scholarly journals Assessment and management of the SARS-CoV-2 infection: A secondary center experience

2021 ◽  
Author(s):  
Cem YARDIMCI ◽  
Erdem ERGEN ◽  
Serkan YILDIZ ◽  
Hatice BALLI ◽  
Elif YILDIZ ◽  
...  
Keyword(s):  
Invasive Mechanical Ventilation ◽  
Case Fatality ◽  
Treatment Modalities ◽  
Treatment Groups ◽  
Non Invasive ◽  
Severe Stage ◽  
Secondary Center ◽  
Significant Difference ◽  
Bilateral Lung ◽  
Secondary Hospital

Background: The aim of the study was to evaluate the management and outcomes of the patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a secondary hospital. Methods: A total of 699 hospitalized patients who had positive rRT-PCR for SARS-CoV-2 and/or typical findings of COVID-19 at chest computed tomography (CT) were enrolled in this study. Demographics, comorbities, initial laboratory tests on admission, treatment modalities, complications and outcomes were evaluated retrospectively. Results: The mean age was 57.0±15.6 (range:16-94 years), and male:female ratio was 1.24. 58.7% of the patients had at least one underlying comorbidity, the most common was hypertension. 72.8% of the patients had positive RT-PCR. 18.1% of the patients had lymphopenia, 35.7% hyperferritinemia, 58.3% increased lactate dehydrogenase, and 58.5% increased D-dimer. Chest CT revealed moderate and severe stage in 57.9% of the patients, and bilateral lung involvement in 78.7%. Hydroxychloroquine was given to 37.2% and favipiravir 67.1% of the patients. No significant difference was observed between treatment groups in terms of mortality (P=0.487). 5.8% of the patients were transferred to the ICU, of whom 75.6% were needed non-invasive and 36.5% invasive mechanical ventilation. The overall case fatality rate was 0.9. Conclusions: Older age, male sex, low lymphocyte count, CT findings including bilateral involvement and severe stage were significantly associated with poor prognosis and mortality.

scholarly journals Pellevé™ vs Lipiflow™ MGD-Related Dry Eye Treatment Study: The ThermaLid™ Procedure

2018 ◽  
Vol 1 (1) ◽  
pp. e11-e21
Author(s):  
Edward Hall Jaccoma ◽  
Craig Litherland ◽  
Andrew Jaccoma ◽  
Aseef Ahmed
Keyword(s):  
Dry Eye ◽  
Randomized Study ◽  
Meibomian Gland ◽  
Treatment Modalities ◽  
Ocular Surface Disease Index ◽  
Non Invasive ◽  
Standard Patient ◽  
Significant Difference ◽  
Surface Staining ◽  
Time Point

Objective: To assess the safety and efficacy of the Pellevé Wrinkle Treatment System as compared to LipiFlow, for treatment of dry eye syndrome due to meibomian gland dysfunction (MGD). Materials and Methods: In this split face, randomized study, ten patients who met specific criteria for inclusion were followed after treatment with the Pellevé Wrinkle Reduction System (what the authors have dubbed the "thermaLid Procedure") and a standard LipiFlow procedure performed the same day, with 1 and 3 months follow-up. Pre- and post- treatment MGD was assessed using a variety of subjective and objective measurements.   Results: The function of the meibomian glands improved significantly from baseline to 3 months for both thermaLid and Lipiflow treated eyes, with no significant difference between them, as measured by MGE grading, wax plug scoring, Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index (OSDI) scoring. A significant change in conjunctival staining was found after both treatments at the 1-month time point but not the 3-month time point. thermaLid but not Lipiflow treatment, significantly decreased MARX line measurements at 3-months. Lipiview, Non-Invasive Tear Breakup Time (NITBUT), corneal surface staining, Tear Osmolarity, and anesthetic Schirmer's testing did not show statistically significant improvement, nor differences between treatment modalities. Conclusions: thermaLid treatment of the eyelids appears to show efficacy similar to Lipiflow treatment in reducing symptoms, reducing wax plugging and improving the number of functioning MGs as well as reducing conjunctival staining in MGD related dry eye disease.

scholarly journals Non-Invasive Mechanical Ventilation in Children with Previous Unsuccessful Weaning from Respiratory Therapy

2020 ◽  
Vol 27 (3) ◽  
pp. E2020311
Author(s):  
Olha Filyk
Keyword(s):  
Mechanical Ventilation ◽  
Invasive Mechanical Ventilation ◽  
Non Invasive ◽  
Group I ◽  
Significant Difference ◽  
Successful Weaning ◽  
Secondary Outcomes ◽  
Group Ii ◽  
Protective Mechanical Ventilation ◽  
Lung Protective Mechanical Ventilation

The objective of the research was to establish the impact of diaphragm-protective mechanical ventilation on the rate of successful weaning from invasive and non-invasive mechanical ventilation in children with acute respiratory failure. Materials and Methods. We conducted a prospective, observational cohort study. Seventy-eight patients were randomly divided into 2 groups: patients of Group I received lung-protective mechanical ventilation; patients of Group II received diaphragm-protective + lung-protective mechanical ventilation. For age-specific data analysis, patients were divided into age subgroups: the 1st subgroup included children being 1 to 12 months old; the 2nd age subgroup comprised children being 12 to 36 months old. We started respiratory support in both groups with invasive mechanical ventilation and when patients met the criteria, we weaned them. We confirmed successful weaning, when patients had no need to be mechanically ventilated within next 48 hours, otherwise, they were intubated again. Before the second trial to wean, patients in Group I were simply extubated, while patients in Group II received non-invasive mechanical ventilation. The primary endpoint was the rate of successful weaning from mechanical ventilation in the first trial. The secondary outcomes were complications, namely reintubation rate, tracheostomy rate and death. Results. We found a significant difference in the primary outcome for the 1st age subgroup: there were 72.4% in Group I vs. 52.6% in Group II successfully weaned patients (p=0.04). No significant difference in the primary outcome was observed in the 2nd age subgroup: there were 80% in Group I vs. 82.3% in Group II successfully weaned patients (p=0.78). There were significant differences in the secondary outcomes between groups in the 1st age subgroup, namely reintubation rate was seen in 9.1% patients of Group I vs. 36.8% patients of Group II (p=0.05); death happened in 18.2% cases in Group I vs. no cases in Group II (p=0.01). There were no differences in tracheostomy rate in the 1st age subgroup and there were no differences in the  secondary outcomes between groups in 2nd age subgroup. Conclusions. Diaphragm-protective mechanical ventilation significantly reduced the incidence of successful weaning from invasive mechanical ventilation; however, it increased the incidence of successful weaning from non-invasive mechanical ventilation, and, significantly decreased the mortality rate in the 1st age subgroup, while in the 2nd age subgroup, it had no impact on the incidence of successful weaning from invasive mechanical ventilation and mortality rate.

Sexuality and fertility in long-term survivors of testicular cancer.

1997 ◽  
Vol 15 (4) ◽  
pp. 1444-1448 ◽  
Author(s):  
Y Arai ◽  
M Kawakita ◽  
Y Okada ◽  
O Yoshida
Keyword(s):  
Sexual Dysfunction ◽  
Testicular Cancer ◽  
Treatment Modalities ◽  
Retroperitoneal Lymph Node Dissection ◽  
Treatment Groups ◽  
Significant Difference ◽  
Chemotherapy Patients ◽  
The Impact ◽  
Long Term Survivors

PURPOSE We assessed the impact of different treatment modalities on sexuality and fertility in long-term survivors of testicular cancer. MATERIALS AND METHODS The sample consisted of 85 testicular cancer patients, of whom 19 had undergone chemotherapy with retroperitoneal lymph node dissection (RPLND), 15 had received chemotherapy only, 42 had received infradiaphragmatic radiotherapy, and nine had received surveillance therapy. The questionnaire reported sexual function, marital status, and issues related to fertility and childbearing. RESULTS One fourth to one half reported some type of sexual impairment in each group. The only significant difference was that approximately 70% of men with RPLND reported inability of ejaculation and a greater decline in semen volume, which is expected. The most striking finding is that the rates and nature of sexual dysfunction of surveillance patients were similar to other treatment groups, except for ejaculatory function. The highest rates of infertility distress were observed in chemotherapy patients. CONCLUSION These data suggest that sexual dysfunction and infertility represent the major persisting side effects, even years after diagnosis. The hypothesis that surveillance patients have fewer sexual problems is not upheld in this study.

scholarly journals Effect of Alternative Palatal Root Access Technique on Fracture Resistance of Root Canal Treated Maxillary Fourth Premolar Teeth in Dogs

2020 ◽  
Vol 7 ◽  
Author(s):  
Jennifer Matelski ◽  
Aaron Rendahl ◽  
Stephanie Goldschmidt
Keyword(s):  
Root Canal ◽  
Fracture Resistance ◽  
Testing Machine ◽  
Maximum Force ◽  
Treatment Modalities ◽  
Control Group ◽  
Materials Testing ◽  
Treatment Technique ◽  
Treatment Groups ◽  
Significant Difference

A biomechanical study was performed to identify the effect of different treatment methods for difficult to instrument palatal roots on the fracture resistance of root canal treated maxillary fourth premolar teeth in dogs. Forty maxillary fourth premolar teeth with surrounding alveolar bone were harvested from beagle cadavers. Inclusion criteria included maxillary fourth premolars with no evidence of disease and similar distal root canal volumes on radiographic evaluation. The teeth were randomly divided into a control group and three treatment groups based on the endodontic treatment technique for the palatal root. The control group had a single 2 mm transcoronal access on the mesiobuccal aspect of the tooth to allow instrumentation of both the mesiobuccal and palatal root through a single small access. Alternative treatment modalities that are described for difficult to instrument palatal roots investigated in this study included enlarging the transcoronal mesiobuccal access to 4 mm, making an additional access directly over the palatal root (2 mm), and hemisection with extraction of the palatal root. All teeth had the same distal root access size (2 mm) and relative location. After access, all teeth were filed, shaped, obturated, and restored in the same fashion. Axial compression testing was performed at an angle of 60 degrees to the long axis of the tooth using a universal materials testing machine. The maximum force prior to fracture was determined for each tooth based on a force vs. deflection curve. The mean maximum force prior to fracture for all teeth was 831 N. No significant difference in mean fracture resistance was identified between the control group and treatment groups or between the different treatment groups themselves. Thus, when faced with a difficult to instrument palatal root, the treatment method chosen should be based on operator preference and experience.

scholarly journals About Cantilevered Resin Bonded Bridges

2021 ◽  
Vol 8 ◽  
Author(s):  
Soraya El Yaagoubi ◽  
Morchad Bouabid ◽  
Amal El Yamani
Keyword(s):  
Periodontal Diseases ◽  
Survival Rates ◽  
Clinical Situation ◽  
Treatment Modalities ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Fixed Dental Prosthesis ◽  
Significant Difference ◽  
All Ceramic ◽  
Post Traumatic

Resin bonded bridge technique was first introduced in 1963 by Rochette. It was the first type of non-invasive fixed dental prosthesis because the abutment tooth didn’t undergo any prior preparation. As early as 1996, Hussey and Linden studied cantilever resin bonded bridges and showed that there was no significant difference in the survival rates of a conventional bridge and cantilever resin bonded bridges. The main indications for a resin bonded bridge in children are post-traumatic edentulousness, during the early detection of agenesis and pre-implant temporization situations. Resin bonded bridges are also recommended in adults when the implant context is unfavourable or contraindicated (periodontal diseases and / or anatomical and prosthetic obstacles). Cantilever resin bonded bridge has many advantages compared to the traditional bridge: simpler and faster to make, more economical for the patient, easier hygiene and absence of partial detachment that can lead to secondary caries lesion.The preparation criteria will be adapted to the clinical situation, which will take into account the patient's age, the extent of edentulousness, the extent of occlusal loads and dental mobility. Thus, when the joint is subject to excessive stress, retention devices will complete the preparation. With the continuous development of materials as well as new minimally invasive treatment modalities, the alternative solution of the bonded bridge in the anterior region now corresponds to the realization of an all-ceramic zirconia cantilever bridge with a single wing.

scholarly journals Cost-Minimization Analysis of Non-Invasive and Invasive Mechanical Ventilation for De Novo Acute Hypoxemic Respiratory Failure in an Eastern European Setting

2019 ◽  
Vol 46 (1) ◽  
pp. 17-20
Author(s):  
V. Ilieva ◽  
T. Mihalova ◽  
Yo. Yamakova ◽  
R. Petkov ◽  
B. Velev
Keyword(s):  
Mechanical Ventilation ◽  
Respiratory Failure ◽  
Cost Minimization ◽  
Invasive Mechanical Ventilation ◽  
Medical Costs ◽  
Non Invasive ◽  
Saps Ii ◽  
Direct Medical Costs ◽  
Saps Ii Score ◽  
Significant Difference

Abstract Introduction: In the light of constant pressure for minimizing healthcare costs we made a cost-minimization analysis comparing invasive mechanical ventilation (IMV) and non-invasive ventilation (NIV) as treatment for hypoxemic acute respiratory failure (ARF). Aim: The primary objective was to estimate the direct medical costs generated by a patient on IMV and NIV. A secondary objective was to identify which aspect of the treatment was most expensive. Material and Methods: This is a single center retrospective study including 36 patients on mechanical ventilation due to hypoxemic ARF, separated in two groups – NIV (n = 18) and IMV (n = 18). We calculated all direct medical costs in Euro and compared them statistically. Results: On admission the PaO2/FiO2 and SAPS II score were comparable in both groups. We observed a significant difference in the costs per patient for drug treatment (NIV: 616.07; IQR: 236.68, IMV:1456.18; IQR:1741.95, p = 0.005), consumables (NIV: 16.47; IQR: 21.44, IMV: 98.79; IQR: 81.52, p < 0.001) and diagnostic tests (NIV: 351; IQR: 183.88, IMV: 765.69; IQR: 851.43, p < 0.001). We also computed the costs per patient per day and there was a significant difference in the costs in all above listed categories. In both groups the highest costs were for drug treatment – around 61%. Conclusions: In the setting of hypoxemic ARF NIV reduces significantly the direct medical costs of treatment in comparison to IMV. The decreased costs in NIV are not associated with severity of disease according to the respiratory quotient and SAPS II score.

scholarly journals Outcomes and characteristics of COVID-19 patients treated with CPAP/ HFNO outside of the intensive care setting

2021 ◽  
pp. 00318-2021
Author(s):  
Dominic L Sykes ◽  
Michael G Crooks ◽  
Khaing Thu Thu ◽  
Oliver I Brown ◽  
Theodore J p Tyrer ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Intensive Care ◽  
Respiratory Failure ◽  
Care Setting ◽  
Treatment Options ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Support ◽  
Intensive Care Setting ◽  
Non Invasive ◽  
Significant Difference

BackgroundContinuous Positive Airway Pressure (CPAP) and High Flow Nasal Oxygen (HFNO) have been used to manage hypoxaemic respiratory failure secondary to COVID-19 pneumonia. Limited data are available for patients treated with non-invasive respiratory support outside of the intensive care setting.MethodsIn this single-centre observational study we observed the characteristics, physiological observations, laboratory tests, and outcomes of all consecutive patients with COVID-19 pneumonia between April 2020 and March 2021 treated with non-invasive respiratory support outside of the intensive care setting.ResultsWe report the outcomes of 140 patients (Mean Age=71.2 [sd=11.1], 65% Male [n=91]) treated with CPAP/HFNO outside of the intensive care setting. Overall mortality was 59% and was higher in those deemed unsuitable for mechanical ventilation (72%). The mean age of survivors was significantly lower than those who died (66.1 versus 74.4 years, p<0.001). Those who survived their admission also had a significantly lower median Clinical Frailty Score than the non-survivor group (2 versus 4, p<0.001). We report no significant difference in mortality between those treated with CPAP (n=92, mortality: 60%) or HFNO (n=48, mortality: 56%). Treatment was well tolerated in 86% of patients receiving either CPAP or HFNO.ConclusionsCPAP and HFNO delivered outside of the intensive care setting are viable treatment options for patients with hypoxaemic respiratory failure secondary to COVID-19 pneumonia, including those considered unsuitable for invasive mechanical ventilation. This provides an opportunity to safeguard intensive care capacity for COVID-19 patients requiring invasive mechanical ventilation.

scholarly journals Chemical characterization and effects of volatile oil of Alpinia zerumbet on the quality of collagen deposition and caveolin-1 expression in a muscular fibrosis murine model

2024 ◽  
Vol 84 ◽  
Author(s):  
T. S. C. Batista ◽  
G. S. Barros ◽  
F. C. Damasceno ◽  
E. A. F. Cândido ◽  
M. V. A. Batista
Keyword(s):  
Gastrocnemius Muscle ◽  
Low Cost ◽  
Chemical Characterization ◽  
Volatile Oil ◽  
Treatment Groups ◽  
Caveolin 1 ◽  
Non Invasive ◽  
Significant Difference ◽  
Alpinia Zerumbet

Abstract This study evaluated the effect of the volatile oil of Alpinia zerumbet (VOAz) on caveolin-1 gene expression and muscular fibrosis. The rats were immobilized to induce fibrosis of the gastrocnemius muscle, and they were treated with VOAz. Collagen quality was assessed by histology and the expression of the caveolin-1 (CAV-1) gene was evaluated using qPCR. Histomorphological analysis indicated a significant reduction in the perimeter, width, and intensity of collagen in the treated groups, thus showing that the oil was effective in regulating the quality of collagen at the three concentrations. The results of expression levels suggested a decrease in the lesioned group and in two treatment groups (0.0115 µg/g and 0.009 µg/g). However, with the lowest concentration (0.0065 µg/g), no significant difference was observed, with levels similar to those found in healthy tissue. Therefore, the results showed that VOAz has the potential to be a non-invasive and low-cost alternative to aid in the treatment of muscular fibrosis.

Ambulatory care of non-invasive mechanical ventilation in COPD patients with global decompensated respiratory acidosis

Pneumologie ◽  
2017 ◽  
Vol 71 (S 01) ◽  
pp. S1-S125
Author(s):  
EJ Soto Hurtado ◽  
P Gutiérrez Castaño ◽  
JJ Torres ◽  
MD Jiménez Fernández ◽  
M Pérez Soriano ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Ambulatory Care ◽  
Invasive Mechanical Ventilation ◽  
Respiratory Acidosis ◽  
Non Invasive ◽  
Copd Patients

Relevance Predictability in Information Retrieval Systems

1967 ◽  
Vol 06 (02) ◽  
pp. 45-51 ◽  
Author(s):  
A. Kent ◽  
J. Belzer ◽  
M. Kuhfeerst ◽  
E. D. Dym ◽  
D. L. Shirey ◽  
...  
Keyword(s):  
Information Retrieval ◽  
Experimental Conditions ◽  
Treatment Groups ◽  
Retrieval Systems ◽  
Significant Difference ◽  
Information Retrieval Systems ◽  
High Predictability ◽  
Intermediate Response ◽  
Quantitative Indicators ◽  
Level Of Processing

An experiment is described which attempts to derive quantitative indicators regarding the potential relevance predictability of the intermediate stimuli used to represent documents in information retrieval systems. In effect, since the decision to peruse an entire document is often predicated upon the examination of one »level of processing« of the document (e.g., the citation and/or abstract), it became interesting to analyze the properties of what constitutes »relevance«. However, prior to such an analysis, an even more elementary step had to be made, namely, to determine what portions of a document should be examined.An evaluation of the ability of intermediate response products (IRPs), functioning as cues to the information content of full documents, to predict the relevance determination that would be subsequently made on these documents by motivated users of information retrieval systems, was made under controlled experimental conditions. The hypothesis that there might be other intermediate response products (selected extracts from the document, i.e., first paragraph, last paragraph, and the combination of first and last paragraph), that would be as representative of the full document as the traditional IRPs (citation and abstract) was tested systematically. The results showed that:1. there is no significant difference among the several IRP treatment groups on the number of cue evaluations of relevancy which match the subsequent user relevancy decision on the document;2. first and last paragraph combinations have consistently predicted relevancy to a higher degree than the other IRPs;3. abstracts were undistinguished as predictors; and4. the apparent high predictability rating for citations was not substantive.Some of these results are quite different than would be expected from previous work with unmotivated subjects.

Sign in / Sign up

Export Citation Format

Share Document