scholarly journals Short-Term Outcomes After Multisystem Inflammatory Syndrome in Children Treatment

2020 ◽  
Author(s):  
Katharine N Clouser ◽  
Jasmine Gadhavi ◽  
Sejal M Bhavsar ◽  
Rachel Lewis ◽  
Cathleen Ballance ◽  
...  
Keyword(s):  
Chart Review ◽  
Clinical Status ◽  
Treatment Algorithm ◽  
Retrospective Chart Review ◽  
Clinical Spectrum ◽  
Short Term ◽  
Inflammatory Syndrome

Abstract This is a retrospective chart review of 20 patients treated with a consensus-driven treatment algorithm in multisystem inflammatory syndrome in children patients across a wide clinical spectrum. Their treatments and clinical status are described as well as their favorable return to functional baseline by 30 days post presentation.

Safety and efficacy of electroconvulsive therapy for depression following cerebrovascular accident

2012 ◽  
Vol 24 (4) ◽  
pp. 226-229 ◽  
Author(s):  
Magdalena Romanowicz ◽  
Bruce Sutor ◽  
Christopher Sola
Keyword(s):  
Electroconvulsive Therapy ◽  
Cerebrovascular Accident ◽  
Chart Review ◽  
Short Term Memory ◽  
Retrospective Chart Review ◽  
Neurological Deficits ◽  
Response To Treatment ◽  
Short Term ◽  
Memory Problems ◽  
Depressive Syndromes

Introduction: Depressive syndromes are common following cerebrovascular accident (CVA) and many patients do not respond to pharmacotherapy. Electroconvulsive therapy (ECT) is a safe and effective treatment for mood disorders arising with many comorbid medical conditions. In this paper, we describe the successful treatment of post-CVA depression with ECT.Methods: Retrospective chart review of 24 patients hospitalised for depression on an in-patient Medical Psychiatry unit between 2000 and 2010. Medical, neurologic and psychiatric histories, physical examination findings, results of laboratory, imaging and neurophysiologic investigations and treatment response with medications and ECT were recorded.Results: Twenty patients (83%) showed a positive response to treatment with ECT. None had worsening of depression after the ECT or experienced exacerbation of post-stroke neurological deficits. Three patients suffered from minor complications of ECT (prolonged confusion or short-term memory problems).Conclusions: This review supports the use of ECT after a stroke with appropriate clinical observation. The treatment was well tolerated and the majority obtained clinical benefit.

scholarly journals Risk of Complications with the Total Contact Cast in Diabetic Foot Disorders

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0036
Author(s):  
Alexandria Riopelle ◽  
Ryan LeDuc ◽  
Michael S. Pinzur ◽  
Adam P. Schiff
Keyword(s):  
Diabetic Foot ◽  
Chart Review ◽  
Hemoglobin A1c ◽  
Treatment Algorithm ◽  
Retrospective Chart Review ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Charcot Foot ◽  
Total Contact Cast ◽  
Definition Of

Category: Diabetes Introduction/Purpose: The total contact cast is an important component of the clinical treatment algorithm for diabetic foot ulcers and Charcot Foot Arthropathy. Few studies have reported on the complications associated with this treatment modality. Methods: Over a ten year period, 2265 total contact casts were placed on 384 patients during their treatment for diabetic foot disorders. All of the casts were applied by a Certified Orthopaedic Technologist under the supervision of a University Faculty member. Complications were grouped as: (1) development of a new ulcer or wound, (2) new or increasing odor or drainage, (3) wound infection, (4) gangrene, (5) newly identified osteomyelitis, and (6) pain or discomfort necessitating cast change / removal. Complications were then associated with Hemoglobin A1C levels at the time of treatment. Results: Using this very stringent definition of a complication, ten percent of patients had some form of a complication. Most complications resolved following cast change or cast removal. Conclusion: The total contact cast has been demonstrated to be a valuable tool in the treatment of diabetic foot disorders. This retrospective chart review should serve as a valuable reference to assist clinicians when counseling patients during treatment for diabetic foot disorders.

Rebleeding risk after treatment of ruptured intracranial aneurysms

2011 ◽  
Vol 114 (6) ◽  
pp. 1778-1784 ◽  
Author(s):  
J. Brett Fleming ◽  
Brian L. Hoh ◽  
Scott D. Simon ◽  
Babu G. Welch ◽  
Robert A. Mericle ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Intracranial Aneurysms ◽  
Large Scale ◽  
Chart Review ◽  
Cerebral Aneurysms ◽  
Retrospective Chart Review ◽  
Short Term ◽  
International Subarachnoid Aneurysm Trial ◽  
Rebleeding Rate ◽  
Ruptured Intracranial Aneurysms

Object Postprocedural rebleeding is a significant source of morbidity following endovascular treatment of ruptured intracranial aneurysms. Previous large-scale reports include the Cerebral Aneurysm Rerupture After Treatment trial, the International Subarachnoid Aneurysm Trial, and the study on Early Rebleeding after Coiling of Ruptured Cerebral Aneurysms, which reported nonprocedural rebleeding rates within 30 days of treatment of 2.7%, 1.9%, and 1.4%, respectively. However, coiling of intracranial aneurysms is in a state of continual change due to advancing device design and evolving techniques. These studies included only patients initially treated prior to 2004. In the present study the authors assess the most recent short-term results with endovascular treatment of ruptured aneurysms. Methods A multicenter retrospective chart review was conducted of patients undergoing endovascular treatment for ruptured intracranial aneurysms between July 2004 and October 2009. The technique used, including the use of stent or balloon assistance, was evaluated. Demographic and clinical factors, such as sex, age, initial clinical presentation, aneurysm size, aneurysm location, and modified Raymond Classification following initial treatment, were also evaluated and compared between the groups in which rebleeding did and did not occur. Results A total of 469 patients underwent endovascular treatment for a ruptured aneurysm; nonprocedural rehemorrhage occurred within 30 days of the initial coiling in 4 cases (0.9%). Two patients (50%) died after rehemorrhage. Stent-assisted coiling was used during the original treatment in 1 (25%) of the 4 patients with a rerupture. However, no technical, clinical, or demographic factors were found to be statistically significant in association with rebleeding. Conclusions Recent data suggest that the periprocedural rebleeding rate may be improving over time.

scholarly journals Impact of COVID-19 pandemic on breast surgery and breast reconstruction in a Japanese university hospital setting.

2020 ◽  
Author(s):  
Dai Shibata ◽  
Takahiko Kawate ◽  
Takako Komiya ◽  
Itaru Nakamura ◽  
Takashi Ishikawa ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Chart Review ◽  
Breast Surgery ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
University Hospital ◽  
Breast Cancer Surgery ◽  
Short Term ◽  
Japanese University

Abstract The new coronavirus disease (COVID-19) is spreading worldwide. In Japan, the number of people infected has been increasing since March 2020. The COVID-19 pandemic has had a significant impact on hospitals, although Tokyo, Japan did not experience a collapse of the medical system. Patients were triaged and prioritized due to surgical limitations during the pandemic period. The purpose of this study was to determine how patients with breast cancer or breast reconstruction were affected by the COVID-19 pandemic at a university hospital in Tokyo. In this retrospective chart review we investigated how patients were treated, including surgical postponements during three periods: April to July 2020, August to November 2019 (after the Allergan recall), and April to July 2019. More than half of breast surgeries and breast reconstructions had to be postponed during the COVID-19 pandemic, and the number of candidates for surgery was also lower compared to the pre-pandemic periods. Triage of patients with breast cancer did not result in any adverse oncological outcomes for these patients. COVID-19 has had a major impact on breast cancer surgery and breast reconstruction, and there was substantial postponement of surgery. Due to triage and prioritization, no patients experienced disease progression in the short-term period, demonstrating that our strategy was appropriate.

scholarly journals 305. Cholecystitis as a Possible Immunologic Consequence of COVID-19; Case Series from a Large Healthcare System

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S258-S259
Author(s):  
Anna Jacobs ◽  
Christopher Polk ◽  
Mindy Sampson ◽  
Banks Kooken ◽  
Thomas Ludden ◽  
...  
Keyword(s):  
Immune Activation ◽  
Chart Review ◽  
Clinical Laboratory ◽  
Case Series ◽  
Panel Member ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Biliary Disease ◽  
Inflammatory Syndrome ◽  
Research Grant

Abstract Background Gastrointestinal manifestations are commonly seen in COVID-19 disease with up to 50% of patients reporting nausea or diarrhea. Cholecystitis has been described in rare cases related to COVID-19, possibly in consequence of immune activation, but biliary disease from SARS-CoV-2 infection is not well described. We examined a case series of patients with both COVID-19 and cholecystitis at our institution. Methods We performed a retrospective chart review of all patients with a diagnosis of cholecystitis within 3 months of SARS-CoV-2 infection; looking at clinical, laboratory, and radiographic characteristics of this population. Results 30 individuals were identified with a diagnosis of cholecystitis within 3 months of diagnosis of SARS-CoV-2 infection. Most patients presenting with cholecystitis were female and obese (see Table 1). 14 individuals were diagnosed with SARS-CoV-2 infection during the same presentation as their cholecystitis diagnosis, usually as part of pre-operative screening. Of 16 individuals diagnosed with SARS-CoV-2 prior to their cholecystitis presentation, a mean of 24 and 17 days elapsed between SARS-CoV-2 infection and cholecystitis symptom onset and radiographic diagnosis, respectively (see Figure 1). Most of these patients had mild respiratory disease, with only 9 developing an oxygen requirement, and only 3 requiring mechanical ventilation. While 17 patients were treated surgically for their cholecystitis, this did not appear to impact symptom resolution. Table 1. Patient Characteristics Figure 1. Time between COVID-19 and Cholecystitis Conclusion Cholecystitis may be an uncommon complication of COVID-19 disease. Cholecystitis may manifest most often 2-4 weeks following SARS-CoV-2 infection. This timing is similar to that in Multisystem Inflammatory Syndrome following SARS-CoV-2 infection and given similarities in timing to we hypothesize that cholecystitis in our patients could be driven by immune activation. Disclosures Christopher Polk, MD, Atea (Research Grant or Support)Gilead (Advisor or Review Panel member, Research Grant or Support)Humanigen (Research Grant or Support)Regeneron (Research Grant or Support) Mindy Sampson, MD, Regeneron (Grant/Research Support) Catherine Passaretti, MD, Nothing to disclose

scholarly journals Occurrence of Hyperbilirubinemia in Neonates Given a Short-term Course of Ceftriaxone versus Cefotaxime for Sepsis

2021 ◽  
Vol 26 (1) ◽  
pp. 99-103
Author(s):  
Garrett B. Hile ◽  
Kaitlin L. Musick ◽  
Adam J. Dugan ◽  
Abby M. Bailey ◽  
Gavin T. Howington
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Patient Characteristics ◽  
Median Number ◽  
Antibiotic Administration ◽  
Neonatal Infections ◽  
Short Term ◽  
Significant Difference ◽  
Abnormal Level ◽  
Antimicrobial Administration

OBJECTIVE Ceftriaxone and cefotaxime are appealing options for the treatment of neonatal infections. Guidelines recommend cefotaxime as the cephalosporin of choice in neonates because of ceftriaxone's potential to cause hyperbilirubinemia. Unfortunately, due to cefotaxime discontinuation, providers must choose between alternative antibiotics. Clinicians at our institution adopted a protocol allowing for the utilization of cefepime and ceftriaxone for the management of neonatal sepsis. The objective of this study was to compare the incidence of hyperbilirubinemia between ceftriaxone and cefotaxime in the treatment of neonatal infections beyond the first 14 days of life. METHODS This was a retrospective chart review of patients receiving ceftriaxone or cefotaxime for the treatment of neonatal infections. Patients were 15 to 30 days old at the time of antimicrobial administration and received at least 1 dose of ceftriaxone or cefotaxime during hospital admission. Patient characteristics and bilirubin levels were compared between ceftriaxone and cefotaxime. RESULTS The analysis included 88 patients. There was no statistically significant difference between groups in age, gestational age, weight, and baseline total calcium and bilirubin levels. Normal baseline bilirubin levels increased to an abnormal level after antibiotic administration in 2 patients in the cefotaxime group and 1 patient in the ceftriaxone group. The median number of doses of cefotaxime and ceftriaxone were 3 and 2, respectively. CONCLUSION Patients who received a short-term course of ceftriaxone did not have a higher likelihood of developing hyperbilirubinemia compared with those who received a short-term course of cefotaxime during their hospital stay.

scholarly journals Short-Term Intraocular Pressure Elevations after Combined Phacoemulsification and Implantation of Two Trabecular Micro-Bypass Stents: Prednisolone versus Loteprednol

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Qianqian Wang ◽  
Paul Harasymowycz
Keyword(s):  
Intraocular Pressure ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Local Inflammation ◽  
Significant Group Effect ◽  
Contributing Factors ◽  
Short Term ◽  
Significant Group ◽  
Aqueous Humor Outflow ◽  
The Mean

Objective. To compare the effects of prednisolone and of loteprednol after combined phacoemulsification and trabecular micro-bypass stent implantation (phaco-iStent).Methods. Patients who underwent phaco-iStent between April 2013 and November 2014 were identified by retrospective chart review. Postoperatively, they received either prednisolone (n=38) or loteprednol (n=58). Baseline data was compared. Primary outcomes including intraocular pressure (IOP) and number of glaucoma medications (NGM) were analyzed at preoperative visit, postoperative day 1, weeks 1-2, weeks 3-4, and months 2-3.Results. Both groups had similar preoperative parameters (p>0.05). The mean IOP spike occurred at postoperative weeks 1-2 with an increase of 2.21 ± 7.30 mmHg in the loteprednol group and 2.54 ± 9.28 mmHg in the prednisolone group. It decreased by weeks 3-4 in both groups and continued to improve at months 2-3. NGM showed significant reduction (p<0.0001) after the surgery and remained stable in both groups. No significant group effect or time-group interaction in IOP and NGM evolution was detected (p>0.05). The proportions of patients needing paracentesis were similar between the two groups.Conclusion. Similar early IOP elevations after combined phaco-iStent occurred with both prednisolone and loteprednol. Facilitated glucocorticoid infusion, altered aqueous humor outflow, and local inflammation may be contributing factors.

scholarly journals Clinical spectrum and short-term outcomes of multisystem inflammatory syndrome in children in a south Indian hospital

2021 ◽  
Author(s):  
Muruganantham Balagurunathan ◽  
Thrilok Natarajan ◽  
Jothilakshmi Karthikeyan ◽  
Venkateshwaran Palanisamy
Keyword(s):  
Clinical Spectrum ◽  
Short Term ◽  
South Indian ◽  
Inflammatory Syndrome

scholarly journals Short-Term Change in Measures of Glycemia in Obese Youth Meeting Criteria for Prediabetes: A Retrospective Chart Review

2020 ◽  
Vol 93 (1) ◽  
pp. 1-6
Author(s):  
Hala K. El Mikati ◽  
Brett M. McKinney ◽  
Lisa Yazel-Smith ◽  
Sarah E. Alders ◽  
Tamara S. Hannon
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Short Term ◽  
Obese Youth ◽  
Short Term Change ◽  
Term Change

A standardized approach for managing chemotherapy-induced rash.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 86-86
Author(s):  
Laura Poggi ◽  
Jennifer Godden ◽  
Sol Yoder
Keyword(s):  
Chart Review ◽  
Treatment Algorithm ◽  
Growth Factor Receptor ◽  
Retrospective Chart Review ◽  
Treatment Recommendations ◽  
Management Algorithm ◽  
Electronic Alerts ◽  
Rash Management ◽  
Therapy Modification ◽  
Dose Reductions

86 Background: Chemotherapy-induced rash can lead to disruptions or discontinuation of therapy, potentially leading to a poorer prognosis for patients. Methods: A retrospective chart review was performed at selected clinics to determine rash incidence, current rash management, and dose reductions, disruptions, and discontinuation of therapy due to rash for epidermal growth factor receptor-inhibitors (EGFR-I) during August and September 2013. A rash management algorithm containing preventative and treatment recommendations was created for selected EGFR-I (cetuximab, panitumumab, erlotinib) and implemented in the clinics’ electronic medical record as part of a pilot study from February through May 2014. When the EGFR-I were ordered, electronic alerts reminded providers of the algorithm. Pharmacists received electronic messages to ensure algorithm compliance. Nurses provided patients with a rash information sheet and preventative prescriptions. Providers assessed patients for rash during follow-up and instituted the rash treatment algorithm, if indicated. Through a chart review, rash incidence, and dose reductions, disruptions, and discontinuation of therapy due to rash were determined. Results: The retrospective chart review revealed 7 of 9 (78%) patients, in whom preventive medications were not utilized, developed rash with the selected EGFR-I. Treatment medications were required in 6 of 7 (86%) patients with rash. Even with treatment, 3 of 7 (43%) patients had a severe rash, making therapy modification necessary. A dose reduction was ordered for 1 patient, a disruption for another, and discontinuation of therapy for a third. During the pilot period, 6 of 7 (86%) patients developed rash, but none required dose reductions or discontinuation of therapy. Of the 6 patients who developed rash, 4 were adequately managed with preventive measures alone. Of the 2 patients who started rash treatment, 1 patient had rash resolution and the other patient continued treatment without any therapy modifications. Conclusions: An algorithm containing preventive and treatment recommendations for EGFR-I-induced rash may be more beneficial than reactive therapy alone in attenuation of dose reductions, disruptions, and discontinuation of therapy.

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