scholarly journals Vancomycin and DRESS: A retrospective chart review of 32 cases in Los Angeles, California

2017 ◽  
Vol 77 (5) ◽  
pp. 973-975 ◽  
Author(s):  
Barbara D. Lam ◽  
Melanie M. Miller ◽  
Adam V. Sutton ◽  
David Peng ◽  
Ashley B. Crew
2003 ◽  
Vol 82 (5) ◽  
pp. 367-370 ◽  
Author(s):  
Maria M. LoTempio ◽  
Marilene B. Wang ◽  
Ahmad Sadeghi

We conducted a retrospective chart review of treatment outcomes in 17 adults who had been selected to undergo concomitant chemotherapy and radiation (chemo/XRT) for late-stage oropharyngeal cancers. All patients had been treated at the West Los Angeles VA Medical Center between March 1, 1998, and Sept. 30, 2000. Nine patients had a primary tumor at the base of the tongue, five had a primary tumor in the tonsillar area, and three had a tumor that affected both sites. Of this group, 15 patients completed one to three cycles of chemo/XRT, and the remaining two died during therapy. At the most recent follow-up, 9 of the 17 patients (52.9%) were documented to still be alive; seven patients had earlier died as a result of their primary tumor or a distant metastasis, and one patient had been lost to follow-up after completing treatment. At study's end, the duration of post-treatment survival ranged from 2 to 36 months (mean: 12.5). Based on the results of our small series, we conclude that chemo/XRT is a valid alternative to surgery with postoperative radiation and to radiation alone. Chemo/XRT yields acceptable rates of local control and allows for organ preservation with tolerable side effects.


Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Martha Power ◽  
Frank Bittner ◽  
Patricia Horstman ◽  
Owen Lander ◽  
Thomas Marshall ◽  
...  

Background and Purpose: Target Stroke SM aims to reduce the Door to Needle (DTN) times to 60 minutes or less in eligible ischemic stroke patients. They advocate Emergency Medical Service (EMS) pre-notification, a rapid triage protocol,stroke team notification, and a single call activation system 1 . Prior to February 2013 the Stroke Team averaged 92.8 Stroke Team Activations monthly. This volume placed a burden on the Stroke Team and ancillary departments. DeLuca and colleagues noted a possible criticism of Stroke Code in that patients with symptoms mimicking a stroke may overload the stroke personnel 2. We set out to decrease unnecessary stroke team activations without missing an opportunity to treat an eligible patient. Methods: A retrospective chart review was performed on all Stroke Team Activations between February and July 2012. We identified the volume of cancelled activations, number of patients too late or symptoms too mild, stroke mimics and treatments provided. The Los Angeles Pre-hospital Stroke Scale (LAPSS) was chosen as a screening tool for Medical Command to use with EMS personnel. The Stroke Team Activation time was shortened from 8 to 6 hours from last known well. The Emergency Department physicians had override authority for Activations. The revised Stroke Team Activation Guideline was disseminated in early 2013. To assess the utility of LAPSS as a Stroke Team Activation tool we compared the pre-LAPSS to the post-LAPSS data. A report completed by Medical Command on all requested Stroke Team Activations was also reviewed. Outcomes: A total of 557 patients were reviewed pre-LAPSS and 426 post-LAPSS. In comparison, the updated Stroke Team Activation Guideline resulted in a decrease of stroke team activations by 23.5%. Average DTN times remained under 60 minutes. A higher percent of patients seen were treated with rtPA (8.6% pre vs. 9.9% post). We have not missed the opportunity to treat an eligible stroke patient. Conclusion: A higher percentage of patients can be treated with DTN times under 60 minutes without overburdening the Stroke Team when procedures are in place for optimum specificity to identify those patients who would benefit from rapid team activation and stroke intervention.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Sukesh Sukumaran ◽  
Katherine Marzan ◽  
Bracha Shaham ◽  
Andreas Reiff

Background. Infliximab (INF) has been shown to be beneficial in treating refractory uveitis, however, no data exist on optimal dosing and the efficacy of higher dosing. Objectives. To compare the efficacy of low-dose (LD) (<10 mg/kg), moderate-dose (MD) (≥10–15 mg/kg), and high-dose (HD) INF (≥15–20 mg/kg) in the treatment of uveitis. Methods. Retrospective chart review children with uveitis diagnosed at Childrens Hospital Los Angeles and Millers Children’s Hospital, CA, USA. Results. Of the 34 INF-treated children, 6 patients received LD, 19 received MD, and 9 received HD. Average disease duration prior to therapy was 10.6, 24.6, and 37.1 months each group, respectively. Topical steroids were discontinued after an average of 3 months, 9.5 months, and 10.2 months in the LD, MD, and HD groups, respectively. We found that 66% of patients receiving LD, 42% of MD, and 66% receiving HD INF failed therapy and required either dose escalation or alternate medication for disease control. Conclusions. INF is beneficial in the treatment of uveitis, and dose escalation up to 4 times above the approved dose is often necessary to achieve disease control in patients with uveitis. Doses < 10 mg/kg every 4 weeks may not be sufficient to control disease.


2020 ◽  
Vol 41 (3) ◽  
pp. 447-456
Author(s):  
Mi-jung Yoon ◽  
Na-kyung Cho ◽  
Hong-sic Choi ◽  
Seung-mo Kim ◽  
Sang-chan Kim ◽  
...  

2014 ◽  
Vol 95 (10) ◽  
pp. e93-e94
Author(s):  
Aziza Azadali Kamani ◽  
Earl L. Smith ◽  
Jeffrey Fine ◽  
Lawrence M. Reich

2021 ◽  
Vol 7 ◽  
pp. 233372142110189
Author(s):  
Brandi M. Mize ◽  
Brandon Duke ◽  
Amanda K. Pangle ◽  
Jeanne Y. Wei ◽  
Gohar Azhar

Cardiovascular disease is a common comorbidity associated with an aging population. However, there is a unique group of individuals whose age-defying qualities are still being investigated. This retrospective chart review analyzed various cardiac and metabolic health parameters to characterize the prevalence of heart failure and metabolic derangements in individuals aged 90 years old or older in central Arkansas. Only 236 of the 291 patients in our study cohort had blood pressures recorded. Of these, 50% had systolic blood pressures ≥140 mmHg. Additionally, 77% had pulse pressures ≥50 mmHg. Of the 96 patients with BNP data, 44% had values ≥300 pg/mL. There was a slight positive correlation between aging and HDL cholesterol, while there was a negative correlation between aging and both total cholesterol and LDL cholesterol. A majority of our patients had both elevated systolic blood pressures and elevated pulse pressures. A majority also had high BNP values, indicative of some degree of heart failure. Additionally, atrial fibrillation was a common arrhythmia identified on EKG. However, these oldest of the old patients had fewer documented metabolic derangements. These findings lay important groundwork for further investigation into lifestyle and genetic components that allow them to live exceptionally long with such comorbidities.


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