scholarly journals Evaluation of favipiravir treatment before intensive care in COVID-19 patients

2021 ◽  
Vol 10 (1) ◽  
pp. 22-30
Author(s):  
Osman Ozudogru ◽  
Emrah Yerlikaya ◽  
Naci Omer Alayunt ◽  
Zafer Çambay
Keyword(s):  
Information System ◽  
Intensive Care ◽  
Hospital Information System ◽  
Treatment Protocol ◽  
Pulmonary Involvement ◽  
Clinical Findings ◽  
Definitive Treatment ◽  
Intensive Care Treatment ◽  
Healing Effect

The purpose of this study is to investigate the healing effect of Favipiravir used in pre-intensive care treatment of patients diagnosed with COVID-19 in order to elucidate the pathogenesis and complications of coronavirus. The data regarding the clinical findings of the patients in the hospital information system and the biochemical parameters made standard in the treatment/follow-up of COVID 19 were taken from the system and evaluated retrospectively. In addition, it was examined as a whole with mild, moderate and severe pulmonary involvement compared to CT findings. Hemogram, coagulation and biochemistry parameters used in the diagnosis and follow-up of COVID-19 were evaluated. SPSS 22.0 statistics program for Windows was used in statistical analysis to evaluate the data obtained from patient files and hospital information system. There is no definitive treatment protocol within the scope of treatment. Drug studies are currently ongoing. In this study, the first clinical findings, treatment types and recovery times of patients diagnosed with COVID-19, the healing effect of favipiravir used before intensive care were determined. Between group 1 (those who started treatment within 0-5 days) and group 2 (those who started treatment within 6-10 days), after 5 days of favipravir treatment, when serum parameters were compared, favipravir treatment was statistically significantly lower in the first group that was started early, WBC, Neutrophil, Creatine, CK, CRP, D-Dimer, PCT, LDH. By collecting the data obtained as a result of the research, early deaths can be prevented worldwide. Our study recommending alternative treatment approaches is important for the protection of patients' quality of life. In this study, when all biochemical markers were evaluated together, it was evaluated that starting Favipiravir treatment early was beneficial in treating COVID-19 disease.

scholarly journals Fully Automated Surveillance of Healthcare-Associated Infections with MONI-ICU

2011 ◽  
Vol 02 (03) ◽  
pp. 365-372 ◽  
Author(s):  
H. Mandl ◽  
K.-P. Adlassnig ◽  
W. Koller ◽  
A. Blacky
Keyword(s):  
Information System ◽  
Intensive Care ◽  
Expert Knowledge ◽  
Good Clinical Practice ◽  
Clinical Findings ◽  
False Alarms ◽  
Sufficient Information ◽  
Healthcare Associated Infections ◽  
Additional Time ◽  
Healthcare Associated

SummaryObjective: Expert surveillance of healthcare-associated infections (HCAIs) is a key parameter for good clinical practice, especially in intensive care medicine. Assessment of clinical entities such as HCAIs is a time-consuming task for highly trained experts. Such are neither available nor affordable in sufficient numbers for continuous surveillance services. Intelligent information technology (IT) tools are in urgent demand.Methods: MONI-ICU (monitoring of nosocomial infections in intensive care units (ICUs)) has been developed methodologically and practically in a stepwise manner and is a reliable surveillance IT tool for clinical experts. It uses information from the patient data management systems in the ICUs, the laboratory information system, and the administrative hospital information system of the Vienna General Hospital as well as medical expert knowledge on infection criteria applied in a multilevel approach which includes fuzzy logic rules.Results: We describe the use of this system in clinical routine and compare the results generated automatically by MONI-ICU with those generated in parallel by trained surveillance staff using patient chart reviews and other available information (“gold standard”). A total of 99 ICU patient admissions representing 1007 patient days were analyzed. MONI-ICU identified correctly the presence of an HCAI condition in 28/31 cases (sensitivity, 90.3%) and their absence in 68/68 of the non-HCAI cases (specificity, 100%), the latter meaning that MONI-ICU produced no “false alarms”. The 3 missed cases were due to correctable technical errors. The time taken for conventional surveillance at the 52 ward visits was 82.5 hours. MONI-ICU analysis of the same patient cases, including careful review of the generated results, required only 12.5 hours (15.2%).Conclusion: Provided structured and sufficient information on clinical findings is online available, MONI-ICU provides an almost real-time view of clinical indicators for HCAI – at the cost of almost no additional time on the part of surveillance staff or clinicians.

Laryngeal Verrucous Carcinoma: A Systematic Review

2016 ◽  
Vol 156 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Kristen A. Echanique ◽  
Stuti V. Desai ◽  
Emily Marchiano ◽  
Eleonora F. Spinazzi ◽  
Primož Strojan ◽  
...  
Keyword(s):  
Local Excision ◽  
Verrucous Carcinoma ◽  
Treatment Protocol ◽  
Disease Free Survival ◽  
Treatment Modalities ◽  
Definitive Treatment ◽  
T Stage ◽  
Number Of Patients ◽  
Disease Free

Objective Laryngeal verrucous carcinoma (LVC) is a rare, locally invasive neoplasm comprising 1% to 3.4% of laryngeal carcinomas. Management strategies are a topic of ongoing conversation, and no definitive treatment protocol based on T stage and presentation exists. This review examines characteristics, treatment modalities, and patient outcomes of LVC. Data Sources PubMed, MEDLINE, EMBASE, and Web of Science. Methods Databases were searched through October 29, 2015, for literature detailing individual patient cases of LVC. Variables analyzed included patient demographics, tumor characteristics, tumor size, treatment, and outcomes. Results Thirty-seven articles with 369 cases were included. LVC was found more commonly in males (13.8:1), at an average age of 58.7 years, and located in the glottis (74.0%). Most patients had local disease at presentation (94.9%). The most common presenting symptom was hoarseness (92.3%). The most common primary treatment was surgery alone (72.3%), with local excision as the most common technique (56.8%). In patients with data available on both surgical modality and T stage, most patients who presented as T1 and were managed surgically underwent local excision (79.2%). Surgical treatment alone led to high rates of disease-free survival at follow-up (86.8%). A large number of patients presenting with T1 disease were disease free at follow-up (88.6%). Overall survival was 80.3%. Conclusion LVC is most often managed surgically. The extent of surgical resection may be guided by T stage, with smaller tumors resected via local excision and larger tumors via partial or total laryngectomy. Regardless of T stage or therapy, LVC has a good posttreatment prognosis.

scholarly journals Measles resurgence in Argentina: 1997–8 outbreak

2000 ◽  
Vol 124 (2) ◽  
pp. 289-293 ◽  
Author(s):  
M. D. BILKIS ◽  
P. R. BARRERO ◽  
A. S. MISTCHENKO
Keyword(s):  
Intensive Care ◽  
Molecular Epidemiology ◽  
Measles Virus ◽  
Buenos Aires ◽  
Clinical Findings ◽  
Hospitalized Children ◽  
Rt Pcr ◽  
Sensitive Tool ◽  
Catch Up

Epidemiological and clinical findings from 1162 serologically confirmed measles cases occurring in Buenos Aires, Argentina in 1997 and 1998 were retrospectively reviewed. From 90 hospitalized children, measles virus was detected by direct RT–PCR from nasopharyngeal secretions. Patients were grouped as follows: (i) not vaccinated: infants < 12 months; (ii) regularly vaccinated: children 1–4 years not covered by the last catch-up; (iii) catch-up vaccinated: patients 5–19 years immunized during the 1993 campaign. Most cases were recorded in non-vaccinated infants (54%), and the lowest in catch-up vaccinated children (16%). Mean age of the 90 hospitalized children was 11·3 months. Pneumonia was the major hospitalization cause followed by pneumonitis. Two children required intensive care and one died. The 1993 catch-up campaign seemed to reduce the number of cases in the 5- to 19-year-old group. Lack of timely follow-up probably led to the accumulation of susceptible individuals allowing measles re-emergence. Direct viral detection by RT–PCR proved to be a sensitive tool for molecular epidemiology surveillance.

Relevance of post-operative radiographs in maxillofacial fractures- A retrospective multicentre study

2019 ◽  
Vol 11 (1) ◽  
pp. 37-43
Author(s):  
Vaibhav N ◽  
Vivek GK, ◽  
Akshay Shetty ◽  
Shashidhara Kamath ◽  
Abhishek Ghosh
Keyword(s):  
Multicentre Study ◽  
Clinical Course ◽  
Treatment Protocol ◽  
Clinical Findings ◽  
Maxillofacial Region ◽  
Maxillofacial Fractures ◽  
Operative Complications ◽  
Case Files ◽  
Potential Risks

The practice of ordering post-operative radiograph is a topic of debate with questions being raised about its usefulness and relevance. In most institutions it is being practised as a part of treatment protocol in all patients with fractures in the maxillofacial region. The aim of this retrospective multicentre study is to assess the need for post-operative radiographs by analyzing its impact on the immediate post surgical management and clinical course. We conducted a retrospective multicentre study in which we analyzed case records of patients with maxillofacial fractures treated under GA or LA during the period Jun 2010 to June 2016. The search yielded 343 case files with a follow-up period of minimum one month. Of these only 3 (0.9%) were re-operated because of findings of the post-operative radiograph. Considering their ability to predict post-operative complications, their benefits, and the potential risks, we recommend that clinical findings alone should dictate the need for ‘check’ post-operative radiographs. The practice of ordering post-operative radiographs routinely for all cases should be discouraged.

scholarly journals Follow-up after paediatric intensive care treatment: parental posttraumatic stress

2008 ◽  
Vol 97 (2) ◽  
pp. 181-186 ◽  
Author(s):  
Madelon B Bronner ◽  
Hennie Knoester ◽  
Albert P Bos ◽  
Bob F Last ◽  
Martha A Grootenhuis
Keyword(s):  
Intensive Care ◽  
Posttraumatic Stress ◽  
Paediatric Intensive Care ◽  
Intensive Care Treatment ◽  
Care Treatment

scholarly journals Use of computed tomography imaging during long-term follow-up of nine feline tuberculosis cases

2017 ◽  
Vol 20 (2) ◽  
pp. 189-199 ◽  
Author(s):  
Alison Major ◽  
Conor O’Halloran ◽  
Andrea Holmes ◽  
Stephanie Lalor ◽  
Rebecca Littler ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Treatment Protocol ◽  
Case Series ◽  
Clinical Findings ◽  
Response To Treatment ◽  
Ct Findings ◽  
Long Term Follow Up ◽  
Diagnostic Investigations

Case series summary Feline tuberculosis is an increasingly recognised potential zoonosis of cats. Treatment is challenging and prognosis can vary greatly between cases. Pulmonary infection requires extended courses of antibiotics, but methodologies for sensitively monitoring response to treatment are currently lacking. In this case series, we retrospectively examined the serial computed tomography (CT) findings in nine cats that had been diagnosed with tuberculosis. Changes in pathology (where applicable to tuberculosis) were correlated with the clinical presentation of each of the cats, the treatment protocol, and previous and contemporary diagnostic investigations. This study found that changes in CT findings during the medium- to long-term management of feline tuberculosis were highly variable between cats. The majority of cats had reduced pathology at re-examination during anti-tuberculous therapy, but pathology only resolved in a minority of cases. In some cases recurrence of pathology detected by CT imaging preceded clinical deterioration, allowing for rapid therapeutic intervention. Relevance and novel information When considered in combination with clinical findings, CT studies can aid in decision making regarding tapering of antibiotic protocols, or reintroduction of therapy in cases of recurrence or reinfection. This series also highlights that, in some cases, persistent abnormalities can be detected by CT, so complete resolution of CT pathology should not always be a goal in the management of feline tuberculosis.

Follow-up after intensive care treatment: a questionnaire survey of intensive care aftercare in Denmark

2017 ◽  
Vol 61 (8) ◽  
pp. 925-934 ◽  
Author(s):  
C. K. W. Kjer ◽  
S. Estrup ◽  
L. M. Poulsen ◽  
O. Mathiesen
Keyword(s):  
Intensive Care ◽  
Questionnaire Survey ◽  
Intensive Care Treatment ◽  
Care Treatment

Improving diagnosis of acute appendicitis with atypical findings by Tc-99m HMPAO leukocyte scan

2002 ◽  
Vol 41 (01) ◽  
pp. 37-41 ◽  
Author(s):  
S. Shung-Shung ◽  
S. Yu-Chien ◽  
Y. Mei-Due ◽  
W. Hwei-Chung ◽  
A. Kao
Keyword(s):  
Acute Appendicitis ◽  
False Positive ◽  
False Positive Rate ◽  
Accurate Method ◽  
Clinical Findings ◽  
Pathological Findings ◽  
Lower Quadrant ◽  
Predictive Values ◽  
Positive Rate

Summary Aim: Even with careful observation, the overall false-positive rate of laparotomy remains 10-15% when acute appendicitis was suspected. Therefore, the clinical efficacy of Tc-99m HMPAO labeled leukocyte (TC-WBC) scan for the diagnosis of acute appendicitis in patients presenting with atypical clinical findings is assessed. Patients and Methods: Eighty patients presenting with acute abdominal pain and possible acute appendicitis but atypical findings were included in this study. After intravenous injection of TC-WBC, serial anterior abdominal/pelvic images at 30, 60, 120 and 240 min with 800k counts were obtained with a gamma camera. Any abnormal localization of radioactivity in the right lower quadrant of the abdomen, equal to or greater than bone marrow activity, was considered as a positive scan. Results: 36 out of 49 patients showing positive TC-WBC scans received appendectomy. They all proved to have positive pathological findings. Five positive TC-WBC were not related to acute appendicitis, because of other pathological lesions. Eight patients were not operated and clinical follow-up after one month revealed no acute abdominal condition. Three of 31 patients with negative TC-WBC scans received appendectomy. They also presented positive pathological findings. The remaining 28 patients did not receive operations and revealed no evidence of appendicitis after at least one month of follow-up. The overall sensitivity, specificity, accuracy, positive and negative predictive values for TC-WBC scan to diagnose acute appendicitis were 92, 78, 86, 82, and 90%, respectively. Conclusion: TC-WBC scan provides a rapid and highly accurate method for the diagnosis of acute appendicitis in patients with equivocal clinical examination. It proved useful in reducing the false-positive rate of laparotomy and shortens the time necessary for clinical observation.

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