scholarly journals Serum magnesium levels in hospitalized patients with SARS-CoV-2

2021 ◽  
pp. jim-2021-001948
Author(s):  
Rupam Sharma ◽  
Arash Heidari ◽  
Royce H Johnson ◽  
Shailesh Advani ◽  
Greti Petersen
Keyword(s):  
Disease Severity ◽  
Chart Review ◽  
Medical Literature ◽  
Adverse Outcome ◽  
Serum Magnesium ◽  
Retrospective Chart Review ◽  
Descriptive Statistics ◽  
Ventilator Support ◽  
Adjusted Logistic Regression ◽  
Electrolyte Abnormalities

Early studies have reported various electrolyte abnormalities at admission in patients with severe COVID-19. 104 out of 193 patients admitted to our institution presented with hypermagnesemia at presentation. It is believed this may be important in the evaluation of severe SARS-CoV-2 infections. This study evaluated the outcomes of hypermagnesemia in patients with COVID-19. A retrospective chart review of patients admitted to the hospital with confirmed SARS-CoV-2 infection was conducted. A review of the medical literature regarding hypermagnesemia, magnesium levels in critical care illness and electrolyte abnormalities in patients with COVID-19 was performed. Differences in demographic and clinical characteristics of patients with hypermagnesemia and normomagnesemia were evaluated using descriptive statistics. Other known variables of disease severity were analyzed. 104 patients (54%) were identified with hypermagnesemia (≥2.5 mg/dL). 48 of those patients were admitted to the intensive care unit (46%, p<0.001). 34 patients required ventilator support (32%, p<0.0001). With age-adjusted logistic regression analysis hypermagnesemia was associated with mortality (p=0.007). This study demonstrates that hypermagnesemia is a significant marker of disease severity and adverse outcome in SARS-CoV-2 infections. We recommend serum magnesium be added to the panel of tests routinely ordered in evaluation of severe SARS-CoV-2 infections.

Combination Therapies for Hidradenitis Suppurativa: A Retrospective Chart Review of 31 Patients

2019 ◽  
Vol 23 (3) ◽  
pp. 270-276 ◽  
Author(s):  
Meghan L. McPhie ◽  
Alanna C. Bridgman ◽  
Mark G. Kirchhof
Keyword(s):  
Disease Severity ◽  
Hidradenitis Suppurativa ◽  
Chart Review ◽  
Small Sample Size ◽  
Demographic Data ◽  
Severe Disease ◽  
Treatment Protocol ◽  
Retrospective Chart Review ◽  
Small Sample ◽  
Combination Therapies

Background: Although a variety of medical and surgical interventions exist for the treatment of hidradenitis suppurativa (HS), it remains a challenging disease to manage because of its variable presentation and unpredictable clinical course. Apart from the combination of clindamycin and rifampin, the success of other combination therapies is largely unknown. Objectives: The goal of our study was to examine the clinical utility of various combination therapies for the treatment of HS. Methods: We conducted a qualitative retrospective chart review of 31 patients with dermatologist-diagnosed HS who were seen at an academic teaching hospital between 2014 and 2018. Demographic data, disease location, disease severity, and treatment protocol were retrieved for analysis. Hurley stage was used to classify disease severity on initial presentation, and the International Hidradenitis Suppurativa Severity Score System (IHS4) was used to track changes across visits. Results: Of the 31 patients (Mage = 37.7 years; 67.7% female) included in the study, 6 (19.4%), 11 (35.5%), and 14 (45.2%) patients were classified as Hurley stages I, II, and III, respectively. Although no statistical results are provided because of the small sample size, we have identified several drug combinations that show promising clinical response for patients with HS based on their IHS4 score, such as isotretinoin/spironolactone for mild disease, isotretinoin or doxycycline with adalimumab for moderate disease, and cyclosporine/adalimumab for severe disease. Conclusions: This preliminary work demonstrates that HS treatment with combination therapy appears to be a promising method of disease management.

scholarly journals Perioperative Intravenous Acetaminophen in Pediatric Tonsillectomies

2018 ◽  
Vol 53 (5) ◽  
pp. 316-320 ◽  
Author(s):  
Brandi Bowman ◽  
Leslie Sanchez ◽  
Preeyaporn Sarangarm
Keyword(s):  
Chart Review ◽  
Primary Outcome ◽  
Pediatric Patients ◽  
Retrospective Chart Review ◽  
Descriptive Statistics ◽  
Pain Medications ◽  
Frequent Administration ◽  
Intravenous Acetaminophen ◽  
Sparing Effect ◽  
Opiate Administration

Purpose: This study investigated the effect of perioperative intravenous (IV) acetaminophen on opioid requirements in pediatric patients undergoing tonsillectomy at a single center. Methods: This retrospective chart review included patients who were less than 18 years old and underwent an outpatient tonsillectomy procedure. Patients who received non–Food and Drug Administration (FDA)-approved dosing of IV acetaminophen, without documented weights, and on chronic pain medications at the time of the procedure were excluded. The primary outcome was opioid requirements postoperatively prior to discharge measured as morphine equivalents per kilogram. Descriptive statistics were used to compare differences between groups. A multivariate analysis was performed, accounting for differences between groups in baseline and procedural characteristics. Results: In total, 157 patients were included in this study, of whom 55 had received IV acetaminophen and 102 had not. The average IV acetaminophen dose for was 14.5 mg/kg for patients weighing less than 50 kg (n = 22); the remaining patients received the maximum 1 g dose. Patients who received IV acetaminophen were less likely to be administered postoperative opiates as compared with those did not (45.5% vs 63.7%, odds ratio = 0.48, P = .036). There was a trend toward a decrease in total amount of opiates administered with IV acetaminophen (0 vs 0.033 µg/kg, P = .61). After adjusting for age and documented pain assessment, IV acetaminophen administration remained a significant factor for postoperative opiate administration. Conclusions: Perioperative administration of IV acetaminophen was associated with less frequent administration of symptom-directed opiates in pediatric tonsillectomies. This finding indicates that the agent may have an opioid-sparing effect in this patient population.

A Descriptive Report of Bleeding Complications Secondary to Warfarin Therapy

2003 ◽  
Vol 38 (1) ◽  
pp. 36-39 ◽  
Author(s):  
Daphne Bernard ◽  
Arjun P. Dutta ◽  
Monika N. Daftary
Keyword(s):  
Medical Records ◽  
Chart Review ◽  
Warfarin Therapy ◽  
Common Factors ◽  
Retrospective Chart Review ◽  
Descriptive Statistics ◽  
Bleeding Complications ◽  
Comorbid Conditions ◽  
Factors Associated ◽  
Anticoagulation Intensity

Purpose This study identified factors that contributed to bleeding complications associated with warfarin therapy that were documented as adverse drug reactions (ADRs). Methods A retrospective chart review was performed using the Medical Records Department's “E” code list of anticoagulant-related ADRs. Descriptive statistics were used to identify common factors associated with bleeding complications related to warfarin use. Results Patients 60 years of age or older experienced 78% of all events; a majority (81%) of reports involved the presence of comorbid conditions such as congestive heart failure, carcinoma, or sepsis. A supratherapeutic INR was documented for 75% of patients with anticoagulant-related ADRS. Conclusions Age, comorbid conditions, and anticoagulation intensity were identified as possible factors contributing to documented ADRs associated with warfarin therapy.

Hemoglobin Levels and Serum C-Reactive Protein in Patients With Moderate to Severe Hidradenitis Suppurativa

2019 ◽  
Vol 23 (5) ◽  
pp. 501-506 ◽  
Author(s):  
Christina M. Huang ◽  
Michelle A. Lowes ◽  
Christine Cserti ◽  
Afsaneh Alavi
Keyword(s):  
Disease Severity ◽  
Hidradenitis Suppurativa ◽  
Chart Review ◽  
Inflammatory Diseases ◽  
Retrospective Chart Review ◽  
C Reactive Protein ◽  
Patient Demographics ◽  
Reactive Protein ◽  
Anemia Of Chronic Inflammation ◽  
One Way Anova

Introduction: Anemia of chronic inflammation is associated with many inflammatory diseases. Little is known about anemia in hidradenitis suppurativa (HS). This study aimed to review the levels of hemoglobin (Hb) and investigate its relationship with serum C-reactive protein (CRP) and disease severity in HS patients. Methods: This was a retrospective chart review of all HS patients from 2015 to 2017 with Hb and CRP blood work. Patient demographics, disease severity, and laboratory results were extracted. Data were analyzed descriptively. A linear regression model was used for the association between Hb and CRP. Two-tailed t-tests and one-way ANOVA were used to compare differences between sexes and disease severities. Results: Of the 25 patients included, 14 (56%) were female. The median age and disease duration of all patients were 41 years (range, 19-56 years) and 10 years (range, 1-40 years), respectively. The overall median CRP level was 11.5 mg/dL (range, 1-86.7 mg/dL). The median Hb levels for women and men were and 123.5 g/L (range, 90-142 g/L) and 152.0 g/L (range, 109-166 g/L), respectively. Anemia was found in 42.9% (6/14) of women and 27.3% (3/11) of men. There was an inverse relationship between Hb and CRP levels in both sexes (men: r = ‒0.88; P = .0006; women r = ‒0.65; P = .012). Conclusions: Anemia was prevalent in the HS population, and Hb levels inversely correlated with CRP. Physicians should be aware that anemia is common in inflammatory states, and that CRP could be a biomarker in patients with HS.

Delay to radical prostatectomy: Who, why and does it matter?

2020 ◽  
pp. 205141582094593
Author(s):  
Alexander L Nesbitt ◽  
Philip G Smith ◽  
Stefan Antoniou ◽  
Garrath A Evans ◽  
Simon W Pridgeon
Keyword(s):  
Radical Prostatectomy ◽  
Chart Review ◽  
Adverse Outcome ◽  
Preoperative Staging ◽  
Retrospective Chart Review ◽  
Emission Tomography ◽  
Postoperative Treatment ◽  
Positron Emission ◽  
Psma Pet ◽  
Specific Membrane

Objective: This study aimed to analyse a population of men undergoing radical prostatectomy to determine whether a delay to surgery is associated with poorer outcomes. A secondary aim was to analyse whether the introduction of positron emission tomography (PET) imaging using probes labelled with radiotracers targeting prostate-specific membrane antigen (PSMA) was associated with delay. Methods: A retrospective chart review was performed for men undergoing radical prostatectomy in Cairns, Australia, between March 2014 and March 2018, who were identified from a prospectively maintained database. Results: A total of 332 cases were analysed. Logistic regression analysis failed to show extra time between biopsy and surgery as a predictor for any adverse outcome. Patients who underwent preoperative staging with PSMA-PET had a longer delay between biopsy and imaging (47.1±40.4 vs. 32.3±22.9 days; p<0.01) but a shorter duration between biopsy and surgery (109.5±64.7 vs. 132.5±70.8 days, p<0.01) compared with men staged with computed tomography and a bone scan. Conclusions: Delay to surgery was not a predictor for adverse pathological outcomes or the need for further postoperative treatment. Patients staged with PSMA-PET took longer to get their imaging but proceeded to surgery quicker overall, likely because they had a higher-risk disease.

scholarly journals Retrospective Review of Interventional Radiology Treatment and Outcomes in Pediatric Liver Disease

2020 ◽  
Vol 3 ◽  
Author(s):  
Anna Purk ◽  
Sean Pfaff ◽  
Francis Marshalleck ◽  
Jean Molleston
Keyword(s):  
Interventional Radiology ◽  
Liver Disease ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Descriptive Statistics ◽  
Data Set ◽  
Pediatric Liver ◽  
Portosystemic Shunts ◽  
Pediatric Liver Disease ◽  
Intrahepatic Portosystemic Shunt

Background: Interventional radiology (IR) procedures offer less invasive and low risk options for the treatment of pediatric liver abnormalities, as well as life sustaining measures to bridge patients to transplant. Literature regarding IR interventions for pediatric liver disease is limited. Common conditions that can be treated with IR procedures include vascular anomalies: congenital portosystemic shunts, arteriovenous malformations (AVM), and Budd-Chiari malformation. Transjugular intrahepatic portosystemic shunt (TIPS) can be used to prevent recalcitrant variceal bleeding in portal HTN.  Liver biopsy (percutaneous and transjugular) is used to sample the liver and can be targeted to tumors and other lesions. Percutaneous approaches to image biliary abnormalities and treat strictures are useful in children after liver transplant and also without.,     Objective: describe liver IR procedures and their outcomes in a single-center cohort study      Methods: Patients will be identified through retrospective chart review at Riley Hospital for Children to identify and record the diagnoses, interventions, and relevant outcomes for eligible patients. Descriptive statistics can then be performed. This data set can be used to help inform clinicians on indications and expected outcomes for relevant hepatic IR procedures.     Conclusion: It is anticipated that data collected for this project will show increased utilization of these procedures at the end of the study period compared to the beginning, and the complication rate for the IR procedure will be lower when compared to equivalent traditional procedures to treat the same condition.  

Concordance and discordance in myeloma bone marrow studies.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e19508-e19508
Author(s):  
Vincent Louie Mendiola ◽  
Meghana Kesireddy ◽  
Bagi RP Jana
Keyword(s):  
Bone Marrow ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Study Groups ◽  
Tumor Burden ◽  
Descriptive Statistics ◽  
P Value ◽  
Exclusion Criteria ◽  
Cell Percentage ◽  
Tool Types

e19508 Background: Multiple myeloma (MM) diagnostic costs, including bone marrow (BM) studies: (flow (F), aspirate (manual differential) (A) and biopsy (Bx)) are increasing. BM studies already have underlying discordance issues that may lead to repetitive studies. Thus, elucidation of characteristics associated with concordant/discordant BM studies in identifying plasma cell percentage (PC%) of ≥10, a key MM diagnostic criteria, arises. Methods: A retrospective chart review (total of152 patients diagnosed with MM and managed at UTMB through 1/2016-1/2018) was completed. 56 subjects met inclusion, PC ≥10% in any BM study, and exclusion criteria. Subjects were grouped into BMA vs BMBx and BMF vs BMBx groups and subdivided into MM subtypes for exploratory review. Two-sample Independent t-test (CI 95%) and descriptive statistics were used for comparison of variables. Two-sided p value ≤ 0.05 was considered significant. Results: Sensitivities in identifying BM PC≥10% were as follows: BMA (66.1%), BMF (39.3%) and BMBx (96.4%) (Gold standard: BMA+BMF+BMBx (100%)). Concordance rates were at 60.7% between BMA and BMBx and 35.7% between BMF and BMBx. Larger BMBx spicule size (mean(cm) = 1.3(1.1-1.48) x 0.27(0.22- 0.31) x 0.21(0.19-0.22), p = 0.037) and higher B2 microglobulin (B2m) levels (mean(mcg/mL) = 11.92 (8.04- 15.79), p = 0.003) were associated with BMA and BMBx concordance in typical/secretory MM types but not in oligo-secretory and non-secretory subtypes of MM, nor is associated with BMF and BMB concordance or discordance. Meanwhile, # of BM acquisition attempts, tool types (hand trochar vs drill) for BM acquisition, LDH and CRP levels had no significant associations with concordance or discordance in any BM study groups. Conclusions: BMF is the least sensitive in identifying PC≥10% likely due to PC damage during flow cytometry, and it may be prudent to just perform BMA with BMBx to save on costs. The associations between larger spicule sizes and higher B2m levels to BMA and BMBx concordance are likely due to an increase in the chance of identifying monoclonal PCs in bigger samples, and greater monoclonal PC tumor burden, respectively, and may have predictability benefits.

A retrospective audit on usage of Diatrizoate Meglumine (Gastrografin®) for intestinal obstruction or constipation in patients with advanced neoplasms

2017 ◽  
Vol 32 (1) ◽  
pp. 294-298
Author(s):  
Sharon Heng ◽  
Janet Hardy ◽  
Phillip Good
Keyword(s):  
Intestinal Obstruction ◽  
Chart Review ◽  
Private Hospital ◽  
Retrospective Chart Review ◽  
Descriptive Statistics ◽  
Median Dose ◽  
Post Dose ◽  
Retrospective Audit ◽  
Quality Evidence ◽  
Patient Episode

Background: Intestinal obstruction and constipation are common conditions in patients with advanced neoplasms. Diatrizoate Meglumine has been used in the management of both these conditions without good quality evidence of its effectiveness and safety. Aim: This audit aimed to assess the usage, effectiveness and adverse effects of Diatrizoate Meglumine for intestinal obstruction and constipation in patients with advanced neoplasms. Design: A retrospective chart review was undertaken. Descriptive statistics were utilised. Setting/participants: All patients with known advanced neoplasms admitted to Mater Health Services and St Vincent’s Private Hospital Brisbane between January 2013 and October 2015; who were administered Diatrizoate Meglumine were included. Results: Seventy-one patients received Diatrizoate Meglumine. The most common diagnoses were ovarian or primary peritoneal neoplasms (33.8%). Diatrizoate Meglumine was most commonly used for intestinal obstruction (59.2%). The median dose used per patient episode was 50 mL (range: 15–500 mL). Thirty-two patients (45%) had imaging 4–24 h post-dose with Diatrizoate Meglumine being present in the large intestine in 75% of these images. Intestinal obstruction or constipation resolved in 90% of patients post-dose. Conclusion: Most clinicians used 50 mL of Diatrizoate Meglumine as a single dose and repeated imaging after 4–24 h. Diatrizoate Meglumine was well tolerated and may be effective in resolving intestinal obstruction and constipation in patients with advanced neoplasms. Quality controlled studies are needed to further guide the use of Diatrizoate Meglumine in intestinal obstruction and constipation in patients with advanced neoplasms.

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