ABSTRACT
PURPOSE: This study aimed to identify the predictors of acute adverse events resulting from rapid rituximab infusion over 90 min. METHOD: It was a retrospective cohort study using medical record review based on a convenience sampling from 2007 till May 2011 in both in-patient and ambulatory setting in Royal Adelaide Hospital. RESULTS: There were a total of 294 patients who received 376 courses and 1,571 cycles of rapid rituximab infusion. Forty-three (14.6 %) patients experienced acute adverse events of hypotension being the most commonly occurring events followed by patients feeling hot and face-flushed. There were 11 predictors analysed, namely age, gender, diagnosis, stage of disease, presence of cardiac or lung morbidities, type of treatment, number of course and cycles, total white blood cells count, lymphocyte counts and lactate dehydrogenase using log generalised estimating equation for univariate and multivariate analysis. The findings successfully demonstrated that high lymphocyte counts were the independent predictor of acute adverse event from rapid rituximab infusion (p = 0.0009). Patient with high lymphocyte counts were 6.9382 times the odd to experience an adverse event as compared to those with normal lymphocyte counts. CONCLUSION: There are no specific patient characteristics to preclude prescribing rapid rituximab infusion following a 90-min regimen for non-Hodgkin lymphoma except a potential for adverse events to occur when patients have abnormally high lymphocyte counts.
Subject(s)
Antibodies, Monoclonal, Murine-Derived/adverse effects , Antineoplastic Agents/adverse effects , Hypotension/chemically induced , Lymphoma, Non-Hodgkin/drug therapy , Adult , Age Factors , Aged , Aged, 80 and over , Antibodies, Monoclonal, Murine-Derived/administration & dosage , Antibodies, Monoclonal, Murine-Derived/therapeutic use , Antineoplastic Agents/administration & dosage , Antineoplastic Agents/therapeutic use , Female , Humans , Lymphocyte Count , Male , Middle Aged , Retrospective Studies , Risk Factors , Rituximab , Sex FactorsABSTRACT
OBJECTIVE: The objective of this review was to critically analyze and systematically review the best evidence related to the effectiveness of the Sitz bath in managing adult patients with anorectal disorders. METHODS: The text terms were established and searched systematically from the relevant databases from 1990 to November 2009 in the English language. The eligible studies that were congruent with the review's inclusion criteria were selected. The selected studies were critically appraised for their methodological validity by two independent reviews and the data were extracted from the studies by using the Joanna Briggs Institute Systems Meta Analysis of Statistical Assessment and Review Instrument. The results were presented in narrative form because statistical pooling was not possible due to clinical heterogeneity. RESULTS: A total of four randomized controlled trials was included in the review. The use of the Sitz bath had no significant impact on reducing the overall intensity of pain and postoperative pain. Conflicting findings for postdefecation pain were reported. The Sitz bath had no impact on accelerating fissure or wound healing. However, the patients were satisfied with using the Sitz bath and no severe complication was reported. CONCLUSION: There was no strong evidence to support the use of the Sitz bath for pain relief and to accelerate fissure or wound healing among adult patients with anorectal disorders. However, the Sitz bath may be prescribed for patients' satisfaction.
Subject(s)
Anus Diseases/therapy , Baths , Rectal Diseases/therapy , Adult , Humans , Patient Satisfaction , Randomized Controlled Trials as Topic , Treatment OutcomeABSTRACT
The purpose of this study is to critically appraise, synthesize and present the best available evidence related to the safety of rapid rituximab infusion in adult non-Hodgkin lymphoma and chronic lymphocytic leukaemia patients. Data are from published and unpublished studies from electronic databases, grey literature and reference lists. The studies that met the inclusion criteria were critically appraised by two independent reviewers for methodological validity using standardized critical appraisal instruments. Proportional meta-analysis based on DerSimonian-Laird weights using a random effects model was used for statistical pooling through Stats Direct. Heterogeneity is assessed using Cochran Q. When statistical pooling is not possible, the findings were presented in narrative summary. Rapid rituximab infusion is safe for non-Hodgkin lymphoma patients at a 90 min regimen. However, there is insufficient evidence to support rapid rituximab infusions for chronic lymphocytic leukaemia patients.
