scholarly journals G6PD deficiency and severity of COVID19 pneumonia and acute respiratory distress syndrome: tip of the iceberg?

2020 ◽  
Author(s):  
Jihad G. Youssef ◽  
Faisal Zahiruddin ◽  
George Youssef ◽  
Sriram Padmanabhan ◽  
Joe Ensor ◽  
...  
Keyword(s):  
G6pd Deficiency ◽  
Chart Review ◽  
Ventilatory Support ◽  
Severe Pneumonia ◽  
Retrospective Chart Review ◽  
The Elderly ◽  
Supplemental Oxygen ◽  
Redox Status ◽  
Clinical Series ◽  
Viral Proliferation

Abstract The severe pneumonia caused by the human Coronavirus (hCoV)- SARS-CoV-2 has inflicted heavy casualties, especially among the elderly and those with co-morbid illnesses irrespective of their age. The high mortality in African-Americans and males, in general, raises the concern for a possible X-linked mediated process that could affect the viral pathogenesis and the immune system. We hypothesized that G6PD, the most common X linked enzyme deficiency associated with redox status, may have a role in severity of pneumonia. Retrospective chart review was performed in hospitalized patients with COVID19 pneumonia needing supplemental oxygen. A total of 17 patients were evaluated; six with G6PD deficiency (G6PDd), and 11 with normal levels. The two groups (Normal and G6PDd) were comparable in terms of age, sex and co-morbidities, and laboratory parameters-LDH, IL-6, CRP, and Ferritin, respectively. Thirteen patients needed ventilatory support with 8 in the normal group and 5 in the G6PDd group (72% vs.83%). The main differences indicating increasing severity in normal vs. G6PDd groups included G6PD levels (12.2 vs. 5.6, P=0.0002), PaO2/FiO2 ratio (159 vs. 108, P=0.05), days on mechanical ventilation (10.25 vs. 21 days P=0.04), hemoglobin level (10 vs. 8.1 P=0.03) and Hematocrit (32 vs. 26 P=0.015). Only one patient with G6PDd died; 16 were discharged home. Our clinical series ascribes a possible biological role for G6PDd in SARS-CoV2 viral proliferation. It is imperative that further studies are performed to understand the interplay between the viral and host factors in G6PDd that may lead to disparity in outcomes.

scholarly journals G6PD deficiency and severity of COVID19 pneumonia and acute respiratory distress syndrome: tip of the iceberg?

2020 ◽  
Author(s):  
Jihad G. Youssef ◽  
Faisal Zahiruddin ◽  
George Youssef ◽  
Sriram Padmanabhan ◽  
Joe Ensor ◽  
...  
Keyword(s):  
G6pd Deficiency ◽  
Chart Review ◽  
Ventilatory Support ◽  
Severe Pneumonia ◽  
Retrospective Chart Review ◽  
The Elderly ◽  
Supplemental Oxygen ◽  
Redox Status ◽  
Clinical Series ◽  
Viral Proliferation

Abstract The severe pneumonia caused by human coronavirus (hCoV)-SARS-CoV-2 has inflicted heavy causalities, especially among the elderly and those with comorbid illnesses irrespective of age. The high mortality in African Americans and males, in general, raises concern for a possible X-linked mediated process that could affect viral pathogenesis and the immune system. We hypothesized that G6PD, the most common X-linked enzyme deficiency associated with redox status, may have a role in the severity of pneumonia. A retrospective chart review was performed in hospitalized patients with COVID19 pneumonia needing supplemental oxygen. A total of 17 patients were evaluated: six with G6PD deficiency and 11 with normal levels. The two groups (normal and G6PD def) were comparable in terms of age, sex and comorbidities and laboratory parameters LDH, IL-6, CRP, and ferritin. Thirteen patients needed ventilatory support, with 6 in the G6PD group (83% vs. 72%). The main differences indicating increasing severity in the G6PD def group included G6PD levels (12.2 vs. 5.6, P=0.0002), PaO2/FiO2 ratio (159 vs. 108, P=0.05), days before intubation (2.5 vs. 4.8 P= 0.03), days on mechanical ventilation (10.25 vs. 21 days P=0.04), hemoglobin level (10 vs. 8.1 P=0.03) and hematocrit (32 vs. 26 P=0.015). Only one patient with G6PD deficiency died; 16 were discharged home. Our clinical series ascribes a possible biological role for G6PD deficiency in SARS-CoV2 viral proliferation. It is imperative that further studies be performed to understand the interplay between the viral and host factors in G6PD deficiency that may lead to disparity in outcomes.

Cochlear Implantation in the Elderly: Results and Quality-of-Life Assessment

2002 ◽  
Vol 111 (10) ◽  
pp. 890-895 ◽  
Author(s):  
Hamid R. Djalilian ◽  
Sharon L. Smith ◽  
Timothy A. King ◽  
Samuel C. Levine
Keyword(s):  
Quality Of Life ◽  
Complication Rate ◽  
Cochlear Implantation ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
The Elderly ◽  
Life Assessment ◽  
Test Results

To assess the efficacy, quality of life, and complication rate of cochlear implantation in patients over 60 years of age, we performed a retrospective chart review of 31 cochlear implant patients more than 60 years old at the time of surgery (mean, 70 years; range, 62 to 86 years). All patients had improvement in their audiological test results after operation. Twenty-eight patients (93%) are regular implant users at a median follow-up of 12 months. Major complications occurred in 2 patients (6%). We conclude that cochlear implantation in the elderly population has excellent results, with a complication rate similar to that in patients less than 60 years old, and yields an improved quality of life.

scholarly journals Delivering Telerehabilitation to COVID-19 Inpatients:A Retrospective Chart Review Suggests It Is a Viable Option

2020 ◽  
Vol 16 (S1) ◽  
pp. 64-70
Author(s):  
Kelsey Rosen ◽  
Monika Patel ◽  
Cecelia Lawrence ◽  
Brianne Mooney
Keyword(s):  
Physical Therapy ◽  
Chart Review ◽  
Vital Signs ◽  
Retrospective Chart Review ◽  
Inpatient Rehabilitation ◽  
Supplemental Oxygen ◽  
Hospitalized Patients ◽  
Home Exercise ◽  
Viable Option ◽  
Therapeutic Exercises

Abstract Background Guidelines for physical therapy management of patients hospitalized with COVID-19 recommend limiting physical therapists’ contact with patients when possible. Telehealth has been viewed as “electronic personal protective equipment” during the COVID-19 pandemic; although telerehabilitation has been shown to be effective with outpatients, it is unknown whether it is a viable option for hospitalized patients. Purpose Our facility developed an algorithm for the use of a physical therapy telerehabilitation program for inpatients with COVID-19. We sought to investigate the safety and viability of the program. Methods We conducted a retrospective chart review of patients admitted with a diagnosis of COVID-19 who received either telerehabilitation only or a combination of telerehabilitation and in-person rehabilitation. Based on the algorithm, COVID-19 inpatients were selected to receive telerehabilitation if they could ambulate independently, could use technology, had stable vital signs, required minimal supplemental oxygen, and were cognitively intact. We analyzed data of inpatients who received telerehabilitation only, which included patient education, therapeutic exercises, and breathing techniques. Results Of 33 COVID-19 inpatients who received telerehabilitation, in-person rehabilitation, or a combination of the two, 12 patients received telerehabilitation only (age range, 33 to 65 years; all but one male). They demonstrated independence with their individualized home exercise programs in one to two sessions, did not require an in-person rehabilitation consultation, did not require increased oxygen, experienced no exacerbation of symptoms, and were discharged home. Conclusions Inpatient telerehabilitation appears to be a viable option for selected hospitalized patients with COVID-19 and may be a safe way of delivering inpatient rehabilitation to isolated or at-risk populations. At our hospital, the use of inpatient telerehabilitation reduced staff exposure while providing important education and services to patients. To our knowledge, no studies have investigated the use of telerehabilitation for hospitalized patients, including those with COVID-19. Our findings suggest that this innovative approach warrants further study.

scholarly journals Prevalence, Clinical Features, and Outcome of Pseudomonas Bacteremia in Under-Five Diarrheal Children in Bangladesh

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Farhana Akram ◽  
Mark A.C. Pietroni ◽  
Pradip Kumar Bardhan ◽  
Samira Bibi ◽  
Mohammod Jobayer Chisti
Keyword(s):  
Chart Review ◽  
Case Fatality ◽  
Severe Pneumonia ◽  
Retrospective Chart Review ◽  
Diarrhoeal Disease ◽  
Multidrug Resistant ◽  
Under Five ◽  
Disease Research ◽  
Resource Poor ◽  
Hospital Management System

We sought to evaluate the prevalence, associated factors, and outcome of under-five diarrheal children with either sex having Pseudomonas bacteremia. A retrospective chart review of under-five diarrheal children admitted to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), from January 2011 to December 2011 was performed using an online hospital management system. Children with Pseudomonas bacteremia constituted the cases (n = 31), and the controls (n = 124), without Pseudomonas bacteremia, were randomly selected. The prevalence of Pseudomonas bacteremia was 1% (31/5,179). The Pseudomonas was multidrug resistant but was 84% sensitive to ceftazidime and 100% to imipenem. The case-fatality rate was significantly higher among the cases than the controls (26% versus 5%; P = 0.003). In logistic regression analysis, after adjusting for potential confounders such as severe wasting, severe underweight, severe pneumonia, and young age (11.71 (4.0, 18.0) months), the cases more often presented with absent peripheral pulses in absence of dehydration (95% CI = 2.31–24.45) on admission. This finding underscores the importance of early identification of this simple clinical sign to ensure prompt management including fluid resuscitation and broad spectrum antibiotics to help reduce morbidity and mortality in such children, especially in resource-poor settings.

Administration of Comfort Medication at End of Life in Neonates: Effects of Weight

2008 ◽  
Vol 27 (4) ◽  
pp. 223-227 ◽  
Author(s):  
Angela Lee Matthews ◽  
Susan O’Conner-Von
Keyword(s):  
End Of Life ◽  
Chart Review ◽  
Ventilatory Support ◽  
Retrospective Chart Review ◽  
Time Frame ◽  
To Receive

Purpose: To examine whether a relationship exists between a neonate’s weight and the neonate’s receipt of comfort medication between four hours prior to elective ventilator withdrawal and death. It was hypothesized that the greater the neonate’s weight, the more likely the neonate was to receive comfort medication at end of life.Design: A retrospective chart review.Sample: One hundred seventy-one neonates in a midwestern Level III NICU who died after withdrawal of ventilatory support.Results: Of the 171 neonates in the sample, 27.5 percent (n = 47) did not receive comfort medication within the designated time frame; neonates who weighed <800 g were significantly less likely to receive comfort medication than were their heavier cohorts.Conclusion: In this sample, smaller neonates were given comfort medication less often while they were dying than were their larger counterparts.

Blunt ocular trauma in patients over 70: Clinical characteristics and prognosis

2020 ◽  
pp. 112067212094657
Author(s):  
Orit Vidne-Hay ◽  
Miri Fogel Levin ◽  
Shahar Luski ◽  
Joseph Moisseiev ◽  
Elad Moisseiev
Keyword(s):  
Chart Review ◽  
Ocular Trauma ◽  
Retrospective Chart Review ◽  
Functional Results ◽  
The Elderly ◽  
Additional Surgery ◽  
Female Predominance ◽  
Open Globe ◽  
Open Globe Injuries

Purpose: To describe the mechanisms and outcomes of open globe injuries (OGIs) in patients 70 years or older. Methods: A retrospective chart review of patients from two large academic centers in Israel who were underwent surgery for OGI. Data was collected from surgical and clinic charts. Anatomical and functional results were recorded as well any additional surgeries and complications. Results: Thirty-two eyes of 32 patients were included. The mechanism of OGI consisted of blunt trauma with ocular rupture secondary to falls. All eyes underwent immediate primary closure of the corneal and scleral lacerations. Additional surgeries were performed in 34.3% of cases. In 31.2% of cases additional surgery was not required, and in 21.9% of cases the damage was so devastating that additional procedures were not recommended. Four patients (12.5%) chose not to undergo additional surgery. Mean visual acuity at presentation was 2.24 ± 0.72 logMAR and it improved to 1.92 ± 0.89 logMAR at final follow-up ( p = 0.002). VA at presentation was significantly correlated to final VA ( p < 0.001). Conclusions: OGI in the elderly represents a unique group. It is mostly related to falls, with a female predominance and a poor visual prognosis. In this patient population, general health concerns and increased risks of anesthesia require special attention. Care should be taken to educate elderly patients and their caretakers on how to avoid falls.

Substance Misuse in the Elderly: A Retrospective Chart Review of Patients in the Senior Recovery Track Outpatient Program

2014 ◽  
Vol 22 (3) ◽  
pp. S104-S105
Author(s):  
Padmapriya Musunuri ◽  
Gibson T. George ◽  
Marc Zisselman ◽  
Carolina Retamero ◽  
Robert Kohn
Keyword(s):  
Chart Review ◽  
Substance Misuse ◽  
Retrospective Chart Review ◽  
The Elderly ◽  
Outpatient Program

scholarly journals Dynamic facial reanimation in the elderly using masseteric-to-facial nerve transfer

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Sadhishaan Sreedharan ◽  
Jieyun Zhou ◽  
George Pratt
Keyword(s):  
Literature Review ◽  
Facial Nerve ◽  
Surgical Techniques ◽  
Retrospective Chart Review ◽  
Nerve Transfer ◽  
The Elderly ◽  
Human Research Ethics ◽  
Average Improvement ◽  
Clinical Series ◽  
Facial Reanimation

Background: Masseteric-to-facial nerve (MTF) transfer offers the advantages of primary nerve coaptation, a high density of motor axons, and the potential connectedness between facial and trigeminal central cortical centres. Despite these benefits, its use in individuals aged greater than 60 years has not been widely described. Methods: A PubMed literature review from 1 January 1978 through to 31 December 2018 was performed to identify individuals older than 60 years who underwent a masseteric-to-facial nerve transfer. In addition, a retrospective chart review of all elderly patients who underwent a masseteric-to-facial nerve transfer at a single institution was conducted. Details on patient demographics, surgical techniques, outcomes and complications were recorded. Ethics approval for the study was obtained through the Monash Health Human Research Ethics Committee (RES-18-0000-768Q). Results: For the literature review, 12 out of 506 articles met the study criteria, with 28 patients identified and analysed. The average time to first facial movement was 5.5 months. Average improvement on oral commissure excursion was 11 mm. Of the eleven patients included in the clinical series, 27 per cent of patients experienced postoperative complications and there were no reported mortalities. Conclusion: Masseteric-to-facial nerve transfer is a safe and viable option for midface and perioral reanimation in the elderly with short term facial nerve palsies.

Geriatric psychiatry consultations in a Turkish university hospital

2006 ◽  
Vol 18 (2) ◽  
pp. 327-333 ◽  
Author(s):  
Izzet Cagri Yazgan ◽  
M. Kemal Kuscu ◽  
Nurhan Fistikci ◽  
Ali Keyvan ◽  
Volkan Topcuoglu
Keyword(s):  
Elderly Population ◽  
Chart Review ◽  
Sleep Problems ◽  
Retrospective Chart Review ◽  
Adjustment Disorder ◽  
The Elderly ◽  
Geriatric Psychiatry ◽  
University Hospital ◽  
Family Ties ◽  
The Mean

Objective: The size of the elderly population is growing rapidly in Turkey. We aimed to characterize geriatric psychiatry consultations to obtain the characteristic pattern of these patients for further interventions.Method: A retrospective chart review was undertaken for each patient.Results: One hundred and sixty-six patients with a mean age (± S.D.) of 75.5 ± 6.6 years were included in this study. Most referrals came from the Department of Internal Medicine (42.2%), with sleep problems (42.1%), depression (29.5%) and anxiety (28.3%) being the most common reasons for referral. Hypertension was the most frequent medical diagnosis (53.6%). The mean number ± S.D.) of medications used by each patient was 4.4 ± 2.0. The leading psychiatric diagnosis at the end of the assessment was adjustment disorder (31.3%).Conclusion: Turkish geriatric psychiatry consultation patients display similar characteristics to elderly patients from other western countries. The main difference comes from diagnosis of adjustment disorder, which may be related to hospital conditions and strong family ties in developing countries.

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