scholarly journals Microbiological profiles of tracheostomy patients: a single-center experience

2021 ◽  
Vol 16 ◽  
Author(s):  
Abdulaziz Alrabiah ◽  
Khaled Alhussinan ◽  
Mohammed Alyousef ◽  
Ahmed Alsayed ◽  
Abdullah Aljasser ◽  
...  
Keyword(s):  
Chart Review ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Strong Association ◽  
Retrospective Chart Review ◽  
Tracheal Aspirate ◽  
Positive Sample ◽  
Culture Result ◽  
Common Procedure ◽  
Single Center Experience ◽  
Antibiotic Dose

Background: This study compared the prevalence of common microorganisms in obstructed and non-obstructed cases across the four quarters on the first post-tracheostomy year.Methods: A retrospective chart review of the microbiological profiles of all adult patients who underwent a tracheostomy was conducted between June 2015 and September 2019 at our hospital. Based on the tracheostomy indications, patients were allocated to obstructed or non-obstructed group. Any patient with at least one positive sample was followed up quarterly for a year. The first culture result obtained was recorded at least one month following the last antibiotic dose in each quarter.Results: Out of the 65 tracheal aspirate results obtained from 58 patients (mean age, 57.5±16.48 years), the most common procedure and indications were surgical tracheostomy (72.4%) and non-obstructed causes (74.1%), respectively. Moreover, 47.7% of the culture results indicated Pseudomonas aeruginosa, which showed significantly different proportions across the quarters (p=0.006). Among obstructed patients, P. aeruginosa was the most common (35%), followed by methicillin-resistant Staphylococcus aureus (MRSA; 23.5%).Conclusions: The most common post-tracheostomy microorganism was P. aeruginosa. MRSA showed a strong association with tracheostomy for obstructive indications.

The Degree of Overjet and Anterior Traumatic Dental Injury in the Mixed Dentition: A Single-Center Experience

2019 ◽  
Vol 43 (5) ◽  
pp. 360-363 ◽  
Author(s):  
Monica Munro ◽  
Marc B Ackerman
Keyword(s):  
Chart Review ◽  
Young Patients ◽  
Retrospective Chart Review ◽  
Mixed Dentition ◽  
Single Center ◽  
Dental Injury ◽  
Single Center Experience ◽  
Single Center Study ◽  
Review Study ◽  
Center Study

Objective. The objective of this retrospective chart review study was twofold. The first was to determine whether there is a correlation between the degree of overjet and the type of anterior traumatic dental injury (ATDI) in the mixed dentition. The second was to assess whether the decision to not treat young patients with prominent upper front teeth for trauma prevention resulted in a greater number of ATDI's in patients of record from a single-center. Study Design. The authors conducted a retrospective chart review of patients presenting to the Boston Children's Hospital (BCH) Emergency Department with an ATDI in the mixed dentition between October 2011 and March 2016. Results. Patients with an overjet less than or equal to 4 millimeters experienced all types of ATDI with greater frequency than those patients with an overjet greater than 4 mm. Conclusions. Our experience at BCH described in this study has led us to believe that a patient's risk of suffering an ATDI has more to do with the type of activities they participate in rather than the degree of their overjet.

Immune related adverse effects (IRAEs) in patients with cancer who received immune checkpoint inhibitors (ICIs): A single center experience from rural Maine.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19265-e19265
Author(s):  
Anannya Patwari ◽  
Vineel Bhatlapenumarthi ◽  
Antoine Joseph Harb ◽  
Adam Curtis
Keyword(s):  
Cancer Patients ◽  
Chart Review ◽  
Checkpoint Inhibitors ◽  
Retrospective Chart Review ◽  
Patients With Cancer ◽  
Single Center Experience ◽  
Review Analysis ◽  
Discontinuation Of Treatment ◽  
Males And Females ◽  
Treatment Table

e19265 Background: ICIs are used for a variety of malignancies and have shown to improve survival, but they are associated with IRAEs. We aim to identify the frequency and severity of new IRAEs and flares of preexisting autoimmune (AI) disorders excluding thyroid disorders in cancer patients treated with ICIs at our institution. Methods: We conducted a retrospective chart review analysis of all cancer patients who received ICIs: nivolumab, pembrolizumab, atezolizumab and durvalumab at the Northern Light Cancer Institute from June 2015 to March 2019. We excluded patients who received ipilimumab. We then studied those who developed IRAEs. Results: Out of 465 who received ICIs, 115(24.7%) developed IRAEs. 83 out of 298 (27.9%) nivolumab recipients, 20/121 (15.7%) pembrolizumab recipients, 5/26 (19.2%) atezolizumab and 7/20 (35%) durvalumab recipients developed IRAEs. Some patients had multiple toxicities. Median age at cancer diagnosis was 66 years, evenly split among males and females. Majority (63%) were treated for Lung cancer, followed by melanoma (20%) and genitourinary cancers (12%). Summary of new IRAEs are as noted in the table below. In patients with new IRAEs treatment was held in 29(6%) for a median duration of 7.2 wks. Upon rechallenge with the same ICI in 27 patients, 20(74%) tolerated and 7 did not leading to permanent discontinuation. Majority were treated with steroids and some required immunomodulators. Interestingly 39(8%) patients with underlying AI condition received ICIs. Of these 11(28.2%) developed flares, resulting in permanent discontinuation of drug in 4. The majority tolerated the treatment well. Treatment was permanently discontinued in 70(15%), 26(6%) required hospital admission for IRAEs. Pneumonitis was the most common toxicity necessitating treatment discontinuation and hospital stay. Conclusions: In real world setting the frequency and severity of IRAEs was more than the reported literature data, leading to higher rates of permanent discontinuation of treatment. [Table: see text]

A comparison of LISA versus insure: A single center experience

2021 ◽  
pp. 1-7
Author(s):  
T. Queliz Pena ◽  
J.A. Perez ◽  
M.J. Corrigan
Keyword(s):  
Replacement Therapy ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Less Invasive ◽  
Surfactant Replacement ◽  
Single Center Experience ◽  
Surfactant Replacement Therapy ◽  
Group 2 ◽  
Respiratory Outcomes ◽  
Group 1

BACKGROUND: Less invasive surfactant replacement therapy (SRT) methods have been linked to better respiratory outcomes. The primary aim of this study was to determine if Less Invasive Surfactant Administration (LISA) altered the rate of bronchopulmonary dysplasia (BPD) in preterm infants. Secondary objectives were to determine if LISA compared to Intubation Surfactant Extubation (InSurE) resulted in different respiratory outcomes and hospital course. METHODS: In this retrospective chart review, outcomes were compared in two preterm infant groups (25–32 weeks gestation). Infants in Group 1 received surfactant replacement therapy (SRT) via InSurE method, while infants in Group 2 received SRT via LISA method. RESULTS: Regardless of SRT method utilized, there were no significant differences in rates of BPD between the two groups in infants born at 25–32 weeks gestation (30.6% vs 33.3% ; P = 0.47). CONCLUSIONS: Despite using LISA method rather than InSurE for SRT, premature infants continue to be at high risk for BPD. LISA shows promise as a safe, noninvasive SRT alternative to invasive methods like InSurE.

Bupropion in the treatment of postural orthostatic tachycardia syndrome (POTS): a single-center experience

2020 ◽  
Vol 68 (6) ◽  
pp. 1156-1158
Author(s):  
Rohit Vyas ◽  
Zeid Nesheiwat ◽  
Mohammed Ruzieh ◽  
Zaid Ammari ◽  
Mohammad Al-Sarie ◽  
...  
Keyword(s):  
Statistical Analysis ◽  
Gold Standard ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Potential Treatment ◽  
Single Center ◽  
Single Center Experience ◽  
Dopamine Reuptake ◽  
Dopamine Reuptake Inhibitor

Postural orthostatic tachycardia syndrome (POTS) is estimated to impact millions of people each year. However, there is no established gold standard for its treatment. Bupropion is a norepinephrine and a dopamine reuptake inhibitor and has been implicated as a potential treatment for POTS. We performed a non-randomized retrospective chart review on 47 patients with POTS with statistical analysis evaluating for significant findings including reduced orthostasis and improvement of symptoms with the use of bupropion. Bupropion was not associated with a statistically significant improvement in orthostatic vitals but there was an overall reduction in reported syncope. While the use of bupropion does not show a statistically significant impact on orthostatic vitals in patients with POTS, it did show a degree of improvement in syncope and as such might be useful in patients with syncope-predominant POTS.

Timing of complications during and after elective endovascular intracranial aneurysm coiling

2017 ◽  
Vol 10 (4) ◽  
pp. 374-379 ◽  
Author(s):  
Michelle Masayo Kameda-Smith ◽  
Paula Klurfan ◽  
Brian Anthony van Adel ◽  
Ramiro Larrazabal ◽  
Forough Farrokhyar ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Chart Review ◽  
Strong Association ◽  
Retrospective Chart Review ◽  
Endovascular Coiling ◽  
Related Complication ◽  
Intraoperative Complication ◽  
Select Group ◽  
Aneurysm Coiling

ObjectiveTo determine the time to complications during and after elective endovascular intracranial aneurysm coiling.MethodsA retrospective chart review of patients undergoing elective endovascular aneurysm coiling between March 2006 and October 2013 in one large Eastern Canadian Neurointerventional Service was performed. Data regarding the incidence, time and type of complication related to the endovascular coiling procedure and clinical outcome at last follow-up were collected. Patient, aneurysm and operation factors were analyzed to determine any factors associated with complication occurrence.ResultsOf the 150 patient procedures analyzed, 16% experienced a coiling-related complication, although none resulted in death. 6.7% of patients experienced an intraoperative complication, of which thromboembolism was the most common type. The majority of the complications were detected in the first 6 hours after reversal of anesthesia, and a small proportion the next morning prior to discharge. Only 3.3% of patients had persistent neurological deficit after the procedure on last follow-up. Duration of the operation demonstrated a strong association with the occurrence of procedure-related complications.ConclusionThis study demonstrates that coiling-related complications of elective endovascular coiling tend to occur either intraoperatively or are detected shortly after reversal of anesthesia. Further investigation with a larger cohort may help to guide important preoperative communication with patients and identify a select group of patients who may not necessarily require prolonged admission to hospital for observation.

scholarly journals P.084 Single-centre follow-up of TYRX Antibiotic Envelope for neuromodulation unit implantation

2017 ◽  
Vol 44 (S2) ◽  
pp. S34-S35
Author(s):  
S Ahmed ◽  
K Waterhouse ◽  
A Vitali
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Cost Effective ◽  
The Body ◽  
Control Group ◽  
Single Centre ◽  
Significant Drop ◽  
Single Center Experience ◽  
Cost Effective Method

Background: Studies have placed the rate of infection associated with neuromodulation units to be up to 20%. We present our experience with the TYRX absorbable antibiotic envelope. Our length of follow-up adds to the body of evidence around the use of antibiotic envelops. Methods: We conducted a retrospective chart review of patients referred to our center for either new implantation or revision of neuromodulation units between July 2014 and September 2016. Consecutive cases were included for analysis. We included a control group of consecutive patients with neuromodulation units placed immediately prior to our experience with the TYRX envelopes for comparison Results: Between July 2014 and September 2016, 76 patients had 81 instances of neuromodulation unit insertion. All patients received the TYRX antibiotic envelope. There were no incidences of infection involving antibiotic envelope-containing implants over an average follow-up period of 11 months. In 77 consecutive cases of neuromodulation unit implantation prior to usage of the antibiotic pouch, there were 4 instances of infection (5.2%). Conclusions: Our single center experience demonstrates a significant drop in the rate of infections with the use of an antibiotic envelope for neuromodulation unit implantation. We consider the routine use of the envelope to be a cost-effective method of infection avoidance.

Radioactive iodine therapy for pediatric Graves’ disease: a single-center experience over a 10-year period

2020 ◽  
Vol 33 (3) ◽  
pp. 383-389 ◽  
Author(s):  
Paul B. Kaplowitz ◽  
Jiji Jiang ◽  
Priya Vaidyanathan
Keyword(s):  
Chart Review ◽  
Pediatric Patients ◽  
Radioactive Iodine ◽  
Thyroid Tissue ◽  
Retrospective Chart Review ◽  
Definitive Treatment ◽  
Multivariate Logistic Regression ◽  
Factors Associated ◽  
Single Center Experience

AbstractIntroductionOnly about 30% of pediatric patients with Graves’ hyperthyroidism achieve remission with medical therapy, and therefore radioactive iodine (RAI) therapy is often used as a definitive treatment. Although the goal of RAI is permanent hypothyroidism, this is not consistently achieved. We conducted a chart review to determine the factors associated with the success of RAI. We also tried to determine optimal follow-up post RAI and if there was an optimal L-thyroxine dose that would normalize the hypothyroid state quickly.MethodsThis is a retrospective chart review of Graves’ patients who underwent RAI between 2008 and 2017. We included age, sex, time from diagnosis, thyroid gland size, total dose of I-131 and dose in μCi/g of thyroid tissue. Patients were grouped based on outcome and analyzed using univariate and multivariate logistic regression. Follow-up thyroid levels post RAI and after starting l-thyroxine were analyzed.ResultsThere were 78 ablations including six repeat ablations. Seventy-three percent became hypothyroid, 23% remained overtly or subclinically hyperthyroid, and 4% were euthyroid. Smaller thyroid size (36.5 vs. 47.4 g; p = 0.037) and higher dose of I-131 (242 vs. 212 μCi/g thyroid tissue; p = 0.013) were associated with a higher likelihood of hypothyroidism. Most patients remained hyperthyroid at 1 month post RAI, but by 3 months the majority became hypothyroid. There was no clear L-thyroxine dose that normalized hypothyroidism quickly.ConclusionsAn I-131 dose close to 250 μCi/g of thyroid tissue has a higher likelihood of achieving hypothyroidism. Testing at 2–3 months after RAI is most helpful to confirm response to RAI.

Skin and Soft Tissue Abscess: 1 Year's Experience

2009 ◽  
Vol 13 (5) ◽  
pp. 257-261 ◽  
Author(s):  
Sandhya Nalmas ◽  
Eliahu Bishburg ◽  
Monica Shah ◽  
Trini Chan
Keyword(s):  
Soft Tissue ◽  
Drug Users ◽  
Chart Review ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Statistical Significance ◽  
Retrospective Chart Review ◽  
Underlying Disease ◽  
Recurrence Rates ◽  
Immunodeficiency Virus ◽  
Soft Tissue Abscess

Background: The incidence of skin and soft tissue abscesses (SSTAs) has increased owing to the emergence of community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA). Some of these patients are treated as outpatients (OPs) and some as inpatients (IPs). Objective: To review the microbiology and clinical features of SSTAs and the clinical parameters that may have influenced clinicians to treat patients as IPs. Methods: The study was conducted in a 673-bed teaching hospital between January and December 2005. A retrospective chart review of patients identified from a microbiology culture log was conducted. Data were collected for demographics, underlying disease, SSTA number and site, recurrence rates, and clinical presentation. Results: One hundred thirty-eight patients were identified; 76 (55%) were female, with a mean age of 42 years (range 18–80 years); 76 (55.5%) had no underlying disease, 27 (19.6%) had diabetes, 20 (14.5%) had human immunodeficiency virus (HIV) infection, and 13 (9.4%) were intravenous drug users. Common SSTA sites involved were the perineal area (43; 31.2%), upper extremities (35; 25.4%), lower extremities (19; 13.8%), head and neck (14; 10.1%), chest (13; 9.4%), and abdomen (8; 5.8%). Conclusions: CA-MRSA was the most commonly isolated organism overall and in patients treated as OPs. The decision to treat SSTA patients as IPs seems to be influenced by SSTA number and site and the presence of fever at presentation. SSTA number and site (variables that led to the decision to treat patients as IPs) were confirmed by demonstrating statistical significance in the analysis between the IP and OP groups, but the other determinant of admission, the presence of fever at presentation, was based on chart review statements and not confirmed by statistical analysis between the IP and OP groups.

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