Concussion Subtyping in Patients With Persistent Post-Concussive Symptoms Using a New Concussion Clinical Profile Screen Tool (CP Screen)

Neurology ◽  
2021 ◽  
Vol 98 (1 Supplement 1) ◽  
pp. S11.1-S11
Author(s):  
Monica Pita ◽  
Luke Muratalla Maes ◽  
Andrew Ortiz ◽  
Saikaashyap Sarva ◽  
Mohammad Mortazavi
Keyword(s):  
Symptom Score ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Pediatric Age ◽  
Screen Tool ◽  
Cognitive Fatigue ◽  
Outcome Scores ◽  
Symptom Scores ◽  
Clinical Profiles ◽  
Age Range

ObjectiveTo identify the prevalence of subtypes in Persistent Post Concussion Symptoms (PPCS) and investigate their potential relationships.BackgroundThe CP-Screen is designed to evaluate 5 clinical profiles and 2 modifiers that are predominant within concussion patients. The CP screen includes 29 items that are expressed as weighted outcome scores for each of the 7 concussion subtypes.Design/MethodsThis was a retrospective-chart review of 1,136 visits for 362 patients with PPCS at a concussion center. Age range was 12–81 and average age was 32, 65.7% were female and 34.3% male. 360 visits were in the 12–21 pediatric age range. Each patient completed an electronic CP-Screen prior to each visit, which was uploaded to the EHR. All patients were seen between October 2020 and April 2021.ResultsOverall, the most common subtypes were cognitive (34.0%), neck (17.8%), and mood (16.8%). The highest overall observed subtype average CP symptom score was mood (32.8/89) and the lowest was visual (23.6/89). For pediatric the most common phenotypes were cognitive (36.7%), mood (17.9%), and visual (15.4%). The highest observed pediatric average CP symptom score was mood (30.8/89) and the lowest was sleep (20.1/89). For those with cognitive primary profile, neck and ocular were the most common secondary and tertiary profiles in both groups. Females presented with cognitive, mood, neck as their most common profiles compared to cognitive, neck, ocular in males in both groups. Neck, mood, and visual primary profiles all presented with cognitive fatigue as their secondary profile.ConclusionsCP screen was overall a useful tool in helping identify clinical profiles in PPCS. Cognitive fatigue was a predominant profile in PPCS across all ages and sexes. Those with predominant mood profiles presented with the highest symptom scores. Mood profile was more predominant in females. Cognitive primary profile was found to be most linked to cervical, mood, and visual profiles.

Reduction in High-Frequency Hearing Aid Gain Can Improve Performance in Patients With Contralateral Cochlear Implant: A Pilot Study

2015 ◽  
Vol 24 (4) ◽  
pp. 462-468 ◽  
Author(s):  
Jessica J. Messersmith ◽  
Lindsey E. Jorgensen ◽  
Jessica A. Hagg
Keyword(s):  
Speech Perception ◽  
Cochlear Implant ◽  
Chart Review ◽  
Hearing Aid ◽  
Retrospective Chart Review ◽  
Improve Performance ◽  
Bimodal Condition ◽  
Overall Performance ◽  
Age Range ◽  
Clinic Population

Purpose The purpose of this study was to determine whether an alternate fitting strategy, specifically adjustment to gains in a hearing aid (HA), would improve performance in patients who experienced poorer performance in the bimodal condition when the HA was fit to traditional targets. Method This study was a retrospective chart review from a local clinic population seen during a 6-month period. Participants included 6 users of bimodal stimulation. Two performed poorer in the cochlear implant (CI) + HA condition than in the CI-only condition. One individual performed higher in the bimodal condition, but the overall performance was low. Three age range–matched users whose performance increased when the HA was used in conjunction with a CI were also included. The HA gain was reduced beyond 2000 Hz. Speech perception scores were obtained pre- and postmodification to the HA fitting. Results All listeners whose HA was programmed using the modified approach demonstrated improved speech perception scores with the modified HA fit in the bimodal condition when compared with the traditional HA fit in the bimodal condition. Conclusion Modifications to gains above 2000 Hz in the HA may improve performance for bimodal listeners who perform more poorly in the bimodal condition when the HA is fit to traditional targets.

scholarly journals A Retrospective Analysis of Patients with Short Stature in the South of China between 2007 and 2015

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Su Wu ◽  
Qian-qi Liu ◽  
Wei Gu ◽  
Shi-ning Ni ◽  
Xing Shi ◽  
...  
Keyword(s):  
Short Stature ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
The South ◽  
Treatment Needs ◽  
Normal Height ◽  
Poor Growth ◽  
Number Of Patients ◽  
Medical University ◽  
Age Range

Objective. To describe the demographic features of children with short stature and poor growth in the south of China and provide better guidance on clinical strategy and decisions. Study Design. This retrospective, chart review study analyzed children with short stature and poor growth admitted to the Department of Endocrinology of Children’s Hospital of Nanjing Medical University from Jan 2007 to Dec 2015. Results. The chart review yielded 4142 patients, including 2546 boys and 1596 girls (P < 0.001); the number of patients gradually increased per year from 2007 to 2015. There was an upward trend in the average levels of height standard deviations (SDs) during the study period (P < 0.001), both in males (P < 0.001) and females (P < 0.001). Mean height SDs were smaller in females (-2.42±1.09) than males (-2.33±1.03; P = 0.01). The percentage of females admitted at normal height (33.83%) was lower than that of males (37.20%; P = 0.028). The peak age range of hospitalization in males was 10–12 years of age, while females were generally admitted earlier—8–10 years. Conclusions. There was an increasing tendency to focus on children’s height. Parents and pediatricians were recommended to pay more attention to the treatment needs of girls while avoiding excessive treatment of those who merely appear not to be tall enough without a clear medical issue related to growth, especially for boys.

CARPAL TUNNEL RELEASE USING THE RADIAL SIDED APPROACH COMPARED WITH THE TWO-INCISION APPROACH

Hand Surgery ◽  
2014 ◽  
Vol 19 (03) ◽  
pp. 375-380 ◽  
Author(s):  
Henry Calleja ◽  
Tsu-Min Tsai ◽  
Christina Kaufman
Keyword(s):  
Grip Strength ◽  
Carpal Tunnel ◽  
Functional Outcomes ◽  
Statistical Difference ◽  
Chart Review ◽  
Carpal Tunnel Release ◽  
Symptom Relief ◽  
Retrospective Chart Review ◽  
Outcome Scores ◽  
Increased Strength

We compared carpal tunnel release using a radial sided approach (RCTR) with a two-incision approach with regards to complications, grip strength, and functional outcomes. Retrospective chart review was done and data was collected pre-operatively, and post-operatively at six weeks and three months. A total of 32 and 26 patients were included in the two-incision and RCTR groups respectively. At six weeks, the RCTR group showed an increased grip strength (+32.24%) while the two-incision group was weaker (-6.75%). Both groups showed an increased strength at three months, RCTR at 98.4% while the two-incision group was significantly lower at 38.6% increase. Both techniques provided improvement in outcome scores, with no statistical difference. RCTR was associated with a significantly earlier return of grip strength and had better grip strength at six weeks and three months post-operatively. Both techniques provided symptom relief and good functional outcome.

scholarly journals Referral pathways between the mental health services and Jigsaw

2018 ◽  
Vol 36 (3) ◽  
pp. 195-199
Author(s):  
E. Beatty ◽  
R. Keogh ◽  
D. Cohen ◽  
G. McDonald ◽  
C. McDonald ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Mental Health Difficulties ◽  
Self Harm ◽  
Clinical Profiles ◽  
Similarities And Differences

ObjectivesTo examine similarities and differences in the demographic and clinical profiles of young people (15–25 years of age) referred between the mental health services (MHS) and Jigsaw Galway.MethodsA retrospective chart review was conducted of clinical files of individuals attending secondary MHS who had been referred to or from Jigsaw Galway over a 5-year period. Differences in demographic and clinical data between individuals referred to or from Jigsaw Galway were compared.ResultsA recent act of self-harm was more prevalent in individuals referred from Jigsaw to the adult MHS (p=0.02). No other demographic or clinical differences were detected between individuals attending Jigsaw Galway and the MHS.ConclusionsEducation sessions for clinical staff working in primary care, Jigsaw Galway and the MHS are suggested to support clinicians in choosing the best referral pathway, which may more optimally address young people’s mental health difficulties.

scholarly journals Absconding During Inpatient Care from a Tertiary Psychiatric Hospital: A Comparative Study

2020 ◽  
Vol 42 (5) ◽  
pp. 456-463
Author(s):  
Dileep Kumar Verma ◽  
Sourav Khanra ◽  
Nishant Goyal ◽  
Basudeb Das ◽  
Christoday Raja Jayant Khess ◽  
...  
Keyword(s):  
Psychiatric Hospital ◽  
Health Care Professionals ◽  
Chart Review ◽  
Matched Control ◽  
Psychiatric Hospitals ◽  
Retrospective Chart Review ◽  
Admission Ward ◽  
Younger Age ◽  
History Of ◽  
Clinical Profiles

Background: Absconding from psychiatric hospitals is of great concern for patients and caregivers. Absconding affects not only the treatment and safety of these patients but also patient’s caregivers and the community. Further investigation is needed to examine the pattern of this event and the characteristics of patients who abscond. Hence, our study was aimed to examine the sociodemographic and clinical profiles of inpatients who absconded from a psychiatric hospital in five years and to compare them with matched controls. Methods: A retrospective chart review of inpatients who absconded and matched control inpatients during the specified period of five years from January 2014 to December 2018 was done at a psychiatric hospital. Each control was matched with a corresponding absconding case on the following order: (a) admission ward, (b) admission period, (c) diagnosis, and (d) age. Results: Among 20,052 adult admissions during the specified period, 38 patients absconded, with a rate of 1.8 per 1,000 admissions. Most of them were male, from a younger age group, diagnosed with schizophrenia or mood disorder, and having comorbid substance use disorder, irritable affect, impaired judgment, and absent insight. Most of the events occurred within the first two weeks of admission. About 11% of them had a history of prior absconding from the hospital. Conclusion: Knowledge about the associated sociodemographic and clinical profile would help clinicians and mental health care professionals to prevent absconding. Further risk assessment using a patient’s profile would help to reduce absconding events from psychiatric hospitals in the future.

scholarly journals Baseline concussion symptom score differences comparing collision, contact, and noncontact sports and comparison of between sexes

Neurology ◽  
2018 ◽  
Vol 91 (23 Supplement 1) ◽  
pp. S12.2-S12
Author(s):  
Sas Andrew ◽  
Foug Katherine ◽  
Gillenkirk Aleah ◽  
Popovich Michael ◽  
Almedia Andrea ◽  
...  
Keyword(s):  
Symptom Score ◽  
Chart Review ◽  
Female Athletes ◽  
Age Groups ◽  
Retrospective Chart Review ◽  
Symptom Reporting ◽  
Male Athletes ◽  
Post Concussion Syndrome ◽  
History Of ◽  
Physical Traits

ObjectiveTo determine if baseline concussion symptoms scores in athletes prior to the start of their season vary by sport or sex.BackgroundConcussion is a clinical diagnosis that includes an appropriate clinical scenario, reporting of symptoms through a post concussion symptom score list, and an objective neurologic exam. Symptom reporting is considered when determining if an athlete has recovered from their concussion. Recent studies have shown that athletes at baseline can report symptoms at a rate high enough to meet criteria for post concussion syndrome without any history of concussion. The number of symptoms reported was found to be higher in female athletes than male athletes, but to date there has not been a clear consideration of how these symptoms compare across different sports played.MethodsRetrospective chart review of baseline pre-participation sport exams from 2016. More than 2000 charts were reviewed for age, sex, sport played, number of past concussions. Baseline concussion symptom checklist scores were reviewed for number of symptoms reported and severity of symptoms reported. Comparisons were made between groups comparing age, sex, sport played, and number of previous concussions prior to the start of this season.ResultsFemale athletes in all sports compared reported more baseline symptoms and more severe symptoms compared to their male counterparts. Athletes of the same sex, male or female who participated in collision or contact sports reported less baseline symptoms than athletes who participated in noncontact sports.ConclusionContact and collision sport athletes report at baseline less concussion checklist symptoms than noncontact sport athletes in all age groups compared. This leads to many questions about why certain athlete populations report less symptoms. Symptom reporting could be due to underlying physical traits in different sports, or player psychology differences between sports.

Screening for Pharyngeal Gonorrhea in the Urban Teenager

PEDIATRICS ◽  
1982 ◽  
Vol 70 (4) ◽  
pp. 620-623
Author(s):  
Mariam R. Chacko ◽  
Sheridan Phillips ◽  
Marc S. Jacobson
Keyword(s):  
Chart Review ◽  
Transmitted Disease ◽  
Retrospective Chart Review ◽  
Self Report ◽  
Sexual Practice ◽  
Sexually Transmitted ◽  
History Of ◽  
Study Population ◽  
Adolescent Clinic ◽  
Age Range

A retrospective chart review assessed the occurrence of pharyngeal gonorrhea among 546 teenagers who attended a general adolescent clinic and were cultured for gonorrhea; they had been routinely cultured at three sites (cervix/urethra, rectum, and pharynx) regardless of their history of sexual practice. No record of specific sexual practice was available. This population was predominantly urban, black, and female; the age range was 11 to 22 years (mean = 16.5). The overall occurrence of gonorrhea was 14.7% (80/546). Pharyngeal gonorrhea was detected in 2.7% of the study population, representing 12 females and three males. Of the 80 patients with gonorrhea, 15% had only pharyngeal gonorrhea. History was available for 13/15 patients: none had pharyngeal symptoms. Approximately half were detected by routine screening at a family planning visit; the remainder had complaints related to sexually transmitted disease. The occurrence of pharyngeal gonorrhea is sufficiently high to merit study of the indications for pharyngeal culture of teenaged patients. Given the potential for disseminated infection and absence of information regarding the reliability of self-report, it currently appears appropriate to culture adolescents routinely for pharyngeal gonorrhea, regardless of stated sexual practice, whenever genital cultures are collected.

scholarly journals A rare cause of tonsil mass in a child: Lymphoid polyp

2017 ◽  
Vol 5 ◽  
pp. 2050313X1668883
Author(s):  
Hongzhao Ji ◽  
Seckin O Ulualp ◽  
Anita Sengupta
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Final Diagnosis ◽  
Palatine Tonsil ◽  
Age Group ◽  
Pediatric Age ◽  
Acute Tonsillitis ◽  
Palatine Tonsils ◽  
Pediatric Age Group ◽  
Mass Lesions

Objective: Solitary mass lesions of the palatine tonsils are rare in children. While a tonsillar mass can be concerning for a neoplasm, benign conditions may present with a mass arising from the surface of the palatine tonsils in children. We describe clinical and histopathological characteristics of a lymphoid polyp in a child with unilateral tonsillar mass. Methods: Retrospective chart review. Results: A 6-year-old girl presented for evaluation of recurrent acute tonsillitis and a mass on the left palatine tonsil. A pedunculated mass with the base attached to the left palatine tonsil was observed. The mass was completely removed by tonsillectomy. The final diagnosis was lymphoid polyp. Conclusion: Pediatricians, otolaryngologists, and pathologists should be aware of the occurrence of tonsillar lymphoid polyp in the pediatric age group.

Comparative analysis of CT-scan and PET-scan with intraoperative ultrasound (IOUS) in detecting liver metastases

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 3632-3632
Author(s):  
M. Patel ◽  
S. Saha ◽  
R. Sehgal ◽  
L. Gallardo ◽  
K. Doan ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Liver Metastases ◽  
Ct Scan ◽  
Chart Review ◽  
Intraoperative Ultrasound ◽  
Imaging Study ◽  
Retrospective Chart Review ◽  
Pet Scan ◽  
Imaging Data ◽  
Age Range

3632 Background: Open, laparoscopic or percutaneous radiofrequency ablation (RFA) has been used for the surgical treatment of liver metastases (mets). However, it requires accurate preoperative (preop) localization of liver mets. CT scan and PET scan have been widely used for such preop evaluation. However, intraoperative ultrasound (IOUS) remains the gold standard. Very little data is available comparing IOUS with preop CT and/or PET scan. Thus, a retrospective study was done to compare the efficacy of IOUS with preop CT and/or PET scan in detecting the number of liver mets. Methods: A retrospective chart review was done that included all patients (pts) who underwent surgical treatment for liver mets. Data was obtained from medical records, radiology, intraop reports. Results: 53 pts including 57% men and 43% women with a median age of 62years (age range 35–80 years) were included in the study. Imaging data was available for CT, PET and IOUS in 53, 24 and 39 pts respectively. CT, PET, and IOUS detected 2.4, 1.7 and 2.6 lesions/ pt respectively. In 24 patients, both CT and PET scan report was available. Of these, the imaging study detecting the maximum number of lesions was selected for comparison of preop evaluation with IOUS. A comparison between preop imaging (CT/PET scan) vs. IOUS in these 24 pts revealed an average of 2.3 vs. 2.8 lesions/pt respectively ( Table ). When compared with preop imaging (CT/PET scan), IOUS detected additional lesions in 33% pts; fewer lesions in 17% pts and similar number of lesions in 50% pts. Comparison between CT and IOUS in 39 patients revealed 1.9 vs. 2.6 lesions/pt respectively and that between PET and IOUS in 24 patients revealed 1.7 vs. 2.8 lesions/pt respectively. Conclusions: Although CT scan and PET scan remains effective modalities for preop evaluation of liver mets, IOUS is found to be superior for planning accurate surgical treatment. Thus, the efficacy of percutaneous RFA may be limited due to inability to perform IOUS. [Table: see text] No significant financial relationships to disclose.

A Study of Speech, Language, Hearing, and Dentition in Children with Cleft Lip Only

2008 ◽  
Vol 45 (5) ◽  
pp. 485-494 ◽  
Author(s):  
Linda D. Vallino ◽  
Ronald Zuker ◽  
Joseph A. Napoli
Keyword(s):  
Language Impairment ◽  
Cleft Lip ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Initial Diagnosis ◽  
Supernumerary Tooth ◽  
Speech And Language Impairment ◽  
Submucous Cleft Palate ◽  
Age Range ◽  
Ear Effusion

Objective: To examine the prevalence of speech, language, hearing, and dental problems in children with an initial diagnosis of isolated cleft lip only (CL), for which evidence-based practice can be developed. Design: Retrospective chart review of 95 patients with cleft lip (age range, 2.8 to 3.7 years; mean, 3.1 years). Results: Speech and language impairment was documented in 13% and 18% of the patients, respectively. Thirty-three percent of the children presented with middle ear effusion. Thirteen percent had abnormal hearing. With one exception, the type and degree of hearing loss was a mild conductive loss most often attributed to the presence of effusion. Dental and/or occlusal anomalies were documented in 62% of the patients. A supernumerary tooth was the most frequently occurring dental anomaly and crossbite the most frequently occurring occlusal anomaly. Two children had a submucous cleft palate. Resonance was abnormal in 5% of the children. Conclusion: Children with an initial diagnosis of CL need to be monitored by the interdisciplinary team for speech, language, ear disease, hearing, and dentition beginning in infancy and followed until all management needs are met.

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