15192 Retrospective chart review of cutaneous adverse events associated with PI3K inhibitors in 15 patients

2020 ◽  
Vol 83 (6) ◽  
pp. AB32
Author(s):  
Padmavathi V. Karri ◽  
Benjamin Denison Freemyer ◽  
Anisha B. Patel
Author(s):  
Ruben Berrocal Timmons

Objective: Treatment of joint pain with an injection of the amniotic membrane has not been adequately studied. This study retrospectively reviewed Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and analgesic usage data from patients treated with the injection of cryopreserved amniotic membrane (CAM) in their knees to determine the impact of treatment on patients’ pain, quality of life, and analgesic usage. Methods: Chart review was conducted on 40 patients. Institutional Review Board (IRB) approval was obtained prior to initiation of the project. The membrane was utilized as per the FDA guidance of 21CFR1271. Retrospective data, including demographics, medical history, pain score, quality of life score, analgesic usage and adverse events, were collected from their medical records for each consenting patient through 6 months after CAM injection. Results: A total of 40 patients were considered in the final analysis. Mean VAS for pain level improved from 7.0 to 2.6 (p<0.001). WOMAC daily activity function score improved from a mean score of 52 to 28 (p<0.001). Opioid and non-steroidal anti-inflammatory drug (NSAID) usage decreased from 97% to 25% (p<0.001). No adverse events were reported. Conclusion: Mean values for VAS and WOMAC scores significantly improved at all time points and the number of patients who used analgesics decreased as compared to baseline. CAM injection into painful knee joints decreases pain, improves physical function, and decreases the use of analgesics in the absence of adverse events.


2016 ◽  
Vol 3 (2) ◽  
Author(s):  
Tara A. Lindeman ◽  
Joan M. Duggan ◽  
Eric G. Sahloff

Abstract This retrospective chart review evaluated changes in serum creatinine and creatinine clearance (CrCl) after initiation of an integrase inhibitor (INSTI)-based regimen as initial treatment in human immunodeficiency virus-infected adults. Serum creatinine and CrCl changes were similar to those seen in clinical trials for INSTIs. No renal-related serious adverse events or discontinuations occurred.


2018 ◽  
Vol 19 (6) ◽  
pp. 899-905 ◽  
Author(s):  
Macartney Welborn ◽  
Shelby L. Kubicki ◽  
Naveen Garg ◽  
Anisha B. Patel

2007 ◽  
Vol 28 (6) ◽  
pp. 695-701 ◽  
Author(s):  
A. Luque ◽  
S. Hulse ◽  
D. Wang ◽  
U. Shahzad ◽  
E. Tanzman ◽  
...  

Objective.To assess adverse events associated with antiretroviral regimens for human immunodeficiency virus (HIV) postexposure prophylaxis (PEP), with a particular focus on the treatment combination of zidovudine, lamivudine, and tenofovir (ZDV-3TC-TDF).Methods.Retrospective chart review for individuals who received HIV PEP for occupational and nonoccupational exposure, and multivariate analyses to identify risk factors for noncompletion of PEP and adverse events associated with PEP.Setting.University of Rochester Health Service Occupational Health Program and University of Rochester AIDS Center.Participants.Healthcare workers who received HIV PEP for occupational exposure from January 1, 1999, to December 31, 2004, and individuals who received HIV PEP for nonoccupational exposure from January 1, 2002, to December 31, 2004.Results.We found increased rates of nausea among subjects who received treatment with ZDV-3TC-TDF and subjects who received treatment with zidovudine, lamivudine, and indinavir (ZDV-3TC-IDV). Analyses showed that female sex was a risk factor for nausea. Compared with subjects who received treatment with ZDV-3TC-TDF, subjects who received treatment with ZDV-3TC-IDV were less likely to not complete the HIV PEP for occupational exposure.Conclusion.Preventive treatment of adverse events may be necessary to ensure completion of HIV PEP.


Author(s):  
Jonathan Cook ◽  
Barry E DiBernardo ◽  
Jason N Pozner

Abstract Background Radiofrequency (RF) technology has ushered in a new paradigm in body contouring for patients with mild to moderate skin laxity who desire fat removal without exacerbating skin laxity issues. The authors utilized a bipolar internal RF device as an adjunct to liposuction and found the device to simpler and more accurate than previous technologies. Objectives Our study aims to review our clinical experience with bipolar RF assisted liposuction (RFAL). Methods A review of our large experience with bipolar RFAL was completed, with evaluation of the nuances from appropriate patient selection and specific treatment areas. The authors treated 745 patients from January 2017 to January 2020 at two centers. A retrospective chart review was performed of the first and last 50 patients treated at each center (for a total of 100 patients in each group), to assess trends in outcomes and adverse events. Results Results were generally excellent from physician evaluation, and overall patient satisfaction was high (96%). The two most common adverse events were temporary swelling (9%) and nodules (8.5%). Selected examples of a variety of cases are reviewed. Conclusions The ability to tighten skin with a minimally invasive tool adds much to the contemporary approach to the body contouring patient with skin laxity. Adverse events were minimal and greatly decreased after an initial short learning curve. Bipolar RFAL is a strong addition to our surgical armamentarium and has become one of the essential tools for our practices.


2021 ◽  
Author(s):  
Jing-Zhou Hou ◽  
Kellie Ryan ◽  
Senxi Du ◽  
Bruno Fang ◽  
Stanley Marks ◽  
...  

Aim: A retrospective chart review of ibrutinib-treated patients with chronic lymphocytic leukemia (CLL) was conducted. Patients & methods: Adults with CLL who initiated ibrutinib were followed for ≥6 months (n = 180). Results: Twenty-five percent of first-line ibrutinib patients experienced ≥1 dose reduction, mainly due to adverse events (AEs; 79%). Treatment discontinuations and dose holds occurred in 20 and 34% of patients, respectively, most commonly due to AEs (73 and 74%). Approximately one-quarter of relapsed/refractory ibrutinib patients experienced ≥1 dose reduction, mainly due to AEs (88%). Treatment discontinuation and dose holds occurred in 40% of patients (58 and 76% due to AEs, respectively). Conclusion: Dose reductions, holds and discontinuations were frequent in patients with CLL receiving ibrutinib in routine clinical practice.


2020 ◽  
Vol 3 (4) ◽  
pp. 141-146
Author(s):  
Padmavathi V. Karri ◽  
Benjamin D. Freemyer ◽  
Omar Pacha ◽  
Anisha B. Patel

ABSTRACT Introduction Phosphoinositide 3-kinase (PI3K) inhibitors are a new class of cancer therapeutics that inhibits one or more enzymes in the PI3K/AKT/mTOR tumor growth pathway. As compared to other tyrosine kinase inhibitors, there is evidence that PI3K inhibitors have a higher incidence of severe cutaneous adverse events (CAEs) ranging from 2-21%. There is a lack of further characterization of clinical trials and management options for these CAEs. Methods A retrospective chart review of our institution's records between January 2015 and May 2019 was conducted; electronic medical records were queried by using a pharmacy database and ICD-10 codes for patients receiving PI3K inhibitor who experienced CAEs during therapy. These CAEs were characterized by two board-certified dermatologists at a major cancer center. Results Eleven patients were identified as having 12 cumulative CAEs. Average time to rash onset was 4 weeks, and the most common identified rashes were eczematous (25%) and morbilliform (17%). Four patients experienced a dose delay, and one patient immediately discontinued their PI3K inhibitor. Conclusion Although most CAEs caused by PI3K inhibitors in this study were limited to grade 1–2 and were controlled with topical corticosteroids and oral antihistamines, a number of patients experienced dose impact. This highlights the dermatologist's role in managing and minimizing interruption of therapy while maintaining quality of life.


OTO Open ◽  
2019 ◽  
Vol 3 (1) ◽  
pp. 2473974X1983643
Author(s):  
Jacqueline Ross ◽  
Kristy McMurray ◽  
Tanis Cameron ◽  
Celia Lanteri

Objective To describe use of a stoma stent to facilitate high-risk decannulation. Methods Retrospective chart review of 14 consecutive patients who received a stent from March 2013 to December 2016 at a quaternary health care service. Primary outcome measures were decannulation outcome and adverse events. Results Decannulation outcome: 12 of 14 patients had their tracheostomy tube (TT) removal facilitated by stent use. Patients had the stent for a median of 6 days (interquartile range, 49). Reasons for use included medical instability, risk of sputum retention, uncertain airway patency, and the need for ongoing airway access. All patients survived to discharge. One patient residing in the community has retained a stoma stent. Adverse events: One patient removed the stent on the day of insertion, necessitating reinsertion of the TT. Granulation tissue at the stoma site was seen in 2 patients. Discussion A tracheostoma will normally close within 48 hours following decannulation, which is problematic if TT reinsertion is required. By using the stent, reversal of decannulation becomes a simple ward-based procedure. In comparison to a TT, which is secured with ties, the stoma stent proved unsuitable for use in an agitated patient. Implications for Practice Decreasing total cannulation time is of benefit as patients with tracheostomy are subject to high rates of complications and adverse events. A stoma stent poses little risk and a low morbidity burden to the patient in comparison to alternative management.


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