scholarly journals Severe and critical COVID-19 in pregnancy: A case series from Montreal

2021 ◽  
pp. 1753495X2199021
Author(s):  
Marie-Julie Trahan ◽  
Isabelle Malhamé ◽  
Cristina Mitric ◽  
Camille Simard ◽  
Jed Lipes ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Chart Review ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Supplemental Oxygen ◽  
Careful Consideration ◽  
Non Invasive ◽  
Individualized Approach ◽  
Obstetric Management ◽  
Supplemental Oxygen Therapy

Background Optimal obstetric management for women with coronavirus disease (COVID-19) is not known. We describe the management of six pregnant women requiring in-hospital care for severe COVID-19. Methods A retrospective chart review was conducted to identify pregnant women who tested positive for Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) between 15 March and 30 June 2020. A subset of women meeting criteria for severe COVID-19 was included. Results Four women required non-invasive supplemental oxygen therapy and two required mechanical ventilation. Four women were discharged from hospital undelivered and two required preterm delivery. One woman had a pulmonary embolism, and two required re-admission for worsening symptoms. Conclusion Management of pregnant women with severe COVID-19 is complex and should involve multidisciplinary expertise. Avoiding early delivery may be a safe option. We recommend an individualized approach to care, including careful consideration of the expected risks and benefits of expectant obstetric management versus delivery.

scholarly journals Clinical Characteristics of Mother–Infant Dyad and Placental Pathology in COVID-19 Cases in Predominantly African American Population

2021 ◽  
Vol 11 (01) ◽  
pp. e15-e20
Author(s):  
Sanket Jani ◽  
Suzanne M Jacques ◽  
Faisal Qureshi ◽  
Girija Natarajan ◽  
Sujit Bajaj ◽  
...  
Keyword(s):  
Inner City ◽  
Pregnant Women ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Supplemental Oxygen ◽  
Placental Pathology ◽  
Invasive Ventilation ◽  
Key Points ◽  
Baseline Characteristics ◽  
The Impact

Objective In this currently evolving coronavirus disease 2019 (COVID-19) pandemic, the evidence is scarce about the impact of COVID-19 infection on women in labor and neonates in an inner city African-Americans (AA) population. The objective of this study was to evaluate the clinical outcomes and placental pathology in mother–infant dyads in COVID-19 cases. Study Design Retrospective chart review was conducted on 34 COVID-19 positive mother–infant dyads to study their baseline characteristics and outcomes. Placental pathology was reviewed by two perinatal pathologists. Results COVID-19 was noted in 3% of pregnant women who delivered in our institution. The majority (82%) of them were asymptomatic. Out of the four mothers who were symptomatic, only three (9%) required supplemental oxygen. None of them required invasive ventilation. All the neonates tested negative for COVID-19 at 24 hours of age. There were no gross or microscopic pathological abnormalities detected that could be definitely associated with any COVID-19 related complications during pregnancy in any of the 34 placentas. Conclusion COVID-19 does not appear to increase morbidity and mortality among pregnant women and their neonates in a predominantly AA population. Our study did not find any evidence of vertical transmission of COVID-19 infection nor any specific findings on placental pathology. Key Points

Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series

2021 ◽  
Author(s):  
Jonathan P Scoville ◽  
Evan Joyce ◽  
Joshua Hunsaker ◽  
Jared Reese ◽  
Herschel Wilde ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Chart Review ◽  
Statistical Tests ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Opioid Use ◽  
Pain Scores ◽  
Surgical Methods ◽  
Significant Difference

Abstract BACKGROUND Minimally invasive surgery (MIS) has been shown to decrease length of hospital stay and opioid use. OBJECTIVE To identify whether surgery for epilepsy mapping via MIS stereotactically placed electroencephalography (SEEG) electrodes decreased overall opioid use when compared with craniotomy for EEG grid placement (ECoG). METHODS Patients who underwent surgery for epilepsy mapping, either SEEG or ECoG, were identified through retrospective chart review from 2015 through 2018. The hospital stay was separated into specific time periods to distinguish opioid use immediately postoperatively, throughout the rest of the stay and at discharge. The total amount of opioids consumed during each period was calculated by transforming all types of opioids into their morphine equivalents (ME). Pain scores were also collected using a modification of the Clinically Aligned Pain Assessment (CAPA) scale. The 2 surgical groups were compared using appropriate statistical tests. RESULTS The study identified 43 patients who met the inclusion criteria: 36 underwent SEEG placement and 17 underwent craniotomy grid placement. There was a statistically significant difference in median opioid consumption per hospital stay between the ECoG and the SEEG placement groups, 307.8 vs 71.5 ME, respectively (P = .0011). There was also a significant difference in CAPA scales between the 2 groups (P = .0117). CONCLUSION Opioid use is significantly lower in patients who undergo MIS epilepsy mapping via SEEG compared with those who undergo the more invasive ECoG procedure. As part of efforts to decrease the overall opioid burden, these results should be considered by patients and surgeons when deciding on surgical methods.

scholarly journals Penile Prosthesis Placement with Immediate Buried Penis Correction: A Retrospective Chart Review

2021 ◽  
pp. 1-3
Author(s):  
Christopher J. Salgado ◽  
Christopher J. Salgado ◽  
Genesis Navas ◽  
Lalama Maria ◽  
Lindsay M. Tanner ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Chart Review ◽  
Functional Performance ◽  
Case Series ◽  
Penile Prosthesis ◽  
Retrospective Chart Review ◽  
Combined Approach ◽  
Suspensory Ligament ◽  
Cosmetic Appearance ◽  
Buried Penis

Introduction: We present a case report on six patients who underwent a combined approach to improve the cosmetic appearance and functional performance of their buried penis. Aim: To report our combined approach to improve both buried penis and erectile dysfunction. Methods: In one surgery, we performed: a malleable penile prosthesis, ventral phalloplasty, and penile suspensory ligament release followed by a suprapubic lipectomy. Results: Postoperatively, all patients had an increase in penile length and were able to achieve successful penetrative intercourse. The average difference between the pre-operational and post-operational flaccid length of our six patients was 3.5 cm ± 1.38 (range, 1.9 to 5.08 cm). Conclusion: This case series serves as successful examples of using a combined approach in one stage to not only improve the cosmetic appearance of a buried penis but also address erectile dysfunction.

scholarly journals Low-Dose Aminophylline for the Treatment of Neonatal Non-Oliguric Renal Failure—Case Series and Review of the Literature

2008 ◽  
Vol 13 (2) ◽  
pp. 80-87
Author(s):  
Bethany A. Lynch ◽  
Peter Gal ◽  
J. Laurence Ransom ◽  
Rita Q. Carlos ◽  
Mary Ann V.T. Dimaguila ◽  
...  
Keyword(s):  
Renal Failure ◽  
Renal Function ◽  
Acute Renal Failure ◽  
Chart Review ◽  
Low Dose ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Review Of The Literature ◽  
Oliguric Renal Failure ◽  
The Impact

OBJECTIVE Aminophylline is a methylxanthine with multiple physiologic actions. At low doses, aminophylline can antagonize adenosine and improve renal function via increased glomerular filtration rate. Despite its clinical use, little data exists in neonates for this indication. Therefore, the objective of this report is to describe the impact of aminophylline on renal function indices in a series of neonates with acute renal failure. MATERIALS AND METHODS This was a retrospective chart review of 13 neonates with acute renal failure who received aminophylline during a 15-month study period. Aminophylline was administered at 1 mg/kg intravenously or orally every twelve hours. Forty-six percent (n = 6) of the patients received a 5 mg/kg loading dose before initiation of maintenance therapy. Most patients had already received other treatments for renal failure, including diuretics and dopamine. RESULTS Resolution of acute renal failure (with normalization of serum creatinine and blood urea nitrogen) was documented in 10 patients (77%). Four of the thirteen patients died from complications due to their prematurity. Failure of low-dose aminophylline was observed in 3 of the 4 patients who died. CONCLUSIONS Low-dose aminophylline in neonates with acute renal failure is associated with an improvement in renal function indices.

Antibody Testing of Infants Born to Asymptomatic COVID-19 Positive Mothers

2021 ◽  
Vol 16 (10) ◽  
pp. 3-7
Author(s):  
Tonya Robinson ◽  
Nicole Pozzi ◽  
Saeed Jortani
Keyword(s):  
Pregnant Women ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Igg Antibodies ◽  
Rt Pcr ◽  
Antibody Testing ◽  
University Of Louisville ◽  
Specific Igg ◽  
Negative Conclusion ◽  
Future Management

Awareness of SARS-COV-2 IgG may contribute to the management of asymptomatic RT PCR COVID-19 positive pregnant women, their newborns, and future vaccination practices. Objective: Characterize COVID testing results of asymptomatic COVID-19 positive pregnant women and their infants. Our assumption/hypothesis maintained that all infants born to asymptomatic COVID-19 positive mothers would have detectable SARS-CoV-2 specific IgG. Study Design: Retrospective chart review. Clinical demographics/COVID-19 testing of maternal/infant dyads were reviewed/collected for reporting purposes. Setting: Center for Women and Infants (CWI), University of Louisville Hospital, Louisville, KY Participants: Asymptomatic COVID-19 positive pregnant women/infant dyads admitted to the CWI between June 2020 to February 2021. Results: 36 COVID-19 positive asymptomatic mother/37 infant dyads (one set of twins) reviewed. 38% of the mother/infant dyads were positive for SARS-CoV-2 IgG, while 27% of mother/infant dyads were negative for IgG. A COVID-19 positive mother of twins was IgG negative, but both twins were positive. Two mothers in this study group had developed significant COVID-19 disease at 28w4d gestation and 34w0d gestation. Both required intensive care but recovered, and their pregnancies were maintained until 37w4d and 39w3d gestation, respectively. By the time of delivery, both mothers had negative COVID-19 RT PCR testing, but both infants were positive for SARS-CoV-2 IgG antibodies. COVID-19 RT PCR testing on both of these infants at 24 and 48 hours of age was negative. Conclusion: SARS-CoV-2 IgG is passively transferred to the infant during pregnancy of asymptomatic positive COVID-19 mothers however appears variable and/or possibly based on the ability of IgG detection with current testing. Further investigation of the immune system’s response to the SARS-CoV-2 virus during pregnancy can direct future management/treatment during pregnancy, especially in the wake of vaccination for the virus during pregnancy and emerging variants.

scholarly journals P.123 Normal pressure hydrocephalus with associated tremor

2019 ◽  
Vol 46 (s1) ◽  
pp. S45-S46
Author(s):  
A Persad ◽  
K Meguro
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Normal Pressure Hydrocephalus ◽  
Chart Review ◽  
Functional Decline ◽  
Retrospective Chart Review ◽  
Normal Pressure ◽  
Careful Consideration ◽  
The Other ◽  
Extrapyramidal Signs

Background: Normal pressure hydrocephalus is a frequent cause of cognitive and functional impairment. Many symptoms are shared between Parkinson’s disease and normal pressure hydrocephalus. Only few studies examine extrapyramidal signs in NPH, and only one case report exists describing tremor improvement with shunting. Methods: We performed a retrospective chart review of our NPH database. We selected patients who had both NPH and question of Parkinsonism due to tremor. Results: Six patients with both NPH diagnosis and tremor were identified. Three patients were treated for Parkinson’s disease and followed by neurology. After shunting, all three improved and attempt was made to wean medications, which led to functional decline. The other three patients improved with shunting and after titration of the shunt had resolution of tremor. Conclusions: We provide evidence that NPH can result in tremor, treatable by shunting. We also emphasize that those patients do exist who have both diseases. This likely exists along a continuum. Careful consideration of NPH should be undertaken in those patients with suspected Parkinson’s disease and imaging findings reminiscent of NPH.

scholarly journals P.138 Minimally invasive treatment of syringomyelia using tubular retractors

2018 ◽  
Vol 45 (s2) ◽  
pp. S53-S53
Author(s):  
K Yang ◽  
M Sourour ◽  
N Zagzoog ◽  
K Reddy
Keyword(s):  
Minimally Invasive ◽  
Chart Review ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Senior Author ◽  
Invasive Technique ◽  
Single Center ◽  
Invasive Treatment ◽  
Multiple Modalities ◽  
Subarachnoid Spaces

Background: Multiple modalities have been used in the treatment of syringomyelia, including direct drainage, shunting into peritoneal, pleural and subarachnoid spaces. The authors report their experience of surgical treatment of syringomyelia in a minimally invasive fashion. Methods: We conducted a single-center retrospective chart review on our syringomyelia cases treated with minimally invasively using Metrx Quadrant retractor system since January 2011. Lateral fluoroscopy was used to guide the placement of the retractor onto the lamina of the corresponding level. This was followed by laminectomy and a small durotomy. Once the syrinx cavity was identified and the proximal end of the tubing was inserted into the syrinx cavity, the tubing was tunneled into the pleural incision subcutaneously. Insertion of the pleural end of the shunt was performed under the microscope, with removal of a small amount of the rib at its upper edge. Results: 10 procedures were performed in 7 patients by the senior author. Etiologies of syringomyelia included Chiari malformation, trauma, diastematomyelia and kyphoscoliosis. All patients improved neurologically. No patients had immediate postoperative complications. One patient underwent two revisions of syringopleural shunts due to multilobulated nature of syringomyelia. Conclusions: Our case series presents a novel, minimally invasive technique for shunting of syringomyelia with results comparable to open procedures.

scholarly journals Delivering Telerehabilitation to COVID-19 Inpatients:A Retrospective Chart Review Suggests It Is a Viable Option

2020 ◽  
Vol 16 (S1) ◽  
pp. 64-70
Author(s):  
Kelsey Rosen ◽  
Monika Patel ◽  
Cecelia Lawrence ◽  
Brianne Mooney
Keyword(s):  
Physical Therapy ◽  
Chart Review ◽  
Vital Signs ◽  
Retrospective Chart Review ◽  
Inpatient Rehabilitation ◽  
Supplemental Oxygen ◽  
Hospitalized Patients ◽  
Home Exercise ◽  
Viable Option ◽  
Therapeutic Exercises

Abstract Background Guidelines for physical therapy management of patients hospitalized with COVID-19 recommend limiting physical therapists’ contact with patients when possible. Telehealth has been viewed as “electronic personal protective equipment” during the COVID-19 pandemic; although telerehabilitation has been shown to be effective with outpatients, it is unknown whether it is a viable option for hospitalized patients. Purpose Our facility developed an algorithm for the use of a physical therapy telerehabilitation program for inpatients with COVID-19. We sought to investigate the safety and viability of the program. Methods We conducted a retrospective chart review of patients admitted with a diagnosis of COVID-19 who received either telerehabilitation only or a combination of telerehabilitation and in-person rehabilitation. Based on the algorithm, COVID-19 inpatients were selected to receive telerehabilitation if they could ambulate independently, could use technology, had stable vital signs, required minimal supplemental oxygen, and were cognitively intact. We analyzed data of inpatients who received telerehabilitation only, which included patient education, therapeutic exercises, and breathing techniques. Results Of 33 COVID-19 inpatients who received telerehabilitation, in-person rehabilitation, or a combination of the two, 12 patients received telerehabilitation only (age range, 33 to 65 years; all but one male). They demonstrated independence with their individualized home exercise programs in one to two sessions, did not require an in-person rehabilitation consultation, did not require increased oxygen, experienced no exacerbation of symptoms, and were discharged home. Conclusions Inpatient telerehabilitation appears to be a viable option for selected hospitalized patients with COVID-19 and may be a safe way of delivering inpatient rehabilitation to isolated or at-risk populations. At our hospital, the use of inpatient telerehabilitation reduced staff exposure while providing important education and services to patients. To our knowledge, no studies have investigated the use of telerehabilitation for hospitalized patients, including those with COVID-19. Our findings suggest that this innovative approach warrants further study.

scholarly journals Pseudoseptic Arthritis: A Case Series and Review of the Literature

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Brian P. Oppermann ◽  
Jonida K. Cote ◽  
Stephanie J. Morris ◽  
Thomas Harrington
Keyword(s):  
Rheumatoid Arthritis ◽  
Inflammatory Arthritis ◽  
Chart Review ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Published Data ◽  
Inflammatory Condition ◽  
Gram Stain ◽  
Review Of The Literature ◽  
Pseudoseptic Arthritis

Purpose. Pseudoseptic arthritis is an acute inflammatory monoarthritis with a sterile synovial gram stain and culture. Pseudoseptic arthritis has been previously described in the literature in a variety of settings including rheumatoid arthritis and microcrystalline disease. Despite pseudoseptic arthritis being a described entity, there is little published data on this topic with no published reports since 1992.Methods. This paper was a retrospective chart review over a 20-year period that identified all rheumatology inpatient consultations at our tertiary rural hospital for pseudoseptic arthritis.Results. We identified 10 patients with pseudoseptic arthritis and presented 5 of those cases in this paper. Majority of these patients had known autoimmune inflammatory arthritis or microcrystalline inflammatory arthritis.Conclusion. Pseudoseptic arthritis is a syndrome that should be in the differential diagnosis with patients with long standing inflammatory condition who present with an acute monoarthritis with no known bacterial source for septic arthritis.

scholarly journals The Use of Daptomycin in the Treatment of Persistent Coagulase-Negative Staphylococcal Sepsis in Premature Infants: A Case Series

2021 ◽  
Vol 26 (1) ◽  
pp. 92-98
Author(s):  
Suzan S. Asfour ◽  
Raneem S. Asfour ◽  
Thanaa M. Khalil ◽  
Mountasser M. Al-Mouqdad
Keyword(s):  
Premature Infants ◽  
Chart Review ◽  
Creatine Phosphokinase ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Coagulase Negative Staphylococci ◽  
Gram Positive ◽  
Safety And Efficacy ◽  
Gram Positive Bacteria ◽  
Lipopeptide Antibiotic

OBJECTIVE Daptomycin is a lipopeptide antibiotic with rapid bactericidal activity against Gram-positive bacteria. Reports regarding the use of daptomycin in infants are still limited. Thus, the objective of this report is to describe the safety and efficacy of daptomycin in premature infants with persistent coagulase-negative staphylococci (CoNS) infection. METHODS This was a retrospective chart review of 10 premature infants with persistent CoNS infection who received daptomycin therapy between January 2018 and September 2019. Four patients had endocarditis and 1 had bacterial meningitis and infectious endocarditis. The other 5 patients had persistent CoNS bacteraemia only. RESULTS Daptomycin treatment was successful for 5 patients. The others died owing to multiple factors such as prematurity, sepsis, and chronic lung disease. Adverse drug reactions, including elevation of creatine phosphokinase and/or hepatotoxicity, were noted in 4 patients. CONCLUSIONS Large and randomized studies are necessary to ensure daptomycin's safety and efficacy for the treatment of infants with persistent sepsis caused by Gram-positive bacteria.

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