scholarly journals AB0639 TREATMENT EFFICACY WITH SECUKINUMAB IN A COHORT OF SPONDYLOARTHRITIS PATIENTS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1614.2-1614
Author(s):  
A. Castilla ◽  
Á. García Martos ◽  
L. Sala Icardo ◽  
A. Prada-Ojeda ◽  
L. Barrio Nogal ◽  
...  
Keyword(s):  
New York ◽  
Clinical Practice ◽  
Clinical Manifestations ◽  
Previous Treatment ◽  
Response To Treatment ◽  
Das 28 ◽  
Number Of Patients ◽  
Symptoms And Signs ◽  
Real Clinical Practice

Background:Spondyloarthropathies are a heterogeneous group of similar diseases, with interrelated clinical manifestations, such as Psoriasis Arthritis (APs) and Ankylosing Spondylitis (EA). There are different treatments for this group of pathologies.Objectives:It is very important to differentiate between those that present predominantly axial (spine and/or sacroiliac) or peripheral involvement, since the response to treatment is very different.In some clinical trials, secukinumab significantly improved versus placebo, the symptoms and signs, physical function and quality of life, however, at present, we do not have enough data from secukinumab in real clinical practice.This is the real reason of this study: the use of secukinumab in clinical practice.Methods:Multicentric longitudinal observational study of 5 Hospitals in Madrid.Patients are over 18 years old and meet the following inclusion criteria: New York criteria for AS, ASAS for EA, CASPAR for APs, and all of them are with secukinumab or have received it.We will evaluate the effectiveness rate as well as its confidence interval at 95%. In addition, the effectiveness of secukinumab will be compared in the different pathologies by using χ2.Results:72 patients were collected, 41 of them were women (57,75%).12 patients (16,90%) had not received FAME before secukinumab and 22 patients (33,99%) were naive to biological treatment.In 4 patients, the reason for starting secukinumab was the patient’s comorbidities, in 2 the adverse effects of previous treatment and in the rest, was the lack of efficacy of the previous treatment.The patients were divided into 4 categories according to the level of DAS-28 or BASDAI, at the beginning of the treatment and the last recorded value, in: Absence of activity, mild, moderate and severe activity. Of the patients with data, they managed to improve the DAS-28 score (change category) by 30,95%, while only 4,76% worsened their score. With respect to BASDAI, of the total number of patients, only 3,03% worsened, while his score improved 27,27%.According to baseline diagnosis, a greater improvement of the disease activity in peripheral APs(66,67%) and mixed APs(61,54%) is achieved.Conclusion:In real clinical practice, treatment with secukinumab was effective in patients with spondyloarthritis, achieving improvement in previous activity rates. In this study, the most significant improvement was obtained in peripheral and mixed APs.Disclosure of Interests:None declared

Concrescence of the cervical vertebrae and neurological complications

2021 ◽  
pp. 195-201
Author(s):  
Sabiyat Abdulaevna Yakhyaeva ◽  
Naida Isagadzhievna Garabova ◽  
Madina Garunovna Burzhunova
Keyword(s):  
Cervical Spine ◽  
Clinical Practice ◽  
Research Methods ◽  
Neurological Disorders ◽  
Cervical Vertebrae ◽  
Clinical Manifestations ◽  
Neurological Complications ◽  
Timely Diagnosis ◽  
Number Of Patients ◽  
Genetically Determined

In clinical practice, a sufficiently large number of patients complain of neurological disorders caused by osteochondrosis of the cervical spine. Despite this, in some cases, the development and progression of this symptomatology may be due to an anomaly in the structure of the cervical spine (Klippel-Feil syndrome), which is genetically determined. Timely diagnosis of this pathology with the implementation of complex research methods allows you to develop individual tactics for each individual patient, taking into account the severity of clinical manifestations to slow the progression of complications.

scholarly journals QL4 - ASSESSMENT OF QUALITY OF LIFE IN PATIENTS WITH METASTATIC MELANOMA IN REAL CLINICAL PRACTICE IN FRANCE

2018 ◽  
Vol 21 ◽  
pp. S13
Author(s):  
M. Kandel ◽  
C. Allayous ◽  
S. Dalle ◽  
L. Mortier ◽  
S. Dalac ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Metastatic Melanoma ◽  
Real Clinical Practice

Clinical Significance of the Tumor Suppressor p53 Codon 72 Polymorphic Variants in Multiple Myeloma.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 5102-5102
Author(s):  
Natalia C. Gonzalez-Paz ◽  
Wee Joo Chng ◽  
Shaji Kumar ◽  
Tammy Price-Troska ◽  
Scott Van Wier ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Tumor Suppressor ◽  
Plasma Cell ◽  
Survival Data ◽  
Clinical Manifestations ◽  
Cellular Transformation ◽  
Response To Treatment ◽  
Codon 72 ◽  
Number Of Patients ◽  
Polymorphic Variants

Abstract Background: The p53 tumor suppressor gene has a common sequence polymorphism that results in either proline or arginine at amino-acid position 72. The Pro72 and Arg72 variants have been reported to differ in its functional activity. The Arg72 variant induces apoptosis more efficiently than Pro72 variant by its greater ability to localize to the mitochondria and increase the release of cytochrome c into the cytoplasm. In addition, recent studies have demonstrated that Arg72 variant was a better suppressor of cellular transformation, an activity believed to rely on the pro-apoptotic function of p53. Moreover, the Pro72 variant has been associated with a higher incidence of tumors. Aim: To evaluate the effect of the polymorphic variants of codon 72 and clinical outcome in patients with plasma cell malignancies. Patients and Methods: We analyzed 79 patients with plasma cell malignancies seen at Mayo Clinic between 2000 and 2003. Genomic DNA was extracted from CD138+ sorted plasma cell from bone marrow aspirates. PCR amplification of codon 72 and posterior sequencing was used for the analysis. Results: A total of 79 patients were analyzed. Thirty-four patients (34%) were heterozygous for p53, 57 (59%) homozygous for Arginine and 6 (6%) homozygous for Proline. The distribution among disorders was as follow, 52 patients had MM, 14 patients with SMM and 13 with MGUS. Among patient with MM 25% were Pro/Arg heterozygous, 71 % were Arg/Arg homozygous and 3.8% Pro/Pro homozygous. Survival data among MM patients and genotype were analyzed to Kaplan- Meier method. No significant differences were found among patients who carried homozygous (72R) or heterozygous genotype and overall survival. We exclude the analysis in MGUS and SMM for a low number of patients available. Conclusions: These findings indicate that codon 72 arginine p53 may not be associated with a prolonged survival in patients with Multiple Myeloma, but further study is needed to assess whether this polymorphism is associated with progression of MGUS to MM, age of onset, clinical manifestations, response to treatment etc.

scholarly journals Comorbidity in real clinical practice - the patient with gout, cardiovascular disease and kidney damage

2021 ◽  
Vol 2 (3) ◽  
pp. 112-117
Author(s):  
N. A. Kosheleva ◽  
N. A. Magdeeva
Keyword(s):  
Clinical Practice ◽  
Progressive Increase ◽  
Control Treatment ◽  
Comorbid Conditions ◽  
Treatment Efficiency ◽  
Number Of Patients ◽  
High Prevalence ◽  
Systemic Side Effects ◽  
Adherence To Therapy ◽  
Real Clinical Practice

In real clinical practice more and more often doctors treat comorbid patients. The high prevalence of cardiovascular diseases with various comorbid conditions contributes to the progressive increase in the number of patients with a concurrence of several diseases. A comorbid patient is a serious problem for any clinician, since in this case it is necessary to take into account several components of therapy, which makes it difficult to control treatment efficiency, contributes to an increase in polypharmacy, the risk of local and systemic side effects of drugs, and reduces adherence to therapy. A comorbid patient is a serious problem for any clinician. The paper describes and discusses the clinical case of a comorbid patient, who admitted to the cardiological department initially but he had also rheumatological problems (gout), kidney affection.

Research in anaesthesia

2017 ◽  
Author(s):  
Gary Minto ◽  
J. Robert Sneyd
Keyword(s):  
Clinical Practice ◽  
Clinical Research ◽  
Basic Science ◽  
Critical Appraisal ◽  
Perioperative Medicine ◽  
Limited Information ◽  
Priority Areas ◽  
Number Of Patients ◽  
Critical Appraisal Skills

Clinicians need critical appraisal skills to weigh up the quality of the literature and to decide whether it has implications for their practice. Every belief in medicine is a construct created from the limited information available and carries a degree of uncertainty. A centralized approach to research identifies the highest priority areas of uncertainty so as to bring about the most improvement for the largest number of patients. This patient-centred model classifies studies into basic science, translational, and clinical research. Adequately powered mega-trials are required to bridge the translational gap between efficacy (does a treatment work?) and effectiveness (does a treatment work when applied in ordinary clinical practice?). There is a paucity of these in perioperative medicine.

scholarly journals Assessment of quality of life in patients with metastatic melanoma in real clinical practice in France

2018 ◽  
Vol 29 ◽  
pp. viii460
Author(s):  
M. Kandel ◽  
C. Allayous ◽  
S. Dalle ◽  
L. Mortier ◽  
S. Dalac Rat ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Metastatic Melanoma ◽  
Real Clinical Practice

scholarly journals AB0963 HOW OFTEN DO DOCTORS TREAT PATIENTS WITH LOCAL DAMAGE TO THE PERIARTICULAR SOFT TISSUES IN REAL CLINICAL PRACTICE?

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1778.2-1778
Author(s):  
A. Karateev ◽  
A. Lila ◽  
N. Zagorodniy ◽  
E. Pogozheva
Keyword(s):  
Clinical Practice ◽  
Soft Tissues ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Clinical Manifestations ◽  
Treatment Result ◽  
The Third ◽  
Orthopedic Surgeons ◽  
Acute Injuries ◽  
Real Clinical Practice

Background:Damage of the periarticular soft tissues (DPST) - tendinitis, entesitis, bursitis, etc. are one of the most common reasons for patients to contact rheumatologists and orthopedic surgeons.Objectives:To evaluate the frequency and localization of DPST in real clinical practice, as well as the effectiveness of therapy for this pathology in the acute period.Methods:68 outpatient orthopaedic surgeons evaluated the frequency of initial patient recourse due to DPST within one month. The study did not include patients with systemic rheumatic diseases such as spondyloarthritis. The localization of DPST and the dynamics of clinical manifestations were evaluated in 1227 patients (women 42.5%, cf. age 51.3±15.5 years). Non-steroidal anti-inflammatory drugs (NSAIDs), mainly meloxicam, were used as a first-line treatment for DPST. The results of treatment were evaluated after 10-14 days with repeated visits of patients.Results:7766 cases of primary outpatient treatment by orthopedic surgeons were evaluated. DPST was the cause of treatment in 1227 (15.8%) patients. This was the third highest incidence after acute injuries (37.2%) and knee osteoarthritis (20.6%).In patients with DPST, the most common lesions were in the knee area (knee entesopathy, prepatellar bursitis, pes anserinus area tendinitis/bursitis) - 21.2%, the foot (plantar fasciitis) - 16.9%, the shoulder (tendinitis of the rotator cuff) – 16.4%, and the elbow (lateral and medial epicondylitis) - 15.3%. After treatment, there was a significant decrease in the severity of pain during movement – from 6.58±1.61 to 2.48±1.60 points on the numerical rating scale (p<0.001), a decrease in the intensity of pain at rest, at night and during palpation, as well as the severity of functional disorders. The need for local injection of glucocorticoids occurred in 22.1% of patients. Significant improvement was observed in all DPST localities, with 68.1% of patients rating the treatment result as “good” and “excellent”. Adverse reactions were observed in 15.0% of patients, and no serious complications were reported.Conclusion:DPST is the third most frequent reason of recourse to a doctor after acute injuries and osteoarthritis of large joints in the practice of outpatient orthopedic surgeons. The use of NSAIDs in the maximum therapeutic dose for 10-14 days allows for significant improvement in DPST of different localization.Disclosure of Interests:None declared

scholarly journals Identifying homelessness using health information exchange data

2015 ◽  
Vol 22 (3) ◽  
pp. 682-687 ◽  
Author(s):  
John Zech ◽  
Gregg Husk ◽  
Thomas Moore ◽  
Gilad J Kuperman ◽  
Jason S Shapiro
Keyword(s):  
New York ◽  
Health Information ◽  
Information Exchange ◽  
Health Information Exchange ◽  
Housing Status ◽  
Number Of Patients ◽  
Address Data ◽  
Patients Experience ◽  
Exchange Data

Abstract Background Homeless patients experience poor health outcomes and consume a disproportionate amount of health care resources compared with domiciled patients. There is increasing interest in the federal government in providing care coordination for homeless patients, which will require a systematic way of identifying these individuals. Objective We analyzed address data from Healthix, a New York City–based health information exchange, to identify patterns that could indicate homelessness. Methods Patients were categorized as likely to be homeless if they registered with the address of a hospital, homeless shelter, place of worship, or an address containing a keyword synonymous with “homelessness.” Results We identified 78 460 out of 7 854 927 Healthix patients (1%) as likely to have been homeless over the study period of September 30, 2008 to July 19, 2013. We found that registration practices for these patients varied widely across sites. Conclusions The use of health information exchange data enabled us to identify a large number of patients likely to be homeless and to observe the wide variation in registration practices for homeless patients within and across sites. Consideration of these results may suggest a way to improve the quality of record matching for homeless patients. Validation of these results is necessary to confirm the homeless status of identified individuals. Ultimately, creating a standardized and structured field to record a patient’s housing status may be a preferable approach.

scholarly journals Evaluation of the efficacy and safety of injectable glycosaminoglycan-peptide complex (GPC) in patients with osteoarthritis: a multicenter observational study GLADIOLUS (GPC in the treatment of osteoarthritis: a follow-up study of pain relief and local symptom reduction)

2020 ◽  
Vol 14 (2) ◽  
pp. 76-83
Author(s):  
L. I. Alekseeva ◽  
A. E. Karateev ◽  
E. Yu. Pogozheva ◽  
V. N. Amirdzanova ◽  
E. S. Filatova ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Large Scale ◽  
Rating Scale ◽  
Response To Therapy ◽  
Efficacy And Safety ◽  
Functional Disorders ◽  
Peptide Complex ◽  
Number Of Patients ◽  
Pain At Rest ◽  
Real Clinical Practice

Glycosaminoglycan-peptide complex (GPC) is a popular injectable extended-release symptomatic agent (ERSA) in Russia for the treatment of osteoarthritis (OA). To date, no large-scale studies of GPC used in real clinical practice have been conducted in our country.Objective: to evaluate the efficacy and safety of GPC in the treatment of OA in real clinical practice.Patients and methods. A multicenter observational non-interventional study was performed to evaluate the efficacy of GPC (Rumalon® , a cycle of intramuscular injections thrice weekly; a total of 25 injections). A study group consisted of 2,955 patients (75.4% female) aged 61.4±11.8 years) with knee and hip OA, and generalized OA (GOA) with the previous inefficacy of oral ERSAs, moderate/severe pain, and the need for regular use of nonsteroidal anti-inflammatory drugs (NSAIDs). 414 (14%) patients received a GPC and diacerein combination 100 mg/day. The investigators assessed the dynamics of pain during movement and at rest, functional disorders (on a numeric rating scale (NRS) of 0–10), as well as the need for NSAIDs at 12 weeks after starting the GPC cycle.Results and discussion. 98.5% of the patients completed their GPC treatment cycle. The therapy decreased the intensity of pain at rest from 4 [3; 5] to 1 [0; 2] and during movement from 6 [5; 7] to 2 [1; 3] and reduced the severity of functional disorders from 5 [4; 6] to 1 [0; 3]. The number of patients with a good response to therapy (a≥50% decrease in symptom severity) for pain at rest and during movement was 55.6 and 53.5%, respectively; and for functional disorders was 50.8%. 68.1% of patients stopped taking NSAIDs. The GPC and diacerein combination was more effective than GPC monotherapy: the number of patients with a ≥50% decrease in movement pain was 62.8 and 54.3%, respectively (p <0.001). GPC was well tolerated. During treatment, there were skin allergic reactions (0.3%), moderate injection-site pain (0.37%), and adverse reactions (ARs) related to the gastrointestinal tract (8%) and cardiovascular system (6%) (which were likely to be caused by NSAIDs). There were no serious ARs that were life-threatening and required hospitalization.Conclusion. GPC allows successful control of the main symptoms of knee and hip OA and GOA, by reducing pain, and those of functional disorders, and the need for NSAIDs. The GPC and diacerein combination is more effective than GPC monotherapy. GPC therapy is well tolerated and very rarely causes ARs.

scholarly journals Damage to periarticular soft tissues in real clinical practice: frequency, nature, effectiveness of non - steroidal anti - inflammatory drugs

2019 ◽  
Vol 91 (12) ◽  
pp. 21-28
Author(s):  
A E Karateev ◽  
A M Lila ◽  
N V Zagorodni ◽  
E Yu Pogozheva
Keyword(s):  
Clinical Practice ◽  
Knee Joint ◽  
Soft Tissues ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Clinical Manifestations ◽  
Results Of Treatment ◽  
Inflammatory Drugs ◽  
Anti Inflammatory ◽  
Real Clinical Practice

Damage to periarticular soft tissues is a common pathology that causes severe pain and impaired function of the musculoskeletal system. Aim. To determine the frequency, nature and clinical features of damage to periarticular soft tissues in real clinical practice, as well as the effectiveness of non - steroidal anti - inflammatory drugs (NSAIDs) in the debut of treatment of this pathology. Materials and methods. During the observational study, the frequency of defeat of the periarticular soft tissues in the structure of visits to 68 outpatient orthopedic surgeons in different cities of Russia for 1 month was estimated. Assessed the nature and dynamics of clinical manifestations during treatment in 1227 patients with defeat of the periarticular soft tissues. NSAIDs, mainly the original meloxicam, were used as a “first line” treatment for damage of the periarticular soft tissues. The results of treatment were evaluated after 10-14 days at a repeat visit of patients. Results. The proportion of patients with damage of the periarticular soft tissues was 15.8% of the total number of people who applied for outpatient care. Among 1227 patients (men 57.5%, average age 51.3±15.5 years) who were observed in the dynamics, prevailed were those with damage of the periarticular soft tissues of the knee joint area (knee joint enthesopathy, prepatellar bursitis, tendonitis/ bursitis of the goose foot area) - 21.2%, feet (plantar fasciitis, calcaneal spur) - 16.9%, shoulder (tendonitis of the muscles of the shoulder rotators) - 16.4% and the elbow (lateral and medial epicondylitis) - 15.3%. During treatment, there was a significant decrease in the total severity of pain - from 6.58±1.61 to 2.48±1.60 points on an 11-point numerical rating scale (p

Sign in / Sign up

Export Citation Format

Share Document