The Impact of Implementing 24/7 Cardiac CTA Interpretation in the Emergency Department on Patient Care: Retrospective Analysis of a Single-Center Experience

2021 ◽  
pp. 1-7
Author(s):  
Rawan Abu Mughli ◽  
Tong Wu ◽  
Adam I. Kramer ◽  
Nicolas Murray ◽  
Ana-Maria Bilawich ◽  
...  
Keyword(s):  
Emergency Department ◽  
Patient Care ◽  
Retrospective Analysis ◽  
Single Center ◽  
Single Center Experience ◽  
Cardiac Cta ◽  
The Impact

scholarly journals Impact of Tocilizumab on Clinical Outcomes in COVID-19-Associated Cytokine Release Syndrome: A Single-Center Experience

2021 ◽  
pp. 089719002110282
Author(s):  
Karan Raja ◽  
Nicole Daniel ◽  
Susan Morrison ◽  
Ruben Patel ◽  
Jessica Gerges ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Clinical Status ◽  
Rank Test ◽  
Cytokine Release ◽  
Cytokine Release Syndrome ◽  
Single Center ◽  
Post Dose ◽  
Single Center Experience ◽  
Signed Rank Test ◽  
The Impact

Background: Tocilizumab is an interleukin-6 receptor antagonist hypothesized to blunt the uncontrolled immune response, cytokine release syndrome, in severe COVID-19 and prevent attributable morbidity and mortality. Objective: The objective of this study was to assess the impact of tocilizumab on clinical outcomes in COVID-19-associated cytokine release syndrome. Methods: Single-center, retrospective cohort study assessing sixty-nine adult patients receiving tocilizumab for suspected COVID-19 cytokine release syndrome. The primary outcome was change in WHO clinical status scale on day seven post-dose analyzed using the Wilcoxon signed rank test. Secondary outcomes assessed impact of timing of administration on clinical outcome. Safety analyses included development of neutropenia, thrombocytopenia, transaminitis, and sepsis within 7 days post-dose. Statistical analyses were conducted using Microsoft Excel. Results: No aggregate clinical change was found between day 0 and day 7. Eleven patients improved, twenty-seven worsened, and thirty-one showed no change. Clinical outcomes were weakly correlated with time from symptom onset (rs = 0.21; p = 0.08) or hospital admission (rs = -0.08; p = 0.49) to dose. In-hospital mortality was 63%. Sepsis was diagnosed in 21 patients, five of which were post-dose. Transaminitis, neutropenia, and thrombocytopenia occurred in seven, one, and six patients, respectively. Conclusion: Tocilizumab did not appear to influence clinical outcomes in our study population, irrespective of timing of administration. Adverse events were not considered drug-related.

The Impact of Marijuana Use on Liver Transplant Recipients: A 900 Patient Single Center Experience

2021 ◽  
Author(s):  
Jacob Guorgui ◽  
Takahiro Ito ◽  
Daniela Markovic ◽  
Antony Aziz ◽  
Stephanie Younan ◽  
...  
Keyword(s):  
Liver Transplant ◽  
Marijuana Use ◽  
Transplant Recipients ◽  
Single Center ◽  
Single Center Experience ◽  
Liver Transplant Recipients ◽  
The Impact

scholarly journals Effectiveness of early assessment and intervention by interdisciplinary teams including health and social care professionals in the emergency department: protocol for a systematic review

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e023464 ◽  
Author(s):  
Marica Cassarino ◽  
Katie Robinson ◽  
Rosie Quinn ◽  
Breda Naddy ◽  
Andrew O’Regan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Emergency Department ◽  
Patient Care ◽  
Systematic Reviews ◽  
Social Care ◽  
Interdisciplinary Teams ◽  
Cochrane Library ◽  
Early Assessment ◽  
Health And Social Care ◽  
The Impact

IntroductionFinding cost-effective strategies to improve patient care in the emergency department (ED) is an increasing imperative given growing numbers of ED attendees. Encouraging evidence indicates that interdisciplinary teams including health and social care professionals (HSCPs) enhance patient care across a variety of healthcare settings. However, to date no systematic reviews of the effectiveness of early assessment and/or interventions carried by such teams in the ED exist. This systematic review aims to explore the impact of early assessment and/or intervention carried out by interdisciplinary teams including HSCPs in the ED on the quality, safety and cost-effectiveness of care, and to define the content of the assessment and/or intervention offered by HSCPs.Methods and analysisUsing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses standardised guidelines, we will conduct a systematic review of randomised controlled trials (RCTs), non-RCTs, controlled before–after studies, interrupted time series and repeated measures studies that report the impact of early assessment and/or intervention provided to adults aged 18+ by interdisciplinary teams including HSCPs in the ED. Searches will be carried in Cumulative Index of Nursing and Allied Health Literature, Embase, Cochrane Library and MEDLINE from inception to March 2018. We will also hand-search the reference lists of relevant studies. Following a two-step screening process, two independent reviewers will extract data on the type of population, intervention, comparison, outcomes and study design. The quality of the studies will be appraised using the Cochrane Risk of Bias Tool. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval will not be sought since it is not required for systematic reviews. The results of this review will be disseminated through publication in a peer-review journal and presented at relevant conferences.Trial registration numberCRD42018091794.

Retrospective analysis of 95 patients with large vessel vasculitis: a single center experience

2015 ◽  
Vol 19 (1) ◽  
pp. 87-94 ◽  
Author(s):  
Masaaki Yoshida ◽  
Ryu Watanabe ◽  
Tomonori Ishii ◽  
Tomoaki Machiyama ◽  
Kanae Akita ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Single Center ◽  
Single Center Experience

scholarly journals Repeat and Relapsing Peritonitis Microbiological Trends and Outcomes: A 21-Year Single-Center Experience

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Marina Reis ◽  
Catarina Ribeiro ◽  
Ana Marta Gomes ◽  
Clara Santos ◽  
Daniela Lopes ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Catheter Removal ◽  
Control Group ◽  
Single Center ◽  
Cure Rate ◽  
Technique Survival ◽  
Tenckhoff Catheter ◽  
Single Center Experience ◽  
The Impact ◽  
Multiple Episodes

Peritonitis is a major peritoneal dialysis complication. Despite a high cure rate, relapsing and repeat peritonitis is associated with Tenckhoff catheter biofilm and multiple episodes of peritoneal damage. In relapsing peritonitis, prompt catheter removal is mandatory; otherwise, in repeat peritonitis, there is not a clear indication for catheter removal. It is questionable if the approach to removal should be different. There are few recent data on repeat and relapsing peritonitis microbiology and clinical outcomes since most studies are from the past decade. This study evaluates the microbiology, clinical outcomes, and impact of relapsing and repeat peritonitis on technique survival and the impact of catheter removal in development of further peritonitis episodes by the same microorganism. We developed a single-center retrospective study from 1998 to 2019 that compared repeat and relapsing peritonitis with a control group in terms of causative microorganisms, cure rate, catheter removal, and permanent and temporary transfer to hemodialysis. We also compared repeat and relapsing peritonitis clinical outcomes when Tenckhoff catheter was not removed. Comparing to the control group, the repeat/relapsing group had a higher cure rate (80.4% versus 74.5%, p = 0.01 ) and lower rate of hospitalization (10.9% versus 27.7%, p = 0.01 ). Technique survival was superior in the repeat/relapsing group (log rank = 4.5, p = 0.03 ). Gram-positive peritonitis was more common in the repeat/relapsing group especially Streptococci viridans (43.5% versus 21.3%, p = 0.01 ) and Gram-negatives in the control group (26.6% vs 9.0%, p = 0.02 ). When the Tenckhoff catheter was not removed after a repeat episode, 58.6% developed a new repeat/relapsing episode versus 60.0% in the relapsing group. Although repeat and relapsing peritonitis have a higher cure rate, it leads to further episodes of peritonitis and consequent morbidity. When Tenckhoff catheter was not removed, the probability of another peritonitis episode by the same microorganism is similar in repeat and relapsing peritonitis.

Sign in / Sign up

Export Citation Format

Share Document