scholarly journals A Retrospective Comparison of Varenicline Monotherapy Versus the Combination of Varenicline and Bupropion or Bupropion and Nicotine Patches in a VA Tobacco Cessation Clinic

2011 ◽  
Vol 6 (1) ◽  
pp. 65-73 ◽  
Author(s):  
Dane Shiltz ◽  
Angie Paniagua ◽  
James E. Hastings
Keyword(s):  
Smoking Cessation ◽  
Tobacco Cessation ◽  
Chart Review ◽  
Nicotine Patch ◽  
Retrospective Chart Review ◽  
P Value ◽  
Completion Rates ◽  
Self Confidence ◽  
Retrospective Comparison ◽  
Cessation Clinic

AbstractPurpose:To determine whether the combination of bupropion SR and varenicline offers improved smoking cessation outcomes compared to varenicline monotherapy or to combination of bupro-pion SR and nicotine patch.Methods:This retrospective chart review included 489 volunteer enrolees in a Veterans Affairs (VA) tobacco cessation clinic who received one of the three treatments upon clinic enrolment. The study endpoints were smoking cessation and clinic completion rates, changes in the number of cigarettes smoked, carbon monoxide (CO) levels, urges to smoke, self-confidence to quit and medication-attributed adverse effects.Results:The relative smoking cessation rates were 33%, 32%, and 40% for bupropion SR and nicotine patch, bupropion SR and varenicline, and varenicline groups, respectively. The 0.21 p value established that no significant cessation rate differences existed between any of the groups. Varenicline alone or in combination was as well tolerated as the combination of bupropion SR and nicotine patch.Conclusions:The combination of bupropion SR and varenicline did not demonstrate any smoking cessation advantage over varenicline monotherapy or the combination of bupropion SR and nicotine patch and therefore do not support the use of bupro-pion SR and varenicline over varenicline monotherapy.

scholarly journals Clopidogrel, an ADP-P2Y12 Receptor Antagonist, Can Prevent Severe Postoperative Pain: A Retrospective Chart Review

Life ◽  
2020 ◽  
Vol 10 (6) ◽  
pp. 92
Author(s):  
Rikuhei Tsuchida ◽  
Masahiko Sumitani ◽  
Hiroaki Abe ◽  
Masae Ando ◽  
Kosuke Saita ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Abdominal Surgery ◽  
Chart Review ◽  
Stable State ◽  
Analgesic Efficacy ◽  
Retrospective Chart Review ◽  
Treated Group ◽  
P2y12 Receptor ◽  
Nociceptive Pain ◽  
P Value

The purinergic P2Y12 receptor regulates microglial activation, resulting in persistence and aggravation of pain in neuropathic and nociceptive pain models. We conducted a retrospective chart review to explore the analgesic potency of the P2Y12 receptor-specific antagonist, clopidogrel, for clinical management of postoperative pain in patients who underwent abdominal surgery. Twenty-seven patients with cardiovascular comorbidities, who underwent laparoscopic abdominal surgery and had ceased aspirin (ASP, n = 17) or clopidogrel (CLP, n = 10) for 14 days pre-operatively, were enrolled retrospectively. In both groups, the number of opioids and non-steroidal anti-inflammatory drugs (NSAIDs) consumed for managing postoperative pain was compared using the chi-square test and Mann–Whitney test. Our results showed that from postoperative day (POD) 0 to POD 3, the average numerical rating reflecting the postoperative pain was comparable between the two groups (CLP: 4.0 ± 1.4 vs. ASP: 3.7 ± 0.8, P-value = 0.56). However, at POD 7, opioid consumption in the CLP-treated group (fentanyl-equivalent dose: 0.49 ± 0.56 mg) was significantly lower than that in the ASP-treated group (1.48 ± 1.35 mg, P-value = 0.037). After reaching a stable state by repeated systemic administration, clopidogrel sustained the analgesic efficacy for a certain period. In conclusion, microglial P2Y12 receptors may mediate signal transduction of postoperative nociceptive pain and enhance clinical opioid analgesia.

scholarly journals Surgical Outcomes of Myelomeningocele Repair: a 20-Year Experience from a Single Center in a Middle-Income Country

2021 ◽  
Author(s):  
Sina Zoghi ◽  
Maryam Feili ◽  
Mohammad Amin Mosayebi ◽  
Mohammad Amin Afifi ◽  
Afrooz Feili ◽  
...  
Keyword(s):  
Surgical Management ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Wound Dehiscence ◽  
P Value ◽  
Fars Province ◽  
Middle Income ◽  
Middle Socioeconomic Status ◽  
Myelomeningocele Repair ◽  
Complications And Mortality

Abstract Objective Spina bifida primarily affects people of low and middle socioeconomic status. Herein, we describe the outcome of myelomeningocele surgical management in Iran and predictors of its postoperative complications and mortality. Methods This retrospective chart review studies the children who underwent surgical management for myelomeningocele in Shiraz, Fars province, Iran, from May 2001 to September 2020. To this end, we investigated mortality and 30-day complications and the factors that determined the operation's outcome. Results 256 patients were enrolled. The median age at the operation was roughly eight days (IQR: 7). The most common site of involvement of Myelomeningocele (MMC) was Lumbosacral (86%, n = 204). At the evaluation conducted prior to operation, CSF leaking was observed in 7% (n=16) of the patients. Postoperatively, 5.7% of the patients were expired in the 30 days following the operation (n = 14), while 24% needed readmission (n = 47). The most common complications leading to readmission included wound dehiscence (n = 10, 42%) and wound purulence (n = 6, 25%). No variable was significantly associated with postoperative complication except for the site of the lesion (p-value = 0.035) and the presence of the lipid content in the defect (p-value = 0.044). Conclusions Most patients born with MMC are referred for the neurosurgical evaluation following their birth; however, as results show there is much left to be desired compared with the 48h recommended by The Congress of Neurological Surgeons. Here, we concluded that presence of lipid compartment in the lesion and the site of the lesion are the two factor that were associated with the rate of mortality. However, further investigation into preoperative interventions and risk factors to mitigate risk of postoperational complications and mortality is highly encouraged. We highly advocate for the investigation and dissemination of the outcome of the conventional surgical management of MMC in financially restrained areas; because they can show the limitation these settings are confronted with (that are in a way unique to them and different from the resourceful settings) and provide a model for other similar areas with limited suitable care.

scholarly journals Failure to Quit Smoking Extent and Determinants among Attendees of Tobacco Cessation Clinic

2021 ◽  
pp. 221-235
Author(s):  
Rafat Hussam Abushanab ◽  
Abdullah H. Alshehri ◽  
Abdullah Muidh Y. Alqthami ◽  
Abdulsalam Alshehri
Keyword(s):  
Smoking Cessation ◽  
Tobacco Cessation ◽  
Sociodemographic Factors ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Quit Smoking ◽  
Quitting Smoking ◽  
Cross Sectional Design ◽  
Cessation Clinic ◽  
Smoking Cessation Clinic

Smoking is a global health risk factor despite the efforts to control and the existance of tobacco cessation program. The objective of this study was to measure the proportion of people who failed to quit smoking at the end of six months after attending the smoking cessation clinic and to identify the factors associated with failure to quit. We used an analytical cross-sectional design which was conducted at Taif city, Saudi Arabia between January 2019 and March 2020. The attendees of smoking cessation clinic were invited to participate in the study. We used a questionnaire as the data collection too. The statistical package for the social sciences (IBM Corp. Released 2020. IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp ) was used to analyze the data. The total responses was 393, out of them  201 (51.1%) failed to quit smoking after six months. Age, marital status, income, and occupation were significantly associated with the outcome variable (quit or not). Even before attending the clinic (62.3%) have indicated previous failed attempts. Among the different types of smoking, hookah showed a significant association with failure, while nicotine dependence did not showed any significance. Failure to quit was associated with advanced age, smoking hookah, while those who indicated the price of tobacco products as a reason to quit were more prone to fail in quitting smoking. In conclusion, smoking cessation can be influenced by a sociodemographic factors, willingness and family support. Smoking hookah is associated with higher rates of failure to quit smoking.

scholarly journals Optical Coherence Tomography based indices in predicting functional outcomeof macular hole surgery: A retrospective chart review

2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Haroon Tayyab ◽  
Rehman Siddiqui ◽  
Sana Jahangir ◽  
Shiraz Hashmi
Keyword(s):  
Optical Coherence Tomography ◽  
Functional Outcome ◽  
Macular Hole ◽  
Functional Outcomes ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
P Value ◽  
Optical Coherence ◽  
Macular Hole Surgery ◽  
Hole Index

Objectives: The objective of this study was to assess the utility of novel macular hole indices of Optical Coherence Tomography (OCT) and predicting the functional outcome of surgery. Methods: This was a retrospective chart review of 28 eyes who underwent surgery for idiopathic Full Thickness Macular Hole (FTMH) at The Aga Khan University Hospital (AKUH), Karachi from January 2016 to March 2020. Data of preoperative OCTs were recovered from data server of OCT machine. Measurements of the pre-operative OCTs were calculated using caliper function of OCT software by two independent technicians. Parameters included Macular Hole Index (MHI), Traction Hole Index (THI), Hole Form Factor (HFF) and Diameter Hole Index (DHI) were recorded. Receiver operating characteristic (ROC) curve was used to evaluate the performance of DHI, THI, HFF and MHI for improved BCVA after surgery, by looking at sensitivity, specificity and area under curve (AUC). P-value of <0.05 was considered significant. Results: Out of 30 eyes, final data analysis was done for 28 eyes. Mean age was 61.5 ± 6.2 years. Mean pre-operative and 6 months post-operative LogMAR best corrected visual acuity (BCVA) was 0.84 ± 0.23 and 0.32 ± 0.30 (p-value <0.001). Area under the curve with 95% confidence interval estimated for DHI, THI, HFF, and MHI was [0.750 (0.559 to 0.889)], [0.827 (0.637 to 0.943)], [0.846 (0.660 to 0.954)], [0.827 (0.637 to 0.943)]. Cut off values for predicting good functional outcome (post-op BCVA equal or better that 0.4) for DHI, THI, HFF and MHI were 0.454, 1.086, 0.856 and 0.501 respectively. All ROC value of less than 0.5 were considered unlikely to predict functional outcomes with macular hole indices. Conclusion: Novel macular hole indices can be used as a tool to predict the functional outcomes of macular hole surgery. Larger studies may be required to assess their wider effectiveness. doi: https://doi.org/10.12669/pjms.37.5.4126 How to cite this:Tayyab H, Siddiqui R, Jahangir S, Hashmi S. Optical Coherence Tomography based indices in predicting functional outcome of macular hole surgery: A retrospective chart review. Pak J Med Sci. 2021;37(5):---------. doi: https://doi.org/10.12669/pjms.37.5.4126 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Varenicline versus transdermal nicotine patch: a 3-year follow-up in a smoking cessation clinic in Taiwan

2014 ◽  
Vol 231 (14) ◽  
pp. 2819-2823 ◽  
Author(s):  
Kuang-Chieh Hsueh ◽  
Shu-Chun Hsueh ◽  
Ming-Yueh Chou ◽  
Lee-Fei Pan ◽  
Ming-Shium Tu ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Nicotine Patch ◽  
Transdermal Nicotine ◽  
Transdermal Nicotine Patch ◽  
Cessation Clinic ◽  
Smoking Cessation Clinic

Relationship of Treatment Effects On Hemoglobin and M-Protein Levels in Relapsed or Refractory Multiple Myeloma: Final Analysis of a Retrospective Chart Review Study.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4892-4892 ◽  
Author(s):  
Donna E. Reece ◽  
Faraz Zaman ◽  
Young Trieu ◽  
Giovanni Piza Rodriguez ◽  
Bruno Teixeira ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Inverse Relationship ◽  
Chart Review ◽  
Surrogate Marker ◽  
Retrospective Chart Review ◽  
M Protein ◽  
P Value ◽  
Protein Levels ◽  
Ortho Biotech ◽  
Over Time

Abstract Abstract 4892 Introduction In multiple myeloma (MM), hemoglobin (Hb) levels have long been part of staging of the disease and an important determinant in assessing treatment options, response to therapy and prognosis. The causes of a low Hb level are complex, but reflect in part the extent of myeloma cell infiltration in the bone marrow. Changes in the level of the monoclonal immunoglobulin protein in the blood and/or urine (M protein) serve as the main surrogate marker for response to treatment and progression of disease in the majority of patients (pts). This analysis explores the longitudinal relationship between treatment response (using M protein levels from serum protein electrophoresis [SPEP] results) and Hb levels. Methods This retrospective chart review included all pts who initiated drug treatment for relapsed/refractory MM between Jan-06 and Dec-07, inclusive, at Princess Margaret Hospital, Toronto, ON. Hb and M protein (SPEP) results were collected before the start of each treatment cycle. These results were then plotted over time to explore the association between these 2 variables. Results 136 of 281 (48.4%) of pts treated for relapsed/refractory MM had at least one simultaneous measurement of Hb and serum M protein levels and were included in the analysis. Mean age was 66 (SD±9.7) years, 65% of pts were male. More than half (63.2%) of the pts were receiving treatment for 1st MM relapse. Treatments for relapsed/refractory MM included cyclophosphamide ± steroids (33.1%), bortezomib-based regimens (20.6%), thalidomide-based regimens (26.5%), steroid monotherapy (15.4%), and other regimens (4.4 %). Patients received between 1 and 17 cycles of therapy (mean = 2.5 ± 2.9 cycles). Supportive care measures included erythropoiesis stimulating agents (ESAs) in 33.8% [mean dose was 488 (SD±23) μg q3 weeks and 42,343 (SD±7,768) IU weekly for darbepoetin alfa and Epoetin alfa, respectively], RBC and/or platelet transfusions in 17% (14.1% RBC and 6.7% platelets), and G-CSF in 7.4% of pts. The plot below (Figure 1) demonstrates a decrease in serum M protein levels over time and an inverse relationship between Hb and serum M protein levels. Both the decrease of serum M protein levels (p-value <0.001)) and the relationship to rising Hb levels (p-value < 0.001) were found to be statistically significant based on mixed model analyses (linear model taking into account repeated measurements) after accounting for confounding factors such as transfusions and ESA use. Conclusion There was a statistically significant improvement in disease burden across all treatments as evidenced by the drop in serum M protein levels over the cycles of therapy, which was accompanied by a decrease in the level of anemia. A statistically significant inverse relationship between Hb and serum M protein levels was observed in this exploratory analysis. Further studies are required to assess the relevance of Hb change as a viable clinical surrogate marker of response in MM and its potential predictive impact on outcome over time. This research was funded by an unrestricted grant from Ortho Biotech (a division of Janssen-Ortho, Inc.), Toronto, ON, Canada. Disclosures Reece: Ortho Biotech: Honoraria, Research Funding. Teixeira:Ortho Biotech: Employment. Yoong:Janssen Ortho Inc: Employment. Camacho:Janssen Ortho Inc: Consultancy. Plante:Janssen Ortho: Employment.

Concordance and discordance in myeloma bone marrow studies.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e19508-e19508
Author(s):  
Vincent Louie Mendiola ◽  
Meghana Kesireddy ◽  
Bagi RP Jana
Keyword(s):  
Bone Marrow ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Study Groups ◽  
Tumor Burden ◽  
Descriptive Statistics ◽  
P Value ◽  
Exclusion Criteria ◽  
Cell Percentage ◽  
Tool Types

e19508 Background: Multiple myeloma (MM) diagnostic costs, including bone marrow (BM) studies: (flow (F), aspirate (manual differential) (A) and biopsy (Bx)) are increasing. BM studies already have underlying discordance issues that may lead to repetitive studies. Thus, elucidation of characteristics associated with concordant/discordant BM studies in identifying plasma cell percentage (PC%) of ≥10, a key MM diagnostic criteria, arises. Methods: A retrospective chart review (total of152 patients diagnosed with MM and managed at UTMB through 1/2016-1/2018) was completed. 56 subjects met inclusion, PC ≥10% in any BM study, and exclusion criteria. Subjects were grouped into BMA vs BMBx and BMF vs BMBx groups and subdivided into MM subtypes for exploratory review. Two-sample Independent t-test (CI 95%) and descriptive statistics were used for comparison of variables. Two-sided p value ≤ 0.05 was considered significant. Results: Sensitivities in identifying BM PC≥10% were as follows: BMA (66.1%), BMF (39.3%) and BMBx (96.4%) (Gold standard: BMA+BMF+BMBx (100%)). Concordance rates were at 60.7% between BMA and BMBx and 35.7% between BMF and BMBx. Larger BMBx spicule size (mean(cm) = 1.3(1.1-1.48) x 0.27(0.22- 0.31) x 0.21(0.19-0.22), p = 0.037) and higher B2 microglobulin (B2m) levels (mean(mcg/mL) = 11.92 (8.04- 15.79), p = 0.003) were associated with BMA and BMBx concordance in typical/secretory MM types but not in oligo-secretory and non-secretory subtypes of MM, nor is associated with BMF and BMB concordance or discordance. Meanwhile, # of BM acquisition attempts, tool types (hand trochar vs drill) for BM acquisition, LDH and CRP levels had no significant associations with concordance or discordance in any BM study groups. Conclusions: BMF is the least sensitive in identifying PC≥10% likely due to PC damage during flow cytometry, and it may be prudent to just perform BMA with BMBx to save on costs. The associations between larger spicule sizes and higher B2m levels to BMA and BMBx concordance are likely due to an increase in the chance of identifying monoclonal PCs in bigger samples, and greater monoclonal PC tumor burden, respectively, and may have predictability benefits.

Dexamethasone Use in the Treatment of Pediatric Deep Neck Space Infections

2019 ◽  
Vol 129 (4) ◽  
pp. 376-379 ◽  
Author(s):  
James B. Tansey ◽  
John Hamblin ◽  
Madhu Mamidala ◽  
Jerome Thompson ◽  
Jennifer Mclevy ◽  
...  
Keyword(s):  
Chart Review ◽  
Primary Outcome ◽  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
P Value ◽  
Surgical Drainage ◽  
Dexamethasone Group ◽  
Deep Neck Space Infections

Objectives: Assess the outcome of Intravenous (IV) dexamethasone in the treatment of pediatric deep neck space infections (DNSI) in combination with IV antibiotics. Methods: Retrospective chart review of pediatric patients admitted for a DNSI from March 2014 to June 2016. Patient characteristics including demographics, abscess type, antibiotic, dexamethasone, surgery, culture, and length of stay (LOS) were obtained. Patients treated with antibiotics alone versus antibiotics and dexamethasone were compared. Primary outcome measures were rate of surgical drainage and LOS. Results: Overall 153 patients with DNSI were identified, including 62 lateral neck, 18 parapharyngeal, 40 peritonsillar, 32 retropharyngeal, and 1 submandibular. All patients received antibiotics. Dexamethasone was used in 35% of patients. The rate of surgical drainage in the dexamethasone and non-dexamethasone group was 36% and 53% respectively ( P = .043). LOS was shorter for the dexamethasone group (2.9 days) compared to the non-dexamethasone group (3.8 days) but was non-significant, P-value-.09. The most common microorganisms cultured were MRSA (25), MSSA (11), and Streptococcus pyogenes (10). Conclusion: Dexamethasone use was associated with a decreased rate of surgical drainage in pediatric patients with DNSI. Further prospective study is needed to determine the role of dexamethasone in treatment.

Teriparatide treatment increases Hounsfield units in the lumbar spine out of proportion to DEXA changes

2020 ◽  
Vol 32 (1) ◽  
pp. 50-55 ◽  
Author(s):  
Anthony L. Mikula ◽  
Ross C. Puffer ◽  
Jeffery D. St. Jeor ◽  
James T. Bernatz ◽  
Jeremy L. Fogelson ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
P Value ◽  
Mineral Density ◽  
Hounsfield Units ◽  
Teriparatide Treatment ◽  
Before And After ◽  
The Mean ◽  
Better Than

OBJECTIVEThe authors sought to assess whether Hounsfield units (HU) increase following teriparatide treatment and to compare HU increases with changes in bone mineral density (BMD) as measured by dual-energy x-ray absorptiometry (DEXA).METHODSA retrospective chart review was performed from 1997 to 2018 across all campuses at our institution. The authors identified patients who had been treated with at least 6 months of teriparatide and compared HU and BMD as measured on DEXA scans before and after treatment.RESULTSFifty-two patients were identified for analysis (46 women and 6 men, average age 67 years) who underwent an average of 20.9 ± 6.5 months of teriparatide therapy. The mean ± standard deviation HU increase throughout the lumbar spine (L1–4) was from 109.8 ± 53 to 133.9 ± 61 HU (+22%, 95% CI 1.2–46, p value = 0.039). Based on DEXA results, lumbar spine BMD increased from 0.85 to 0.93 g/cm2 (+9%, p value = 0.044). Lumbar spine T-scores improved from −2.4 ± 1.5 to −1.7 ± 1.5 (p value = 0.03). Average femoral neck T-scores improved from −2.5 ± 1.1 to −2.3 ± 1.0 (p value = 0.31).CONCLUSIONSTeriparatide treatment increased both HU and BMD on DEXA in the lumbar spine, without a change in femoral BMD. The 22% improvement in HU surpassed the 9% improvement determined with DEXA. These results support some surgeons’ subjective sense that intraoperative bone quality following teriparatide treatment is better than indicated by DEXA results. To the authors’ knowledge, this is the first study demonstrating an increase in HU with teriparatide treatment.

scholarly journals Effectiveness of Varenicline in Psychiatric Patients with Co-Morbid Polysubstance Dependence

2014 ◽  
Vol 11 (1) ◽  
pp. 1-4
Author(s):  
Jungjin Kim ◽  
Prashant Kaul ◽  
Thomas L. Schwartz ◽  
James Megna
Keyword(s):  
Smoking Cessation ◽  
Substance Use ◽  
Chart Review ◽  
Psychiatric Patients ◽  
Retrospective Chart Review ◽  
Future Studies ◽  
Patient Demographics ◽  
Quit Smoking ◽  
Larger Sample ◽  
Treat Population

Introduction: Individuals with substance use disorders (SUDs) and mental health disorders (MHDs) have greater prevalence of smoking and suffer greater tobacco-related morbidity and mortality. Varenicline is the latest FDA-approved smoking-cessation agent and few studies have investigated the use of varenicline in this difficult-to-treat population.Aims: This study examines the smoking cessation outcomes and tolerability of varenicline when used to help quit smoking in 16 patients enroled in both psychiatric and substance abuse programme.Methods: A retrospective chart review was conducted on 16 patient charts. Patient demographics, psychiatric disorder diagnoses, substance use history, dosing, side effects, number of cigarettes used pre/post varenicline use and the number of complete smoking cessation outcomes were tabulated.Results: After varenicline intervention, 25% of those who completed treatment completely quit smoking. Thirty-one per cent were able to substantially cut back the amount that they smoked to one cigarette per day. The average reduction in cigarettes was 16 per day (64%), and all but one patient tolerated varenicline.Conclusions: The authors observed reasonable clinical benefit when varenicline was used to help quit smoking in patients with comorbid SUDs and MHDs. Better-controlled future studies with larger sample sizes will help further determine clinical utility of varenicline in this difficult-to-treat nicotine-dependent population.

Sign in / Sign up

Export Citation Format

Share Document