scholarly journals Generalized myoclonus in COVID-19

Neurology ◽  
2020 ◽  
Vol 95 (6) ◽  
pp. e767-e772 ◽  
Author(s):  
Pablo Rábano-Suárez ◽  
Laura Bermejo-Guerrero ◽  
Antonio Méndez-Guerrero ◽  
Javier Parra-Serrano ◽  
Daniel Toledo-Alfocea ◽  
...  
Keyword(s):  
Medical Records ◽  
Startle Response ◽  
Respiratory Arrest ◽  
University Hospital ◽  
Voluntary Movements ◽  
Inflammatory Phase ◽  
Immune Mediated ◽  
The University ◽  
Order Structures ◽  
Rule Out

ObjectiveTo report 3 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) who developed generalized myoclonus.MethodsPatient data were obtained from medical records from the University Hospital “12 de Octubre,” Madrid, Spain.ResultsThree patients (2 men and 1 woman, aged 63–88 years) presented with mild hypersomnia and generalized myoclonus following the onset of the so-called inflammatory phase of coronavirus disease 2019 (COVID-19). All of them had presented previously with anosmia. Myoclonus was generalized with both positive and negative jerks, predominantly involving the facial, trapezius, sternocleidomastoid, and upper extremities muscles. These myoclonic jerks occurred spontaneously and were extremely sensitive to multisensory stimuli (auditive and tactile) or voluntary movements, with an exaggerated startle response. Other causes of myoclonus were ruled out, and none of the patients had undergone respiratory arrest or significant prolonged hypoxia. All of them improved, at least partially, with immunotherapy.ConclusionsOur 3 cases highlight the occurrence of myoclonus during the COVID-19 pandemic as a post- or para-infectious immune-mediated disorder. However, we cannot rule out that SARS-CoV-2 may spread transneuronally to first- and second-order structures connected with the olfactory bulb. Further investigation is required to clarify the full clinical spectrum of neurologic symptoms and optimal treatment.

scholarly journals Low adherence to pneumococcal vaccination in lung cancer patients in a tertiary care university hospital in Southern Germany

2021 ◽  
Author(s):  
Arno Mohr ◽  
Mia Kloos ◽  
Christian Schulz ◽  
Michael Pfeifer ◽  
Bernd Salzberger ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Medical Records ◽  
Hepatitis A ◽  
Tertiary Care ◽  
Pneumococcal Vaccination ◽  
University Hospital ◽  
Lung Cancer Patients ◽  
Tick Borne Encephalitis ◽  
The University

Abstract IntroductionThe aim of this study was to investigate the adherence to vaccinations, especially pneumococcal vaccinations, in lung cancer patients.MethodsThe study was performed at the University Hospital Regensburg, Germany. All patients with a regular appointment scheduled between December 1, 2020, and April 29, 2021, and who provided informed consent were included. Available medical records, vaccination certificates and a questionnaire were analyzed.Results136 lung cancer patients (NSCLC n = 113, 83.1%, SCLC n = 23, 16.9%) were included. A correct pneumococcal vaccination according to national recommendations was performed in 9.4% (12/127) of patients.A correct vaccination was performed for tetanus in 50.4% (6/131), diphtheria in 34.4% (44/128), poliomyelitis in 25.8% (33/128), tick-borne encephalitis in 40.7% (24/59), hepatitis A in 45.5% (7/11), hepatitis B in 38.5% (5/13), shingles in 3.0% (3/101), measles in 50.0% (3/6), pertussis in 47.7% (62/130), influenza in 54.4% (74/136) and meningococcal meningitis in 0% (0/2).ConclusionAdherence to pneumococcal vaccinations, as well as other vaccinations, is rather low in lung cancer patients.

scholarly journals COMEPA (COVID-19 Medicina Policlinico Palermo): a study in hospitalized patients

2021 ◽  
Vol 7 (3) ◽  
Author(s):  
The COMEPA group
Keyword(s):  
Internal Medicine ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Prognostic Factors ◽  
Clinical Practice ◽  
Medical Records ◽  
University Hospital ◽  
Efficacy And Safety ◽  
The Past ◽  
The University

Coronavirus disease 2019 (COVID-19) has dramatically changed our lives. In the past months, hospitals were saturated of patients; therefore, it is still important to have simple and standardized prognostic factors and to evaluate the efficacy and safety of medications commonly used for COVID-19. We aimed to collect data of the patients hospitalized in Internal Medicine and Geriatrics Wards at the University Hospital (Policlinico) ‘P. Giaccone’ in Palermo, Italy (COMEPA, COVID-19 Medicina Policlinico Palermo), with the main purpose of finding prognostic tools that can be easily used in clinical practice in order to identify patients hospitalized for/with COVID-19 at higher risk of negative outcomes, such as mortality, transfer to Intensive Care Unit (ICU) and institutionalization, as well as evaluating the efficacy/safety of medications commonly used for COVID-19. For reaching these aims, the medical records of approximately 600 patients will be recorded, having data on several parameters and including as outcomes mortality, ICU placement, institutionalization. With the COMEPA study, we therefore plan to update current literature, giving new data on prognostic factors and on the efficacy/safety of some medications used for COVID-19.

scholarly journals Procedimentos invasivos e sepse em recém-nascidos de muito baixo peso: estudo descritivo

2016 ◽  
Vol 15 (4) ◽  
pp. 704
Author(s):  
Flavia do Valle Andrade Medeiros ◽  
Valdecyr Herdy Alves ◽  
Cristina Ortiz Sobrinho Valete ◽  
Eny Dórea Paiva ◽  
Diego Pereira Rodrigues ◽  
...  
Keyword(s):  
Birth Weight ◽  
Medical Records ◽  
Neonatal Intensive Care ◽  
Secondary Data ◽  
Delivery Room ◽  
University Hospital ◽  
Central Catheter ◽  
The Mean ◽  
The University ◽  
The City

Aim:  To  identify  the  type  of  sepsis  which  affected  newborns  withvery  low  birth  weight  and  invasive  care  procedures  to  which  they were  subjected  in  a university hospital in the city of Niterói, between the years 2008 and 2012. Method: This is a retrospective descriptive study using secondary data research in the medical records of  newborns  admitted  to  the  Neonatal  Intensive  Care  Unit  of  the  University  Hospital Antônio Pedro. Results: Of the 49 infants studied, 35 were diagnosed with early sepsis, eight with early and late sepsis and six late. The mean gestational age was 30.5 weeks and  the  weight  1.176,1  kg.  The  most  frequently  performed  care procedures  were: peripheral  venipuncture  (87.8%),  central  catheter  peripheral  venipuncture  (81.6%), assistance  to  ventilation  in  the  delivery  room  (69.4%)  and  intubation  in  the  delivery room  (28.6%).  Conclusion:  It is inferred  that the  lower  birth  weight is  associated  with the higher incidence of sepsis.

scholarly journals Reconciliation of medications upon the admission of patients to the cardiology sector of a university hospital

2020 ◽  
Vol 10 (4) ◽  
pp. 0353
Author(s):  
Lorena S. Miranda ◽  
Ana L. Cavalcante ◽  
Rafael M. Pinheiro ◽  
Dayani Galato ◽  
Emília V. Silva
Keyword(s):  
Medical Records ◽  
Medication Reconciliation ◽  
Adverse Reactions ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Medical Prescription ◽  
Cross Sectional ◽  
Cardiology Department ◽  
The University

Introduction: The reconciliation of medications is an important process that impacts on patient safety during the level of care transition, a moment with high discrepancy rates that can lead to adverse reactions. Objective: To analyze the results of medication reconciliation in order to identify discrepancies between the medical prescription and the medications previously used by the patient. Method: A descriptive, cross-sectional study was conducted between May and November 2017 (until the second fortnight of the month), with patients admitted to the cardiology department of the University Hospital of Brasília. Data was collected through interviews with patients, relatives and/or caregivers, and through consultation of the medical records. The reconciliation of medications was performed daily, from Monday to Friday, within 48 hours of the patient’s admission to the unit, through a medication reconciliation form prepared by the author. Results: 90 patients were included in the study and a total of 297 discrepancies were found, 267 (90%) being intentional and 30 (10%), unintentional. Among the unintentional discrepancies, the most frequent was omission of medication in use by the patient (56%). Of the intentional discrepancies, the dosage modifications were more common in 45% of the cases. Conclusion: The reconciliation of medications was a crucial clinical service for the identification and resolution of unintentional discrepancies between previously used medications and hospital medical prescription.

scholarly journals Limited Mobility to the Bed Reduces the Chances of Discharge and Increases the Chances of Death in the ICU

2021 ◽  
Vol 12 (1) ◽  
pp. 8-16
Author(s):  
Talita Leite dos Santos Moraes ◽  
Joana Monteiro Fraga de Farias ◽  
Brunielly Santana Rezende ◽  
Fernanda Oliveira de Carvalho ◽  
Michael Silveira Santiago ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Retrospective Study ◽  
Medical Records ◽  
High Mobility ◽  
University Hospital ◽  
Limited Mobility ◽  
The Mean ◽  
The University

Background: Progressive mobility in the ICU has been recommended; however, the definitions of low, moderate, and high mobility in the ICU still diverge between studies. Therefore, our objective was to classify the mobility of the sample from verticalization and active withdrawal from the bed, and from that, to analyze the chances of discharge, death, and readmission to the ICU. Materials and methods: This is an observational and retrospective study that consults the medical records of individuals admitted to the ICU of the University Hospital of Sergipe (HU/SE) between August 2017 and August 2018. Mobility level was classified based on the Intensive Care Unit Mobility Scale (IMS). Results: A total of 121 individuals were included. The mean age was 61.45 ± 16.45, being 53.7% female. Of these, 28 (23.1%) had low mobility, 33 (27.3%) had moderate mobility, and 60 (49.6%) had high mobility. Individuals with low mobility were 45 times more likely to die (OR = 45.3; 95% CI = 3.23–636.3) and 88 times less likely to be discharged from the ICU (OR = 0.22; 95% CI = 0.002–0.30). Conclusion: Those who evolved with low mobility had a higher chance of death and a lower chance of discharge from the ICU. Moderate and high mobility were not associated with the investigated outcomes.

scholarly journals Profile of cases suspected of attempted suicide by exogenous intoxication

2018 ◽  
Vol 9 (2) ◽  
pp. 123
Author(s):  
Fernanda Pamela Machado ◽  
Marcos Hirata Soares ◽  
Patricia Dias Francisquini ◽  
Layla Karina Ferrari Ramos
Keyword(s):  
Medical Records ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
University Hospital ◽  
Professional Service ◽  
Information Center ◽  
Life Threatening ◽  
Physical Consequences ◽  
The University ◽  
Present Life

Objective: To characterize the profile of patients suspected of attempting suicide, based on cases reported by the Toxicological Information Center of the University hospital of Southern Brazil.Methods: This is a retrospective aggregate study, based on the analysis of medical records and files between January 2009 and December 2012, aiming to collect information that would create the profile of patients suspected of attempting suicide, from the cases notified by the Toxicological Information Center.Results: Regarding the physical consequences and the danger of the suicide attempt, 97% of the suicide attempts did not present life threatening (n = 1,605); 85.4% were not referred to any professional service (n = 1,412). The year 2012 was the year with the highest number of suicide attempts that the other years.Conclusions: It is considered important to improve the notification form for poisoning injuries, to better detect information about suicide attempts.

scholarly journals Clinical and epidemiological features of 123 cases of cryptococcosis in Mato Grosso do Sul, Brazil

2008 ◽  
Vol 50 (2) ◽  
pp. 75-78 ◽  
Author(s):  
Andrea De Siqueira Campos Lindenberg ◽  
Marilene Rodrigues Chang ◽  
Anamaria Melo Miranda Paniago ◽  
Márcia Dos Santos Lazéra ◽  
Paula Maria Frank Moncada ◽  
...  
Keyword(s):  
Medical Records ◽  
University Hospital ◽  
Mato Grosso ◽  
Drug Of Choice ◽  
Cryptococcus Species ◽  
The Central Nervous System ◽  
Male Patients ◽  
Epidemiological Profile ◽  
The University ◽  
Mato Grosso Do Sul

To identify the clinical and epidemiological profile of cryptococcosis diagnosed at the University Hospital of the Federal University of Mato Grosso do Sul, Brazil, medical records of 123 patients admitted from January 1995 to December 2005 were analyzed. One hundred and four cases (84.5%) had HIV infection, six (4.9%) had other predisposing conditions and 13 (10.6%) were immunocompetent. Male patients predominated (68.3%) and their age ranged from 19 to 69 years (mean: 35.9). Most patients (73.2%) were born and lived lifelong in the state of Mato Grosso do Sul. Involvement of the central nervous system occurred in 103 patients (83.7%) and headache and vomiting were the most frequent symptoms. In 77 cases it was possible to identify the Cryptococcus species: 69 (89.6%) C. neoformans and eight (10.4%) C. gattii. Amphotericin B was the drug of choice for treatment (106/123), followed by fluconazole in 60% of cases. The overall lethality rate was 49.6%, being 51% among the HIV infected patients and 41.2% among the non-HIV infected (p > 0.05). Although cryptococcosis exhibited in our region a similar behavior to that described in the literature, the detection of an important rate of immunocompetent individuals and five C. gattii cryptococcosis in HIV-infected patients is noteworthy.

scholarly journals Temporal Relation between Double Fortification of Wheat Flour with Iron and Folic Acid, and Markers and Prevalence of Anemia in Children

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2013
Author(s):  
Flinle Danielle Biemi ◽  
Vijay Ganji
Keyword(s):  
Folic Acid ◽  
Wheat Flour ◽  
Medical Records ◽  
Ivory Coast ◽  
University Hospital ◽  
Blood Cell Count ◽  
Red Blood Cell Count ◽  
Iron And Folic Acid ◽  
The University ◽  
Prevalence Of Anemia

Fortification of wheat flour with iron and folic acid became mandatory in Ivory Coast in 2007. The purpose of this study was to determine the time trend relation between mandatory double fortification of wheat flour with iron and folic acid and markers and prevalence of anemia by comparing the data between pre- and post-fortification periods in Ivory Coast children. Data were derived from the pediatric unit of the University Hospital of Treichville, Abidjan, Ivory Coast. Medical records of 467 children from 5 to 14 years old were analyzed from the years 2004 through 2010. Periods from 1 January 2004 to 31 December 2006 and 1 January 2008 to 31 December 2010 were considered as pre- and post-fortification periods, respectively. Data on hemoglobin, hematocrit, red blood cell count (RBC), mean corpuscular volume (MCV), and anemia between pre- and post-fortification periods were compared. There were no significant differences in hemoglobin, hematocrit, RBC, and prevalence of anemia between pre- and post-fortification periods. However, MCV in post-fortification period was significantly higher compared to pre-fortification period in all subjects (77.6 fL vs. 76.8 fL; p = 0.02) and in young girls (79.1 fL vs. 75.2 fL; p = 0.01). Lack of significant differences in anemia and in markers of anemia between pre- and post-fortification periods need further investigation in children of Ivory Coast.

External validation of a suggested extension of the ESC 0/1h-algorithm for early rule out of myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Lopez Ayala ◽  
T Nestelberger ◽  
I Strebel ◽  
P.D Ratmann ◽  
J Boeddinghaus ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin T ◽  
Clinical Care ◽  
External Validation ◽  
High Sensitivity ◽  
University Hospital ◽  
Funding Source ◽  
Absolute Change ◽  
The University ◽  
Rule Out

Abstract Background The European Society of Cardiology (ESC) high sensitivity cardiac troponin T 0/1h-algorithm has substantially improved the management of patients with suspected acute myocardial infarction (AMI) by triaging about 75% of patients to rapid rule-out and/or rapid rule-in. However, about 25% of patients remain in the “observe-zone”, and the optimal management of these patients is unknown. Recently, a pilot single center study with a low prevalence of AMI suggested that an absolute change of less than 7ng/L between the 0h and 3h hs-cTnT concentration would allow to help in the evaluation of patients in the observe-zone and allow triage towards rule-out with very high negative predictive value [NPV]. Purpose To externally validate this suggested modification of the ESC 0/1h-algorithm for early rule out of AMI. Methods In an ongoing multicentre international study, we prospectively enrolled unselected patients presenting to the emergency department with symptoms suggestive of MI. Final diagnoses were centrally adjudicated by two independent cardiologists using all available medical records obtained during clinical care including 90 day follow-up information and cardiac imaging. High sensitivity-cTnT (Elecsys) concentrations were measured at presentation and after 1 and 3 hours. The primary outcome was safety, quantified by the sensitivity and NPV for early rule out of NSTEMI. Results Among 1633 enrolled patients with available 0, 1 and 3h hs-cTnT concentrations, NSTEMI was the adjudicated final diagnosis in 337 (20.6%) patients. The ESC 0/1h-algorithm ruled out 918 (56.2%) patients, with a sensitivity of 98.8% (95% confidence interval [CI], 97.0–99.5) and a NPV of 99.6% (95% CI, 98.9–99.8). A total of 428 patients (26.2%) remained in the observe zone. After applying the suggested 0–3 hour absolute change cut-off criteria of 7ng/L, 393 (92.0%) additional patients from the observe zone were triaged towards ruled out. However, the safety of this triage step was poor with 62 patients with NSTEMI missed, resulting in a sensitivity of 33.3% and a NPV of 84.2% for rule-out. Conclusions The suggested 0/3h absolute change cut-off of 7ng/L for patients remaining in the observe zone of the ESC 0/1h-algorithm does NOT allow safe rule-out of AMI and should therefore NOT be implemented into routine clinical care. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Swiss National Science Foundation, the Swiss Heart Foundation, the Stiftung für kardiovaskuläre Forschung Basel, the University of Basel and the University Hospital Basel

scholarly journals Lack of Evidence for an Association between Previous HEV Genotype-3 Exposure and Glomerulonephritis in General

Pathogens ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 18
Author(s):  
Sven Pischke ◽  
Sarah Tamanaei ◽  
Maria Mader ◽  
Julian Schulze zur Wiesch ◽  
Christine Petersen-Benz ◽  
...  
Keyword(s):  
Blood Donors ◽  
Statistical Significance ◽  
University Hospital ◽  
Genotype 3 ◽  
Seropositivity Rate ◽  
Future Studies ◽  
Age Related ◽  
Immune Mediated ◽  
The University ◽  
Age And Sex

Among numerous other immune-mediated diseases, glomerulonephritis has also been suspected to be an extrahepatic manifestation of HEV infection. In this prospective study, we tested 108 patients with glomerulonephritis and 108 age- and sex-matched healthy controls at the University Hospital Hamburg Eppendorf, Hamburg, Germany, for anti-HEV IgG (Wantai test) as a marker for previous HEV exposure. A total of 24 patients (22%) tested positive for anti-HEV IgG. Males tended to be more frequently anti-HEV IgG positive (29%) in comparison to females (16%). However, this does not reach statistical significance (p = 0.07). Anti-HEV IgG positive patients were older in comparison to negative patients (mean 53 vs. 45 years, p = 0.05). The kidney function seems to be slightly decreased in anti-HEV IgG positive patients in comparison to and anti-HEV IgG negative patients basing on creatinine (p = 0.04) and glomerular filtration rate (GFR) (p = 0.05). Slightly higher values of bilirubin could be found in IgG positive patients (p = 0.04). Anti-HEV-IgG seropositivity rate (22%) in glomerulonephritis patients, did not differ significantly in comparison to an age- and sex-matched control cohort of healthy blood donors (31/108 positive, 29%). A total of 2/2 patients with membranoproliferative glomerulonephritis (MPGN) tested anti-HEV IgG positive (p = 0.002 in comparison to glomerulonephritis patients with other subtypes).In conclusion, our findings indicate that previous HEV exposure in a region where GT3 is endemic is not associated with glomerulonephritis in general. However, the subgroup of MPGN patients should be investigated in future studies. Furthermore, future studies are needed to investigate whether the observed association between anti-HEV IgG positivity and reduced GFR in glomerulonephritis patients is HEV associated or is an age-related effect.

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