Retrospective assessment of chemotherapy/biotherapy toxicity in a Hispanic/Latinx population versus published study population

2021 ◽  
pp. 107815522110532
Author(s):  
Sara B Leidy ◽  
Lauren R Hull ◽  
Monica R Macik ◽  
Jasmine D Gonzalvo ◽  
Kellie J Weddle
Keyword(s):  
Myeloid Leukemia ◽  
Chart Review ◽  
Adverse Drug Events ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Retrospective Assessment ◽  
Toxicity Risk ◽  
Study Population ◽  
Cancer Côlon ◽  
Specific Impact

Introduction Eskenazi Health in Indianapolis, Indiana, USA. services diverse communities in Central Indiana, including the Hispanic/Latinx community. It has been postulated that this population experiences toxicities at a higher rate and with a faster onset than the general population when treated with chemotherapy or biotherapy. The published clinical trials that have evaluated chemotherapy/biotherapy efficacy and toxicity have not adequately represented the Hispanic/Latinx population. This retrospective analysis aims to analyze the incidence and severity of adverse drug events in the Hispanic/Latinx population compared to the general study population. Methods A retrospective chart review included patients reported as Hispanic/Latinx in the electronic medical record who had breast cancer, colon cancer, acute myeloid leukemia, or multiple myeloma currently receiving chemotherapy/biotherapy and/or received chemotherapy/biotherapy during the study period. Seventy-three instances of patients receiving chemotherapy/biotherapy and 46 unique patients were included in the final analysis. Results Of the 73 instances, 29 (40%) had toxicity at baseline prior to chemotherapy/biotherapy received during the study period. Of those 29 baseline toxicities, 26 (90%) of them had new toxicity during the study period. Of the 73 instances, 62 (85%) experienced toxicities during the study period. Conclusion Ethnicity has a proven effect on medication efficacy and safety, but the specific impact of ethnicity on chemotherapy/biotherapy toxicity risk has not been well elucidated. This study found that a majority (85%) of Hispanic/Latinx patients treated with chemotherapy/biotherapy experienced toxicity of any grade, and the majority (90%) patients who had prior toxicity experienced another toxicity.

scholarly journals Is Orally Administered Pentobarbital a Safe and Effective Alternative to Chloral Hydrate for Pediatric Procedural Sedation?

2018 ◽  
Vol 23 (6) ◽  
pp. 460-465
Author(s):  
Jordan Anderson ◽  
Sevilay Dalabih ◽  
Esma Birisi ◽  
Abdallah Dalabih
Keyword(s):  
Chart Review ◽  
Chloral Hydrate ◽  
Pediatric Patients ◽  
Age Groups ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Age Group ◽  
Imaging Studies ◽  
Airway Complications ◽  
Adequate Sedation

OBJECTIVES Chloral hydrate had been extensively used for children undergoing sedation for imaging studies, but after the manufacturer discontinued production, pediatric sedation providers explored alternative sedation medications. Those medications needed to be at least as safe and as effective as chloral hydrate. In this study, we examined if pentobarbital is a suitable replacement for chloral hydrate. METHODS Subjects who received pentobarbital were recruited from a prospectively collected database, whereas we used a retrospective chart review to study subjects who received chloral hydrate. Sedation success was defined as the ability to provide adequate sedation using a single medication. We included electively performed sedations for subjects aged 2 months to 3 years who received either pentobarbital or chloral hydrate orally. We excluded subjects stratified as American Academy of Anesthesiologists category III or higher and those who received sedation for electroencephalogram. The data collected captured subject demographics and complications. RESULTS Five hundred thirty-four subjects were included in the final analysis, 368 in the chloral hydrate group and 166 in the pentobarbital group. Subjects who received pentobarbital had a statistically significant higher success rate [136 (82%) vs 238 (65%), p < 0.001], but longer sleeping time (18.1% vs 0%, p < 0.001) in all age groups. Subjects who received chloral hydrate had a higher risk of airway complications in the <1 year of age group (6.5% vs 1.8%, p = 0.03). CONCLUSIONS For pediatric patients younger than 3 years of age undergoing sedation for imaging studies, oral pentobarbital may be at least as effective and as safe as chloral hydrate, making it an acceptable and practical alternative.

Retrospective Chart Review of Cryopreserved Amniotic Membrane for Knee Pain

2020 ◽  
Author(s):  
Ruben Berrocal Timmons
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Amniotic Membrane ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Mean Values ◽  
Number Of Patients ◽  
The Impact

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.

scholarly journals 4225 Evaluation of Neurotransmitters in Channelopathy-Related Epilepsy

2020 ◽  
Vol 4 (s1) ◽  
pp. 95-95
Author(s):  
Sunita N Misra ◽  
Theresa M. Czech ◽  
Jennifer A. Kearney
Keyword(s):  
Mouse Model ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Brain Regions ◽  
Autism Spectrum ◽  
Wild Type ◽  
Voltage Gated Sodium Channels ◽  
Study Population ◽  
Genotype A

OBJECTIVES/GOALS: Variants in voltage-gated sodium channels (VGSC) are a common cause of severe early onset epilepsy. Changes in CSF neurotransmitters (NT) were identified in 2 cases of VGSC-related epilepsy. Here we investigate NT changes in patients and a novel mouse model of VGSC-related epilepsy. METHODS/STUDY POPULATION: We conducted a single site IRB approved retrospective chart review of patients with VGSC-related epilepsy who underwent CSF NT testing for diagnostic purposes. In parallel, we examined NT levels from the brains of wild-type (WT) and a novel VGSC-related epilepsy mouse model after obtaining IACUC approval. We rapidly isolated forebrain, cortex, striatum, and brainstem from 5-6 animals per sex and genotype. A combination of HPLC with electrochemical detection and mass spectrometry were used to quantify NT levels from brain samples. RESULTS/ANTICIPATED RESULTS: We identified 10 patients with VGSC-related epilepsy who received CSF NT testing. Two of these patients had abnormal NT results including changes to dopamine (DA) or serotonin (5-HT) metabolites. We analyzed NT levels from four brain regions from male and female WT and VGSC-related epilepsy mice. We anticipate that most of the NT levels will be similar to WT, however subtle changes in the DA or 5-HT metabolites may be seen in VGSC-related epilepsy. DISCUSSION/SIGNIFICANCE OF IMPACT: Patients with VGSC-related epilepsy often have autism spectrum disorder, sleep, and movement disorders. Understanding the role of aberrant NT levels in VGSC-related epilepsy may provide additional therapeutic targets that address common neuropsychological comorbidities as well as seizures.

Post-operative problems and complications in 313 consecutive cochlear implantations

2008 ◽  
Vol 123 (5) ◽  
pp. 492-496 ◽  
Author(s):  
T Ovesen ◽  
L V Johansen
Keyword(s):  
Cochlear Implantation ◽  
Surgical Planning ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Safe Procedure ◽  
Tertiary Referral Centre ◽  
Antibiotic Resistant ◽  
Danish Patient ◽  
Study Population ◽  
Radical Cavity

AbstractObjective:To describe problems and complications associated with cochlear implantation, and their management, in a Danish patient population comprising both paediatric and adult patients.Design:Retrospective chart review.Setting:Tertiary referral centre.Subjects:Three hundred and thirteen consecutive cochlear implantations were studied. The median age of the study population was 10 years. Sixty per cent of patients were children and 40 per cent were adult; 52 per cent were female and 48 per cent were male.Intervention:Two hundred and ninety-four patients received a Cochlear Nucleus®implant. The remaining 19 received an Advanced Bionics implant.Main outcome measure:Presence of problems and complications after cochlear implantation.Results:Post-operative complications were found in 15.7 per cent of patients. The majority of these complications (11.2 per cent) were minor; 4.5 per cent were major. The major complications included one patient with meningitis, one patient with multiple antibiotic resistantStaphylococcus aureusinfection of a radical cavity, and one diabetic patient who developed a severe skin infection and whose implant became exposed.Conclusion:Cochlear implantation is a safe procedure within the studied setting. However, it is essential that careful attention be paid to surgical planning and technique, and it is important that healthcare staff and patients be aware of the possible problems and complications.

Posttraumatic Resuscitation Affects Stent Graft Sizing in Patients with Blunt Thoracic Aortic Injury

2016 ◽  
Vol 82 (1) ◽  
pp. 75-78 ◽  
Author(s):  
Jordan R. H. Hoffman ◽  
Ritam Chowdhury ◽  
Laura S. Johnson ◽  
Luke P. Brewster ◽  
Yazan Duwayri ◽  
...  
Keyword(s):  
Stent Graft ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Aortic Injury ◽  
Aortic Diameter ◽  
Related Complication ◽  
Blunt Thoracic Aortic Injury ◽  
Thoracic Aortic Injury ◽  
Study Population ◽  
Level I

Patients with blunt aortic injury often present to the emergency department in a relatively hypovolemic state. These patients undergo extensive inhospital resuscitation. The effect of posttraumatic resuscitation on aortic diameter has implications for stent graft sizing. The potential utility of repeat aortic imaging after resuscitation remains unclear. A retrospective chart review of all adult patients presenting to a Level I trauma center between the years 2007 and 2013 was performed. Fifty-three patients were identified with a diagnosis of traumatic aortic injury. Of those, 10 had 2 CT scans before aortic repair and were selected as the study population for analysis. After resuscitation, there was a significant increase in aortic diameter both proximal and distal to the aortic injury: proximal aortic diameter increase of 1.97 mm and distal aortic diameter increase of 1.48 mm. This retrospective study shows that after resuscitation, there is a significant increase in proximal and distal aortic diameter. Interval reimaging of the thoracic aorta may be beneficial after adequate stabilization of the patient's other injuries. In certain cases, more appropriate sizing may prevent a device-related complication.

scholarly journals 4401 Incidence, management, and outcomes of immune-related adverse events (irAEs): an analysis of a multidisciplinary toxicity team for cancer immunotherapy related irAEs

2020 ◽  
Vol 4 (s1) ◽  
pp. 73-73
Author(s):  
Aanika Balaji ◽  
Jiajia Zhang ◽  
Jarushka Naidoo
Keyword(s):  
Chart Review ◽  
Relative Risk Reduction ◽  
Retrospective Chart Review ◽  
Risk Groups ◽  
Hospitalization Rate ◽  
Johns Hopkins Hospital ◽  
Inpatient Hospitalizations ◽  
Study Population ◽  
Patient Referrals ◽  
Historical Controls

OBJECTIVES/GOALS: This study aims to assess the outcomes of a new virtual multidisciplinary immune-related toxicity (IR-tox) team implemented at Johns Hopkins Hospital. In particular, to understand if the IR-tox team’s input reduced the number of inpatient hospitalizations for irAEs for referred patients. METHODS/STUDY POPULATION: Since August 2017, nearly 250 patient referrals to the IR-tox team have been created and stored in an electronic database. Through retrospective chart review, hospitalization and irAE management data will be collected for these patients to assess whether rates for suspected irAEs have decreased. These rates will be compared against historical controls. We will assess the features of hospitalized patients, their immunotherapy regimens, and management to identify high-risk groups who may require early intervention. Additionally, we aim to understand what patient features are associated with IR-Tox team referral and subsequent hospitalization. RESULTS/ANTICIPATED RESULTS: The IR-tox team provided a new multidisciplinary channel to help physicians diagnose and manage complex irAEs. The goal of the team was the reduce the number of irAE-related hospitalizations as, historically, 85% of high-grade irAEs have required hospitalization. A clinically meaningful reduction is defined as lowering the hospitalization rate to 75%. Planned analyses includes calculating the hospitalization rate, using descriptive statistics to summarize patient features, multivariate analyses to understand features associated with both IR-Tox team referral and hospitalization, and computing the relative risk reduction to assess the efficacy of subspecialist referral implementation. DISCUSSION/SIGNIFICANCE OF IMPACT: IrAEs are challenging to diagnose and treat. They contribute to a notable proportion of hospitalizations in those treated with immunotherapy. With expanding use of immunotherapy, widespread implementations of IR-Tox teams may help reduce hospitalizations and costs associated with care for irAEs.

scholarly journals High Prevalence of Hypertension in Ethiopian and Non-Ethiopian HIV-Infected Adults

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Maya Korem ◽  
Tali Wallach ◽  
Michael Bursztyn ◽  
Shlomo Maayan ◽  
Karen Olshtain-Pops
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Chart Review ◽  
Pressure Rise ◽  
Retrospective Chart Review ◽  
Close Monitoring ◽  
Related Factors ◽  
The Metabolic Syndrome ◽  
High Prevalence ◽  
Study Population

Objectives. Prevalence of hypertension has not been studied in the Ethiopian HIV-infected population, which represents 60% of the patients in our AIDS unit. Our aim was to identify risk factors and characterize the prevalence of hypertension in the population monitored at our unit. Methods. A retrospective chart review categorized subjects according to their blood pressure levels. Hypertension prevalence was determined and stratified according to variables perceived to contribute to elevated blood pressure. Results. The prevalence of hypertension in our study population was significantly higher compared to the general population (53% versus 20%, P<0.0001) and was associated with known risk factors and not with patients’ viral load and CD4 levels. Ethiopian HIV-infected adults had a prominently higher rate of blood pressure rise over time as compared to non-Ethiopians (P=0.016). Conclusions. The high prevalence of hypertension in this cohort and the rapid increase in blood pressure in Ethiopians are alarming. We could not attribute high prevalence to HIV-related factors and we presume it is part of the metabolic syndrome. The lifelong cardiovascular risk associated with HIV infection mandates hypertension screening and close monitoring in this population.

scholarly journals Effectiveness of home-based fortified diet in the rehabilitation of malnourished children in resource restrained country: an institution based retrospective study

2020 ◽  
Author(s):  
Saba Shahid ◽  
Marvi Mahesar ◽  
Anum Rahim ◽  
Yumna Sadiq
Keyword(s):  
Weight Gain ◽  
Chart Review ◽  
Data Extraction ◽  
Real Life ◽  
Retrospective Chart Review ◽  
Final Analysis ◽  
Nutrition Survey ◽  
Community Based ◽  
Malnourished Children ◽  
Home Based

Abstract Background: Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3% and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections, and currently, WHO recommends community-based management of malnutrition with the provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using the home-fortified diet in Pakistan. This study evaluated the effectiveness of using the home-fortified diet in achieving recovered from malnutrition through a retrospective chart review.Methods: A retrospective chart review of pediatric patients (aged six months –5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A predesigned data extraction form was used to record detailed information about demographic characteristics, feeding, anthropometric, micronutrient, and nutritional details at enrollment and on follow-up.Results: A total of 361 patients were included in the final analysis. The median age of children was 14 months. 102 children were recovered from malnutrition with a median length of stay in the program of 28 days. The median for weight gain was 4.8 (0-10.3) g/Kg/day, 226 children defaulted and 10 died.Conclusion: This study revealed adequate weight gain and recovered from malnutrition in children by using the home-fortified diet in real-life situations. Home-fortified diets may serve as an effective strategy in community-based rehabilitation of malnourished children, especially in resource constraint contexts.

scholarly journals Immediate Intravenous Epinephrine Versus Early Intravenous Epinephrine for In-Hospital Cardiopulmonary Arrest

2021 ◽  
Author(s):  
Abdullah Bakhsh ◽  
Maha Safhi ◽  
Ashwaq Alghamdi ◽  
Amjad Alharazi ◽  
Bedoor Alshabibi ◽  
...  
Keyword(s):  
Chart Review ◽  
Cardiopulmonary Arrest ◽  
Retrospective Chart Review ◽  
Spontaneous Circulation ◽  
Chi Square ◽  
Epinephrine Administration ◽  
Return Of Spontaneous Circulation ◽  
Study Population ◽  
Epinephrine Dose ◽  
The Ideal

Abstract Background intravenous epinephrine has been a key treatment for cardiopulmonary arrest since the early 1960s. Although, many studies have questioned neurological outcome benefit, it remains to be recommended in international guidelines for its benefit on return of spontaneous circulation (ROSC). The ideal timing for the first epinephrine dose is uncertain. We aimed to look at the association of immediate epinephrine administration (within 1-minute of cardiac arrest recognition) with return of spontaneous circulation (ROSC) up to 24-hours and beyond 24-hours. Methods this was a multicenter retrospective chart review of patients undergoing cardiopulmonary resuscitation. Descriptive statistics were used to characterize study population, while t-test and chi-square were used to compare groups and outcomes. Results immediate epinephrine administration (within 1-minute) is associated with higher rates of ROSC up to 24-hours (OR = 2.36, 95% CI; [1.46–3.81]) and beyond 24-hours (OR = 2.26, 95% CI; [1.06–4.83]). Conclusions we encourage immediate administration of epinephrine in conjunction with high-quality CPR, as this is associated with higher rates of ROSC.

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