Cofactors of Pediatric Tinnitus: A Look at the Whole Picture

2018 ◽  
Vol 58 (3) ◽  
pp. 320-327
Author(s):  
Jessica Levi ◽  
Krystyne Basa ◽  
Kevin Wong ◽  
Thierry Morlet ◽  
Robert O’Reilly
Keyword(s):  
General Population ◽  
Otitis Media ◽  
Chart Review ◽  
Noise Exposure ◽  
Historical Data ◽  
Age Distribution ◽  
Retrospective Chart Review ◽  
Psychiatric Diagnoses ◽  
Laboratory Results ◽  
Tube Dysfunction

Retrospective chart review of 248 children (1-19 years old) with tinnitus who presented to a tertiary pediatric hospital between 2006 and 2011, looking at which cofactors are predictors of pediatric tinnitus. In our review, we extracted demographics, symptoms, historical data, imaging, and laboratory results; we compared with the general population. Eighty-seven percent had normal hearing. Age distribution, noise exposure, and frequency of psychiatric diagnoses in our cohort were consistent with previous reports. We found a lower incidence of otitis media and the same prevalence of dizziness, asthma, and hearing loss as the general population, a lower prevalence of Eustachian tube dysfunction, otitis media, headaches, and higher incidence of rhinosinusitis. Lack of patient reporting and objective testing complicate the ability to detect pediatric tinnitus. We revealed a gap in the literature regarding rhinosinusitis as a cofactor, imaging during diagnosis, and if psychiatric diagnoses are associated with tinnitus in younger children.

Post-operative complications of cochlear implantation in adults and children: five years' experience in Maastricht

2006 ◽  
Vol 121 (4) ◽  
pp. 318-323 ◽  
Author(s):  
J T F Postelmans ◽  
B Cleffken ◽  
R J Stokroos
Keyword(s):  
Otitis Media ◽  
Cochlear Implantation ◽  
Chart Review ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Retrospective Chart Review ◽  
Operative Complications ◽  
Ventilation Tubes ◽  
Adults And Children ◽  
Post Operative Complications

Although cochlear implantation is considered a safe method of rehabilitation for profoundly deaf individuals, a number of these patients suffer complications after surgery. To evaluate post-operative complications after cochlear implantation, a retrospective chart review was performed for 112 patients who had undergone implantation in the Maastricht Academic Hospital. Minor complications were defined as those that could be overcome by medical or audiological management. These occurred in 36 patients (32 per cent) and all were managed successfully. Major complications were defined as device extrusion and those requiring further surgery, and these were identified in four patients (3.6 per cent). These complications included wound infection and device failure mediated by middle-ear pathology. In cases of chronic otitis media, we recommend performance of cochlear implantation as a staged procedure. In order to reduce the post-operative incidence of acute otitis media, we recommend adenoidectomy, placement of ventilation tubes and early antibiotic treatment.

Survival, Outcomes, and Use of Acuity Scoring Systems Following Tracheotomy in Veteran Patients

2020 ◽  
Vol 37 (11) ◽  
pp. 890-896
Author(s):  
Carol M. Bier-Laning ◽  
Jeffrey Hotaling ◽  
W. Jeffrey Canar ◽  
Aziz A. Ansari
Keyword(s):  
General Population ◽  
Critically Ill ◽  
Organ Dysfunction ◽  
Critically Ill Patients ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Scoring Systems ◽  
Survival Outcomes ◽  
Logistic Organ Dysfunction ◽  
Failure Assessment

Objectives: To determine whether established prognosis tools used in the general population of critically ill patients will accurately predict tracheotomy-related outcomes and survival outcomes in critically ill patients undergoing tracheotomy. Methods: Retrospective chart review of 94 consecutive critically ill patients undergoing isolated tracheotomy. Results: Logistic Organ Dysfunction System (LODS) and sepsis-related organ failure assessment (SOFA) scores, 2 validated measures of acuity in critically ill patients, were calculated for all patients. The only tracheotomy-related outcome of significance was the finding that patients with an LODS score ≤6 were more likely to become ventilator independent ( P < .015). Higher LODS or SOFA scores were associated with in-house death (LODS, P = .001, SOFA, P = .008) and death within 90 days (LODS, P = .009, SOFA, P = .031), while death within 180 days was associated only with a higher LODS score (LODS, P = .018). When controlling for age, there was an association between both LODS ( P = .015) and SOFA ( P = .019) scores and death within 90 days of tracheotomy. Conclusions: The survival outcome for critically ill patients undergoing tracheotomy seems accurately predicted based on scoring systems designed for use in the general population of critically ill patients. Logistic Organ Dysfunction System may also be useful to predict the likelihood of the tracheotomy-related outcome of ventilator independence. This suggests that LODS scores may be helpful to palliative care clinicians as part of a shared decision-making aid in critically ill, ventilated patients for whom tracheotomy is being considered.

scholarly journals Inflammatory cast of the tympanic membrane after acute otitis media

2013 ◽  
Vol 127 (3) ◽  
pp. 314-317
Author(s):  
J Byun ◽  
DS Massi ◽  
A Sehgal ◽  
M Saadia-Redleaf
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Primary Care Physicians ◽  
Otitis Externa ◽  
Chart Review ◽  
Acute Otitis Media ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Patient Treatment

AbstractObjective:To describe a relatively unknown clinical entity – inflammatory cast of the tympanic membrane after acute otitis media – and its simple out-patient treatment.Study design:Retrospective review of case series.Setting:Subspecialty practice at a tertiary hospital.Patients:Seven patients diagnosed previously with acute otitis media with perforation or otitis externa, and with persistent ear discomfort.Methods:Retrospective chart review.Results:The patients presented with weeks to months of persistent hearing loss after acute otitis media with perforation or acute otitis externa. Visits to their primary care physicians had been uninformative. After comparison of the affected and unaffected tympanic membranes, a thin, hard cast was identified and removed from the affected tympanic membrane. Improvement in hearing was documented in the three patients who underwent audiometric testing; the remainder had subjective improvement without audiometric evaluation.Conclusion:Otolaryngologists should be aware of the possibility of an inflammatory cast of the tympanic membrane following acute otitis media with perforation or otitis externa, and should carefully compare the unaffected and affected ears in such cases. Treatment – removal of the rigid cast – is both simple and effective.

scholarly journals Predictors of Psychiatric Disorders or uses of Psychotropic Drugs in Patients with Confirmed COVID-19 During Treatment in a Hospital : A Retrospective Chart Review Running title : Mental health of COVID-19 patients

2020 ◽  
Author(s):  
Jang Rae Kim ◽  
Myung Hwa Han ◽  
So Hee Lee
Keyword(s):  
Mental Health ◽  
Psychotropic Drugs ◽  
Acute Treatment ◽  
Chart Review ◽  
Mental Health Problems ◽  
Acute Stress ◽  
Retrospective Chart Review ◽  
Treatment Phase ◽  
Psychiatric Diagnoses ◽  
Depressive Episodes

Abstract BackgroundThis study aims to examine the psychiatric diagnoses, psychotropic drug use, and related factors in patients with coronavirus disease-19 (COVID-19) during their acute treatment phase.MethodsWe performed a retrospective chart review of patients admitted to the isolation ward at a nationally designated hospital during the COVID-19 outbreak. All the COVID-19 patients admitted to the hospital were assigned to psychiatrists by consultation in order to monitor their mental health during their hospital stay. We analyzed the medical records and self-reported psychological tests of 80 out of 112 patients.ResultsOn admission, 16.3% of the subjects had self-reported depression and 6.3% had post-traumatic stress disorder (PTSD). Twenty-five patients (31.3%) had current diagnoses of mental disorders. These disorders consisted of nonorganic insomnia, acute stress reaction, panic disorder, and depressive episodes. Nineteen patients (23.8%) were prescribed psychotropic drugs, including trazodone, alprazolam, clonazepam, and zolpidem. Factors associated with these psychiatric diagnoses included self-reported PTSD on the day of admission and having a spouse. Previous psychiatric history and age of 40 years or more were associated with the use of psychotropic drugs.ConclusionMental health services rendered to quarantined COVID-19 patients undergoing an acute treatment phase and self-reported PTSD on the day of admission might be useful in predicting mental health problems during hospital days.

scholarly journals Otogenic Intracranial Complications in Bir Hospital; an Eight Years Retrospective Review

2018 ◽  
Vol 6 (1) ◽  
pp. 25-28
Author(s):  
Lal Kishor Yadav ◽  
Prakash Bahadur Thapa ◽  
Jayendra Pradhananga
Keyword(s):  
Otitis Media ◽  
Chart Review ◽  
Early Recognition ◽  
Sinus Thrombosis ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Retrospective Chart Review ◽  
Neck Surgery ◽  
Lateral Sinus ◽  
Intracranial Complications

Objectives: To review our experiences on intracranial complications secondary to otitis media and to compare the results with other studies.Material and Methods: A retrospective chart review of  all patients with intracranial complications secondary to otitis media over eight years period in Bir hospital was done. Clinical presentation, radiological findings, microbiology, surgical management and antibiotics used were studied.Results: Forty eight cases were included in this study of which 23 had meningitis, 15 had brain abscess, 7 had lateral sinus thrombosis and 3 had petrositis. 37 of these were secondary to chronic otitis media and 11 were secondary to acute otitis media. Otorrhoea, headache, earache, fever, vertigo and vomiting were the main symptoms. Staphylococcus aureus was the most common bacteria isolated followed by Pneumococcus, Haemophilus influenzae and Klebsiella.Conclusion: Early recognition, multi drug treatment with broad spectrum antibiotic and multi disciplinary approach are the mainstay of management of otogenic intracranial complications.Nepalese Journal of ENT Head and Neck Surgery, Vol. 6, No. 1, 2015

Clinical characteristics and course of chronic lymphocytic leukemia patients with the combination favorable and unfavorable cytogenetics

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 8086-8086
Author(s):  
R. R. Harting ◽  
P. Venugopal ◽  
W. Hsu ◽  
R. Catchatourian ◽  
O. Ogundipe
Keyword(s):  
Median Survival ◽  
Chart Review ◽  
Historical Data ◽  
Clinical Course ◽  
Retrospective Chart Review ◽  
Lymphocytic Leukemia ◽  
Stage Disease ◽  
Genetic Abnormalities ◽  
Genomic Aberrations

8086 Background: Patients with CLL have a highly variable clinical course. Genomic aberrations detected by FISH have been shown to correlate with survival and treatment free interval (TFI). Patients with the presence of 17p or 11q deletions (del) either alone or in combination with other cytogenetic abnormalities have the worst prognosis while patients with 13q del as a sole abnormality have the best prognosis. Our objective was to further investigate poor prognosis CLL patients with either del 17p or 11q to determine if the addition of the favorable 13q del influences the predicted clinical course and survival. Methods: We performed a retrospective chart review on 22 patients (pts) who had been identified by FISH as having either the combination of del 17p and 13q or del 11q and 13q. Results: 128 CLL FISH panels were performed from April of 2003 through October of 2006. Twenty-two pts (17%) had either del 17p and 13q (9%) or del 11q and 13q (9%). Historical data notes a frequency of 7% and 8% for deletions 17p and 11q, respectively, and 55% for 13q as a sole aberration. The median age was 66 yrs, the majority of whom were male (73%). Two of 22 pts (9%) presented with advanced stage disease. Splenomegaly was seen more often in the 17p/13q pts (36%) vs 11q/13q pts (9%). With a median follow up of 46 months since diagnosis, the median TFI for all patients (20 known) was 56 months. TFI was 13 months for patients with 17p/13q del; whereas TFI was not reached for patients with 11q/13q. Historical data noted a TFI for patients with deletions 17p, 11q, and 13q (as a sole aberration) as 9, 13, and 92 months respectively. The median survival from diagnosis was not reached for the group overall or for either combination of genetic abnormalities. Historical data noted, with 70 months follow up, a median survival of 108 months overall and 32, 79, and 133 months for 17p, 11q, and 13q (as a sole aberration) respectively. Conclusions: The addition of favorable cytogenetics, del 13q, in a CLL patient with an unfavorable cytogenetic pattern (either del 17p or del 11q) appears to improve the predicted clinical outcome and survival. Additional follow up and prospective studies are needed to further define which genetic subgroups help to prognosticate CLL patients. No significant financial relationships to disclose.

scholarly journals Eosinophilia: A Poor Predictor ofStrongyloidesInfection in Refugees

2013 ◽  
Vol 24 (2) ◽  
pp. 93-96 ◽  
Author(s):  
Prenilla Naidu ◽  
Stephanie K Yanow ◽  
Kinga T Kowalewska-Grochowska
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Refugee Camps ◽  
Tropical Diseases ◽  
Negative Group ◽  
Positive Group ◽  
The Past ◽  
Canadian Data ◽  
Poor Predictor ◽  
Laboratory Results

BACKGROUND: Canada resettles 10,000 to 12,000 refugees annually. Despite this being a highly vulnerable population, there are little Canadian data on subclinical tropical diseases harboured in this population over the past 20 years.OBJECTIVES: To determine the seroprevalence and predictors ofStrongyloidesinfection in refugees arriving in Edmonton, Alberta.METHODS: A retrospective chart review of all refugees seen at the New Canadians Clinic between March 2009 and April 2010 was performed. Demographic, symptom and physical examination data were collected from the charts. Laboratory results were obtained from the electronic laboratory records.RESULTS: A total of 350 subjects were studied. The overall seroprevalence of strongyloidiasis was 4.6%. Equivocal results were found in 6.3%. In the positive group, the majority were male (62.5%); 75% were born in Africa (P=0.004) and 81.2% lived in refugee camps in Africa (P=0.002). Eosinophilia was present in 25% of the positive subjects (P=0.05), in none of the equivocal group and in 8.7% of the negative group.DISCUSSION: Persistent asymptomaticStrongyloidesinfection is maintained for years through autoinfection. Traditionally, eosinophilia was used as one of the key tools to diagnose chronic but stable diseases, but it was shown to have a poor predictive value for strongyloidiasis in returning expatriates as well as in those presenting with a disseminated form of the disease. It is important to raise awareness of the severe limitations of eosinophilia as a marker for strongyloidiasis when managing patients who either are immunocompromised, or about to start immunosuppressive therapy.CONCLUSIONS: The present study indicated that eosinophilia is a poor predictor of seropositivity and, thus,Strongyloidesinfection. Residence in Africa (birth/refugee camps) proved to be a significantly better predictor ofStrongyloidesseropositivity.

Practice Characteristics of Pediatric Otolaryngology Same-Day Appointments

2021 ◽  
pp. 014556132110581
Author(s):  
Jenna Berg ◽  
Alexander Tu ◽  
Dwight Jones ◽  
Katie Geelan-Hansen
Keyword(s):  
Patient Satisfaction ◽  
Otitis Media ◽  
Chart Review ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Demographic Data ◽  
Retrospective Chart Review ◽  
Pediatric Otolaryngology ◽  
Practice Characteristics ◽  
Day Clinic

Objectives This study aims to assess characteristics of same-day clinic appointments in a pediatric population at an academic otolaryngology practice. Methods Retrospective chart review of patients aged 18 or younger who had same-day clinic appointments between January 1, 2016, and December 31, 2018, at a single academic institution. Demographic data, diagnosis(es), procedures, and operations completed were included in the analysis. Results There were 363 same-day visits by 322 patients in the 3-year study period. Two hundred sixty-nine (269) of these visits were from new patients. Otitis media and rhinosinusitis were the most frequently coded diagnoses. One hundred forty-four (144) procedures were completed the day of the visit and 169 operations were performed as a result of the same-day visit. If the patient had a procedure or operation performed, they were more likely to have been referred by another provider. Conclusions Providing same-day appointments can help provide timely and appropriate otolaryngology specialty care to pediatric patients. Further evaluation is needed to determine the effects on patient satisfaction as well as no-show rates.

scholarly journals Prevalence of essential tremor in an idiopathic Parkinson’s disease patient population

2015 ◽  
Vol 42 (S1) ◽  
pp. S31-S31
Author(s):  
A Rana ◽  
AM Qureshi ◽  
MA Rana ◽  
M Rahman ◽  
I Abdullah ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
General Population ◽  
Essential Tremor ◽  
Chart Review ◽  
Disease Patient ◽  
Retrospective Chart Review ◽  
Type Frequency ◽  
Exact Relationship ◽  
Mutually Independent

Objective of this study was assess the prevalence of Essential of Essential Tremor in Parkinson’s disease population Essential tremor (ET) is the most common movement disorders and is much more common than Parkinson’s disease, in general population. Essential Tremor and Parkinson’s disease (PD) tremor differ in type, frequency and distribution. Despite being two separate disorders, there have been cases reported of coexistence of ET-PD. Some studies have reported an increase in the incidence of ET in relatives of patients with PD, yet the risk of developing PD in ET patients has not been thoroughly investigated. Our study set out to determine the prevalence of precedent ET in PD patients. We conducted a retrospective chart review analysis of 332 idiopathic PD patients to determine how many of them had ET prior to the diagnosis of PD and the percentage of them who were also diagnosed with ET. Our results indicated that the prevalence of precedent ET among a population of idiopathic PD patients was not any higher than the prevalence of ET in a comparable general population. Our results support the notion that ET and PD are mutually independent disorders. Further studies are needed to understand the exact relationship between these two disorders

scholarly journals Diagnostic Accuracy, Prescription Behavior, and Watchful Waiting Efficacy for Pediatric Acute Otitis Media

2018 ◽  
Vol 58 (1) ◽  
pp. 60-65 ◽  
Author(s):  
David L. Brinker ◽  
Erina L. MacGeorge ◽  
Nicole Hackman
Keyword(s):  
Physical Examination ◽  
Otitis Media ◽  
Chart Review ◽  
Watchful Waiting ◽  
Acute Otitis Media ◽  
Retrospective Chart Review ◽  
Antibiotic Use ◽  
Central Pennsylvania ◽  
Current Guidelines ◽  
Prescription Behavior

Current guidelines recommend “watchful waiting” (WW) as an alternative to immediate antibiotic treatment. Continued high rates of antibiotic use suggest that WW may be underutilized. We conducted a retrospective chart review of 474 pediatric acute otitis media (AOM) cases at a clinic in central Pennsylvania. We assessed physical examination findings, diagnostic behavior, WW utilization, prescription writing, and filling in cases of pediatric AOM to evaluate the underutilization of WW. We evaluate diagnostic consistency with published guidelines and rates of antibiotic prescription resulting from misdiagnosis. We report WW instructions and compliance, and prescription filling behaviors. Fifty percent of AOM diagnoses in this sample were not supported by physical examination findings. The majority of these AOM diagnoses received antibiotic prescriptions, suggesting that unsupported diagnoses translated to injudicious prescribing. WW instructions corresponded to 57% fewer filled prescriptions and longer fill delay. We discuss the implications and recommendations to improve antibiotic stewardship.

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