scholarly journals Mortality among involuntary inpatients of psychiatric hospital

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Iuliu Fulga ◽  
Anca-Iulia Neagu ◽  
Marius Neagu ◽  
Ana Fulga
Keyword(s):  
Psychiatric Patients ◽  
Psychiatric Hospitals ◽  
Medical Documentation ◽  
Upper Respiratory Tract ◽  
Cardiotoxic Effect ◽  
Autopsy Data ◽  
Upper Respiratory ◽  
Death Cases ◽  
Annual Mortality

Abstract Background Mortality is often used as an indicator of public health efforts. Even if mortality in psychiatric hospitals decreased since the introduction of modern treatment, the death toll is still high. The authors have analyzed the forensic autopsy data and the medical documentation regarding 115 death cases from psychiatric hospitals in south-eastern Romania during the period of 2000–2020. Results The average annual mortality rate was 5.13‰, the necropsy data corroborated with those from the medical documentary material indicates acute myocardial infarction as the dominant cause, with 65 (56.5%) cases, followed by upper respiratory tract occlusion with 23 cases (20%) and pulmonary thromboembolism in 4 cases (12.2%). Furthermore, in 6 cases (5.2%) the cause of death was traumatic: 4 cases of cranio-cerebral trauma and 2 cases of hanging. Conclusions In the mortality structure of psychiatric patients, cardiac death predominated, being influenced by the cardiotoxic effect of medication administered for the specific pathology; hence, an early involvement of cardiologists in the follow-up of patients and the finding of treatment schemes with a reduced cardiotoxic effect are required.

Effects of procalcitonin testing on antibiotic use and clinical outcomes in patients with upper respiratory tract infections. An individual patient data meta-analysis

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Jonas Odermatt ◽  
Natalie Friedli ◽  
Alexander Kutz ◽  
Matthias Briel ◽  
Heiner C. Bucher ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Therapy ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Antibiotic Exposure ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Restricted Activity ◽  
Tract Infections

AbstractBackground:Several trials found procalcitonin (PCT) helpful for guiding antibiotic treatment in patients with lower respiratory tract infections and sepsis. We aimed to perform an individual patient data meta-analysis on the effects of PCT guided antibiotic therapy in upper respiratory tract infections (URTI).Methods:A comprehensive search of the literature was conducted using PubMed (MEDLINE) and Cochrane Library to identify relevant studies published until September 2016. We reanalysed individual data of adult URTI patients with a clinical diagnosis of URTI. Data of two trials were used based on PRISMA-IPD guidelines. Safety outcomes were (1) treatment failure defined as death, hospitalization, ARI-specific complications, recurrent or worsening infection at 28 days follow-up; and (2) restricted activity within a 14-day follow-up. Secondary endpoints were initiation of antibiotic therapy, and total days of antibiotic exposure.Results:In total, 644 patients with a follow up of 28 days had a final diagnosis of URTI and were thus included in this analysis. There was no difference in treatment failure (33.1% vs. 34.0%, OR 1.0, 95% CI 0.7–1.4; p=0.896) and days with restricted activity between groups (8.0 vs. 8.0 days, regression coefficient 0.2 (95% CI –0.4 to 0.9), p=0.465). However, PCT guided antibiotic therapy resulted in lower antibiotic prescription (17.8% vs. 51.0%, OR 0.2, 95% CI 0.1–0.3; p<0.001) and in a 2.4 day (95% CI –2.9 to –1.9; p<0.001) shorter antibiotic exposure compared to control patients.Conclusions:PCT guided antibiotic therapy in the primary care setting was associated with reduced antibiotic exposure in URTI patients without compromising outcomes.

scholarly journals Perioperative Respiratory Adverse Events in General Anesthesia Among Pediatric Surgical Patients in Comprehensive Specialized Hospitals in Northwest Ethiopia, 2020; A Cross-Sectional Follow-Up

2021 ◽  
Author(s):  
Yophtahe Woldegerima ◽  
Desalegn Muche ◽  
Wubie Birlie ◽  
Habtu Adane ◽  
Misganaw Mengie
Keyword(s):  
Adverse Events ◽  
Respiratory Tract Infections ◽  
Northwest Ethiopia ◽  
Surgical Patients ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Cross Sectional ◽  
Upper Respiratory ◽  
Tract Infections

Abstract Introduction: Perioperative respiratory adverse events (PRAEs) are the most frequent complications in pediatrics which frequently result in morbidity and mortality. They are accountable for 75% of perioperative critical incidents and 33% of cardiac arrests. The occurrence and severity of PRAEs depends on the natures of surgery, anesthesia & patient’s status.Objective: To assess the incidence and factors associated with PRAEs in general anesthesia among pediatric surgical patients at the University of Gondar and Tibebe-Ghion Comprehensive Hospital and Specialized Hospitals, Northwest Ethiopia, 2020.Methods: After obtaining the ethical approval, a hospital-based prospective cross-sectional follow-up study was conducted among pediatric surgical patients who underwent variety of surgical operations. A total of 225 patients were included. The associations between independent variables and the outcome variables were determined at 95% CI with the Chi-squared test, Fisher–exact test, bivariate, and multivariate logistic regression. Hosmer-Lemeshow test was used to assess the goodness of fit. Variables with a p-value < 0.05 were considered significant.Results: The incidence of PRAEs among 210 (93.3% response rate) pediatrics surgical patients was 26.2% (95% CI: 20.5, 30.9). A total of 129 episodes of PRAEs were observed. Most of the adverse events (89 (69.0%)) were occurred postoperatively. Desaturation was found to be the predominant adverse event which was occurred 61 (47.3%) times. Age < 1 year (AOR: 3.6, 95% CI: 1.3, 10.0), ASA ≥ 3 (AOR: 5.2, 95% CI: 1.9, 22.9), upper respiratory tract infections (AOR: 7.6, 95% CI: 1.9, 30.2), presence of secretions in the upper airway (AOR: 4.8, 95% CI: 1.4, 15.9) and airway related procedures (AOR: 6.0, 95% CI: 1.5, 24.1) were significantly associated PRAEs.Conclusions: The incidence of PRAEs among pediatric surgical patients was relatively high (26.2%). Especially, the postoperative phase is the most critical time for the occurrence of PRAEs and desaturation was the predominant adverse event. Age less than a year, presence of upper respiratory tract infections, presence of secretions in the upper airways, ASA ≥ 3 and airway related procedures were associated with PRAEs. Clinicians should carry out effective risk assessment, optimization and adequate preparation for the management of perioperative respiratory adverse events.

scholarly journals Guttural pouch mycosis in a donkey (Equus asinus): a case report

2010 ◽  
Vol 55 (No. 11) ◽  
pp. 561-565 ◽  
Author(s):  
F. Laus ◽  
E. Paggi ◽  
M. Cerquetella ◽  
D. Spaziante ◽  
A. Spaterna ◽  
...  
Keyword(s):  
Clinical Presentation ◽  
Present Report ◽  
Topical Therapy ◽  
Clinical Feature ◽  
Upper Respiratory Tract ◽  
Equus Asinus ◽  
Upper Respiratory ◽  
Physiological Peculiarity ◽  
Main Distinguishing Feature

Guttural pouch mycosis is an emergency disease of the upper respiratory tract in equine species. In the present report a case of guttural pouch mycosis in a female, seven year-old pregnant donkey is described. A serious dyspnea which necessitated tracheotomy and preceding epistaxis was the most important clinical feature of guttural pouch mycosis in the donkey. A full and rapid effectiveness of the topical therapy, the protocol for which is described, is the main distinguishing feature with regard to treatment. In the Authors' knowledge a detailed description of clinical features, treatment and follow up of guttural pouch mycosis in a donkey is not available in the scientific literature. The anatomical and physiological peculiarity of donkeys could explain some of the differences with horses in clinical presentation and therapeutic management.

Effects of individually chosen homoeopathic medicines on recurrent URTI in children

1996 ◽  
Vol 85 (01) ◽  
pp. 4-14
Author(s):  
J. Blommers ◽  
D.J. Kuik ◽  
L. Feenstra ◽  
P.D. Bezemer ◽  
E.S.M. De Lange-De Klerk
Keyword(s):  
Clinical Trial ◽  
University Hospital ◽  
Controlled Clinical Trial ◽  
Upper Respiratory Tract ◽  
Eligibility Criteria ◽  
Double Blind ◽  
Upper Respiratory ◽  
The University ◽  
Current Standards

AbstractThe effects of homoeopathic medicines on children suffering from recurrent upper respiratory tract infection (URTI) were studied in a randomized double-blind placebo-controlled clinical trial conducted at the paediatric outpatients department of the university hospital of the Vrije Universiteit in Amsterdam from 1987 to 1992.The study was designed to meet both the requirements of proper homoeopathic practice and the current standards of a clinical trial. The purpose of a randomized placebo-controlled double-blind trial is to identify the effects of the agents under investigation by equalizing the effects of other factors that may influence outcome.The object of the trial, eligibility criteria, follow-up period, treatments and concurrent interventions, data collection and effect measures are discussed in the light of homoeopathic thinking.

scholarly journals Two-Month Follow-up of Persons with SARS-CoV-2 Infection: Zambia, September 2020

2021 ◽  
Author(s):  
James Exnobert Zulu ◽  
Dabwitso Banda ◽  
Jonas Z Hines ◽  
Musisye Luchembe ◽  
Suilanji Sivile ◽  
...  
Keyword(s):  
Symptom Duration ◽  
Upper Respiratory Tract ◽  
Chi Square ◽  
Duration Of Symptoms ◽  
Prevalence Studies ◽  
Persistent Symptoms ◽  
Contact Information ◽  
Upper Respiratory ◽  
Structured Questionnaire

Background COVID-19 is often characterized by an acute upper respiratory tract infection. However, information on longer-term clinical sequelae following acute COVID-19 is emerging. We followed a group of persons with COVID-19 in Zambia at two months to assess persistent symptoms. Methods In September 2020, we re-contacted participants from SARS-CoV-2 prevalence studies conducted in Zambia in July 2020 whose PCR tests were positive. Participants with valid contact information were interviewed using a structured questionnaire that captured demographics, pre-existing conditions, and types and duration of symptoms. We describe the frequency and duration of reported symptoms and used chi-square tests to explore variability of symptoms by age group, gender, and underlying conditions. Results Of 302 participants, 155 (51%) reported one or more acute COVID-19-related symptoms in July 2020. Cough (50%), rhinorrhoea (36%) and headache (34%) were the most frequently reported symptoms proximal to diagnosis. The median symptom duration was 7 days (IQR: 3-9 days). At a median follow up of 54 days (IQR: 46-59 day), 27 (17%) symptomatic participants had not yet returned to their pre-COVID-19 health status. These participants most commonly reported cough (37%), headache (26%) and chest pain (22%). Age, sex, and pre-existing health conditions were not associated with persistent symptoms. Conclusion A notable percentage of persons with SARS-CoV-2 infection in July still had symptoms nearly two months after their diagnosis. Zambia is implementing post-acute COVID-19 clinics to care for patients with prolonged symptoms of COVID-19, to address their needs and better understand how the disease will impact the population over time.

Malignant sinonasal tumors in Stockholm, 2000-2005.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e17001-e17001
Author(s):  
Mattias Jangard
Keyword(s):  
Malignant Melanoma ◽  
Squamous Cell ◽  
Cell Cancer ◽  
Undifferentiated Carcinoma ◽  
Treatment Modalities ◽  
Upper Respiratory Tract ◽  
Malignant Tumours ◽  
The Mean ◽  
Upper Respiratory

e17001 Background: Between2000-2005 58 patients developed malignant sinonasal tumours in the region of Stockholm that consist of 2.5 million people. Sinonasal malignant tumours are uncommon and account for approximately 3% to 5% of all upper respiratory tract malignancies and 0.2% of all malignancies. Because these tumours are rare and the treatment varies internationally and also in different parts of Sweden; our aim was to follow up these patients to get a better picture of this group and also find out which treatment modalities that had the best outcome. Methods: All the patients have been identified through a database that register all new malignant head and neck tumours in Stockholm. We identified the patients from 2000-2005 and studied all the medical charts for the patients. Results: 10-15 patients develop malignant sinonasal tumour per year in the region of Stockholm. The mean age at diagnosis was 67 year (21-95 year). The distribution between men and women where equal. We found that 50 % was squamous cell carcinoma, 20% was malignant melanoma, 10 % adenocarcinoma, 10 % SNUC (Sino Nasal Undifferentiated Carcinoma) and 10 % other tumours. The 3-year survival was 50 % between 2000-2005. The prognosis varies between differnet tumour types. Squamous cell cancer and adenocarcinoma has a better prognosis than malignant melanoma and SNUC. Conclusions: This study brings light to the distribution of the different tumour types and also we found that malignant melanoma has a tendency to increase if you compare to a study from Sweden 2003. We were not able to analyse which treatment modality to prefer in this study due to short follow up and a small material.

Alterations In Immunity After Total vs Partial Tonsillectomy

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P104-P104
Author(s):  
Mohamed A Bitar ◽  
Charbel E Rameh ◽  
Nour Ataya ◽  
Alik Najarian ◽  
Marita Chakhtoura ◽  
...  
Keyword(s):  
Secretory Iga ◽  
Immunoglobulin Level ◽  
Upper Respiratory Tract ◽  
Palatine Tonsils ◽  
History Of ◽  
Upper Respiratory ◽  
Secondary Lymphoid Organs ◽  
Immunoglobulin Levels ◽  
Partial Tonsillectomy

Problem Palatine tonsils are secondary lymphoid organs active in sampling antigens entering the upper respiratory tract and in producing immunoglobulin (Ig) both locally and distally through migrating tonsillar B cells. Their size has been found to be directly proportional to the number of B and T cells. The aim of this study is to compare the change in serum and saliva Ig levels after total and partial tonsillectomy. Methods Children with obstructive tonsils and/or adenoid undergoing total or partial tonsillectomy were recruited in a pilot study. Patients with history of recurrent infections or immunodeficiency were excluded. Blood and saliva samples were obtained immediately preoperatively and at the 1st follow-up visit. Serum Ig's (G,M&A) concentrations were determined using radial immunodiffusion. Saliva secretory IgA was measured using an Enzyme Immuoassay (EIA). Results Twenty five patients (13 partial and 12 total) were included. There were no statistically significant changes in serum Ig's levels after total or partial tonsillectomy, except for IgM which increased (1.317 to 1.632 g/L) after partial tonsillectomy, more significantly in males, in those aged 5 years and older, and when the postoperative samples were taken within a 2 month-period. Moreover, there was statistically non-significant decrease in secretory IgA level after both total and partial tonsillectomy. Conclusion The effect of partial or total tonsillectomy on immunoglobulin level seems reassuring. The increase in IgM and the non-significant decrease in SIgA may represent a kind of immunological readjustment after tonsillar surgery. Significance This is the first study (to our knowledge) that compares the changes in immunoglobulin levels (in serum & saliva) after partial vs. total tonsillectomy. The obtained results are preliminary and are reassuring to the parents and physicians who have concerns regarding the immunological sequalae of tonsillectomy in children. A longer follow up will be done in a larger future study. Support This study was supported by Medtronic.

scholarly journals Nasal fibrosis: long-term follow up of four cases of eosinophilic angiocentric fibrosis

2005 ◽  
Vol 119 (2) ◽  
pp. 119-124 ◽  
Author(s):  
Santdeep Paun ◽  
Valerie J Lund ◽  
Andrew Gallimore
Keyword(s):  
Soft Tissues ◽  
Disease Process ◽  
Upper Respiratory Tract ◽  
Comprehensive Review ◽  
Long Term Follow Up ◽  
Upper Respiratory ◽  
Facial Soft Tissues ◽  
Eosinophilic Angiocentric Fibrosis

Eosinophilic angiocentric fibrosis is a rare, benign cause of submucosal thickening and fibrosis within the upper respiratory tract. It predominantly affects the nose although cases have been reported in the subglottis. We describe four cases of the disease centred around the nasal cavity, with widespread infiltration of the facial soft tissues and orbit in three of the four patients. Each underwent long term follow up. Multiple surgical resections were required with two of our patients and, to date, medical therapy has been of limited help. The disease process, with its clinical and characteristic histopathological findings, is described. We also discuss the management of the disease following a comprehensive review of, and comparison with, the few prior reported cases.

scholarly journals Outcome of upper respiratory tract infections in healthy children: Antibiotic stewardship in treatment of acute upper respiratory tract infections

2020 ◽  
Vol 36 (4) ◽  
Author(s):  
Ejaz Ahmed Khan ◽  
Mazhar Hussain Raja ◽  
Shehla Chaudhry ◽  
Tehreem Zahra ◽  
Salman Naeem ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Stewardship ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract Infections ◽  
Healthy Children ◽  
Supportive Treatment ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Objective: The objective of the study was to assess the outcome of upper respiratory tract infections (URTI) in healthy children. Methods: This descriptive study was conducted on 314 children aged 3-36 months in the paediatric outpatient clinic and emergency department with symptoms of URTI (fever, cough, rhinorrhoea) for ≤5 days. Patient’s demographics, clinical features, laboratory data and outcome were recorded. Follow up phone calls were made to parents on day 7 (response 93.6%) and day 14 (response 94.6%) to record outcome. Results: A total of 314 children with URTIs were included. Majority (57.6%) were males and <1year of age (40%). Common manifestations of URTI were fever (89%), cough (79%), rhinorrhoea (62%), pharyngitis (79%) and conjunctivitis (46%). More than half (53%) had history of contact with URTI in a family member. Mean duration of symptoms was 2.7±1.3 days. Majority (93%) of children were given supportive treatment and only 6.7% received antibiotics initially. Most of children (76%) recovered within one week and 91.8% within two weeks with supportive care only. Only 4% children were hospitalized and 12% required follow up visit of which 16% needed oral antibiotics. Complications or deaths did not occur. Conclusions: Majority of URTIs in healthy children resolved with supportive treatment and do not require antibiotics. Antibiotic stewardship in simple URTIs should be practiced using awareness and advocacy campaigns. doi: https://doi.org/10.12669/pjms.36.4.1420 How to cite this:Khan EA, Raja MH, Chaudhry S, Zahra T, Naeem S, Anwar M. Outcome of upper respiratory tract infections in healthy children: Antibiotic stewardship in treatment of acute upper respiratory tract infections. Pak J Med Sci. 2020;36(4):---------.  doi: https://doi.org/10.12669/pjms.36.4.1420 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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