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.

Outcomes of selective laser trabeculoplasty in corticosteroid-induced ocular hypertension and glaucoma

2021 ◽  
pp. 112067212110233
Author(s):  
Ibrahim AlObaida ◽  
Adi Mohammed Al Owaifeer ◽  
Hajar Alotaibi ◽  
Aisha Alsafi ◽  
Leyla Ali Aljasim
Keyword(s):  
Intraocular Pressure ◽  
Success Rate ◽  
Ocular Hypertension ◽  
Chart Review ◽  
Surgical Intervention ◽  
Retrospective Chart Review ◽  
Selective Laser Trabeculoplasty ◽  
Laser Trabeculoplasty ◽  
The Mean

Purpose: To report the outcomes of selective laser trabeculoplasty (SLT) in lowering intraocular pressure (IOP) in patients with steroid-induced ocular hypertension and glaucoma. Methods: A retrospective chart review of patients who underwent SLT for steroid-induced ocular hypertension or glaucoma between January 2014 and October 2018. Success of SLT was defined as ⩾20% IOP reduction from baseline without further medical or surgical intervention and/or a reduction in the number of glaucoma medications by ⩾1 from baseline while maintaining the target IOP. Main outcome measures were change in IOP from baseline and reduction in the number of medications post-laser. Results: A total of 25 eyes of 17 patients were included in the study. The mean duration of follow-up was 18.8 ± 4.5 months. IOP decreased from 23.7 ± 6.7 mmHg pre-laser to 14.4 ± 3.2 mmHg post-laser, at the last follow-up visit ( p < 0.001). The mean number of medications was 1.8 ± 1.6 medications pre-laser and 1.4 ± 1.3 medications post-laser ( p = 0.262). The overall success rate at 12 months was 72%. No visually significant complications were encountered during the whole duration of follow-up. Conclusion: SLT is a safe and effective procedure that can result in well-controlled IOP in patients with steroid-induced ocular hypertension and glaucoma.

Late endoscopic evaluation of the ostium size after external dacryocystorhinostomy

2020 ◽  
pp. 112067212097604
Author(s):  
Reem R Al Huthail ◽  
Yasser H Al-Faky
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Nasal Endoscope ◽  
Long Term Follow Up ◽  
Mean Size ◽  
External Dacryocystorhinostomy ◽  
The Mean

Objective: To evaluate the effect of chronicity on the size of the ostium after external dacryocystorhinostomy (DCR) with intubation. Methods: Design: A retrospective chart review of patients who underwent external DCR with intubation over 10 years from January 2003 at a tertiary hospital. All patients were recruited and examined with rigid nasal endoscope. Results: A total number of 66 (85 eyes) patients were included. The mean age at the time of evaluation was 53.1 years with gender distribution of 54 females (81.8 %). The mean duration ±SD between the date of surgery and the date of evaluation was 33.2 ± 33.6 (6–118 months). Our study showed an overall anatomical and functional success of 98.8% and 95.3%, respectively. The mean size of the ostium (±SD) was 23.0 (±15.7) mm2 (ranging from 1 to 80.4 mm2). The size of the ostium was not a significant factor for failure ( p = 0.907). No statistically significant correlation was found between the long-term duration after surgery and the size of the ostium ( R: 0.025, p = 0.157). Conclusions: Nasal endoscopy after DCR is valuable in evaluating the ostium with no observed potential correlation between the long-term follow-up after surgery and the size of the ostium.

Pediatric Organ Donor Maintenance: Pathophysiologic Derangements and Nursing Requirements

PEDIATRICS ◽  
1989 ◽  
Vol 84 (4) ◽  
pp. 688-693
Author(s):  
N. Kissoon ◽  
T. C. Frewen ◽  
M. Bloch ◽  
M. Gayle ◽  
C. Stiller
Keyword(s):  
Chart Review ◽  
Premature Ventricular Contraction ◽  
Retrospective Chart Review ◽  
Stability Index ◽  
Organ Donor ◽  
Pulmonary Insufficiency ◽  
Organ Donors ◽  
Maintenance Time ◽  
Donor Support ◽  
The Mean

A retrospective chart review was conducted of 26 organ donors to determine hemodynamic and metabolic derangements encountered and nursing requirements for donor organ maintenance. There were 15 boys and 11 girls with a mean age 6.57 ± 5.46 years. Mean donor maintenance time was 10.5 ± 6.7 hours. Cardiorespiratory derangements included hypotension in 16, hypertension in 6, arrhythmias in 17 (premature ventricular contraction in 4, bradycardia in 8, paroxysmal atrial tachycardia in 3, and ventricular tachycardia in 2), asystolic events in 5, pulmonary insufficiency in 6, anemia in 8, and thrombocytopenia in 8. Metabolic and hormonal derangements included hyperglycemia in 18, hypokalemia in 20, hyperkalemia in 4, hyponatremia in 3, hypernatremia in 17, metabolic acidosis in 10, and diabetes insipidus in 15. Hypothermia (temperature 33.3°± 0.4°C, mean ± SD) occurred in 14 donors. The mean physiologic Stability Index score was 22.2 ± 4.7 and mean Therapeutic Intervention Score was 46.7 ± 5.8. Total number of nursing hours spent in donor maintenance was 424.5 hours. Therapies offered included diuretics in 10, sodium bicarbonate in 8, antibiotics in 6, insulin in 12, pitressin in 13, verapamil in 3, isoproterenol in 3, dopamine in 17, and intravenous potassium boluses in 14. Of the potential 26 donors, 46 kidneys, 8 hearts, 14 livers, 3 pancreas, and 9 corneas were retrieved in transplantable condition. With appropriate donor maintenance, organs suitable for transplantation can be retrieved despite significant pathophysiologic derangements. Physicians intending to provide donor support should be comfortable with invasive monitoring and cardiorespiratory support and be prepared to provide a nurse to patient ratio of 2:1 at the bedside.

scholarly journals Prevalence of amblyopia and patterns of refractive error in the amblyopic children of a tertiary eye care center of Nepal

2013 ◽  
Vol 5 (1) ◽  
pp. 38-44 ◽  
Author(s):  
K Sapkota ◽  
A Pirouzian ◽  
NS Matta
Keyword(s):  
Visual Acuity ◽  
Refractive Error ◽  
Chart Review ◽  
Care Center ◽  
Retrospective Chart Review ◽  
Ophthalmological Examination ◽  
Eye Care ◽  
Common Cause ◽  
Ocular Pathology ◽  
The Mean

Introduction: Refractive error is a common cause of amblyopia. Objective: To determine prevalence of amblyopia and the pattern and the types of refractive error in children with amblyopia in a tertiary eye hospital of Nepal. Materials and methods: A retrospective chart review of children diagnosed with amblyopia in the Nepal Eye Hospital (NEH) from July 2006 to June 2011 was conducted. Children of age 13+ or who had any ocular pathology were excluded. Cycloplegic refraction and an ophthalmological examination was performed for all children. The pattern of refractive error and the association between types of refractive error and types of amblyopia were determined. Results: Amblyopia was found in 0.7 % (440) of 62,633 children examined in NEH during this period. All the amblyopic eyes of the subjects had refractive error. Fifty-six percent (248) of the patients were male and the mean age was 7.74 ± 2.97 years. Anisometropia was the most common cause of amblyopia (p < 0.001). One third (29 %) of the subjects had bilateral amblyopia due to high ametropia. Forty percent of eyes had severe amblyopia with visual acuity of 20/120 or worse. About twothirds (59.2 %) of the eyes had astigmatism. Conclusion: The prevalence of amblyopia in the Nepal Eye Hospital is 0.7%. Anisometropia is the most common cause of amblyopia. Astigmatism is the most common types of refractive error in amblyopic eyes. Nepal J Ophthalmol 2013; 5(9):38-44 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7820

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.

Age and Sex Differences in Overuse Injuries Presenting to Pediatric Sports Medicine Clinics

2019 ◽  
Vol 58 (7) ◽  
pp. 770-777 ◽  
Author(s):  
Amy Elizabeth Valasek ◽  
Julie A. Young ◽  
Lihong Huang ◽  
Bhavna Singichetti ◽  
Jingzhen Yang
Keyword(s):  
Sports Medicine ◽  
Chart Review ◽  
Sports Injuries ◽  
Retrospective Chart Review ◽  
Overuse Injuries ◽  
Cartilage Injuries ◽  
Red Flag ◽  
The Mean ◽  
Articular Cartilage Injuries ◽  
Age And Sex

Pediatric overuse injuries present with a gradual mechanism of onset and an underlying pathogenesis of microtrauma. We evaluated the clinical presentation of pediatric sports injuries to determine if differences exist between age and sex. A retrospective chart review was performed over a 6-year period; 6593 overuse injuries were included with the mean age of 13.4 years. Males presented with a greater proportion of apophysis, physis, and articular cartilage injuries ( P < .01). Females presented with greater bone, tendon, and “other” injuries ( P < .01). Children <9 years of age demonstrated apophysis and physis injuries. Conversely, children older than 15 years of age presented with tendon, bone, bursa, and other ( P < .01) overuse injuries. A significant number of pediatric athletes in this cohort reported playing through pain prior to clinical evaluation. Injury prevention programs need to educate children, and a red flag should be raised when pediatric athletes are participating with pain.

Safety and Efficacy of Brivaracetam in Pediatric Refractory Epilepsy: A Single-Center Clinical Experience

2019 ◽  
Vol 35 (2) ◽  
pp. 102-105 ◽  
Author(s):  
Sara McGuire ◽  
Gustavo Silva ◽  
Darshan Lal ◽  
Divya S. Khurana ◽  
Agustin Legido ◽  
...  
Keyword(s):  
Seizure Frequency ◽  
Chart Review ◽  
Refractory Epilepsy ◽  
Focal Epilepsy ◽  
Retrospective Chart Review ◽  
Average Dose ◽  
Limited Data ◽  
Duration Of Treatment ◽  
Seizure Reduction ◽  
The Mean

Brivaracetam is a new antiepileptic drug with limited data in children. The objective of this study was to assess the efficacy/tolerability of brivaracetam. This is a retrospective chart review of children/adolescents with refractory epilepsy treated with brivaracetam from 2016 to 2018. The primary outcome was seizure reduction (decrease in seizure frequency >50%). Twenty-three patients were identified. Mean age at initiation was 12.5 years. Fourteen were females. Epilepsy was focal in 11, generalized in 6, and mixed in 3. Average dose was 3.9 mg/kg/d. The mean duration of treatment was 8.2 months. Eight had greater than 50% decrease in seizure frequency, of which 7 had focal epilepsy, and 1 had Lennox-Gastaut/mixed epilepsy. Two had drowsiness and 3 behavioral complaints. One experienced tingling and dizziness. Our retrospective review suggests that brivaracetam is an effective therapy for refractory focal epilepsy in children older than 4 years of age.

Outcomes After the Use of Silicone Oil in Complex Retinal Detachment Repair

2020 ◽  
Vol 4 (2) ◽  
pp. 96-102
Author(s):  
Omar A. Saleh ◽  
Efrat Fleissig ◽  
Charles C. Barr
Keyword(s):  
Visual Acuity ◽  
Retinal Detachment ◽  
Chart Review ◽  
Silicone Oil ◽  
Retrospective Chart Review ◽  
Final Visit ◽  
Complication Rates ◽  
Minimum Angle ◽  
The Mean ◽  
Better Than

Purpose: This study compares visual acuity (VA), anatomic outcomes, and complications in eyes that underwent complex retinal detachment (RD) repair in which silicone oil (SO) was retained vs removed. Methods: A retrospective chart review of patients undergoing vitrectomy with SO tamponade. The eyes were divided into 2 groups based upon SO removal or retention. Main outcome measures were corrected VA, anatomic outcomes, and the presence of SO-related complications. Results: Fifty-seven eyes with removed SO and 53 eyes with retained SO were identified. In both groups, the mean best-corrected VA (BCVA) at the final visit was significantly better than at baseline. In the retained-SO group, vision improved from 1.79 ± 0.6 to 1.2 ± 0.7 logarithm of the minimum angle of resolution (logMAR) (Snellen, 20/1200 to 20/350) at the final visit ( P < .001). In the removed-SO group, mean BCVA improved from 1.84 ± 0.5 at baseline to 1.55 ± 0.6 logMAR units (Snellen, 20/1400 to 20/700) at the visit preceding SO removal ( P < .002) and to 1.43 ± 0.6 logMAR units (Snellen, 20/500) at the final visit ( P < .001). Complication rates were similar in both groups, apart from RD, which occurred more frequently in the removed-SO group ( P = .03). Conclusions: There was similarity in VA and complications among patients with removed or retained SO. Removal of SO may benefit eyes with SO-related complications, but SO retention may decrease the chance of RD and may be indicated in selected cases.

Effect of Intravenous Immunoglobulin on Prednisone Dose in Patients with Pemphigus Vulgaris

2006 ◽  
Vol 10 (5) ◽  
pp. 222-227 ◽  
Author(s):  
Nicole Mittmann ◽  
Brian Chan ◽  
Sandra Knowles ◽  
P. Régine Mydlarski ◽  
Lidia Cosentino ◽  
...  
Keyword(s):  
Intravenous Immunoglobulin ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Pemphigus Vulgaris ◽  
High Dose ◽  
Women's College ◽  
Prednisone Dose ◽  
Systemic Corticosteroids ◽  
The Mean ◽  
Ivig Administration

Background: Current therapeutic options for the treatment of pemphigus vulgaris (PV) are prednisone and immunosuppressants. Patients unresponsive to high-dose systemic corticosteroids and conventional immunosuppressants may respond to intravenous immunoglobulin (IVIG). Objective: The primary outcome was the change in prednisone dose at 6 months and 1 year post-IVIG administration. Methods: A retrospective chart review of PV patients treated at Sunnybrook and Women's College Health Sciences Centre between January 1999 and October 2004 was conducted. Demographic information, corticosteroid and IVIG use, dosage, and the timing of administration for all patients were obtained. Results: Eight PV patients, mean age of 50 years (± 14.7 years), were reviewed. There was a significant decrease in mean prednisone dose at 6 months (45%) and 12 months (71%) compared with the mean dose at the start of treatment ( p < .05). Limitations: Concomitant medication use may influence results. Conclusion: This study demonstrates that IVIG can lower prednisone doses in PV patients.

scholarly journals Evaluation of Levetiracetam for Early Post-Traumatic Seizure Prophylaxis: A Level II Trauma Center Experience

2021 ◽  
Author(s):  
Timothy A. Amin ◽  
Steven F. Nerenberg ◽  
Osama A. Elsawy ◽  
Antai Wang ◽  
Jackie P. Johnston
Keyword(s):  
Trauma Center ◽  
Chart Review ◽  
Primary Outcome ◽  
Retrospective Chart Review ◽  
Hospital Length ◽  
Hospital Length Of Stay ◽  
Level Ii ◽  
Post Traumatic ◽  
The Mean ◽  
Secondary Outcomes

Abstract Background: Traumatic brain injury (TBI) can induce early or late post-traumatic seizures (PTS). While PTS incidence is low, prophylaxis is used despite a lack of consensus on agent or duration. Levetiracetam (LEV) for early PTS prophylaxis is preferred due to its safety and efficacy. The purpose of this study was to evaluate LEV for early PTS prophylaxis.Methods: A single-center, retrospective chart review of TBI patients > 18 years who received LEV for early PTS prophylaxis between August 2018 - July 2019. The primary outcome was LEV duration. Secondary outcomes were incidence of seizure, intensive care unit (ICU) and hospital length of stay (LOS).Results: Of the 137 included, mean age was 59±20 years and 69.3% were male. The mean admission GCS was 13±4 and 77.4% had mild TBI. Median LEV duration was 7 (IQR 4-10) days and 13.9% met recommended 7-day duration. Those prescribed LEV > 7 days had more than twice the median LEV duration than those prescribed ≤ 7 days (10.25 (8.5-15.5) vs 4 (1.5-4.5) days, p < 0.0001). EEG-confirmed PTS occurred in 2.2%, with an early PTS incidence of 0.73%. Median ICU and hospital LOS were 2 (IQR 1-7) and 7 (IQR 3-16) days, respectively. Conclusions: The incidence of PTS was low as most patients in our study had mild or moderate TBI. Early PTS prophylaxis with LEV for 7 days is appropriate, although the majority of patients did not meet the recommended duration. Efforts to standardize and implement PTS prophylaxis protocols are needed.

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