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Yamada Z, Muraoka S, Kawazoe M, Hirose W, Kono H, Yasuda S, Sugihara T, Nanki T. Long-term effects of abatacept on atherosclerosis and arthritis in older vs. younger patients with rheumatoid arthritis: 3-year results of a prospective, multicenter, observational study. Arthritis Res Ther 2024; 26:87. [PMID: 38627782 PMCID: PMC11022315 DOI: 10.1186/s13075-024-03323-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/14/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND We aimed to reveal the effect of abatacept (ABT) on atherosclerosis in rheumatoid arthritis (RA) patients, 3-year efficacy for arthritis, and safety in a population of older vs. younger patients. METHODS In this open-label, prospective, observational study, patients were stratified into four groups: younger (20-64 years old) and older (≥ 65 years) patients taking ABT (AY and AO) and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) (CY and CO). Primary endpoints were change from baseline in mean intima-media thickness (IMT) of the common carotid artery, IMT max (bulbus, bifurcation, and internal and common carotid artery), and plaque score at Week 156. Disease activity, retention rate, and adverse effects were also evaluated. RESULTS The ABT group (AY + AO) tended to have smaller increases in mean IMT, max IMT, and plaque score than the csDMARD group (CY + CO) at Week 156, although the differences between groups were not statistically significant. Multivariate analysis showed significantly lower increases in plaque score with ABT than with csDMARDs, only when considering disease activity at 156 weeks (p = 0.0303). Proportions of patients with good or good/moderate European League Against Rheumatism response were higher in the ABT group, without significant difference between older and younger patients. No significant differences were observed in ABT retention rates between older and younger patients. Serious adverse effects, especially infection, tended to be more frequent with ABT than with csDMARDs, although no significant differences were found. CONCLUSIONS ABT may decelerate atherosclerosis progression and may be useful for patients with high risk of cardiovascular disease, such as older patients. TRIAL REGISTRATION NUMBER UMIN000014913.
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Affiliation(s)
- Zento Yamada
- Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Sei Muraoka
- Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Mai Kawazoe
- Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Wataru Hirose
- Hirose Clinic of Rheumatology, 2-14-7 Midoricho, Tokorozawa, 359-1111, Saitama, Japan
| | - Hajime Kono
- Department of Internal Medicine, Teikyo University School of Medicine, 2-11-1, Kaga, Itabshi- ku, Tokyo, 173-8606, Japan
| | - Shinsuke Yasuda
- Department of Rheumatology, Endocrinology and Nephrology, Graduate School of Medicine, Faculty of Medicine, Hokkaido University, Kita 14, Nishi 5, Kita-ku, Sapporo, 060-8648, Japan
| | - Takahiko Sugihara
- Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
- Department of Medicine and Rheumatology, Tokyo Metropolitan Geriatric Hospital, 35-2, Sakaecho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Toshihiro Nanki
- Division of Rheumatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
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Xiong L, He H, Wang D, Liu T, Xiao N. Effectiveness and safety of Lacosamide in pediatric patients with epilepsy under four years: Results from a prospective cohort study in China. Seizure 2024; 118:71-79. [PMID: 38643678 DOI: 10.1016/j.seizure.2024.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/25/2024] [Accepted: 04/09/2024] [Indexed: 04/23/2024] Open
Abstract
BACKGROUND Lacosamide (LCM) has shown promising efficacy and safety outcomes in clinical trials. However, the evidence is limited among pediatric patients especially under four years in real-world. The study investigated the treatment outcomes and safety of LCM in patients under four years based on the data of the epilepsy registry of Children in China. METHODS A prospective cohort study was conducted among patients under 4 years who newly received LCM as monotherapy or adjunctive therapy. The treatment outcomes were measured by retention rate of LCM, 50 % response rates and seizure-free rates during follow-up. The retention rate of LCM was assessed using the Kaplan-Meier survival model. Adverse events were reported as a percentage of all participants. RESULTS Of 109 participants (mean follow-up: 18.6 months), 59 received LCM as monotherapy and 50 as adjunctive therapy. Sixty patients had focal epilepsy, 44 had generalized epilepsy and 5 had combined generalized and focal epilepsy. 70 % of patients in the monotherapy group and 41 % in the adjunctive therapy group remained on LCM treatment without additional treatments for at least one year. In patients with monotherapy, 50 % response rate and seizure-free rate were 75 % and 56 % at 12 months, respectively. In adjunctive therapy group, these rates were 51 % and 36 %, respectively. Lower baseline seizure frequency in both treatment groups (monotherapy: p < 0.001; adjunctive therapy: p = 0.02) and younger age groups within the monotherapy group (P = 0.04) correlated with a higher LCM retention rate. Adverse events were reported by 15 patients (13.8 %), with somnolence being the most common (7 of 15 patients). CONCLUSION With a comprehensive information and high-quality of data, the study demonstrates the effective treatment outcome and safety of LCM. The study adds reliable evidence to exiting real-word evidence of LCM in the specific age group of patients with epilepsy to fill the evidence gap.
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Affiliation(s)
- Li Xiong
- Department of Rehabilitation, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, No.136 Zhongshan Er Road, Yuzhong District, Chongqing 400000, China
| | - Huan He
- Department of Rehabilitation, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, No.136 Zhongshan Er Road, Yuzhong District, Chongqing 400000, China
| | - Duan Wang
- Department of Rehabilitation, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, No.136 Zhongshan Er Road, Yuzhong District, Chongqing 400000, China
| | - Tailin Liu
- Department of Rehabilitation, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, No.136 Zhongshan Er Road, Yuzhong District, Chongqing 400000, China
| | - Nong Xiao
- Department of Rehabilitation, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, No.136 Zhongshan Er Road, Yuzhong District, Chongqing 400000, China.
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Li L, Chen L, Chen S, Zhang Y, Xu Y, Zhi X, Meng X, Shen Z, Liu Y, Yang D, Tang L. The cumulative effects of cascade reservoirs control nitrogen and phosphorus flux: Base on biogeochemical processes. Water Res 2024; 252:121177. [PMID: 38290240 DOI: 10.1016/j.watres.2024.121177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/08/2024] [Accepted: 01/20/2024] [Indexed: 02/01/2024]
Abstract
The reservoir serves as a water source, a flood control structure, a navigational aid, and also impacts the downstream ecosystem as well as the reservoir zone. However, debate exists about effectiveness of cascade reservoirs in controlling the transportation of nutrients, particularly in the Yangtze River basin, which has been significantly affected by reservoir development. This research develops a new model X-NPSEM (X with Nitrogen and Phosphorus Steady-state Reservoir Model) based on biogeochemical processes of nitrogen and phosphorus reaction for investigating the dynamic storage capacity of cascade reservoirs at both reservoir- and watershed scales. Then the cumulative effects of cascade reservoirs and the related mechanism were investigated in Fujiang watershed, China. Based on the results, cascade reservoirs retained 16.3 % of nitrogen fluxes and 37.6 % of phosphorus fluxes annually. Downstream reservoirs have higher retention rates of phosphorus (0.48/d) compared to upstream reservoirs (0.10/d), mainly due to inflow sediment. Nitrogen retention rates show seasonal variations: wet season (0.21/d) and dry season (0.17/d). These fluctuations in nitrogen retention are primarily influenced by changes in temperature rather than other factors such as operation period, nitrogen and phosphorus concentration, or the nitrogen/phosphorus ratio. In upstream, the concentration of sediment entering the reservoir plays a decisive role in the transformation of P retention from sink to source. The X-NPSRM coupler model could be used for global reservoir operation and watershed management.
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Affiliation(s)
- Leifang Li
- School of Environment, Beijing Normal University, Beijing 100875, China; Department of Hydraulic Engineering, Tsinghua University, Beijing 100084, China
| | - Lei Chen
- School of Environment, Beijing Normal University, Beijing 100875, China; State Key Laboratory of Water Environment Simulation, School of Environment, Beijing Normal University, Beijing 100875, China.
| | - Shibo Chen
- School of Environment, Beijing Normal University, Beijing 100875, China; State Key Laboratory of Water Environment Simulation, School of Environment, Beijing Normal University, Beijing 100875, China
| | - Yuhan Zhang
- School of Environment, Beijing Normal University, Beijing 100875, China; State Key Laboratory of Water Environment Simulation, School of Environment, Beijing Normal University, Beijing 100875, China
| | - Yanzhe Xu
- School of Environment, Beijing Normal University, Beijing 100875, China; State Key Laboratory of Water Environment Simulation, School of Environment, Beijing Normal University, Beijing 100875, China
| | - Xiaosha Zhi
- School of Environment, Beijing Normal University, Beijing 100875, China; State Key Laboratory of Water Environment Simulation, School of Environment, Beijing Normal University, Beijing 100875, China
| | - Xinyi Meng
- School of Environment, Beijing Normal University, Beijing 100875, China; State Key Laboratory of Water Environment Simulation, School of Environment, Beijing Normal University, Beijing 100875, China
| | - Zhenyao Shen
- School of Environment, Beijing Normal University, Beijing 100875, China; State Key Laboratory of Water Environment Simulation, School of Environment, Beijing Normal University, Beijing 100875, China; Key Laboratory of Hydrology and Sediment Science of Ministry of Education, Beijing 100875, China
| | - Yong Liu
- State Environmental Protection Key Laboratory of All Materials Flux in River Ecosystems, College of Environment science and Engineering, Peking University, Beijing 100871, China
| | - Dawen Yang
- Department of Hydraulic Engineering, Tsinghua University, Beijing 100084, China
| | - Lihua Tang
- Department of Hydraulic Engineering, Tsinghua University, Beijing 100084, China
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Still MB, Tedesco D, Hawkins C, Putnam H. Improving access to melarsomine therapy: treating canine heartworm infection in a high-volume, outpatient community clinic setting. Parasit Vectors 2024; 17:119. [PMID: 38459570 PMCID: PMC10924336 DOI: 10.1186/s13071-024-06153-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 01/22/2024] [Indexed: 03/10/2024] Open
Abstract
BACKGROUND Models that provide high-quality veterinary care for more affordable prices are emerging, but not well documented outside of wellness and preventative care. Effective treatment guidelines for heartworm disease have been developed by the American Heartworm Society; however, not all owners are able to access treatment due to the high costs associated with sick and emergency care services. METHODS To increase access to high-quality adulticidal treatment of canine heartworm disease, we developed and implemented a technician-leveraged heartworm treatment protocol for high-volume, outpatient community clinic settings based on the American Heartworm Society guidelines. Modifications were few and included limited pre-treatment blood work, pre-injection sedation, post-injection pain medication, and a reduced exercise restriction period. We monitored retention rates for 556 dogs throughout treatment, evaluated treatment success (defined as no antigen detection 9 months post treatment) for patients that returned for post-treatment antigen testing, and reported on adverse reactions and therapy adherence throughout treatment. RESULTS Of the patients that began adulticide therapy, 539/556 (97%) successfully completed the three-injection series. No microfilariae were detected in 99% (428/433) of those who returned for post-injection microfilaria testing. Among those that returned for or reported the results of post-injection antigen testing, no antigen was detected for 99% (245/248) and no microfilariae were detected for 99.5% (200/201). During the course of treatment, 483/539 (90%) of patients experienced at least one adverse reaction, with the most frequently reported types being behavioral and injection site reactions. 25/539 (4.6%) of owners sought additional medical care for adverse reactions at some point during the treatment course. The overall mortality rate was 1.3% (7/556). CONCLUSIONS This study represents the first evaluation of a heartworm treatment protocol optimized for implementation in a high-volume, outpatient community clinic setting. Our findings align with those previously reported in private practice or tertiary referral centers, illustrating that through the inclusion of pre-treatment blood work, employing short-acting or reversible sedatives, ensuring proper analgesia, minimizing the use of ancillary diagnostics, reducing the duration of in-clinic monitoring while focusing on outpatient care, and maximizing technician involvement, we can deliver effective and safe melarsomine therapy at a more affordable cost to pet owners.
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Affiliation(s)
- Meghan B Still
- Research, Data, and Analytics, Emancipet, Austin, TX, USA
| | - Dana Tedesco
- Clinical Services Group, Emancipet, Austin, TX, USA
| | - Christina Hawkins
- Community Medicine, American Society for the Prevention of Cruelty to Animals, New York, NY, USA
| | - Holly Putnam
- Clinical Services Group, Emancipet, Austin, TX, USA.
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Monnot M, Ollivier J, Taligrot H, Garry P, Cordier C, Stravakakis C, Le Guyader FS, Moulin P. Retention of Virus Versus Surrogate, by Ultrafiltration in Seawater: Case Study of Norovirus Versus Tulane. Food Environ Virol 2024; 16:14-24. [PMID: 38184502 DOI: 10.1007/s12560-023-09574-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/28/2023] [Indexed: 01/08/2024]
Abstract
In the field of chemical engineering and water treatment, the study of viruses, included surrogates, is well documented. Often, surrogates are used to study viruses and their behavior because they can be produced in larger quantities in safer conditions and are easier to handle. In fact, surrogates allow studying microorganisms which are non-infectious to humans but share some properties similar to pathogenic viruses: structure, composition, morphology, and size. Human noroviruses, recognized as the leading cause of epidemics and sporadic cases of gastroenteritis across all age groups, may be mimicked by the Tulane virus. The objectives of this work were to study (i) the ultrafiltration of Tulane virus and norovirus to validate that Tulane virus can be used as a surrogate for norovirus in water treatment process and (ii) the retention of norovirus and the surrogate as a function of water quality to better understand the use of the latter pathogenic viruses. Ultrafiltration tests showed significant logarithmic reduction values (LRV) in viral RNA: around 2.5 for global LRV (i.e., based on the initial and permeate average concentrations) and between 2 and 6 for average LRV (i.e., retention rate considering the increase of viral concentration in the retentate), both for norovirus and the surrogate Tulane virus. Higher reduction rates (from 2 to 6 log genome copies) are obtained for higher initial concentrations (from 101 to 107 genome copies per mL) due to virus aggregation in membrane lumen. Tulane virus appears to be a good surrogate for norovirus retention by membrane processes.
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Affiliation(s)
- M Monnot
- Aix Marseille Univ., CNRS, Centrale Marseille, M2P2 UMR 7340, Equipe Procédés Membranaires (EPM), Europôle de l'Arbois, Pavillon Laennec, Hall C, BP80, 13545, Aix-en-Provence, France
| | - J Ollivier
- Ifremer - U. Microbiologie, Aliment, Santé et Environnement (LSEM/RBE), Rue de l'Ile d'Yeu, BP 21105, 44311, Nantes, Cedex 3, France
| | - H Taligrot
- Aix Marseille Univ., CNRS, Centrale Marseille, M2P2 UMR 7340, Equipe Procédés Membranaires (EPM), Europôle de l'Arbois, Pavillon Laennec, Hall C, BP80, 13545, Aix-en-Provence, France
| | - P Garry
- Ifremer - U. Microbiologie, Aliment, Santé et Environnement (LSEM/RBE), Rue de l'Ile d'Yeu, BP 21105, 44311, Nantes, Cedex 3, France
| | - C Cordier
- Aix Marseille Univ., CNRS, Centrale Marseille, M2P2 UMR 7340, Equipe Procédés Membranaires (EPM), Europôle de l'Arbois, Pavillon Laennec, Hall C, BP80, 13545, Aix-en-Provence, France
| | - C Stravakakis
- Ifremer - EMMA Plateforme Expérimentale Mollusques Marins Atlantique, 85230, Bouin, France
| | - F S Le Guyader
- Ifremer - U. Microbiologie, Aliment, Santé et Environnement (LSEM/RBE), Rue de l'Ile d'Yeu, BP 21105, 44311, Nantes, Cedex 3, France
| | - P Moulin
- Aix Marseille Univ., CNRS, Centrale Marseille, M2P2 UMR 7340, Equipe Procédés Membranaires (EPM), Europôle de l'Arbois, Pavillon Laennec, Hall C, BP80, 13545, Aix-en-Provence, France.
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Hu Z, Liu Q, Tian X, Li L, Wu W, Gao W, Li X. Resumption of production operations during the silent disposal period of African swine fever outbreaks: a case study. Porcine Health Manag 2023; 9:43. [PMID: 37817220 PMCID: PMC10563274 DOI: 10.1186/s40813-023-00338-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/21/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Batch production, a widely implemented production model in large-scale pig farms, was characterized by its long-term duration, cost-effectiveness, and efficiency. Nevertheless, the recent occurrence of African swine fever (ASF) outbreaks in China has necessitated the implementation of discreet mating operations within this model, leading to disruptions in production cycles and substantial indirect losses. CASE PRESENTATION This study implemented a novel operational procedure, which involved the division of risk areas for zone management and allowed mating operations, in 12 farms experiencing ASF outbreaks. Another 12 farms were used as a control group, employing the old procedure. Subsequently, the prognoses of both the old and new procedures were calculated and analyzed. The findings indicate that the new method resulted in an enhanced retention rate and reduced non-productive days (NPD), without impacting the positive detection rate and disposal time. Consequently, this approach significantly mitigated economic losses (p < 0.05). CONCLUSION The efficacy of the novel procedure in mitigating the indirect economic losses stemming from ASF outbreaks, through the reduction of NPD while maintaining retention rates and disposition days, has been substantiated. This methodology has demonstrated feasibility in extensive pig farming operations and exhibits promise for broader application.
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Affiliation(s)
- Zhiqiang Hu
- Shandong Engineering Laboratory of Pig and Poultry Healthy Breeding and Disease Diagnosis Technology, Xiajin New Hope Liuhe Agriculture and Animal Husbandry Co., Ltd, Xiajin Economic Development Zone, Qingwo Venture Park, Dezhou, 253200, Shandong Province, P. R. China
- Shandong New Hope Liuhe Co.,Ltd, No. 592-26 Jiushui East Road Laoshan District, Qingdao, 266100, Shandong, P. R. China
- Shandong New Hope Liuhe Agriculture and Animal Husbandry Technology Co., Ltd (NHLH Academy of Swine Research), 6596 Dongfanghong East Road Yuanqiao Town, Dezhou, 253000, Shandong, People's Republic of China
- China Agriculture Research System-Yangling Comprehensive test Station, Intersection of Changqing Road and Park Road 1, Yangling District, Xianyang, P. R. China
| | - Qingyuan Liu
- Shandong Engineering Laboratory of Pig and Poultry Healthy Breeding and Disease Diagnosis Technology, Xiajin New Hope Liuhe Agriculture and Animal Husbandry Co., Ltd, Xiajin Economic Development Zone, Qingwo Venture Park, Dezhou, 253200, Shandong Province, P. R. China
- Shandong New Hope Liuhe Co.,Ltd, No. 592-26 Jiushui East Road Laoshan District, Qingdao, 266100, Shandong, P. R. China
- Shandong New Hope Liuhe Agriculture and Animal Husbandry Technology Co., Ltd (NHLH Academy of Swine Research), 6596 Dongfanghong East Road Yuanqiao Town, Dezhou, 253000, Shandong, People's Republic of China
| | - Xiaogang Tian
- Shandong Engineering Laboratory of Pig and Poultry Healthy Breeding and Disease Diagnosis Technology, Xiajin New Hope Liuhe Agriculture and Animal Husbandry Co., Ltd, Xiajin Economic Development Zone, Qingwo Venture Park, Dezhou, 253200, Shandong Province, P. R. China
- Shandong New Hope Liuhe Co.,Ltd, No. 592-26 Jiushui East Road Laoshan District, Qingdao, 266100, Shandong, P. R. China
- Shandong New Hope Liuhe Agriculture and Animal Husbandry Technology Co., Ltd (NHLH Academy of Swine Research), 6596 Dongfanghong East Road Yuanqiao Town, Dezhou, 253000, Shandong, People's Republic of China
| | - Lulu Li
- Shandong Engineering Laboratory of Pig and Poultry Healthy Breeding and Disease Diagnosis Technology, Xiajin New Hope Liuhe Agriculture and Animal Husbandry Co., Ltd, Xiajin Economic Development Zone, Qingwo Venture Park, Dezhou, 253200, Shandong Province, P. R. China
- Shandong New Hope Liuhe Co.,Ltd, No. 592-26 Jiushui East Road Laoshan District, Qingdao, 266100, Shandong, P. R. China
| | - Weisheng Wu
- Shandong Engineering Laboratory of Pig and Poultry Healthy Breeding and Disease Diagnosis Technology, Xiajin New Hope Liuhe Agriculture and Animal Husbandry Co., Ltd, Xiajin Economic Development Zone, Qingwo Venture Park, Dezhou, 253200, Shandong Province, P. R. China
- Shandong New Hope Liuhe Co.,Ltd, No. 592-26 Jiushui East Road Laoshan District, Qingdao, 266100, Shandong, P. R. China
| | - Wenchao Gao
- Shandong Engineering Laboratory of Pig and Poultry Healthy Breeding and Disease Diagnosis Technology, Xiajin New Hope Liuhe Agriculture and Animal Husbandry Co., Ltd, Xiajin Economic Development Zone, Qingwo Venture Park, Dezhou, 253200, Shandong Province, P. R. China
- Shandong New Hope Liuhe Co.,Ltd, No. 592-26 Jiushui East Road Laoshan District, Qingdao, 266100, Shandong, P. R. China
- Shandong New Hope Liuhe Agriculture and Animal Husbandry Technology Co., Ltd (NHLH Academy of Swine Research), 6596 Dongfanghong East Road Yuanqiao Town, Dezhou, 253000, Shandong, People's Republic of China
| | - Xiaowen Li
- Shandong Engineering Laboratory of Pig and Poultry Healthy Breeding and Disease Diagnosis Technology, Xiajin New Hope Liuhe Agriculture and Animal Husbandry Co., Ltd, Xiajin Economic Development Zone, Qingwo Venture Park, Dezhou, 253200, Shandong Province, P. R. China.
- Key Laboratory of Feed and Livestock and Poultry Products Quality & Safety Control, Ministry of Agriculture and Rural Affairs, New Hope Liuhe Co., Ltd, 316 Jinshi Road, Chengdu, 610100, Sichuan, P. R. China.
- Shandong New Hope Liuhe Co.,Ltd, No. 592-26 Jiushui East Road Laoshan District, Qingdao, 266100, Shandong, P. R. China.
- Shandong New Hope Liuhe Agriculture and Animal Husbandry Technology Co., Ltd (NHLH Academy of Swine Research), 6596 Dongfanghong East Road Yuanqiao Town, Dezhou, 253000, Shandong, People's Republic of China.
- China Agriculture Research System-Yangling Comprehensive test Station, Intersection of Changqing Road and Park Road 1, Yangling District, Xianyang, P. R. China.
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Khalaf R, Meyers A, Sadeghi P, Reyes J, Fodor R, Jo D, Xia T, Papay F, Rampazzo A, Gharb BB. Efficacy of virtual plastic surgery encounters in establishment of care and surgical conversion. J Plast Reconstr Aesthet Surg 2023; 85:299-308. [PMID: 37541046 DOI: 10.1016/j.bjps.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 07/02/2023] [Accepted: 07/04/2023] [Indexed: 08/06/2023]
Abstract
BACKGROUND The efficacy of virtual visits in converting new patients into established patients undergoing surgical treatment has not been demonstrated. The aim of this study was to evaluate patient retention and surgical conversion rate after an initial virtual plastic surgery consultation. METHODS An IRB-approved retrospective review of all new plastic surgery patients seen between May and August 2020 at a single institution was conducted. The initial encounter type, chief complaint, demographics, treatment recommendation, insurance approval rate, number and modality of pre- and postoperative visits, time to procedure, follow up, and complications were recorded. Patient retention and surgery conversion rate were calculated. Statistical analysis was performed with Chi-squared test, Fisher's exact test, and unpaired t-test. RESULTS In total, the records of 1889 new patients were reviewed (1635 in-person, 254 virtual). Virtual patients were younger (44.5 ± 19.0 versus 49.5 ± 20.7 years, p < 0.001), and nearly half resided greater than 50 miles away (42% versus 16%, p < 0.001). Virtual patients more frequently presented for cosmetic surgery (14% versus 7%, p < 0.001), lymphedema (15% versus 3%, p < 0.001), and gender dysphoria (11% versus 2%, p < 0.001). In-person patients presented more often for trauma (18% versus 5%, p < 0.001), elective hand complaints (16% versus 3%, p < 0.001), and breast reconstruction (9% versus 4%, p < 0.01). There were no differences in patient retention (p = 0.45) and procedure conversion rate (p = 0.21) between the groups. CONCLUSION Telemedicine provides an opportunity to increase the practice catchment area and is as effective as in-person first encounters for establishing care and transition to surgery.
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Affiliation(s)
- Ryan Khalaf
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Abigail Meyers
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Payam Sadeghi
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Jose Reyes
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - R'ay Fodor
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Diane Jo
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Thomas Xia
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Francis Papay
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
| | - Antonio Rampazzo
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH, USA
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Lim SC, Lee WG, Kim DW, Kim KK, Shon YM, Park J, Lee Y, Seo DW. Safety and effectiveness of perampanel monotherapy after adjunctive therapy through retention rate in subjects with focal-onset seizures with or without focal to bilateral tonic-clonic seizures: A multicenter retrospective study in Korea. Epilepsy Behav 2023; 145:109291. [PMID: 37336136 DOI: 10.1016/j.yebeh.2023.109291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 05/26/2023] [Accepted: 05/27/2023] [Indexed: 06/21/2023]
Abstract
OBJECTIVE To assess the effectiveness and tolerability of perampanel monotherapy following conversion from adjunctive therapy. METHODS This was a multicenter, retrospective, non-interventional study of Korean patients aged ≥12 years with focal-onset seizures (FOS) with or without focal to bilateral tonic-clonic seizures. Data were extracted from electronic medical records of perampanel-treated patients from 1 February 2016 to 31 October 2020. Kaplan-Meier estimated retention rates, effectiveness, and safety were recorded. RESULTS Subjects (n = 66, mean age 46.2 years) were mostly male (68.2%) with focal to bilateral tonic-clonic seizure (71.2%). Mean duration of illness was 86.3 months. Retention rates after conversion to perampanel monotherapy at 3, 6, and 12 months (primary outcome) were 96.0%, 96.0%, and 75.6%, respectively. Overall retention rates in patients receiving perampanel as adjunctive or monotherapy at 3, 6, 12, 18, and 24 months after perampanel add-on were 100%, 98.3%, 95.9%, 92.6%, and 92.6%, respectively. Mean retention duration was 41.2 months (overall perampanel administration) and 21.4 months (monotherapy). Mean seizure frequency/28 days in the Full Analysis Set (n = 61) was comparable for adjunctive and monotherapy (0.2 ± 0.79 vs 0.2 ± 0.64; change between adjunctive and monotherapy periods: 0.0 ± 0.59; p = 0.498). Perampanel was well tolerated and no new safety signals were identified. Dizziness (4.6%), only reported during adjunctive therapy, was the most common treatment-emergent adverse event. CONCLUSIONS Conversion to perampanel monotherapy from adjunctive therapy showed promising results in subjects with FOS with/without focal to bilateral tonic-clonic seizures; further studies in a larger population are needed to confirm these encouraging data.
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Affiliation(s)
- Sung Chul Lim
- Department of Neurology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Won Gu Lee
- Department of Neurology, Kosin University Gospel Hospital, University of Kosin College of Medicine, Busan, Republic of Korea
| | - Dong Wook Kim
- Department of Neurology, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Kwang Ki Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, Republic of Korea
| | - Young-Min Shon
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | | | - Yoona Lee
- Eisai Korea Inc., Seoul, Republic of Korea
| | - Dae-Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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9
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Wakabayashi K, Osaka H, Yamagishi H, Kuwajima M, Ikeda T, Matsumoto A, Muramatsu K, Yamagata T. Investigation of the efficacy and adverse effects of lacosamide over 36 months. Epilepsy Behav 2023; 144:109227. [PMID: 37207404 DOI: 10.1016/j.yebeh.2023.109227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/13/2023] [Accepted: 04/15/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVE To evaluate the efficacy and retention rate of lacosamide (LCM) over 36 months as a treatment for children and adolescents with focal and generalized epilepsy based on a retrospective study. METHODS All patients prescribed LCM as monotherapy and add-on therapy between October 2016 and September 2019 at Jichi Children's Medical Center Tochigi were included in the study. The response rate, retention rate, and adverse effects were calculated. RESULTS A total of 126 (female, n = 73) patients of 1.3 to 34.9 years old (median age: 12.8 years; mean ± SD 13.2 ± 6.6 years) received LCM as monotherapy or add-on treatment for focal, generalized, and combined focal and generalized epilepsy. The response rate was 40.5% at 3 months, 40.5% at 6 months, 38.1% at 9 months, 35.7% at 12 months, 25.9% at 24 months, and 29.4% at 36 months. For 34 patients who were observable for 36 months, the retention rate was 70.6% at 3 months, but then gradually declined to 34.8% at 36 months. According to the number of concomitant anti-seizure medications (ASMs), the retention rate was higher in patients receiving <3 ASMs than in those receiving ≥3 ASMs at all observation points. The most common adverse effects were somnolence in 21 patients (16.7%) and dizziness in 5 patients (39.7%). CONCLUSION Our response rate was lower and our retention rate was higher in comparison to a previous study that observed patients over 36 months. Further prospective studies in children are required to confirm the response rate and retention rate in patients treated with LCM over 36 months.
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Affiliation(s)
- Kei Wakabayashi
- Department of Pediatrics, Jichi Medical University, Division of Human Genetics, Center for Molecular Medicine, Jichi Medical University, Japan.
| | - Hitoshi Osaka
- Department of Pediatrics, Jichi Medical University, Division of Human Genetics, Center for Molecular Medicine, Jichi Medical University, Japan.
| | - Hirokazu Yamagishi
- Department of Pediatrics, Jichi Medical University, Division of Human Genetics, Center for Molecular Medicine, Jichi Medical University, Japan
| | - Mari Kuwajima
- Department of Pediatrics, Jichi Medical University, Division of Human Genetics, Center for Molecular Medicine, Jichi Medical University, Japan
| | - Takahiro Ikeda
- Department of Pediatrics, Jichi Medical University, Division of Human Genetics, Center for Molecular Medicine, Jichi Medical University, Japan
| | - Ayumi Matsumoto
- Department of Pediatrics, Jichi Medical University, Division of Human Genetics, Center for Molecular Medicine, Jichi Medical University, Japan
| | - Kazuhiro Muramatsu
- Department of Pediatrics, Jichi Medical University, Division of Human Genetics, Center for Molecular Medicine, Jichi Medical University, Japan
| | - Takanori Yamagata
- Department of Pediatrics, Jichi Medical University, Division of Human Genetics, Center for Molecular Medicine, Jichi Medical University, Japan
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10
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Aboumatar S, Krishnaiengar SR, Cantu D, Zhang Y, Grinnell T. Time to baseline seizure count in patients with focal seizures receiving adjunctive eslicarbazepine acetate in a phase IV clinical trial. Clin Neurol Neurosurg 2023; 225:107552. [PMID: 36657359 DOI: 10.1016/j.clineuro.2022.107552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 11/21/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The efficacy and tolerability of eslicarbazepine acetate (ESL), a once-daily, orally-administered, anti-seizure medication (ASM), have primarily been established in treatment-resistant epilepsy patients, the population most often enrolled in clinical trials of anti-seizure medications. More recently, ESL was also shown to be effective and well-tolerated as first adjunctive therapy in non-treatment-resistant patients in an open-label, non-randomized, Phase IV, 24-week study of ESL using standard efficacy parameters in adults with focal seizures. OBJECTIVE To determine the time required to reach baseline seizure count, as an alternative method of assessing the efficacy of adjunctive ESL in patients with relatively low baseline monthly seizure frequencies. This additional analysis was undertaken, as subtle changes and improvements are difficult to analyze using standard efficacy parameters, such as standardized seizure frequency reduction when the baseline frequency of seizures is particularly low. METHODS This was a post-hoc analysis of the Phase IV study data, which investigated time to baseline seizure count in patients aged ≥ 18 years with focal seizures as an alternative measure of anti-seizure efficacy. In the Phase IV trial, patients had been enrolled into 2 groups: Arm 1: ESL as first adjunctive therapy to levetiracetam (LEV) or lamotrigine (LTG), the two most commonly-prescribed ASMs, in patients with inadequate response to treatment; Arm 2: ESL as a later adjunctive therapy, following prior use of 1-2 ASMs in patients who required an additional therapeutic option. RESULTS The time to reach individual baseline seizure count was longer in patients with focal seizures receiving ESL as a first (Arm 1) versus later (Arm 2) adjunctive therapy (p = 0.005). Patients who received ESL as a first adjunctive therapy had a longer time to ESL discontinuation than patients who received ESL as a later adjunctive therapy (p = 0.04). In Arm 1, patients receiving concomitant LTG reported treatment-emergent adverse events (TEAEs) significantly earlier than those receiving LEV (p = 0.02). Compared to patients receiving concomitant LTG, a greater number of patients in Arm 1 who were taking concomitant LEV had a modal ESL dose > 1200 mg and completed the full maintenance period. A greater number of patients in Arm 1 who were receiving concomitant LEV and completed the 24-week maintenance period reached a maximum ESL dose of 1600 mg, compared to those taking LTG, who reached a maximum ESL dose of 1200 mg. CONCLUSIONS This analysis of the Phase IV clinical trial data provides an alternative way of assessing efficacy beyond standardized seizure frequency reduction, in the context of relatively low monthly median seizure frequencies at baseline (SSF 2.0-2.4). These results provide further support for the use of ESL as an earlier or later adjunctive therapy to LEV or LTG.
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Affiliation(s)
- Sami Aboumatar
- Austin Epilepsy Care Center, Suite 203, 2200 Park Bend Drive Building 2, Austin, TX 78758, USA.
| | | | - David Cantu
- Sunovion Pharmaceuticals Inc., Marlborough, MA, USA.
| | - Yi Zhang
- Sunovion Pharmaceuticals Inc., Marlborough, MA, USA.
| | - Todd Grinnell
- Sunovion Pharmaceuticals Inc., Marlborough, MA, USA.
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11
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Prial A, Zhu X, Bol L, Williams MR. The impact of moderate physical activity and student interaction on retention at a community college. J Am Coll Health 2023; 71:154-161. [PMID: 33734951 DOI: 10.1080/07448481.2021.1881103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 11/21/2020] [Accepted: 01/15/2021] [Indexed: 06/12/2023]
Abstract
Objective: The purpose of this study was to explore the effect of a voluntary walking program that combined moderate physical activity and student interaction on student retention at a community college. Methods: A sample of 69 students at a suburban community college voluntarily joined a walking program and logged the number of minutes they walked and the number of people they spoke to each day. Using a Chi-Squared Test of Independence, the study sample was compared to a matched sample of nonparticipating students. Results: There was a significant difference in these groups relative to retention. A Fisher's Exact Test was used to consider (a) the difference between participants who walked at least 150 minutes per week Reference (1) and those who did not relative to retention and (b) the difference between participants who interacted while walking and those who did not relative to retention. These tests showed no significant differences. Conclusions: Participation in the walking program was significantly associated with retention, but amount of moderate activity or interaction was not.
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Affiliation(s)
- Anne Prial
- Academic Affairs, Orange County Community College, Middletown, New York, USA
| | - Xihe Zhu
- Department of Human Movement Sciences, Old Dominion University, Norfolk, Virginia, USA
| | - Linda Bol
- Department of Educational Foundations and Leadership, Darden College of Education and Professional Studies, Old Dominion University, Norfolk, Viriginia, USA
| | - Mitchell R Williams
- Department of Educational Foundations and Leadership, Old Dominion University, Norfolk, Virginia, USA
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12
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Li J, Zhong Z, Yang Y, Zhang S, Du H, Ren P. Experiment and mechanism study on enrichment of heavy metals during MSW pyrolysis by modified kaolin. Environ Sci Pollut Res Int 2023; 30:4309-4322. [PMID: 35971048 DOI: 10.1007/s11356-022-22509-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Experiment and mechanism studies on the enrichment of Pb, Cd, Zn, As, and Cr by modified kaolin were investigated during MSW (municipal solid waste) pyrolysis at 450 ~ 650 °C. The results showed that γAlOK(micro- and nano-γAl2O3 by hydrothermal method modified kaolin) was relatively selective for the solid phase enrichment of Cr and As, while CaHPK (CaHPO4 impregnated modified kaolinite) was more advantageous for the adsorption of Pb and Zn, which might be related to the thermal stability of γAl2O3 and the thermal conversion of CaHPO4. Compared with the original kaolin, the adsorption and retention capacity of γAlOK for As was improved by 20 ~ 30%. Moreover, the retention rate of modified kaolin for Cd decreased from 66.75 to 30.30% at 450 ~ 650 ℃, and the effect of temperature on the volatilization of Cd was always greater than the active components on the surface of modified kaolin. In the fluidized bed experiment, the physical mixing of different modified kaolin achieves complementary advantages on the retention capacity of heavy metals. In addition, the ∆E between Ca2P2O7 and PbCl2 is smaller than that of γAl2O3 at 500 ~ 650 °C, i.e., their electron transfer induction is stronger, and therefore more favorable for electron transfer and stable chemical bond formation.
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Affiliation(s)
- Jiefei Li
- Key Laboratory of Energy Thermal Conversion and Control of Ministry of Education, School of Energy and Environment, Southeast University, Nanjing, 210096, China
- Central Plains Environmental Protection Co., Ltd, Zhengzhou, 450000, China
| | - Zhaoping Zhong
- Key Laboratory of Energy Thermal Conversion and Control of Ministry of Education, School of Energy and Environment, Southeast University, Nanjing, 210096, China.
| | - Yuxuag Yang
- Key Laboratory of Energy Thermal Conversion and Control of Ministry of Education, School of Energy and Environment, Southeast University, Nanjing, 210096, China
| | - Shan Zhang
- Key Laboratory of Energy Thermal Conversion and Control of Ministry of Education, School of Energy and Environment, Southeast University, Nanjing, 210096, China
| | - Haoran Du
- Key Laboratory of Energy Thermal Conversion and Control of Ministry of Education, School of Energy and Environment, Southeast University, Nanjing, 210096, China
| | - Pengkun Ren
- Key Laboratory of Energy Thermal Conversion and Control of Ministry of Education, School of Energy and Environment, Southeast University, Nanjing, 210096, China
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13
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Tan J, Wang M, Sun H, Wang C, Wei H, Jiang S, Zhou Y, Peng J. Optimizing feeding regimen of replacement gilts to improve their reproductive performance and retention rate of their first 2 parities. Anim Nutr 2022; 12:227-235. [PMID: 36712407 PMCID: PMC9868321 DOI: 10.1016/j.aninu.2022.06.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/23/2022] [Accepted: 06/09/2022] [Indexed: 11/07/2022]
Abstract
The effects of age, body weight (BW), and backfat thickness (BF) of replacement gilts at first estrus and first mating on their subsequent reproductive performance and retention of their first 2 parities as sows was evaluated. A total of 3,025 Danish replacement gilts were categorized by farm (allocated to 4 farms), cross combination, age, BW and BF at first estrus and first mating, estrous cycle number at first mating, and flush feeding before first mating. The result shows that all the factors mentioned above were significantly associated with reproductive performance and retention rates of the first 2 parities. Farm 3 had more piglets born alive per litter (BA) (P < 0.05). Farms 3 and 4 had more healthy piglets per litter (HP) (P < 0.05). Farm 4 had the most piglets weaned per litter (PW) (P < 0.05). Landrace × Landrace × Yorkshire (L × L × Y) replacement gilts had the most total piglets born per litter (TB), BA, HP, PW and a higher retention rate of the 2 parities than Landrace × Yorkshire (L × Y) replacement gilts (P < 0.05). In addition, flush feeding before first mating had the most TB, BA, HP, PW, and a higher retention rate of the 2 parities than no flush feeding (P < 0.05). Because the effects of replacement gilts rearing parameters on reproductive performance traits differed, we used 100 replacement gilts as a unit and the total number of weaned piglets from the first 2 parities as a new index. Replacement gilts undergoing their first estrus between 180 and 210 d of age at 115 to 124.9 kg BW and 14 to 15 mm BF had significantly higher reproductive indexes for their first 2 parities per 100 replacement gilts. Replacement gilts that mated between 210 and 230 d of age at 140 to 149.9 kg BW and 15 to 16 mm BF had optimal reproductive indexes. These results provide a new insight into the complex relationships among these reproductive performance traits and may help guide successful management of replacement gilts as a pivotal starting point for future fertility and longevity of rearing herds.
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Affiliation(s)
- Jiajian Tan
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China,Guangxi Yang Xiang Joint Stock Company, Guigang 537000, China
| | - Miaomiao Wang
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Haiqing Sun
- Guangxi Yang Xiang Joint Stock Company, Guigang 537000, China
| | - Chao Wang
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Hongkui Wei
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China
| | - Siwen Jiang
- Key Lab of Agricultural Animal Genetics, Breeding and Reproduction of Ministry of Education & Key Lab of Swine Genetics and Breeding of Ministry of Agriculture, Huazhong Agricultural University, Wuhan 430070, China,The Cooperative Innovation Center for Sustainable Pig Production, Wuhan 430070, China
| | - Yuanfei Zhou
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China,Corresponding authors.
| | - Jian Peng
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Huazhong Agricultural University, Wuhan 430070, China,The Cooperative Innovation Center for Sustainable Pig Production, Wuhan 430070, China,Corresponding authors.
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Augustin M, Sator PG, von Kiedrowski R, Conrad C, Rigopoulos D, Romanelli M, Ghislain PD, Torres T, Ioannides D, Aassi M, Schulz B, Jagiello P. Secukinumab demonstrated sustained retention, effectiveness and safety in a real-world setting in patients with moderate to severe plaque psoriasis: long-term results from an interim analysis of the SERENA study. J Eur Acad Dermatol Venereol 2022; 36:1796-1804. [PMID: 35696305 DOI: 10.1111/jdv.18329] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/29/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Randomised controlled trials of secukinumab have shown sustained efficacy and a favourable safety profile in multiple manifestations of psoriatic disease. OBJECTIVES To assess the long-term, real-world retention, effectiveness, and safety of secukinumab in routine clinical practice for the treatment of moderate to severe plaque-type psoriasis (PsO). METHODS SERENA (CAIN457A3403) is a large, ongoing, longitudinal, observational study conducted at 438 sites and 19 countries across Europe for an expected duration of up to 5 years in adult patients with moderate to severe PsO, psoriatic arthritis, and ankylosing spondylitis. Patients received ≥16 weeks of secukinumab treatment before enrolment. This interim analysis presents data from PsO patients, who were enrolled in the study between October-2016-October-2018 and were observed for ≥2 years. RESULTS In total, 1756 patients (67.3% male) with a mean age of 48.4 years and body mass index of 28.8 kg/m2 were included in the analysis. The secukinumab treatment retention rates after 1, 2 and 3 years in the study were 88.0%, 76.4% and 60.5%, respectively. Out of the 648 patients who discontinued the study, the most common reasons included lack of efficacy (42.6%), adverse event (17.4%), physician decision (12.2%) and subject decision (11.6%). Mean±SD absolute PASI was 21.0±13.0 at the start of treatment (n=1,564). At Baseline, the mean±SD PASI score reduced to 2.6±4.8 and remained low at Year 1 (2.3±4.3), Year 2 (1.9±3.6) and Year 3 (1.9±3.5). The safety profile of secukinumab during the SERENA study was consistent with its known safety profile, with no new safety signals reported. Particularly low rates of inflammatory bowel disease (0.3%; Incidence Rate [IR]:0.15), candida infections (3.1%; IR:1.43) and MACE (0.9%; IR:0.37) were observed. CONCLUSIONS Secukinumab showed high treatment persistence, sustained effectiveness and a favourable safety profile up to 3 years of follow-up in the real-world population of PsO patients observed in SERENA.
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Affiliation(s)
- M Augustin
- Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P G Sator
- Department of Dermatology, Municipal Hospital Hietzing, Vienna, Austria
| | - R von Kiedrowski
- Company for Medical Study & Service Selters (CMS3) GmbH, Selters, Germany
| | - C Conrad
- Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - D Rigopoulos
- Dermatology and Venerology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - M Romanelli
- Dermatology Department, University of Pisa, Pisa, Italy
| | - P-D Ghislain
- Dermatology, Cliniques Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - T Torres
- Department of Dermatology, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - D Ioannides
- First Department of Dermatology and Venereology, School of Medicine, Aristotle University, Thessaloniki, Greece
| | - M Aassi
- Novartis Pharma AG, Basel, Switzerland
| | - B Schulz
- Novartis Pharma AG, Basel, Switzerland
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Yi J, He Q, Peng G, Fan Y. Improved water solubility, chemical stability, antioxidant and anticancer activity of resveratrol via nanoencapsulation with pea protein nanofibrils. Food Chem 2022; 377:131942. [PMID: 34990943 DOI: 10.1016/j.foodchem.2021.131942] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/01/2021] [Accepted: 12/20/2021] [Indexed: 11/28/2022]
Abstract
Fabricated pea protein isolate (PPI) nanofibrils were used as nanocarriers to encapsulate, stabilize and deliver resveratrol (RES). PPI nanofibrils possessed a dramatically higher surface hydrophobicity than PPI (native), and PPI nanofibrils exhibited nanoscale widths of 10 nm and average lengths of 1.0 μm. Fluorescence analyses demonstrated PPI nanofibrils had high binding constant with RES. Compared with RES (free), the aqueous solubility of RES was improved by approximately 1000-fold with PPI nanofibrils complex. DPPH and ABTS radical scavenging activity assays showed that the antioxidant capacity of RES was pronouncedly enhanced through the nanocomplexation with PPI nanofibrils. RES-PPI nanofibrils complexes exhibited higher antiproliferative activities than RES (free), with the cell viabilities of 52.6% and 38.5% for RES (free) and RES-PPI nanofibrils complex at 20 μg/mL. This study demonstrates that PPI nanofibrils can be utilized as novel nanocarriers for improvements of the water solubility, chemical stability and in vitro biological activities of hydrophobic nutraceuticals.
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Affiliation(s)
- Jiang Yi
- Department of Food Science and Engineering, College of Chemistry and Environmental Engineering, Shenzhen University, Shenzhen, Guangdong 518060, China.
| | - Qingyu He
- Department of Food Science and Engineering, College of Chemistry and Environmental Engineering, Shenzhen University, Shenzhen, Guangdong 518060, China
| | - Gaofei Peng
- Department of Food Science and Engineering, College of Chemistry and Environmental Engineering, Shenzhen University, Shenzhen, Guangdong 518060, China
| | - Yuting Fan
- School of Public Health, Health Science Center, Shenzhen University, Shenzhen, Guangdong 518060, China.
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16
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Schill H, Graeser P, Bücher K, Pfisterer J, Khazaei Y, Enggist L, Hickel R, Kühnisch J. Clinical performance of a new fissure sealant-results from a 2-year randomized clinical trial. Clin Oral Investig 2022. [PMID: 35499655 DOI: 10.1007/s00784-022-04514-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 04/23/2022] [Indexed: 12/13/2022]
Abstract
Objectives The aim of this randomized clinical trial (RCT) was to explore the clinical survival of a new, Bis-GMA-free pit and fissure sealant (Helioseal F Plus) in comparison to an established control material (Helioseal F). Material and methods This in vivo study was designed as a prospective, 2-year, two-centre RCT with a split-mouth design. The initial study population consisted of 92 adolescents who were followed up 1 month (N = 89), 6 months (N = 88), 1 year (N = 85) and 2 years (N = 82) after sealant application. The attrition rate was 10.9% after 2 years. At each examination, the sealant retention and presence of caries were recorded. The statistical analysis included the calculation of Kaplan–Meier survival curves, log-rank tests and a Cox proportional hazard regression model. Results No adverse events during the application or any of the follow-up visits were documented. The proportion of completely intact sealants and those with minimal loss was almost identical in both groups at 85.9% (Helioseal F Plus) and 86.5% Helioseal F) after 2 years of observation. The regression analysis revealed operator dependency; no significant differences were found between the materials, the study centres, the chosen isolation technique and patient age or sex. Conclusion The newly developed sealant can be evaluated as at least equivalent in terms of survival and retention behaviour compared to the established control material. Clinical relevance The new sealant can be recommended for clinical use. With respect to the material properties (Bis-GMA-free, less light polymerisation time and better thixotropic behaviour), it offers additional advantages with clinical relevance.
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Im K, Lee SA, Kim JH, Kim DW, Lee SK, Seo DW, Lee JW. Long-term efficacy and safety of perampanel as a first add-on therapy in patients with focal epilepsy: Three-year extension study. Epilepsy Behav 2021; 125:108407. [PMID: 34785411 DOI: 10.1016/j.yebeh.2021.108407] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 10/20/2021] [Accepted: 10/23/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE We investigated the long-term efficacy and safety of perampanel as a first add-on therapy in patients with focal epilepsy. METHODS This retrospective study represented the 3-year extension phase of a multicenter, open-label, phase 4, prospective study of perampanel as a first add-on therapy in patients with focal epilepsy. Seizure and safety outcomes were assessed annually from the start of the extension study, and the retention rate was calculated from the start of perampanel exposure in the original study. RESULTS The 50% responder and seizure freedom rates were 84.8% and 58.7%, respectively, during the third year and 71.7% and 32.6%, respectively, during the entire 3-year period of the extension study. The 1-, 2-, and 3-year retention rates were 62.5%, 53.1%, and 52.1%, respectively. Efficacies were higher in patients that were aged >55 years, male, and receiving ≤4 mg of perampanel. Perampanel was generally well tolerated; 47.3% of patients experienced at least one adverse event during the 3 years of extension (46 adverse events (AEs) in 35 patients). The most common AEs were dizziness (33.8%), somnolence (5.4%), anger (4.1%), and irritability (4.1%). AEs were resolved with perampanel dose reduction or discontinuation in 10 (13.5%) and 12 (16.2%) patients, respectively. CONCLUSION Long-term treatment with perampanel as a first add-on therapy did not raise new safety signals in patients with focal epilepsy. Especially at low perampanel doses (≤4 mg/day), sustained improvement in seizure control was achieved, which could potentially avoid adverse drug reactions.
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Affiliation(s)
- Kayeong Im
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sang-Ahm Lee
- Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Ji Hyun Kim
- Department of Neurology, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Dong Wook Kim
- Department of Neurology, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Sang Kun Lee
- Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dae Won Seo
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Prabhasawat P, Chotikavanich S, Ngowyutagon P, Pinitpuwadol W. Long-term Outcomes of Boston Type I Keratoprosthesis, and Efficacy of Amphotericin B and Povidone-Iodine in Infection Prophylaxis. Am J Ophthalmol 2021; 232:40-48. [PMID: 34102154 DOI: 10.1016/j.ajo.2021.05.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/26/2021] [Accepted: 05/26/2021] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the long-term outcomes, anatomic retention, and complications of Boston type I keratoprosthesis (KPro). DESIGN Retrospective, interventional case series METHODS: A retrospective chart review of implantations performed January 2008-December 2017 was conducted. Risk factors for anatomical retention and functional success were analyzed. The incidences of infections with and without antimicrobial medications were compared. RESULTS Twenty-seven eyes of 26 patients were recruited. The most common indication for KPro surgery was failed penetrating keratoplasties (22 eyes, 81.5%). All patients had preoperative best-corrected visual acuity (BCVA) worse than 3/60. Over the mean follow-up of 83.4 ± 28.4 months, 15 eyes (55.6%) demonstrated improved BCVA. The anatomical retention rate was 88.9%, and the functional success rate was 44.4% (retained KPro with BCVA ≥ 3/60). Eyes with ocular surface disease (OSD) had significantly more complications than those without OSD. The most common complications were retroprosthetic membrane formation (15 eyes, 55.6%) and infection (13 eyes, 48.1%). Infectious keratitis was primarily caused by gram-positive bacteria, whereas endophthalmitis was chiefly caused by fungal infection. The infection incidence was significantly lower in eyes using topical 0.1% amphotericin B and 5% povidone iodine (P = .008 and .021, respectively). CONCLUSIONS With its good retention rate and visual outcomes, Boston type I KPro could be an alternative treatment for patients with conventional penetrating keratoplasty failure, especially with appropriate patient selection and complication prevention. Standard prophylactic antibiotics with the addition of topical 0.1% amphotericin B and 5% povidone iodine might be optional effective regimens for infection prevention, especially in tropical countries.
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Affiliation(s)
- Pinnita Prabhasawat
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Suksri Chotikavanich
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Panotsom Ngowyutagon
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
| | - Warinyupa Pinitpuwadol
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Generali E, Carrara G, Bortoluzzi A, De Santis M, Ceribelli A, Scirè CA, Selmi C. Non-adherence and discontinuation rate for oral and parenteral methotrexate: A retrospective-cohort study in 8,952 patients with psoriatic arthritis. J Transl Autoimmun 2021; 4:100113. [PMID: 35005587 PMCID: PMC8716656 DOI: 10.1016/j.jtauto.2021.100113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 08/14/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND AND AIMS Treatment options for PsA, following non-steroidal anti-inflammatory drugs (NSAIDs), include conventional synthetic disease modifying anti-rheumatic drugs (csDMARDS), particularly methotrexate (MTX). The present study was performed to determine the non-adherence and discontinuation rates of different methotrexate (MTX) formulations in psoriatic arthritis (PsA). APPROACH AND RESULTS We performed a retrospective-cohort study on patients with PsA identified by disease-specific code in the administrative-health-databases of a Northern Italian region (Lombardy) between 2004 and 2015. Subjects were defined as non-adherent if less than 80% of the prescribed MTX dose was taken based on the time between each prescription. Discontinuation rates were calculated using the time between the first and the last MTX prescription over an observation period of 120 months. Among 8952 patients with PsA, 33% were treated with MTX (mean dosage 10 mg/week ± 2.5 mg standard deviation), more frequently (59%) in its parenteral formulation at a 10 mg weekly dosage (35%). Oral glucocorticoids were prescribed to 21% of patients, while non-steroidal anti-inflammatory drugs to 45%. Approximately 37% of patients with PsA were defined as non-adherent to MTX, with the oral formulation associated with an increased risk of non-adherence (hazard ratio 2.08, 95% confidence interval 1.84-2.35, p < 0.001) compared with parenteral 10-15 mg weekly doses. Oral MTX was discontinued in 52% of cases without a significantly increased risk of discontinuation compared to parenteral formulations which, at higher dosages, had a more favorable retention rate. CONCLUSION Oral MTX formulation is associated with a 2-fold risk of non-adherence compared to MTX parenteral route in PsA.
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Key Words
- Adherence
- HCQ, hydroxychloroquine
- HR, Hazard ratio
- IQR, inter-quartile range
- LEF, leflunomide
- MTX, methotrexate
- Methotrexate
- NSAIDs, non-steroidal anti-inflammatory drugs
- OGC, oral glucocorticoids
- Oral
- Parenteral
- PsA, psoriatic arthritis
- PsO, psoriasis
- Psoriatic arthritis
- Retention rate
- SSZ, sulfasalazine
- TNF, tumor necrosis factor alpha
- list: csDMARDs, conventional synthetic disease modifying anti-rheumatic drugs
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Affiliation(s)
- Elena Generali
- Division of Rheumatology and Clinical Immunology, Humanitas Research Hospital - IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Greta Carrara
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
| | | | - Maria De Santis
- Division of Rheumatology and Clinical Immunology, Humanitas Research Hospital - IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Angela Ceribelli
- Division of Rheumatology and Clinical Immunology, Humanitas Research Hospital - IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
| | - Carlo A. Scirè
- Epidemiology Unit, Italian Society for Rheumatology, Milan, Italy
- University of Ferrara, Ferrara, Italy
| | - Carlo Selmi
- Division of Rheumatology and Clinical Immunology, Humanitas Research Hospital - IRCCS, Rozzano, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy
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Fernandes M, Dainese F, Operto F, Lattanzi S, Matricardi S, Renna R, Placidi F, Paladin F, Pastorino GMG, Foschi N, Cesaroni E, Mercuri NB, Liguori C. Perampanel effectiveness and tolerability in patients with epilepsy at long-term follow-up. Epilepsy Behav 2021; 121:108069. [PMID: 34077902 DOI: 10.1016/j.yebeh.2021.108069] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/22/2021] [Accepted: 05/09/2021] [Indexed: 01/13/2023]
Abstract
INTRODUCTION The main of the present study was to assess the effectiveness and tolerability of perampanel (PER) in association with 1 or 2 concomitant antiseizure medications (ASMs) in patients with epilepsy throughout a follow-up period of 24 months or longer in a real-world setting. METHODS This retrospective, observational, multi-center study collected data from both underage (<18 years old) and adult patients who had started PER in association with 1 or 2 ASMs. Only patients who had started PER and were followed up for at least 24 months were included. Response to treatment was analyzed at the 24-, 36-, and 48-month visits by considering the last visit undergone by patients. Subgroup analyses were performed according to age, gender, and epilepsy type and patients were categorized following PER treatment in concomitance with 1 or 2 ASMs to evaluate the factors affecting the achievement of seizure freedom (SF) at the 24-month FU. RESULTS Ninety-four patients were included (mean age 36.89 years; 51.1% female). At the 24-month follow-up visit, 90 (95.74%) patients were still receiving PER concomitantly with 1 or 2 ASMs. The mean PER dose was 6.02 mg/day and SF was achieved by 33 (35.1%) patients. A significantly higher SF rate was found in patients who had started PER with only 1 ASM when compared to those who had started PER with 2 concomitant ASMs. Effectiveness was maintained also in the subgroups of patients with a 36- or 48-month follow-up visit. Adult patients had a higher final daily dosage of PER than underage patients. Logistic regression found that the lowest number of previously failed ASMs was associated with a higher SF rate (p = 0.036). CONCLUSION Perampanel demonstrated a good effectiveness in association with 1 or 2 ASMs in both pediatric and adult patients, without having to use a high dose of the drug. The possibility to present SF was higher when PER was added early. Finally, the maintenance of effectiveness was observed also in the subgroups of patients with a follow-up of 36 and 48 months.
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Affiliation(s)
- Mariana Fernandes
- Epilepsy Centre, Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy; Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy
| | - Filippo Dainese
- Epilepsy Centre, Neurologic Unit, SS.Giovanni e Paolo Hospital, Venice, Italy
| | - Francesca Operto
- Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Italy
| | - Simona Lattanzi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Sara Matricardi
- Department of Child Neuropsychiatry, Children's Hospital "G. Salesi", Ospedali Riuniti Ancona, Italy
| | - Rosaria Renna
- Neurological Clinic and Stroke Unit, "A. Cardarelli" Hospital, Naples, Italy; Outpatient Clinic for Epilepsy, "A. Cardarelli" Hospital, Naples, Italy
| | - Fabio Placidi
- Epilepsy Centre, Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy; Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy
| | - Francesco Paladin
- Epilepsy Centre, Neurologic Unit, SS.Giovanni e Paolo Hospital, Venice, Italy
| | | | - Nicoletta Foschi
- Neurological Clinic, Department of Experimental and Clinical Medicine, Marche Polytechnic University, Ancona, Italy
| | - Elisabetta Cesaroni
- Department of Child Neuropsychiatry, Children's Hospital "G. Salesi", Ospedali Riuniti Ancona, Italy
| | - Nicola Biagio Mercuri
- Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy; IRCCS Fondazione Santa Lucia, Rome, Italy
| | - Claudio Liguori
- Epilepsy Centre, Department of Systems Medicine, University of Rome 'Tor Vergata", Rome, Italy; Neurology Unit, University Hospital of Rome "Tor Vergata", Rome, Italy.
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Wang Q, Chen X, Wang X, Du Y, Li Y, Bai R, Luo S, Hao L. A Reliable Method for Chin Augmentation by Mechanical Micronization of Lipoaspirates. Aesthetic Plast Surg 2021; 45:1507-17. [PMID: 33837461 DOI: 10.1007/s00266-021-02237-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/11/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Desire for improved aesthetic contour of the lower third of the face has resulted in an increase in chin augmentation. Although many fillers, including hyaluronic acid (HA), autologous fat and stromal vascular fraction gel (SVF-gel), have been used to improve facial morphology, chin augmentation requires fillers that provide greater support. METHODS The elastic and viscous moduli of SVF-gel and Coleman fat were assessed in vitro by rheological testing, whereas their elasticity were evaluated in vivo by ultrasonic elastography. Results in vitro were compared with those of highly elastic HA (HE-HA) and highly viscous HA (HV-HA), whereas results in vivo were compared with HE-HA. Changes in chin volume, SVF-gel retention rate and absorptivity for at least 12 months were measured by 3D white light scanning. Questionnaires were administered to assess patient satisfaction. RESULTS The elastic and viscous modulus of SVF-gel was, respectively, slightly lower than HE-HA and HV-HA but higher than the other two in vitro, with the elasticity of the three layers of SVF-gel lower than HE-HA but slightly higher than normal control in vivo. The average retention rate was 62.34±3.34% at 12 months. The absorptivity of 90% of the samples was <3% from 6 to 12 months, which was considered stable. Patients expressed satisfaction with their results. CONCLUSION SVF-gel has ideal rheologic characteristics in vitro, which has slightly higher elasticity than normal fat tissue of chin in vivo, and could keep well retention rate for chin augmentation in clinic. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Mahamud Z, Håkansson S, Burman J, Zelano J. Retention of antiseizure medications for epilepsy in multiple sclerosis: A retrospective observational study. Epilepsy Behav 2021; 121:108034. [PMID: 34004524 DOI: 10.1016/j.yebeh.2021.108034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/22/2021] [Accepted: 04/24/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE Epilepsy in multiple sclerosis (MS) is rare, and longitudinal clinical studies evaluating treatment with antiseizure medications (ASMs) are difficult to conduct. We instead designed a nationwide register study to estimate retention rates of ASMs prescribed as initial monotherapy for epilepsy in MS and investigated factors influencing their retention. METHODS multiple sclerosis patients with a first prescription of ASM for epilepsy were identified by cross-referencing the Swedish MS register with comprehensive national registers. One and five-year retention rates of ASMs were estimated using Kaplan-Meier analysis. Cox proportional regression was employed to estimate hazard ratios (HR) of discontinuation for different ASMs as well as for baseline predictors. RESULTS One hundred and twenty-nine MS patients were included. The most commonly prescribed ASMs were: carbamazepine (n = 38, 29.5%), lamotrigine (n = 33, 25.6%) and levetiracetam (n = 19, 14.7%). One-year retention rates (95% CI) were: lamotrigine 87.5% [76, 98.9], carbamazepine 60.5% [45, 76], levetiracetam 60.2% [37.2, 83.2], valproate 51.3% [23, 79.6] and phenytoin 44.4% [11.8, 77]. Fiveyear retention rates (95% CI) were: lamotrigine 74.4% [57.3, 91.5], carbamazepine 52.2% [34.9, 69.4], valproate 51.3% [23.1, 79.5] and phenytoin 14.8% [0, 40.9]. With carbamazepine as reference, lamotrigine was the only ASM that displayed a lower hazard of discontinuation, HR 0.41 [0.17, 0.99]. We could not identify any baseline factors that influenced the risk of discontinuation. CONCLUSION Lamotrigine displayed the lowest risk of discontinuation when prescribed as initial monotherapy for epilepsy in MS. Newer ASMs generally compared well to older ones, at least suggesting non-inferiority.
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Affiliation(s)
- Zamzam Mahamud
- Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Samuel Håkansson
- Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Joachim Burman
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Johan Zelano
- Department of Clinical Neuroscience, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden; Wallenberg Centre for Molecular and Translational Medicine, Sahlgrenska Academy, Gothenburg, Sweden.
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Reyes-Rivet L, Bellier A, Baillet A, Pham T, Gaudin P, Allenet B, Gastaldi R. Adherence to EULAR's recommendations on comorbidity management minimizes the discontinuation of bDMARDS for intolerance in patients with chronic inflammatory rheumatic diseases. Joint Bone Spine 2021; 88:105234. [PMID: 34098103 DOI: 10.1016/j.jbspin.2021.105234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 05/19/2021] [Indexed: 11/18/2022]
Affiliation(s)
- Lisa Reyes-Rivet
- Department of Rheumatology, Grenoble-Alpes University, Grenoble Hospital, Grenoble, France.
| | - Alexandre Bellier
- Department of Public Health, Grenoble-Alpes University, Grenoble Hospital, Grenoble, France
| | - Athan Baillet
- Department of Rheumatology, Grenoble-Alpes University, Grenoble Hospital, Grenoble, France; GREPI, TIMC UMR 5525, Grenoble-Alpes University, Grenoble, France
| | - Thao Pham
- Department of Rheumatology, Aix-Marseille University, Sainte-Marguerite Hospital, Marseille, France
| | - Philippe Gaudin
- Department of Rheumatology, Grenoble-Alpes University, Grenoble Hospital, Grenoble, France; GREPI, TIMC UMR 5525, Grenoble-Alpes University, Grenoble, France
| | - Benoit Allenet
- Department of Pharmacology, Grenoble-Alpes University, Grenoble Hospital, Grenoble, France
| | - Romain Gastaldi
- Department of Rheumatology, Grenoble-Alpes University, Grenoble Hospital, Grenoble, France
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Sebastiani M, Venerito V, Bugatti S, Bazzani C, Biggioggero M, Petricca L, Foti R, Bortoluzzi A, Balduzzi S, Visalli E, Frediani B, Manfredi A, Gremese E, Favalli E, Iannone F, Ferraccioli G, Lapadula G. Retention rate of a second line with a biologic DMARD after failure of a first-line therapy with abatacept, tocilizumab, or rituximab: results from the Italian GISEA registry. Clin Rheumatol 2021; 40:4039-4047. [PMID: 33881676 DOI: 10.1007/s10067-021-05734-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVES EULAR recommendations do not suggest which biologic disease-modifying anti-rheumatic drug (bDMARD) should be preferred after failure of a first bDMARD in the treatment of rheumatoid arthritis (RA). In particular, few data are available regarding the effectiveness of a second-line bDMARD after failure of abatacept (ABA), tocilizumab (TCZ), and rituximab (RTX). The aim of this study was to analyze the retention rate of a second line with tumor necrosis factor inhibitors (TNFi) or other mechanisms of action (MoAs), after the failure of either RTX, TCZ, or ABA. METHODS Two hundred and seventy-eight RA patients from the Italian GISEA registry were included in the study. RTX was the first bDMARD in 18% of patients, ABA in 45.7%, and TCZ in 36.3%, while the second bDMARD was a TNFi (group 1) in 129 patients and an agent with a different MoA (group 2) in 149. RESULTS During a median follow-up of 22 months (IQR 68), 129 patients discontinued their treatment; patients of group 1 discontinued the treatment more frequently than patients of group 2 (p<0.001) with retention rates of 33.6±5.7% and 63.6±4.6% after 104 weeks for group 1 and group 2, respectively (p<0.001). At multivariate analysis, the mechanism of action was the only predictor for the maintenance in therapy. CONCLUSIONS According to our data, ABA, RTX, and TCZ seem to maintain a good retention rate also when used as a second-line therapy, suggesting their use after the failure of a non-TNFi as first-line therapy. However, specifically designed studies are needed to evaluate the more appropriate therapeutic strategies in RA, according to the first-line drug, including new targeted synthetic DMARDs. Key Points • A large proportion of rheumatoid arthritis patients fail the first biologic DMARD. • Few data are available about the efficacy of biologic DMARD after the failure of a non-TNF inhibitor. • Abatacept, rituximab, or tocilizumab seem to maintain a good retention rate after the failure of a first-course therapy with a non-TNF inhibitor.
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Affiliation(s)
- Marco Sebastiani
- Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico di Modena, Via del Pozzo, 41125, Modena, Italy.
| | - Vincenzo Venerito
- Department of Emergency and Organ Transplantation, Rheumatology Unit, University of Bari, Bari, Italy
| | - Serena Bugatti
- Division of Rheumatology, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Chiara Bazzani
- Unit of Rheumatology and Clinical Immunology, ASST Spedali Civili, Brescia, Italy
| | | | - Luca Petricca
- Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy
| | - Rosario Foti
- Rheumatology Unit, A.O.U. Policlinico San Marco, Catania, Italy
| | - Alessandra Bortoluzzi
- Section of Rheumatology, Department of Medical Sciences, University of Ferrara and Azienda Ospedaliera-Universitaria di Ferrara, Ferrara, Italy
| | - Silvia Balduzzi
- Division of Rheumatology, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy
| | - Elisa Visalli
- Rheumatology Unit, A.O.U. Policlinico San Marco, Catania, Italy
| | - Bruno Frediani
- Rheumatology Unit, Department of Medical Sciences, Surgery e Neurosciences, University of Siena, Siena, Italy
| | - Andreina Manfredi
- Rheumatology Unit, University of Modena and Reggio Emilia, Azienda Ospedaliero-Universitaria Policlinico di Modena, Via del Pozzo, 41125, Modena, Italy
| | - Elisa Gremese
- Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy
| | - Ennio Favalli
- Department of Rheumatology, Gaetano Pini Institute, Milan, Italy
| | - Florenzo Iannone
- Department of Emergency and Organ Transplantation, Rheumatology Unit, University of Bari, Bari, Italy
| | | | - Giovanni Lapadula
- Department of Emergency and Organ Transplantation, Rheumatology Unit, University of Bari, Bari, Italy
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Canas N, Félix C, Silva V, Arraiolos A, Fernandez-Llimos F. Comparative 12-month retention rate, effectiveness and tolerability of perampanel when used as a first add-on or a late add-on treatment in patients with focal epilepsies: The COM-PER study. Seizure 2021; 86:109-115. [PMID: 33592505 DOI: 10.1016/j.seizure.2021.01.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/26/2021] [Accepted: 01/31/2021] [Indexed: 01/23/2023] Open
Abstract
OBJECTIVES To compare the 12-month retention rate, effectiveness and tolerability of perampanel (PER) as a first or late add-on treatment in adult patients with focal-onset seizures (FOS), including focal to bilateral tonic-clonic seizures (FBTCS). METHODS This retrospective, observational, multicenter study was carried out in patients with FOS that received PER as a late add-on (n = 60), after failure of > 3 AEDs, and a group that received PER as a first add-on treatment (n = 21). RESULTS At 12 months, the retention (90.5 % vs. 48.3 %; p = 0.001), seizure-freedom (71.4 % vs. 13.3 %; p < 0.001) and responder (85.7 % vs. 28.3 %; p < 0.001) rates were significantly higher in the first add-on group compared with the late add-on group. In patients with FBTCS, the 12-month retention rate did not differ significantly between the first and late add-on groups (93.8 % vs. 66.7 %); however, seizure-freedom (81.2 % vs. 27.8 %; p = 0.002) and responder rate response (93.8 % vs. 44.4 %; p = 0.002) were significantly higher in the first add-on group. There were no significant differences in tolerability between the two groups, including in patients with FBTCS. Adverse events were reported in 54.3 % of patients (44/81), most were mild or moderate, with dizziness being the most frequent one. CONCLUSION Overall, retention rate and effectiveness at 12 months were significantly higher in patients taking PER as a first add-on than as a late add-on, and the tolerability of PER did not differ significantly between groups. PER demonstrated high effectiveness in patients with FBTCS, even as a late add-on treatment.
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Affiliation(s)
- Nuno Canas
- Hospital Beatriz Ângelo, Neurology Department, Loures, Portugal; Centro Hospitalar Lisboa Ocidental, Reference Center for Refractory Epilepsies, Neurology Department, Hospital Egas Moniz, Lisbon, Portugal; Hospital CUF Descobertas, Neurology Department, Lisbon, Portugal.
| | - Catarina Félix
- Centro Hospitalar e Universitário do Algarve, Neurology Department, Faro, Portugal
| | - Vanessa Silva
- Hospital Beatriz Ângelo, Neurology Department, Loures, Portugal
| | - Ana Arraiolos
- Hospital Beatriz Ângelo, Neurology Department, Loures, Portugal
| | - Fernando Fernandez-Llimos
- Laboratory of Pharmacology, Department of Drug Sciences, College of Pharmacy, University of Porto, Porto, Portugal
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Bao W, Cao L, Wei H, Zhu D, Zhou G, Wang J, Guo S. Effect of 3D printed polycaprolactone scaffold with a bionic structure on the early stage of fat grafting. Mater Sci Eng C Mater Biol Appl 2021; 123:111973. [PMID: 33812601 DOI: 10.1016/j.msec.2021.111973] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/30/2021] [Accepted: 02/10/2021] [Indexed: 11/24/2022]
Abstract
Mature adipocytes are sensitive to stress and hypoxia, which are the two major obstacles in large-volume fat grafting. Bionic scaffolds are considered beneficial for fat grafting; however, their mechanism is still unclear. In this study, polycaprolactone scaffolds were fabricated by a 3D-printing technique and compounded with liposuction fat. They were implanted subcutaneously into nude mice. At different times, gross and histological observations were performed to evaluate the retention rates and histological morphologies. Adipocyte viability, apoptosis, and vascularization were analyzed by special immunostaining. Quantitative polymerase chain reaction was used to detect the variations in hypoxia and inflammation. The results showed that the volume and weight retentions in the scaffold group were higher than those in the fat group with the former exhibiting fewer vacuoles and less fibrosis. In immunostaining, elevated CD31+ capillaries, more perilipin+ adipocytes, and fewer TUNEL+ apoptotic cells were observed in the scaffold group by week 4. The lower expression of HIF-1α indicated the alleviation of hypoxia. In conclusion, the scaffold provided mechanical support to resist skin tension, thereby decreasing the interstitial pressure, and improving substance exchange and vascular ingrowth. In this regard, the scaffold attenuated hypoxia and promoted vascularization, making it a feasible method to increase long-term retention in fat grafting using scaffolds with suitable degradation rates and additional vascular maturation stimulation.
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Liu M, Yang C, Liu E, Zhang F, Meng X, Liu B. Effect of environmental stresses on physicochemical properties of ALA oil-in-water nanoemulsion system prepared by emulsion phase inversion. Food Chem 2021; 343:128475. [PMID: 33168257 DOI: 10.1016/j.foodchem.2020.128475] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/10/2020] [Accepted: 10/21/2020] [Indexed: 01/27/2023]
Abstract
To solve the stability and oxidation issues of alpha-linolenic acid (ALA), this study focused on developing ALA nanoemulsion system (ALA-NE, oil-in-water) and evaluating the effect of environmental conditions on physical stability and the effect of antioxidants on oxidative stability. The physicochemical properties of nanoemulsions were measured at different conditions, including particle diameter, zeta potential, retention rate and peroxidation value (POV). The particle diameter increased significantly and the retention rate decreased after 25 days storage under the conditions of high temperature and metal ions. However, the influence of ionic strength, pH and light was insignificant. As an antioxidant, Vitamin E was more effective at retarding lipid oxidation of nanoemulsions than that of vitamin C. These results provided reference information in preparing effective and stable ALA-NE systems and enlarging the application fields.
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Dai L, Yu X, Shao Y, Wang Y, Li Z, Ye J, Bai S, Guo X, Wang J, Su B, Jiang T, Zhang T, Wu H, Scott SR, Liu A, Sun L. Effect of a multi-dimensional case management model on anti-retroviral therapy-related outcomes among people living with human immunodeficiency virus in Beijing, China. BMC Infect Dis 2020; 20:489. [PMID: 32646373 PMCID: PMC7350672 DOI: 10.1186/s12879-020-05219-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/02/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This paper introduces a comprehensive case management model uniting doctors, nurses, and non-governmental organizations (NGOs) in order to shorten the time from HIV diagnosis to initiation of antiviral therapy, improve patients' adherence, and ameliorate antiretroviral treatment (ART)-related outcomes. METHODS All newly diagnosed human immunodeficiency virus (HIV) cases at Beijing YouAn Hospital from January 2012 to December 2013 were selected as the control group, while all newly diagnosed HIV-infected patients from January 2015 to December 2016 were selected as the intervention group, receiving the comprehensive case management model. RESULTS 4906 patients were enrolled, of which 1549 were in the control group and 3357 in the intervention group. The median time from confirming HIV infection to ART initiation in the intervention group was 35 (18-133) days, much shorter than the control group (56 (26-253) days, P < 0.001). Participants in the intervention group had better ART adherence compared to those in the control group (intervention: 95.3%; control: 89.2%; p < 0.001). During the 2 years' follow-up, those receiving case management were at decreased odds of experiencing virological failure (OR: 0.27, 95%CI: 0.17-0.42, P < 0.001). Observed mortality was 0.4 deaths per 100 patient-years of follow-up for patients in the control group compared with 0.2 deaths per 100 patient-years of follow-up in the intervention group. CONCLUSIONS People living with HIV engaged in the comprehensive case management model were more likely to initiate ART sooner and maintained better treatment compliance and improved clinical outcomes compared to those who received routine care. A comprehensive case management program could be implemented in hospitals across China in order to reduce the HIV disease burden in the country.
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Affiliation(s)
- Lili Dai
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Xiaochun Yu
- School of Public Health, Anhui Medical University, Hefei, 230032, Anhui, China
| | - Ying Shao
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Yali Wang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Zaicun Li
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Jiangzhu Ye
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Shaoli Bai
- Lanzhou Municipality Pulmonary Hospital, Lanzhou, 730046, Gan Su, China
| | - Xiaoling Guo
- Lanzhou Municipality Pulmonary Hospital, Lanzhou, 730046, Gan Su, China
| | - Jianyun Wang
- Lanzhou Municipality Pulmonary Hospital, Lanzhou, 730046, Gan Su, China
| | - Bin Su
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Taiyi Jiang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Hao Wu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China
| | - Sarah Robbins Scott
- The National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 100037, China
| | - An Liu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
| | - Lijun Sun
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, 100069, China.
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Kawabe A, Nakano K, Kubo S, Asakawa T, Tanaka Y. Differential long-term retention of biological disease-modifying antirheumatic drugs in patients with rheumatoid arthritis by age group from the FIRST registry. Arthritis Res Ther 2020; 22:136. [PMID: 32513309 PMCID: PMC7282084 DOI: 10.1186/s13075-020-02233-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/02/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The effectiveness and safety of biological disease-modifying antirheumatic drugs (bDMARDs) by age group (< 65, 65-74, and ≥ 75 years) are uncertain. We examined retention rates reflecting the effectiveness and safety of bDMARDs in actual clinical practice for clarifying optimal therapeutic strategies for rheumatoid arthritis (RA) by age groups. METHODS Data of patients who were treated with tumor necrosis factor inhibitors (TNFi), abatacept (ABA), and tocilizumab (TCZ) between February 2011 and April 2017 were collected from a prospective observational registry of RA patients. A total of 1362 patients were enrolled, of which 695 were aged < 65 years, 402 were aged 65-74 years, and 265 were aged ≥ 75 years. Primary outcome was the drug retention rate in adjusted data using inverse probability of treatment weighting based on generalized propensity scores. RESULTS In patients aged < 65 years, 3-year retention rates of TNFi, ABA, and TCZ were 43%, 47%, and 69%, respectively (ABA versus TCZ, p = 0.017; TNFi versus TCZ, p = 0.002). In patients aged 65-74 years, 3-year retention rates of TNFi, ABA, and TCZ were 44%, 53%, and 60%, respectively (TCZ versus TNFi, p = 0.034). In patients aged ≥ 75 years, 3-year retention rates for TNFi, ABA, and TCZ were 38%, 63%, and 58%, respectively (ABA versus TNFi, p = 0.017). CONCLUSIONS We found that the effectiveness and safety of TCZ were maximal in patients aged < 75 years and that patients aged ≥ 75 years might be suitable candidates for TCZ and ABA therapy. The use of therapeutic strategies appropriate to each age group might improve the outcomes of bDMARD therapy for RA.
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Affiliation(s)
- Akio Kawabe
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi, Kitakyushu, 807-8555, Japan
| | - Kazuhisa Nakano
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi, Kitakyushu, 807-8555, Japan
| | - Satoshi Kubo
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi, Kitakyushu, 807-8555, Japan
| | - Takeshi Asakawa
- Department of Information Systems Center, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi, Kitakyushu, 807-8555, Japan
| | - Yoshiya Tanaka
- The First Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Japan, 1-1 Iseigaoka, Yahatanishi, Kitakyushu, 807-8555, Japan.
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Abstract
This study was carried out for extraction of soy isoflavones and entrapment of the isoflavones so obtained into whole milk via encapsulation techniques. Three different solvent (ethanol, methanol and acetonitrile) were used for the extraction of isoflavone using three stage of extraction. The extracted isoflavone was encapsulated into 200 ml of whole milk by spray drying using different concentrations of gum acacia (4, 6 and 8% w/v) and 10% w/v maltodextrin DE 18. The ratio between cores to coating materials was 1:10. Though acetonitrile extracted higher amount of isoflavone, ethanol was selected for subsequent studies of extraction of isoflavone, as per the legislations regarding use of Food-grade solvents. There was no significant difference (p > 0.5) among all three samples 4% gum acacia+10% maltodextrin (A), 6% gum acacia+10% maltodextrin (B) and 8% gum acacia+10% maltodextrin (C) in terms of moisture content and hygroscopicity. However, insolubility index showed that sample A possessed a higher solubility index. Encapsulation techniques suggested that sample A showed higher encapsulation efficiency than others. Statistical analysis suggested that there was no significant difference among samples A, B and C during storage at 4°C for the time period (30 days) studied, in terms of isoflavone retention rate. However, samples stored at 25 and 37°C showed significant difference in the retention rate. Among all the three samples, sample B showed significantly lower isoflavone degradation rate of 3.80, 4.07 and 4.70 × 10-3/day at 4, 25 and 37°C, respectively. The highest amount of isoflavone degradation was observed at 37°C. Results indicate that isoflavone can be encapsulated using a combination of gum acacia either 4 or 6% w/v and 10% maltodextrin along with milk proteins at 4°C for longer shelf life.
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Affiliation(s)
- Md. Anisur Rahman Mazumder
- Department of Food Processing Technology, School of Agriculture and Bioscience, Karunya Institute of Technology and Sciences, Coimbatore, 641114, Tamil Nadu, India
- Department of Food Technology and Rural Industries, Faculty of Agricultural Engineering and Technology, Bangladesh Agricultural University, Mymensingh, 2202, Bangladesh
| | - Thottiam Vasudevan Ranganathan
- Department of Food Processing Technology, School of Agriculture and Bioscience, Karunya Institute of Technology and Sciences, Coimbatore, 641114, Tamil Nadu, India
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Cao DQ, Yang XX, Yang WY, Wang QH, Hao XD. Separation of trace pharmaceuticals individually and in combination via forward osmosis. Sci Total Environ 2020; 718:137366. [PMID: 32092521 DOI: 10.1016/j.scitotenv.2020.137366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 02/14/2020] [Accepted: 02/15/2020] [Indexed: 06/10/2023]
Abstract
With a high rejection coefficient for trace pharmaceuticals and personal care products (PPCPs), forward osmosis (FO) membrane separation has become a cutting-edge technology in water treatment owing to its low energy consumption and low membrane fouling. Wastewater contains many types of PPCPs, and one pharmaceutical molecule affects the separation behaviors of other pharmaceuticals in FO. Therefore, simultaneous FO of multiple PPCPs needs to be investigated. In this study, the separation behaviors of four trace pharmaceuticals (ciprofloxacin (CIP), sulfamethoxazole (SMX), acetaminophen (ACP), carbamazepine (CBZ)), individually (termed "single pharmaceuticals") and in combination (termed "binary pharmaceuticals" as two pharmaceuticals were studied simultaneously), during FO were investigated at trace concentrations using ultra-high performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The results showed that for single pharmaceuticals, the molecular sieve dominates their retention rate-the retention rate increases with increasing Stokes radius of the molecules (29.1 → 94.8% for 0.35 → 0.47 nm). For binary pharmaceuticals, the retention rates of both pharmaceuticals without charge decrease with increasing total molecule number (for ACP + CBZ, 31.4 → 52.1% (ACP), 75.1 → 83.0% (CBZ)). Negatively charged pharmaceuticals are mutually exclusive with the negatively charged FO membrane, resulting in the increase of the retention rate of pharmaceuticals (83.1 → 90.1% (CIP) when CIP + ACP → CIP + SMX). In the presence of a positively charged pharmaceutical, the retention rate of negatively charged pharmaceuticals decreases (85.7 → 80.4% (SMX) when SMX + ACP → SMX + CIP) because the positively charged pharmaceutical neutralizes the negative charge on the FO membrane surface, resulting in the weakening of electrostatic repulsion between the negatively charged pharmaceutical and FO membrane surface. The positively charged molecule attracts the negatively charged molecule, forming a couple of molecules with larger molecule weight and increasing the retention rate of the pharmaceuticals (80.4 → 88.2% (SMX) when pH = 7 → 5 for SMX + CIP). The results suggest that the interactions between pharmaceuticals cannot be ignored in the process of removing PPCPs by FO.
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Affiliation(s)
- Da-Qi Cao
- Sino-Dutch R&D Centre for Future Wastewater Treatment Technologies/Key Laboratory of Urban Stormwater System and Water Environment, Beijing University of Civil Engineering and Architecture, Beijing 100044, China.
| | - Xiao-Xuan Yang
- Sino-Dutch R&D Centre for Future Wastewater Treatment Technologies/Key Laboratory of Urban Stormwater System and Water Environment, Beijing University of Civil Engineering and Architecture, Beijing 100044, China
| | - Wen-Yu Yang
- Sino-Dutch R&D Centre for Future Wastewater Treatment Technologies/Key Laboratory of Urban Stormwater System and Water Environment, Beijing University of Civil Engineering and Architecture, Beijing 100044, China
| | - Qun-Hui Wang
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, University of Science and Technology Beijing, 30 Xueyuan Road, Haidian District, Beijing 100083, China
| | - Xiao-Di Hao
- Sino-Dutch R&D Centre for Future Wastewater Treatment Technologies/Key Laboratory of Urban Stormwater System and Water Environment, Beijing University of Civil Engineering and Architecture, Beijing 100044, China.
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Navarini L, Costa L, Tasso M, Chimenti MS, Currado D, Fonti GL, Ciccozzi M, Margiotta DPE, Benigno C, De Martino E, Perricone R, Afeltra A, Scarpa R, Caso F. Retention rates and identification of factors associated with anti-TNFα, anti-IL17, and anti-IL12/23R agents discontinuation in psoriatic arthritis patients: results from a real-world clinical setting. Clin Rheumatol 2020; 39:2663-2670. [PMID: 32189149 DOI: 10.1007/s10067-020-05027-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 02/12/2020] [Accepted: 03/05/2020] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Biologic disease-modifying antirheumatic drugs (bDMARDs) play a pivotal role in the treatment of psoriatic arthritis (PsA). Despite this, their discontinuation due to inefficacy or adverse events is often observed. The aims of this study are to describe retention rates and treatment trends of anti-TNFα, anti-IL17, and anti-IL12/23R agents in patients with PsA and to identify factors associated with bDMARDs discontinuation in a real-world clinical setting. METHODS A retrospective cohort study based on the analysis of the three Italian prescription cohorts of patients with PsA has been performed. Survival analysis was performed using Kaplan-Meier curves and Cox proportional-hazards model. RESULTS During the follow up, which lasted 25.5 (12-60) months, 68 patients discontinued a bDMARD: 13 for primary failure, 12 for secondary failure, 15 for adverse events, 5 for remission, 12 because of lost at follow-up, and 11 for other causes. Cox proportional-hazards demonstrated that a shorter disease duration (HR 0.994991, 95% CI 0.9910336-0.9989647, p = 0.014) and first-line bDMARD (HR 0.5090986, 95% CI 0.3073519-0.8432722, p = 0.009) have a protective role on bDMARD retention rate, while the multivariable analysis failed in demonstrating an independent protective role of male sex on drug retention rate (p = 0.083). No significant differences in retention rate have been found regarding biologic drugs, combination therapy or monotherapy, and class of bDMARD (anti-TNFα or anti-pIL12/23R and anti-IL-17). CONCLUSIONS This study shows that a shorter disease duration and treatment with a first-line bDMARD are predictors of bDMARDs retention rate, further highlighting the importance of early diagnosis of PsA. Key Points • No significant difference in retention among patients treated with anti-IL17A, anti-IL12/23R, and anti-TNFα agents has been demonstrated. • A shorter disease duration and first-line bDMARD treatment are associated with persistence in biologic treatment.
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Affiliation(s)
- Luca Navarini
- Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy.
| | - Luisa Costa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Marco Tasso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Maria Sole Chimenti
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Damiano Currado
- Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Giulia Lavinia Fonti
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Massimo Ciccozzi
- Unit of Clinical Laboratory Science, Department of Medicine, Campus Bio-Medico of Rome University, Rome, Italy
| | - Domenico Paolo Emanuele Margiotta
- Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Carolina Benigno
- Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Erica De Martino
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Roberto Perricone
- Rheumatology, Allergology and Clinical Immunology, University of Rome Tor Vergata, Rome, Italy
| | - Antonella Afeltra
- Unit of Allergology, Clinical Immunology and Rheumatology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy
| | - Raffaele Scarpa
- Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
| | - Francesco Caso
- Rheumatology Unit, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples Federico II, Naples, Italy
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Campochiaro C, Tomelleri A, Sartorelli S, Cavalli G, De Luca G, Baldissera E, Dagna L. Drug retention and discontinuation reasons between seven biologics in patients with Takayasu arteritis. Semin Arthritis Rheum 2020; 50:509-514. [PMID: 32088012 DOI: 10.1016/j.semarthrit.2020.01.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/13/2020] [Accepted: 01/21/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We retrospectively investigated drug retention rate (DRR) and reasons for discontinuation of seven biologic disease-modifying anti-rheumatic drugs (bDMARDs) in Takayasu's arteritis (TA) in a real-world setting. METHODS TA patients followed-up in our center fulfilling the 1990 ACR criteria and treated with ≥1 bDMARD were selected. Data about disease duration, number of bDMARDs, reasons for bDMARDs discontinuation, and concomitant conventional synthetic (cs)DMARDs were collected. Survival curves were examined by the Kaplan-Meier method and compared using a stratified log-rank test. 24-month DRR was calculated. Hazard ratio (HR) for concomitant csDMARDs and for previous bDMARDs was evaluated. A comparative sub-analysis between anti-TNFα drugs and tocilizumab was performed. RESULTS We identified 50 patients and 86 bDMARD-courses. No significant differences were observed in age and disease duration between the seven groups. Infliximab was the most frequent first-line bDMARD (78.6%). At bDMARDs initiation, all patients were prescribed prednisone (mean dose, 13.5 ± 10.3 mg/day) and 85.2% concomitant csDMARD therapy. 43% of treatment courses were stopped by 24 months. Golimumab had the highest DRR (71.4%), followed by infliximab (69%), adalimumab (56.3%), abatacept (50%), tocilizumab (41.1%), anakinra (0%) and rituximab (0%), p = 0.016. Concomitant csDMARDs therapy showed positive effects on DRR (HR=2.87, 95% CI=1.19-6.92, p = 0.019). Anti-TNFα drugs had significantly higher DRR compared to tocilizumab (67.2% vs 41.1%, p = 0.028). Even in these subgroups, csDMARDs showed positive effects on DRR (HR=3.79, 95% CI=1.49-9.6, p = 0.005). CONCLUSIONS Anti-TNFα agents had the highest DRR overall and a higher DRR in a head-to-head comparison with tocilizumab. Concomitant csDMARDs had a significant positive effect on bDMARDs DRR.
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Affiliation(s)
- Corrado Campochiaro
- Unit of Immunology, Rheumatology, Allergy and Rare diseases, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy.
| | - Alessandro Tomelleri
- Unit of Immunology, Rheumatology, Allergy and Rare diseases, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy
| | - Silvia Sartorelli
- Unit of Immunology, Rheumatology, Allergy and Rare diseases, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy
| | - Giulio Cavalli
- Unit of Immunology, Rheumatology, Allergy and Rare diseases, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy
| | - Giacomo De Luca
- Unit of Immunology, Rheumatology, Allergy and Rare diseases, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy
| | - Elena Baldissera
- Unit of Immunology, Rheumatology, Allergy and Rare diseases, IRCCS San Raffaele Hospital, Milan, Italy
| | - Lorenzo Dagna
- Unit of Immunology, Rheumatology, Allergy and Rare diseases, IRCCS San Raffaele Hospital, Milan, Italy; Vita-Salute San Raffaele University, Via Olgettina 60, 20132 Milan, Italy
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Ishikawa M. Distribution and retention trends of physician-scientists in Japan: a longitudinal study. BMC Med Educ 2019; 19:394. [PMID: 31660958 PMCID: PMC6819329 DOI: 10.1186/s12909-019-1840-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 10/15/2019] [Indexed: 05/09/2023]
Abstract
BACKGROUND Physician Scientists (PSs) play a significant role in medical science because of their clinical practice and research expertise. Although it is important to analyze the distribution and retention trends in the number of PSs in Japan, research on this topic has been insufficient. Thus, the purpose of this study is to analyze PSs distribution and retention trends, identify factors related to their retention, and consider the policy implications. METHOD I analyzed individual data from 1996 to 2016 from a national census survey that had been administered by the national government of Japan every 2 years. The number of PSs in 1996 and 2016 were 4930 (2.1% of all physicians) and 5212 (1.6%), respectively. I conducted a descriptive analysis and identified retention trends. I then used a multivariable logistic regression analysis to identify the factors related to the retention of PSs. RESULTS Between 1996 and 2016, the total number of PSs in Japan increased by 6%. The number of PSs aged 39 years or younger decreased by 48%, while those aged between 55 and 69 increased by 91%, indicating a notable decrease in the number of PSs under the age of 39. From 2014 to 2016, the annual retention rate of PSs was estimated to be 75.5%, which represented a low and stable rate compared to other physicians over the study period. The odds of continuing to practice as a PS were significantly higher for those who have between 15 to 29 years of experience after qualification as a physician. CONCLUSION This study indicates that it is likely for the total number of PSs to decrease in the future. Although the Japanese government has implemented various measures to retain PSs, these have not been effective. Possible new interventions to address this problem include increasing the knowledge of medical students and younger physicians of the role of PSs and the benefits of a career as a PS, providing specific career paths for PSs, securing specific positions for PSs, and increasing the compensation for PSs.
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Affiliation(s)
- Masatoshi Ishikawa
- Takemi Program in International Health, Harvard T.H. Chang School of Public Health, Boston, Massachusetts, USA.
- Health Services Research & Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan.
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Peichl P, Alten R, Galeazzi M, Lorenz HM, Nüßlein H, Navarro F, Elbez Y, Chartier M, Hackl R, Rauch C, Connolly SE. Abatacept retention and clinical outcomes in Austrian patients with rheumatoid arthritis: real-world data from the 2-year ACTION study. Wien Med Wochenschr 2019; 170:132-140. [PMID: 31654156 DOI: 10.1007/s10354-019-00710-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 09/20/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND AbataCepT In rOutiNe clinical practice (ACTION; NCT02109666) was a 2-year international observational study of patients with moderate to severe rheumatoid arthritis. METHODS Baseline characteristics, abatacept retention rates, and clinical outcomes were compared by treatment line in the Austrian cohort of ACTION. RESULTS Of 100 patients enrolled in Austria, 98 (98.0%) were evaluable: 33/98 (33.7%) biologic naïve and 65/98 (66.3%) with ≥1 prior biologic failure. At baseline, biologic-naïve patients had shorter disease duration and lower concomitant corticosteroid use than biologic-failure patients. Overall crude abatacept retention rate was 60.5% and retention rate was higher in biologic-naïve (65.1%) versus biologic-failure (58.0%) patients. Good/moderate EULAR (European League Against Rheumatism) response rates were 85.7% in biologic-naïve and 100% in biologic-failure patients. CONCLUSIONS In the Austrian cohort of ACTION, overall abatacept retention at 2 years was high, with higher retention rates in patients receiving abatacept as an earlier treatment line. Good/moderate EULAR response rate was higher in biologic-failure than in biologic-naïve patients.
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Affiliation(s)
- Peter Peichl
- Evangelisches Krankenhaus Wien, Hans-Sachs-Gasse 10-12, 1180, Vienna, Austria.
| | - Rieke Alten
- Schlosspark-Klinik University Medicine, Berlin, Germany
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Sartini A, Scaioli E, Liverani E, Bellanova M, Ricciardiello L, Bazzoli F, Belluzzi A. Retention Rate, Persistence and Safety of Adalimumab in Inflammatory Bowel Disease: A Real-Life, 9-Year, Single-Center Experience in Italy. Dig Dis Sci 2019; 64:863-874. [PMID: 30334112 DOI: 10.1007/s10620-018-5329-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 10/09/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND "Real-life" data of retention rate and persistence of adalimumab in inflammatory bowel disease are still limited. AIMS To analyze retention rate, persistence, and safety of adalimumab in a 9-year real-life cohort of inflammatory bowel disease patients. METHODS In this observational, retrospective single-center study, all adult patients treated with adalimumab as the first- and second-line biological treatment for steroid-dependent or refractory inflammatory bowel disease between March 2008 and March 2017 were included. Primary outcomes were persistence, retention rate, and adverse events; the secondary outcome was the identification of predictors of withdrawal. RESULTS Ninety-six out of 181 patients (53%) withdrew their first course of adalimumab. The retention rate was 47% and 46.9% in Crohn's disease and ulcerative colitis patients, respectively; median persistence was 26 and 24 months in CD and UC patients, respectively. The cumulative probability of treatment persistence was 80.2%, 54.5%, and 29.6% and 69.6%, 40.4%, and 21.5% in CD and UC patients, respectively. The incidence rate of any adverse event was 12.5/100 patients-year; severe adverse events were 1.7/100 patients-year. The Cox regression revealed that CD patients with baseline disease duration > 72 months have a higher likelihood for withdrawal due to failure and/or adverse events (HR 1.62, 95% CI 1-2.62, p = 0.04); no predictors of discontinuation were found in UC. CONCLUSIONS Adalimumab showed a great persistence in the first 12 months of therapy and excellent safety profile. Early treatment of CD patients could increase efficacy and reduce the adverse event rate.
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Affiliation(s)
- Alessandro Sartini
- Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Eleonora Scaioli
- Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Elisa Liverani
- Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Matteo Bellanova
- Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Luigi Ricciardiello
- Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Franco Bazzoli
- Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy
| | - Andrea Belluzzi
- Department of Medical and Surgical Sciences, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138, Bologna, Italy.
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Ehsani-Chimeh E, Majdzadeh R, Delavari S, Gharebelagh MN, Rezaei S, Rad EH. Physicians' retention rate and its effective factors in the Islamic Republic of Iran. East Mediterr Health J 2018; 24:830-837. [PMID: 30570115 DOI: 10.26719/2018.24.9.830] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 08/08/2018] [Indexed: 11/09/2022]
Abstract
Background Migration of physicians from less developed countries to affluent ones has become as one of the major concerns of human resource policy-makers. This leads to problems such as inequity in the distribution of physicians, lack of physicians in less developed areas, as well as an excess of the health workforce in developed environs. Thus, policy-makers aim to increase retention of physicians in their places of origin. Aims This study aimed to find those effective factors for the retention of physicians in the Islamic Republic of Iran. Methods 30 569 records of public sector physicians in 2016 were gathered from the Ministry of Health and Medical Education database, and the retention rate of each province was calculated. Geographic information system (GIS) was used to show retention in each province, and linear and logistic regression analysis were used to determine the effective factors for physicians' retention in the country. Results There was a significant relationship between per capita gross domestic product of each province and its retention rate of physicians (OR = 1.56), retention rate of family physicians (OR = 7.38), and retention rate of specialists (OR = 1.59). In addition, relationships were significant for the human development index (all physicians [OR = 1.22], family physicians [OR = 2.36], and specialists [OR = 1.23]). Married physicians, higher paid physicians, and those who worked in headquarters and clinics showed greater willingness to stay in their area of origin. Conclusions Physicians' retention rate is dependent on both macro and microlevel factors.
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Affiliation(s)
- Elham Ehsani-Chimeh
- National Institute of Health Research (NIHR), Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Reza Majdzadeh
- Knowledge Utilization Research Center, Community-Based Participatory-Research Center and School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Sajad Delavari
- School of Health Management and Informatics, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran
| | | | - Satar Rezaei
- Research Center for Environmental Determinants of Health, Kermanshah University of Medical Sciences, Kermanshah, Islamic Republic of Iran
| | - Enayatollah Homaie Rad
- Social Determinants of Health Research Center, Guilan University of Medical Sciences, Rasht, Islamic Republic of Iran
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Tani S, Piñeiro C, Koketsu Y. Culling in served females and farrowed sows at consecutive parities in Spanish pig herds. Porcine Health Manag 2018; 4:3. [PMID: 29484195 PMCID: PMC5819191 DOI: 10.1186/s40813-018-0080-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2017] [Accepted: 01/08/2018] [Indexed: 11/28/2022] Open
Abstract
Background The objectives of our study were 1) to characterize culling and retention patterns in parities 0 to 6 in served females and farrowed sows in two herd groups, and 2) to quantify the factors associated with by-parity culling risks for both groups in commercial herds. Lifetime data from first-service to removal included 465,947 service records of 94,691 females served between 2008 and 2013 in 98 Spanish herds. Herds were categorized into two groups based on the upper 25th percentile of the herd means of annualized lifetime pigs weaned per sow: high-performing (> 24.7 pigs) and ordinary herds (≤ 24.7 pigs). Two-level log-binomial regression models were used to examine risk factors and relative risk ratios associated with by-parity culling risks. Results Mean by-parity culling risks (± SE) for served females and farrowed sows were 5.9 ± 0.03 and 12.4 ± 0.05%, respectively. Increased culling risks were associated with sows that farrowed 8 or fewer pigs born alive (PBA). Also, farrowed sows in high-performing herds in parities 2 to 6 had 1.5–5.6% higher culling risk than equivalent parity sows in ordinary herds (P < 0.05). Furthermore, sows in parities 1 to 6 that farrowed 3 or more stillborn piglets had 2.2–4.8% higher culling risk than for sows that did not farrow any stillborn piglets (P < 0.05). For served sows, culling risk in parity 1 to 6 sows with a weaning-to-first-service interval (WSI) of 7 days or more were 2.2–3.9% higher than equivalent parity sows with WSI 0–6 days (P < 0.05). With regard to relative risk ratios, served sows with WSI 7 days or more were 1.56–1.81 times more likely to be culled than those with WSI 0–6 days. Conclusion Producers should reduce non-productive days by culling sows after weaning, instead of after service or during pregnancy. Also, producers should pay special attention to sows farrowing stillborn piglets or having prolonged WSI, and reconsider culling policy for mid-parity sows when they farrow 8 or fewer PBA. Electronic supplementary material The online version of this article (10.1186/s40813-018-0080-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Satomi Tani
- 1School of Agriculture, Meiji University, Higashi-mita 1-1-1, Tama-ku, Kawasaki, Kanagawa 214-8571 Japan
| | - Carlos Piñeiro
- PigCHAMP pro Europa S.L., c/Santa Catalina 10, 40003 Segovia, Spain
| | - Yuzo Koketsu
- 1School of Agriculture, Meiji University, Higashi-mita 1-1-1, Tama-ku, Kawasaki, Kanagawa 214-8571 Japan
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Gil-Nagel A, Burd S, Toledo M, Sander JW, Lebedeva A, Patten A, Laurenza A. A retrospective, multicentre study of perampanel given as monotherapy in routine clinical care in people with epilepsy. Seizure 2017; 54:61-66. [PMID: 29288911 DOI: 10.1016/j.seizure.2017.10.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 10/03/2017] [Accepted: 10/17/2017] [Indexed: 11/28/2022] Open
Abstract
PURPOSE Perampanel is approved for adjunctive treatment of focal seizures, with or without secondarily generalised seizures, and for primary generalised tonic-clonic seizures in people with epilepsy aged ≥12 years. Perampanel was recently approved for monotherapy use for partial seizures in the United States. This study provides insight into the feasibility of perampanel monotherapy in real-world settings. METHODS This retrospective, non-interventional, multicentre study (NCT02736162) was conducted between January 2013 and March 2016 in specialist epilepsy centres in Europe and Russia. Eligible individuals had a diagnosis of epilepsy and received perampanel primary or secondary monotherapy as routine clinical care. The primary endpoint was proportion of individuals remaining on perampanel monotherapy, after conversion from perampanel adjunctive treatment, at 3, 6, 12, 18 and 24 months (retention rate). RESULTS Sixty individuals were in the safety set (female, 63%; white, 97%; aged 18 to <65 years, 73%). Most (85%) received secondary monotherapy with perampanel. At study cut-off, 68% of individuals were continuing on perampanel monotherapy (secondary monotherapy: 55%). The median duration of retention was not calculable due to the high number of individuals ongoing on monotherapy. Twelve individuals had treatment-emergent adverse events that started during perampanel monotherapy, the most frequent was dizziness (5%). One serious treatment-emergent adverse event was reported (pneumonia during adjunctive perampanel treatment). CONCLUSIONS In this small retrospective study of individuals who received perampanel monotherapy, the majority maintained monotherapy. Perampanel monotherapy may be an achievable option in some people with epilepsy.
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Affiliation(s)
- Antonio Gil-Nagel
- Hospital Ruber Internacional, Calle de la Masó 38, 28034 Madrid, Spain.
| | - Sergey Burd
- Pirogov Russian National Research Medical University, Ostrovitianov Str. 1, Moscow, 117997, Russia.
| | - Manuel Toledo
- Hospital Universitario Vall d'Hebron, Passeig de la Vall d'Hebron 119-129, 08035 Barcelona, Spain.
| | - Josemir W Sander
- UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK; Chalfont Centre for Epilepsy, Chalfont St Peter, Gerrards Cross, SL9 0RJ, UK; Stichting Epilepsie Instellingen Nederland (SEIN), Achterweg 5, Heemstede, 2103 SW, The Netherlands.
| | - Anna Lebedeva
- Pirogov Russian National Research Medical University, Ostrovitianov Str. 1, Moscow, 117997, Russia.
| | - Anna Patten
- Eisai Ltd., European Knowledge Centre, Mosquito Way, Hatfield, Hertfordshire, AL10 9SN, UK.
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Hong CM, Kim CY, Son SH, Jung JH, Lee CH, Jeong JH, Jeong SY, Lee SW, Lee J, Ahn BC. I-131 biokinetics of remnant normal thyroid tissue and residual thyroid cancer in patients with differentiated thyroid cancer: comparison between recombinant human TSH administration and thyroid hormone withdrawal. Ann Nucl Med 2017; 31:582-589. [PMID: 28677070 DOI: 10.1007/s12149-017-1188-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 06/19/2017] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of this study was to assess I-131 biokinetics in thyroid cancer and remnant tissue in patients with differentiated thyroid cancer using whole-body scan (WBS) and SPECT images acquired after I-131 therapy. The influence of thyroid stimulating hormone (TSH) stimulation method on the kinetics was also evaluated. METHODS A total of 57 patients who received I-131 therapy (2.96-7.4 GBq) were retrospectively included. TSH stimulation was achieved by recombinant human thyrotropin (rhTSH) or by thyroid hormone withdrawal (THW). Each patient received three sequential WBSs on days 1, 2, and 4 (or 5) after I-131 administration. All lesions were classified either as thyroid remnant (ThyR) or as metastatic lymph nodes (mLN) after considering the SPECT/CT images acquired during the last WBS. The lesion-based retention rate and absorbed dose of ThyR and mLN were calculated using a commercial dosimetric toolkit combined with the OLINDA software. RESULTS The retention rate and the effective half-time of mLN were lower than that of ThyR (p < 0.001, p = 0.003). In addition, the retention rate and the effective half-time of ThyR in the rhTSH group were higher than those in the THW group (p < 0.001, p < 0.001). The differences in the retention rate and the effective half-time of mLN were not statistically significant between the THW group and rhTSH group (p = 0.549, p = 0.571). CONCLUSIONS Radioiodine therapy using rhTSH delivered an at least similar radiation dose to target lesions compared to using THW in thyroid remnants and metastatic lymph nodes.
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Affiliation(s)
- Chae Moon Hong
- Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, 50 Samduk-dong 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea
| | - Choon-Young Kim
- Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, 50 Samduk-dong 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea
| | - Seung Hyun Son
- Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, 50 Samduk-dong 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea
| | - Ji-Hoon Jung
- Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, 50 Samduk-dong 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea
| | - Chang-Hee Lee
- Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, 50 Samduk-dong 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea
| | - Ju Hye Jeong
- Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, 50 Samduk-dong 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea
| | - Shin Young Jeong
- Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, 50 Samduk-dong 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, 50 Samduk-dong 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea
| | - Jaetae Lee
- Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, 50 Samduk-dong 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea
| | - Byeong-Cheol Ahn
- Department of Nuclear Medicine, Kyungpook National University School of Medicine/Hospital, 50 Samduk-dong 2-ga, Jung Gu, Daegu, 700-721, Republic of Korea.
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Abstract
Background Substance abuse has been considered as a growing challenge in Georgia that is closely linked with human immune deficiency virus (HIV) and hepatitis C transmission due to unsafe injection and other uncontrolled behaviors. Methadone maintenance therapy is one of the major treatment options for opioid-dependent individuals. It has proven efficacy in decreasing illegal opioid consumption and criminal behavior as well as reducing the level of HIV infection, mortality, HCV infection, and increasing social functioning. Methods The data was initially extracted from the electronic database, as of October 30, 2015, for the patients undergoing methadone maintenance therapy in 2014 and 2015. We used two types of statistical analysis: binary regression and time-to-event analysis (Kaplan-Meier). For binary regression analysis, patients who initiated the treatment 12, 9, 6, and 3 months prior to October 30, 2015, respectively, were eligible for >12-, >9-, >6-, and >3-month retention analysis. We identified two types of the retention periods: (I) “the program specific retention period” (the time spent (uninterruptedly) in the Global Fund to Fight HIV/AIDS, Tuberculosis, and Malaria (GFATM) opioid substitution treatment (OST) program after the clients’ last entry) and (II) “being on OST retention period” (the time spent (uninterruptedly) on OST since the clients’ last entry). For time-to-event analysis, the two different endpoints were investigated: (i) dropouts and (ii) being detained. Results The analysis showed that at each time point, “being on OST retention” rates are slightly higher than “program specific retention” rates. The percentages of patients retained in OST treatment after 3, 6, 9, and 12 months from the initiation of the treatment, respectively, were 89, 86, 85, and 83% and the percentages of patients retained in the GFATM program at the same time points were 88, 83, 82, and 80%. Patients older than 40 years are twice as likely to stay in the program compared to younger individuals. Gender is only associated with >9 and >12 months retention with approximately three times the odds for men compared to women. The strength of the association between hepatitis C status and “program specific” retention increases with time spent in the program as p values decrease from 0.07 for >3- and >6-month retention to 0.01 for >9- and >12-month retention. The younger age group was more likely to get dropouts and be detained. HIV status and social status did not show statistically significant association with retention. Conclusions These findings identify the need for more support for younger patients as they are more vulnerable to dropouts and detention compared to the older age group, especially during the early stage of treatment.
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Affiliation(s)
- Ekaterine Ruadze
- The National Center for Disease Control and Public Health, 9 Asatiani Street, Tbilisi, Georgia.
| | - Khatuna Todadze
- Center for Mental Health and Prevention of Addiction, 21 Kavtaradze Street, Tbilisi, Georgia.,Addiction Department, Tbilisi State Medical University, 7 Asatiani Street, Tbilisi, Georgia
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Svendsen T, Brodtkorb E, Reimers A, Molden E, Sætre E, Johannessen SI, Johannessen Landmark C. Pharmacokinetic variability, efficacy and tolerability of eslicarbazepine acetate-A national approach to the evaluation of therapeutic drug monitoring data and clinical outcome. Epilepsy Res 2017; 129:125-31. [PMID: 28043062 DOI: 10.1016/j.eplepsyres.2016.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 11/29/2016] [Accepted: 12/03/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND Eslicarbazepine acetate (ESL) is a new antiepileptic drug (AED), still insufficiently studied regarding pharmacokinetic variability, efficacy and tolerability. The purpose of this study was to evaluate therapeutic drug monitoring (TDM) data in Norway and relate pharmacokinetic variability to clinical efficacy and tolerability in a long-term clinical setting in patients with refractory epilepsy. METHODS This retrospective observational study included TDM-data from the main laboratories and population data from the Norwegian Prescription Database in Norway, in addition to clinical data from medical records of adult patients using ESL for up to three years, whenever possible. RESULTS TDM-data from 168 patients were utilized for assessment of pharmacokinetic variability, consisting of 71% of the total number of patients in Norway using ESL, 2011-14. Median daily dose of ESL was 800mg (range 400-1600mg), and median serum concentration of ESL was 53μmol/L (range 13-132μmol/L). Inter-patient variability of ESL was extensive, with 25-fold variability in concentration/dose ratios. Additional clinical data were available from 104 adult patients out of the 168, all with drug resistant focal epilepsy. After 1, 2 and 3 years follow-up, the retention rate of ESL was 83%, 72% and 64%, respectively. ESL was generally well tolerated as add-on treatment, but sedation, cognitive impairment and hyponatremia were reported. Hyponatremia (sodium <137mmol/L) was present in 36% of the patients, and lead to discontinuation in three. CONCLUSION Pharmacokinetic variability of ESL was extensive and the demonstration of usefulness of TDM requires further studies. In patients with drug resistant focal Epilepsy, the high retention rate indicated good efficacy and tolerability. Hyponatremia was observed in one third of the patients. The present results point to a need for individualization of treatment and TDM may be useful.
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Truchetet ME, Poursac N, Barnetche T, Shipley E, Gottenberg JE, Bannwarth B, Richez C, Schaeverbeke T. Abatacept monotherapy compared with abatacept plus disease-modifying anti-rheumatic drugs in rheumatoid arthritis patients: data from the ORA registry. Arthritis Res Ther 2016; 18:72. [PMID: 27029339 PMCID: PMC4815200 DOI: 10.1186/s13075-016-0956-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/12/2016] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Retention rate, efficacy, and safety of abatacept (ABA) was compared between patients with rheumatoid arthritis receiving ABA as monotherapy to those in combination ABA + conventional synthetic DMARD (csDMARD). METHODS The patients were obtained from the ORA registry. The retention rate was analysed in two ways: (1) therapeutic strategy retention, in which the addition of a csDMARD was considered to indicate failure of the monotherapy strategy; and (2) ABA retention, which was assessed by the discontinuation of ABA regardless of other treatment modifications. Efficacy and safety were compared between ABA initiated alone and ABA used in combination with a csDMARD. RESULTS The retention rate at month 6 (M6) was evaluated in 569 patients. A significant difference was identified in the retention rate between the ABA monotherapy strategy and the ABA + csDMARD strategy (58.5 % [110/188] vs. 68 % [258/381], respectively, p = 0.031). No significant difference was identified in the ABA retention rate initiated either as a monotherapy or in combination with csDMARDs (75 % [142/188] vs. 76 % [291/381], respectively, p = 0.824). Data regarding ABA efficacy were available for 444 patients. There was no significant difference in the responder proportion after 6 months of treatment between ABA monotherapy and ABA + csDMARD treatment (60.2 % [88/146] vs. 60 % [179/298], respectively, p = 0.967). CONCLUSIONS This "real-life" analysis, which is relevant for bedside practice, emphasised the satisfactory efficacy and safety of ABA used in monotherapy, which provides an acceptable alternative when csDMARDs are undesirable.
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Affiliation(s)
- Marie-Elise Truchetet
- Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France. .,Groupe Epidemiologie Clinique des Maladies Inflammatoires d'Aquitaine (GECMIA) Study Group, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France.
| | - Nicolas Poursac
- Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France
| | - Thomas Barnetche
- Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France
| | - Emilie Shipley
- Département de Rhumatologie, Hôpital de Dax, 18 Avenue Paul Doumer, 40100, Dax, France
| | - Jacques-Eric Gottenberg
- Hôpitaux Universitaires de Strasbourg et Universités de Strasbourg, 1 Place de L Hôpital, 67000, Strasbourg, France
| | - Bernard Bannwarth
- Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France
| | - Christophe Richez
- Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France.,Groupe Epidemiologie Clinique des Maladies Inflammatoires d'Aquitaine (GECMIA) Study Group, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France
| | - Thierry Schaeverbeke
- Département de Rhumatologie, Hôpital Pellegrin, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France.,Groupe Epidemiologie Clinique des Maladies Inflammatoires d'Aquitaine (GECMIA) Study Group, CHU de Bordeaux, Place Amélie Raba-Léon, 33076, Bordeaux, France
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Luque-Martinez I, Muñoz MA, Mena-Serrano A, Hass V, Reis A, Loguercio AD. Effect of EDTA conditioning on cervical restorations bonded with a self-etch adhesive: A randomized double-blind clinical trial. J Dent 2015; 43:1175-83. [PMID: 25963586 DOI: 10.1016/j.jdent.2015.04.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Revised: 04/22/2015] [Accepted: 04/24/2015] [Indexed: 02/01/2023] Open
Abstract
OBJECTIVE To compare the 18-month retention rates of composite restorations in non-carious cervical lesions [NCCLs] bonded with a self-etch adhesive with and without preliminary conditioning with EDTA. METHODS Forty-eight patients with two similar-sized NCCL were selected and randomly allocated to one of two groups. Two calibrated operators placed 96 restorations with a one-step self-etch adhesive (Adper Easy One, 3M ESPE). Half of the restorations were placed according to the manufacturer's instructions while, for the other half, the surfaces of the lesions were conditioned with 17% EDTA for 2 min prior to adhesive application. Two blinded and independent examiners evaluated the restorations at baseline, 6, 12, and 18 months, according to the FDI criteria. The comparison between groups in each period was conducted with the Fisher's exact test, and the performance of each group at the different periods was evaluated by McNemar's test (α=0.05). RESULTS After 18 months, significantly higher retention rates (95% CI) were observed for the EDTA group (95.5 [84.9-98.7]) than the control group (79.6% [65.5-88.9]) (p=0.02). Significant deterioration of the marginal adaptation and marginal discoloration were observed for both groups over the 18-month evaluation. CONCLUSIONS The preliminary conditioning with EDTA before application of a one-step self-etch adhesive significantly improved the retention rates of composite restorations in cervical lesions. CLINICAL SIGNIFICANCE Conditioning with EDTA is an alternative that improves the 18-month retention rate of cervical restorations bonded with a self-etch adhesive.
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Kessler SK, McCarthy A, Cnaan A, Dlugos DJ. Retention rates of rufinamide in pediatric epilepsy patients with and without Lennox-Gastaut Syndrome. Epilepsy Res 2015; 112:18-26. [PMID: 25847334 PMCID: PMC4805421 DOI: 10.1016/j.eplepsyres.2015.02.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Revised: 01/26/2015] [Accepted: 02/06/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of rufinamide (RFM) in patients with Lennox-Gastaut Syndrome (LGS) compared to those with other epilepsy syndromes using time to treatment failure (retention rate) as the outcome measure. METHODS In this retrospective cohort study, characteristics and outcomes of all patients receiving RFM in 2009 and 2010 were recorded. The primary outcome measure was RFM failure, defined as discontinuation of RFM or initiation of an additional antiepileptic therapy. The secondary outcome measure was discontinuation of RFM. Kaplan-Meier method survival curves were generated for time to RFM failure, for all patients and by the presence or absence of Lennox Gastaut Syndrome (LGS). The impact of age, seizure type, fast or slow drug titration, and concomitant therapy with valproate on retention rate were evaluated using Cox regression models. RESULTS One hundred thirty-three patients were included, 39 (30%) of whom had LGS. For all patients, the probability of remaining on RFM without additional therapy was 45% at 12 months and 30% at 24 months. LGS diagnosis was an independent predictor of time to RFM failure (HR 0.51, 95% CI 0.31-0.83), with a median time to failure of 18 months in LGS compared to 6 months in all others (p=0.006). CONCLUSIONS In a broad population of children with refractory epilepsy, around half will continue taking the medication for at least a year without additional therapy. Patients with LGS are two times more likely to continue RFM without additional therapy compared to those without LGS.
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Affiliation(s)
- Sudha Kilaru Kessler
- Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania and the Children's Hospital of Philadelphia, United States.
| | - Ann McCarthy
- Temple University School of Medicine, United States
| | - Avital Cnaan
- Departments of Pediatrics and Epidemiology and Biostatistics, George Washington University and Children's National Medical Center, United States
| | - Dennis J Dlugos
- Departments of Neurology and Pediatrics, Perelman School of Medicine at the University of Pennsylvania and the Children's Hospital of Philadelphia, United States
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Feng XF, Chen YX, Liu L, Xiao N. Retention rates of levetiraceram in Chinese children and adolescents with epilepsy. Eur J Paediatr Neurol 2015; 19:143-8. [PMID: 25497592 DOI: 10.1016/j.ejpn.2014.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Revised: 10/31/2014] [Accepted: 11/09/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Levetiracetam (Lev) is a new antiepileptic drugs, proved to be effective and tolerance in regulatory trials, but these controlled trials do not always predict how useful a drug will be in day to day clinical practice, Retention rates can provide a better indication of efficacy and tolerability in everyday use. METHODS Totally 124 patients with more than 3 months disease course were enrolled in the study from June 2007 to December 2007. The LEV dose ranged from 10 to 60 mg/kg per day. Follow up visit were performed at 6 months, 12 months, 24 months and 36 months, and treatment effects, adverse effects were recorded. RESULTS The LEV retention rates at 6, 12, 24, and 36 months were 93.5% (116/124), 84.7% (105/124), 65.3% (81/124), and 58.9% (73/124), respectively. The predominant causes of withdrawal were lack of efficacy (62.7%) and serious adverse effects (17.6%). In addition, 48.6% (51/105), 60.5% (49/81) and 72.6% (53/73) patients were seizure-free for 12 months, 24 months and 36 months, respectively. In this study, 75 (60.5%) patients experienced at least one side effect. The most common side effects observed were irritability 38.7% (29/75), somnolence 17.3% (13/75), learning disability 16.0% (12/75), anorexia 17.3% (13/75), somnipathy 13.3% (10/75), and abnormal behavior 13.3% (10/75). CONCLUSIONS Our study revealed the high retention rate of LEV in Chinese children and adolescents with epilepsy.
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Correia FD, Freitas J, Magalhães R, Lopes J, Ramalheira J, Lopes-Lima J, Chaves J. Two-year follow-up with eslicarbazepine acetate: a consecutive, retrospective, observational study. Epilepsy Res 2014; 108:1399-405. [PMID: 25060997 DOI: 10.1016/j.eplepsyres.2014.06.017] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Revised: 06/03/2014] [Accepted: 06/28/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Eslicarbazepine acetate (ESL) is a new generation voltage-gated sodium channel blocker. It has completed one phase II clinical trial and three phase III clinical trials, two of which with 1-year open label extensions. ESL was approved in 2009 by the European Medicines Agency as adjunctive therapy in adults with partial-onset seizures with or without secondary generalization. It is marketed in Portugal since April 1st 2010. Despite good safety and efficacy shown in clinical trials, little is known about its effectiveness in a clinical day-to-day setting. Our purpose was to assess the post-marketing experience with ESL in our centre, in terms of safety and efficacy profile, and ascertain whether the results were comparable to the published data. METHODS This is a retrospective, consecutive, single-centre 2-year observational study. All the patients who initiated treatment with ESL between April 1st 2010 and October 31st 2011 at Hospital de Santo António were consecutively included. Data was collected on demographics, clinical features, adverse events and treatment response, using a standardized data form. Follow-up data was considered until October 31st 2013. Efficacy analysis was performed using an "intention to treat" approach. KEY FINDINGS We included 152 patients, 74 (48.7%) female. Mean age was 38.5 years-old (sd=14.2). Eight patients were less than 18 years old. Mean epilepsy duration was 26.8 (sd=13.1) years and mean seizure frequency in the previous 3 months was 19.7 seizures per month. At baseline, about 57.9% of all patients were taking ≤2 concomitant AEDs. The total adverse rate was 42.1% (64/152), with 50.0% (32/64) leading to treatment discontinuation. The most frequent adverse events were dizziness and somnolence/slowness. Adverse events were higher in regimens including carbamazepine, and mean age was higher in the patients reporting adverse events. Retention rates as estimated by Kaplan-Meyer curves were 82.9%, 71.3%, 65.1% and 62.8%, respectively, at 6, 12, 18 and 24 months. Retention time was not influenced by gender, diagnosis, age or epilepsy duration. Fifty-six patients (36.8%) dropped out of treatment, 32 (57.1%) due to adverse events, 19 (33.9%) due to lack of efficacy and 5 (8.9%) for other reasons. At 6,12,18 and 24 months, the responder rates were 25.7%, 25.7%, 19.0% and 17.1%, respectively and favourable global clinical impression rates were 27.7%, 19.7%, 17.8% and 16.5%. SIGNIFICANCE This is the first study reporting follow-up data for up to 2 years in patients treated with ESL in the setting of daily clinical practice. The retention rates in our study are sustained throughout the 2 years of follow-up, and at 6 and 12 months are globally comparable to those of phase III trials and open-label extensions. The adverse event rate is also comparable to previous studies, and no new safety issues attributable to ESL were found. Responder rates were lower than those of previous studies, even though efficacy results must be interpreted with caution given the different study design. Thus, ESL appears to be a clinically useful add-on AED, with good safety profile and high retention rates, even in a very refractory group of patients like the presented cohort.
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Affiliation(s)
- Fernando D Correia
- Department of Neurology, Hospital Santo António-Centro Hospitalar do Porto, Largo Prof Abel Salazar, Oporto, Portugal.
| | - Joel Freitas
- Department of Neurology, Hospital Santo António-Centro Hospitalar do Porto, Largo Prof Abel Salazar, Oporto, Portugal
| | - Rui Magalhães
- Department of Population Studies, Instituto de Ciências Biomédicas Abel Salazar, University of Porto, Portugal
| | - João Lopes
- Department of Neurophysiology, Hospital Santo António-Centro Hospitalar do Porto, Oporto, Portugal
| | - João Ramalheira
- Department of Neurophysiology, Hospital Santo António-Centro Hospitalar do Porto, Oporto, Portugal
| | - José Lopes-Lima
- Department of Neurology, Hospital Santo António-Centro Hospitalar do Porto, Largo Prof Abel Salazar, Oporto, Portugal
| | - João Chaves
- Department of Neurology, Hospital Santo António-Centro Hospitalar do Porto, Largo Prof Abel Salazar, Oporto, Portugal
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Hao SQ, Zhao M, Zhang RW, Zhang JC, Zhang J, Feng XS. The effectiveness comparison of Jitai tablets versus methadone in community-based drug treatment: a 1-year follow-up study. Addict Behav 2013; 38:2596-600. [PMID: 23827820 DOI: 10.1016/j.addbeh.2013.05.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 04/11/2013] [Accepted: 05/28/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of the study was to compare the effectiveness of Jitai tablets (JTT) versus methadone in a community drug treatment program. METHODS A cohort study was conducted with 386 eligible subjects from 7 districts to 65 communities in Shanghai. The subjects were placed into the JTT group (n=206) or the methadone group (n=180). The data were collected at 8-, 26- and 52-week follow-ups. RESULTS The retention rates of the methadone group at the 8-, 26-, and 52-week follow-ups were 97.78%, 91.67%, and 85.00%, respectively. The retention rates of the JTT group at these follow-ups were 90.78%, 83.50%, and 74.27%, respectively. A Chi-square test indicated a significant difference, and the P values were 0.0037, 0.0161, and 0.0095 for each follow-up. The relapse rates for the JTT group were 3.88%, 6.31% and 11.17% for each follow-up, and those for the methadone group were 1.11%, 2.78%, and 7.78% for each follow-up. The Chi-square test indicated no significance, and the P values were 0.1128, 0.1005 and 0.2594. A survival analysis indicated that the relapse survival curve had no significant difference between the two groups (log-rank test, P=0.188). CONCLUSION Methadone and JTT combined with psychological intervention and social support provided effective maintenance treatment and relapse prevention in a community drug treatment program. The retention rate in the methadone group was higher, but the JTT group had the same relapse prevention as the methadone group. JTT can be recommended to clinical doctors and drug addicts.
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Swellengrebel HAM, Marijnen CAM, Vincent A, Cats A. Evaluating long-term attachment of two different endoclips in the human gastrointestinal tract. World J Gastrointest Endosc 2010; 2:344-8. [PMID: 21160584 PMCID: PMC2998819 DOI: 10.4253/wjge.v2.i10.344] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 08/31/2010] [Accepted: 09/07/2010] [Indexed: 02/05/2023] Open
Abstract
AIM: To evaluate the long-term attachment of two types of endoclips in the human gastrointestinal tract.
METHODS: In this prospective observational study, endoclips were placed and followed-up during endoscopies or using fluoroscopic images as part of a prospective feasibility study evaluating external beam radiotherapy (EBRT, wk 1-3) followed by high dose rate brachytherapy (HDRBT with an endoluminal applicator once a week for 3 wk, wk 9-11) in medically inoperablerectal cancer patients. Initially, the type and number of endoclips were chosenrandomly and later refined to 1 Resolution® clip (Microvasive) proximal and 2 Quickclips® (Olympus) distal to the tumor. Nine consecutive patients from between September 2007 and August 2008 were analyzed. Retention rates were evaluated over three different observational periods [period 1: pre-HDRBT (wk -2-8), period 2: during HDRBT (wk 9-11) and period 3: post-HDRBT (wk 12-16)].
RESULTS: In this study, a total of 44 clips were placed during endoscopy, either at the beginning or at the end of period 1. The Resolution clip had a higher overall retention rate than the Quickclip (P = 0.01). After a median period of 81 d after placement (in period 1), long-term retention rates for the Resolution clip and Quickclip clip were 67% and 35% respectively.
CONCLUSION: The Resolution clip has a high retention rate and is useful in situations where long-term attachment to the human gastrointestinal mucosa is warranted.
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Affiliation(s)
- Hendrik Albert Maurits Swellengrebel
- Hendrik Albert Maurits Swellengrebel, Annemieke Cats, Department of Gastroenterology and Hepatology, the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, Amsterdam 1066CX, The Netherlands
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