Clinical characteristics and mortality rates for suprachoroidal hemorrhage: seven-year experience at a tertiary eye center

2021 ◽  
Author(s):  
Terry Lee ◽  
Atalie C. Thompson ◽  
C. Ellis Wisely ◽  
Mitchell G. Nash ◽  
Eric A. Postel ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Mortality Rates ◽  
Suprachoroidal Hemorrhage

scholarly journals P13 Abdominal Surgery during the COVID-19 Pandemic: A Multicentre Audit

BJS Open ◽  
2021 ◽  
Vol 5 (Supplement_1) ◽  
Author(s):  
Christopher Hadjittofi ◽  
Aaliya Uddin ◽  
Sanjid Seraj ◽  
Zeba Ali ◽  
Philipp Antonas ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Emergency Surgery ◽  
Clinical Characteristics ◽  
Mortality Rates ◽  
University Hospital ◽  
Rt Pcr ◽  
Clinical Issue ◽  
Electronic Data Collection ◽  
Chinese Study

Abstract Introduction The threshold for surgery has increased during the COVID-19 pandemic. A widely cited Chinese study (n = 34) reported postoperative COVID-19 pneumonia and mortality rates of 100% and 21% respectively [1]. This audit assessed outcomes after abdominal surgery across three hospitals within Mid & South Essex NHS Foundation Trust. Methods Patients undergoing abdominal surgery at Basildon University Hospital, Mid Essex Hospital and Southend University Hospital between 1st March and 27th April 2020 were included. Obstetric, gynaecological, vascular, inguinal/femoral hernia, and skin operations were excluded. Electronic data collection was supplemented by telephone follow-up. Results 306 patients were included. The median age was 57 years. 148 (48.4%) were female. 156 (51.0%) and 150 (49.0%) patients underwent elective and emergency surgery respectively. The preoperative and postoperative SARS-CoV-2 rates (based on RT-PCR or imaging) were 0.3% (n = 1) and 4.6% (n = 14) respectively. 84.6% (n = 259) did not have RT-PCR tests. All-cause 30-day mortality was 3.6% (n = 11). Amongst patients with SARS-CoV-2, mortality was 50% (7/14), occurring only after emergency surgery. Elective (vs. emergency) surgery was associated with lower postoperative SARS-CoV-2 (0.6% vs. 8.7%; p < 0.001) and mortality (0.6% vs. 6.7%; p = 0.005). At follow-up, 79.1% (242/306) of patients responded, most (85.1%; 206/242) without major clinical issue. Conclusion Local SARS-CoV-2 and mortality rates are lower than previously reported [1]. Perioperative COVID-19 carries a high mortality risk. We recommend perioperative SARS-CoV-2 testing for all patients and cohorting by infection status. References 1. Lei et al., Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection, EClinicalMedicine(2020), https://doi.org/10.1016/j.eclinm.2020.100331

A Comprehensive Assessment of Phase 1 Clinical Trials in Acute Myeloid Leukemia

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 2282-2282 ◽  
Author(s):  
Joshua F. Zeidner ◽  
Judith E. Karp ◽  
Amanda Blackford ◽  
Jose Mejias ◽  
Gary Smith ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Myeloid Leukemia ◽  
Clinical Characteristics ◽  
Phase 1 ◽  
Mortality Rates ◽  
Relative Increase ◽  
Over Time ◽  
Treatment Related Mortality ◽  
Related Mortality ◽  
Acute Myeloid

Abstract Introduction: There have been minimal therapeutic advancements in the management of acute myeloid leukemia (AML) over the past 3 decades. Although approximately 70% of younger AML patients will achieve a complete remission (CR) with standard induction chemotherapy regimens, overall outcomes are dismal. It is unclear why drug development has been particularly hindered in AML when compared to other hematologic malignancies and cancers. Methods: A retrospective analysis was performed on 65 phase 1 clinical trials supported by the Cancer Therapy Evaluation Program (CTEP) of the National Cancer Institute (NCI) from 1984-2009. A total of 711 adult AML patients were enrolled in these studies. The primary objectives were to assess overall response rates ([ORR]: CR + partial remission) and treatment-related mortality (all causes of 60-day mortality) over time. Clinical characteristics and outcomes were summarized by study date, grouped as: 1) 1984-1990, 2) 1991-1995, 3) 1996-2000, 4) 2001-2005, 5) 2006-2009. Two multivariable logistic regression modeling approaches were used to estimate the ORR and treatment-related mortality rates with A) a comparison of subgroups with 1984-1990 as the reference group, and B) time as a continuous variable. Results: The number of AML patients enrolling on phase 1 clinical trials increased substantially over time (1984-1990: n=61, 2006-2009: n=256). The clinical characteristics resembled a high-risk, relapsed/refractory patient population: median age = 60 years, median # of prior therapies = 4 (63% had ≥3 prior therapies), and median white blood cell count = 3,600/mm3. The proportion of patients ≥60 years increased from the earliest subgroup (1984-1990: 18%) to the most recent (2006-2009: 64%). Additionally, there was a relative increase in the proportion of patients without any prior therapies over time from 1984-1990 (13%) to 2006-2009 (24%). Figure 1 demonstrates the ORR and treatment-related mortality for each subgroup. The ORR for the entire cohort was 15%. ORR was significantly improved in the most recent subgroup (2006-2009: ORR=23%) when compared with the earliest subgroup (1984-1990: ORR=9%), p=0.05. Additionally, there was a small but significant improvement in ORR and 60-day mortality rates with each increasing year, odds ratio (OR)=1.04, p=0.03, OR=0.96, p=0.008, respectively. Discussion: Our analysis of CTEP-sponsored phase 1 clinical trials demonstrates a relative upsurge of AML patients being enrolled in phase 1 studies over the last 26 years. ORRs and 60-day mortality rates appear to be modestly improving over time, which may be due to the relative increase of treatment-naïve patients enrolling in phase 1 studies. To our knowledge, this is the largest compilation of phase 1 clinical trials reported for AML. Continued enrollment of AML patients on early-phase clinical trials at all stages of disease, including those with newly diagnosed AML with poor-risk features, is vital for drug development and improvement in therapeutic outcomes. Figure 1 Figure 1. Disclosures No relevant conflicts of interest to declare.

scholarly journals Clinical characteristics and prognosis of patients with Pneumocystis jirovecii pneumonia without a compromised illness

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246296
Author(s):  
Tae-Ok Kim ◽  
Jae-Kyeong Lee ◽  
Yong-Soo Kwon ◽  
Yu-Il Kim ◽  
Sung-Chul Lim ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Hematological Malignancy ◽  
Immunosuppressive Agents ◽  
Mortality Rates ◽  
Pneumocystis Jirovecii ◽  
Pneumocystis Jirovecii Pneumonia ◽  
Solid Organ ◽  
Immunodeficiency Virus ◽  
Immunocompromised Status ◽  
Median Interval

Objective Pneumocystis jirovecii pneumonia (PCP) is a fatal respiratory infection, mostly associated with immunocompromised conditions. Several reports have described PCP development in patients who were not immunocompromised, but the clinical course and prognosis of PCP are not well understood. We compared the clinical characteristics and prognoses between patients with and without immunocompromised conditions who developed PCP. Methods We retrospectively analyzed patients who had been treated for PCP from three hospitals. We defined immunocompromised (IC) status as following: human immunodeficiency virus (HIV) infection; hematological malignancy; solid organ tumor under chemotherapy; rheumatic disease; medication with immunosuppressive agents. Patients without immunocompromised status were defined as being non-immunocompromised (non-IC). Results The IC and non-IC groups comprised 173 and 14 patients. The median ages were 62.0 and 74.0 years in the IC and the non-IC group, respectively. The median interval between admission and anti-PCP treatment was significantly longer for patients in the non-IC group than that for patients in the IC group (7 vs. 2 days). The in-hospital mortality rates were significantly higher for patients in the non-IC group than that for patients in the IC group (71.4% vs. 43.9%; P = 0.047). A longer interval between admission and anti-PCP therapy was associated with increased 90-day mortality rate in patients with PCP (hazard ratio, 1.082; 95% confidence interval, 1.015–1.153; P = 0.016). Conclusions Patients with PCP with no predisposing illnesses were older and had higher mortality rates than IC patients with PCP. Delayed anti-PCP treatment was associated with increased 90-day mortality.

Ischemic Stroke with Troponin Elevation: Patient Characteristics, Resource Utilization, and In-Hospital Outcomes

2016 ◽  
Vol 42 (3-4) ◽  
pp. 213-223 ◽  
Author(s):  
Krishi Peddada ◽  
Salvador Cruz-Flores ◽  
Larry B. Goldstein ◽  
Eliahu Feen ◽  
Kevin F. Kennedy ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Hospital Mortality ◽  
Clinical Characteristics ◽  
Causes Of Death ◽  
Mortality Rates ◽  
Hospital Death ◽  
Stroke Patients ◽  
Troponin Elevation ◽  
Changes Over Time ◽  
Over Time

Background: Among patients hospitalized for acute ischemic stroke, abnormal serum troponins are associated with higher risk of short-term mortality. However, most findings have been reported from European hospitals. Whether troponin elevation after stroke is independently associated with death among a more heterogeneous US population remains unclear. Furthermore, only a few studies have evaluated the association between the magnitude of troponin elevation and subsequent mortality, patterns of dynamic troponin changes over time, or whether troponin elevation is related to specific causes of death. Methods: Using data collected in the American Heart Association's ‘Get With The Guidelines' stroke registry between 2008 and 2012 at a tertiary care US hospital, we used logistic regression to evaluate the independent relationship between troponin elevation and mortality after adjusting for demographic and clinical characteristics. We then assessed whether the magnitude of troponin elevation was related to in-hospital mortality by calculating mortality rates according to tertiles of peak troponin levels. Dynamic troponin changes over time were evaluated as well. To better understand whether troponin elevation identified patients most likely to die due to a specific cause of death, investigators blinded from troponin values reviewed all in-hospital deaths, and the association between troponin elevation and mortality was evaluated among patients with cardiac, neurologic, or other causes of death. Results: Of 1,145 ischemic stroke patients, 199 (17%) had elevated troponin levels. Troponin-positive patients had more cardiovascular risk factors, more intensive medical therapy, and greater use of cardiac procedures. These individuals had higher in-hospital mortality rates than troponin-negative patients (27 vs. 8%, p < 0.001), and this association persisted after adjustment for 13 clinical and management variables (OR 4.28, 95% CI 2.40-7.63). Any troponin elevation was associated with higher mortality, even at very low peak troponin levels (mortality rates 24-29% across tertiles of troponin). Patients with persistently rising troponin levels had fewer anticoagulant and antiatherosclerotic therapies, with markedly worse outcomes. Furthermore, troponin-positive patients had higher rates of all categories of death: neurologic (17 vs. 7%), cardiac (5 vs. <1%), and other causes of death (5 vs. <1%; p < 0.001 for all comparisons). Conclusions: Ischemic stroke patients with abnormal troponin levels are at higher risk of in-hospital death, even after accounting for demographic and clinical characteristics, and any degree of troponin elevation identifies this higher level of risk. Troponins that continue to rise during the hospitalization identify stroke patients at markedly higher risk of mortality, and both neurologic and non-neurologically mediated mortality rates are higher when troponin is elevated.

scholarly journals Clinical Characteristics ofNocardiaInfection in Patients with Rheumatic Diseases

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Mieko Yamagata ◽  
Koichi Hirose ◽  
Kei Ikeda ◽  
Hiroshi Nakajima
Keyword(s):  
Risk Factors ◽  
Rheumatic Disease ◽  
Rheumatic Diseases ◽  
Medical Records ◽  
Clinical Characteristics ◽  
Mortality Rates ◽  
Pulmonary Diseases ◽  
High Dose ◽  
Glucocorticoid Treatment ◽  
Pulmonary Lesions

AlthoughNocardiosishas considerable recurrence and mortality rates, characteristics and risk factors ofNocardiainfection have not been assessed in patients with rheumatic diseases. Here, we examined the characteristics and risk factors ofNocardiainfection in rheumatic disease patients in our hospital. Ten rheumatic disease patients who developedNocardiainfection were identified by retrospectively reviewing the medical records. Possible predisposing factors forNocardiainfection were high-dose glucocorticoid treatment, concomitant use of immunosuppressants, preexisting pulmonary diseases, and diabetes mellitus. All patients had pulmonaryNocardiosis, and six of them had disseminatedNocardiosiswhen their pulmonary lesions were identified.

scholarly journals Serologic Profile and Mortality Rates of Scleroderma Renal Crisis in Italy

2009 ◽  
Vol 36 (7) ◽  
pp. 1464-1469 ◽  
Author(s):  
VERONICA CODULLO ◽  
ILARIA CAVAZZANA ◽  
CLAUDIA BONINO ◽  
CLAUDIA ALPINI ◽  
LORENZO CAVAGNA ◽  
...  
Keyword(s):  
Medical Records ◽  
Clinical Characteristics ◽  
Antinuclear Antibodies ◽  
Survival Rates ◽  
Mortality Rates ◽  
Scleroderma Renal Crisis ◽  
Delayed Onset ◽  
Autoantibody Profile ◽  
Rare Manifestation ◽  
Renal Crisis

Objective.To analyze clinical and serological characteristics of subjects with scleroderma renal crisis (SRC) in Italian patients with systemic sclerosis (SSc).Methods.A retrospective analysis of medical records from 9 Italian rheumatologic referral centers was carried out. All patients with SRC and an available serum sample at the time of crisis were included. Antinuclear antibodies (ANA) by indirect immunofluorescence, anti-topoisomerase (topo) I by enzyme-linked assay (ELISA), anti-RNA polymerases (RNAP) by ELISA for the subunit III, and immunoprecipitation (IP) were performed.Results.Forty-six cases (38 female; 40 diffuse cutaneous SSc) were identified. Mean age at SSc and SRC onset was 52.8 years ± 13.2 and 55.4 years ± 11.8, respectively. ANA were present in 44 patients (96%). Anti-topo I antibodies were detected in 30 (65%), anti-RNAP I–III in 7 (15%). No differences emerged between these 2 groups for their main clinical characteristics. The proportion of patients in the anti-RNAP I–III group developing SRC early (< 18 mo) in the course of SSc was significantly higher (p = 0.03). Cumulative survival rates were 64%, 53%, and 35% at 1, 2, and 10 years of followup, respectively. Survival rates of SSc patients significantly differed according to their autoantibody profile, being lower in the anti-topo I than in the anti-RNAP I–III group (p = 0.034).Conclusion.SRC is a rare manifestation of SSc in Italy but it is still associated with severe prognosis. Anti-topo I reactivity was more frequent than anti-RNAP I–III in our patients with SRC and was associated with delayed onset and high mortality rates.

scholarly journals 403. Clinical Characteristics and Outcomes of Patients with COVID-19 Admitted to the Intensive Care Unit in the Dominican Republic

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S303-S303
Author(s):  
Rita Alexandra Rojas-Fermin ◽  
Ann Sanchez ◽  
Anel E Guzman ◽  
Edwin Germosen ◽  
Cesar Matos ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Dominican Republic ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Clinical Characteristics ◽  
Age Groups ◽  
Mortality Rates ◽  
Older Age ◽  
Obesity And Diabetes

Abstract Background The disease caused by SARS-CoV-2, COVID-19, has caused a global public health crisis. Reported mortality rates across the world vary by region, local population characteristics and healthcare systems. There is a paucity of data on COVID-19 in low and middle income countries (LMICs). Our objective is to describe the clinical characteristics of critically ill patients with COVID-19 in the Dominican Republic (DR) Methods We performed a retrospective review of patients admitted to the intensive care unit (ICU) with severe COVID-19 from March to December 31, 2020, at a 295-bed tertiary teaching hospital in the DR. Clinical characteristics, demographics, comorbidities, management and outcomes were tabulated. Survival was categorized by age and comorbidities. Results A total of 382 patients were admitted to the ICU. The median age was 64 (range 14-97) and 64.3% (246) were male. Hypertension, diabetes, and obesity were the most common risk factors (Table 1). Corticosteroids were used in 91.6% (350), tocilizumab in 63% (82), and remdesivir in 31.6% (31). Antibacterials were used in 99.2% (379) of patients in the ICU. All-cause mortality in the ICU was 35.3% (135). Mortality was higher in older age groups (Figure 1) and in patients with multiple coexisting comorbidities (Figure 2). Table 1. Comorbidities of patients with COVID-19 admitted to the ICU Conclusion Hypertension, obesity and diabetes were common in critically ill patients with COVID-19 in the DR. Corticosteroids and tocilizumab were commonly used. Antibacterials were used in &gt;99% of patients admitted to the ICU and may signal a target for future antimicrobial stewardship. Higher mortality rates were present in older age groups and those with multiple comorbidities. Risk of death increased drastically after age 40 and was comparative to those in advanced age groups. In patients with 4 comorbidities and above, mortality was more than three times higher. Disclosures All Authors: No reported disclosures

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