scholarly journals Daily Headache in Chronic Migraine Is a Predictive Factor of Response in Patients Who Had Completed Three Sessions of OnabotulinumtoxinA

Toxins ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 432
Author(s):  
Enrique Martínez-Pías ◽  
Ángel L. Guerrero ◽  
Álvaro Sierra ◽  
Javier Trigo ◽  
David García-Azorín

OnabotulinumtoxinA is one of the main preventive treatments for chronic migraine. Despite that up to one third of patients with chronic migraine suffer from daily headache, these individuals have hardly been studied. We conducted a prospective cohort study, including patients with chronic migraine and treated with OnabotulinumtoxinA according to the PREEMPT paradigm. The primary endpoint was to assess whether patients with chronic migraine and daily headache had a different response after three sessions of OnabotulinutoxinA than patients without daily headache. The secondary endpoint was to analyse the presence of predictive factors that could be associated with a higher response to OnabotulinumtoxinA. Patients with daily headache had a reduction of 14.9 (SD: 9.7) headache days per month, patients with 22–29 headache days a reduction of 10.6 (SD: 9.9) days, and patients with 15–21 headache days a reduction of 8.6 (SD: 7.1) days (p < 0.001). In the univariate regression analysis, a higher number of headache days per month at baseline was associated with higher odds of reduction in the number of headache days per month after OnabotulinumtoxinaA treatment (OR: 0.474, 95% CI: 0.278–0.670, p < 0.001). This association was maintained in the multivariate regression analysis (OR: 0.540, 95% CI: 0.333–0.746, p < 0.001). In our sample, daily headache was not associated with a worse response to OnabotulinumtoxinA treatment. A higher frequency of headache at baseline was a predictor of better response to OnabotulinumtoxinA treatment.

2018 ◽  
Vol 76 (1) ◽  
pp. 78-85 ◽  
Author(s):  
Stefano Malinverni ◽  
Anne-Françoise Gennotte ◽  
Monica Schuster ◽  
Stéphane De Wit ◽  
Pierre Mols ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jing Hu ◽  
Chenwei Lv ◽  
Xingxing Hu ◽  
Jiangyun Liu

AbstractThe objective of the study was to evaluate the effect of hypoproteinemia on the prognosis of sepsis patients and the effectiveness of exogenous albumin supplementation. A retrospective cohort study was conducted in adult ICUs. The subjects were 1055 sepsis patients in MIMIC III database from June 2001 to October 2012. There were no interventions. A total of 1055 sepsis patients were enrolled and allocated into two groups based on the lowest in-hospital albumin level: 924 patients were in the hypoproteinemia group (the lowest in-hospital albumin ≤ 3.1 g/dL) and 131 patients were in the normal group (the lowest in-hospital albumin > 3.1 g/dL). A total of 378 patients [331 (35.8%) were in the hypoproteinemia group, and 47 (35.9%) were in the normal group] died at 28 days, and no statistically significant difference was found between the two groups (P = 0.99). The survival analysis of the 28-day mortality rate was performed using the Cox proportional risk model and it was found that the lowest in-hospital albumin level showed no significant effect on the 28-day mortality rate (P = 0.18, 95%CI). Patients in the hypoproteinemia group exhibited a longer length of stay in ICU and hospital and more complications with AKI than those in the normal group. However, multivariate regression analysis found that there was no statistical significance between the two groups. In addition, multivariate regression analysis showed that patients in the hypoproteinemia group had a shorter time without vasoactive drugs and time without mechanical ventilation than those in the normal group (P < 0.01). In the subgroup analysis, univariate analysis and multivariate regression analysis showed that there was no significant difference in the 28-day mortality rate (39.6% vs 37.5%, P = 0.80), the proportion of mechanical ventilation time (P = 0.57), and vasoactive drug time (P = 0.89) between patients with and without albumin supplementation. However, patients in the albumin supplementation group had a longer length of ICU stay and hospital stay than those in the non-supplementation group (P < 0.01). Albumin level may be an indicator of sepsis severity, but hypoproteinemia has no significant effect on the mortality of sepsis patients. Despite various physiological effects of albumin, the benefits of albumin supplementation in sepsis patients need to be evaluated with caution.


2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e14578-e14578
Author(s):  
Joshua Michael Ruch ◽  
Michelle A Anderson ◽  
Suman Lata Sood

e14578 Background: The incidence of VTE is increased in pancreatic cancer. Predictive models for cancer-associated VTE have been developed, but none specific for the pancreas. Our primary objective was to identify risk factors for VTE in outpatients with pancreatic cancer. Secondary objective was to develop a predictive model. Methods: Patients seen at the University of Michigan Comprehensive Cancer Center (UMCC) and previously consented and enrolled in a prospective cohort study were eligible. Inclusion criteria included a diagnosis of pancreatic adenocarcinoma, evaluation at UMCC, and follow up in the Electronic Medical Record (EMR) at least every 6 months. Demographics, clinical data, and VTE events (defined as deep vein thrombosis [DVT], portal vein thrombosis [PVT], or pulmonary embolism [PE]) were obtained from the EMR. A retrospective cohort study was performed including univariate and multivariate regression analysis. Results: Between 2005 and 2011, 92 patients were eligible for analysis. Median follow-up was 263.5 (18-2433) days. Twenty (21.7%) patients had a VTE; 10 (50%) DVT, 2 (10%) PE, 4 (20%) PVT, and 4 (20%) multiple VTEs. Mean (SD) age was 63.4 (8.9) with and 65.6 (11.8) without VTE. 55% of patients with and 47% without VTE were women. Higher body mass index (BMI) (median 28.8 [21.2-44.7] vs. 25.5 [16.4-43.3], p=0.02) and lower platelet count (median 241 [145-323] vs. 288 [75-645], p=0.04) were associated with VTE in univariate analysis. In multivariate regression analysis, lower platelet count (β -0.01, SE 0.004) and lower hemoglobin (β -0.44, SE 0.20) were predictive of VTE after adjusting for BMI, tumor location, and treatment with surgery, chemotherapy or radiation (area under the ROC curve 0.78). Conclusions: Pancreatic cancer outpatients with higher BMI, lower platelet count, and lower hemoglobin were more likely to develop VTE. Other clinical variables did not add additional predictive information. Given the small magnitude of difference, basic clinical criteria alone may be inadequate to identify patients at highest risk for developing VTE who may benefit from thromboprophylaxis. Additional studies are warranted to further define risk factors for VTE in this population, including novel biomarkers.


2008 ◽  
Vol 168 (6) ◽  
pp. 655-665 ◽  
Author(s):  
Artemis Tsitsika ◽  
Elena Critselis ◽  
Georgios Kormas ◽  
Anastasia Filippopoulou ◽  
Despoina Tounissidou ◽  
...  

2020 ◽  
pp. 014556132090139
Author(s):  
Hao Xiong ◽  
Xiaoya Wang ◽  
Genghui Li ◽  
Jingjing Xu ◽  
Jinming Zhai ◽  
...  

Background: Congenital auricular deformities are common diseases in newborn infants. We compared the efficacy of 2 ear molding systems in the nonsurgical management of newborn auricular deformities in Chinese infants. Methods: A total of 462 newborns with auricular deformities were treated with either the EarWell or the LiangEar ear molding systems. The posttreatment outcome was graded as excellent, fair, and poor. The differences in effectiveness between the 2 ear molding systems and factors that may affect the posttreatment outcome were analyzed. Results: Both ear molding systems showed substantial efficacy in the treatment of newborn auricular deformities. The effective rate was comparable between the EarWell and the LiangEar systems for 4 types of auricular deformities (cryptotia, prominent ear, helical rim abnormality, and cup ear), while the costs for the LiangEar systems were half as much as that for the EarWell systems. Multivariate regression analysis showed that earlier time points at treatment initiation, less severe auricular deformities, treatment duration, and breastfeeding were the most significant predictive factors for a better outcome. Conclusion: Our findings demonstrate that using the EarWell and the LiangEar systems are both optimal nonsurgical approaches for treatment of most newborn auricular deformities.


Author(s):  
Ping Wen ◽  
Sheng-Duo Chen ◽  
Jia-Rui Wang ◽  
Ying-He Zeng

This study evaluated the difference in treatment response and survival profiles between drug-eluting bead transarterial chemoembolization (DEB-TACE) and conventional transarterial chemoembolization (cTACE) treatments in Chinese hepatocellular carcinoma (HCC) patients. A total of 120 HCC patients were consecutively enrolled in this prospective cohort study, which showed that DEB-TACE achieved higher complete response (CR) (30.8%) compared with cTACE (7.4%) with no difference in overall response rate (ORR) for patients treated with DEB-TACE and cTACE (80.8% vs. 73.5%). In addition, DEB-TACE was associated with a lower rate of progressive disease (PD) compared with cTACE (1.9% vs. 11.8%). With respect to survival, patients in the DEB-TACE group achieved median progression-free survival (PFS) of 15 months (95% CI 12‐18 months), which was longer than the cTACE group [median PFS 11 months (95% CI 10‐12 months)]. Median overall survival (OS) was also longer with DEB-TACE [25 months (95% CI 22-28 months)] when compared with cTACE [21 months (95% CI 18‐24 months)]. Univariate and multivariate logistic regression analysis showed that DEB-TACE was an independent predictive factor for achieving CR. Univariate Cox’s regression analysis revealed that DEB-TACE was a predictive factor for prolonged PFS and OS, while multivariate analysis demonstrated that DEB-TACE was not an independent factor for predicting PFS or OS. In conclusion, we found that DEB-TACE achieved higher treatment response and prolonged survival compared with cTACE in Chinese HCC patients.


2009 ◽  
Vol 12 (5) ◽  
pp. 545-550 ◽  
Author(s):  
Artemis Tsitsika ◽  
Elena Critselis ◽  
Georgios Kormas ◽  
Eleftheria Konstantoulaki ◽  
Andreas Constantopoulos ◽  
...  

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