scholarly journals Anosmia in SARS-CoV-2 Patients: a Retrospective Study

2021 ◽  
Author(s):  
ChenHui Yee ◽  
Matthew Koh ◽  
Paul Anantharajah Tambyah ◽  
David Allen ◽  
Jyoti Somani ◽  
...  
Keyword(s):  
Objective Assessment ◽  
University Hospital ◽  
University Of Pennsylvania ◽  
Control Group ◽  
Inpatient Setting ◽  
Item Questionnaire ◽  
Olfactory Testing ◽  
National University ◽  
Smell Identification ◽  
Question Survey

Abstract BackgroundPost viral anosmia has been reported in human coronavirus infections. In this current pandemic, olfactory dysfunction (OD) has emerged as a common key presenting symptom of COVID-19 infection. In this study, we describe OD assessment in the inpatient setting of patients both suspected of and with confirmed COVID-19 infection via University of Pennsylvania Smell Identification Test (UPSIT) objective assessment and a simple self-reported 3-item questionnaire.MethodsThirty patients admitted to the isolation wards of the National University Hospital, Singapore for either suspected or confirmed COVID-19 infection from April to May 2020 were recruited to this study. 10 patients who tested negative for SARS-CoV-2 were recruited as control subjects. The 20 patients with COVID-19 infection were divided into two groups (10 had olfactory testing performed during the first week of illness, 10 in the second week of illness). A simple 3-question survey was administered to each participant - to rank the severity, state the onset and duration of their hyposmia. Olfactory testing was performed using an English version of the UPSIT.ResultsLoss of smell was reported in 2 participants from the control group, 6 participants from the in the first week of illness and 5 participants from the second week of illness. Two COVID-19 patients have anosmia on the UPSIT. COVID-19 patients were more likely to have severe hyposmia or anosmia by objective assessment, a difference that was statistically significant (P = 0.0485). The differences in degree of OD among COVID-19 patients in their first and second week of illness were not statistically significant (P= 0.6563).ConclusionSelf-reported anosmia was higher among COVID-19 patients compared to controls who were admitted to isolation wards for respiratory symptoms but were tested negative for SARS-CoV-2 infection. On objective assessment by the UPSIT, COVID-19 patients were found to have higher rates of severe hyposmia or anosmia, a difference that was statistically significant (P = 0.0485). A limitation of this study is the odorants used in UPSIT which may be less familiar to the primarily Asian participants in this study, owing to cultural differences.

scholarly journals Olfaction and essential tremor

2009 ◽  
Vol 67 (1) ◽  
pp. 21-24 ◽  
Author(s):  
Lucas Barasnevicius Quagliato ◽  
Maura Aparecida Viana ◽  
Elizabeth Maria Aparecida Barasnevicius Quagliato ◽  
Samuel Simis
Keyword(s):  
Essential Tremor ◽  
Age Groups ◽  
Epidemiological Data ◽  
University Of Pennsylvania ◽  
Control Group ◽  
Clinical Scale ◽  
Olfactory Identification ◽  
Identification Test ◽  
The University ◽  
Smell Identification

OBJECTIVE: To characterize the olfactory identification in 40 essential tremor (ET) patients, with the University of Pennsylvania 12 Smell Identification Test (UPSIT), to correlate UPSIT scores to clinical and epidemiological data and to compare it to 89 aged matched controls. METHOD: Patients were assessed using ET Clinical Scale of Evaluation and UPSIT. RESULTS: In patients with ET, the UPSIT medium score was 9.10, similar to the control group (9.11), which was also observed in all age groups. ET severity did not correlate to UPSIT scores. CONCLUSION: This study demonstrated normality of olfactory identification on ET, qualifying UPSIT to be an important tool on tremor differential diagnosis of undetermined origin.

scholarly journals Carelign: A Novel Handoff System for Medical and Surgical Consultants

2020 ◽  
Vol 12 (01) ◽  
pp. e63-e66
Author(s):  
Brian Michael Shafer ◽  
Thomasine Gorry ◽  
Paul Tapino ◽  
Subha Airan-Javia
Keyword(s):  
Medical Center ◽  
University Of Pennsylvania ◽  
Inpatient Setting ◽  
Patient Centered ◽  
System A ◽  
Item Questionnaire ◽  
Department Of Ophthalmology ◽  
Significant Difference ◽  
The University ◽  
Work Management

Abstract Background Patient handoffs are ubiquitous in hospital settings. Historically, formal handoffs of patient information have been conducted in the inpatient setting mainly by primary teams, as opposed to medical and surgical consultants. Carelign is a software developed by the University of Pennsylvania Health System to function as an interdisciplinary, patient-centered handoff. While mainly utilized by primary teams for work management and transitions, it has been enhanced to include specialty consultant handoff functionality. Objective The aim of this study is to determine whether using Carelign for consultant handoffs improves clinical handoffs in comparison to the prior handoff system (a custom-built handoff report within the electronic health record) used by the Department of Ophthalmology at Penn Presbyterian Medical Center. Methods A 7-item questionnaire assessing the effectiveness, efficiency, accessibility, reliability, communication, and security of the handoff using a 1 to 5 scale was distributed to residents prior to and 6 months subsequent to the implementation of Carelign. Results Users reported a statistically significant increase in Health Insurance Portability and Accountability Act (HIPPA)-compliance (44 vs. 100%, p < 0.0001) and ability to communicate with primary teams (38 vs. 70%, p = 0.019) after implementation of Carelign. There was a trend toward significance with ease of accessing information after switching to Carelign (67 vs. 85%, p = 0.185). There was no statistically significant difference in effectiveness, efficiency, accessibility from home, or reliability of information on handoff after converting to the new system. Conclusion Carelign is perceived to be an effective tool that can be used by consulting providers to ensure HIPPA-compliance and the ability to communicate with primary teams without sacrificing effectiveness, efficiency, accessibility, or reliability.

Verbal communication disorders in psychogenic dysphonia

2019 ◽  
Vol 73 (2) ◽  
pp. 1-5
Author(s):  
Bożena Kosztyła-Hojna ◽  
Diana Moskal-Jasińska ◽  
Anna Kraszewska ◽  
Anna Łobaczuk-Sitnik ◽  
Maciej Zdrojkowski ◽  
...  
Keyword(s):  
Objective Assessment ◽  
Communication Disorders ◽  
Vocal Folds ◽  
Speech Quality ◽  
University Hospital ◽  
Mental Condition ◽  
Control Group ◽  
Self Assessment ◽  
Speech Prosody ◽  
Voice And Speech

Psychogenic dysphonia is defined as disturbances in voice and speech quality with emotional background with lack of organic changes in the larynx. Mental condition has significant impact on the process of producing voice, functioning of respiratory-phonatory-articulation mechanism and speech prosody. The aim of the study was visual, acoustic, perceptual assessment as well as self-assessment of voice and speech quality using subjective and objective methods in patients with psychogenic dysphonia. The study included 50 patients with psychogenic dysphonia diagnosed in the Department of Clinical Fonoaudiology and Logopedics, Medical University of Białystok and treated at the Foniatric Outpatient Clinic, University Hospital in Białystok in 2017 - 2018. The control group consisted of 30 subjects with euphonic voice. All patients underwent subjective and objective assessment of voice and speech quality. The GRBAS scale, breathing pathway assessment, respiratory-phonatory-articulation analysis, voice and speech intensity evaluation have been performed. Speech prosody has also been examined. Patient self-assessment of voice has been conducted using Voice Handicap Index (VHI). Objective evaluation of larynx included vibrations of vocal folds visualization using High Speed Digital Imaging (HSDI). Acoustic analysis of voice quality has been performed using DiagNova Technologies. The maximum phonation time (MPT) has been determined. Hyperfunctional dysphonia is the most common clinical form of psychogenic dysphonia. Abnormal breathing pathway influence the reduction of MPT and disturbance of respiratory-phonatory-articulation coordination in patients with psychogenic dysphonia. In psychogenic dysphonia intonation and speech rate disorders are observed. Results of voice self-assessment in the majority of examined patients indicates a mild voice disability.

scholarly journals Subjective and Objective Assessment of Olfactory Function in Post-Laryngectomy Patients

2009 ◽  
Vol 24 (2) ◽  
pp. 19-22
Author(s):  
Ricardo L. Ramirez ◽  
Windolyn D. Panganiban ◽  
Joel A. Ramirez
Keyword(s):  
Health Care Providers ◽  
Total Laryngectomy ◽  
Objective Assessment ◽  
Olfactory Function ◽  
Care Providers ◽  
Management Options ◽  
Olfactory Testing ◽  
Significant Difference ◽  
Identification Test ◽  
Smell Identification

Objective:       To determine the olfactory function among post-laryngectomy patients using a questionnaire adapted from that of the Smell and Taste Clinic of Hospital of University Pennsylvania (HUP) and the Santo Tomas Smell Identification Test. Methods: Design: Descriptive study Setting: Tertiary Private Hospital Outpatient Department Patients: Twenty five subjects who had undergone total laryngectomy and met inclusion and exclusion criteria underwent rigid nasal endoscopy and olfactory function assessment using an adaptation of the questionnaire of the Smell and Taste Clinic of Hospital of University Pennsylvania (HUP) and the Santo Tomas Smell Identification Test (ST-SIT). Results: Twenty one male subjects completed olfactory testing. All had subjective sense of smell before laryngectomy. Statistically significant correlation was noted between the subjective post-operative smell function and the objective olfactory function test scores. There was no statistically significant difference noted in the ST SIT scores with regards age, duration from laryngectomy to olfactory testing, number of smoking pack- years, use of olfactory technique/maneuver, loss of appetite and adjunctive chemotherapy and radiotherapy. Conclusion: All subjects post-laryngectomy had subjective complaints of varying levels of olfactory difficulties based on a structured questionnaire and were documented to be anosmic by an objective smell identification test. Olfactory problems following laryngectomy can have significant effects on the lives of laryngectomees, and health care providers should be knowledgeable of available management options for this condition. Key words: olfaction, anosmia, total laryngectomy, olfactory testing

scholarly journals Usefulness of Age-Stratified N-Terminal Prohormone of Brain Natriuretic Peptide for Diagnosing Kawasaki Disease

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Sang Hoon Lee ◽  
Eun Song Song ◽  
Somy Yoon ◽  
Seunghee Hong ◽  
Hwa Jin Cho ◽  
...  
Keyword(s):  
Kawasaki Disease ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Laboratory Data ◽  
Febrile Illness ◽  
University Hospital ◽  
Control Group ◽  
Cutoff Value ◽  
Cutoff Values ◽  
National University

N-terminal prohormone of brain natriuretic peptide (NT-proBNP) was recently reported as a biomarker for diagnosing Kawasaki disease (KD). The basal NT-proBNP level, however, gradually decreases with age. We investigated the usefulness of an age-stratified cutoff value of NT-proBNP for diagnosing KD. All the patients enrolled in this study visited Chonnam National University Hospital between December 2007 and March 2016. The KD groups consisted of 214 patients with complete KD and 129 patients with incomplete KD. The control group included 62 children with simple febrile illness but without heart disease. Laboratory data including NT-proBNP level were evaluated. Each group was divided into subgroups according to patient age (<6 months, 6–12 months, 12–24 months, and >24 months), and different cutoff values of NT-proBNP were calculated. The cutoff values of NT-proBNP used to diagnose total KD and incomplete KD were 762 and 762 pg/mL (<6 months), 310 and 310 pg/mL (6–12 months), 326 and 326 pg/mL (12–24 months), and 208 and 137 pg/mL (>24 months), respectively. In conclusion, age-stratified NT-proBNP is a useful biomarker for the differential diagnosis of KD in patients with a simple febrile illness.

scholarly journals Mitochondrial DNA Mutations and Rheumatic Heart Diseases

2019 ◽  
Vol 6 (4) ◽  
pp. 36
Author(s):  
Fatou Balla Wade ◽  
Marie Parsine Sall ◽  
Fatimata Mbaye ◽  
Mbacké Sembene
Keyword(s):  
Cardiovascular Surgery ◽  
Heart Diseases ◽  
University Hospital ◽  
Control Group ◽  
Cardiovascular Pathology ◽  
Dna Mutations ◽  
National University ◽  
Two Populations ◽  
Valvular Replacement ◽  
Rheumatic Heart

Acute rheumatic fever (ARF) is an autoimmune disease affecting the heart-valve endocardium in its final stage. Although rare in developing countries, ARF persists in third-world countries, particularly Senegal, where rheumatic heart diseases (RHDs) are the most common pediatric cardiovascular pathology. This study aimed to investigate mutations in MT-CYB in ARF and RHD in Senegalese patients. MT-CYB was amplified from blood samples from ARF patients at the Clinical of Thoracic and Cardiovascular Surgery of Fann National University Hospital Centre, Dakar, Senegal (control group, healthy individuals) and sequenced. More than half of the MT-CYB mutations (58.23%) were heteroplasmic. Transitions (61.67%) were more frequent than transversions (38.33%), and non-synonymous substitutions represented 38.33% of mutations. Unoperated RHD patients harbored frequent MT-CYB polymorphisms (7.14 ± 14.70 mutations per sample) and accounted for 72.73% of mutations. Paradoxically, subjects undergoing valvular replacement harbored infrequent polymorphisms (1.39 ± 2.97 mutations per patient) and lacked 36 mutations present in unoperated subjects. A genetic differentiation was observed between these two populations, and the mutations in operated subjects were neutral, while those in unoperated subjects were under positive selection. These results indicate a narrow link (perhaps even causal) between MT-CYB mutations and ARF and its complications (i.e., RHDs) and that these mutations are largely deleterious.

scholarly journals Tetra-ataxiometric Posturography in Patients with Migrainous Vertigo

2016 ◽  
Vol 1;19 (1;1) ◽  
pp. E87-E95
Author(s):  
Dr. Nedim Ongun
Keyword(s):  
Visual Information ◽  
Objective Assessment ◽  
University Hospital ◽  
Controlled Study ◽  
Control Group ◽  
High Frequencies ◽  
Migrainous Vertigo ◽  
Static Posturography ◽  
Vestibular Symptoms ◽  
Postural Abnormalities

Background: Migraine is a common disorder characterized by headache attacks frequently accompanied by vestibular symptoms like dizziness, vertigo, and balance disorders. Clinical studies support a strong link between migraine and vertigo rather than between other headache types and vertigo or nonvertiginous dizziness. There is a lack of consensus regarding the pathophysiology of migrainous vertigo. Activation of central vestibular processing during migraine attacks and vasospasm-induced ischemia of the labyrinth are reported as the probable responsible mechanisms. Because vestibular examination alone does not provide enough information for diagnosis of migrainous vertigo, posturography systems which provide objective assessment of somatosensory, vestibular, and visual information would be very helpful to show concomitant involvement of the vestibular and somato-sensorial systems. There are few posturographic studies on patients with migraine but it seems that how balance is affected in patients with migraine and/or migrainous vertigo is still not clear. We want to investigate balance function in migraineurs with and without vertigo with a tetra-ataxiometric posturography system and our study is the first study in which tetra-ataxiometric static posturography was used to evaluate postural abnormalities in a well-defined population of patients with migrainous vertigo. Objective: To investigate balance functions in migraineurs with and without vertigo with a tetra-ataxiometric posturography system. Study Design: Prospective, nonrandomized, controlled study. Setting: Pamukkale University Hospital, Neurology and Physical Therapy and Rehabilitation outpatient clinics. Methods: Sixteen patients with migrainous vertigo, 16 patients with migraine without aura and no vestibular symptoms, and 16 controls were included in the study. Computerized static posturography system was performed and statistical analyses of fall, Fourier, Stability, and Weight distribution indexes were performed. The tetra-ataxiometric posturography device measures vertical pressure fluctuations on 4 independent stable platforms, each placed beneath 2 heels and toe parts of the patient; inputs from these platforms are integrated and processed by a computer digitally. Four separate plates are used and perpendicular pressures of the anterior and posterior feet are measured. Pressure of each force plate is measured and data was analyzed by the software program. Limitations: A very small, non-randomized, and controlled study with the inability to find an answer to the mechanism of involvement of the somatosensorial system and vestibular system in migrainous headaches. Results: The distribution of patients with posturographical abnormalities in the migrainous vertigo group was significantly different than the control group. Distribution of the patients with posturographical abnormalities in the high frequencies of the head-right position was significantly different in the migrainous vertigo group than in the control group and distribution of the patients with posturographical abnormalities in high frequencies of the head-right position was significantly different in the migraine group than in the controls groups. The stability index of the migrainous vertigo group was significantly higher than in the control group when tested on in the neutral-head position with open eyes. Conclusion: In this first study of tetra-ataxiometric static posturography evaluating postural abnormalities in a well-defined population of patients with migrainous vertigo, the central part of the vestibular apparatus would be responsible of postural abnormalities in patients with migraine and migrainous vertigo. Key words: Fall index, migraine, migrainous vertigo, static posturography

scholarly journals Multimodal prehabilitation before major abdominal surgery: A retrospective study

2021 ◽  
Vol 50 (12) ◽  
pp. 892-902
Author(s):  
Ning Qi Pang ◽  
Stephanie Shengjie He ◽  
Joel Qi Xuan Foo ◽  
Natalie Hui Ying Koh ◽  
Tin Wei Yuen ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Retrospective Review ◽  
Older Patients ◽  
Psychosocial Support ◽  
Enhanced Recovery ◽  
Major Abdominal Surgery ◽  
University Hospital ◽  
Control Group ◽  
National University ◽  
Postoperative Length

Introduction: Prehabilitation may benefit older patients undergoing major surgeries. Currently, its efficacy has not been conclusively proven. This is a retrospective review of a multimodal prehabilitation programme. Methods: Patients aged 65 years and above undergoing major abdominal surgery between May 2015 and December 2019 in the National University Hospital were included in our institutional programme that incorporated aspects of multimodal prehabilitation and Enhanced Recovery After Surgery concepts as 1 holistic perioperative pathway to deal with issues specific to older patients. Physical therapy, nutritional advice and psychosocial support were provided as part of prehabilitation. Results: There were 335 patients in the prehabilitation cohort and 256 patients whose records were reviewed as control. No difference in postoperative length of stay (P=0.150) or major complications (P=0.690) were noted. Patients in the prehabilitation group were observed to ambulate a longer distance and participate more actively with their physiotherapists from postoperative day 1 until 4. In the subgroup of patients with cancer, more patients underwent neoadjuvant therapy in the prehabilitation group compared to the control group (21.7% versus 12.6%, P=0.009). Prehabilitation patients were more likely to proceed to adjuvant chemotherapy (prehabilitation 87.2% vs control 65.6%, P<0.001) if it had been recommended. Conclusion: The current study found no differences in traditional surgical outcome measures with and without prehabilitation. An increase in patient mobility in the immediate postoperative period was noted with prehabilitation, as well as an association between prehabilitation and increased adherence to postoperative adjuvant therapy. Larger prospective studies will be needed to validate the findings of this retrospective review. Keywords: Frailty, general surgery, geriatric surgery, perioperative care, prehabilitation

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