Prediction of severe adverse event from vital signs for post-operative patients

2021 ◽  
Author(s):  
Ying Gu ◽  
Soren M. Rasmussen ◽  
Jesper Molgaard ◽  
Camilla Haahr-Raunkjar ◽  
Christian S. Meyhoff ◽  
...  
Keyword(s):  
Adverse Event ◽  
Vital Signs ◽  
Severe Adverse Event

scholarly journals The efficacy of remdesivir in coronavirus disease 2019 (COVID-19): a systematic review

2020 ◽  
Author(s):  
Amirhossein Roshanshad ◽  
Alireza Kamalipour ◽  
Mohammad Ali Ashraf ◽  
Romina Roshanshad ◽  
Sirous Jafari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Adverse Event ◽  
Cohort Studies ◽  
Clinical Improvement ◽  
Day Treatment ◽  
Mortality Rates ◽  
Severe Adverse Event ◽  
Adverse Event Rate ◽  
Significant Difference ◽  
Event Rates

Background and Objectives: Researchers all around the world are working hard to find an effective treatment for the new coronavirus 2019. We performed a comprehensive systematic review to investigate the latest clinical evidence on the efficacy and safety of treatment with Remdesivir in hospitalized patients with COVID-19. Materials and Methods: We performed a systematic search in Pubmed, Embase, Web of Science, Google scholar and MedRxiv for relevant observational and interventional studies. The outcomes measures were mortality rates, improvement rates, time to clinical improvement, all adverse event rates and severe adverse event rates. Results: Three randomized controlled trials and 2 cohort studies were included in our study. In the 2 cohort studies, patients received Remdesivir for 10 days. 2 RCTs evaluated 10-day efficacy of treatment with Remdesivir versus placebo group and the other RCT compared its 5-day regimen versus 10-day regimen. Visual inspection of the forest plots revealed that the efficacy of Remdesivir was not much different in reducing 28-day mortality versus 14-day mortality rates. Besides, 10-day treatment regimen overpowered 5-day treatment and placebo in decreasing time to clinical improvement. All adverse event rates did not have a significant difference; however, severe adverse event rate was lower in the 5-day Remdesivir group compared to the 10-day and placebo groups. Conclusion: 5-day course of Remdesivir therapy in COVID-19 patients is probably efficacious and safe, and patients without invasive mechanical ventilation benefit the most. Treatment can be extended to 10 days if satisfactory improvement is not seen by day 5. Most benefits from Remdesivir therapy take place in the first 14 days of the start of the treatment.

Owner Perceptions of Long-Term Systemic Use of Subcutaneous Administration of Polysulfated Glycosaminoglycan

2021 ◽  
Author(s):  
Gabriella Varcoe ◽  
Julia Tomlinson ◽  
Jane Manfredi
Keyword(s):  
Adverse Event ◽  
Adverse Events ◽  
Gastrointestinal Symptoms ◽  
Subcutaneous Administration ◽  
Degenerative Joint Disease ◽  
Severe Adverse Event ◽  
Joint Disease ◽  
Disease Modifying ◽  
Rehabilitation Clinic

ABSTRACT Polysulfated glycosaminoglycan (PSGAG) is a slow-acting disease-modifying agent used to treat degenerative joint disease. Although labeled for intramuscular use, it is commonly given by owners via a subcutaneous (SC) route. There is little information on adverse events related to SC administration or what other therapies are used concurrently with PSGAG. We hypothesized that SC PSGAG is perceived by owners as having minimal adverse events and that it would most often be given with other therapies. Owners (n = 378) were surveyed about their perceptions regarding SC PSGAG prescribed to dogs at one veterinary rehabilitation clinic. Complete surveys were provided for 69 dogs (two owners had multiple dogs). Overall, 13/69 (18.8%) dogs had an adverse event reported during the use of PSGAG. Most events were considered minor (stomach upset, loose stool, pain at injection site, fear) and did not lead to discontinuation of PSGAG. One dog experienced a moderate adverse event (persistent gastrointestinal symptoms) and one a severe adverse event (thrombocytopenia, bruising), which resolved after discontinuing PSGAG. PSGAG is most commonly administered along with other medications and rehabilitation therapies. The present study demonstrates that SC administration of PSGAG is well tolerated in most of the dogs, with primarily mild, self-resolving adverse events.

Retreatment with talimogene laherparepvec for advanced melanoma

Immunotherapy ◽  
2020 ◽  
Vol 12 (16) ◽  
pp. 1167-1172
Author(s):  
Janice Hu ◽  
Sabran J Masoud ◽  
Surya Ravichandran ◽  
Georgia M Beasley ◽  
Paul J Mosca
Keyword(s):  
Adverse Event ◽  
Disease Progression ◽  
Initial Treatment ◽  
Relevant Literature ◽  
Complete Response ◽  
Advanced Melanoma ◽  
Severe Adverse Event ◽  
Stage Iiib ◽  
Talimogene Laherparepvec ◽  
Mixed Response

Aim: Talimogene laherparepvec (T-VEC) is a genetically modified oncolytic herpesvirus approved for the treatment of unresectable, locoregionally advanced and recurrent melanoma. There is little relevant literature in the context of retreatment with T-VEC. Materials & methods: We reviewed four patients aged 71–87 years old with stage IIIB–IV melanoma at treatment who were rechallenged with T-VEC after experiencing recurrence of locoregional disease or prior treatment-limiting toxicity. Results: Cessation of initial treatment was due to one of the following reasons: severe adverse event (one case), mixed response (one case) or complete response (two cases). Three males and one female underwent T-VEC retreatment with a mean of 5.5 injection cycles. Three patients experienced a complete response to retreatment, while one experienced disease progression. Conclusion: Intralesional T-VEC may be effective and well-tolerated in patients who have completed prior T-VEC therapy.

scholarly journals Early warning score using electronically-held data for patients discharged from intensive care units

2020 ◽  
Author(s):  
Marco Pimentel ◽  
Alistair Johnson ◽  
Julie Darbyshire ◽  
Lionel Tarassenko ◽  
David Clifton ◽  
...  
Keyword(s):  
Adverse Event ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Early Warning ◽  
Vital Sign ◽  
Scoring System ◽  
Vital Signs ◽  
Early Warning Score ◽  
Hospital Death ◽  
Icu Discharge

Abstract Rationale. Intensive care units (ICUs) admit the most severely ill patients. Once these patients are discharged from the ICU to a step-down ward, they continue to have their vital signs monitored by nursing staff, with early warning score (EWS) systems being used to identify those at risk of deterioration. Objectives. We report the development and validation of an enhanced continuous scoring system for predicting adverse events, which combines vital signs measured routinely on acute care wards (as used by most EWSs) with a risk score of a future adverse event calculated on discharge from ICU.Methods. A modified Delphi process identified common, and candidate variables frequently collected and stored in electronic records as the basis for a ‘static’ score of the patient’s condition immediately after discharge from the ICU. L1-regularised logistic regression was used to estimate the in-hospital risk of future adverse event. We then constructed a model of physiological normality using vital-sign data from the day of hospital discharge, which is combined with the static score and used continuously to quantify and update the patient’s risk of deterioration throughout their hospital stay. Data from two NHS Foundation Trusts (UK) were used to develop and (externally) validate the model.Measurements and Main Results. A total of 12,394 vital-sign measurements were acquired from 273 patients after ICU discharge for the development set, and 4,831 from 136 patients in the validation cohort. Outcome validation of our model yielded an area under the receiver operating characteristic curve (AUROC) of 0.724 for predicting ICU re-admission or in-hospital death within 24h. It showed an improved performance with respect to other competitive risk scoring systems, including the National EWS (NEWS, 0.653). Conclusion. We showed that a scoring system incorporating data from a patient’s stay in ICU has better performance than commonly-used EWS systems based on vital signs alone.

scholarly journals Remdesivir Efficacy in Coronavirus Disease 2019 (COVID-19): A Systematic Review

2020 ◽  
Author(s):  
Amirhossein Roshanshad ◽  
Alireza Kamalipour ◽  
Mohammad Ali Ashraf ◽  
Romina Roshanshad ◽  
Mohammad Reza Akbari
Keyword(s):  
Systematic Review ◽  
Adverse Event ◽  
Clinical Improvement ◽  
Day Treatment ◽  
Invasive Mechanical Ventilation ◽  
Mortality Rates ◽  
Severe Adverse Event ◽  
Adverse Event Rate ◽  
Significant Difference ◽  
Event Rates

AbstractBackgroundResearchers are working hard to find an effective treatment for the new coronavirus 2019. We performed a comprehensive systematic review to investigate the latest clinical evidence on the treatment efficacy and safety of Remdesivir in hospitalized patients with COVID-19.MethodsWe performed a systematic search of the Pubmed, Embase, Web of Science, Google scholar, and MedRxiv for relevant observational and interventional studies. Measured outcomes were mortality rates, improvement rates, time to clinical improvement, all adverse event rates and severe adverse event rates.Results3 RCTs and 2 cohorts were included in our study. In 2 cohort studies, patients received Remdesivir for 10 days. 2 RCTs evaluated 10-day treatment of Remdesivir efficacy versus placebo group and the other RCT compared its 5-day regimen versus 10-day regimen. Visual inspection of the forest plots revealed that Remdesivir efficacy was not much different in reducing 28-day mortality versus 14-day mortality rates. Besides, 10-day treatment regimen overpowers 5-day treatment and placebo in decreasing time to clinical improvement. All adverse event rates did not have significant difference; however, severe adverse event rate was lower in 5-day Remdesivir group compared to 10-day and placebo groups.Conclusion5-day course of Remdesivir therapy in COVID-19 patients is probably efficacious and safe and patients without invasive mechanical ventilation benefit the most. Treatment can be extended to 10 days if satisfactory improvement is not seen by day 5. Most benefits from Remdesivir therapy take place in the first 14 days of the start of the treatment.

Anti-PD-1 induced collagenous colitis in metastatic melanoma: a rare severe adverse event

2020 ◽  
Vol 30 (6) ◽  
pp. 603-605
Author(s):  
Raphaël Janela-Lapert ◽  
Julie Bouteiller ◽  
Aurélie Deschamps-Huvier ◽  
Anne-Bénédicte Duval-Modeste ◽  
Pascal Joly
Keyword(s):  
Adverse Event ◽  
Metastatic Melanoma ◽  
Collagenous Colitis ◽  
Severe Adverse Event

Owner Perceptions of Long-Term Systemic Use of Subcutaneous Administration of Polysulfated Glycosaminoglycan

2021 ◽  
Vol 57 (5) ◽  
pp. 205-211
Author(s):  
Gabriella Varcoe ◽  
Julia Tomlinson ◽  
Jane Manfredi
Keyword(s):  
Adverse Event ◽  
Adverse Events ◽  
Gastrointestinal Symptoms ◽  
Subcutaneous Administration ◽  
Degenerative Joint Disease ◽  
Severe Adverse Event ◽  
Joint Disease ◽  
Disease Modifying ◽  
Rehabilitation Clinic

ABSTRACT Polysulfated glycosaminoglycan (PSGAG) is a slow-acting disease-modifying agent used to treat degenerative joint disease. Although labeled for intramuscular use, it is commonly given by owners via a subcutaneous (SC) route. There is little information on adverse events related to SC administration or what other therapies are used concurrently with PSGAG. We hypothesized that SC PSGAG is perceived by owners as having minimal adverse events and that it would most often be given with other therapies. Owners (n = 378) were surveyed about their perceptions regarding SC PSGAG prescribed to dogs at one veterinary rehabilitation clinic. Complete surveys were provided for 69 dogs (two owners had multiple dogs). Overall, 13/69 (18.8%) dogs had an adverse event reported during the use of PSGAG. Most events were considered minor (stomach upset, loose stool, pain at injection site, fear) and did not lead to discontinuation of PSGAG. One dog experienced a moderate adverse event (persistent gastrointestinal symptoms) and one a severe adverse event (thrombocytopenia, bruising), which resolved after discontinuing PSGAG. PSGAG is most commonly administered along with other medications and rehabilitation therapies. The present study demonstrates that SC administration of PSGAG is well tolerated in most of the dogs, with primarily mild, self-resolving adverse events.

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