Clinical outcomes of EUS-guided drainage of debris-containing pancreatic pseudocysts: a large multicenter study

Abstract Background and study aims Data on clinical outcomes of endoscopic drainage of debris-free pseudocysts (PDF) versus pseudocysts containing solid debris (PSD) are very limited. The aims of this study were to compare treatment outcomes between patients with PDF vs. PSD undergoing endoscopic ultrasound (EUS)-guided drainage via transmural stents. Patients and methods Retrospective review of 142 consecutive patients with pseudocysts who underwent EUS-guided transmural drainage (TM) from 2008 to 2014 at 15 academic centers in the United States. Main outcome measures included TM technical success, treatment outcomes (symptomatic and radiologic resolution), need for endoscopic re-intervention at follow-up, and adverse events (AEs). Results TM was performed in 90 patients with PDF and 52 with PSD. Technical success: PDF 87 (96.7 %) vs. PSD 51 (98.1 %). There was no difference in the rates for endoscopic re-intervention (5.5 % in PDF vs. 11.5 % in PSD; P = 0.33) or AEs (12.2 % in PDF vs. 19.2 % in PSD; P = 0.33). Median long-term follow-up after stent removal was 297 days (interquartile range [IQR]: 59 – 424 days) for PDF and 326 days (IQR: 180 – 448 days) for PSD (P = 0.88). There was a higher rate of short-term radiologic resolution of PDF (45; 66.2 %) vs. PSD (21; 51.2 %) (OR = 0.30; 95 % CI: 0.13 – 0.72; P = 0.009). There was no difference in long-term symptomatic resolution (PDF: 70.4 % vs. PSD: 66.7 %; P = 0.72) or radiologic resolution (PDF: 68.9 % vs. PSD: 78.6 %; P = 0.72) Conclusions There was no difference in need for endoscopic re-intervention, AEs or long-term treatment outcomes in patients with PDF vs. PSD undergoing EUS-guided drainage with transmural stents. Based on these results, the presence of solid debris in pancreatic fluid collections does not appear to be associated with a poorer outcome.

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Long-Term Treatment Outcomes for Heroin Dependence: The 11-Year Follow-Up of the ATOS Study

PsycEXTRA Dataset ◽

10.1037/e612192013-001 ◽

2013 ◽

Author(s):

Christina Marel ◽

Maree Teesson ◽

Shane Darke ◽

Katherine Mills ◽

Joanne Ross ◽

...

Keyword(s):

Treatment Outcomes ◽

Term Treatment ◽

Heroin Dependence ◽

Long Term Treatment

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Atezolizumab (atezo) in patients with metastatic urothelial carcinoma (mUC): A 2-year clinical update from a phase Ia study.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.6_suppl.290 ◽

2017 ◽

Vol 35 (6_suppl) ◽

pp. 290-290 ◽

Cited By ~ 7

Author(s):

Daniel Peter Petrylak ◽

Thomas Powles ◽

Joaquim Bellmunt ◽

Fadi S. Braiteh ◽

Yohann Loriot ◽

...

Keyword(s):

Objective Response ◽

The United States ◽

Term Treatment ◽

Long Term Results ◽

Platinum Based Chemotherapy ◽

Long Term Treatment ◽

Previously Treated ◽

Ecog Ps

290 Background: Atezo (anti–PD-L1) has demonstrated safety and efficacy in a broad range of cancers and is approved in the United States for mUC previously treated with platinum-based chemotherapy. Here we report long-term results in mUC from Phase Ia study NCT01375842 (PCD4989g). Methods: Previously treated mUC patients received atezo 15 mg/kg or 1200 mg IV q3w. Enrollment in this Phase Ia expansion cohort initially required PD-L1–selected status and later opened to patients regardless of PD-L1 expression on tumor-infiltrating immune cells. The primary endpoint was safety/tolerability. Secondary endpoints included investigator-assessed RECIST v1.1 ORR (confirmed), DOR and OS. Results: 95 patients were safety evaluable (Table). Median age was 66 years, 76% were male and 80% had primary bladder tumors. 61% had ECOG PS 1. 52% received ≥ 3 prior systemic therapies for mUC (70% platinum). Median treatment duration was 3 months (range: 0-32 months); 24% were treated for ≥ 1 year. Treatment-related AEs occurred in 66% (all Grade) and 8% (Grade 3-4) of patients. No treatment-related deaths were reported. In 94 objective response–evaluable patients (follow-up ≥ 12 weeks), the ORR was 27% (95% CI: 18, 37%), and the CR rate was 10%; the SD rate was 19%. mDOR was 22.1 months (95% CI: 12.1, NE months) in all patients; 56% of responses (7/9 CRs and 7/16 PRs) were ongoing at the December 15, 2015 data cutoff. With a 24-month median follow-up duration (range: 1+ to 32 months), the 1-year OS rate was 47% (95% CI: 36, 58%), and the 2-year rate was 29% (19, 40%); mOS is in the Table. Updated clinical data with further follow-up and analyses by PD-L1 status will be presented. Conclusions: Long-term treatment with atezo was well tolerated, without new safety signals in heavily pre-treated mUC patients. The durability of responses, including CRs, along with extended OS, confirm atezo as a new standard for previously treated mUC patients. Clinical trial information: NCT01375842. [Table: see text]

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Collaborative Care Management Associated With Improved Depression Outcomes in Patients With Personality Disorders, Compared to Usual Primary Care

Journal of Primary Care & Community Health ◽

10.1177/2150132718773266 ◽

2018 ◽

Vol 9 ◽

pp. 215013271877326 ◽

Cited By ~ 3

Author(s):

Jeremy J. Solberg ◽

Mark E. Deyo-Svendsen ◽

Kelsey R. Nylander ◽

Elliot J. Bruhl ◽

Dagoberto Heredia ◽

...

Keyword(s):

Treatment Outcomes ◽

Clinical Outcomes ◽

Collaborative Care ◽

Care Management ◽

Term Treatment ◽

Study Cohort ◽

Long Term Treatment ◽

Patient Health ◽

Short And Long Term

Background: The use of a collaborative care management (CCM) model can dramatically improve short- and long-term treatment outcomes for patients with major depressive disorder (MDD). Patients with comorbid personality disorder (PD) may experience poorer treatment outcomes for MDD. Our study seeks to examine the differences in MDD treatment outcomes for patients with comorbid PD when using a CCM approach rather than usual care (UC). Methods: In our retrospective cohort study, we reviewed the records of 9614 adult patients enrolled in our depression registry with the clinical diagnosis MDD and the diagnosis of PD (Yes/No). Clinical outcomes for depression were measured with Patient Health Questionnaire–9 (PHQ-9) scores at 6 months. Results: In our study cohort, 59.4% of patients (7.1% of which had comorbid PD) were treated with CCM, as compared with 40.6% (6.8% with PD) treated with UC. We found that the presence of a PD adversely affected clinical outcomes of remission within both groups, however, at 6 months patients with PD had significantly lower MDD remission rates when treated with UC as compared with those treated with CCM (11.5% vs 25.2%, P = .002). Patients with PD in the UC group were also noted to have an increased rate of persistent depressive symptoms (PHQ-9 score ≥10) at 6 months as compared with those in the CCM group (67.7% vs 51.7%, P = .004). Conclusions: In patients with comorbid MDD and PD, clinical outcomes at 6 months were significantly improved when treated with CCM compared with UC. This finding is encouraging and supports the idea that CCM is an effective model for caring for patients with behavioral concerns, and it may be of even greater benefit for those patients being treated for comorbid behavioral health conditions.

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Chronic pain program management outcomes: Long-term follow-up for Veterans and civilians

Journal of Military Veteran and Family Health ◽

10.3138/jmvfh-2021-0054 ◽

2021 ◽

pp. e20210054

Author(s):

Eleni G. Hapidou ◽

Eric Pham ◽

Kate Bartley ◽

Jennifer Anthonypillai ◽

Sonya Altena ◽

...

Keyword(s):

Chronic Pain ◽

Treatment Outcomes ◽

Term Treatment ◽

Men And Women ◽

Rehabilitation Programs ◽

Long Term Treatment ◽

Veteran Status ◽

Interdisciplinary Pain Management

LAY SUMMARY Interdisciplinary pain rehabilitation programs are effective in treating chronic pain. Not many studies have explored how Veterans differ from civilians in responding to treatment. In this study, several measures were administered at different time points to examine and compare the long-term treatment outcomes of Veteran and civilian men and women. Results from 67 participants showed an overall long-term improvement in levels of pain-related disability, anxiety, and depression, as well as many other pain-related variables. While no differences in treatment outcomes between Veterans and civilians were found, men and women showed some differences. Women reported higher depressive symptoms overall and more pain-related disability than men at follow-up from the program. This study demonstrates the long-term effectiveness of interdisciplinary pain management programs regardless of Veteran status. It highlights some differences between genders. Previous studies have not compared the long-term outcomes of Veterans and civilians from an interdisciplinary program.

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Joint-preserving surgical treatment options for irreparable posterosuperior rotator cuff tear

Obere Extremität ◽

10.1007/s11678-021-00657-6 ◽

2021 ◽

Author(s):

Florian Grubhofer ◽

Jon JP Warner

Keyword(s):

Rotator Cuff ◽

Treatment Outcomes ◽

Treatment Options ◽

Term Treatment ◽

Therapeutic Options ◽

Rotator Cuff Tears ◽

Long Term Treatment ◽

Long Term Follow Up

AbstractTreatment of irreparable rotator cuff tears in young active patients is challenging. A variety of therapeutic options are available. Only a few joint-preserving treatment options show reliable improvements over a long-term follow-up period. However, the treatment outcomes of joint preservation procedures are not comparable to those of RTSA, as patients are typically younger and have higher expectations. It is remarkable that most of the joint-preserving therapeutic options for irreparable rotator cuff ruptures lack long-term treatment results. This article highlights the indications, technical aspects, and treatment outcomes of the most commonly performed joint-preserving surgeries for irreparable rotator cuff rupture.

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Oral tacrolimus in refractory inflammatory bowel disease - long term treatment outcomes and follow-up in a UK cohort

Gut ◽

10.1136/gut.2011.239301.436 ◽

2011 ◽

Vol 60 (Suppl 1) ◽

pp. A207-A207

Author(s):

J. Landy ◽

S. T. Peake ◽

N. Karim ◽

N. Ikin ◽

S. Ng ◽

...

Keyword(s):

Inflammatory Bowel Disease ◽

Treatment Outcomes ◽

Bowel Disease ◽

Term Treatment ◽

Long Term Treatment ◽

Inflammatory Bowel

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Coats’ disease: trends and long-term treatment outcomes in a tertiary referral centre

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211055957 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110559

Author(s):

Avadhesh Oli ◽

Divya Balakrishnan ◽

Subhadra Jalali

Keyword(s):

Visual Acuity ◽

Treatment Outcomes ◽

Term Treatment ◽

Lower Stage ◽

Long Term Treatment ◽

Coats Disease ◽

The Mean ◽

Anatomical Outcomes

Background: The long-term treatment outcomes in Coat’s disease – particularly in the era of newer pharmacotherapies such as anti-vascular endothelial growth factor (VEGF) agents and depot steroids – are poorly understood. Aim: To describe the clinical features and treatment outcomes of 148 eyes with Coats’ disease assessed in a referral centre over 30 years. Materials and methods: We conducted a retrospective chart review of patients diagnosed with Coats’ disease between 1 June 1987 and 31 July 2017. The demographic, clinical and treatment data were collected and long-term functional and anatomical outcomes were analysed based on the treatment either with conventional therapy (cryo/laser) or along with adjuvants like intravitreal steroids or anti-VEGFs. Results: The mean age at presentation was 15.22 years (median 11). Familial exudative vitreoretinopathy was the most common referral diagnosis, 76/148 (51.5%), followed by Coats’ disease, 37/148 (25%), and retinoblastoma, 35/148 (23.6%). Stage 3B was most common at presentation (31.8%), followed by 2B (22.3%) and 2A (16.9%). A total of 107 patients were treated either with conventional therapy or in combination with adjuvants. The mean follow-up period was 24.95 months. The visual acuity improved from baseline logMAR 2.17 (Snellen-20/2958) to logMAR 1.88 (Snellen-20/1517) at final follow-up ( p = 0.004). The improvement in visual acuity was better when the presenting BCVA was <1 logMAR (Snellen 20/200), p = 0.004. No statistically significant change in BCVA was noted between conventional and adjuvant groups, p = 0.5. However, the final anatomical outcome was good in 78/99 (78.8%) in the conventional group and 45/49 (91.8%) in the adjuvant group, respectively ( p = 0.046). Conclusion: In this series of patients with Coats’ disease over three decades, the use of intravitreal steroids or anti-VEGFs as adjuvants resulted in better anatomical outcomes. A better baseline visual acuity, lower stage of the disease, and older age at presentation were found to be the factors leading to favourable visual outcomes. Summary In the current series of 148 eyes with Coats’ disease, adjuvant treatment with intravitreal steroids or anti-VEGFs resulted in better outcomes as compared with conventional cryotherapy or laser photocoagulation alone. Patients with Coats’ disease who had presented with better visual acuity at baseline, lower stage of the disease and older age had better final visual outcomes.

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