scholarly journals Therapeutic Plasma Exchange in Multiple Sclerosis and Autoimmune Encephalitis: a Comparative Study of Indication, Efficacy and Safety

2019 ◽  
Vol 9 (10) ◽  
pp. 267 ◽  
Author(s):  
Moser ◽  
Harutyunyan ◽  
Karamyan ◽  
Otto ◽  
Bacher ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Plasma Exchange ◽  
Care Center ◽  
Tertiary Care ◽  
Autoimmune Encephalitis ◽  
Retrospective Chart Review ◽  
Therapeutic Plasma Exchange ◽  
Efficacy And Safety ◽  
Cns Disorders ◽  
Immune Mediated

Therapeutic plasma exchange (TPE) is a well-established method of treatment for steroid-refractory relapses in multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). Little is known about indications and clinical responses to TPE in autoimmune encephalitis and other immune-mediated disorders of the central nervous system (CNS). We performed a retrospective chart review of patients with immune-mediated disorders of the CNS undergoing TPE at our tertiary care center between 2003 and 2015. The response to TPE within a 3- to 6-month follow-up was scored with an established rating system. We identified 40 patients including 21 patients with multiple sclerosis (MS, 52.5%), 12 with autoimmune encephalitis (AE, 30%), and 7 with other immune-mediated CNS disorders (17.5%). Among patients with AE, eight patients had definite AE (Immunolobulin G for N-methyl-D-aspartate receptor n = 4, Leucine-rich, glioma inactivated 1 n = 2, Ma 2 n = 1, and Alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic Acid n = 1). Intravenous immunoglobulins had been given prior to TPE in all but one patient with AE, and indications were dominated by acute psychosis and epileptic seizures. While TPE has a distinct place in the treatment sequence of different immune-mediated CNS disorders, we found consistent efficacy and safety. Further research should be directed toward alternative management strategies in non-responders.

Therapeutic Plasma Exchange in Children — Experience From a Tertiary Care Center

2021 ◽  
Vol 58 (12) ◽  
pp. 1151-1154
Author(s):  
Rufaida Mazahir ◽  
Kanav Anand ◽  
P. K. Pruthi
Keyword(s):  
Plasma Exchange ◽  
Care Center ◽  
Tertiary Care ◽  
Therapeutic Plasma Exchange ◽  
Tertiary Care Center

Therapeutic plasma exchange in neurological diseases: Eleven years experience a tertiary care center in Turkey

2021 ◽  
Author(s):  
Ahmet Seyhanli ◽  
Boran Yavuz ◽  
Ismail Selımoglu ◽  
İhsan Sukru Sengun ◽  
Abdullah Taha Aslan ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Neurological Diseases ◽  
Care Center ◽  
Tertiary Care ◽  
Therapeutic Plasma Exchange ◽  
Tertiary Care Center

scholarly journals Therapeutic plasma exchange in a tertiary care center: 185 patients undergoing 912 treatments - a one-year retrospective analysis

2018 ◽  
Vol 19 (1) ◽  
Author(s):  
Julius J. Schmidt ◽  
Firas Asper ◽  
Gunilla Einecke ◽  
Gabriele Eden ◽  
Carsten Hafer ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Retrospective Analysis ◽  
Care Center ◽  
Tertiary Care ◽  
Therapeutic Plasma Exchange ◽  
Tertiary Care Center ◽  
One Year

Therapeutic Plasma Exchange Use in Pediatric Neurologic Disorders at a Tertiary Care Center: A 10-Year Review

2018 ◽  
Vol 33 (2) ◽  
pp. 140-145 ◽  
Author(s):  
Sonika Agarwal ◽  
Jake R. Keller ◽  
Chloe E. Nunneley ◽  
Eyal Muscal ◽  
Michael C. Braun ◽  
...  
Keyword(s):  
Plasma Exchange ◽  
Mental Status ◽  
Pediatric Population ◽  
Care Center ◽  
Tertiary Care ◽  
Motor Impairment ◽  
Inpatient Rehabilitation ◽  
Therapeutic Plasma Exchange ◽  
Vision Impairment ◽  
Neurologic Disorders

Pediatric neurologic conditions requiring therapeutic plasma exchange are rare in children and literature is sparse. The study aims to determine the outcomes, safety, and feasibility of therapeutic plasma exchange treatment in pediatric neurologic disorders. This retrospective analysis looked at the outcomes and safety of therapeutic plasma exchange in children (n = 50) with neurologic conditions. Patient age ranged <1 to 19 years old with a mean of 10.35 years. Of the 50 children treated with plasmapheresis, 26 patients received inpatient rehabilitation. At discharge, functional status can be summarized as follows: 24 (48%) with mental status impairment, 10 (20%) with vision impairment, 19 (38%) with bladder incontinence, and 37 (74%) with motor impairment. Three-month follow-up: 30% with mental status impairment, 10% with vision impairment, 18% with bladder incontinence, and 52% with motor impairment. Therapeutic plasma exchange is an effective and safe therapy for neurological conditions in the pediatric population.

Prevalence, Correlates and Management of Hyperglycemia in Diabetic Non-critically Ill Patients at a Tertiary Care Center in Lebanon

2019 ◽  
Vol 15 (2) ◽  
pp. 133-140 ◽  
Author(s):  
Ghada El Khoury ◽  
Hanine Mansour ◽  
Wissam K. Kabbara ◽  
Nibal Chamoun ◽  
Nadim Atallah ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Care Center ◽  
Descriptive Analysis ◽  
Tertiary Care ◽  
Multivariable Analysis ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Diabetic Patients

Background: Diabetes Mellitus is a chronic metabolic disease that affects 387 million people around the world. Episodes of hyperglycemia in hospitalized diabetic patients are associated with poor clinical outcomes and increased morbidity and mortality. Therefore, prevention of hyperglycemia is critical to decrease the length of hospital stay and to reduce complications and readmissions. Objective: The study aims to examine the prevalence of hyperglycemia and assess the correlates and management of hyperglycemia in diabetic non-critically ill patients. Methods: The study was conducted on the medical wards of a tertiary care teaching hospital in Lebanon. A retrospective chart review was conducted from January 2014 until September 2015. Diabetic patients admitted to Internal Medicine floors were identified. Descriptive analysis was first carried out, followed by a multivariable analysis to study the correlates of hyperglycemia occurrence. Results: A total of 235 medical charts were reviewed. Seventy percent of participants suffered from hyperglycemia during their hospital stay. The identified significant positive correlates for inpatient hyperglycemia, were the use of insulin sliding scale alone (OR=16.438 ± 6.765-39.941, p=0.001) and the low frequency of glucose monitoring. Measuring glucose every 8 hours (OR= 3.583 ± 1.506-8.524, p=0.004) and/or every 12 hours (OR=7.647 ± 0.704-79.231, p=0.0095) was associated with hyperglycemia. The major factor perceived by nurses as a barrier to successful hyperglycemia management was the lack of knowledge about appropriate insulin use (87.5%). Conclusion: Considerable mismanagement of hyperglycemia in diabetic non-critically ill patients exists; indicating a compelling need for the development and implementation of protocol-driven insulin order forms a comprehensive education plan on the appropriate use of insulin.

Comparative Morbidity Profile of Elective vs Therapeutic Neck Dissection

2021 ◽  
pp. 019459982110089
Author(s):  
Quinn Dunlap ◽  
James Reed Gardner ◽  
Amanda Ederle ◽  
Deanne King ◽  
Maya Merriweather ◽  
...  
Keyword(s):  
Neck Dissection ◽  
Surgical Complications ◽  
Chart Review ◽  
Care Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Neck Surgery ◽  
Continuous Variables ◽  
Significant Difference ◽  
History Of

Objective Neck dissection (ND) is one of the most commonly performed procedures in head and neck surgery. We sought to compare the morbidity of elective ND (END) versus therapeutic ND (TND). Study Design Retrospective chart review. Setting Academic tertiary care center. Methods Retrospective chart review of 373 NDs performed from January 2015 to December 2018. Patients with radical ND or inadequate chart documentation were excluded. Demographics, clinicopathologic data, complications, and sacrificed structures during ND were retrieved. Statistical analysis was performed with χ2 and analysis of variance for comparison of categorical and continuous variables, respectively, with statistical alpha set a 0.05. Results Patients examined consisted of 224 males (60%) with a mean age of 60 years. TND accounted for 79% (n = 296) as compared with 21% (n = 77) for END. Other than a significantly higher history of radiation (37% vs 7%, P < .001) and endocrine pathology (34% vs 2.6%, P < .001) in the TND group, no significant differences in demographics were found between the therapeutic and elective groups. A significantly higher rate of structure sacrifice and extranodal extension within the TND group was noted to hold in overall and subgroup comparisons. No significant difference in rate of surgical complications was appreciated between groups in overall or subgroup analysis. Conclusion While the significantly higher rate of structure sacrifice among the TND population represents an increased morbidity profile in these patients, no significant difference was found in the rate of surgical complications between groups. The significant difference seen between groups regarding history of radiation and endocrine pathology likely represents selection bias.

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