1
|
Szarek M, Debus ES, Nehler MR, Anand SS, Patel MR, Haskell LP, Muehlhofer ES, Berkowitz SD, Bauersachs RM, Bonaca MP. Total hospitalizations after peripheral arterial revascularization in the VOYAGER trial. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In the VOYAGER PAD trial, rivaroxaban reduced first and total (first and subsequent) occurrences of major adverse limb and cardiovascular events in patients with peripheral artery disease (PAD) after lower extremity revascularization (LER), but also increased incident bleeding.
Purpose
Assessment of disease burden by the onset of a particular set of events does not necessarily capture all consequences of a disease process that negatively impact patients' quality of life, motivating the adoption of more patient-centered outcomes. The present analysis of VOYAGER PAD describes the total incidence and duration of hospitalizations reported during the study as a broader measure of total disease burden and net benefit of rivaroxaban therapy.
Methods
Patients were randomized 1:1 to rivaroxaban 2.5 mg twice daily plus aspirin (n=3286) or aspirin alone (n=3278). Investigators documented the primary reason and duration for each hospitalization occurring after randomization. Total hospitalization rates were estimated by events per 100 patient-years. Treatment group comparisons on total hospitalizations as a time-to-event outcome were by marginal proportional hazards models with death as a competing terminal event, while days in hospital were compared by zero-inflated Poisson regression. All analyses were intention-to-treat.
Results
A total of 7156 hospitalizations (3265 first, 3891 subsequent) occurred during a median 2.5 years of follow-up, with nearly 40% being hospitalizations for PAD and a small fraction attributed to bleeding events (Figure 1). The rivaroxaban rate was lower for PAD hospitalizations and higher for bleeding event hospitalizations, with more hospitalizations prevented than caused (Table 1). Mean days in hospital among patients hospitalized at least once was significantly lower in the rivaroxaban group for any reason, for PAD, and for bleeding, so that total days in hospital was numerically lower for rivaroxaban.
Conclusion
Patients with PAD undergoing LER have a high rate of subsequent hospitalizations after an index procedure, driven by re-hospitalizations for PAD. Rivaroxaban decreased both the incidence and duration of PAD hospitalizations. While rivaroxaban increased incident hospitalizations due to bleeding, the mean durations of these hospitalizations were lower relative to placebo, leading to fewer total days in hospital for bleeding (1252 vs. 1531 total days). These findings may be useful for clinicians and patients weighing the risks and benefits of rivaroxaban in PAD after revascularization.
Funding Acknowledgement
Type of funding sources: Private company. Main funding source(s): BayerJanssen
Collapse
Affiliation(s)
- M Szarek
- University of Colorado , Aurora , United States of America
| | - E S Debus
- The University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - M R Nehler
- University of Colorado , Aurora , United States of America
| | - S S Anand
- Population Health Research Institute , Hamilton , Canada
| | - M R Patel
- Duke Clinical Research Institute , Durham , United States of America
| | - L P Haskell
- Janssen Research and Development , Raritan , United States of America
| | | | - S D Berkowitz
- University of Colorado , Aurora , United States of America
| | | | - M P Bonaca
- University of Colorado , Aurora , United States of America
| |
Collapse
|
2
|
Hanauer SB, Robinson M, Pruitt R, Lazenby AJ, Persson T, Nilsson LG, Walton-Bowen K, Haskell LP, Levine JG. Budesonide enema for the treatment of active, distal ulcerative colitis and proctitis: a dose-ranging study. U.S. Budesonide enema study group. Gastroenterology 1998; 115:525-32. [PMID: 9721148 DOI: 10.1016/s0016-5085(98)70131-3] [Citation(s) in RCA: 139] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Budesonide is a highly potent topical glucocorticosteroid that is characterized by low systemic availability as a result of high first-pass hepatic metabolism. The aim of this study was to evaluate the efficacy and safety of three doses of an enema preparation of budesonide in patients with active distal ulcerative colitis/proctitis. METHODS In a double-blind multicenter trial, 233 patients were randomized to receive either a placebo enema or budesonide enema at a dose of 0.5 mg/100 mL, 2.0 mg/100 mL, or 8.0 mg/100 mL. The primary efficacy variables were an improvement of sigmoidoscopic inflammation grade, total histopathology score, and remission rates. Effects on cortisol concentrations were also assessed. RESULTS After 6 weeks of treatment, there was significant improvement in sigmoidoscopy and histopathology scores in the budesonide 2.0-mg and 8.0-mg dose groups compared with placebo. Remission was achieved in 19% of patients in the 2.0-mg budesonide group (P </= 0.050) and 27% of patients in the 8.0-mg budesonide group (P </= 0.001) compared with 4% in the placebo group. More than 90% of all budesonide patients had a normal adrenocorticotropin (ACTH)-stimulated cortisol response at the last visit. The budesonide enemas were well tolerated. CONCLUSIONS Budesonide enema is both effective and safe for the treatment of active distal ulcerative colitis/proctitis. A dose of 2. 0 mg/100 mL budesonide is the lowest effective dose.
Collapse
Affiliation(s)
- S B Hanauer
- Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Abstract
We describe a patient with hematuria, pyuria, eosinophiluria, decreased renal function, and severe anemia that developed while she was receiving chronic therapy with griseofulvin for onychomycosis. We offer evidence that griseofulvin can cause an isolated erythroid hypoplasia and possibly an allergic interstitial nephritis. This is the first documented case of the above entities induced by the agent. We would recommend, based on our report, that otherwise healthy patients, when maintained on the drug for extended periods of time, have periodic determinations of renal function and hematologic status. As drug-induced erythroid hypoplasia typically occurs after a relatively long period of dosing, it may be prudent in certain individuals to monitor the CBC at approximately bimonthly intervals after initiation of therapy. Recommendations regarding monitoring of renal function are more difficult, as acute allergic interstitial nephritis can occur after either short- or long-term exposure to certain drugs.
Collapse
Affiliation(s)
- L P Haskell
- Department of Medicine, Texas Tech University Regional Academic Health Sciences Center, Amarillo
| | | | | | | |
Collapse
|
4
|
Haskell LP, Fusco MJ, Wadler S, Sablay LB, Mennemeyer RP. Crescentic glomerulonephritis associated with prostatic carcinoma: evidence of immune-mediated glomerular injury. Am J Med 1990; 88:189-92. [PMID: 1689105 DOI: 10.1016/0002-9343(90)90473-q] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- L P Haskell
- Department of Nephrology, Texas Tech University Regional Academic Health Sciences Center, Amarillo
| | | | | | | | | |
Collapse
|
5
|
Haskell LP, Tannenberg AM. Elevated urinary specific gravity in acute oliguric renal failure due to hetastarch administration. N Y State J Med 1988; 88:387-8. [PMID: 2457189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
|
6
|
Abstract
Heroin-associated nephropathy (HAN) occurs almost exclusively in black heroin abusers, suggesting a genetic link to the disease. To further study this possibility, the frequencies of HLA-A, B, C, and DR antigens were determined in a group of 47 black patients with HAN. Included in the analyses is a subgroup of 16 patients with biopsy-proven focal glomerulosclerosis. Patient frequencies were compared with three separate control populations, the first a normal black population from New York City, the second from a national registry, and the third a group of blacks with idiopathic focal glomerulosclerosis. Only the frequency of HLA-BW53 was consistently increased significantly in the patients as compared with the control groups. This finding supports the notion that a genetic predisposition may exist in the addicted population for the development of renal disease.
Collapse
Affiliation(s)
- L P Haskell
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10467
| | | | | |
Collapse
|
7
|
Itescu S, Haskell LP, Tannenberg AM. Thiazide-induced clinically significant hypophosphatemia. Clin Nephrol 1987; 27:161-2. [PMID: 3568463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
|
8
|
Haskell LP, Nidus BD. Pericardial friction rubs in hepatorenal failure. Lancet 1987; 1:52. [PMID: 2879143 DOI: 10.1016/s0140-6736(87)90754-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
|
9
|
Abstract
Tuberculosis (TB) is a relatively common infectious complication in the dialysis population. Most cases are extrapulmonary and pose a diagnostic dilemma for the clinician. Tuberculous arthritis is a rare form of extrapulmonary TB occurring in approximately 1% of cases in nonuremics. Only 1 case in a dialysis patient (not proven by positive synovial fluid culture) has been reported. We report here a culture-proven case of tuberculous arthritis in a hemodialysis patient which masqueraded as an acute septic arthritis. TB should be considered early as an etiologic agent along with synovial biopsy when the exact cause of a monoarthritis has not been discovered, thus avoiding delay in initiation of appropriate therapy.
Collapse
Affiliation(s)
- L P Haskell
- Department of Medicine, Metropolitan Hospital Center, New York, N.Y
| | | |
Collapse
|
10
|
|
11
|
Abstract
To determine the relative effects of systemic pH, PCO2, and bicarbonate concentration on colonic electrolyte transport, states of acute metabolic acidosis and alkalosis were created in Sprague-Dawley rats by gavage feeding (NH4)2SO4 and NaHCO3, respectively. During in situ perfusion of the distal colon in pentobarbital-anesthetized animals, electrolyte transport was measured before and after respiratory compensation of the systemic pH. Acute respiratory acidosis and alkalosis also were studied by ventilating animals with 0, 3, or 8% CO2. When animals in all groups were considered, net sodium absorption correlated well with blood PCO2 (r = 0.99) but not with blood pH. Net bicarbonate secretion correlated with the plasma (r = 0.95) and luminal (r = -0.63) bicarbonate concentrations but not with blood pH or PCO2. Net chloride absorption correlated with both blood PCO2 (r = 0.92) and the plasma bicarbonate concentration (r = 0.80). These results suggest that systemic PCO2 affects a sodium chloride absorptive process and that the plasma bicarbonate concentration affects a chloride absorptive-bicarbonate secretory exchange process in the rat colon.
Collapse
|
12
|
Abstract
To determine the relative effects of systemic pH, CO2 tension (PCO2), and bicarbonate concentration on ileal electrolyte transport, states of acute metabolic acidosis and alkalosis were created in Sprague-Dawley rats by gavage feeding (NH4)2SO4 and NaHCO3, respectively. During in situ perfusion of the ileum in anesthetized animals, electrolyte transport was measured before and after respiratory compensation of the systemic pH. Acute respiratory acidosis and alkalosis also were studied by ventilating animals with 0, 3, or 8% CO2. When animals in all groups were considered, net sodium absorption correlated very well with blood pH (r = -0.97). Net bicarbonate secretion correlated with the plasma bicarbonate concentration (r = 0.91) independently of blood pH and PCO2. Net chloride absorption correlated with blood PCO2 (r = 0.92) and was altered when systemic pH and bicarbonate concentration changed in opposite directions. Alterations in luminal pH and PCO2 did not affect electrolyte transport. These results suggest that systemic pH affects a sodium chloride absorptive process and that the plasma bicarbonate concentration affects a chloride absorptive-bicarbonate secretory exchange process in the rat ileum.
Collapse
|
13
|
Haskell LP. Personal Experience. Dent Regist 1916; 70:521-522. [PMID: 33703441 PMCID: PMC7852716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
14
|
Haskell LP. Retention of Upper Dentures. J Natl Med Assoc 1914; 6:234. [PMID: 20891429 PMCID: PMC2622035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
|
15
|
Haskell LP. Important Aphorisms. Applied to Plate Work. Dent Regist 1910; 64:471-474. [PMID: 33702201 PMCID: PMC6986614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
16
|
Haskell LP. An Unusual Condition. Dent Regist 1910; 64:371-373. [PMID: 33702221 PMCID: PMC6986638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
|
17
|
Haskell LP. In Search of a Dentist. Dent Regist 1900; 54:586-587. [PMID: 33700971 PMCID: PMC6969715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
18
|
Haskell LP. Some Established Principles in Prosthetic Dentistry. Am J Dent Sci 1897; 31:31-35. [PMID: 30750062 PMCID: PMC6065741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Haskell LP. Air-Chambers. Am J Dent Sci 1896; 30:118-120. [PMID: 30757589 PMCID: PMC6118532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
20
|
Haskell LP. Fifty Years in the Laboratory; or the Evolution of the Dental Laboratory as I Have Seen It. Am J Dent Sci 1895; 29:145-153. [PMID: 30757633 PMCID: PMC6118653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
21
|
Haskell LP. The Cracking of Teeth in Soldering. Am J Dent Sci 1894; 28:33-34. [PMID: 30757445 PMCID: PMC6115090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
22
|
Haskell LP. A Few Things to Be Remembered. Am J Dent Sci 1894; 27:565-566. [PMID: 30757395 PMCID: PMC6114826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
23
|
Haskell LP. Some Difficult Cases and Their Treatment. Am J Dent Sci 1888; 22:168-173. [PMID: 30749226 PMCID: PMC6046737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
|
24
|
Haskell LP. Metal Work. Am J Dent Sci 1887; 21:35-37. [PMID: 30757088 PMCID: PMC6112466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
|
25
|
Haskell LP. Metal Work: Read before the Central Dental Association of Northern New Jersey. Indep Pract 1887; 8:133-134. [PMID: 37826545 PMCID: PMC10085260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
|
26
|
Haskell LP. Bridge Work. Am J Dent Sci 1886; 20:280-282. [PMID: 30749160 PMCID: PMC6045277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
27
|
Haskell LP. Injurious Effects of Vulcanized Rubber. Chic Med J Exam 1881; 42:29-32. [PMID: 37617568 PMCID: PMC9847775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
|
28
|
Haskell LP. Injurious Effects of Vulcanized Rubber. Dent Regist 1877; 31:470-471. [PMID: 33696076 PMCID: PMC6903044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
|
29
|
Haskell LP. Mechanical Dentistry at the Meeting of the American Association. Dent Regist 1877; 31:376-378. [PMID: 33696099 PMCID: PMC6903072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
30
|
Haskell LP. Mechanical Dentistry. Dent Regist 1876; 30:468-472. [PMID: 33695700 PMCID: PMC6892103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
31
|
Haskell LP. Mechanical Dentistry-Its Present Condition. &c. Am J Dent Sci 1876; 10:97-104. [PMID: 30752804 PMCID: PMC6100878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
|
32
|
Haskell LP. Dental Hobbies. Dent Regist 1866; 20:205-210. [PMID: 33697597 PMCID: PMC6911403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|