Clinical and Microbiological Factors Associated With Abscess Formation in Adult Acute Epiglottitis

2021 ◽  
pp. 000348942110518
Author(s):  
Giorgos Sideris ◽  
Nikolaos Papadimitriou ◽  
Georgios F. Korres ◽  
Anastasios Karaganis ◽  
Pavlos Maragkoudakis ◽  
...  

Objectives: To evaluate clinical and microbiological findings that are correlated with abscess formation in adult acute epiglottitis (AE). Methods: We reviewed 140 cases of adult AE. Demographic, clinical, imaging, and microbiological findings are analyzed for all patients with AE in comparison to those with epiglottic abscess (EA). Results: A total of 113 patients presented with AE and 27 presented or progressed to EA (19.3%). Age, sex, seasonality, smoking, body mass index (BMI), and comorbidities were statistically insignificant between the 2 groups. Muffled voice ( P < .013), respiratory distress ( P < .001), and pre-existence of epiglottic cyst ( P < .001) are symptoms and signs connected with abscess formation. A total of 120 patients were treated conservatively. Surgical treatment was performed on 20 patients with EA. About 72 out of 80 cultures revealed monomicrobial infection. Mixed flora was isolated in 8 patients with EA. Streptococcus was isolated in 51 out of 80 positive cultures (64%). Haemophilus Influenza ( Hib) was not isolated in any sample. EA and mixed flora relates to a higher rate of airway intervention ( P < .001). Conclusion: A high level of suspicion for abscess formation is required if clinical examination reveals dyspnea, muffled voice, or an epiglottic cyst in adult with AE. The existence of EA doubles the duration of hospitalization. EA is typically found on the lingual surface of the epiglottis. Supraglottic or deep neck space expansion should be treated surgically. EA is associated with a mixed flora and a higher rate of airway obstruction. Streptococcus is discovered to be the most common pathogen.

Author(s):  
Yoko Iwaki ◽  
Santosh Kumar Rauniyar ◽  
Shuhei Nomura ◽  
Michael C. Huang

Tuberculosis (TB) has still remained a serious global health threat in low- and middle-income countries in recent years. As of 2021, Nepal is one of the high TB burden countries, with an increasing prevalence of cases. This study evaluates factors associated with TB awareness in Nepal. This study uses data from the Nepal Demographic and Health Survey, a cross-sectional survey carried out from June 2016 to January 2017. Multilevel logistic regression is performed to examine the association of demographic and socioeconomic factors with TB awareness. Our findings show a high level of TB awareness in all seven provinces of Nepal. Province 5 has the highest level of awareness (98.1%) among all provinces, followed by provinces 3 and 4, while province 6 has the lowest awareness level (93.2%) compared to others. Socioeconomic factors such as wealth, education and owning a mobile phone are significantly associated with TB awareness. Socioeconomic determinants are influential factors associated with TB awareness in Nepal. The wide variation in the proportion of awareness at a regional level emphasizes the importance of formulating tailored strategies to increase TB awareness. For instance, the use of mobile phones could be an effective strategy to promote TB awareness at a regional level. This study provides valuable evidence to support further research on the contribution of information and communication technology (ICT) usage to improving TB awareness in Nepal.


2021 ◽  
Vol 73 (12) ◽  
pp. 832-840
Author(s):  
Katti Sathaporn ◽  
Jarurin Pitanupong

Objective: To determine the level of and factors associated with empathy among medical students.Materials and Methods: This cross-sectional study surveyed all first- to sixth-year medical students at the Facultyof Medicines, Prince of Songkla University, at the end of the 2020 academic year. The questionnaires consisted of:1) The personal and demographic information questionnaire, 2) The Toronto Empathy Questionnaire, and 3) ThaiMental Health Indicator-15. Data were analyzed using descriptive statistics, and factors associated with empathylevel were assessed via chi-square and logistic regression analyses.Results: There were 1010 participants with response rate of 94%. Most of them were female (59%). More than half(54.9%) reported a high level of empathy. There was a statistically significant difference in empathy levels betweenpre-clinical and clinical medical students; in regards to empathy subgroups (P-value < 0.001). The assessment ofemotional states in others by demonstrating appropriate sensitivity behavior, altruism, and empathic respondingscores among the pre-clinical group were higher than those of the clinical group. Multivariate analysis indicatedthat female gender, pre-clinical training level, and minor specialty preference were factors associated with empathylevel. The protective factor that significantly improved the level of empathy was having fair to good mental health.Conclusion: More than half of the surveyed medical students reported a high level of empathy. The protective factorthat improved the level of empathy was good mental health. However, future qualitative methods, longitudinalsurveillance, or long-term follow-up designs are required to ensure the trustworthiness of these findings.


2021 ◽  
Vol 10 (4) ◽  
pp. 210-215
Author(s):  
Musab Ghaderi ◽  
Arman Azadi ◽  
Azad Rahmani ◽  
Zohreh Sanaat ◽  
Hosein Nazemiyeh ◽  
...  

Introduction: Cancer-related fatigue (CRF) is one of the major problems experienced by cancer patients. Identifying the prevalence and factors associated with CRF may be effective in designing appropriate interventions to reduce this problem. This study aimed to examine the prevalence of CRF and its related factors among Iranian cancer survivors. Methods: The samples of this descriptive cross-sectional study included 131 cancer survivors referred to outpatient clinic of Shahid Gazi Hospital affiliated to Tabriz University of Medical Sciences. Brief fatigue inventory (BFI) questionnaire was used for data collection. The data were analyzed using SPSS software version 13, descriptive statistics, and regression analysis. Results: The mean (SD) fatigue score was 6.41 (1.68) and 89% of survivors reported that they had suffered from CRF. The factors affecting CRF included blood pressure, diabetes mellitus, anemia, serum levels of blood urea nitrogen (BUN), marital status, type of cancer, and physical activity. Conclusion: High level of CRF in cancer survivors requires special attention and designing effective interventions through considering the identified factors associated with CRF.


2020 ◽  
Vol 14 (1) ◽  
pp. 18-26
Author(s):  
Cristina Macía-Rodríguez ◽  
Emilio Páez-Guillán ◽  
Vanesa Alende-Castro ◽  
Alba García-Villafranca ◽  
Lara Maria Mateo-Mosquera ◽  
...  

Objective: The aim of this study was to describe the clinical characteristics of patients that have had a heart failure with preserved ejection fraction (HF-pEF) and to identify the factors associated with 5-year mortality and readmission. Methods: A prospective cohort study was conducted of patients followed by the Heart Failure Unit of the Internal Medicine Department. Clinical characteristics and outcomes were collected. Univariate and multivariate analyses were performed in order to identify factors associated with 5-year mortality and readmission. Results: A total of 209 patients with HF-pEF were followed, 59.3% of these were women, with a mean age 79 years. The main etiology was hypertensive heart disease and a high level of comorbidity (chronic renal failure, hypertension and atrial fibrillation) was observed. The 5-year mortality was 55.5%; the related variables were anemia (hazard ratio [HR]=1.7; 95% confidence interval [CI]: 1.2-2.5), in patients being treated with statins (HR=0.7; 95%CI 0.5-0.9) and spironolactone (HR= 1.6; 95% CI: 1.1-2.3); 24.5% of patients had >2 admission in 5 years, with the main related factors being atrial fibrillation (HR=2.7; 95%CI: 1.4-5.5), anemia (HR=1.9; 95%CI:1.0-3.3) and were being treated with spironolactone (HR=2.1; 95%CI:1.2-3.7). Conclusion: Patients with HF-pEF are old and present a high level of comorbidity. Furthermore, they have a high 5-year mortality and readmission rate. The only factor associated with lower mortality was the treatment with statins. The use of spironolactone was associated with a higher mortality risk.


2017 ◽  
Vol 41 (S1) ◽  
pp. S654-S654
Author(s):  
G. Jmi ◽  
L. Robbana ◽  
F. Ghali ◽  
M. Zghal ◽  
M. Mezghani ◽  
...  

IntroductionThe Alzheimer's patient assistance relationship is a morally painful experience, most frequently discussed in terms of “burden” in the literature, especially as professionals and institutional intermediaries are underdeveloped in Tunisia.GoalIt is intended to assess the level of burden among caregivers of patients with Alzheimer's disease and to search factors associated with a high level of burden.MethodologyThis is a retrospective descriptive study. Patients were recruited from neurology department of Razi hospital, which were hospitalised between the months of December 2012 and March 2013. The burden was measured using the Zarit inventory.Results and discussionThirty patients were included. The majority female, most caregivers are descendants (60%), then, daughters in law (33%), and finally the spouses (23%). 80% of caregivers lived in the same home as patients. Caregivers were asked about all the items of the grid Zarit. The average burden in our sample is 59.9 + 16 3. We observed that 33% have absent to light burden (score <21), 10% have a light to moderate burden (between 21 and 40), 36, 66% have moderate to severe burden (between 41 and 60) and 50% have a severe burden (>60), according to the classification proposed by Zarit. Sex, kinship and cohabitation with the patient were not associated with a higher burden.ConclusionThe study of factors correlated with high levels of burden aims at finding ways of intervention and support to fight against the isolation of caregivers and the occurrence of anxiodepressive complications.Disclosure of interestThe authors have not supplied their declaration of competing interest.


2014 ◽  
Vol 54 (6) ◽  
pp. 543-550
Author(s):  
Vaidehi Agrawal ◽  
Avery Wright ◽  
Brinda Mehta ◽  
Chunxiao Zhu ◽  
Erin Lindholm ◽  
...  

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Dardouri ◽  
M Mallouli ◽  
S Chelbi ◽  
M Ben Rejeb

Abstract Introduction Stress and its deleterious effects are currently a major topic in public health. Health care studies can be very stressful as they pose a challenge for students around the world. The aim of this study was to assess stress perception among healthcare students and to identify its associated factors. Methods A descriptive cross-sectional study was carried out over a five-month period (January-May 2017) among healthcare students at the Higher School of Health Sciences, University of Sousse (Tunisia), during the 2016/2017 academic year. The socio-demographic and health status data have been collected using a pre-established data collection sheet. Stress perception was assessed by the French version of the Perceived Stress Scale with 10 items (PSS-10). Factors associated with stress were examined using ANOVA and T-student tests. Results A total of 237 students participated in the study with a response rate of 64.40%. The average age was 20.57±1.05 with a female predominance of 90.7%. The mean of the PSS-10 total score was 31.37±4.406. A rate of 89% of cases had a perceived high-stress score. Factors associated with stress were social status (p = 0.005), housing (p = 0.01), hometown (p = 0.03), presence of a diagnosed health condition (p = 0.02), presence of eating disorder (p = 0.04), presence of sleeping disorder (p = 0.004). Conclusions This study reported that healthcare students had a high level of stress associated with endogenous and exogenous factors. Stress management strategies must be included in the educational curriculum in healthcare schools. Key messages Health care studies pose a challenge for students around the world. Healthcare students had a high level of stress associated with endogenous and exogenous factors.


2005 ◽  
Vol 119 (12) ◽  
pp. 967-972 ◽  
Author(s):  
Hideaki Katori ◽  
Mamoru Tsukuda

We reviewed acute epiglottitis (AE) and identified factors associated with airway intervention. This report was a retrospective review of patients with AE and compared with factors associated with airway intervention. We reviewed 96 patients who were diagnosed with AE in our hospitals in Japan. Ninety-two (96 per cent) patients were adults, and no seasonal variation in the incidence of AE was encountered. Eight (8 per cent) patients had tracheostomy and endotracheal intubation had not been done. We found that symptoms of stridor and muffled voice, a rapid clinical course, and diabetes mellitus were the factors associated with airway intervention. Extremely severe swelling of the epiglottis such that only less than half of the posterior vocal fold (scope classification (SC): III) could be seen, and extension of the swelling to the arytenoids (SC: B) were the two factors that were strongly associated with airway intervention.


2018 ◽  
Vol 01 (01) ◽  
pp. e1-e5 ◽  
Author(s):  
Michihisa Kono ◽  
Takashi Goto ◽  
Nobuyuki Bandoh ◽  
Yasuaki Harabuchi

AbstractAcute epiglottitis is an acute inflammation of the upper respiratory airway that rarely causes airway obstruction. A retrospective study was conducted on 115 patients with acute epiglottitis from April 2007 to December 2017 (65 males and 50 females; aged 12–85 years old, median age of 45 years). When counting the number of patients according to the month, from April to September more than 10 patients were treated. Median duration from symptom onset to first visit was 3 days (1–14 days). Eight (7%) of 115 patients had diabetes, and 16 (13.9%) had epiglottic cyst. We divided all the patients into six groups by laryngeal findings according to the classification of Katori and Tsukuda. Number of patients classified as IA, IB, IIA, IIB, IIIA, and IIIB was 41 (35.7%), 21 (18.3%), 22 (19.1%), 15 (13%), 8 (7%), and 8 (7%), respectively. Median duration of hospitalization was 5 days (2–26 days). In the blood test on the first day of hospitalization, the number of white blood cells (WBC) ranged from 3,400 to 25,350/μL (median 10,350/μL) and the C-reactive protein (CRP) ranged from 0.01 to 23.3 mg/dL (median, 2.5 mg/dL). The number of WBC and CRP at the fourth day after the hospitalization was significantly lower than those at the first day. Eight (7%) patients required the airway management such as tracheotomy or cricothyroidotomy. Age, laryngeal finding (severe epiglottis swelling and arytenoid edema; Katori and Tsukuda's classification IIIB), and high inflammatory reaction in blood test (WBC ≥ 20,000/μL and CRP ≥ 20 mg/dL) were the factors that significantly correlated with the airway management.


BioMedica ◽  
2020 ◽  
Vol 36 (4) ◽  
pp. 367-373
Author(s):  
Zi-Ang Li ◽  
Prof. Jun Lin

Background and Objective: Coronavirus disease 2019 (COVID-19) has caused a large number of casualties and economic losses. Reducing the number of hospitalization days can alleviate pressure on health services and save more people. This study was carried out to find associated factors with the duration of hospitalization at a COVID-19 dedicated hospital in China. Methods: In this retrospective study, the demographic details and laboratory tests of 556 patients were collected. These patients were cured and discharged. The data was analyzed using statistical package for the social sciences (SPSS), version 22. The Shapiro-Wilk method was used for the normality of data with P ≤ 0.05 as significant to relate factors with the duration of hospitalization. Results: A total of 556 patients with COVID-19 were included in the study; 249 were males and 307 were females. Among the factors associated with longer hospital stay, lower K+ and Na+ levels were noticed in 102 (18.5%) and 61 (11%) respectively. Among liver functions tests, elevated AST levels was found in 109 (19.6%) patients, decreased serum albumin seen in 301 (54.1%) patients, elevated serum ALT levels in 80 (14.3%) patients with longer hospital stay (P = 0.032). Increased procalcitonin (PCT) was noticed in 66 (11.8%) patients. An elevated level of plasma D-dimer was seen in 125(22.4%) and increased NT-pro BNP levels in 64 (11.5%) patients. Increased cTnT levels were found in 76(13.6%) patients and elevated creatinine levels in 114 (21%) patients.(P = 0.015). Conclusion: Patients with elevated serum total cholesterol had significantly lesser hospital stay than the normal group. Patients with temperature ≥ 38°C and elevated blood glucose had longer hospitalization stay. We recommend that health care providers should not ignore multiple organ support when treating patients.


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