A retrospective cohort using pharmacy and medical claims was analysed to determine whether the di... more A retrospective cohort using pharmacy and medical claims was analysed to determine whether the di¡erences in e⁄cacy of various inhaled corticosteroids demonstrated in clinical trials lead to di¡erences in costs of care observed in clinical practice. Subjects that had an ICD-9 (493.XX) code for asthma and a new pharmacy claim for inhaled £uticasone propionate 44 mcg (FP), beclomethasone dipropionate (BDP), triamcinolone acetonide (TAA), budesonide (BUD) or £unisolide (FLU) were identi¢ed and followed for 12 months. Annual asthma care charges (pharmacy and medical) over the 12-month observation period were signi¢cantly (Po0?03) higher in patients treated with BDP,TAA, BUD and FLU compared to FP, 24%, 27%, 34% and 45% respectively.In addition, patients treated with BDP,TAA, and FLU were associated with signi¢cantly (P 0?005) higher total healthcare (asthma þ non-asthma) charges compared to patients on FP, 53%, 46% and 39% respectively. Asthma care and total healthcare charges remained lower for FP after including FP110 mcg and excluding patients who were extreme cost outliers (72 SD from the mean) in a univariate sensitivity analysis.This analysis supports recent randomized control trials that FP o¡ers a superior e⁄cacy pro¢le at lower asthma care as well as total healthcare charges compared to other inhaled corticosteroids.
RATIONALE: Fall-winter seasonal increases in asthma-related ED and hospitalizations are widely do... more RATIONALE: Fall-winter seasonal increases in asthma-related ED and hospitalizations are widely documented and associated with viral infections. This study attempts to establish whether there is a correlation with initial asthma diagnosis and treatment and the fall-winter seasonal increase in epidemic viral-induced wheezing. METHODS: Retrospective data analysis of pediatric subjects who had their first asthma reliever or controller prescription between 1998-2002, were <18 years of age at time of initial asthma diagnosis, and had continuous enrollment for 6 months pre-and post-index claim was performed. Monthly counts of initial asthma diagnosis and initial asthma prescription claims were examined in the following age groups: infant (0-1 year), toddler (2-4 years), elementary school-age (5-12 years) and adolescent (13-17 years). RESULTS: There were 6,794 (0-1 year), 27,784 (2-4 years), 64,514 (5-12 years) and 36,787 (13-17 years) subjects. Over the 5 study years, epidemic peaks for both initial asthma diagnosis and initial asthma prescription claims were noted in October for both school-age groups (5-17 years). Infants had more of a winter peak. These peaks correlate with viral epidemics (fall-winter) and were outside the time frame of epidemic seasonal allergic exposure (spring). CONCLUSION: Using administrative claims data, this study shows that initial asthma diagnosis and prescription claims coincide with the same epidemics of ED visits and hospitalizations in children of all ages and suggests the importance of viral infections as a sentinel event defining the need for asthma treatment.
American Journal of Alzheimer's Disease and Other Dementias, 2010
Background: The Dependence Scale (DS) was designed to assess levels of patient need for care due ... more Background: The Dependence Scale (DS) was designed to assess levels of patient need for care due to deficits typical of Alzheimer's disease (AD). This study examined content validity of the DS based on input from patients, caregivers, and clinicians. Methods: Qualitative interviews with experts, patients, and caregivers were used to collect information on the concept of dependence and to assess content validity. Results: Nine clinicians rated item relevance ''high'' with consensus on the primacy of functional abilities and dependence in the measurement of AD progression. Twenty-two US, 11 UK, and 14 informal caregivers from Spain participated in focus groups; 18 patients participated in 3 separate focus groups. Discussion supported DS hierarchy of dependence, capture of mild-to-severe dependence, suitability of response options, and short recall time frame. Conclusions: Clinicians, caregivers, and patients support content validity of the DS in mild-to-moderate AD. The DS may be valuable to capture dependence within future clinical dementia trials.
OBJECTIVES: Health-related quality of life is an important issue in the treatment of breast cance... more OBJECTIVES: Health-related quality of life is an important issue in the treatment of breast cancer (BC) and health-state utility values (HSUVs) are essential for costutility analysis. The aim of the study was to identify published values for common health states for breast cancer and to determine pooled estimates of HSUVs for each identifiable health state. METHODS: A systematic review of HSUVs for conditions relating to BC was undertaken. Thirteen databases were searched in March 2009. HSUVs were allocated to six categories: screening related states, preventative states, adverse events in breast cancer and its treatment, non-specific breast cancer, early breast cancer (EBC) states and metastatic breast cancer (MBC) states. Where appropriate meta analysis was used to provide utilities based on combining all available evidence. Mean utility estimates were pooled using ordinary least squares with utilities clustered within study group and weighted by both number of respondents and inverse of the variance of each utility. Regressions included controls for disease state, utility assessment method and other features of study design. RESULTS: Forty-nine articles were identified, providing 476 unique utility values. From these, 117 values for MBC and 230 values for EBC were extracted and analysed by regression analysis. Utilities were found to vary significantly by valuation method (e.g. in EBC standard gamble had higher valuations than TTO and EQ-5D), and source of values. For MBC values significantly varied in expected direction by severity of condition, treatment and side-effects. CONCLUSIONS: Despite the numerous studies it was not feasible to generate a definitive list of HSUVs that could be used in future economic evaluations, due to the complexity of the health states involved and the variety of methods used to obtain values. Future research into quality of life in BC should make greater use of validated generic preference-based measures for which public preferences exist.
Anti-inflammatories (steroids, leukotriene modifiers) are recommended for most levels of asthma s... more Anti-inflammatories (steroids, leukotriene modifiers) are recommended for most levels of asthma severity and should be able to alter these endpoints. However, initial prescription filling (50-80%) and refilling (20-40%) rates are so poor as to preclude comparisons of drug effectiveness or health care plans. While disease management of asthma would wish to alter these endpoint costs, it is not possible to develop a PD-PE model to compare effectiveness of asthma anti-inflammatories across or within plans. OBJECTIVES: To develop a PD-PE model to compare effectiveness of anti-inflammatory therapies. To obviate the above limitations, we used published clinical results involving moderate-severe asthmatics in terms of improved lung function ((⌬0.1L FEV1) calibrated against the antiinflammatory inhaled therapy costs (per-day ϫ treatment duration). Additional cost reductions related to reduced need for metered dose inhalers were also tabulated.
ponent summary score as well as on the general health, vitality, social functioning and role emot... more ponent summary score as well as on the general health, vitality, social functioning and role emotional domains of the SF-36 (P Ͻ 0.05). CONCLUSIONS: The results of this interim analysis suggest that TM patients have a lower quality of life than patients with EM.
This article reviews measures of Alzheimer's disease (AD) progression in relation to patient depe... more This article reviews measures of Alzheimer's disease (AD) progression in relation to patient dependence and offers a unifying conceptual framework for dependence in AD. Clinicians typically characterize AD by symptomatic impairments in three domains: cognition, function, and behavior. From a patient's perspective, changes in these domains, individually and in concert, ultimately lead to increased dependence and loss of autonomy. Examples of dependence in AD range from a need for reminders (early AD) to requiring safety supervision and assistance with basic functions (late AD). Published literature has focused on the clinical domains as somewhat separate constructs and has given limited attention to the concept of patient dependence as a descriptor of AD progression. This article presents the concept of dependence on others for care needs as a potential method for translating the effect of changes in cognition, function, and behavior into a more holistic, transparent description of AD progression.
The effectiveness of a sensor configuration, based solely on body surface pressure readings, for ... more The effectiveness of a sensor configuration, based solely on body surface pressure readings, for feedback flow control of the wake of a "D" shaped cylinder is investigated by DNS. The research is aimed at suppressing unsteady loads resulting from the von Kármán vortex shedding in the wake of bluff bodies at a Reynolds number range of 100-1000. The design of sensor number and placement was based on data from a laminar direct numerical simulation of the Navier Stokes equations for the baseline condition. A low-dimensional Proper Orthogonal Decomposition (POD) procedure was applied to the pressure and stream-wise velocity of the flow field. The sensor placement was based on the intensity of the spatial Eigen-functions obtained by applying POD to 286 surface pressures. The numerically generated data was comprised of 100 snapshots taken from the flow regime that corresponds to steady state vortex shedding. A Linear Stochastic Estimator (LSE) was employed to map the pressure signals from the body mounted sensors to the temporal coefficients of the reduced order model of the wake flow field in order to provide accurate yet compact estimates of the lowdimensional states. For a ten sensor configuration, results show that the root mean square estimation error of the estimates of the first two modes is within 1-3% of the desired values and for the third mode it is 12-20% accurate. This level of error is acceptable for a moderately robust controller required to close the loop, based on previous investigation.
For successful feedback flow control, an accurate estimation of the flow state is necessary. Prop... more For successful feedback flow control, an accurate estimation of the flow state is necessary. Proper Orthogonal Decomposition (POD) has been used to achieve this. However, if the POD modes are derived from a set of snapshots obtained from one flow condition only, the resulting modes will become less and less valid for a flow field that is for example altered by the effect of feedback flow control. In the past, a shift mode has been added to account for the change in the mean flow. Here, we present a new scheme that allows for the derivation of shift modes for all of the original POD modes. This DPOD mode set thus may span a range of flow conditions that are different in forcing, Reynolds number or other parameters affecting the modes. Artificial Neural Network Estimation (ANNE) allows for real time monitoring of the time coefficients associated with these DPOD modes.
Feedback flow control of a three-dimensional wake behind a circular cylinder at a Reynolds number... more Feedback flow control of a three-dimensional wake behind a circular cylinder at a Reynolds number of Re = 100 was investigated. A combination of numerical simulations, experiments, and control theory was used to understand the flow field and to develop a sensor configuration, a flow state estimator, and a controller. The flow field was analysed by using proper orthogonal decomposition (POD) in two dimensions, and two-dimensional and threedimensional sensor placements were investigated. The controller input was computed from the POD time coefficients, and actuation was performed by using rigid cylinder motion normal to the free stream. In the two-dimensional computations, feedback was shown to effectively reduce the drag and the fluctuating lift force. When feedback forcing was applied in the threedimensional wake, both simulations and experiments showed that the vortex shedding could be controlled initially and the amplitude of the fluctuations decreased. However, spanwise phase variations eventually appeared and rendered the controller ineffective.
The current study was initiated to determine whether insulin resis- tance and/or hyperinsulinemia... more The current study was initiated to determine whether insulin resis- tance and/or hyperinsulinemia affected the ability of obese individuals to lose weight in response to hypocaloric diets. Thirty-one obese, non- diabetic women, with values for body mass index ranging from 28.0-35.0 kg/m2, volunteered for this program. Resistance to insulin-mediated glucose disposal was assessed by determining their steady state plasma insulin and glucose concentration during the last 30 min of a 180-min infusion of somatostatin, insulin, and glucose. The total integrated in- sulin response to breakfast and lunch was also determined. After the baseline measurements, volunteers were placed on a hypocaloric diet calculated to lead to a minimum weekly loss of 1% of ideal body weight. Individuals who met the criteria after 30 days of dieting were defined as weight loss successes (n 5 20) and continued on the diet for another 30 days. Individuals not meeting the criteria were designated as weight loss fai...
Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year perio... more Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year period. Results were driven by the impact of ICS on quality of life, rather than on mortality. Findings were stable over most input data ranges. However, at efficacy levels below 3% and toxicity rates greater than 2.9%, the cost-effectiveness estimate exceeded $100,000/QALY. CONCLUSION: Results suggest that inhaled steroids deliver good comparative value in mild-to-moderate adult asthma. More research is needed, however, on the impact of ICS toxicity on patient preferences.
JNCI Journal of the National Cancer Institute, 1997
against Kaposi's sarcoma, the most common tumor in patients infected with human immunodeficiency ... more against Kaposi's sarcoma, the most common tumor in patients infected with human immunodeficiency virus type 1 (HIV-1). Methods: A phase I trial was conducted in 18 male patients with acquired immunodeficiency syndrome-related Kaposi's sarcoma. Successive cohorts of six patients each received human chorionic gonadotropin (A.P.L.; Wyeth-Ayerst, Radnor, PA) subcutaneously at doses of 5000 IU daily (level I), 10 000 IU three times a week (level II), or 10 000 IU daily (level III). Toxic effects, changes in reproductive hormone levels, HIV-1 RNA plasma levels, and response to therapy were evaluated. Results: A.P.L. treatment was well tolerated at all dose levels, and no maximum-tolerated, dosedefined toxic effects were observed at the highest dose tested. The most common side effects were weight gain, increased libido, and increased energy. A persistent increase in testosterone level and a persistent decline in luteinizing hormone and follicle-stimulating hormone levels were seen over time. Major responses were observed in six patients.
The objective of this study was too compare the effect of amlodipine vs Angiotensin Converting En... more The objective of this study was too compare the effect of amlodipine vs Angiotensin Converting Enzyme Inhibitors (ACE-I) or Angiotensin Receptor Blockers (ARB) in the treatment of hypertension in subjects 60 years of age or older. A retrospective cohort analysis was performed using the Physicians Data Corporation (PDC) Cardiology database. Subjects starting therapy with amlodipine, an ACE-I, or ARB for
A retrospective cohort using pharmacy and medical claims was analysed to determine whether the di... more A retrospective cohort using pharmacy and medical claims was analysed to determine whether the di¡erences in e⁄cacy of various inhaled corticosteroids demonstrated in clinical trials lead to di¡erences in costs of care observed in clinical practice. Subjects that had an ICD-9 (493.XX) code for asthma and a new pharmacy claim for inhaled £uticasone propionate 44 mcg (FP), beclomethasone dipropionate (BDP), triamcinolone acetonide (TAA), budesonide (BUD) or £unisolide (FLU) were identi¢ed and followed for 12 months. Annual asthma care charges (pharmacy and medical) over the 12-month observation period were signi¢cantly (Po0?03) higher in patients treated with BDP,TAA, BUD and FLU compared to FP, 24%, 27%, 34% and 45% respectively.In addition, patients treated with BDP,TAA, and FLU were associated with signi¢cantly (P 0?005) higher total healthcare (asthma þ non-asthma) charges compared to patients on FP, 53%, 46% and 39% respectively. Asthma care and total healthcare charges remained lower for FP after including FP110 mcg and excluding patients who were extreme cost outliers (72 SD from the mean) in a univariate sensitivity analysis.This analysis supports recent randomized control trials that FP o¡ers a superior e⁄cacy pro¢le at lower asthma care as well as total healthcare charges compared to other inhaled corticosteroids.
RATIONALE: Fall-winter seasonal increases in asthma-related ED and hospitalizations are widely do... more RATIONALE: Fall-winter seasonal increases in asthma-related ED and hospitalizations are widely documented and associated with viral infections. This study attempts to establish whether there is a correlation with initial asthma diagnosis and treatment and the fall-winter seasonal increase in epidemic viral-induced wheezing. METHODS: Retrospective data analysis of pediatric subjects who had their first asthma reliever or controller prescription between 1998-2002, were <18 years of age at time of initial asthma diagnosis, and had continuous enrollment for 6 months pre-and post-index claim was performed. Monthly counts of initial asthma diagnosis and initial asthma prescription claims were examined in the following age groups: infant (0-1 year), toddler (2-4 years), elementary school-age (5-12 years) and adolescent (13-17 years). RESULTS: There were 6,794 (0-1 year), 27,784 (2-4 years), 64,514 (5-12 years) and 36,787 (13-17 years) subjects. Over the 5 study years, epidemic peaks for both initial asthma diagnosis and initial asthma prescription claims were noted in October for both school-age groups (5-17 years). Infants had more of a winter peak. These peaks correlate with viral epidemics (fall-winter) and were outside the time frame of epidemic seasonal allergic exposure (spring). CONCLUSION: Using administrative claims data, this study shows that initial asthma diagnosis and prescription claims coincide with the same epidemics of ED visits and hospitalizations in children of all ages and suggests the importance of viral infections as a sentinel event defining the need for asthma treatment.
American Journal of Alzheimer's Disease and Other Dementias, 2010
Background: The Dependence Scale (DS) was designed to assess levels of patient need for care due ... more Background: The Dependence Scale (DS) was designed to assess levels of patient need for care due to deficits typical of Alzheimer's disease (AD). This study examined content validity of the DS based on input from patients, caregivers, and clinicians. Methods: Qualitative interviews with experts, patients, and caregivers were used to collect information on the concept of dependence and to assess content validity. Results: Nine clinicians rated item relevance ''high'' with consensus on the primacy of functional abilities and dependence in the measurement of AD progression. Twenty-two US, 11 UK, and 14 informal caregivers from Spain participated in focus groups; 18 patients participated in 3 separate focus groups. Discussion supported DS hierarchy of dependence, capture of mild-to-severe dependence, suitability of response options, and short recall time frame. Conclusions: Clinicians, caregivers, and patients support content validity of the DS in mild-to-moderate AD. The DS may be valuable to capture dependence within future clinical dementia trials.
OBJECTIVES: Health-related quality of life is an important issue in the treatment of breast cance... more OBJECTIVES: Health-related quality of life is an important issue in the treatment of breast cancer (BC) and health-state utility values (HSUVs) are essential for costutility analysis. The aim of the study was to identify published values for common health states for breast cancer and to determine pooled estimates of HSUVs for each identifiable health state. METHODS: A systematic review of HSUVs for conditions relating to BC was undertaken. Thirteen databases were searched in March 2009. HSUVs were allocated to six categories: screening related states, preventative states, adverse events in breast cancer and its treatment, non-specific breast cancer, early breast cancer (EBC) states and metastatic breast cancer (MBC) states. Where appropriate meta analysis was used to provide utilities based on combining all available evidence. Mean utility estimates were pooled using ordinary least squares with utilities clustered within study group and weighted by both number of respondents and inverse of the variance of each utility. Regressions included controls for disease state, utility assessment method and other features of study design. RESULTS: Forty-nine articles were identified, providing 476 unique utility values. From these, 117 values for MBC and 230 values for EBC were extracted and analysed by regression analysis. Utilities were found to vary significantly by valuation method (e.g. in EBC standard gamble had higher valuations than TTO and EQ-5D), and source of values. For MBC values significantly varied in expected direction by severity of condition, treatment and side-effects. CONCLUSIONS: Despite the numerous studies it was not feasible to generate a definitive list of HSUVs that could be used in future economic evaluations, due to the complexity of the health states involved and the variety of methods used to obtain values. Future research into quality of life in BC should make greater use of validated generic preference-based measures for which public preferences exist.
Anti-inflammatories (steroids, leukotriene modifiers) are recommended for most levels of asthma s... more Anti-inflammatories (steroids, leukotriene modifiers) are recommended for most levels of asthma severity and should be able to alter these endpoints. However, initial prescription filling (50-80%) and refilling (20-40%) rates are so poor as to preclude comparisons of drug effectiveness or health care plans. While disease management of asthma would wish to alter these endpoint costs, it is not possible to develop a PD-PE model to compare effectiveness of asthma anti-inflammatories across or within plans. OBJECTIVES: To develop a PD-PE model to compare effectiveness of anti-inflammatory therapies. To obviate the above limitations, we used published clinical results involving moderate-severe asthmatics in terms of improved lung function ((⌬0.1L FEV1) calibrated against the antiinflammatory inhaled therapy costs (per-day ϫ treatment duration). Additional cost reductions related to reduced need for metered dose inhalers were also tabulated.
ponent summary score as well as on the general health, vitality, social functioning and role emot... more ponent summary score as well as on the general health, vitality, social functioning and role emotional domains of the SF-36 (P Ͻ 0.05). CONCLUSIONS: The results of this interim analysis suggest that TM patients have a lower quality of life than patients with EM.
This article reviews measures of Alzheimer's disease (AD) progression in relation to patient depe... more This article reviews measures of Alzheimer's disease (AD) progression in relation to patient dependence and offers a unifying conceptual framework for dependence in AD. Clinicians typically characterize AD by symptomatic impairments in three domains: cognition, function, and behavior. From a patient's perspective, changes in these domains, individually and in concert, ultimately lead to increased dependence and loss of autonomy. Examples of dependence in AD range from a need for reminders (early AD) to requiring safety supervision and assistance with basic functions (late AD). Published literature has focused on the clinical domains as somewhat separate constructs and has given limited attention to the concept of patient dependence as a descriptor of AD progression. This article presents the concept of dependence on others for care needs as a potential method for translating the effect of changes in cognition, function, and behavior into a more holistic, transparent description of AD progression.
The effectiveness of a sensor configuration, based solely on body surface pressure readings, for ... more The effectiveness of a sensor configuration, based solely on body surface pressure readings, for feedback flow control of the wake of a "D" shaped cylinder is investigated by DNS. The research is aimed at suppressing unsteady loads resulting from the von Kármán vortex shedding in the wake of bluff bodies at a Reynolds number range of 100-1000. The design of sensor number and placement was based on data from a laminar direct numerical simulation of the Navier Stokes equations for the baseline condition. A low-dimensional Proper Orthogonal Decomposition (POD) procedure was applied to the pressure and stream-wise velocity of the flow field. The sensor placement was based on the intensity of the spatial Eigen-functions obtained by applying POD to 286 surface pressures. The numerically generated data was comprised of 100 snapshots taken from the flow regime that corresponds to steady state vortex shedding. A Linear Stochastic Estimator (LSE) was employed to map the pressure signals from the body mounted sensors to the temporal coefficients of the reduced order model of the wake flow field in order to provide accurate yet compact estimates of the lowdimensional states. For a ten sensor configuration, results show that the root mean square estimation error of the estimates of the first two modes is within 1-3% of the desired values and for the third mode it is 12-20% accurate. This level of error is acceptable for a moderately robust controller required to close the loop, based on previous investigation.
For successful feedback flow control, an accurate estimation of the flow state is necessary. Prop... more For successful feedback flow control, an accurate estimation of the flow state is necessary. Proper Orthogonal Decomposition (POD) has been used to achieve this. However, if the POD modes are derived from a set of snapshots obtained from one flow condition only, the resulting modes will become less and less valid for a flow field that is for example altered by the effect of feedback flow control. In the past, a shift mode has been added to account for the change in the mean flow. Here, we present a new scheme that allows for the derivation of shift modes for all of the original POD modes. This DPOD mode set thus may span a range of flow conditions that are different in forcing, Reynolds number or other parameters affecting the modes. Artificial Neural Network Estimation (ANNE) allows for real time monitoring of the time coefficients associated with these DPOD modes.
Feedback flow control of a three-dimensional wake behind a circular cylinder at a Reynolds number... more Feedback flow control of a three-dimensional wake behind a circular cylinder at a Reynolds number of Re = 100 was investigated. A combination of numerical simulations, experiments, and control theory was used to understand the flow field and to develop a sensor configuration, a flow state estimator, and a controller. The flow field was analysed by using proper orthogonal decomposition (POD) in two dimensions, and two-dimensional and threedimensional sensor placements were investigated. The controller input was computed from the POD time coefficients, and actuation was performed by using rigid cylinder motion normal to the free stream. In the two-dimensional computations, feedback was shown to effectively reduce the drag and the fluctuating lift force. When feedback forcing was applied in the threedimensional wake, both simulations and experiments showed that the vortex shedding could be controlled initially and the amplitude of the fluctuations decreased. However, spanwise phase variations eventually appeared and rendered the controller ineffective.
The current study was initiated to determine whether insulin resis- tance and/or hyperinsulinemia... more The current study was initiated to determine whether insulin resis- tance and/or hyperinsulinemia affected the ability of obese individuals to lose weight in response to hypocaloric diets. Thirty-one obese, non- diabetic women, with values for body mass index ranging from 28.0-35.0 kg/m2, volunteered for this program. Resistance to insulin-mediated glucose disposal was assessed by determining their steady state plasma insulin and glucose concentration during the last 30 min of a 180-min infusion of somatostatin, insulin, and glucose. The total integrated in- sulin response to breakfast and lunch was also determined. After the baseline measurements, volunteers were placed on a hypocaloric diet calculated to lead to a minimum weekly loss of 1% of ideal body weight. Individuals who met the criteria after 30 days of dieting were defined as weight loss successes (n 5 20) and continued on the diet for another 30 days. Individuals not meeting the criteria were designated as weight loss fai...
Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year perio... more Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year period. Results were driven by the impact of ICS on quality of life, rather than on mortality. Findings were stable over most input data ranges. However, at efficacy levels below 3% and toxicity rates greater than 2.9%, the cost-effectiveness estimate exceeded $100,000/QALY. CONCLUSION: Results suggest that inhaled steroids deliver good comparative value in mild-to-moderate adult asthma. More research is needed, however, on the impact of ICS toxicity on patient preferences.
JNCI Journal of the National Cancer Institute, 1997
against Kaposi's sarcoma, the most common tumor in patients infected with human immunodeficiency ... more against Kaposi's sarcoma, the most common tumor in patients infected with human immunodeficiency virus type 1 (HIV-1). Methods: A phase I trial was conducted in 18 male patients with acquired immunodeficiency syndrome-related Kaposi's sarcoma. Successive cohorts of six patients each received human chorionic gonadotropin (A.P.L.; Wyeth-Ayerst, Radnor, PA) subcutaneously at doses of 5000 IU daily (level I), 10 000 IU three times a week (level II), or 10 000 IU daily (level III). Toxic effects, changes in reproductive hormone levels, HIV-1 RNA plasma levels, and response to therapy were evaluated. Results: A.P.L. treatment was well tolerated at all dose levels, and no maximum-tolerated, dosedefined toxic effects were observed at the highest dose tested. The most common side effects were weight gain, increased libido, and increased energy. A persistent increase in testosterone level and a persistent decline in luteinizing hormone and follicle-stimulating hormone levels were seen over time. Major responses were observed in six patients.
The objective of this study was too compare the effect of amlodipine vs Angiotensin Converting En... more The objective of this study was too compare the effect of amlodipine vs Angiotensin Converting Enzyme Inhibitors (ACE-I) or Angiotensin Receptor Blockers (ARB) in the treatment of hypertension in subjects 60 years of age or older. A retrospective cohort analysis was performed using the Physicians Data Corporation (PDC) Cardiology database. Subjects starting therapy with amlodipine, an ACE-I, or ARB for
Uploads
Papers by T. McLaughlin