scholarly journals Persistent symptoms and lab abnormalities in patients who recovered from COVID-19

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julian Varghese ◽  
Sarah Sandmann ◽  
Kevin Ochs ◽  
Inga-Marie Schrempf ◽  
Christopher Frömmel ◽  
...  

AbstractWith increasing numbers of patients recovering from COVID-19, there is increasing evidence for persistent symptoms and the need for follow-up studies. This retrospective study included patients without comorbidities, who recovered from COVID-19 and attended an outpatient clinic at a university hospital for follow-up care and potential convalescent plasma donation. Network analysis was applied to visualize symptom combinations and persistent symptoms. Comprehensive lab-testing was ascertained at each follow-up to analyze differences regarding patients with vs without persistent symptoms. 116 patients were included, age range was 18–69 years (median: 41) with follow-ups ranging from 22 to 102 days. The three most frequent persistent symptoms were Fatigue (54%), Dyspnea (29%) and Anosmia (25%). Lymphopenia was present in 13 of 112 (12%) cases. Five of 35 cases (14%) had Lymphopenia in the later follow-up range of 80–102 days. Serum IgA concentration was the only lab parameter with significant difference between patients with vs without persistent symptoms with reduced serum IgA concentrations in the patient cohort of persistent symptoms (p = 0.0219). Moreover, subgroup analyses showed that patients with lymphopenia experienced more frequently persistent symptoms. In conclusion, lymphopenia persisted in a noticeable percentage of recovered patients. Patients with persistent symptoms had significantly lower serum IgA levels. Furthermore, our data provides evidence that lymphopenia is associated with persistence of COVID-19 symptoms.

2020 ◽  
Author(s):  
Julian Varghese ◽  
Sarah Sandmann ◽  
Richard Vollenberg ◽  
Kevin Ochs ◽  
Inga Schrempf ◽  
...  

Abstract Background: With increasing numbers of patients recovering from COVID-19, there is increasing evidence for persisting symptoms and the need for follow-up studies. Methods: This retrospective study included patients without comorbidities, who recovered from COVID-19 and attended an outpatient clinic at a university hospital for follow-up care and potential convalescent plasma donation. Network analysis was applied to visualize symptom combinations and persistent symptoms. Comprehensive lab-testing was ascertained at each follow-up to analyze differences regarding patients with vs without persistent symptoms. Results: 116 patients were included, age range was 18-69 years (median: 41) with follow-ups ranging from 22 to 102 days. The three most frequent persisting symptoms were Fatigue (54%), Dyspnea (29%) and Anosmia (25%). Lymphopenia was present in 13 of 112 (12%) cases. Five of 35 cases (14%) had Lymphopenia in the later follow-up range of 80-102 days. Serum IgA concentration was the only lab parameter with significant difference between patients with vs without persistent symptoms with reduced serum IgA concentrations in the patient cohort of persisting symptoms (p=0.0219). Conclusion: Lymphopenia persisted in a noticeable percentage of recovered patients. Moreover, higher serum IgA concentration is associated with a positive effect regarding symptom persistence.


2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Ahmed Gamal Khafagy ◽  
Mohamed El-Begermy ◽  
Marwa Mohamed El-Begermy ◽  
Pretty O. Afifi

Abstract Background This study aims to compare the graft uptake rate and hearing improvement of fat graft versus inlay butterfly tragal cartilage in the repair of perforations in chronic otitis media mucosal in adults. In this retrospective study, twenty-eight patients were included with small dry anteroinferior tympanic membrane perforations (less than 1/3 of the tympanic membrane). The age range was 18 to 44 years old. Myringoplasty was done under general anesthesia for 8 patients with a fat graft (FG) and 20 patients with inlay butterfly cartilage graft (IBCG). Six months postoperatively, a follow-up evaluation was done for successful graft uptake and hearing outcomes. Results The success rate of graft uptake in the first group (fat graft) was 6/8 cases (75%) while in the second group (IBCG) was 19/20 (95%) with no statistically significant difference (P = 0.0148). Also, there was no statistical difference between the two groups as regards postoperative ABG, improvement changes in ABG, and number of patients with improved hearing. Conclusions Inlay butterfly cartilage graft is a useful graft in repairing small tympanic membrane perforations as regard graft take and hearing outcomes.


2020 ◽  
Vol 1 (3) ◽  
pp. 154-159
Author(s):  
Suzan Amana Rattan ◽  
◽  
Mahir Kadhim Mutashar ◽  

AIM: To evaluate the effectivity of the combination of intracameral moxifloxacin 0.1% with subconjunctival triamcinolone acetonide 4 mg as prophylaxis of infection and inflammation after phacoemulsification in comparison with topical medication treated group. METHODS: A total one thousand patients with age range from 38 to 70 years old who scheduled for phacoemulsification were divided into 2 groups of no statistically significant differences in age, preoperative intraocular pressure (IOP) and central macular thickness (CMT), P=0.6, 0.9 and 0.8 respectively. The surgeries were done by 2 surgeons each one planned to use one method of prophylaxis at Eye Speciality Private hospital, Baghdad, Iraq. For the 1st group of patients (500) a topical moxifloxacin hydrochloride 0.5% and dexamethasone 0.1% eye drops were prescribed four times a day for 1mo postoperatively. For the 2nd group intracameral (IC) diluted moxifloxacin at 0.1% with subconjunctival (SC) triamcinolone 4mg in 0.4 cc were administered at the conclusion of the surgery. Follow up visits were on the first postoperative day, 1wk, 1mo, and 3mo postoperatively. Anterior chamber (AC) reaction was examined during the 4 visits while IOP was measured during the last 3 and CMT was measured only in the last one. RESULTS: The current clinical trial study compared 2 samples with 2 different prophylaxis methods. No endophthalmitis case reported in both group. By a 2-Sample t-test, the IC-treated group (group 2) had statistically significant lower AC cells at the 1st day postoperative visit than the other group while there were no statistically significant differences at 1wk, 1 mo and 3mo visits between the 2 groups. There was no statistically significant difference at 3mo visits in IOP and CMT between the two groups. A breakthrough inflammation rate with the topical medication was (9.6%) while in the other group (IC treated ) was 4.0%. A significant IOP elevation ≥10 mm Hg at 1mo in 2.4% within the topical medication group which was higher than the rate in the other group (0.8%). CONCLUSION: In addition to the safety and effectivity of the combination of intracameral moxifloxacin and subconjunctival triamcinolone in preventing infection and inflammation after cataract surgery. The majority (480) of our included patients didn’t require any topical postoperative medication that is cost saving for the patient, helped patients who were unable to administer topical medication, and decreased chance of complication related to patient poor adherence to postoperative medication.


2011 ◽  
Vol 9 (1-2) ◽  
pp. 0-0
Author(s):  
Tomas Abalikšta ◽  
Gintautas Brimas ◽  
Kęstutis Strupas

Tomas Abalikšta, Gintautas Brimas, Kęstutis Strupas Vilniaus universiteto Medicinos fakultetas, M. K. Čiurlionio g. 21, LT-03101 VilniusVilniaus universiteto ligoninės Santariškių klinikų Pilvo chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl. paštas: [email protected] Darbo tikslas: Remiantis literatūros duomenimis palyginti skirtingas skrandžio apjuosimo reguliuojamas juostas, naudojamas chirurginiam nutukimo gydymui. Tyriamoji medžiaga ir metodai: Publikacijų paieška atlikta elektroninėse MEDLINE, Current Contents ir Cochrane Library duomenų bazėse. Apžvelgtos visos skrandį apjuosiančių reguliuojamų juostų lyginamųjų studijų publikacijos, paskelbtos iki 2010 m. sausio 1 d. Rezultatai: Atlikus literatūros šaltinių paiešką rasta 10 publikacijų, lyginančių skirtingas skrandį apjuosiančias reguliuojamas juostas. Išsamiai atlikta viena studija: perspektyvi, atsitiktinių imčių, jos tiriamųjų skaičius didelis ir stebėjimo laikotarpis ilgas, įvertinti visi gydymo rezultatai. Statistiškai reikšmingo skirtumo tarp SAGB ir LAP-BAND juostų šioje studijoje nerasta. Kitos lyginamosios juostų studijos turi trūkumų: keturios buvo ne atsitiktinių imčių (dvi iš jų retrospektyvios), trijose tiriamųjų imtis maža, visų stebėjimo laikas trumpas. Vienoje iš šių studijų nustatytas kūno masės kritimo skirtumas tarp grupių: LAP-BAND grupėje pradinė viršnorminė kūno masė sumažėjo 41,7 %, Heliogast – 28,3 %. Mechaninių juostų komplikacijų dažnis skyrėsi vienoje studijoje: LAP-BAND – 7 %, SAGB – 1 %. Skirtumas tarp „mažo skrandžio“ išsiplėtimo arba juostos nuslinkimo dažnio rastas trijose studijose (MiniMizer Extra – 0 % ir LAP-BAND – 10,8 %; SAGB – 2,4 % ir LAP-BAND – 27,6 %; SAGB – 2 % ir LAP-BAND – 23 %). Skirtumo tarp gretutinių ligų ir gyvenimo kokybės pokyčio, hospitalizacijos trukmės, juostos reguliavimų skaičiaus/dažnio, juostos penetracijos/migracijos į skrandį bei infekcinių komplikacijų dažnio nerasta. Išvados: Tik viena studija atlikta laikantis šiuolaikinių įrodymais pagrįstos medicinos keliamų reikalavimų, skirtumo tarp lygintų juostų nerasta. Reikalingos perspektyvios, atsitiktinių imčių ilgalaikės (>5 metų) lyginamosios studijos, vertinančios juostų konstrukcijos ar formos skirtumų įtaką gydymo efektyvumui ar komplikacijoms. Reikšminiai žodžiai: nutukimas, bariatrinė chirurgija, skrandžio apjuosimo reguliuojama juosta operacija. Adjustable gastric bands: review of comparative studies Tomas Abalikšta, Gintautas Brimas, Kęstutis Strupas Vilnius University Medical Faculty, M. K. Čiurlionio Str. 21, LT-03101 Vilnius, LithuaniaVilnius University Hospital Santariškių Klinikos Centre of Abdominal Surgery,Santariškių Str. 2, LT-08661 Vilnius, LithuaniaEl. paštas: [email protected] Objective: The objective of this review is to compare different adjustable gastric bands according to the data of comparative studies. Materials and Methods: A search of articles published in any language before January 2010 was carried out through the MEDLINE, Current Contents and Cochrane Library electronic databases. All articles about comparative studies of different adjustable gastric bands were eligible for review. All possible data were extracted from accepted studies and reviewed. Results: Ten comparative studies of different adjustable gastric bands were accepted. Only one comparative study of the bands was accomplished properly. It was a prospective randomised study type with a large number of patients and a long follow-up period with all possible results evaluated. No statistically significant difference between SAGB and LAP-BAND gastric bands was found in this study. The other band studies had shortcomings: four studies were non-randomised (two of them retrospective), a small number of patients in three studies, and a too short follow-up period in all studies. The difference in weight loss was stated in one of these studies: 41.7% of initial excess weight loss in the LAP-BAND group and 28.3% in the Heliogast group. Band leakage frequency was different in one study: LAP-BAND – 7%, SAGB – 1%. A difference between pouch dilatation or band slippage frequency was found in three studies (MiniMizer Extra – 0% and LAP-BAND – 10.8%; SAGB – 2.4% and LAP-BAND – 27.6%; SAGB – 2% and LAP-BAND – 23%). There was no difference between the resolution of comorbidities, improvement of the quality of life, hospital stay, band adjustment frequency, band migration or band infection rate. Conclusion: Only one accepted study was accomplished properly. There was no difference between compared adjustable gastric bands in this study. Prospective randomised long-term (more than 5 years) comparative studies are needed for a proper evaluation of band construction or shape influence on weight loss and complications. Keywords: obesity, bariatric surgery, adjustable gastric banding.


2017 ◽  
Vol 24 (06) ◽  
pp. 824-827
Author(s):  
Ambreen Amna ◽  
Farkhunda Nadeem ◽  
Pushpa Srichand

Background: Genitourinary fistula remains a major cause of morbidity worldwide.Approximately 2 million of women suffer from urinary leakage. Since the establishment ofGenito urinary Fistula center at Isra University Hospital –Hyderabad Sindh. We are able to shareour experience of fistulous women at the time of admission and at follow up visit. Objectives:To determine the different types of urinary incontinence in a woman after genitourinary fistularepair. Study Design: A Follow-up Descriptive study. Study Setting: This Study was done atFistula center Isra University Hospital Hyderabad GU – 11 from January 2011 to December2013. All the women who were admitted with true incontinence followed by Obstetrical andmajor gynecological surgeries were included. However women with stress incontinence andurge incontinence and women who are not willing to include in the study were excluded.Result: Out of one hundred and ten (110) women included in this study, 59 (53.6%) were foundto have obstetrical fistula, while 43 (39%) were suffering from Iatrogenic fistula. Continencestatus were explored at follow up visit. Out of 110 women, 108 (98.18%) & 96 (87.27 %) werehaving no signs of incontinence on examination at first visit and after six week and secondvisit after three month respectively. Only 7 % women fell into incontinence grade 2 at six weekfollow up and only one percent had persistent symptoms of stress incontinence at 3 monthrespectively. Women fall on incontinence grade 3, 4 and 5 were completely cured at 3 month.Conclusion: Success rate of genitor- urinary fistula repair is 98 %. Majority of women (96 %)on short term follow up at 6 weeks showed improved urinary symptoms. Moreover on follow upvisit at 3 months, these women reported improved quality of life and social reintegration afterfistula closure.


2019 ◽  
Vol 128 (10) ◽  
pp. 693-698
Author(s):  
Sabine Dillenberger ◽  
Detlef K. Bartsch ◽  
Elisabeth Maurer ◽  
Peter Herbert Kann

Abstract Purpose It is assumed that primary hyperparathyroidism (pHPT) in Multiple Endocrine Neoplasia (MEN) and lithium-associated pHPT (LIHPT) are associated with multiple gland disease (MGD), persistence and recurrence. The studies purpose was to determine frequencies, clinical presentation and outcome of sporadic pHPT (spHPT), LIHPT and pHPT in MEN. Additional main outcome measures were the rates of MGD and persistence/recurrence. Methods Retrospective analysis of medical records of 682 patients with pHPT who had attended the University Hospital of Marburg between 01–01–2004 and 30–06–2013. All patients were sent a questionnaire asking about their history of lithium medication. Results Out of 682 patients, 557 underwent primary surgery (532 spHPT, 5 LIHPT, 20 MEN), 38 redo-surgery (31 spHPT, 7 MEN), 55 were in follow-up due to previous surgery (16 spHPT, 1 LIHPT, 38 MEN) and 37 were not operated (33 spHPT, 1 LIHPT, 3 MEN). Primary surgeries were successful in 97.4%, revealed singular adenomas in 92.4%, double adenomas in 2.9% and MGD in 3.4% of the cases. Rates of MGD in MEN1 (82.35%) were significantly higher than in spHPT (3.8%), while there was no significant difference between LIHPT (20%) and spHPT. Rates of persistence/recurrence did not significantly differ due to type of surgery (bilateral/unilateral) or type of HPT (spHPT/LIHPT/MEN). Conclusions History of lithium medication is rare among pHPT patients. While MGD is common in MEN1, rates of MGD, persistence or recurrence in LIHPT were not significantly higher than in spHPT.


2020 ◽  
Vol 35 (1) ◽  
pp. 104-112
Author(s):  
Vilja Koskensalo ◽  
Marianne Udd ◽  
Mia Rainio ◽  
Jorma Halttunen ◽  
Matias Sipilä ◽  
...  

Abstract Background Transpancreatic biliary sphincterotomy (TPBS) is an advanced cannulation method for accessing common bile duct (CBD) in endoscopic retrograde cholangiopancreatography (ERCP). If CBD cannulation is difficult, an endoscopist can open the septum between the pancreatic and biliary duct with a sphincterotome to gain access. Long-term results of this procedure are unclear. We wanted to evaluate the short- and long-term complications of TPBS on patients with native papilla and benign indication for ERCP. Patients and Methods ERCPs performed in Helsinki University Hospital between 2007 and 2013 were reviewed. The study group comprised 143 consecutive patients with TPBS and 140 controls (CG). Data were collected from patient records and a phone survey was performed as a follow-up ≥ 4 years after the index ERCP. Results Post-ERCP pancreatitis (PEP) developed in seven patients (4.9%) in TPBS and one patient (0.7%) in CG (p = 0.067). The rates of other acute complications were similar between the groups. ERCP ended with no access to CBD in four cases (2.8%) in TPBS. The median length of follow-up was 6 years in TPBS and 7 years in CG. During this period, three patients (2.1%) in TPBS and six patients (4.3%) in CG suffered from acute pancreatitis (AP) (p = 0.238). One (0.7%) patient in CG and none in TPBS developed chronic pancreatitis (CP). Abdominal pain was suffered by ten patients (6.9%) in TPBS and twelve patients (8.6%) in CG daily, whereas by six patients (4.2%) in TPBS and twelve patients (8.6%) in CG weekly. Conclusion TPBS is a useful procedure, with acceptable complication rates. No significant difference occurred between the groups when evaluating the short-term or long-term complications with a follow-up period of four to 10 years. Additionally, no significant differences occurred in upper abdominal pain, episodes of AP, or development of CP.


Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 5015-5015
Author(s):  
Francesco Cicone ◽  
Francesco Scopinaro ◽  
Sebastien Baechler ◽  
Nicolas Ketterer ◽  
Franz Buchegger ◽  
...  

Abstract Background and Aim: Due to limited data regarding the efficacy of Radioimmunotherapy with 90Y-Zevalin (RIT-Z) outside of controlled clinical trials, we carried out a biinstitutional, international retrospective study to assess the efficacy of RIT-Z in a routine clinical setting. The relationship between the number of previous therapies and outcomes as well as the response to the last therapy was assessed. Possible differences in outcomes for patients treated in the two different centers were also analyzed. Materials and Methods: Forty-three consecutive patients treated at the University Hospital of Lausanne (CHUV, Switzerland) and at S. Andrea University Hospital of Rome (Italy) were evaluated, none of which had been previously included in clinical trials. Only 31 patients entered the final analysis: patients lost at follow up, undergoing autologous transplantation (ASCT), or treated within the last 3 months were excluded. Efficacy of therapy was evaluated in terms of Overall Survival (OS), Progression Free Survival (PFS), and Time to Next Treatment (TTNT). Survival curves were obtained with the Kaplan- Meier method (statistical significance = p<0.05). Results: Characteristics of the patient population are listed in Table 1. Although 50% of the patients had aggressive histologies, patients treated at S. Andrea had slightly more favorable features than those treated at CHUV. Fourteen patients (45%) had received at least 4 previous treatments, and all had received Rituximab. Fourteen patients (45%) had not responded to the last therapy, while 6 (19%), all treated at S.Andrea, were considered disease-free at the time of RIT-Z, which was administered for consolidation. Median follow up time was 20 months (11.5 vs. 25 months for S.Andrea and CHUV, respectively). Median PFS and TTNT were similar. After achieving a partial response, 2 patients were referred to Rituximab maintenance after RIT-Z and remain progression-free. Median OS was still not attained. Although not statistically significant, a trend towards better outcomes for S. Andrea patients was found. In comparing patients with indolent and aggressive lymphoma, only PFS was found to be significantly different (median PFS: 10 vs. 5 months, p<0.05). In patients with <4 and ≥ 4 previous therapies, twenty month OS was 88% vs. 53.6% (p=0.02), respectively; median TTNT was 22 vs. 5 months (p=0.013), while differences in PFS did not attain statistical significance. The duration of response in non-responders to their last therapy was shorter than in responders: 20-month OS- 44% vs. 94% (p=0.0015), median PFS and TTNT- 3.5 vs. 15 months (p=0.0002) and 4 vs. 15 months (p=0.0001), respectively. Median PFS and TTNT after RIT-Z did not differ from those found after the last therapy. A significant difference in outcomes for heavily pretreated or refractory patients was found in those with low grade follicular lymphoma. Conclusions: Poorer outcomes were found in our patient population treated in a routine clinical setting compared to those enrolled in clinical trials. This may be related to greater heterogeneity of our study cohort which included more patients with unfavorable conditions (e.g. aggressive NHL, ≥4 treatment courses including rituximab in all, and ASCT in 25%). Our results suggest that the best benefit may be expected with RIT-Z either for consolidation or relatively earlier in the course of NHL treatment. Table 1. Total CHUV S. Andrea Population Analyzed (72%) Number of patients 43 23 20 31 Median Age 61 63 58,5 62 Aggressive Histology (FL grade 3 or DLBCL) 18 (41,8%) 8 (34,7%) 10 (50%) 11 (35,5%) Indolent Histology (FL grade 1 or 2) (%) 25 (58,2%) 15 (65,3%) 10 (50%) 20 (64,5%) Patients with ≥4 previous treatments 19 (44,2%) 12 (52,1%) 7 (35%) 14 (45,2%) Patients with previous ASCT 11 (25,6%) 6 (26%) 5 (25%) 8 (25%)


2021 ◽  
Vol 32 (2) ◽  
pp. 53-63
Author(s):  
Guilherme de Siqueira Ferreira Anzaloni Saavedra ◽  
João Paulo Mendes Tribst ◽  
Nathália de Carvalho Ramos ◽  
Renata Marques de Melo ◽  
Vinícius Anéas Rodrigues ◽  
...  

Abstract The present study was a prospective, controlled, randomized, clinical short-term trial aiming to evaluate the clinical performance of adhesively luted, lithium disilicate and feldspathic glass-ceramics onlays over a period up to 2 years. A total of 11 patients (7 female, 4 male; age range: 18-60 years, mean age: 39 years) were selected for this study. Each patient received a maximum of two restorations per group in a split-mouth-design. LD: Eleven onlays, performed with lithium disilicate-based ceramic (IPS e.max CAD, Ivoclar Vivadent, Schaan, Liechtenstein), and FP: Eleven onlays, performed with feldspathic ceramic (Vita Mark II, Vita Zanhfabrik, Bad Säckingen). Recalls were performed at 2 weeks (baseline = R1), 1 year (R2) and 2 years (R3) after the cementation by three calibrated blinded independent investigators using mirrors, magnifying eyeglasses, probes and bitewing radiographs. The postoperative sensitivity, secondary caries, marginal integrity, marginal discoloration, color match, surface roughness, tooth integrity, and restoration integrity were evaluated. The Friedman test was used to determine if there was a statistically significant difference in time-to-time comparison of the parameters in the ceramics restorations. A total of 95.4% of the restorations were clinically acceptable at the 2-year recall, without a difference for any evaluation parameter for both ceramic materials. Based on the 2-year data, the CAD-CAM onlays manufactured with feldspathic and lithium-disilicate based ceramics showed similar clinical performance.


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