scholarly journals 204 A lost-to-follow-up autoantibody for the diagnosis of autoimmune disease: prevalence and clinical characteristics of anti-NOR90/hUBF positive patients

Rheumatology ◽  
2018 ◽  
Vol 57 (suppl_3) ◽  
Author(s):  
Christos Koutsianas ◽  
Kirsty Levasseur ◽  
Megan Rutter ◽  
Caroline Webber ◽  
Malini V Bhole ◽  
...  
Keyword(s):  
Autoimmune Disease ◽  
Clinical Characteristics ◽  
Disease Prevalence ◽  
Lost To Follow Up

Characteristics of elderly metastatic prostate cancer (M1 PC) long-term survivors in the SEER Medicare database receiving androgen-deprivation therapy (ADT)

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e17513-e17513
Author(s):  
N. A. Obeidat ◽  
C. D. Mullins ◽  
E. Onukwugha ◽  
B. Seal ◽  
A. Hussain
Keyword(s):  
Clinical Characteristics ◽  
Population Based ◽  
Short Term ◽  
Time To First Treatment ◽  
Medicare Database ◽  
Different Characteristics ◽  
Lost To Follow Up ◽  
Long Term Survivors

e17513 Background: ADT remains standard treatment for pts with M1 PC, with radiation (RT) and chemotherapy (CT) providing additional palliation. This population-based analysis evaluated if long-term survivors (LT) receiving ADT possessed different characteristics relative to short-term survivors (ST). Methods: Pts age >/= 66y in SEER Medicare diagnosed with M1 PC between 1998 and 2002 and receiving ADT with or without subsequent CT were identified. Median overall survival (OS) for the sample was used as a cut-off to categorize ST and LT pts. Within these categories, demographic, and clinical characteristics were evaluated. Results: 2,665 ADT pts were first identified who had median OS of 26 months (95% CI 24.0 - 27.0). 1,349 pts died at </= 26 months (ST pts), while 1,245 pts survived or were lost to follow-up beyond 26 months (LT pts). Median time to first treatment with ADT was 1 mo in both ST and LT groups. Within this 66y+ population, LT pts were younger (p < 0.0001), more likely to be married (p = 0.0277), and were comprised of lower % of non-Hispanic white pts and higher % of ‘other’ races, but comparable % of African American and White-Hispanics (p = 0.0005). Distributional differences in PSA were detected, but interpreting the results was difficult due to missing or unknown information. Both ST and LT pts received RT and prostatectomy at similar rates, but LT pts had less comorbidities (p = 0.0008), and were more likely to receive CT (p = 0.0026). Conclusions: Long-term survivors were found to have demographic and clinical characteristics that differed from short-term survivors. Evidence regarding how these characteristics simultaneously impact the type and timing of treatment as well as survival deserve more exploration. [Table: see text]

scholarly journals Multidisciplinary Management of Pediatric Sports-Related Concussion

2016 ◽  
Vol 44 (1) ◽  
pp. 24-34 ◽  
Author(s):  
Michael J. Ellis ◽  
Lesley J. Ritchie ◽  
Patrick J. McDonald ◽  
Dean Cordingley ◽  
Karen Reimer ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Return To Play ◽  
Multidisciplinary Management ◽  
Duration Of Symptoms ◽  
Clinical Criteria ◽  
Pediatric Concussion ◽  
The Mean ◽  
Concussion Recovery ◽  
Lost To Follow Up

AbstractObjectives: To summarize the clinical characteristics and outcomes of pediatric sports-related concussion (SRC) patients who were evaluated and managed at a multidisciplinary pediatric concussion program and examine the healthcare resources and personnel required to meet the needs of this patient population. Methods: We conducted a retrospective review of all pediatric SRC patients referred to the Pan Am Concussion Program from September 1st, 2013 to May 25th, 2015. Initial assessments and diagnoses were carried out by a single neurosurgeon. Return-to-Play decision-making was carried out by the multidisciplinary team. Results: 604 patients, including 423 pediatric SRC patients were evaluated at the Pan Am Concussion Program during the study period. The mean age of study patients was 14.30 years (SD: 2.32, range 7-19 years); 252 (59.57%) were males. Hockey (182; 43.03%) and soccer (60; 14.18%) were the most commonly played sports at the time of injury. Overall, 294 (69.50%) of SRC patients met the clinical criteria for concussion recovery, while 75 (17.73%) were lost to follow-up, and 53 (12.53%) remained in active treatment at the end of the study period. The median duration of symptoms among the 261 acute SRC patients with complete follow-up was 23 days (IQR: 15, 36). Overall, 25.30% of pediatric SRC patients underwent at least one diagnostic imaging test and 32.62% received referral to another member of our multidisciplinary clinical team. Conclusion: Comprehensive care of pediatric SRC patients requires access to appropriate diagnostic resources and the multidisciplinary collaboration of experts with national and provincially-recognized training in TBI.

scholarly journals Clinical Characteristics and Treatment Outcome of Pediatric Rhabdomyosarcoma; Retrospective Review

2021 ◽  
Vol 7 (2) ◽  
Author(s):  
Zunaira Shaukat ◽  
Raheela Mansoor ◽  
Najma Shaheen ◽  
Saliha Sarfraz ◽  
Komal Seher
Keyword(s):  
Treatment Outcome ◽  
Clinical Characteristics ◽  
Chart Review ◽  
Treatment Plan ◽  
Retrospective Chart Review ◽  
Group Classification ◽  
Primary Tumor Site ◽  
Lost To Follow Up ◽  
Late Stages

Introduction: Rhabdomyosarcoma is the most common soft tissue sarcoma in children. This paper aimed to assess the stage, site, and treatment outcome among rhabdomyosarcoma (RMS) patients. Materials and Methods: A retrospective chart review was completed from January 2011 to December 2017 of patients that presented to the Department of Pediatric Oncology, Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, for the management of RMS. Data collection included clinical characteristics, staging, grouping, risk stratification, treatment plan, radiotherapy doses, and treatment outcome. Results: Among 24 subjects, there were a total of 13 (54.2%) males and 11 (45.8%) females. The median age at the time of diagnosis was 2.5 years (range: 0.75 - 17 years). The majority of the subjects (91.7%) were less than 10 years of age. The median follow-up time was 0.6 years. According to the Children's Oncology Group Classification, 4 (16.7%) subjects were classified as low risk, 14 (58.3%) subjects were rated as intermediate risk, and 6 (0.25%) subjects were stratified as high risk. The most common primary tumor site were genitourinary (62.5%) and abdomen/retroperitoneal (20.8%) regions. At the time of analysis, nine (37.5%) subjects had died because of the disease, twelve (50%) were alive with no evidence of disease, and one subject had a recurrence of disease and was alive. One subject had abandoned the therapy, and another was lost to follow-up. Conclusion: Patients with Rhabdomyosarcoma presented at the late stages of the disease, and it most frequently affected genitourinary and abdomen or retroperitoneal areas. Overall, Rhabdomyosarcoma was found to have a poor outcome to therapy.

scholarly journals 2542. ID-Psych Addiction Rounds: A New Model to Address Opioid Use Disorder For Patients on the Infectious Disease Consult Service

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S883-S883
Author(s):  
William West ◽  
Benjamin Eckhardt ◽  
Gabriel M Cohen
Keyword(s):  
Substance Use ◽  
Clinical Characteristics ◽  
Safety Net ◽  
Opioid Use Disorder ◽  
Opioid Epidemic ◽  
Opioid Use ◽  
Consult Service ◽  
Case Conferences ◽  
Lost To Follow Up

Abstract Background ID physicians often treat the infectious sequelae of opioid use disorder (OUD) and are uniquely poised to link hospitalized patients to substance use resources. In a large safety net hospital, we launched a multi-disciplinary initiative to ensure that patients on the ID consult service with OUD were always offered medication-assisted treatment (MAT). We used infections as “sentinel” events to identify patients with OUD and described the clinical characteristics of the high-risk patient population jointly consulted by ID and Psychiatry teams. This healthcare workforce initiative aimed to expand the role of ID providers in the opioid epidemic and decrease barriers to buprenorphine prescribing. Methods Every 2 weeks, ID fellows identified patients on their consult lists with infectious complications of OUD. Focused discussions were then held with the Psychiatry service and discussion of each patient continued at subsequent case conferences with attention paid to re-engaging those lost to follow-up. We performed chart abstraction of demographic and clinical characteristics as part of a quality improvement initiative. Results From October 2018 to March 2019, 23 patients were discussed at 10 case conferences with input from attendings, fellows, housestaff, social workers, and representatives from a novel Primary Care Safety Net program. The average patient age was 43 (range 24–50). Patients were predominantly male (65%), heroin users (90%) with high rates of HIV (22%) and untreated HCV (40%). ID-related infections included endocarditis (39%), osteomyelitis (31%), skin and soft-tissue infections (17%) and spinal abscesses (17%). The median time for a patient to be presented at an ID-Psych Addiction Rounds was 7 days (IQR 4.5–11.5). The mean length of hospitalization was 30 days (range 2–112). MAT was initiated in 75% of patients (41% buprenorphine; 59% methadone). The 30-day lost to follow-up rate was exceedingly high, with 80% of post-hospital appointments being missed. Conclusion ID physicians can effectively link hospitalized patients with OUD to substance use resources. A multi-disciplinary approach is key to addressing the opioid epidemic. Future work should explore how to create effective post-hospital transitions to decrease those lost to follow-up. Disclosures All authors: No reported disclosures.

Clinical Characteristics and Treatment Outcome Of CNS Involvement (Bing-Neel Syndrome) In Waldenstrom’s Macroglobulinemia

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 5090-5090 ◽  
Author(s):  
Tushar Kulkarni ◽  
Steven Peter Treon ◽  
Robert Manning ◽  
Lian Xu ◽  
Mikael Rinne ◽  
...  
Keyword(s):  
Flow Cytometry ◽  
Treatment Outcome ◽  
Stable Disease ◽  
Clinical Characteristics ◽  
High Dose ◽  
Liposomal Cytarabine ◽  
Lower Extremity Weakness ◽  
Lost To Follow Up ◽  
Myd88 L265p

Abstract Background Waldenstrom’s Macroglobulinaemia (WM) is an IgM secreting lymphoplasmocytic lymphoma characterized by involvement mainly in the bone marrow, and occasionally in the lymph nodes and spleen. Central nervous system involvement of WM, known as Bing-Neel syndrome (BNS), is very uncommon and as such the clinical characteristics and treatment outcomes remain to be clarified. Methods We evaluated the incidence, clinical characteristics, and treatment outcome of BNS among patients with WM who were diagnosed at our Institution. Results We identified 13 patients with BNS from our database of 1,523 patients diagnosed with WM from 1999 -2013. The median age at diagnosis of BNS was 60 (range 51-75 years). The median time to development of BNS after WM diagnosis was 6.3 (range 0.3-11.9 years). Patients presented with a variety of neurological signs and symptoms including seizures, hearing loss, cognitive impairment, gait instability and lower extremity weakness. The diagnosis of BNS was confirmed by MRI in 11, and by examination of the CSF in 12 patients. CSF cytopathologic analysis demonstrated definitive evidence of malignant lymphoplasmacytic cells in 6 patients, and was suspicious for malignant cells in 2 patients. CSF flow cytometry was positive in 8, and a clonal immunoglobulin heavy chain gene rearrangement was identified in 6 patients. MYD88 L265P was identified in CSF sample of two patients in whom this examination was undertaken, and who demonstrated malignant disease by flow cytometry and cytological examination. Seven patients were treated with high-dose methotrexate (HD-MTX), 2 with intrathecal liposomal cytarabine, 1 with rituximab and intrathecal methotrexate, and 1 with rituximab and bendamustine. One patient was recommended treatment with HD-MTX and was lost to follow-up, 1 has been initiated on HD-MTX. Of 11 patients, 5 had a response in CSF and/or MRI, 4 had stable disease and 1 progressed following therapy. Of the responders, 2 patients had received HD-MTX, 2 intrathecal liposomal cytarabine and 1 rituximab-bendamustine. Four patients with stable disease had received HD-MTX. One patient who received intrathecal MTX developed treatment related “chemical meningitis”, and was subsequently treated with HD-MTX to which she had a CSF response. The median overall survival was not reached. Eleven patients are alive, 1 died and 1 was lost to follow-up. Conclusions BNS is an uncommon late complication of WM. MYD88 L265P may help in the diagnosis of BNS, and may represent a novel approach for targeted therapy of WM. HD-MTX is active in the treatment of BNS, though prospective studies are required to standardize treatment and improve outcomes. Disclosures: No relevant conflicts of interest to declare.

Lost to Follow-Up

2009 ◽  
Vol 40 (12) ◽  
pp. 13
Author(s):  
ALAN ROCKOFF
Keyword(s):  
Lost To Follow Up
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