Clinical characteristics, treatment patterns, and outcomes among African American and White patients with multiple myeloma in the United States.

Multiple myeloma (MM) is more common among Black/African American (AA) patients than White patients, but survival rate improvements are less pronounced for AA patients. This study evaluated treatment patterns and survival among 1810 AA and 5904 White adults in the United States with ≥1 MM treatment and ≥3 months of follow-up. Median time from diagnosis to systemic treatment was longer (37 [0-3053] vs. 35 [0-3664] days) and median time to stem cell transplant (SCT) was longer for AA than White patients (255 [1-2352] vs. 225 [1-3094] days), and AA patients were less likely to receive SCT (odds ratio [OR]: 0.66; 95% confidence interval [CI]: 0.58-0.76). Despite disparities in treatment between AA and White patients, AA patients demonstrated lower risk of death (OR: 0.89; 95% CI: 0.81-0.96). These data highlight the value of equal access to care for the improvement of health outcomes in underserved populations.

Economic Burden of HIV Antiretroviral Therapy Adverse Events in the United States.

OBJECTIVE: To estimate health care costs associated with medical events identified as antiretroviral therapy (ART)-attributable adverse events (AEs). METHODS: During September 2006 to June 2012, adults with ≥1 HIV International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis code (042/V08), ≥1 claim for ART prescription (March 2007-June 2011; index date), and continuous health plan enrollment for ≥6 months pre- and ≥12 months postindex were included (IMS' PharMetrics Plus Health Plan Claims Database). Patients with events of interest/ART claim during preindex period or with pregnancy/hepatitis C virus diagnosis/hepatitis B virus/cancer/tuberculosis during the study period were excluded. Postindex medical events were defined as first diagnosis code of event with ART claim ≤60 days prior to start of the event. RESULTS: Differences in median total all-cause health care costs observed for diabetes/insulin resistance management (US$14,547 median all-cause health care costs during time periods identified as diabetes/insulin resistance medical events versus US$11,237 without diabetes/insulin resistance events; P=.0021), lipid disorders (US$12,825 versus US$10,033; P=.0004), and renal disorders (US$1389 versus US$0; P<.0001). DISCUSSION/CONCLUSION: Health care costs of ART AEs should be key consideration for payers/providers in HIV management.

Sonographically guided percutaneous needle release of the carpal tunnel for treatment of carpal tunnel syndrome: preliminary report.

OBJECTIVES: The purpose of this study was to evaluate the effectiveness of a novel treatment procedure, sonographically guided percutaneous needle release of the carpal tunnel, for individuals with carpal tunnel syndrome. METHODS: Seventeen patients (89% female; mean age, 62 years; SD, 13.6 years) with a clinical diagnosis of carpal tunnel syndrome who had undergone a sonographically guided percutaneous needle release of the carpal tunnel at least 6 months before follow-up evaluation were retrospectively reviewed. At the follow-up evaluation, to ascertain previous and current symptoms as well as functional impairment, the patients filled out a hand diagram and a questionnaire. In addition, medical records were reviewed, and patients were queried regarding complications such as infection or nerve damage. Median nerve sonographic measurements and a physical evaluation were performed on a subset of 13 patients who came to the office for evaluation. RESULTS: Postprocedure sonography showed that patients had a significantly smaller (P = .03) cross-sectional area of the median nerve compared to pretreatment values. In addition, patients had significantly fewer symptoms (P < .0001), less functional impairment (P = .0002), and an improved hand diagram score (P < .0001). Postprocedure patients had grip strength that was 12 lb below average (≈1 SD below) compared to grip strength norms. However, most patients (84.6%) had negative clinical diagnostic test results for carpal tunnel syndrome, and 86% said they were satisfied with the procedure. There were no procedure-related infections or nerve injuries. CONCLUSIONS: Of the patients with carpal tunnel syndrome who agreed to participate in this study, most had favorable symptomatic and functional outcomes. Sonographically guided percutaneous needle release of the carpal tunnel may be an alternative option to traditional surgical treatment of carpal tunnel syndrome.