Retrospective Analysis Of Efficacy And Tolerability Of Keppra XR In An Outpatient Setting

10.5580/2cb3 ◽  
2012 ◽  
Vol 14 (1) ◽  
Keyword(s):  
Retrospective Analysis ◽  
Outpatient Setting

scholarly journals 116 Retrospective Analysis of Clozapine Augmentation in Treatment-Resistant Schizophrenia in an Outpatient Setting

CNS Spectrums ◽  
2018 ◽  
Vol 23 (1) ◽  
pp. 73-74
Author(s):  
Charles Odom ◽  
Frozan Walyzada ◽  
Pankaj Manocha ◽  
Monika Gashi ◽  
Ashaki Martin ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Treatment Options ◽  
D2 Receptor ◽  
Treatment Strategies ◽  
Outpatient Setting ◽  
Mood Stabilizers ◽  
Adjunctive Treatment ◽  
Supporting Evidence ◽  
Treatment Resistant ◽  
Augmentation Strategies

AbstractStudy ObjectivesThis retrospective analysis hopes to add to the literature about Treatment Resistant Schizophrenia (TRS), augmentation strategies with antipsychotics used in our patient population with the hopes of clarifying what possibilities should be further studied. In addition, we aim to emphasize the need for focusing on individualized treatment and multidisciplinary efforts to ensure compliance and appropriate disposition options.MethodWe reviewed retrospectively 3025 charts of patients between January 2017 to March 2017 in our outpatient department establishing which antipsychotic clozapineaugmentation strategies were being used. We also did a literature review to establish what augmentation strategies are recommended. These patients will then be compared to a random sample of patients in the clinic who were not prescribed clozapine and compared for readmission rate, side effect profile, length of stay while admitted, frequency of clinic attendance and compliance with outpatient appointments.ResultsOut of 3025 patients 35 were prescribed Clozapine as monotherapy and 5 patients had clozapine plus psychopharmacological augmentation. Ages ranged from 21-86. Out of the 39 patients, there were 13 male and 26 female. The predominant diagnosis was mood disorder or MDD with psychotic features followed by schizophrenia. The augmentation antipsychotics used were aripiprazole and risperidone. In the literature, the most frequent augmentation strategy for TRS is adding another antipsychotic with more D2 receptor blockade. Other strategies involve identifying and treating the symptoms not controlled by clozapine.ConclusionsCurrently augmentation of Clozapine in TRS is highly individualized due to lack of supporting evidence to state the contrary. When working with treatmentresistant patients who are not responding to clozapine alone, it is imperative to thoroughly review and consider all treatment options and augmentation strategies. More studies should be done in controlled settings to better evaluate possibilities as well as more evaluations to be done on other ways of augmentation of clozapine. Literature has stated between 20-60% of patients are defined as TRS. Clozapine is considered as one of the most effective treatment available at present time for TRS. Recent literature suggests despite its superior efficacy, as many as 70% of those suffering from TRS on clozapine continue to suffer from positive, negative or cognitive symptoms. The literature has abundant adjunctive treatment strategies such as the addition of antipsychotics, mood stabilizers, antidepressants, or even with the use of electroconvulsive therapy. We emphasize the importance of correctly identifying TRS patients who may benefit from the initiation of clozapine, what would be beneficial for them if they do not respond, how to tailor their treatment to target symptoms not being ameliorated, and recommend treatment in these complex cases be multidisciplinary.Funding AcknowledgementsNo funding.

Retrospective Analysis of Fractionated High-Dose Melphalan (F-MEL) and Bortezomib-Thalidomide-Dexamethasone (VTD) with Autotransplant (AT) Support for Advanced and Refractory Multiple Myeloma (AR-MM).

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 3102-3102 ◽  
Author(s):  
Mauricio Pineda-Roman ◽  
Michelle H. Fox ◽  
Klaus A. Hollmig ◽  
Elias J. Anaissie ◽  
Frits van Rhee ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Single Agent ◽  
Patient Characteristics ◽  
Median Number ◽  
Outpatient Setting ◽  
High Dose ◽  
Life Threatening ◽  
Grade 3 ◽  
High Dose Melphalan ◽  
Asco 2006

Abstract Background: MEL is an effective and safe AT regimen for MM, usually administered as a single dose at 200mg/m2; mucositis is dose-limiting. There is recent pre-clinical and clinical evidence of synergistic interaction of MEL with both immuno-modulatory agents (thalidomide, MPT [Palumbo, Lancet, 2006], lenalidomide, RMP [Palumbo, ASCO, 2006]) and with the first-in-class proteasome inhibitor, bortezomib (VelcadeR) (VMP, Mateos, ASCO, 2006). We previously reported on the marked activity of VTD in AR-MM, even in a setting of resistance to single agent thalidomide and bortezomib (Blood, January, 2004). In a clinical setting of AR-MM, we administered IV MEL after bortezomib (V) on days 1, 4, 7 +/− d 10, along with daily thalidomide (T) and dexamethasone (D), in order to achieve maximum pharmacological synergy of all 4 drugs. Patients and Methods: A retrospective analysis was performed of 22 patients with AR-MM, who were treated with the F-MEL-VTD regimen with the following MEL fractions: 3-F at 50–80mg/m2 for total doses of 150–240 mg/m2, 18 patients; 4-F at 50–60mg/m2 for total doses of 200–240 mg/m2, 4 patients; 5-F at 15–50 mg/m2 for total doses of 150–250 mg/m2, 2 patients. V was given at doses of 1.0–1.3 mg/m2 immediately preceding each MEL fraction; T was dosed at 100–200 mg/d from day 1 until the last day of MEL; D was given at 20–40 mg on the day of and after V and MEL. Two patients received 2 cycles of F-MEL-VTD, so that 24 courses could be evaluated. Results: Patient characteristics included a median age of 61yr (range, 46–75yr), median creatinine of 0.85mg/dL (range, 0.6–1.9mg/dL); abnormal cytogenetics (CA) were present in 15/22 (68%) - typifying the high-risk nature of their disease; the median number of prior regimens was 6 (range, 1–14); prior AT: 0 in 3 patients, 1 in 11, 2 in 8 and 3 in 1 patients. F-MEL-VTD was initiated in the outpatient setting in 15, only 3 of whom required subsequent hospital admission. Toxicities included grade 3–4 diarrhea mainly due to C. difficile in 8 (33%) and oral mucositis > grade 2 in only 1; grade 3 fever in 3 (12%) with Aspergillus pneumonia in 2 patients; no transplant-related mortality. Hematopoietic recovery was excellent with median times to ANC>500/microL of 10 days (range, 8–19d) and platelets > 50.000/microL of 17 days (range, 10–24d); 2 patients receiving 1.88 and 1.95 x 106 CD34+ cells/kg failed to recover platelet counts to >50.000/microL. Response rates were measured at 6 weeks, using Blade criteria: CR, 11 (46%) with an additional 3 achieving near-CR (>=n-CR, 59%); PR, 4 (17%); the remainder 24% had transient or no response. Conclusion: F-MEL-VTD was remarkably well tolerated, permitting total MEL dose escalation to > 200mg/m2 in 13 of 22 patients, without incurring grade >2 stomatitis in the majority of patients. Due to the protracted administration involved in this regimen, the median duration of neutropenia was 10 d (range, 8 to 19d) with life-threatening infections observed in only 2 patients. These encouraging data form the basis for a randomized trial of VTD followed by standard 1-F MEL versus 3-F MEL with VTD preceding each MEL dose.

Trigeminal nerve injuries after mandibular oral surgery in a university outpatient setting—a retrospective analysis of 1,559 cases

2014 ◽  
Vol 19 (1) ◽  
pp. 149-157 ◽  
Author(s):  
Herbert Deppe ◽  
Thomas Mücke ◽  
Stefan Wagenpfeil ◽  
Marco Kesting ◽  
Eva Linsenmeyer ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Trigeminal Nerve ◽  
Oral Surgery ◽  
Outpatient Setting ◽  
Nerve Injuries ◽  
Trigeminal Nerve Injuries

scholarly journals An Assessment of Azithromycin Prescribed Interactions’ at the Outpatient Setting

2020 ◽  
pp. 102-107
Author(s):  
Nehad J. Ahmed ◽  
Altaf Ali Mangi ◽  
Menshawy A. Menshawy ◽  
Ziyad S. Almalki ◽  
Mohammed A. Alhajri
Keyword(s):  
Drug Interactions ◽  
Retrospective Analysis ◽  
Muscle Pain ◽  
Public Hospital ◽  
Heart Rhythm ◽  
Antibiotic Use ◽  
Outpatient Setting ◽  
International Standard ◽  
Common Drug

Aims: The present study was designed to identify and assess the severity of azithromycin interactions with other drugs in the outpatient setting in Alkharj. Methodology: A retrospective analysis was performed of azithromycin prescriptions in the outpatient setting in a public hospital in Alkharj in order to determine the incidence of interactions between azithromycin and other medications. Results: There were 182 prescriptions included in the study. There was a major interaction in only 1 prescription (0.55%) and moderate interactions in 15.30% of the prescriptions. So the percentage of overall interactions was about 20.88%. The most common drug interactions in the present study were between azithromycin and salbutamol. Conclusion: It can be concluded that the interactions between azithromycin with other medications were common, but these interactions could lead to irregular heart rhythm and lead to muscle pain and weakness. Adoption of international standard and locally conformable guidelines of antibiotic use can help in avoiding such problems.

scholarly journals Fever of unknown origin in the outpatient setting: A retrospective analysis of 30 cases of familial Mediterranean fever

2016 ◽  
Vol 39 (2) ◽  
pp. 130-139 ◽  
Author(s):  
Junwa KUNIMATSU ◽  
Junko MAEDA ◽  
Riri WATANABE ◽  
On KATO ◽  
Dai KISHIDA ◽  
...  
Keyword(s):  
Familial Mediterranean Fever ◽  
Retrospective Analysis ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Outpatient Setting ◽  
Mediterranean Fever

Sound Production Treatment for Acquired Apraxia of Speech: An Examination of Dosage in Relation to Probe Performance

2020 ◽  
pp. 1-16
Author(s):  
Julie L. Wambaugh ◽  
Lydia Kallhoff ◽  
Christina Nessler
Keyword(s):  
Retrospective Analysis ◽  
Sound Production ◽  
Apraxia Of Speech ◽  
Practice Schedule ◽  
Practice Schedules ◽  
Baseline Performance ◽  
The Mean ◽  
Number Of Treatment ◽  
The Impact

Purpose This study was designed to examine the association of dosage and effects of Sound Production Treatment (SPT) for acquired apraxia of speech. Method Treatment logs and probe data from 20 speakers with apraxia of speech and aphasia were submitted to a retrospective analysis. The number of treatment sessions and teaching episodes was examined relative to (a) change in articulation accuracy above baseline performance, (b) mastery of production, and (c) maintenance. The impact of practice schedule (SPT-Blocked vs. SPT-Random) was also examined. Results The average number of treatment sessions conducted prior to change was 5.4 for SPT-Blocked and 3.9 for SPT-Random. The mean number of teaching episodes preceding change was 334 for SPT-Blocked and 179 for SPT-Random. Mastery occurred within an average of 13.7 sessions (1,252 teaching episodes) and 12.4 sessions (1,082 teaching episodes) for SPT-Blocked and SPT-Random, respectively. Comparisons of dosage metric values across practice schedules did not reveal substantial differences. Significant negative correlations were found between follow-up probe performance and the dosage metrics. Conclusions Only a few treatment sessions were needed to achieve initial positive changes in articulation, with mastery occurring within 12–14 sessions for the majority of participants. Earlier occurrence of change or mastery was associated with better follow-up performance. Supplemental Material https://doi.org/10.23641/asha.12592190

Lingual Strengthening: Success in an Outpatient Setting

2015 ◽  
Vol 24 (2) ◽  
pp. 71-74
Author(s):  
Ali Meier
Keyword(s):  
Oropharyngeal Dysphagia ◽  
Patient Discharge ◽  
Outpatient Setting ◽  
Oral Performance ◽  
Exercise Protocol ◽  
Anterior Position ◽  
Tongue Position ◽  
Bolus Propulsion ◽  
Posterior Position

In the last decade or more, dysphagia research has investigated the effect of lingual strengthening on oropharyngeal dysphagia with promising results. Much of this research has utilized strengthening devices such as the Iowa Oral Performance Instrument (IOPI) or the Madison Oral Strengthening Therapeutic (MOST) Device. Patients are often given a device to use, and are able to complete an exercise protocol daily or multiple times per day. This case study was completed to determine the effectiveness of using the IOPI in an outpatient clinic where therapy was conducted two to three times per week. The patient was seen post tongue resection due to oropharyngeal cancer. From initiation of IOPI use to patient discharge, the patient demonstrated a 71% increase in lingual strength at the anterior position, a 61% increase at the posterior position, and a 314% increase at the base of tongue position. His diet advanced from NPO to general based on gains in lingual strength and bolus propulsion.

Abstract #1142: Improving Diabetes Management By Residents in an Outpatient Setting

2017 ◽  
Vol 23 ◽  
pp. 312-313
Author(s):  
Jahnavi Sagi ◽  
Lavanya Vuppu ◽  
Medha Joshi
Keyword(s):  
Diabetes Management ◽  
Outpatient Setting
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