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A Real-World Observational Study of Patients with Advanced Melanoma Receiving First-Line Ipilimumab in a Community Practice Setting  [PDF]
Debra A. Patt, Debra Rembert, Menaka Bhor, Debajyoti Bhowmik, Sumati A. Rao
Journal of Cancer Therapy (JCT) , 2014, DOI: 10.4236/jct.2014.512110
Abstract: Background: Following approval of ipilimumab, this observational cohort study (CA184-332) was initiated to describe patient and disease characteristics, patterns of care, survival, and adverse events (AEs) in advanced melanoma (AM) patients treated with first-line ipilimumab in realworld US community practice. Methods: Adult patients with treatment-naive AM who received ≥1 dose of ipilimumab 3 mg/kg between April 2011 and September 2012 were retrospectively identified at US Oncology sites. Clinical data were abstracted from patient medical records. Results: Median age of the 157 patient cohorts was 66 years (range 21 - 91). 68.2% were male, and 90.5% had a cutaneous primary site. At ipilimumab initiation, 80.9% of patients had an ECOG performance status of 0 or 1; 54.1% were stage M1c; 34.4% had brain metastases; 24.8% had elevated lactate dehydrogenase, and 13.4% were positive for BRAF mutation. All 4 cycles of ipilimumab were completed by 55.8% of patients. At a median follow-up of 8.5 months (range 2.9 - 15.0), median overall survival was 11.5 months (95% CI: 8.9 - 16.6) and 1-year survival was 46.7% (95% CI: 38.1 - 54.9). During ipilimumab treatment, AEs were experienced by 63.7% of patients. The most frequent AEs were gastrointestinal (41.4%; diarrhea in 19.1%) and skin-related (28.0%; rash in 17.8%); 17.8% of patients had an AE that led to ipilimumab discontinuation. Conclusions: These real-world results are consistent with those from clinical trials and provide evidence supporting the effectiveness and safety of first-line ipilimumab 3 mg/kg monotherapy in patients with AM treated in a community practice setting.
Economic modeling of the combined effects of HIV-disease, cholesterol and lipoatrophy based on ACTG 5142 trial data
Kit N Simpson, Birgitta Dietz, Robert W Baran, Kevin W Garren, Sharon A Riddler, Menaka Bhor, Richard H Haubrich
Cost Effectiveness and Resource Allocation , 2011, DOI: 10.1186/1478-7547-9-5
Abstract: We populated the Markov model of HIV-disease with data from ACTG 5142 study to estimate the economic outcomes of starting ARV therapy with a PI-containing regimen as compared to an NNRTI-containing regimen, given their virologic and immunologic efficacy and effects on cholesterol and lipoatrophy. CNS toxicities and GI tolerability were not included in the model because of their transient nature or low cost remedies, and therefore lack of economic impact. CD4+ T-cell counts and the HIV-1 RNA (viral load) values from the study were used to assign a specific health state (HS) to each patient for each quarter year. The resulting frequencies used as "raw" data directly into the model obviate the reliance on statistical tests, and allow the model to reflect actual patient behavior in the clinical trial. An HS just below the last observed HS was used to replace a missing value.The modeled estimates (undiscounted) for the LPV/r-based regimen resulted in 1.41 quality-adjusted life months (QALMs) gained over a lifetime compared to the EFV-based regimen. The LPV/r-based regimen incurred $7,458 (1.8%) greater cost over a lifetime due to differences in drug costs and survival. The incremental cost effectiveness ratio using the discounted cost and QALYs was $88,829/QALY. Most of the higher costs accrue before the 7th year of treatment and were offset by subsequent savings. The estimates are highly sensitive to the effect of lipoatrophy on Health-related Quality of Life (HRQOL), but not to the effect of cholesterol levels.The cost effectiveness of ARV regimens may be strongly affected by enduring AEs, such as lipoatrophy. It is important to consider specific AE effects from all drugs in a regimen when ARVs are compared.(ClinicalTrials.gov number, NCT00050895http://[ClinicalTrials.gov] webcite).The use of combination antiretroviral therapy (ART) has led to a well-documented trend of declining AIDS-related morbidity and mortality among HIV-positive patients [1-3]. Treatment strategi
Scoring systems in dermatology
Bhor Urmila,Pande Sushil
Indian Journal of Dermatology, Venereology and Leprology , 2006,
Hodgkin′s lymphoma in a patient of psoriasis treated with long-term, low-dose methotrexate therapy
Khopkar Uday,Bhor Urmila
Indian Journal of Dermatology, Venereology and Leprology , 2008,
Abstract: Methotrexate (MTX) is used in the treatment of a variety of diseases such as rheumatoid arthritis, dermatomyositis, juvenile rheumatoid arthritis and chronic plaque psoriasis. It has been well documented that there is a risk of development of lymphomas in these patients although none have been reported in patients of psoriasis treated with methotrexate. A 58-year-old male patient, a known case of psoriasis since 1994, had been receiving treatment with a low dose of MTX, 5 mg weekly for ten years intermittently (7-8 months/year). The cumulative dose of MTX taken was 1.5 gm. He developed high-grade fever with cervical lymphadenopathy that was nonresponsive to routine line of management. Lymph node biopsy revealed the presence of mixed cellularity type of Hodgkin′s lymphoma. CT scan showed cervical, mediastinal and abdominal lymphadenopathy. The patient responded well to withdrawal of MTX and chemotherapy. This is the first case of lymphoma occurring in a patient of psoriasis treated with low-dose MTX.
Identifying Semantic Relations for DiseaseTreatment in Medline
P. Menaka,Prof.D.Thilagavathy
International Journal of Electronics and Computer Science Engineering , 2012,
Abstract: The Machine Learning (ML) is almost used in any domain of research and now it has become a reliable tool in the medical domain.ML is a tool by which medical field is integrated with the computer based systems to provide more efficient medical care. The main objective of this work is to show what Natural Language Processing (NLP) and Machine Learning (ML) techniques used for representation of information and what classification algorithms are suitable for identifying and classifying relevant medical information in short texts. It acknowledges the fact that tools capable of identifying reliable information in the medical domain stand as building blocks for a healthcare system that is up-to-date with the latest discoveries. In this research, it focuses on diseases and treatment information, and the relation that exists between these two entities.
Seed dormancy and germination improvement treatments in fodder sorghum
M Shanmugavalli,PR Renganayaki,C Menaka
Journal of SAT Agricultural Research , 2007,
Natural Products for the Treatment of Obesity, Metabolic Syndrome, and Type 2 Diabetes
Menaka C. Thounaojam,Srinivas Nammi,Ravirajsinh Jadeja
Evidence-Based Complementary and Alternative Medicine , 2013, DOI: 10.1155/2013/871018
Activity Modeling in Smart Home using High Utility Pattern Mining over Data Streams
Menaka Gandhi. J,K. S. Gayathri
Computer Science , 2013,
Abstract: Smart home technology is a better choice for the people to care about security, comfort and power saving as well. It is required to develop technologies that recognize the Activities of Daily Living (ADLs) of the residents at home and detect the abnormal behavior in the individual's patterns. Data mining techniques such as Frequent pattern mining (FPM), High Utility Pattern (HUP) Mining were used to find those activity patterns from the collected sensor data. But applying the above technique for Activity Recognition from the temporal sensor data stream is highly complex and challenging task. So, a new approach is proposed for activity recognition from sensor data stream which is achieved by constructing Frequent Pattern Stream tree (FPS - tree). FPS is a sliding window based approach to discover the recent activity patterns over time from data streams. The proposed work aims at identifying the frequent pattern of the user from the sensor data streams which are later modeled for activity recognition. The proposed FPM algorithm uses a data structure called Linked Sensor Data Stream (LSDS) for storing the sensor data stream information which increases the efficiency of frequent pattern mining algorithm through both space and time. The experimental results show the efficiency of the proposed algorithm and this FPM is further extended for applying for power efficiency using HUP to detect the high usage of power consumption of residents at smart home.
Golden Research Thoughts , 2012, DOI: 10.9780/22315063
Abstract: Food, clothing and shelter are the primary needs of human being. Today in clothing ,textile industry is playing important role. Textile industry is second largest employer after agriculture. In modern world,consumer are now aware of many things especially eco-friendly textile. Their demand for eco-friendly textile is also related with quality, quantity ,price. For this Government ,Production dept of textile, Manager and also Consumers are playing important role .There are ill effects on health to overcome this problem some solutions are suggested ,also government role ,managerial role ,production department role are important factor to make India eco friendly textile.
Type I lepra reaction presenting as immune reconstitution inflammatory syndrome
Kharkar Vidya,Bhor Urmila,Mahajan Sunanda,Khopkar Uday
Indian Journal of Dermatology, Venereology and Leprology , 2007,
Abstract: Immune reconstitution inflammatory syndrome (IRIS) is an unusual inflammatory reaction due to infectious and non-infectious causes occurring in human Immunodeficiency virus (HIV)-infected patients. IRIS occurs after the initiation of antiretroviral therapy. There are no reports of type I lepra reaction due to IRIS in published literature from India. We report two cases of HIV-infected males who presented with borderline tuberculoid leprosy in type 1 reaction after the initiation of highly active antiretroviral treatment (HAART). Case 1 presented with multiple, tender, erythematous and hypoesthetic plaques on the trunk and extremities after 3 months of antiretroviral therapy. In case 2, type I lepra reaction was observed 2 months after the initiation of HAART.
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