Sociodemographic features and treatments of pregnant psychiatric inpatients in an university hospital: a retrospective chart review

Author(s):  
Selcuk Ozdin ◽  
Omer Boke ◽  
Merve Bilgin Kocak
Author(s):  
Azzeddine Kermad ◽  
Jacques Speltz ◽  
Guy Danziger ◽  
Thilo Mertke ◽  
Robert Bals ◽  
...  

Abstract Purpose In this retrospective study, we compared inhaled sedation with isoflurane to intravenous propofol in invasively ventilated COVID-19 patients with ARDS (Acute Respiratory Distress Syndrome). Methods Charts of all 20 patients with COVID-19 ARDS admitted to the ICU of a German University Hospital during the first wave of the pandemic between 22/03/2020 and 21/04/2020 were reviewed. Among screened 333 days, isoflurane was used in 97 days, while in 187 days, propofol was used for 12 h or more. The effect and dose of these two sedatives were compared. Mixed sedation days were excluded. Results Patients’ age (median [interquartile range]) was 64 (60–68) years. They were invasively ventilated for 36 [21–50] days. End-tidal isoflurane concentrations were high (0.96 ± 0.41 Vol %); multiple linear regression yielded the ratio (isoflurane infusion rate)/(minute ventilation) as the single best predictor. Infusion rates were decreased under ECMO (3.5 ± 1.4 versus 7.1 ± 3.2 ml∙h−1; p < 0.001). In five patients, the maximum recommended dose of propofol of 4 mg∙hour−1∙kg−1ABW was exceeded on several days. On isoflurane compared to propofol days, neuro-muscular blocking agents (NMBAs) were used less frequently (11% versus 21%; p < 0.05), as were co-sedatives (7% versus 31%, p < 0.001); daily opioid doses were lower (720 [720–960] versus 1080 [720–1620] mg morphine equivalents, p < 0.001); and RASS scores indicated deeper levels of sedation (− 4.0 [− 4.0 to − 3.0] versus − 3.0 [− 3.6 to − 2.5]; p < 0.01). Conclusion Isoflurane provided sufficient sedation with less NMBAs, less polypharmacy and lower opioid doses compared to propofol. High doses of both drugs were needed in severely ill COVID-19 patients.


Author(s):  
Oren Ziv ◽  
Aviad Sapir ◽  
Eugene Leibowitz ◽  
Sofia Kordeluk ◽  
Daniel KAPLAN ◽  
...  

Abstract Objectives: To determine the immediate post-operative course and outcome of pediatric patients with complicated acute mastoiditis (CAM) following surgical treatment. Study Design: A retrospective chart review of children diagnosed with CAM who underwent mastoid surgery during 2012-2019. Setting: Tertiary care university hospital. Participants: the study includes 33 patients, divided into two groups: 17 patients with subperiosteal abscess (SPA) alone - single complication group (SCG) and 16 patients with SPA and additional intracranial or intratemporal complications -multiple complications group (MCG). Main Outcome Measures: post-operative fever course and pattern (POF). Results :33 patients belong to the SCG 17(51%) and 16(49%) belonged to the MCG, respectively. 6/17(35.3%) SCG patients experienced POF vs. 12/16(75%) in the MCG (P=0.012). At post-operative day 2 (POD2), 10/13(77%) febrile patients belonged to MCG and 3/13(23%) to SCG (P=0.013). POF was recorded until POD6 in both groups. Seven patients, all from MCG with POF, underwent second imaging with no new findings. Conclusion: Following a cortical mastoidectomy for CAM, POF is not unusual in the first 6 days and seem to be benign condition. POF is more common, higher, and persistent for a longer duration in MCG compared with SCG. At POD 6, fever is expected to normalize in both groups, so if fever persists further evaluation should be considered.


OTO Open ◽  
2020 ◽  
Vol 4 (2) ◽  
pp. 2473974X2093250
Author(s):  
Sai Nimmagadda ◽  
Stephanie Jung-ying Wong ◽  
Madlin Faria ◽  
Paul Allen ◽  
John Faria

Objective To assess the frequency of potential drug-drug interactions affecting cytochrome P450 (CYP)–mediated metabolism of opioids among adult and adolescent patients who underwent adenotonsillectomy. Study Design Retrospective chart review. Setting Tertiary care university hospital. Patients and Methods A retrospective review was conducted of 279 patients who underwent adenotonsillectomy at the University of Rochester. The discharge medication list was reviewed for all patients, and their postoperative medications were compared with a reference list published by the Food and Drug Administration and the University of Indiana’s Department of Clinical Pharmacology (Flockhart Table) to determine whether CYP-inducing or CYP-inhibiting medication was present. Results Out of 279 patients, 197 different medications were taken postoperatively. Approximately 70% of patients were taking 2 medications in addition to the standard postoperative analgesics (acetaminophen, hydrocodone, oxycodone, morphine, and/or ibuprofen). The 5 most commonly prescribed medications excluding the posttonsillectomy medications were oral contraceptives, ondansetron, amoxicillin, albuterol, and methylprednisolone. Four percent of patients were taking a medication that inhibits CYP3A4; <1% were taking a medication that induces CYP3A4; and 15% were taking a medication that inhibits CYP2D6. Conclusions Nearly 20% of the patients in this cohort were taking a medication that may alter opioid metabolism through induction or inhibition of CYP3A4 or CYP2D6. Some of these interactions have the potential to be more clinically relevant than others, particularly interactions that can lead to enhanced toxicity of opioids due to accumulation of active metabolites.


2020 ◽  
Author(s):  
Dai Shibata ◽  
Takahiko Kawate ◽  
Takako Komiya ◽  
Itaru Nakamura ◽  
Takashi Ishikawa ◽  
...  

Abstract The new coronavirus disease (COVID-19) is spreading worldwide. In Japan, the number of people infected has been increasing since March 2020. The COVID-19 pandemic has had a significant impact on hospitals, although Tokyo, Japan did not experience a collapse of the medical system. Patients were triaged and prioritized due to surgical limitations during the pandemic period. The purpose of this study was to determine how patients with breast cancer or breast reconstruction were affected by the COVID-19 pandemic at a university hospital in Tokyo. In this retrospective chart review we investigated how patients were treated, including surgical postponements during three periods: April to July 2020, August to November 2019 (after the Allergan recall), and April to July 2019. More than half of breast surgeries and breast reconstructions had to be postponed during the COVID-19 pandemic, and the number of candidates for surgery was also lower compared to the pre-pandemic periods. Triage of patients with breast cancer did not result in any adverse oncological outcomes for these patients. COVID-19 has had a major impact on breast cancer surgery and breast reconstruction, and there was substantial postponement of surgery. Due to triage and prioritization, no patients experienced disease progression in the short-term period, demonstrating that our strategy was appropriate.


2006 ◽  
Vol 18 (2) ◽  
pp. 327-333 ◽  
Author(s):  
Izzet Cagri Yazgan ◽  
M. Kemal Kuscu ◽  
Nurhan Fistikci ◽  
Ali Keyvan ◽  
Volkan Topcuoglu

Objective: The size of the elderly population is growing rapidly in Turkey. We aimed to characterize geriatric psychiatry consultations to obtain the characteristic pattern of these patients for further interventions.Method: A retrospective chart review was undertaken for each patient.Results: One hundred and sixty-six patients with a mean age (± S.D.) of 75.5 ± 6.6 years were included in this study. Most referrals came from the Department of Internal Medicine (42.2%), with sleep problems (42.1%), depression (29.5%) and anxiety (28.3%) being the most common reasons for referral. Hypertension was the most frequent medical diagnosis (53.6%). The mean number ± S.D.) of medications used by each patient was 4.4 ± 2.0. The leading psychiatric diagnosis at the end of the assessment was adjustment disorder (31.3%).Conclusion: Turkish geriatric psychiatry consultation patients display similar characteristics to elderly patients from other western countries. The main difference comes from diagnosis of adjustment disorder, which may be related to hospital conditions and strong family ties in developing countries.


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