scholarly journals Effect of Dosing Interval on Compliance of Osteoporosis Patients on Bisphosphonate Therapy: Observational Study Using Nationwide Insurance Claims Data

2021 ◽  
Vol 10 (19) ◽  
pp. 4350
Author(s):  
Hyunil Lee ◽  
Sangcheol Lee ◽  
Dokyung Kim ◽  
Weonmin Cho ◽  
Sungtan Cho ◽  
...  
Keyword(s):  
Medication Possession Ratio ◽  
Bisphosphonate Therapy ◽  
Insurance Claims ◽  
Drug Compliance ◽  
Dosing Interval ◽  
Improve Compliance ◽  
Insurance Claims Data ◽  
Male Patients ◽  
Dosing Intervals

Only a few studies are available on the effect of the dosing interval of bisphosphonate on drug compliance. We analyzed the data of patients who were newly prescribed bisphosphonate using a national insurance claims database. Drug compliance was assessed by calculating medication possession ratio (MPR) over a minimum of a 1-year follow-up. This analysis included 281,996 new bisphosphonate users with a mean age of 68.9 years (92% women). The patients were divided into daily, weekly, monthly, 3-monthly, and switch groups (who changed the drug to other dosing intervals). The average MPR was the highest in the switch group (66%), and the longer the dosing interval, the higher the compliance (3-monthly, 56% vs. daily, 37%). “Non-compliant” was defined as an MPR under 80%. Various factors which were possibly associated with “non-compliant” MPR were investigated using multiple regression analysis. Multivariate analysis showed that male patients were more likely to be non-compliant with pharmacotherapy than female patients, with as odds ratio of 1.389. Younger patients had a significantly lower likelihood of being non-compliant than older patients for age 60–69 vs. age 80+. Long dosing intervals were recommended to improve compliance and special attention was given to older and male patients.

scholarly journals Extending rituximab dosing intervals in patients with MS during the COVID-19 pandemic and beyond?

2020 ◽  
Vol 7 (5) ◽  
pp. e825 ◽  
Author(s):  
Adil Maarouf ◽  
Audrey Rico ◽  
Clemence Boutiere ◽  
Marine Perriguey ◽  
Sarah Demortiere ◽  
...  
Keyword(s):  
Disease Activity ◽  
Median Time ◽  
Dosing Interval ◽  
Disability Status ◽  
Relapsing Remitting ◽  
Risk Of Disease ◽  
The Mean ◽  
Edss Score ◽  
Dosing Intervals

ObjectiveTo evaluate disease activity in patients with relapsing-remitting MS (RRMS) receiving rituximab with an extended dosing interval.MethodsIn the context of COVID-19 pandemic, this was an interim analysis of an ongoing prospective observational study of patients who were stable on rituximab for at least 6 months and who had a planned extended dosing interval of 24 months. Only data for patients with active RRMS before rituximab were analyzed.ResultsAmong 177 patients receiving rituximab, 33 had RRMS and MRI activity before rituximab and at least 8 months of follow-up after the last infusion. The mean (SD) age was 40 (14) years, 25 were females, the mean disease duration was 10 (6.8) years, the mean annual relapse rate (ARR) before rituximab was 1.7 (1.3), and the median Expanded Disability Status Scale (EDSS) score before rituximab was 4.5 (1–7). Before extended dosing, when rituximab was infused every 6 months, the mean (SD) ARR decreased to 0.04 (0.1) (p < 0.0001) and the EDSS score to 4 (0–7) (p = 0.04). At the time of this analysis, the median follow-up since the last infusion was 11 (8–31) months. No patient showed relapse or disability progression. In total, 30 patients had at least 1 MRI performed since the last infusion (median time between the last MRI and the last infusion 10 [8–31] months). No MRI showed activity. The CD19+ cell proportion was >1% for 10 of 25 patients at the last count (median time 8 [6–25] months).ConclusionsAn extended dosing interval for rituximab for patients with stable MS during the COVID-19 pandemic may be associated with a low risk of disease activity.

Sustained-Release Theophylline Therapy for Chronic Childhood Asthma

PEDIATRICS ◽  
1978 ◽  
Vol 62 (3) ◽  
pp. 352-358
Author(s):  
Thomas Bell ◽  
Joseph Bigley
Keyword(s):  
Sustained Release ◽  
Childhood Asthma ◽  
Drug Compliance ◽  
Dosing Interval ◽  
Patient Cooperation ◽  
Sustained Release Theophylline ◽  
Excellent Control ◽  
Dosing Intervals ◽  
Higher Doses ◽  
Chronic Childhood

The efficacy of continuous, around-the-clock sustained-release (S-R) theophylline therapy, adjusted to approximate serum or plasma steady state theophylline concentrations (Tc) of 15 µg/ml three hours following the last dose, was assessed in 18 children suffering from moderately severe chronic asthma. Two of the three formulations studied, Slo-Phyllin Gyrocaps and Theo-Dur, had excellent bioavailability and produced stable therapeutic Tc, throughout an eight-hour dosing interval, using average doses of 8.7 ± 0.5 and 8.4 ± 0.6 (SE) mg/kg/dose, respectively. Pulmonary function responses paralleled Tc and were also stable throughout the dosing interval. Aerolate provided comparatively less stability, and higher doses (11.3 ± 0.7 mg/kg) were necessary to produce therapeutic Tc. Toxicity was not evident when dosage was adjusted to avoid Tc exceeding 20 µg/ ml. S-R theophylline therapy, with the use of formulations of acceptable bioavailability, provides excellent control of chronic childhood asthma, offers the advantage of extended dosing intervals, and encourages improved patient cooperation in drug compliance.

scholarly journals Difference in Incontinence Pad Use between Patients after Radical Prostatectomy and Cancer-Free Population with Subgroup Analysis for Open vs. Minimally Invasive Radical Prostatectomy: A Descriptive Analysis of Insurance Claims-Based Data

2021 ◽  
Vol 18 (13) ◽  
pp. 6891
Author(s):  
Dong-Ho Mun ◽  
Lin Yang ◽  
Shahrokh F. Shariat ◽  
Sylvia Reitter-Pfoertner ◽  
Gerald Gredinger ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Minimally Invasive ◽  
Descriptive Analysis ◽  
Surgical Techniques ◽  
Population Based ◽  
Open Approach ◽  
Insurance Claims ◽  
Prostate Hyperplasia ◽  
Insurance Claims Data

Purpose: to quantify and compare pre- and post-surgical incontinence pad use between men treated with radical prostatectomy (RP) for prostate cancer (PCa) and cancer-free controls, using population-based Austrian insurance claims data. Methods: Men who underwent RP for treating PCa between 2013–2015 were identified. Cancer-free men ≥45 years with and without benign prostate hyperplasia (BPH) were used as controls. Longitudinal data on ICD-diagnoses, type of surgery, prescribed incontinence pads, and hospitals’ surgery volumes were aggregated between 2011–2018 to capture pre- and up to three years post-RP follow-up. Monthly rates of pad use were calculated and compared between RP types and cancer-free controls. Results: A total of 6248 RP patients, 7158 cancer-free men with BPH, and 50,257 cancer-free men without BPH were analyzed. Comparing to pre-RP (0.03, 95%CI: 0.02–0.05), RP resulted in significantly higher rates of prescribed pads (at 3 months: 12.61, 95%CI: 11.59–13.65; 12 months: 6.71, 95%CI: 6.10–7.34; 36 months: 4.91, 95%CI: 3.76–4.62). These rates were also higher than those for cancer free controls (with BPH:0.06, 95%CI: 0.04–0.09; without BPH:0.12, 95%CI: 0.10–0.14). The rate of prescribed pads after surgery continued to decline over time and remained higher among men who underwent minimally invasive RP compared to those who underwent an open procedure. Conclusion: Despite progress in surgical techniques, post-RP incontinence remains a prevalent adverse event. The rate of pad usage steadily improved over the first three years post RP. The rate of patients with incontinence needing pads was higher among those who were treated minimally invasive compared to open approach.

Outcome of Buccal Mucosal Graft Urethroplasty in Long Segment Anterior Urethral Stricture

2020 ◽  
Vol 19 (2) ◽  
pp. 64-68
Author(s):  
Mrinmoy Biswas ◽  
Sudip Das Gupta ◽  
Mohammed Mizanur Rahman ◽  
Sharif Mohammad Wasimuddin
Keyword(s):  
Urethral Stricture ◽  
Flow Rate ◽  
Surgical Outcome ◽  
Simple Technique ◽  
Anterior Segment ◽  
Maximum Flow ◽  
Anastomotic Site ◽  
Buccal Mucosal Graft ◽  
Male Patients

Objective: To assess the success of BMG urethroplasty in long segment anterior urethral stricture. Method: From January 2014 to December 2015, twenty male patients with long anterior segment urethral stricture were managed by BMG urethroplasty. After voiding trial they were followed up at 3 month with Uroflowmetry, RGU & MCU and PVR measurement by USG. Patients were further followed up with Uroflowmetry and PVR at 6 months interval.Successful outcome was defined as normal voiding with a maximum flow rate >15ml /sec and PVR<50 ml with consideration of maximum one attempt of OIU after catheter removal. Results: Mean stricture length was 5.2 cm (range 3-9 cm) and mean follow-up was 15.55 months (range 6-23 months). Only two patients developed stricture at proximal anastomotic site during follow-up. One of them voided normally after single attempt of OIU. Other one required second attempt of OIU and was considered as failure (5%). Conclusion: BMG urethroplasty is a simple technique with good surgical outcome. Bangladesh Journal of Urology, Vol. 19, No. 2, July 2016 p.64-68

scholarly journals First Study of the Prevalence and Characterization of Brachial Plexus Injuries in Guatemala

2021 ◽  
Vol 16 (01) ◽  
pp. e46-e50
Author(s):  
Carmen Joanna González Lemus ◽  
Fernando Xavier Romero Prieto
Keyword(s):  
Brachial Plexus ◽  
Brachial Plexus Injury ◽  
Main Mode ◽  
Cross Sectional ◽  
Speed Up ◽  
Male Patients ◽  
Mode Of Transportation ◽  
Surgery Department

Abstract Objective This study aimed to estimate the prevalence of brachial plexus injuries and to characterize clinically and epidemiologically patients with brachial plexus injury. Materials and Methods In this cross-sectional descriptive study, 2,923 medical records of patients aged 1 to 64 years who presented at outpatient peripheral nerve unit of the Orthopedic Surgery Department of Hospital Roosevelt, Guatemala, from January 2017 to December 2017, were prospectively analyzed to identify the prevalence and factors associated with brachial plexus injuries. Results The prevalence rate of brachial plexus injuries in patients was 5.74%. This injury is more common in men (90.5%) aged 24 to 64 years. Brachial plexus injuries occurred secondary to motorcycle accident in 72% of the cases, with the majority affecting the dominant upper extremity. In addition, 64.28% of the patients took 1 to 6 months to seek consultation, whereas only 16.07% requested medical assistance <1 month from the onset of symptoms, and this result was associated with early diagnosis and adequate recovery during follow-up. Furthermore, 66.67% presented upper brachial plexus injury with no associated fractures or vascular injury, manifesting distress while performing daily activities that required hand, arm, and elbow movements. Conclusion The risk of suffering BPIs in Guatemala increases in economically active male patients that use motorcycles as main mode of transportation. Patients should consult immediately after injury onset to optimize management results. For this reason, hospitals must develop specialized clinical guidelines to speed up the identification and treatment of BPI injuries.

scholarly journals Medication Possession Ratio: Predicting and Decreasing Loss to Follow-Up in Antiretroviral Treatment Programs in Côte dʼIvoire

2011 ◽  
Vol 57 ◽  
pp. S34-S39 ◽  
Author(s):  
Eugène Messou ◽  
Martial Kouakou ◽  
Delphine Gabillard ◽  
Patrice Gouessé ◽  
Mamadou Koné ◽  
...  
Keyword(s):  
Antiretroviral Treatment ◽  
Medication Possession Ratio ◽  
Treatment Programs ◽  
Loss To Follow Up

scholarly journals Urinary Artificial Sphincter ZSI 375 for Treatment of Stress Urinary Incontinence in Men: 5 and 7 Years Follow-Up Report

2017 ◽  
Vol 84 (4) ◽  
pp. 263-266 ◽  
Author(s):  
Christophe Llorens ◽  
Tobias Pottek
Keyword(s):  
Urinary Incontinence ◽  
Stress Urinary Incontinence ◽  
Artificial Urinary Sphincter ◽  
Minimal Period ◽  
Artificial Sphincter ◽  
Urethral Erosion ◽  
Randomised Study ◽  
Urinary Sphincter ◽  
Male Patients

Study Design This is a retrospective, non-randomised study. Objectives The aim of this study was to evaluate safety and efficacy of artificial urinary sphincter ZSI 375 inserted in male patients with stress urinary incontinence (SUI). Methods Between May 2009 and January 2017, 45 men with SUI underwent ZSI 375 device insertion. Operations were performed in two French centres by one surgeon. Complications and pad used to manage continence were recorded. Results From May 2009 to January 2012, 45 patients with a mean age of 70.42 years underwent placement of the ZSI 375 device in France. The most common cause for incontinence was radical prostatectomy (RP, 33/45 ­patients, 73.33%). The minimal period of incontinence was 6 months. Twenty-seven out of 45 patients (60.00%) had a severe incontinence (at least four pads per day), 13 patients (28.89%) had moderate incontinence (three pads per day) and five patients (11.11%) had two pads per day. With a long follow-up, the ZSI 375 device was considered to be successful in 73.33% patients after 5 years (60 months) and 72% of patients after 7 years (84 months). The infection rate was 2.2 % affecting one in 45 patients. Six out of 45 patients presented a urethral erosion (13.33%). Mechanical failure with a revision occurred in three patients (6.67%). Conclusions The ZSI 375 device is a safe and effective device to treat severe SUI in men.

Lumbar epidural hematoma associated with spondylolyses

2008 ◽  
Vol 8 (2) ◽  
pp. 174-180 ◽  
Author(s):  
Chima O. Ohaegbulam ◽  
Ian F. Dunn ◽  
Pierre d'Hemecourt ◽  
Mark R. Proctor
Keyword(s):  
Epidural Hematoma ◽  
Surgical Intervention ◽  
Relevant Literature ◽  
Young Male ◽  
Active Patient ◽  
Male Patients

✓ This report describes 3 young male patients with multiple lumbar spondylolyses in combination with a symptomatic epidural hematoma. The records of all 3 patients were reviewed for clinical details. All patients were successfully treated without surgical intervention. Initial neuroimaging results for all patients revealed epidural hematomas, and follow-up imaging confirmed resolution of the hematomas. The relevant literature is briefly reviewed to examine the rarity of this combination. Spontaneous epidural hematomas may occur in the setting of spondylolysis, and this diagnosis should be considered when imaging reveals an unusual epidural lesion in a young active patient.

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