scholarly journals Best Practices for Long-Term Monitoring and Follow-Up of Alemtuzumab-Treated MS Patients in Real-World Clinical Settings

2019 ◽  
Vol 10 ◽  
Author(s):  
Krista Barclay ◽  
Robert Carruthers ◽  
Anthony Traboulsee ◽  
Ann D. Bass ◽  
Christopher LaGanke ◽  
...  
Keyword(s):  
Best Practices ◽  
Real World ◽  
Clinical Settings ◽  
Long Term Monitoring ◽  
Term Monitoring

scholarly journals Outcome in surgically treated Rathke's cleft cysts: long-term monitoring needed

2011 ◽  
Vol 165 (1) ◽  
pp. 33-37 ◽  
Author(s):  
R Trifanescu ◽  
V Stavrinides ◽  
P Plaha ◽  
S Cudlip ◽  
J V Byrne ◽  
...  
Keyword(s):  
Visual Field ◽  
Visual Field Defects ◽  
Rathke's Cleft Cysts ◽  
Long Term Monitoring ◽  
Rathke's Cleft ◽  
Term Monitoring ◽  
Field Defects ◽  
Tsh Deficiency

ObjectiveTo clarify the outcome of all cases of Rathke's cleft cysts (RCC) treated surgically and followed up in Oxford during a long-term period.Subjects and methodsThe records of all patients with RCC seen in the Department of Endocrinology between January 1978 and June 2009 were reviewed.ResultsA total of 33 patients (20 females, median age 43 years) were identified. At presentation, major visual field defects were detected in 58% of patients and gonadotrophin, ACTH and TSH deficiency in 60, 36 and 36% of patients respectively. Desmopressin treatment was required in 18% of patients. Treatment consisted of cyst evacuation combined with or without biopsy/removal of the wall. Post-operatively, visual fields improved in 83% of patients with impairment, whereas there was no reversal of ACTH or TSH deficiency or of diabetes insipidus. All but one subject had imaging follow-up during a mean period of 48 months (range 2–267). Cyst relapse was detected in 22% of patients at a mean interval of 29 months (range 3–48 months); in 57% of them, the recurrence was symptomatic. Relapse-free rates were 88% at 24-months and 52% at 48-months follow-up. At last assessment, at least quadrantanopia was reported in 19% of patients, gonadotrophin, ACTH and TSH deficiency in 50, 42 and 47% of patients respectively. Desmopressin treatment was required in 39% of patients.ConclusionsIn this study of patients with RCC and long-term follow-up, we showed a considerable relapse rate necessitating long-term monitoring. Surgical intervention is of major importance for the restoration of visual field defects, but it does not improve endocrine morbidity, which in the long-term affects a substantial number of patients.

Long-Term Monitoring of Tricyclic Antidepressant Plasma Concentrations

1980 ◽  
Vol 137 (5) ◽  
pp. 444-451 ◽  
Author(s):  
Agrégé Henry Loo ◽  
Kader Benyacoub ◽  
Vincenzo Rovei ◽  
Carlo A. Altamura ◽  
Marthe Vadrot ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Side Effects ◽  
Plasma Concentrations ◽  
Antidepressant Drugs ◽  
Tricyclic Antidepressant ◽  
Self Medication ◽  
Long Term Monitoring ◽  
Term Monitoring

SummaryPlasma levels of antidepressant drugs were measured in 17 depressed patients at roughly monthly intervals over follow-up periods of three to 26 months. Good results in seven were associated with small fluctuations in level from visit to visit, while big fluctuations were associated with poor outcome. Such fluctuations were probably from poor compliance or drug interaction from self-medication. Severe side effects and cardiotoxicity were associated with high levels.

scholarly journals Long-term monitoring of sulfonamides and tetracyclines in manure amended soils and leachate samples - A follow-up study

Heliyon ◽  
2020 ◽  
Vol 6 (8) ◽  
pp. e04656
Author(s):  
Astrid Spielmeyer ◽  
Madeleine S. Petri ◽  
Heinrich Höper ◽  
Gerd Hamscher
Keyword(s):  
Amended Soils ◽  
Follow Up Study ◽  
Long Term Monitoring ◽  
Term Monitoring

Abstract 17109: Real World Assessment of Atrial Fibrillation and Other Arrhythmias After Cryptogenic Stroke

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Naga Venkata K Pothineni ◽  
Uyanga Batnyam ◽  
Jeffrey Arkles ◽  
John Bullinga ◽  
Brett L CUCCHIARA ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Trials ◽  
Real World ◽  
Cryptogenic Stroke ◽  
Premature Ventricular Contractions ◽  
Entire Cohort ◽  
Detection Algorithms ◽  
Term Monitoring

Introduction: Long-term monitoring for atrial fibrillation (AF) is recommended in patients, who have experienced a cryptogenic stroke (CS). Clinical trials have identified AF in ~30% of patients after 3 years of continuous monitoring with insertable cardiac monitors (ICMs). Hypothesis: In a real-world analysis from a large academic healthcare system, we sought to evaluate a CS population with ICMs and a) determine the yield of AF and subsequent initiation of anticoagulation; and b) identify the presence of other arrhythmias. Methods: We evaluated all CS patients who had received an ICM between October 2014 and April 2020. We manually reviewed all stored electrocardiograms that were automatically labeled as AF by the ICM and adjudicated them as either a) AF or b) other cardiac arrhythmia including premature atrial contractions (PAC), premature ventricular contractions (PVC), supraventricular tachycardia (SVT), or nonsustained ventricular tachycardia (NSVT). Results: A total of 84 CS patients with ICMs were included: 51% men, mean age 63 years, and mean CHA 2 DS 2 -VASc 4.1. Over a median follow-up duration of 15.7 months, there were 34 patients (40% of the cohort) who did not have any AF alerts. In the remaining 50 patients, there were 960 stored electrograms that were adjudicated. Only 154 recordings from 16 patients (19% of the entire cohort) were adjudicated as AF. Oral anticoagulation was initiated in all these patients with adjudicated AF. The remaining tracings, which had been automatically categorized by the ICM as AF alerts, represented 34 patients (40% of the cohort). These patients had other arrhythmias including frequent PACs or PVCs, SVT, or NSVT. Conclusions: Compared to clinical trials, our real-world assessment suggests that the yield of AF following CS is lower - approximately 20%. Our findings highlight the importance for reviewing device tracings given the high rates of false positive for AF. Further research to refine AF detection algorithms in ICMs is needed.

scholarly journals Undetectable Sensitive Serum Thyroglobulin (<0.1 ng/ml) in 163 Patients with Follicular Cell-Derived Thyroid Cancer: Results of rhTSH Stimulation and Neck Ultrasonography and Long-Term Biochemical and Clinical Follow-Up

2012 ◽  
Vol 97 (8) ◽  
pp. 2714-2723 ◽  
Author(s):  
A. M. Chindris ◽  
N. N. Diehl ◽  
J. E. Crook ◽  
V. Fatourechi ◽  
R. C. Smallridge
Keyword(s):  
Thyroid Cancer ◽  
Radioactive Iodine ◽  
Stage Iv ◽  
Needle Aspiration ◽  
Serum Thyroglobulin ◽  
Iodine Treatment ◽  
Long Term Monitoring ◽  
Term Monitoring

Abstract Context: Surveillance of patients with differentiated thyroid cancer (DTC) is achieved using serum thyroglobulin (Tg), neck ultrasonography (US), and recombinant human TSH (rhTSH)-stimulated Tg (Tg-stim). Objective: Our primary aim was to assess the utility of rhTSH Tg-stim in patients with suppressed Tg (Tg-supp) below 0.1 ng/ml using a sensitive assay. Our secondary aims were to assess the utility of US and to summarize the profile of subsequent Tg-supp measures. Design: This is a retrospective study conducted at two sites of an academic institution. Patients: A total of 163 patients status after thyroidectomy and radioactive iodine treatment who had Tg-supp below 0.1 ng/ml and rhTSH Tg-stim within 60 d of each other were included. Results: After rhTSH stimulation, Tg remained below 0.1 ng/ml in 94 (58%) and increased to 0.1–0.5 in 56 (34%), more than 0.5–2.0 in nine (6%), and above 2.0 ng/ml in four (2%) patients. Serial Tg-supp levels were obtained in 138 patients followed over a median of 3.6 yr. Neck US were performed on 153 patients; suspicious exams had fine-needle aspiration (FNA). All positive FNA were identified around the time of the initial rhTSH test. Six of seven recurrences were detected by US (Tg-stim &gt;2.0 ng/ml in one, 0.8 in one and ≤0.5 in four). One stage IV patient had undetectable Tg-stim. Conclusion: In patients with DTC whose T4-suppressed serum Tg is below 0.1 ng/ml, long-term monitoring with annual Tg-supp and periodic neck US are adequate to detect recurrences. In our experience, rhTSH testing does not change management and is not needed in this group of patients.

scholarly journals Long-term monitoring of arrhythmias in cardiac sarcoidosis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Bakker ◽  
H Mathijssen ◽  
J Balt ◽  
V.F Van Dijk ◽  
M Veltkamp ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Risk Stratification ◽  
Cardiac Death ◽  
Cardiac Sarcoidosis ◽  
Low Risk ◽  
Risk Patients ◽  
Long Term Monitoring ◽  
Term Monitoring

Abstract Introduction Screening for cardiac sarcoidosis (CS) is recommended since it can manifest with ventricular arrhythmias (VA), atrioventricular conduction block (AVB) and sudden cardiac death (SCD). However, risk stratification for SCD is challenging, in particular in patients without overt cardiac symptoms. Purpose This study reports the practice-based risk stratification for SCD and the incidence of arrhythmias and mortality in CS patients by long-term monitoring of arrhythmias. Methods A retrospective, single center cohort study was performed in 537 patients with sarcoidosis screened for cardiac involvement with cardiac MRI and fluorodeoxyglucose PET in an hospital, a Dutch tertiary referral center. CS was diagnosed in 115 of 537 patients (21%), complete follow up was available in 108 patients (94%). After risk assessment for SCD (figure 1) an ICD was implanted in 16 high-risk patients. Within the92 low-risk patients, 80 had an internal loop recorder (ILR) implanted and 12 patients received no device. Chart review was performed to assess the occurrence of VA, AVB, death, ICD therapy and device related complications. Results During a mean follow-up of 31±15 months, 9 out of 80 ILR patients (11.3%) received an ICD of whom 7 (8.8%) based on recorded arrhythmias (VA in 5 and AVB in 2 patients). Five out of the total 25 ICD patients (20%) experienced sustained VA successfully treated with anti-tachycardia pacing in 2 (8%) and terminated spontaneously in all other patients. Two ICD patients experienced a mild pocket infection, treated with antibiotics. Two deaths occurred in the low-risk patients: 1 non-cardiac death and 1 SCD due to asystole. Conclusion The practice-based risk stratification supported an ICD implantation in up to 5% of sarcoidosis patients screened for CS. Sustained VA occurred in 20% of ICD patients.Early detection of important arrhythmias with an ILR can optimize risk assessment for SCD in CS. Practise-based risk stratification Funding Acknowledgement Type of funding source: None

scholarly journals Pemantauan trauma kepala pada anak

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jufitriani Ismy
Keyword(s):  
Early Childhood ◽  
Head Injury ◽  
Head Trauma ◽  
Head Injuries ◽  
Developmental Abnormalities ◽  
Key Words Head Trauma ◽  
Long Term Monitoring ◽  
Term Monitoring

Abstrak. Trauma kepala pada pada anak dapat terjadi akibat pukulan, jatuh,  benturan maupun hentakan mendadak. Trauma kepala ringan salah satu kasus tersering di bagian neurologi anak. Trauma kepala dapat menyebabkan cedera kepala dan penyebab kematian terbanyak pada anak.  Perbedaan dari segi anatomi, fisiologi, serta metabolisme pada anak dan dewasa sehingga pada anak lebih mudah untuk mengalami  cedera kepala dibandingkan dengan orang dewasa.  Pemantauan saat terjadinya trauma dan pemantauan jangka panjang diperlukan untuk mendeteksi secara dini kelainan perkembangan anak.Kata kunci: Trauma kepala anak, cedera kepala, pemantauan  Abstract. Head trauma in children can occur due to blows, falls, collisions or sudden shocks. Mild head trauma is one of the most common cases in pediatric neurology. Head trauma can cause head injuries and is the leading cause of death in children. Differences in terms of anatomy, physiology, and metabolism in children and adults make it easier for children to experience head injuries than adults. Monitoring when trauma occurs and long-term monitoring is needed to detect early childhood developmental abnormalities. Key words: head trauma in children,  head injury, follow up

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