morbidity and mortality. Knowing all characteristics of this manifestation helps to a prompt recognition and treatment. Aim To compare the differences in clinical data, serological profile and treatment response of nephritis of early and late onset. Methods Retrospective study of 71 SLE patients with biopsy proven nephritis divided in early nephritis group (diagnosis of nephritis in the first 5 years of the disease) and late nephritis (diagnosis of nephritis after 5 years). Epidemiological, serological, clinical and treatment data were collected from charts and compared. Results In this sample, 70. 4% had early onset nephritis and 29.6% had late onset. No differences were noted in epidemiological, clinical, serological profile, SLICC and SLEDAI, except that late onset nephritis patients were older at nephritis diagnosis (p = 0.01). Regarding renal biopsy classification, C3 and C4 levels, serum creatinine, 24 h proteinuria and response rate to treatment the two groups were similar (p = NS). Patients with early onset had lower levels of hemoglobin at nephritis onset than those of late onset (p = 0.02). Conclusions Most of SLE patients had nephritis in the first 5 years of disease. No major differences were noted when disease profile or treatment outcome of early and late onset nephritis were compared.


2001 ◽  
Vol 37 (5) ◽  
pp. 489-496 ◽  
Author(s):  
AN Smith ◽  
JC Wright ◽  
Brawner WRJr ◽  
SM LaRue ◽  
L Fineman ◽  
...  

A retrospective study was performed of 17 dogs and seven cats with various stages of thymoma treated with radiation alone or as an adjunctive therapy. Analysis revealed an overall response rate of 75% (15/20 evaluable cases). Partial (i.e., >50% reduction in tumor size) and complete (i.e., no detectable tumor) responses were included. Complete responses were rare (4/20). Three of five animals with stable disease (i.e., <50% change in tumor size) had improvements in clinical signs, despite lack of measurable response. A median survival time of 248 days (range, 93 to 1,657+ days) was achieved in dogs, and a median survival time of 720 days (range, 485 to 1,825+ days) was achieved in cats. Radiation therapy appears to be useful in the management of invasive thymomas in dogs and cats.


2013 ◽  
Vol 28 (3) ◽  
pp. 132-139 ◽  
Author(s):  
C A Thomas ◽  
J M Holdstock ◽  
C C Harrison ◽  
B A Price ◽  
M S Whiteley

Objectives This is a retrospective study over 12 years reporting the healing rates of leg ulcers at a specialist vein unit. All patients presented with active chronic venous leg ulcers (clinical, aetiological, anatomical and pathological elements [CEAP]: C6) and had previously been advised elsewhere that their ulcers were amenable to conservative measures only. Method Seventy-two patients (84 limbs) were treated between March 1999 and June 2011. Patients were contacted in August 2011 by questionnaire and telephone. Of 72 patients, two were deceased and two had moved location at follow-up, so were not contactable. Fifty patients replied and 18 did not (response rate 74%), representing a mean follow-up time of 3.1 years. Results Ulcer healing occurred in 85% (44 of 52 limbs) of which 52% (27) limbs were no longer confined to compression. Clinical improvement was achieved in 98% of limbs. Conclusions This study shows that a significant proportion of ulcers currently managed conservatively can be healed by surgical intervention.


2018 ◽  
Vol 07 (03) ◽  
pp. 200-202 ◽  
Author(s):  
Ajay Gogia ◽  
Chandan K. Das ◽  
Lalit Kumar ◽  
Atul Sharma ◽  
Akash Tiwari ◽  
...  

Abstract Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin's lymphoma. We conducted a retrospective study to analyze the clinicopathological characteristics, cell of origin, response to therapy, and the outcome of patients with DLBCL. Materials and Methods: This was a retrospective study which included all patients with DLBCL registered at our center, between May 1, 2013, and July 31, 2015. The data regarding demography, clinical presentation, histopathology, stage, prognostic index, treatment, and treatment-related outcome were collected from prospectively maintained clinical case records of the patients. Results: In the study, we included 267 patients. The median age is 49 (20–81) years with male: female ratio of 2:1. B symptoms were seen in 124 (45%) of patients. Early Stages (I and II) were seen in 130 (52%) patients, while advanced Stages (III and 1V) were seen in 119 (48%) patients. Bulky disease (>7.5 cm) was seen in 30% of cases, and bone marrow was involved in 12%. Extranodal involvement is present in 35% of cases. Cell of origin data was available in 160 (60%) of cases, of which 88 (55%) were germinal center and 72 (45%) were activated B cell in origin. The distribution according to the international prognostic index (IPI) was as follows: low risk 40%, intermediate risk 45%, and high risk in 15%. Rituximab was used in 45% of cases. The overall response rate was 84% with a complete response (CR) rate of 70.5%. The CR rates were better with RCHOP compared with CHOP (77% vs. 61.5%, P = 0.001) and good-risk IPI (83.3% vs. 65.2%, P < 0.001) compared with intermediate- and high-risk IPI. Median follow-up period was 24 months, and 2-year event-free survival (EFS) was 70%. The presence of B symptoms, high IPI, failure to attain CR, poor PS, and nonrituximab-based chemotherapy were significantly associated with lower EFS. Conclusions: This is the first study from India, which investigated the impact of chemotherapy with or without rituximab in context of cell of origin. Adding rituximab to CHOP showed better response rate and EFS irrespective of cell of origin.


Author(s):  
Ritika M. Basnotra ◽  
Meena D. Sidhu

Background: Blood transfusion is associated with the risk of transmitting transfusion transmissible infections (TTI) even after the thorough mandatory TTI screening of blood units. To prevent disease transmission, it is important to inform, notify and counsel the donors about their seroreactive status at the blood centre. The present study determines the response of various TTI reactive donors for post donation counselling after notification and their persistence in society as reactive donors.Methods: It was a retrospective study conducted at tertiary care center from 1May2015 to 30April2017. Re-active donors were called to the blood bank by telephonic call and letters. Reactive donors on complying at center were retested, counselled and referred to appropriate centre for further management.Results: There were 34,204 blood donations over period of two years, out of which 375[1.09%] were reactive donors. Of these HBV reactive comprises of 166/34204(0.48%), HCV were 40/34204(0.11%), HIV reactive donors comprises of 26/34204(0.07%), Syphilis 138/34204[0.40%] and there were five cases of co-infection, two for HIV+ HCV, two cases HIV+HBV and one case of co-infection with HBV+ Syphilis. A total of 375 TTI reactive donors were identified, out of which (227/375) 60.5% contacted by tele-phone calls and letters and remaining (148/375) 39.46% cannot be contacted. Out of 227 contacted donors only 117 donors reported for post donation counselling i.e. response rate of 51.54%.Conclusions: Donor notification is efficient method of curtailing TTI but undermined by communication failure with donors, resulting in persistent load of blood transmissible infectious risk.


Sarcoma ◽  
2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Shoko Marshall ◽  
Kenji Nakano ◽  
Yoshiya Sugiura ◽  
Shinichiro Taira ◽  
Makiko Ono ◽  
...  

Background. Doxorubicin is the key drug for treatment of advanced soft tissue sarcoma (STS). The appropriate dosage of doxorubicin, regarding monotherapy or the role of combination therapy, is unclear. Methods. We retrospectively reviewed patients with advanced or metastatic STS of nonextremities who were treated with doxorubicin-based chemotherapies in our institution. Time to treatment failure (TTF), overall survival (OS), overall response, and prognostic factors for OS were evaluated. Results. Seventy-five patients were enrolled. The median TTF was 4.7 months, and the median OS was 20.1 months. The overall response rate was 20%. Doses of doxorubicin monotherapy did not show significant difference either in TTF or in OS. There were no significant differences in OS between combination therapy and monotherapy, but the TTF with combination therapy was better than monotherapy. The overall response for combination therapy indicated a better response rate. Less number of involved organs, no bulky mass, and a normal CRP level were independent favorable prognostic factors for OS. Conclusions. Combination therapy showed better response and TTF than monotherapy but did not show better OS. Possible prognostic factors for OS were indicated. This retrospective study was approved by the institutional review board. This trial is registered with UMIN000028787.


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