Burden of respiratory syncytial virus (RSV) disease in adults: final analysis from a retrospective chart review

OBJECTIVES Chloral hydrate had been extensively used for children undergoing sedation for imaging studies, but after the manufacturer discontinued production, pediatric sedation providers explored alternative sedation medications. Those medications needed to be at least as safe and as effective as chloral hydrate. In this study, we examined if pentobarbital is a suitable replacement for chloral hydrate. METHODS Subjects who received pentobarbital were recruited from a prospectively collected database, whereas we used a retrospective chart review to study subjects who received chloral hydrate. Sedation success was defined as the ability to provide adequate sedation using a single medication. We included electively performed sedations for subjects aged 2 months to 3 years who received either pentobarbital or chloral hydrate orally. We excluded subjects stratified as American Academy of Anesthesiologists category III or higher and those who received sedation for electroencephalogram. The data collected captured subject demographics and complications. RESULTS Five hundred thirty-four subjects were included in the final analysis, 368 in the chloral hydrate group and 166 in the pentobarbital group. Subjects who received pentobarbital had a statistically significant higher success rate [136 (82%) vs 238 (65%), p < 0.001], but longer sleeping time (18.1% vs 0%, p < 0.001) in all age groups. Subjects who received chloral hydrate had a higher risk of airway complications in the <1 year of age group (6.5% vs 1.8%, p = 0.03). CONCLUSIONS For pediatric patients younger than 3 years of age undergoing sedation for imaging studies, oral pentobarbital may be at least as effective and as safe as chloral hydrate, making it an acceptable and practical alternative.

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Retrospective Chart Review of Cryopreserved Amniotic Membrane for Knee Pain

Journal of Regenerative Biology and Medicine ◽

10.37191/mapsci-2582-385x-2(6)-047 ◽

2020 ◽

Author(s):

Ruben Berrocal Timmons

Keyword(s):

Quality Of Life ◽

Adverse Events ◽

Amniotic Membrane ◽

Chart Review ◽

Retrospective Chart Review ◽

Final Analysis ◽

Mean Values ◽

Number Of Patients ◽

The Impact

Objective: Treatment of joint pain with an injection of the amniotic membrane has not been adequately studied. This study retrospectively reviewed Visual Analog Scale (VAS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and analgesic usage data from patients treated with the injection of cryopreserved amniotic membrane (CAM) in their knees to determine the impact of treatment on patients’ pain, quality of life, and analgesic usage. Methods: Chart review was conducted on 40 patients. Institutional Review Board (IRB) approval was obtained prior to initiation of the project. The membrane was utilized as per the FDA guidance of 21CFR1271. Retrospective data, including demographics, medical history, pain score, quality of life score, analgesic usage and adverse events, were collected from their medical records for each consenting patient through 6 months after CAM injection. Results: A total of 40 patients were considered in the final analysis. Mean VAS for pain level improved from 7.0 to 2.6 (p<0.001). WOMAC daily activity function score improved from a mean score of 52 to 28 (p<0.001). Opioid and non-steroidal anti-inflammatory drug (NSAID) usage decreased from 97% to 25% (p<0.001). No adverse events were reported. Conclusion: Mean values for VAS and WOMAC scores significantly improved at all time points and the number of patients who used analgesics decreased as compared to baseline. CAM injection into painful knee joints decreases pain, improves physical function, and decreases the use of analgesics in the absence of adverse events.

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Effectiveness of home-based fortified diet in the rehabilitation of malnourished children in resource restrained country: an institution based retrospective study

10.21203/rs.3.rs-60166/v2 ◽

2020 ◽

Author(s):

Saba Shahid ◽

Marvi Mahesar ◽

Anum Rahim ◽

Yumna Sadiq

Keyword(s):

Weight Gain ◽

Chart Review ◽

Data Extraction ◽

Real Life ◽

Retrospective Chart Review ◽

Final Analysis ◽

Nutrition Survey ◽

Community Based ◽

Malnourished Children ◽

Home Based

Abstract Background: Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3% and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections, and currently, WHO recommends community-based management of malnutrition with the provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using the home-fortified diet in Pakistan. This study evaluated the effectiveness of using the home-fortified diet in achieving recovered from malnutrition through a retrospective chart review.Methods: A retrospective chart review of pediatric patients (aged six months –5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A predesigned data extraction form was used to record detailed information about demographic characteristics, feeding, anthropometric, micronutrient, and nutritional details at enrollment and on follow-up.Results: A total of 361 patients were included in the final analysis. The median age of children was 14 months. 102 children were recovered from malnutrition with a median length of stay in the program of 28 days. The median for weight gain was 4.8 (0-10.3) g/Kg/day, 226 children defaulted and 10 died.Conclusion: This study revealed adequate weight gain and recovered from malnutrition in children by using the home-fortified diet in real-life situations. Home-fortified diets may serve as an effective strategy in community-based rehabilitation of malnourished children, especially in resource constraint contexts.

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Hemodynamic Changes Associated with Mydriatic Eye Drop Administration in Anesthetized Pediatric Patients

Ocular Oncology and Pathology ◽

10.1159/000500593 ◽

2019 ◽

Vol 6 (3) ◽

pp. 203-209

Author(s):

Vittoria Arslan-Carlon ◽

Maria C. Walline ◽

Kenneth Seier ◽

Kay See Tan ◽

David H. Abramson

Keyword(s):

Chart Review ◽

Pediatric Patients ◽

Retrospective Chart Review ◽

Final Analysis ◽

Hemodynamic Instability ◽

Systemic Effects ◽

Eye Drops ◽

General Anesthetic ◽

Baseline Blood Pressure ◽

Hemodynamic Changes

Background: Dilating eye drops are routinely used in pediatric retinoblastoma patients during anesthetized ophthalmologic exams. Information on the systemic effects of ocular mydriatics, especially in anesthetized pediatric patients, is limited. Objective: The primary aim of this study was to analyze hemodynamic changes during mydriatic eye drop administration in anesthetized pediatric patients. Methods: A retrospective chart review was performed for pediatric retinoblastoma patients who underwent MRI with anesthesia. Baseline blood pressure (BP) and heart rate (HR) were charted for each patient at induction. HR and mean arterial pressure (MAP) measurements were recorded at 5, 10, 15, 30, and 45 min after eye drop administration. Secondarily, we included data from 15 patients who received dilating eye drops while under sevoflurane general anesthetic. All patients were dilated with phenylephrine 2.5 or 10% (depending on age) and tropicamide 1%. Results: The final analysis included 176 anesthesia encounters. The results demonstrate no statistically significant deviation of more than 20% from baseline for either HR or MAP. Additionally, we did not detect any difference between patients who were anesthetized with propofol versus sevoflurane. Conclusions: We did not observe significant hemodynamic instability with administration of dilating eye drops during propofol anesthesia.

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Obesity and Heart Failure as Predictors of Failure in Outpatient Skin and Soft Tissue Infections

Antimicrobial Agents and Chemotherapy ◽

10.1128/aac.02389-16 ◽

2017 ◽

Vol 61 (3) ◽

Cited By ~ 11

Author(s):

Erin L. Conway ◽

John A. Sellick ◽

Kari Kurtzhalts ◽

Kari A. Mergenhagen

Keyword(s):

Heart Failure ◽

Chart Review ◽

Primary Outcome ◽

Retrospective Chart Review ◽

Final Analysis ◽

Skin Infections ◽

Unit Increase ◽

Classification Of Diseases ◽

International Statistical Classification

ABSTRACT The purpose of this study was to evaluate risk factors for failure of antibiotic treatment within 30 days for uncomplicated skin infections of outpatients treated in a Veterans Affairs hospital. A retrospective chart review of outpatients between January 2006 and July 2015 with an ICD-9 (International Statistical Classification of Diseases and Related Health Problems) code of cellulitis or abscess was included in the analysis. The primary outcome was success versus failure of the antibiotic, with failure defined as another antibiotic prescribed or hospitalization within 30 days for the original indication. A total of 293 patients were included in the final analysis, 24% of whom failed within 30 days. Obesity/overweight (body mass index [BMI] of >25 kg/m2) was identified in 83% of the overall population, with 16% of that population having a BMI greater than 40 kg/m2. An elevated mean BMI of 34.2 kg/m2 (P = 0.0098) was found in the subset of patients who failed oral antibiotics compared to a BMI of 31.32 kg/m2 in patients who were treated successfully. Additionally, the patients who failed had an increased prevalence of heart failure at 16% (P = 0.027). Using multivariate logistic regression, BMI and heart failure were determined to be significant predictors of antibiotic prescription failure. Each 10-kg/m2 unit increase in BMI was associated with a 1.62-fold-greater odds of failure. A diagnosis of heart failure increased the odds of failure by 2.6-fold (range, 1.1- to 5.8-fold). Outpatients with uncomplicated skin infections with an elevated BMI and heart failure were found to have increased odds of failure, defined as hospitalization or additional antibiotics within 30 days.

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Refractive Changes Induced by Strabismus Corrective Surgery in Adults

Journal of Ophthalmology ◽

10.1155/2017/2680204 ◽

2017 ◽

Vol 2017 ◽

pp. 1-8

Author(s):

Daphna Mezad-Koursh ◽

Ari Leshno ◽

Tomer Ziv-Baran ◽

Chaim Stolovitch

Keyword(s):

Postoperative Period ◽

Side Effect ◽

Chart Review ◽

Retrospective Chart Review ◽

Final Analysis ◽

Spherical Equivalent ◽

Corrective Surgery ◽

Significant Side Effect ◽

Refractive Change ◽

Clinically Significant

Purpose. To investigate refractive changes after strabismus correction procedures among adults.Methods. Retrospective chart review of adult patients who had horizontal recti muscles surgery with preoperative and postoperative cycloplegic refraction measurements. The preoperative refraction was mathematically subtracted from the postoperative refraction, and the induced refractive changes were statistically analyzed. Vector analysis was used to examine the magnitude of the toric change. The proportion of clinically significant refractive change was evaluated as well.Results. Thirty-one eyes from 22 subjects met the criteria and were included in the final analysis. A significant postoperative refractive change of the spherical equivalent towards myopia and a change of the astigmatism in the with-the-rule direction were observed. In a subset of 9 cases a third cycloplegic refraction measurement demonstrated stable refraction compared to the 1-month postoperative measurement. In 10 cases of single eye surgery, significant refractive changes were observed only in the operated side when compared to the sound eye. The induced surgical refractive change was of clinical significance (≥0.5 D) in 11 eyes of 9 patients (40.9% of patients).Conclusions. Refractive changes are a significant side effect of horizontal strabismus corrective surgery among adults. Therefore, patients should be informed about it prior to surgery and should be rerefracted in the postoperative period.

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A comparison of human metapneumovirus and respiratory syncytial virus WHO-defined severe pneumonia in Moroccan children

Epidemiology and Infection ◽

10.1017/s095026881500151x ◽

2015 ◽

Vol 144 (3) ◽

pp. 516-526 ◽

Cited By ~ 11

Author(s):

I. JROUNDI ◽

C. MAHRAOUI ◽

R. BENMESSAOUD ◽

C. MORALEDA ◽

H. TLIGUI ◽

...

Keyword(s):

Respiratory Syncytial Virus ◽

Family Environment ◽

Bacterial Infections ◽

Respiratory Infections ◽

Severe Pneumonia ◽

Final Analysis ◽

Human Metapneumovirus ◽

Socioeconomic Background ◽

Moroccan Children ◽

Syncytial Virus

SUMMARYAcute respiratory infections remain the principal cause of morbidity and mortality in Moroccan children. Besides bacterial infections, respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are prominent among other viruses due to their high prevalence and association with severe clinical episodes. We aimed to describe and compare RSV- and hMPV-associated cases of WHO-defined severe pneumonia in a paediatric population admitted to Morocco's reference hospital. Children aged 2–59 months admitted to the Hôpital d'Enfants de Rabat, Morocco meeting WHO-defined severe pneumonia criteria were recruited during 14 months and thoroughly investigated to ascertain a definitive diagnosis. Viral prevalence of RSV, hMPV and other viruses causing respiratory symptoms was investigated in nasopharyngeal aspirate samples through the use of molecular methods. Of the 683 children recruited and included in the final analysis, 61/683 (8·9%) and 124/683 (18·2%) were infected with hMPV and RSV, respectively. Besides a borderline significant tendency for higher age in hMPV cases, patients infected with either of the viruses behaved similarly in terms of demographics, patient history, past morbidity and comorbidity, vaccination history, socioeconomic background and family environment. Clinical presentation on arrival was also similar for both viruses, but hMPV cases were associated with more severity than RSV cases, had a higher risk of intensive care need, and received antibiotic treatment more frequently. RSV and hMPV are common and potentially life-threatening causes of WHO-defined pneumonia in Moroccan children. Both viruses show indistinctive clinical symptomatology, but in Moroccan children, hMPV was associated with a more severe evolution.

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Experience of using home-based fortified diet in rehabilitation of malnourished children at Indus Hospital, Karachi, Pakistan: an institution based retrospective chart review study

BMC Nutrition ◽

10.1186/s40795-021-00455-x ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Saba Shahid ◽

Marvi Mahesar ◽

Anum Rahim ◽

Yumna Sadiq

Keyword(s):

Weight Gain ◽

Chart Review ◽

Real Life ◽

Retrospective Chart Review ◽

Final Analysis ◽

Average Weight ◽

Nutrition Survey ◽

Community Based ◽

Malnourished Children ◽

Therapeutic Food

Abstract Background Globally, it is estimated that 50 million children under five are wasted. National nutrition survey-2018 has shown that 23.3 and 45.5% of children are wasted and stunted in Pakistan. Many studies have shown that hospital-based management of malnutrition is not practical due to high cost and iatrogenic infections and currently WHO recommends community-based management of malnutrition with provision of therapeutic food. There is limited evidence of community rehabilitation of malnourished children by using home fortified diet in Pakistan. This study explores use of energy dense, home fortified diet in achieving weight gain of malnourished children in Karachi. Methods A descriptive, retrospective chart review of pediatric patients (aged 6 month–5 years) seen in Indus Hospital between January 2017 to June 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about demographic characteristics, feeding, anthropometric, micronutrient, and nutritional details at enrollment and on follow-up. Results A total of 361 patients were included in the final analysis. The median age (IQR) of children was 15 (14) months. Forty eight percent (n = 172) children had diarrhea and 54% (n = 195) children had respiratory tract infection. The median length of stay in the program was 28 days. The median (IQR) for average weight gain was 4.8 (0–10.3) g/Kg/day, 64.6% (n = 226) children defaulted, 29% (n = 102) were cured and 3% (n = 10) died. Conclusion This study showed adequate weight gain and recovery in malnourished children by using home fortified diet in real life situations without using therapeutic food or monetary support. Home fortified diets may serve as effective strategy in community-based rehabilitation of malnourished children.

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