scholarly journals A Real-World Effectiveness of Subcutaneous Immunotherapy on the Cost of Medication, Allergic Rhinitis, and Asthma Exacerbations, as well as Upper Respiratory Tract Infection in Subjects with Allergic Rhinitis with or without Asthma: A Retrospective Pilot Study

Medicina ◽  
2021 ◽  
Vol 57 (11) ◽  
pp. 1229
Author(s):  
Chaicharn Pothirat ◽  
Warawut Chaiwong
Keyword(s):  
Allergic Rhinitis ◽  
Tract Infection ◽  
Real World ◽  
Upper Respiratory Tract ◽  
Chiang Mai ◽  
Asthma Exacerbations ◽  
Upper Respiratory ◽  
The One ◽  
The Cost

Background and Objectives: Real-world studies are limited regarding the effectiveness of SCIT on allergic rhinitis (AR) with and without asthma and the cost of medication in Thailand. Moreover, limited data exist regarding the effectiveness of SCIT on worldwide upper respiratory tract infection (URTI). Therefore, the objective of this study was to compare the medication costs, rate of AR and asthma exacerbations, and rate of URTI in AR with or without asthma subjects before and during three years after receiving the maintenance phase of SCIT, compared with a standard usual care (SUC) group. Materials and Methods: A real-world retrospective study was conducted in AR subjects with or without asthma. From January 2001 to December 2018, 24 subjects with or without asthma received SCIT added to SUC, and 16 subjects were treated with SUC only at the Allergy and Chest Clinic of Chiang Mai Ram Hospital, Chiang Mai, Thailand. The cost of medication was recorded. AR and asthma exacerbations and URTI events were also collected. Results: From between-group comparisons, the cost of medication (THB) in the SCIT group at the one-, two-, and three-year follow up was significantly lower (587.4 (348.3–1374.6) vs. 1562.4 (1315.1–1857.3), p < 0.001, 501.2 (302.9–839.0) vs. 1728.3 (1190.0–2236.1), p < 0.001, and 372.4 (284.8–752.4) vs. 1500.3 (1217.9–1748.9), p < 0.001, respectively)), and AR and asthma exacerbations were significantly reduced at the three-year follow-up. From within-group comparisons, the cost of medication (THB) and AR and asthma exacerbations were significantly lower in the SCIT group at the one-, two-, and three-year follow-up. The URTI event was significantly reduced in the SCIT group at the two- and three-year follow-up. Conclusions: SCIT in subjects with AR with or without asthma was associated with a significantly reduced cost of medication, rates of AR and asthma exacerbations, and URTI events in the long term.

An Open-Label, Phase 2 Trial of Denosumab in the Treatment of Relapsed (R) or Plateau-Phase (PP) Multiple Myeloma (MM).

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 3604-3604 ◽  
Author(s):  
Ravi Vij ◽  
Noemi Horvath ◽  
Andrew Spencer ◽  
Kerry Taylor ◽  
Saroj Vadhan-Raj ◽  
...  
Keyword(s):  
Tract Infection ◽  
Disease Progression ◽  
Stable Disease ◽  
Myeloma Cell ◽  
M Protein ◽  
Upper Respiratory Tract ◽  
Protein Levels ◽  
Upper Respiratory ◽  
Median Change

Abstract Denosumab is a fully human monoclonal antibody that inhibits RANKL, an essential mediator of osteoclast (OC) formation, function, and survival. Denosumab is being investigated in a phase 3 study to delay skeletal-related events in patients (pts) with MM. Preclinical data suggest that OCs may interact either directly with MM cells or indirectly through a “vicious cycle” of bone destruction that releases factors promoting myeloma cell growth. In a mouse MM model, RANKL inhibition reduced OC number, osteolysis, serum paraprotein levels, and prolonged survival. In this single-arm, proof-of-concept study of denosumab in pts with R (≥ 2 prior therapies and relapse after a response to most recent therapy) or PP (response to the most recent therapy and stable, detectable serum M-protein for ≥3 mos) MM, we report efficacy data on pts who could have completed 6 mos of treatment; for the R cohort, this represented a complete analysis and for the PP cohort, this was an interim analysis. Eligible MM pts (age ≥18 yrs; measurable M-protein; ECOG of 0 or 1; life expectancy &gt;3mos) were given subcutaneous injections of denosumab 120mg monthly with additional loading doses on days 8 and 15 of mo 1. Pts were instructed to take calcium 500mg and Vit D 400 IU daily. The primary endpoint was the % of pts with complete response (CR) or partial response (PR), which included serum M-protein reductions ≥50%. Pt incidence of adverse events (AEs) was measured. 52 pts in R (13 women, 39 men) and 33 pts in PP (20 women, 13 men) received 1 to 12 mos of denosumab. The median ages of the R and PP cohorts were 63 and 62 yrs. 79% of the R cohort, and 58% in PP had ≥3 prior therapies. In R, the median on-study follow up time was 3.1 mos; 85% of pts who discontinued denosumab was due to disease progression. In PP, the median on-study follow up time was 8.1 mos; 81% of pts who discontinued treatment was due to disease progression. No objective CR or PR was observed in either cohort. In R, 13 pts (25%) had stable disease for &gt;6 mos; maximum reductions of ≥25% in serum M-protein levels were seen in 3 pts (6%) and &lt;25% in 19 pts (37%). In PP, 19 pts (59%) had stable disease for &gt;6 mos; maximum reductions of ≥25% in serum M-protein levels were seen in 4 pts (13%) and &lt;25% in 18 pts (56%). In R, the median % change from baseline in serum C-telopeptide (sCTx) and bone serum alkaline phosphatase (BSAP) levels at 4 mos was −70% and −33%. In PP, the median % change from baseline in sCTx and BSAP levels at 4 mos was −52% and −16%. The most common AEs were anemia, upper respiratory tract infection, and fatigue (in R); and upper respiratory tract infection, diarrhea, fatigue, headache, peripheral edema, and pain in extremity (in PP). 3 cases of grade 2 hypocalcemia (1 in R, 2 in PP) and 1 case of grade 3 hypocalcemia (in PP) were observed. Of the 19 pts who reported serious AEs across both R and PP, the most common were 2 cases each of thrombocytopenia, pneumonia, relapsed MM, and renal failure. 4 deaths (2 disease progression, 2 pneumonia) occurred on-study, which were not considered to be treatment-related. The stable disease observed in some MM pts in the R and PP cohorts may reflect an inhibitory effect of denosumab on myeloma cell growth and warrants further study.

scholarly journals Fruit and vegetable intake and risk of upper respiratory tract infection in pregnant women

2009 ◽  
Vol 13 (2) ◽  
pp. 276-282 ◽  
Author(s):  
Lin Li ◽  
Martha M Werler
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Fruits And Vegetables ◽  
Vegetable Intake ◽  
Fruit And Vegetable Intake ◽  
Upper Respiratory Tract ◽  
Fruit And Vegetable ◽  
Upper Respiratory

AbstractObjectiveThe present study evaluated the association between fruit and vegetable intake and the incidence of upper respiratory tract infection (URTI) during pregnancy.DesignIn a cohort of 1034 North American women, each subject was asked retrospectively about their fruit and vegetable intake during the six months before the pregnancy and their occurrences of URTI during the first half of pregnancy. Multivariable-adjusted hazard ratios (HR) were calculated with Cox proportional hazards models.ResultsThe adjusted HR of URTI for women in the highest quartile (median 8·54 servings/d)v. the lowest quartile (median 1·91 servings/d) of total fruit and vegetable intake was 0·74 (95 % CI 0·53, 1·05) for the 5-month follow-up period and 0·61 (95 % CI 0·39, 0·97) for the 3-month follow-up period, respectively. A dose-related reduction of URTI risk according to quartile of intake was found in the 3-month (Pfor trend = 0·03) but not the 5-month follow-up. No association was found between either fruit or vegetable intake alone in relation to the 5-month or the 3-month risk of URTI.ConclusionsWomen who consume more fruits and vegetables have a moderate reduction in risk of URTI during pregnancy, and this benefit appears to be derived from both fruits and vegetables instead of either alone.

The Burden and Visit Prevalence of Pediatric Chronic Rhinosinusitis

2017 ◽  
Vol 157 (6) ◽  
pp. 1048-1052 ◽  
Author(s):  
Sapideh Gilani ◽  
Jennifer J. Shin
Keyword(s):  
Allergic Rhinitis ◽  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
Chronic Rhinosinusitis ◽  
Otitis Media ◽  
Upper Respiratory Tract Infection ◽  
Upper Respiratory Tract ◽  
Acute Rhinosinusitis ◽  
Upper Respiratory

Objectives Pediatric chronic rhinosinusitis has a substantial impact, but its epidemiology has yet to be elucidated. Our objectives were (1) to determine the associated national visit burden and (2) to assess its frequency relative to other frequent childhood otolaryngological illnesses. Study Design Analysis of national survey databases. Setting Ambulatory care settings in the United States, 2005 to 2012. Subjects and Methods Cases with a diagnosis of chronic rhinosinusitis were assessed in total and as a proportion of all visits reported in National Ambulatory Medical Care Surveys. To place these data into context, results for acute rhinosinusitis, allergic rhinitis, upper respiratory tract infection, and otitis media were also extracted and compared. Data specific to individual age group and calendar year were assessed. Results Chronic rhinosinusitis accounted for 5.6 million visits per annum (range, 3.7-7.5 million) among patients 0 to 20 years of age. Children in the >5- to 10-year-old and >10- to 15-year-old age groups were more likely to be affected ( P < .001). Among all visits, chronic rhinosinusitis was diagnosed in 2.1% (95% confidence interval [CI], 1.9%-2.4%), acute rhinosinusitis in 0.6% (95% CI, 0.5%-0.7%), allergic rhinitis in 2.6% (95% CI, 2.3%-2.8%), upper respiratory tract infection in 8.0% (95% CI, 7.5%-8.4%), and otitis media in 6.7% (95% CI, 6.5%-7.1%). Chronic rhinosinusitis visits were significantly more prevalent than for acute rhinosinusitis (relative risk, 3.40; 95% CI, 2.70-4.10; P < .0001). Among those >15 to 20 years of age, chronic rhinosinusitis was 2.18-fold (95% CI, 1.65-2.70) more frequently diagnosed than otitis media. Conclusions The visit burden from pediatric chronic rhinosinusitis exceeds that of acute rhinosinusitis and equals the burden from allergic rhinitis.

scholarly journals Neutrophil Counts and Rates in Otorhinolaryngology

2020 ◽  
Author(s):  
Erkan Yildiz
Keyword(s):  
Allergic Rhinitis ◽  
Blood Count ◽  
Complete Blood Count ◽  
Critical Role ◽  
Chronic Otitis Media ◽  
Sudden Hearing Loss ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Bell Palsy

Complete blood count is a fairly inexpensive test that is widely used in the clinic. Neutrophils are also one of the most important parameters in complete blood count. They play a critical role in upper respiratory tract infection, as well as in many chronic otolaryngology diseases. It also has widespread uses in otorhinolaryngology practice. There are many publications on neutrophil counts and neutrophil lymphocyte ratios in patients. Neutrophil counts and rates play an important role in the follow-up and prognosis of many important otolaryngology diseases such as bell palsy, sudden hearing loss, allergic rhinitis, chronic otitis media, nasal polyposis, and chronic rhinosinusitis. In this chapter, the importance of neutrophils in these diseases will be discussed with the literature.

MOG-related disorders: A new cause of imaging-negative myelitis?

2019 ◽  
Vol 26 (4) ◽  
pp. 511-515 ◽  
Author(s):  
Gabrielle Macaron ◽  
Daniel Ontaneda
Keyword(s):  
Tract Infection ◽  
Respiratory Tract ◽  
Respiratory Tract Infection ◽  
High Titer ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Upper Respiratory Tract Infection ◽  
Upper Respiratory Tract ◽  
Initial Testing ◽  
Upper Respiratory

Knowledge on the clinical and radiological phenotype of myelin oligodendrocyte glycoprotein (MOG)–related disorders has been growing. We report the case of a patient who presented with subacute onset myelitis after an upper respiratory tract infection with normal cord imaging at onset and follow-up after 4 months (absence of lesions and atrophy), high-titer positive MOG-IgG, and a broad workup excluding other etiologies. The full clinical and radiological spectrum of MOG-related disorders is yet to be completely understood. Testing for MOG-IgG using cell-based assays should be considered in imaging-negative myelitis particularly if initial testing is non-revealing.

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