Pneumatized Crista Galli: A Histopathologic Study

2020 ◽  
Vol 163 (3) ◽  
pp. 517-521
Author(s):  
Marcel Marjanovic Kavanagh ◽  
Tomislav Tokic ◽  
Antonia Jakovcevic ◽  
Ranko Smiljanic ◽  
Boris Bumber ◽  
...  

Objective This is the first histopathologic study that investigates the incidence of the pneumatized crista galli. Study Design A prospective histopathologic study. Setting Tertiary academic medical center. Subjects and Methods A total of 109 specimens of crista galli were obtained postmortem during 2018 from randomly chosen patients who died at the University Hospital Centre Zagreb and had an autopsy at our Department of Pathology and Cytology. Specimens were surgically resected during the autopsy and then fixed, decalcinated, dehydrated, and embedded in paraffin. All slides were cut into 5-µm-thin sections and stained with a standard method (hematoxylin and eosin) for light microscope analysis. Specimens were histopathologically analyzed for the existence of pneumatization inside crista galli. The criterion to declare a specimen pneumatized was the presence of mucosa inside the cavity. Results Pneumatized crista galli was found in 5 of 109 specimens (4.59%). In 5 of 5 cases (100%) of pneumatized crista galli, there was evidence of chronic inflammation. Conclusion We found that the incidence of pneumatized crista galli is significantly lower in our histopathologic study in comparison with the majority of previous radiologic studies. Our study also found that all 5 specimens with pneumatized crista galli had chronic inflammation in the mucosa, which is a considerably higher incidence than in the previous studies (7.7%-44%). Due to the emerging evidence of pneumatized crista galli being of clinical importance, we suggest that a larger study be conducted before the results are generalized to the general population.

Author(s):  
Mohammed Alsuhaibani ◽  
Takaaki Kobayashi ◽  
Alexandra Trannel ◽  
Stephanie Holley ◽  
Oluchi J. Abosi ◽  
...  

Abstract Objective: Patients admitted to the hospital may unknowingly carry SARS-CoV-2 and hospitals have implemented SARS-CoV-2 admission screening. However, because SARS-CoV-2 RT-PCR may remain positive for months after infection, positive results may represent active or past infection. We determined the prevalence and infectiousness of patients who were admitted for reasons unrelated to COVID-19 but tested positive on admission screening. Methods: We conducted an observational study at the University of Iowa Hospitals & Clinics from July 7 to October 25, 2020. All patients admitted without suspicion of COVID-19 infection were included and medical records of those with a positive admission screening test were reviewed. Infectiousness was determined using patient history, PCR cycle threshold (Ct) value, and serology. Results: A total of 5,913 patients were screened and admitted for reasons unrelated to COVID-19. Of these, 101 had positive admission RT-PCR results. Thirty-six patient were excluded because they had respiratory signs/symptoms on admission on chart review. Sixty-five patients (1.1%) did not have respiratory symptoms. A total of 55 patients had Ct values available and were included in this analysis. The median age was 56 years, and (51%) were male. Our assessment revealed that 23 patients (42%) were likely infectious. The median duration of in-hospital isolation was five days for those likely infectious and two days for those deemed non-infectious. Conclusions: COVID-19 infection was infrequent among patients admitted for reasons unrelated to COVID-19. An assessment of the likelihood of infectiousness using clinical history, RT-PCR Ct values, and serology may help discontinue isolation and conserve resources.


2017 ◽  
Vol 23 (11) ◽  
Author(s):  
Blake M Snyder ◽  
Jessica S Mounessa ◽  
Melissa Fazzari ◽  
Joseph V Caravaglio ◽  
Alexandra Kretowicz ◽  
...  

2020 ◽  
Vol 4 (s1) ◽  
pp. 73-73
Author(s):  
Chin Chin Lee ◽  
Helenmarie M. Blake ◽  
Carlos A. Canales ◽  
Stephen J. DeGennaro ◽  
Ishwar Ramsingh ◽  
...  

OBJECTIVES/GOALS: The objectives of this presentation are to discuss 1) the implementation of Consent to Contact at an Academic Medical Center; 2) the access to lists of potential participants by study teams; and 3) the challenges and adjustments made to the initial conceptualized process. METHODS/STUDY POPULATION: Participant recruitment is critical to the success of all research studies. It is particularly challenging when investigators do not have a patient population from which to recruit. Thus, the University of Miami launched the CTC initiative in 2016 to facilitate study recruitment. Study investigators can request access to a registry of participants who agreed to be contacted and meet the initial study eligibility criteria. A multidisciplinary Operational Committee provides oversight and regulates access to the CTC registry. RESULTS/ANTICIPATED RESULTS: The registry has over 110K patients who have agreed to be contacted for eligible research studies. The demographic distribution of the patients in the registry mirrors the diversity of the UHealth population. As of January 2018, when the registry became available to the research community, 25 study teams from different departments, including the All of Us Research Program, have requested potential participant lists. The process of requesting access to patient lists is adapted to studies’ needs, with particular reference to sensitive populations, such as HIV/AIDS, substance abuse, etc. Results on utilization and satisfaction of the CTC initiative are being collected and will be presented. DISCUSSION/SIGNIFICANCE OF IMPACT: The CTC initiative allows UHealth patients to opt-in to the registry for research studies. The Operational Committee continues to monitor the successful consent of patients to participate in individual research studies and improving the request process.


2011 ◽  
Vol 32 (11) ◽  
pp. 1127-1129 ◽  
Author(s):  
Robert Chang ◽  
M. Todd Greene ◽  
Carol E. Chenoweth ◽  
Latoya Kuhn ◽  
Emily Shuman ◽  
...  

Little is known about the epidemiology of nosocomial urinary tract-related bloodstream infection. In a case series from an academic medical center, Enterococcus (28.7%) and Candida (19.6%) species were the predominant microorganisms, which suggests a potential shift from gram-negative microorganisms. A case-fatality rate of 32.8% highlights the severity of this condition.


2019 ◽  
Author(s):  
Jennifer Costigan ◽  
Sue S Feldman ◽  
Mark Lemak

BACKGROUND Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey responses are considered significant indicators of the quality of care and patient satisfaction. There is a pressing need to improve patient satisfaction rates as CAHPS survey responses are considered when determining the amount a facility will be reimbursed by the Centers of Medicare and Medicaid each year. Low overall CAHPS scores for an academic medical center’s dermatology clinics were anecdotally attributed to clinic type. However, it was unclear whether clinic type was contributing to the low scores or whether there were other factors. OBJECTIVE This study aimed to determine where the efforts of patient satisfaction improvement should be focused for two different types of dermatology clinics (private and rapid access clinics). METHODS This study used a concurrent mixed methods design. Secondary data derived from the University of Alabama at Birmingham Hospital’s Press Ganey website were analyzed for clinic type comparisons and unstructured data were qualitatively analyzed to further enrich the quantitative findings. The University of Alabama at Birmingham Hospital is an academic medical center. The data were analyzed to determine the contributors responsible for each clinic not meeting national benchmarks. Thereafter, a review of these contributing factors was further performed to assess the difference in CAHPS scores between the private and rapid access clinics to determine if clinic type was a contributing factor to the overall scores. RESULTS The data sample included 821 responses from May 2017 to May 2018. Overall, when both private clinics and rapid access clinics were viewed collectively, majority of the patients reported stewardship of patient resources as the most poorly rated factor (367/549, 66.8%) and physician communication quality as the most positively rated factor (581/638, 91.0%). However, when private clinics and rapid access clinics were viewed individually, rapid access clinics contributed slightly to the overall lower dermatology scores at the academic medical center. CONCLUSIONS This study determined that different factors were responsible for lower CAHPS scores for the two different dermatology clinics. Some of the contributing factors were associated with the mission of the clinic. It was suspected that the mission had not been properly communicated to patients, leading to misaligned expectations of care at each clinic.


2019 ◽  
Vol 51 (1) ◽  
pp. 50-55
Author(s):  
Fei Fei ◽  
Marisa B Marques ◽  
Elizabeth M Staley ◽  
Lance A Williams

ABSTRACT Objective To evaluate how clinical practice was affected by the change in direct antiglobulin testing (DAT) methodologies and subsequent stronger reported DAT results at our large academic medical center. Method We retrospectively reviewed DAT results of umbilical cord blood from infants with blood type A or B born to mothers with antibody-negative type O blood, based on records kept at the University of Alabama at Birmingham (UAB) Hospital, a 1400-bed academic medical center. Results We randomly chose 50 neonates with positive DAT results who had been tested using the tube method and 50 whose testing had used the gel method. Although 86% of results with the tube method were positive microscopically, 52% and 40% of the DAT results with the gel method were 1+ and 2+ positive, respectively. Further, we observed an increase in the number of neonates treated with phototherapy who had been tested using the gel method. Conclusion We report that DATs performed using the gel method had increased DAT strength compared with tube testing, which led to increased use of phototherapy by our clinical colleagues.


2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Dafna Koldobskiy ◽  
Soleyah Groves ◽  
Steven M. Scharf ◽  
Mark J. Cowan

Background. Recent studies of risks in cardiopulmonary arrest (CPA) have been performed using large databases from a broad mix of hospital settings. However, these risks might be different in a large, urban, academic medical center. We attempted to validate factors influencing outcomes from CPA at the University of Maryland Medical Center (UMMC). Methods. Retrospective chart review of all adult patients who underwent CPA between 2000 and 2005 at UMMC. Risk factors and outcomes were analyzed with appropriate statistical analysis and compared with published results. Results. 729 episodes of CPA were examined during the study period. Surgical patients had better survival than medical or cardiac patients. Intensive care unit' (ICU) patients had poor survival, but there was no difference on monitored or unmonitored floors. Respiratory etiologies survived better than cardiac etiologies. CPR duration and obesity were negatively correlated with outcome, while neurologic disease, trauma, and electrolyte imbalances improved survival. Age, gender, race, presence of a witness, presence of a monitor, comorbidities, or time of day of CPA did not influence survival, although age was associated with differences in comorbidities. Conclusions. UMMC risk factors for CPA survival differed from those in more broad-based studies. Care should be used when applying the results of database studies to specific medical institutions.


2018 ◽  
Vol 79 (11) ◽  
pp. 613
Author(s):  
Ariel Deardoff ◽  
Dylan Romero

The University of California-San Francisco (UCSF) Library is a graduate-only health science university with four professional schools (medicine, pharmacy, nursing, and dentistry), a graduate division, and an academic medical center. For several years UCSF has been the number one public recipient of NIH funding, reflecting the school’s dedication to biomedical research. Around 2015, the UCSF Library began investigating new ways to serve the university’s research population. Seeing a need for more computational and entrepreneurship training the library piloted two new programs: the Data Science Initiative (DSI) and the Makers Lab.


10.2196/17171 ◽  
2020 ◽  
Vol 3 (1) ◽  
pp. e17171
Author(s):  
Jennifer Costigan ◽  
Sue S Feldman ◽  
Mark Lemak

Background Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey responses are considered significant indicators of the quality of care and patient satisfaction. There is a pressing need to improve patient satisfaction rates as CAHPS survey responses are considered when determining the amount a facility will be reimbursed by the Centers of Medicare and Medicaid each year. Low overall CAHPS scores for an academic medical center’s dermatology clinics were anecdotally attributed to clinic type. However, it was unclear whether clinic type was contributing to the low scores or whether there were other factors. Objective This study aimed to determine where the efforts of patient satisfaction improvement should be focused for two different types of dermatology clinics (private and rapid access clinics). Methods This study used a concurrent mixed methods design. Secondary data derived from the University of Alabama at Birmingham Hospital’s Press Ganey website were analyzed for clinic type comparisons and unstructured data were qualitatively analyzed to further enrich the quantitative findings. The University of Alabama at Birmingham Hospital is an academic medical center. The data were analyzed to determine the contributors responsible for each clinic not meeting national benchmarks. Thereafter, a review of these contributing factors was further performed to assess the difference in CAHPS scores between the private and rapid access clinics to determine if clinic type was a contributing factor to the overall scores. Results The data sample included 821 responses from May 2017 to May 2018. Overall, when both private clinics and rapid access clinics were viewed collectively, majority of the patients reported stewardship of patient resources as the most poorly rated factor (367/549, 66.8%) and physician communication quality as the most positively rated factor (581/638, 91.0%). However, when private clinics and rapid access clinics were viewed individually, rapid access clinics contributed slightly to the overall lower dermatology scores at the academic medical center. Conclusions This study determined that different factors were responsible for lower CAHPS scores for the two different dermatology clinics. Some of the contributing factors were associated with the mission of the clinic. It was suspected that the mission had not been properly communicated to patients, leading to misaligned expectations of care at each clinic.


2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S481-S482
Author(s):  
Zane Conrad ◽  
Minji Kang ◽  
Elizabeth Thomas ◽  
Doramarie Arocha ◽  
Julie B Trivedi

Abstract Background Central line-associated bloodstream infections (CLABSI) are one of the leading healthcare-acquired infections (HAI) with significant morbidity and mortality. We aimed to identify risk factors of CLABSI at an academic medical center to determine high-risk populations and target interventions. Methods This is an observational retrospective cohort study at William P. Clements Jr. University Hospital from January 1, 2017 to December 31, 2020. Retrospective chart review was conducted to identify demographics and co-morbidities of hospitalized patients diagnosed with CLABSI as defined by National Healthcare Safety Network (NHSN). Infections due to mucosal barrier injuries were excluded. Means were compared using independent-samples T-test and proportions were compared using chi-square. Results Ninety-three CLABSI events were identified with an increase in the standardized infection ratio from 0.38 in 2017 to 0.74 in 2020 (Figure 1). Bacterial organisms were identified in 71 (76%) cases while fungal organisms were identified in 22 (24%) (Table 2). There was no significant difference in the timing of CLABSI after line insertion (p=0.09) or organism identified (p=0.61) in PICC lines (n=33, 34%) vs all other central lines (n=60, 67%). When comparing immunocompromised patients with CLABSI (n=47, 51%) vs non-immunocompromised (n=46, 50%), there was a significant difference in the indication for line (chemotherapy), but no difference was seen in the number of line days prior to event (p=0.57), line type (p=0.17), or organism identified (p=0.94). Of all CLABSI, 46% (n=43) were in the intensive care unit (ICU) with significantly more Candida species (p=0.018) identified compared to non-ICU patients with CLABSI (n= 50, 54%). Figure 1. CLABSI Rate and SIR from 2017 to 2020 by Quarter Conclusion Candida species were more likely to be found in ICU patients with CLABSI as compared to non-ICU counterparts with further investigation in the ICU population revealing lack of flushing after administration of total parenteral nutrition. Otherwise, this observational cohort of CLABSI events did not identify any difference in immunosuppression status or line type. Given this information, infection prevention efforts will continue to be directed towards proper central line maintenance and removal when no longer indicated. Disclosures All Authors: No reported disclosures


Sign in / Sign up

Export Citation Format

Share Document