Search results for "treatment failure"

showing 10 items of 114 documents

Multiclass HCV resistance to direct-acting antiviral failure in real-life patients advocates for tailored second-line therapies

2017

Background & Aims: Despite the excellent efficacy of direct-acting antivirals (DAA) reported in clinical trials, virological failures can occur, often associated with the development of resistance-associated substitutions (RASs). This study aimed to characterize the presence of clinically relevant RASs to all classes in real-life DAA failures. Methods: Of the 200 virological failures that were analyzed in 197 DAA-treated patients, 89 with pegylated-interferon+ribavirin (PegIFN+RBV) and 111 without (HCV-1a/1b/1g/2/3/4=58/83/1/6/24/25; 56.8% treatment experienced; 65.5% cirrhotic) were observed. Sanger sequencing of NS3/NS5A/NS5B was performed by home-made protocols, at failure (N= 200) and w…

Male0301 basic medicinehepatitis C virusSustained Virologic ResponseSofosbuvirHepacivirusDrug ResistanceHepacivirusresistance-associated substitutionsViral Nonstructural ProteinsVARIANTSNS5Amedicine.disease_causeGastroenterologychemistry.chemical_compound0302 clinical medicineRecurrenceINFECTIONantiviral therapyMedicinehepatitis C viruViralTreatment FailureChronicantiviral therapy; direct-acting antivirals; hepatitis C virus; resistance test; resistance-associated substitutions; hepatologybiologyGENOTYPE 1virus diseasesMiddle Agedantiviral therapy; direct-acting antivirals; hepatitis C virus; resistance test; resistance-associated substitutionsSettore MED/07 - Microbiologia e Microbiologia ClinicaHepatitis CItalyCombinationInterferonDrug Therapy CombinationFemale030211 gastroenterology & hepatologyAuthor Keywords:antiviral therapyRIBAVIRINSequence AnalysisHumanmedicine.drugmedicine.medical_specialtyDaclatasvirGenotypeHepatitis C virusAntiviral AgentsLONG-TERM PERSISTENCEDACLATASVIR03 medical and health sciencesDrug Therapyantiviral therapy; direct-acting antivirals; hepatitis C virus; resistance test; resistance-associated substitutions; Aged; Antiviral Agents; Drug Resistance Viral; Drug Therapy Combination; Female; Genotype; Hepacivirus; Hepatitis C Chronic; Humans; Interferons; Italy; Male; Middle Aged; Mutation; Recurrence; Ribavirin; Sequence Analysis DNA; Sofosbuvir; Sustained Virologic Response; Treatment Failure; Viral Nonstructural Proteins; HepatologyTREATMENT-NAIVEInternal medicineDrug Resistance ViralRibavirinHumansNS5Aresistance testdirect-acting antiviralsAgedAntiviral Agentresistance-associated substitutiondirect-acting antiviralHepaciviruHepatologyresistance test KeyWords Plus:HEPATITIS-C VIRUSbusiness.industryRibavirinViral Nonstructural ProteinSequence Analysis DNADNAHepatitis C ChronicHepatologybiology.organism_classificationClinical trial030104 developmental biologySOFOSBUVIRchemistrySequence AnalysihepatologyMutationImmunologyInterferonsSofosbuvirbusiness
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Incidence and risk factors of post-engraftment invasive fungal disease in adult allogeneic hematopoietic stem cell transplant recipients receiving or…

2015

Studies that analyze the epidemiology and risk factors for invasive fungal disease (IFD) after engraftment in alloSCT are few in number. This single-center retrospective study included 404 alloSCT adult recipients surviving > 40 days who engrafted and were discharged without prior IFD. All patients who received >= 20 mg/day of prednisone were assigned to primary oral prophylaxis (itraconazole or low-dose voriconazole). The primary end point was the cumulative incidence (CI) of probable/proven IFD using the European Organization for Research and Treatment of Cancer and Mycoses Study Group (EORTC/MSG) criteria. The independent prognostic factors after multivariate analyses were used to constr…

MaleAntifungal AgentsTransplantation ConditioningPremedicationmedicine.medical_treatmentMULTICENTERAdministration OralHematopoietic stem cell transplantationEchinocandinsCOMPETING RISKCaspofunginRisk FactorsCause of DeathINFECTIONGranulocyte Colony-Stimulating FactorEPIDEMIOLOGYCumulative incidenceTreatment FailureFramingham Risk ScoreIncidenceIncidence (epidemiology)Hematopoietic Stem Cell TransplantationHematologyMiddle AgedAllograftsHematologic NeoplasmsVORICONAZOLEDrug Therapy CombinationFemaleASPERGILLOSISRisk assessmentFungemiamedicine.drugAdultmedicine.medical_specialtyNeutropeniaANTIFUNGAL PROPHYLAXISNeutropeniaRisk AssessmentITRACONAZOLEMedication AdherenceImmunocompromised HostLipopeptidesYoung AdultAmphotericin BInternal medicinemedicineAspergillosisHumansAgedRetrospective StudiesVoriconazoleTransplantationbusiness.industryRetrospective cohort studyFLUCONAZOLETriazolesmedicine.diseaseSurvival AnalysisSurgeryMycosesPatient CompliancebusinessSCT
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Outcome of lower-risk patients with myelodysplastic syndromes without 5q deletion after failure of erythropoiesis-stimulating agents

2017

Purpose Most anemic patients with non-deleted 5q lower-risk myelodysplastic syndromes (MDS) are treated with erythropoiesis-stimulating agents (ESAs), with a response rate of approximately 50%. Second-line treatments, including hypomethylating agents (HMAs), lenalidomide (LEN), and investigational drugs, may be used after ESA failure in some countries, but their effect on disease progression and overall survival (OS) is unknown. Here, we analyzed outcome after ESA failure and the effect of second-line treatments. Patients and Methods We examined an international retrospective cohort of 1,698 patients with non-del(5q) lower-risk MDS treated with ESAs. Results Erythroid response to ESAs was 6…

MaleCancer Research0302 clinical medicineRecurrenceRisk Factorshemic and lymphatic diseasesHydroxyureaCumulative incidenceTreatment FailureEnzyme InhibitorsLenalidomideAged 80 and overCytarabineAnemiaMiddle AgedThalidomideMelodysplastic syndromeSurvival RateLeukemia Myeloid AcuteOncologyInternational Prognostic Scoring System030220 oncology & carcinogenesisRetreatmentAzacitidineCyclosporineDisease ProgressionChromosomes Human Pair 5FemaleChromosome DeletionErythrocyte Transfusionmedicine.drugmedicine.medical_specialtyMelodysplastic syndrome erytropoiesis stimulating agents 5q-erytropoiesis stimulating agentsDecitabineAntineoplastic AgentsTretinoinDecitabineLower risk5q-Arsenic03 medical and health sciencesInternal medicinemedicineHumansImmunologic FactorsSurvival rateAgedAntilymphocyte SerumRetrospective StudiesLenalidomidebusiness.industryValproic AcidMyelodysplastic syndromesRetrospective cohort studymedicine.diseaseMyelodysplastic SyndromesHematinicsPhysical therapybusiness030215 immunology
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A multicentre case control study on complicated coeliac disease: two different patterns of natural history, two different prognoses

2014

Background: Coeliac disease is a common enteropathy characterized by an increased mortality mainly due to its complications. The natural history of complicated coeliac disease is characterised by two different types of course: patients with a new diagnosis of coeliac disease that do not improve despite a strict gluten-free diet (type A cases) and previously diagnosed coeliac patients that initially improved on a gluten-free diet but then relapsed despite a strict diet (type B cases). Our aim was to study the prognosis and survival of A and B cases. Methods: Clinical and laboratory data from coeliac patients who later developed complications (A and B cases) and sex- and age-matched coeliac p…

MaleComplicationsSettore MED/09 - Medicina InternaLymphomaSmallGastroenterologyCoeliac diseaseEnteropathy-Associated T-Cell LymphomaIntestine SmallMedicineCeliac diseaseEnteropathyTreatment FailureINTESTINAL T-CELL LYMPHOMAGastroenterologyGLUTEN FREE DIETGeneral Medicinecomplicated coeliac disease; natural history; prognosis;IleitisMiddle AgedPrognosisEnteritisIntestineNatural historyAdult; Aged; Carcinoma; Case-Control Studies; Celiac Disease; Collagenous Sprue; Disease Progression; Enteritis; Enteropathy-Associated T-Cell Lymphoma; Female; Humans; Ileitis; Intestinal Neoplasms; Intestine Small; Jejunal Diseases; Lymphoma B-Cell; Male; Middle Aged; Prognosis; Treatment Failure; Diet Gluten-Freenatural historyGluten-free dietDisease ProgressionEnteropathy-associated T-cell lymphomaFemaleprognosiResearch ArticleCollagenous SprueAdultmedicine.medical_specialtyLymphoma B-CellGlutensSettore MED/12 - GASTROENTEROLOGIAcomplicated coeliac diseasecomplications/drug therapy/mortality Myocytes; celiac diseaseNODiet Gluten-FreeInternal medicineIntestinal NeoplasmsHumanscomplications/drug therapy/mortalitySurvival rateCELIAC DISEASE; Complications; INTESTINAL T-CELL LYMPHOMA; prognosis; GLUTEN FREE DIETAgedcomplications/drug therapy/mortality; Myocytes; celiac diseaseMyocytesbusiness.industryCarcinomaB-CellCase-control studynutritional and metabolic diseasesJejunal DiseasesHepatologymedicine.diseasedigestive system diseasesDietEATLCase-Control StudiesGluten-FreeGluten freebusinessComplicationcoeliac disease
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Mapping of failures after radiochemotherapy in patients with non-metastatic esophageal cancer: A posteriori analysis of the dose distribution in the …

2015

Abstract Background and purpose We aimed to evaluate the patterns of loco-regional failure (LRF) after exclusive chemoradiotherapy (eCRT) for esophageal cancer with respect to planned dose and/or the incidental (unplanned) dose outside target volumes. Materials and methods Co-image registration of CT or 18 F-FDG PET-CT at the time of failure (tf) and at the time of CRT (t0) was performed in 34 patients with LRF. Dosimetric parameters with regard to local failure (LF), nodal failure (NF) and involved nodal stations (NS) were derived. Results Twenty-two patients (64.7%) had LF, the majority of which (95.5%) were located at the epicenter of the GTV of the primary tumor. The mean doses recalcul…

MaleEsophageal NeoplasmsDose distributionPlanned DoseFluorodeoxyglucose F18MedicineNon metastaticHumansRadiology Nuclear Medicine and imagingIn patientTreatment FailureAgedAged 80 and overbusiness.industryLocal failureRadiotherapy DosageHematologyChemoradiotherapyEsophageal cancerMiddle Agedmedicine.diseasePrimary tumorOncologyFemaleLymph NodesNeoplasm Recurrence LocalbusinessNuclear medicineTomography X-Ray ComputedChemoradiotherapyRadiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology
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Low Rate of Virological Failure and Maintenance of Susceptibility to HIV-1 Protease Inhibitors with First-Line Lopinavir/Ritonavir-Based Antiretrovir…

2010

Protease inhibitor (PI)-resistant HIV-1 has hardly ever been detected at failed boosted PI-based first-line antiretroviral regimens in clinical trials. However, this phenomenon has not been investigated in clinical practice. To address this gap, data from patients starting a first-line lopinavir/ritonavir (LPV/rtv)-based therapy with available baseline HIV-1 RNA load, a viral genotype and follow-up viral load after 3 and 6 months of treatment were extracted from the Italian Antiretroviral Resistance Cohort Analysis (ARCA) observational database. Based on survival analysis, 39 (7.1%) and 43 (7.8%) of the 548 examined patient cases had an HIV-1 RNA >500 and >50 copies/ml, respectively, after …

MaleLopinavir/ritonavirHIV Infectionsboosted protease inhibitorLopinavirCohort Studies0302 clinical medicineAntiretroviral Therapy Highly Activevirologic failureHIV InfectionTreatment Failure030212 general & internal medicinePyrimidinone0303 health scienceseducation.field_of_studylopinavir/ritonavirLopinavirViral LoadResistance mutationfirst-line antiretroviral therapyReverse Transcriptase Inhibitor3. Good healthTreatment OutcomeInfectious DiseasesRNA ViralReverse Transcriptase InhibitorsMedicineDrug Therapy CombinationFemaleSurvival AnalysiViral loadHumanmedicine.drugAnti-HIV AgentsPopulationPyrimidinones.Settore MED/17 - MALATTIE INFETTIVEEmtricitabinehuman immunodeficiency virus type 103 medical and health sciencesVirologyDrug Resistance Viralantiretroviral drug resistancemedicineHumansProtease inhibitor (pharmacology)educationHIV Protease InhibitorRitonavir030306 microbiologybusiness.industryAnti-HIV AgentHIV Protease InhibitorsSurvival AnalysisVirologyHIV-1RitonavirCohort Studiebusiness
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Lixisenatide in Patients with Type 2 Diabetes and Acute Coronary Syndrome

2015

BACKGROUND: Cardiovascular morbidity and mortality are higher among patients with type 2 diabetes, particularly those with concomitant cardiovascular diseases, than in most other populations. We assessed the effects of lixisenatide, a glucagon-like peptide 1-receptor agonist, on cardiovascular outcomes in patients with type 2 diabetes who had had a recent acute coronary event.METHODS: We randomly assigned patients with type 2 diabetes who had had a myocardial infarction or who had been hospitalized for unstable angina within the previous 180 days to receive lixisenatide or placebo in addition to locally determined standards of care. The trial was designed with adequate statistical power to …

MaleMyocardial InfarctionKaplan-Meier Estimate2700 General MedicineType 2 diabetesAnginachemistry.chemical_compoundTreatment FailureMyocardial infarctionResearch Support Non-U.S. Gov'tHemoglobin AGeneral MedicineAnginaMiddle AgedMulticenter StudyCardiovascular DiseasesRandomized Controlled TrialCardiologyFemalelixisenatideType 2medicine.medical_specialtyAcute coronary syndromeGlycosylated610 Medicine & healthUnstableGlucagon-Like Peptide-1 Receptor11171 Cardiocentro TicinoLixisenatideAcute Coronary Syndrome; Aged; Angina Unstable; Cardiovascular Diseases; Diabetes Mellitus Type 2; Female; Glucagon-Like Peptide-1 Receptor; Hemoglobin A Glycosylated; Humans; Hypoglycemic Agents; Kaplan-Meier Estimate; Male; Middle Aged; Myocardial Infarction; Peptides; Proportional Hazards Models; Treatment FailureInternal medicineJournal ArticleDiabetes MellitusmedicineHumansHypoglycemic AgentsAngina UnstableAcute Coronary SyndromeAgedProportional Hazards ModelsHemoglobin A GlycosylatedUnstable anginabusiness.industrySemaglutideta3121medicine.diseaseDiabetes Mellitus Type 2chemistryMyocardial infarction complicationsPeptidesbusinessNew England Journal of Medicine
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Efficacy of FOLFIRI-3 (irinotecan D1,D3 combined with LV5-FU) or other irinotecan-based regimens in oxaliplatin-pretreated metastatic colorectal canc…

2009

Abstract Background: Second-line irinotecan-based chemotherapy is commonly used in metastatic colorectal cancers after first-line oxaliplatin-based chemotherapy. No standard schedule of irinotecan has been established in this situation. Patients and methods: Metastatic colorectal cancer patients included in the OPTIMOX1 phase III study received first-line oxaliplatin-based chemotherapy (FOLFOX). No second line was defined in the protocol, but data concerning second line were prospectively registered. Inclusion criterion was patients receiving an irinotecan-based second-line chemotherapy. Second-line progression-free survival (PFS) and tumor response were evaluated according to type of irino…

MaleOncologymedicine.medical_specialtyOrganoplatinum CompoundsColorectal cancermedicine.medical_treatmentLeucovorinIrinotecanBolus (medicine)FOLFOXInternal medicineAntineoplastic Combined Chemotherapy ProtocolsmedicineHumansTreatment FailureneoplasmsChemotherapybusiness.industryHematologyMiddle Agedmedicine.diseasedigestive system diseasesOxaliplatinOxaliplatinIrinotecanRegimenTreatment OutcomeOncologyFOLFIRICamptothecinFemaleFluorouracilColorectal Neoplasmsbusinessmedicine.drugAnnals of Oncology
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Mid- and Longer-term Follow up of Chimney and/or Periscope Grafts and Risk Factors for Failure

2016

Objective The aim was to report on chimney and periscope grafts (CPGs) and their mid- and longer-term outcomes when they are used to preserve reno-visceral artery (RVA) perfusion in endovascular repair of pararenal (PRAAs) or thoraco-abdominal aortic aneurysm (TAAAs). In addition, factors associated with CPG failure are presented. Limited data exist on the outcomes of CPGs, and mid- and long-term results are generally not reported. Methods This was a prospective study in a cohort of 100 patients with PRAA (69) or TAAA (31). A total of 224 (mean 2.24 per patient) RVAs were preserved with 136 (61%) chimney and 88 (39%) periscope grafts. CPGs were constructed mainly using self expandable stent…

MalePercutaneousmedicine.medical_treatment030204 cardiovascular system & hematologyEndovascular aneurysm repairSettore MED/22 - Chirurgia VascolareAortic aneurysm0302 clinical medicineRenal ArteryRisk FactorsOcclusion030212 general & internal medicineTreatment FailureProspective cohort studyAortaPararenal aortic aneurysm10042 Clinic for Diagnostic and Interventional RadiologyReno2746 SurgeryAortic AneurysmFemaleRadiologyCardiology and Cardiovascular Medicinemedicine.medical_specialty610 Medicine & health2705 Cardiology and Cardiovascular Medicine03 medical and health sciencesEndovascular aneurysm repairabdominal aortic aneurysmAneurysmChimney and periscope graftChimney and periscope graft; Complex aortic aneurysm; Endovascular aneurysm repair; Pararenal aortic aneurysm; Reno-visceral arteries; Thoraco-abdominal aortic aneurysm; Cardiology and Cardiovascular Medicine; SurgerymedicineHumansAgedRetrospective StudiesReno-visceral arterieThoraco-abdominal aortic aneurysmbusiness.industryComplex aortic aneurysmStentRetrospective cohort studyThoracomedicine.diseaseSurgeryvisceral arteriesSurgeryVascular GraftingbusinessFollow-Up Studies
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Long-Term Follow-Up of Repeat Endoscopic Third Ventriculostomy in Obstructive Hydrocephalus.

2017

Endoscopic third ventriculostomy (ETV) is a safe and less-invasive treatment strategy for patients with obstructive hydrocephalus and provides excellent outcome. Nevertheless, repeat ETV in cases of ETV failure is a controversial issue.Between 1993 and 1999, 113 patients underwent a total of 126 ETVs at the Department of Neurosurgery, Mainz University Hospital. Obstructive hydrocephalus was the causative pathology in all cases. A very long-term follow-up of up to 16 years could be achieved. All medical reports of patients who received ETV were reviewed and analyzed with focus on ETV failure with following repeat ETV and its initial as well as very long-term success.Thirty-one events of ETV …

MaleReoperationmedicine.medical_specialtyPediatricsAdolescentLong term follow upObstructive hydrocephalusConstriction PathologicVentriculostomyCentral Nervous System Neoplasms03 medical and health sciencesYoung Adult0302 clinical medicinemedicineHumansTreatment FailureChildRetrospective StudiesThird Ventriclebusiness.industryCystsEndoscopic third ventriculostomyCerebral AqueductInfantUniversity hospitalSurgeryTreatment Outcome030220 oncology & carcinogenesisChild PreschoolNeuroendoscopyCerebrospinal fluid circulationTreatment strategySurgeryFemaleNeurology (clinical)NeurosurgerybusinessIntracranial Hemorrhages030217 neurology & neurosurgeryFollow-Up StudiesHydrocephalusWorld neurosurgery
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