scholarly journals Subcutaneous administration of triamcinolone as part of the management of feline eosinophilic keratoconjunctivitis

2020 ◽  
pp. 1098612X2096866
Author(s):  
Danica R Lucyshyn ◽  
Kathryn L Good ◽  
Kelly E Knickelbein ◽  
Maggie W Chang ◽  
Ann R Strøm ◽  
...  
Keyword(s):  
Adverse Reactions ◽  
Antiviral Treatment ◽  
Subcutaneous Administration ◽  
Reference Population ◽  
Retrospective Case ◽  
Corneal Ulcers ◽  
Triamcinolone Injection ◽  
Study Population ◽  
Immunomodulatory Therapies ◽  
Control Study

Objectives The aim of this retrospective case-control study was to report the efficacy of subcutaneous triamcinolone as part of a regimen for feline eosinophilic keratoconjunctivitis (FEK). Methods Records and clinical photographs were reviewed and lesions semi-quantitatively graded for cats with cytologically confirmed FEK. Clinical data were compared between a study population of nine cats (11 eyes) treated with, and a reference population of seven cats (eight eyes) treated without, a median 0.11 mg/kg (range 0.10–0.20 mg/kg) of triamcinolone acetonide subcutaneously. Results Breed, sex, age and prevalence of corneal ulceration at presentation; corneal disease severity before and at the initiation of immunomodulation; and duration of antiviral treatment before immunomodulation did not differ significantly between populations ( P ⩾0.059). Corneal plaques resolved in five cats each from the study and reference populations ( P = 0.366). Median (range) time from immunomodulation to corneal plaque resolution did not significantly differ ( P = 0.246) between the study (median 14 days; range 8–38 days) and reference (median 28 days, range 14–46 days) populations. No adverse reactions were attributed to triamcinolone administration, and all corneal ulcers in the study population re-epithelialized within 14 days (range 8–38 days) following triamcinolone injection. Time to corneal ulcer re-epithelialization following triamcinolone injection varied minimally in those receiving antivirals prior to (8 or 30 days until re-epithelialization), simultaneously with (38 days) or after (14 or 24 days) triamcinolone. Conclusions and relevance In otherwise healthy cats with FEK, subcutaneous administration of triamcinolone appears to be well tolerated and as efficacious as conventional topical immunomodulatory therapies. It may be especially useful in ulcerated eyes where topical immunomodulation is contraindicated.

scholarly journals Self-retained cryopreserved amniotic membrane for treating severe corneal ulcers: a comparative, retrospective control study

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Han Y. Yin ◽  
Anny M. S. Cheng ◽  
Sean Tighe ◽  
Philip Kurochkin ◽  
Jamie Nord ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Adjuvant Therapy ◽  
Corneal Ulcer ◽  
Control Group ◽  
Retrospective Case ◽  
Corneal Ulcers ◽  
Initial Visual Acuity ◽  
Snellen Visual Acuity ◽  
Clinically Significant ◽  
Control Study

Abstract To compare the effectiveness of self- retained cryopreserved AM as an adjuvant therapy for infectious corneal ulcers. Retrospective, case–control study of 24 eyes of 24 consecutive patients with central and paracentral corneal infectious ulcers and initial visual acuity worse than 20/200. Among them, 11 eyes of 11 patients received additional placement of self-retained cryopreserved AM. Epithelialization and Best Corrected Snellen Visual Acuity (BCSVA) were compared between the two groups. At baseline, both groups had comparable age, gender, visual acuity (VA), size and location of corneal ulcer. Patients receiving additional placement of cryopreserved AM had significantly faster epithelialization within 3.56 ± 1.78 weeks vs 5.87 ± 2.20 weeks (p = 0.01) and achieved complete epithelialization in significantly more patients (72.7% vs 23.1% p = 0.04) despite overall larger baseline defect size (32.7 ± 19.5 mm2 vs 21.5 ± 10.7 mm2, p = 0.11). Consequently, the AM group had clinically significant BCSVA (> 3 lines) (81.8% vs 38.4%, p = 0.047) and total VA improvement (log MAR 0.7 ± 0.6 vs 1.6 ± 0.9, p = 0.016) compared to the control group at the time of complete epithelialization. In-office sutureless AM may be an effective adjuvant therapy in treating sight-threatening infectious corneal ulcers by promoting faster corneal epithelialization and overall better recovery of the VA.

scholarly journals Cardiac Troponin I Is Increased in Patients with Polytrauma and Chest or Head Trauma. Results of A Retrospective Case-Control Study

2016 ◽  
Vol 35 (3) ◽  
pp. 275-281 ◽  
Author(s):  
Giuseppe Lippi ◽  
Ruggero Buonocore ◽  
Michele Mitaritonno ◽  
Gianfranco Cervellin
Keyword(s):  
Chest Pain ◽  
Head Trauma ◽  
Cardiac Troponin ◽  
Blood Donors ◽  
Chest Trauma ◽  
Troponin I ◽  
Trauma Patients ◽  
Retrospective Case ◽  
Study Population ◽  
Control Study

Summary Background: We performed a retrospective case-control study to assess the values of cardiac troponin I (cTnI) in a large number of patients admitted to the emergency department (ED) with different types of trauma. Methods: The study population consisted of all patients aged 18 years or older admitted to the local ED with all types of traumas over a 1-year period. Results of cTnI were compared with those of 125 consecutive blood donors and 25 non-cardiac chest pain ED patients. Results: The final study population consisted of 380 trauma patients, 10 with isolated abdominal trauma, 99 with isolated trauma of the limbs, 49 with isolated chest trauma, 145 with isolated head trauma and 77 with polytrauma. The concentration of cTnI did not differ among the three study populations, but the frequency of measurable values was substantially higher in patients with trauma (63%) than in blood donors and non-cardiac chest pain ED patients (both 20%). The frequency of cTnI values above the 99th percentile of the reference range was significantly higher in trauma patients (20%) than in blood donors (0%) and noncardiac chest pain ED patients (8%). Increased cTnI values were more frequent after head trauma (21%), chest trauma (27%) and polytrauma (29%) compared to patients with abdominal (0%) or limbs trauma (8%). Conclusions: These results suggest that the measurement of cardiac troponin may be advisable to identify potential cardiac involvement in trauma patients, especially in those with polytrauma and head or chest trauma.

scholarly journals 791. Evaluation of NSAID Exposure as a Risk Factor for Clostridium difficile infection: A Propensity-Score-Matched Case-Control Study

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S439-S439
Author(s):  
Adam M Ressler ◽  
Alieysa Patel ◽  
Krishna Rao
Keyword(s):  
Logistic Regression ◽  
Risk Factor ◽  
Propensity Score ◽  
Case Control Study ◽  
Case Control ◽  
Comorbid Disease ◽  
Retrospective Case ◽  
Increased Risk ◽  
Study Population ◽  
Control Study

Abstract Background Exposure to certain medications, particularly antibiotics and proton pump inhibitors, has been associated with increased risk for Clostridium difficile infection (CDI). Studies have suggested an increased risk for CDI associated with exposure to certain non-steroidal anti-inflammatory drugs (NSAIDs). We conducted a retrospective case-control study to evaluate the risk for CDI associated with NSAID use. Methods The population included 1338 patients tested for CDI from February–December 2016 at the University of Michigan. NSAID use within 30 days of CDI testing was determined by chart review. Both scheduled and as-needed NSAID use met the definition for exposure, but aspirin use alone did not. Additional clinical data such as comorbid disease and baseline laboratory parameters were extracted through electronic query. A random forest model imputed missing data. A propensity score for NSAID use was developed via logistic regression and included gender, back pain, baseline serum creatinine, osteoarthritis, rheumatoid arthritis, serum albumin, and use of anticoagulant or antiplatelet medications. Cases were matched 1:1 with C. difficile negative controls by propensity score, with a matching caliper of 0.2 x standard deviation of the logit of the score. The final study population consisted of 1256 cases and their matched controls, however 6 cases could not be matched to controls as none had scores within the matching caliper. Conditional logistic regression was used to compare cases to controls. Results NSAID use was similar between the two groups on unadjusted analyses. The adjusted, multivariable model demonstrates that non-aspirin NSAID use is not a significant risk factor for CDI (P =.816), after adjustment for comorbid disease burden, age, and history of prior CDI (Table). Older age and prior CDI were independent risk factors for CDI (Table). Table Study population and modeling results Conclusion In this retrospective case-control study, non-aspirin NSAID use was not associated with an increased risk of CDI. To our knowledge, this is the first study of NSAID use as a risk factor for CDI that accounted for bias due to treatment assignment using a propensity score. Future studies should account for frequency or chronicity of NSAID use, which may affect the results. Disclosures Krishna Rao, MD, MS, Bio-K+ International, Inc. (Consultant)Merck and Co., Inc. (Research Grant or Support)Roche Molecular Systems, Inc. (Consultant)

scholarly journals A one year case control study on oxytocin use in labor and its effect on maternal: fetal outcomes

2018 ◽  
Vol 7 (3) ◽  
pp. 391
Author(s):  
Devendra Singh Kushwah ◽  
Beenu Kushwah
Keyword(s):  
Health Professionals ◽  
Analytical Study ◽  
Case Control Study ◽  
Case Control ◽  
Retrospective Case ◽  
Medical College ◽  
Study Population ◽  
Oxytocin Augmentation ◽  
One Year ◽  
Control Study

Background: Oxytocin is a drug commonly administered drug to a pregnant lady during labor, nowadays even without an indication, in the hope that the progress of labor can be improved and the need for cesarean delivery may be reduced. This study emphasizes the need for using safeguards like use of checklists before starting oxytocin augmentation, therefore ensuring its rational use to minimize maternal and neonatal complications when augmenting labor with oxytocin, including rigorous indications, use of minimal useful dose and careful efficacy evaluation.Methods: This is a retrospective, Case-Control, descriptive and analytical study. Study population included women delivering in labor room of Gandhi Memorial Hospital associated with Shyam Shah Medical College, Rewa, from July 2015 to June 2016, then after data were compiled and assessed in department of pharmacology G.R. Medical College, Gwalior.Results: Results show that the use of oxytocin in labor stimulation can be detrimental to both the mother and the newborn, since they indicate that the use of oxytocin is associated with increased cesarean section rates both in primiparous and multiparous. Furthermore, it was also observed, a significant association between stimulation with oxytocin and low Apgar scores at 1 and 5 minutes both, of the newborns.Conclusions: Therefore, it may conclude that stimulation with oxytocin should not be used without any indication, but only in very specific cases, in which its use is particularly necessary. These results provide to health professionals a better understanding of the effects of the use of oxytocin during labor, which can be useful for decision-making in clinical practice.

scholarly journals Ferritin – The key model inflammatory marker in diabetic and non-diabetic COVID-19

2021 ◽  
Vol 12 (12) ◽  
pp. 23-31
Author(s):  
Mukesh Kumar ◽  
CM Bindu ◽  
AC Shyam ◽  
R Reena
Keyword(s):  
Serum Ferritin ◽  
Inflammatory Marker ◽  
Ferritin Level ◽  
Fatal Outcome ◽  
Elevated Serum ◽  
Retrospective Case ◽  
Medical College ◽  
Study Population ◽  
Control Study

Background: Diabetics exhibit elevated serum ferritin level when compared to non-diabetic counterpart, indicates impact of its association with coronavirus disease 2019 (COVID-19) infection and disease progression. Ferritin is a key mediator of immune dysregulation through direct immunosuppression contributing to cytokine storm resulting in fatal outcome in COVID-19. Aims and Objectives: This study aims to estimate serum ferritin in diabetic (cases) and non-diabetic (controls) COVID-19 patients and its correlation with their diabetic profile (FBS, PPBS, RBS, and HbA1C). Materials and Methods: A retrospective case–control study conducted at Rajarajeswari Medical College and Hospital, Bengaluru, for a period of 8 months among diabetic and non-diabetic COVID-19 patients. Results: The study population consisted of 957 individuals, out of them, 425 patients were type 2 diabetes mellitus and 532 were non-diabetic COVID-19-positive patients (controls). Diabetic profile parameters (FBS, PPBS, RBS, and HbA1c) and serum ferritin were significantly (P<0.05) high in cases as compared to controls. Among diabetic COVID-19, the glycated hemoglobin and serum ferritin showed a significantly positive correlation (r=0.55) with serum ferritin (mean=648.98±320.48). Conclusion: Hyperferritinemia is more prevalent in diabetic COVID-19 individuals. Serum ferritin can be considered as a valuable biomarker to screen the diabetic and non-diabetic for the presence of hyperinflammation and to predict severity of COVID-19 infection so that it will help the clinician for proper management.

scholarly journals Neonatal and maternal outcome in term primigravida with isolated oligohydramnios

2018 ◽  
Vol 8 (1) ◽  
pp. 258
Author(s):  
Shelly Agarwal ◽  
Samta Gupta
Keyword(s):  
Perinatal Outcome ◽  
Induction Of Labour ◽  
Exclusion Criterion ◽  
Control Group ◽  
Medical Sciences ◽  
Retrospective Case ◽  
Study Population ◽  
Vertex Presentation ◽  
And Control ◽  
Control Study

Background: The aim of this study is to evaluate the maternal and perinatal outcome in term primigravida with isolated oligohydramnios.Methods: A retrospective, case–control study was carried out in the department of OBG, School of Medical Sciences and Research, Sharda Hospital, Greater Noida from November 2014 to October 2017. The study population comprised of low-risk primigravida with singleton, term pregnancy, with vertex presentation and intact membranes.  After meeting the inclusion and exclusion criterion, the study population was divided into cases (n = 51) and control group (176) and the results were analyzed in reference to rate of induction of labour, C. Section rate and the perinatal outcome.Results: Isolated oligohydramnios is associated with increased rate of induction of labour and increased operative interference, but perinatal outcome in terms of mean birth weight, Apgar score at 5 min and NICU admissions for over 24 hours, are not statistically significant in comparison with control group.Conclusions: Isolated oligohydramnios is not an indicator of adverse perinatal outcome. 

scholarly journals Risk factors and outcome associated with infection or colonization due to carbapenem-heteroresistant Escherichia coli

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Karen Tan ◽  
Corey Kelsom ◽  
Amanda Chron ◽  
Paul Nieberg ◽  
Holly Huse ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Study Groups ◽  
Retrospective Case ◽  
E Coli ◽  
Icu Admission ◽  
Microbial Characteristics ◽  
Study Population ◽  
Prolonged Hospital ◽  
Control Study

Abstract Background Up to 32% of ESBL-producing Enterobacterales strains display a carbapenem-heteroresistant (cHR) phenotype but its clinical relevance is unknown. Objectives To determine risk factors and clinical outcome associated with infection due to cHR ESBL-producing Escherichia coli (ESBL-EC). Methods A retrospective, case–control study was conducted on patients from whom a pair of clonally related E. coli strains were isolated during separate healthcare encounters with (case) or without (control) development of cHR phenotype in the latter strain. Study groups were compared for host and microbial characteristics and carbapenem exposure. Outcome measures included ICU admission, length of hospitalization, and mortality. Results Study patients (15 cases, 10 controls) were elderly (median age: 74 years) with half admitted from home (52%), most (80%) having ≥3 comorbid conditions and severe functional impairment. Case patients were more likely to have ‘index’ ESBL-EC isolating from blood (27% versus 0%; P = 0.125) and have greater cumulative amount and duration of carbapenem exposure than controls. All control ‘subsequent’ isolates were from urine whereas five cHR case isolates were from blood or respiratory sources. More hospitalized case patients required ICU admission (23% versus 0%; P = 0.257) and prolonged hospital stay (&gt;7 days) than controls (62% versus 38%%; P = 0.387). Conclusions Our findings deserve confirmation with a larger study population and call attention to the potential for increased morbidity with cHR ESBL-EC infections, which underscores the need to screen for cHR phenotype in patients with repeated growth of ESBL-EC, particularly from systemic sites and patients that have had extensive carbapenem exposure.

A Transapical or Transluminal Approach to Aortic Valve Implantation Does Not Attenuate the Inflammatory Response

2011 ◽  
Vol 14 (2) ◽  
pp. 110 ◽  
Author(s):  
Benjamin O'Brien ◽  
Miralem Pasic ◽  
Hermann Kuppe ◽  
Roland Hetzer ◽  
Helmut Habazettl ◽  
...  
Keyword(s):  
Chronic Disease ◽  
Aortic Valve ◽  
Inflammatory Response ◽  
Pulmonary Disease ◽  
Outcome Data ◽  
Surgical Trauma ◽  
Retrospective Case ◽  
Study Population ◽  
Aortic Valve Implantation ◽  
Valve Implantation

Background: Cardiopulmonary bypass (CPB) and cardiac surgery cause an inflammatory response, as measurable by an increase in the concentration of C-reactive protein (CRP), a nonspecific inflammation marker. Previous publications have demonstrated typical perioperative CRP concentration profiles in cases of uncomplicated aortic valve replacement (AVR) with CPB. A regression analysis for modifying factors showed that chronic disease (heart failure, diabetes, and pulmonary disease), along with obesity and sex, all tend to influence the CRP response. We analyzed the inflammatory response to aortic valve implantation (AVI) with interventional techniques, mainly transapical but also transfemoral and transaxillary approaches, in a retrospective case-control study design.Methods: Sixty-eight patients who underwent AVI by the transapical (59 patients), transfemoral (7 patients), or transaxillary (2 patients) approach were matched by age, sex, body mass index (BMI), and chronic-disease state (absence or presence of diabetes, pulmonary disease, and renal impairment) with 68 patients who underwent conventional AVR with CPB. We compared the 2 groups with respect to perioperative CRP concentration, EuroSCORE, and outcome data (time to extubation and 30-day mortality). All data were collected prospectively and analyzed retrospectively.Results: The 2 groupsthe study population (interventional) and the control population (conventional)were similar in age, sex distribution, BMI, and chronic-disease status. As expected, the study population had a significantly higher median EuroSCORE. The 2 groups had similar postoperative CRP profiles over time, but the interventional group had significantly higher peak concentrations on days 2, 3, and 4. The short-term outcomes, as assessed by ventilation time and 30-day mortality, were similar for the 2 groups.Conclusions: Using an interventional transcatheter approach to AVI (thereby eliminating CPB from the procedure and reducing surgical trauma) does not attenuate the patient's innate inflammatory response.

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