Cellulitis in patients with chronic lower-limb lymphedema due to HIV-related Kaposi sarcoma

2021 ◽  
pp. 095646242110593
Author(s):  
Patricia Volkow-Fernández ◽  
Beda Islas-Muñoz ◽  
Pamela Alatorre-Fernández ◽  
Patricia Cornejo-Juárez
Keyword(s):  
Risk Factor ◽  
Lower Limb ◽  
Medical Records ◽  
Antimicrobial Prophylaxis ◽  
Kaposi Sarcoma ◽  
First Episode ◽  
Clinical Factors ◽  
Toxic Shock ◽  
Factors Associated ◽  
Cancer Clinic

Objective Chronic Lower Limb Lymphedema (CL-LL) secondary to Kaposi sarcoma (KS) has not been recognized as a risk factor for cellulitis. The aim was to describe the clinical spectrum and use of antimicrobial prophylaxis in patients with cellulitis and CL-LL due to KS. Methods HIV patients with KS, CL-LL, and at least one episode of cellulitis seen at the AIDS Cancer Clinic at INCan in Mexico from 2004 to 2019 were included. Demographic and clinical data were obtained from medical records. Results Thirty-nine men all with CL-LL were included. Clinical factors associated with cellulitis were groin and/or lymph-node KS infiltration (69.2%), onychomycosis and/or tinea pedis (44.7%), ulcerated lesions (38.4%), and obesity (2.5%). Eighteen (46.1%) were hospitalized in the first episode and eight (20.5%) in recurrence. Six (25.3%) died, two of toxic shock syndrome (TSS), and one of septic shock. Fourteen (35.8%) had at least one recurrent episode of cellulitis. Twenty-five (64.1%) received prophylaxis. Patients without prophylaxis had significantly more unfavorable outcomes (hospitalization and recurrences) than those with prophylaxis. Conclusions CL-LL due to KS is a risk factor for cellulitis and severe complications in patients with a long life expectancy. Antimicrobial prophylaxis needs to be explored as it could prevent complications.

scholarly journals S101. CLINICAL FACTORS ASSOCIATED WITH CANNABIS USE IN A CHILEAN SAMPLE OF FIRST EPISODE PSYCHOSIS PATIENTS

2018 ◽  
Vol 44 (suppl_1) ◽  
pp. S364-S364
Author(s):  
Barbara Iruretagoyena ◽  
Nicolas Crossley ◽  
Alfonso Gonzalez-Valderrama ◽  
Cristian Mena ◽  
Carmen Castañeda ◽  
...  
Keyword(s):  
First Episode Psychosis ◽  
Cannabis Use ◽  
First Episode ◽  
Clinical Factors ◽  
Factors Associated ◽  
Episode Psychosis

Hyponatremia associated with preeclampsia

2017 ◽  
Vol 45 (4) ◽  
Author(s):  
Armin S. Razavi ◽  
Stephen T. Chasen ◽  
Ritu Gyawali ◽  
Robin B. Kalish
Keyword(s):  
Older Women ◽  
Electronic Medical Records ◽  
Serum Sodium ◽  
Medical Records ◽  
Sodium Level ◽  
Descriptive Study ◽  
Clinical Factors ◽  
Factors Associated ◽  
Hypertension In Pregnancy ◽  
In Pregnancy

AbstractObjective:The objective of our study was to evaluate the prevalence and clinical factors associated with hyponatremia in patients with preeclampsia.Study design:This is a descriptive study of all patients who delivered at our institution from 2013 to 2014. Patients with preeclampsia were identified from electronic medical records. Preeclampsia with and without severe features was defined using the criteria outlined in the American Congress of Obstetricians and Gynecologists Hypertension in Pregnancy guidelines. As sodium levels have been shown to be approximately 5 mEq/L lower in pregnancy, hyponatremia was defined as a sodium level <130 mEq/L.Results:We identified 332 pregnancies complicated by preeclampsia, including 277 singletons and 55 twins. Hyponatremia was noted in 32 (9.7%) patients. Preeclampsia with severe features was present in the majority of patients with hyponatremia, and hyponatremia was more common in those with preeclampsia with severe features compared to those without (P<0.001). Hyponatremia also occurred more frequently in twins (P=0.001) and in older women (P=0.017). Only one patient without hyponatremia had an eclamptic seizure.Conclusion:Hyponatremia is not uncommon in preeclampsia, and is even more common in those with preeclampsia with severe features and twin gestations. As women with preeclampsia are at risk for hyponatremia, serum sodium should be monitored, especially in women with preeclampsia with severe features or twin gestations.

Clinical Factors Associated with Readmission among Patients with Lower Limb Cellulitis

Dermatology ◽  
2017 ◽  
Vol 233 (1) ◽  
pp. 58-63 ◽  
Author(s):  
Amit Garg ◽  
Jonathan Lavian ◽  
Gloria Lin ◽  
Cristina Sison ◽  
Michael Oppenheim ◽  
...  
Keyword(s):  
Lower Limb ◽  
Clinical Factors ◽  
Factors Associated

scholarly journals Bacterial and Fungal Co-infection in a Cohort of 333 Patients Hospitalized for COVID-19 (COINFECOVID Study)

2021 ◽  
Author(s):  
Vicente Abril ◽  
Neus Gómez ◽  
Hilary Piedrahita ◽  
Mercedes Chanzá ◽  
Nuria Tormo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Retrospective Study ◽  
Medical Records ◽  
Bacterial Infections ◽  
Main Risk Factor ◽  
Candida Spp ◽  
Factors Associated ◽  
Icu Stay ◽  
Prolonged Icu Stay

Abstract BackgroundCoinfections in COVID19 appear to worsen hospitalized patients prognosis.ObjectiveTo describe the characteristics of bacterial and fungal coinfections in patients admitted for COVID19 and to identify the risk factors associated with its occurrence.Patients and MethodsSingle-center retrospective study reviewing medical records of patients with COVID19 diagnosed with bacterial or fungal infection during hospital admission.Results333 patients were analyzed during March 15-May 15, 2020. 16.82% had some coinfection during admission. Coinfections were more frequent in patients with comorbidities (80.36% vs 19.64% p<0.025) and in those ICU admitted (52.46% vs 8.86%, p<0.001). Coinfections were significantly more frequent in patients with neutrophilia>7500 and increased procalcitonin on admission as well as lymphopenia<1500 on day 5. Mortality in patients with coinfection was 26.79% vs 23.47% in non-coinfected (p 0.596). Length of stay was longer in coinfected patients (mean 30.59 vs 13.47, p<0.01). Most frequent microorganisms were Enterococci, Candida spp, Enterobacteriaceae and Pseudomonas spp. 74% of patients received ceftriaxone: 17.34% of those treated had a coinfection compared to 15.48% not treated (p 0.694).ConclusionsOccurrence of coinfections is frequent and prolongs hospital stay without influencing mortality. The presence of comorbidities and ICU stay were identified as the main risk factor for coinfection, while increased neutrophils and procalcitonin at admission and lymphopenia during evolution were the main biological predictors. Enterococcus was the most frequent pathogen. Ceftriaxone use does not protect against appearance of bacterial infections. C. albicans was the most frequently isolated fungus and was associated with prolonged ICU stay.

scholarly journals Characteristics of Patients with Accommodative Esotropia Who Need Glasses for Stable Alignment after Myopic Shift

2021 ◽  
Vol 62 (8) ◽  
pp. 1116-1122
Author(s):  
Min Woo Kim ◽  
Donghun Lee ◽  
Myung Mi Kim
Keyword(s):  
Medical Records ◽  
Initial Visit ◽  
Inclusion Criteria ◽  
Clinical Factors ◽  
Stable Group ◽  
Factors Associated ◽  
Myopic Shift ◽  
The Mean ◽  
Accommodative Esotropia

Purpose: We analyzed the characteristics of patients with refractive accommodative esotropia (RAET) who required glasses for stable alignment after a myopic shift.Methods: We retrospectively analyzed the medical records of patients diagnosed with RAET at the initial visit, and who had developed a myopic shift in both eyes over the 5-year follow-up period. To evaluate clinical factors associated with the persistence of esotropia after myopia, the enrolled patients were divided into two groups; patients with RAET who needed glasses for stable alignment after a myopic shift (unstable group) and patients with RAET whose esotropia resolved after a myopic shift (stable group).Results: A total of 55 patients met the inclusion criteria. The mean follow-up period was 13.8 ± 5.7 years (5-27 years). Spherical equivalent (SE) refractive errors at the initial visit were +3.1 ± 1.6 diopters (D) (+1.00 to +7.25 D) and -1.5 ± 0.9 D (-4.38 to -0.5 D) at the last visit. Of the 55 RAET patients, 24 were included in the unstable group and 31 were included in the stable group. No significant differences in gender, age at diagnosis, SE refractive error, or angle of esotropia with glasses were observed between the two groups. However, significantly more patients failed the Lang I test or had anisometropia over 1.5 D at the last visit, and the duration between the onset of esotropia and prescribing glasses was significantly longer in the unstable group than in the stable group.Conclusions: Glasses may be needed for stable alignment even after a myopic shift in RAET patients with long durations of misalignment, poor stereopsis, and anisometropia.

scholarly journals Clinical Factors Associated with Reinfection versus Relapse in Infective Endocarditis: Prospective Cohort Study

2021 ◽  
Vol 10 (4) ◽  
pp. 748
Author(s):  
Jorge Calderón-Parra ◽  
Martha Kestler ◽  
Antonio Ramos-Martínez ◽  
Emilio Bouza ◽  
Maricela Valerio ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Clinical Characteristics ◽  
Therapeutic Strategies ◽  
First Episode ◽  
First Year ◽  
Clinical Factors ◽  
Single Episode ◽  
Factors Associated ◽  
Persistent Bacteremia

We aimed to identify clinical factors associated with recurrent infective endocarditis (IE) episodes. The clinical characteristics of 2816 consecutive patients with definite IE (January 2008–2018) were compared according to the development of a second episode of IE. A total of 2152 out of 2282 (94.3%) patients, who were discharged alive and followed-up for at least the first year, presented a single episode of IE, whereas 130 patients (5.7%) presented a recurrence; 70 cases (53.8%) were due to other microorganisms (reinfection), and 60 cases (46.2%) were due to the same microorganism causing the first episode. Thirty-eight patients (29.2%), whose recurrence was due to the same microorganism, were diagnosed during the first 6 months of follow-up and were considered relapses. Relapses were associated with nosocomial endocarditis (OR: 2.67 (95% CI: 1.37–5.29)), enterococci (OR: 3.01 (95% CI: 1.51–6.01)), persistent bacteremia (OR: 2.37 (95% CI: 1.05–5.36)), and surgical treatment (OR: 0.23 (0.1–0.53)). On the other hand, episodes of reinfection were more common in patients with chronic liver disease (OR: 3.1 (95% CI: 1.65–5.83)) and prosthetic endocarditis (OR: 1.71 (95% CI: 1.04–2.82)). The clinical factors associated with reinfection and relapse in patients with IE appear to be different. A better understanding of these factors would allow the development of more effective therapeutic strategies.

Risk factors associated with treatment-resistant schizophrenia in first-episode psychosis

2017 ◽  
Vol Ano 7 ◽  
pp. 8-12
Author(s):  
Ana Beatriz de Oliveira Assis ◽  
Jayse Gimenez Pereira Brandão ◽  
Pedro Otávio Piva Espósito ◽  
Osmar Tessari Junior ◽  
Bruno Berlucci Ortiz
Keyword(s):  
Risk Factors ◽  
First Episode Psychosis ◽  
First Episode ◽  
Treatment Resistant ◽  
Factors Associated ◽  
Syndrome Scale ◽  
Episode Psychosis ◽  
Negative Syndrome

Objetivo: Ainda não está claro quais são os fatores de risco para a esquizofrenia resistente ao tratamento (ERT) em primeiro episódio psicótico (PEP). O objetivo deste trabalho é investigar indicadores de risco para ERT em PEP. Métodos: Foram selecionados 53 pacientes em primeiro episódio psicótico, com diagnóstico de esquizofrenia, que deram entrada à enfermaria de psiquiatria do Hospital das Clínicas Luzia de Pinho Melo entre 2011 e 2015. Ao ser admitido na enfermaria, o paciente era avaliado com a Escala de Sintomas para as Síndromes Positiva e Negativa (Positive and Negative Syndrome Scale – PANSS) e recebia tratamento inicial por 4 semanas. Caso sua resposta fosse inferior a 40% de redução na PANSS, o antipsicótico era trocado, e as escalas eram aplicadas novamente após mais 4 semanas. Após a falha com dois antipsicóticos, em doses plenas, por 4 semanas cada, a clozapina era introduzida, e o paciente era considerado ERT. Uma regressão logística foi aplicada onde sexo, idade de início, tempo de doença não tratada, uso de substâncias, avaliação global do funcionamento inicial e PANSS inicial total foram inseridos como variáveis independentes, e ERT foi inserida como variável dependente. Resultados: Tempo de doença não tratada apresentou significância de p = 0,038 e Exp (B) = 4,29, enquanto que PANSS total apresentou p = 0,012 e Exp (B) = 1,06. Conclusão: Identificar os fatores associados à resistência precoce ao tratamento poderia permitir aos clínicos evitar o atraso na introdução da clozapina e prevenir um pior prognóstico para esses pacientes.

Risk Factor Of Substitution ARV First Line People Living With HIV/AIDS In General Hospital Buleleng Bali

2020 ◽  
Vol 9 (1) ◽  
pp. 190-197
Author(s):  
Luh Putu Desy Puspaningrat ◽  
Gusti Putu Candra ◽  
Putu Dian Prima Kusuma Dewi ◽  
I Made Sundayana ◽  
Indrie Lutfiana
Keyword(s):  
Risk Factor ◽  
General Hospital ◽  
Medical Records ◽  
Secondary Data ◽  
District General Hospital ◽  
People Living With Hiv ◽  
First Line ◽  
The Past ◽  
Factor Substitution ◽  
Living With Hiv

Substitution is still a threat to the failure of ARV therapy so that no matter how small it must be noted and monitored in ARV therapy. The aims  was analysis risk factor substitution ARV first line in therapy ARV. This study was an analytic longitudinal study with retrospective secondary data analysis in a cohort of patients receiving ARV therapy at the District General Hospital of Buleleng District for the period of 2006-2015 and secondary data from medical records of PLHA patients receiving ART.  Result in this study that the percentage of first-line ARV substitution events is 9.88% (119/1204) who received ARV therapy for the past 11 years. Risk factors that increase the risk of substitution in ARV therapy patients are zidovudine (aOR 4.29 CI 1.31 -2.65 p 0.01), nevirapine (aOR1.86 CI 2.15 - 8.59 p 0.01) and functional working status (aOR 1.46 CI 1.13 - 1.98 p 0.01). 

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