scholarly journals Continuous Positive Airway Pressure Adherence for Obstructive Sleep Apnea

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Melissa L. Somers ◽  
Ed Peterson ◽  
Saurabh Sharma ◽  
Kathleen Yaremchuk
Keyword(s):  
Chart Review ◽  
High School Graduates ◽  
Patient Adherence ◽  
Retrospective Chart Review ◽  
Initial Visit ◽  
Obstructive Sleep ◽  
Improve Compliance ◽  
Male Patients ◽  
One Year ◽  
To Receive

Objective. To determine predictors of patient adherence to CPAP. Design. A retrospective chart review identified patients with AHI values greater than 15 who were recommended to receive CPAP. Compliance was measured at a 1-to 4-month interval and at 1 year. Results. There were 106 of 368 (29%) patients who received CPAP therapy that were compliant with CPAP use at 1 to 4 months. Forty-six patients (12%) were using CPAP at one year. For the male group at one year, the model demonstrated the AHI value (P  value=.026) as a predictor of compliance if greater than 27.3 and a significant two-way interaction between age and AHI (P=.023). Increased length of time from the initial visit and receiving the CPAP machine was associated with poorer compliance (P=.002). Those living in areas with higher incomes and with a higher percentage of non-high-school graduates were more likely to be compliant (P=.01 and P=.044). Conclusion. Older male patients with higher AHI values were noted to be more adherent to CPAP. Efforts should be made to try to minimize the length of time between the initial visit and the time to receive CPAP to improve compliance.

Harnessing the Chaplain’s Capacity to Identify Unmet Palliative Needs of Vulnerable Older Adults in the Emergency Department

2021 ◽  
pp. 082585972110033
Author(s):  
Elizabeth Hamill Howard ◽  
Rachel Schwartz ◽  
Bruce Feldstein ◽  
Marita Grudzen ◽  
Lori Klein ◽  
...  
Keyword(s):  
Emergency Department ◽  
Palliative Care ◽  
End Of Life Care ◽  
Older Patients ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Life Care ◽  
Emergency Medicine Physician ◽  
Medicine Physician ◽  
One Year

Objective: To explore chaplains’ ability to identify unmet palliative care (PC) needs in older emergency department (ED) patients. Methods: A palliative chaplain-fellow conducted a retrospective chart review evaluating 580 ED patients, age ≥80 using the Palliative Care and Rapid Emergency Screening (P-CaRES) tool. An emergency medicine physician and chaplain-fellow screened 10% of these charts to provide a clinical assessment. One year post-study, charts were re-examined to identify which patients received PC consultation (PCC) or died, providing an objective metric for comparing predicted needs with services received. Results: Within one year of ED presentation, 31% of the patient sub-sample received PCC; 17% died. Forty percent of deceased patients did not receive PCC. Of this 40%, chaplain screening for P-CaRES eligibility correctly identified 75% of the deceased as needing PCC. Conclusion: Establishing chaplain-led PC screenings as standard practice in the ED setting may improve end-of-life care for older patients.

Incidence of hypersensitivity reactions in patients on H1-receptor antagonists receiving oxaliplatin-based chemotherapy

2021 ◽  
pp. 107815522110039
Author(s):  
Christine Barrett ◽  
Seon Jo Park ◽  
Lindsay Edmondson ◽  
Dulabh Monga
Keyword(s):  
Observational Study ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Controlled Trials ◽  
Severe Reaction ◽  
Hypersensitivity Reactions ◽  
H1 Receptor ◽  
Receptor Antagonists ◽  
Randomized Controlled ◽  
To Receive

Objective This study determined the incidence of hypersensitivity reactions in patients receiving oxaliplatin-based chemotherapy while on H1-receptor antagonists (H1RAs). Prophylaxis for patients receiving oxaliplatin is not currently recommended. H1RAs are used for the treatment of reactions; however, prophylactic H1RAs have not been well-studied. Methods This retrospective chart review included patients with solid tumor malignancies who received H1RAs while on oxaliplatin-based chemotherapy between August 1, 2016 and October 31, 2019. Results Of fifty-one patients, there were four hypersensitivity reactions (8%), most of which were mild, occurred within 60 minutes of the start of the infusion, and did not result in an interruption in treatment. One severe reaction occurred, which required discontinuation of therapy. Forty-two patients (82%) were able to receive at least 9 cycles of oxaliplatin without a reported reaction. Conclusion In this observational study, the incidence rate of hypersensitivity reactions in patients receiving oxaliplatin while on H1RAs was lower than reported in previous literature. Most reactions were mild, and patients were able to continue oxaliplatin-based therapy. With future, randomized controlled trials, H1RAs may prove to be effective in preventing or delaying the onset of hypersensitivity reactions related to oxaliplatin.

scholarly journals The mortality of ill infants with false tooth extraction in a rural Ugandan emergency department

2017 ◽  
Vol 8 (1) ◽  
Author(s):  
Amyna Husain ◽  
M. Douglas Baker ◽  
Mark C. Bisanzo ◽  
Martha W. Stevens
Keyword(s):  
Emergency Department ◽  
Tooth Extraction ◽  
Chart Review ◽  
Statistical Significance ◽  
Univariate Analysis ◽  
Retrospective Chart Review ◽  
Cultural Practice ◽  
Fluid Bolus ◽  
Significant Difference ◽  
To Receive

False tooth extraction (FTE), a cultural practice in East Africa used to treat fever and diarrhea in infants, has been thought to increase infant mortality. The mortality of clinically similar infants with and without false tooth extraction has not previously been examined. The objective of our retrospective cohort study was to examine the mortality, clinical presentation, and treatment of infants with and without false tooth extraction. We conducted a retrospective chart review of records of infants with diarrhea, sepsis, dehydration, and fever in a rural Ugandan emergency department. Univariate analysis was used to test statistical significance. We found the mortality of infants with false tooth extraction (FTE+) was 18% and without false tooth extraction (FTE−) was 14% (P=0.22). The FTE+ study group, and FTE− comparison group, had similar proportions of infants with abnormal heart rate and with hypoxia. There was a significant difference in the portion of infants that received antibiotics (P=0.001), and fluid bolus (P=0.002). Although FTE+ infants had clinically similar ED presentations to FTE− infants, the FTE+ infants were significantly more likely to receive emergency department interventions, and had a higher mortality than FTE− infants.

574 Sleep-disordered breathing symptoms in children who co-sleep: Are caregivers better reporters?

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A226-A227
Author(s):  
Nimra Alvi ◽  
Allison Clarke ◽  
Pallavi Patwari
Keyword(s):  
Sleep Disordered Breathing ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Caregiver Distress ◽  
Inclusion Criteria ◽  
Demographic Information ◽  
Older Children ◽  
Obstructive Sleep ◽  
Morbid Conditions ◽  
Disordered Breathing

Abstract Introduction Medical consensus advises against co-sleeping for infants to protect against SIDS, but co-sleeping in older children is often dismissed if not associated with caregiver distress. While some families may choose to co-sleep due to cultural, circumstantial, or psychosocial factors, this choice can also be due to medical concerns warranting greater caregiver attention. We aimed to explore characteristics of co-sleeping children referred for sleep disordered breathing and hypothesized that children with polysomnogram confirmed obstructive sleep apnea (OSA) would have higher caregiver-reported sleep disordered breathing symptoms as compared to children without confirmed OSA. Methods Caregivers who accompanied their child for polysomnogram were asked to complete a questionnaire that included sleep-related symptoms of sleep-disordered breathing (snoring, apnea, gasping/choking), restlessness, and parasomnias. Inclusion criteria are age >1.0 years and <18 years, baseline study for sleep disordered breathing, and completed questionnaire. Retrospective chart review included demographic information, BMI, co-morbid conditions, and polysomnogram results. The cohort was divided into 2 groups based on polysomnogram confirmed diagnosis of “snoring” or “OSA”. Results Of 75 co-sleeping children, 27 (36%) had a diagnosis of snoring and 48 (64%) of OSA. The cohort was similar in age, gender, and insurance type for snoring and OSA groups (Average 5.7 +/- 2.6 yrs and 5.4 +/- 2.9 yrs, respectively; 41% and 35% female, respectively; 44% and 50% Medicaid, respectively). Notable differences in the snoring and OSA groups were found with BMI z-score (1.6 +/- 4.6 and 1.0 +/- 1.5, respectively) and absence of co-morbid conditions (44% and 63%, respectively). Regarding reported symptoms, the snoring-group compared to OSA-group had lower report of gasping/choking (19% vs 29%), bedwetting (7% vs 13%), and nightmares (7% vs 15%); and had higher report of movement (74% vs 60%), kicking (48% vs 31%), and startle/jump (30% vs 19%). Conclusion Although we predicted that co-sleeping would be associated with increased caregiver vigilance, witnessed sleep-disordered-breathing symptoms was only higher for report of gasping/choking and did not differ significantly for report of snoring and apnea in children with and without OSA. Interestingly, co-sleeping in children without OSA appeared to be more strongly related to report of sleep disruption in the form of restless sleep. Support (if any):

scholarly journals Buccal versus Vaginal Misoprostol for Term Induction of Labor: A Retrospective Cohort Study

2018 ◽  
Vol 36 (07) ◽  
pp. 765-772 ◽  
Author(s):  
Meredith L. Dorr ◽  
Rebecca C. Pierson ◽  
Joanne Daggy ◽  
Sara K. Quinney ◽  
David M. Haas
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
Induction Of Labor ◽  
Premature Rupture Of Membranes ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Vaginal Misoprostol ◽  
To Receive ◽  
Time To Delivery ◽  
Labor Outcomes

Objective To compare the efficacy of similar buccal and vaginal misoprostol doses for induction of labor. Study Design Retrospective chart review of 207 consecutive women undergoing term induction of labor with misoprostol. Misoprostol route and dosing were collected. Time to delivery and other labor outcomes (e.g., vaginal delivery less than 24 hours) were compared between women receiving buccal and vaginal misoprostol. Results There was no significant difference in time to delivery for women receiving buccal (median 18.2 hour, 95% confidence interval [CI] = [14.9, 21.5]) versus vaginal (median 18.3 hour, 95% CI = [15.0, 20.4]) misoprostol (p = 0.428); even after adjusting for covariates (p = 0.381). Women who presented with premature rupture of membranes were more likely to receive buccal misoprostol (92.7% received buccal vs. 7.3% received vaginal, p < 0.001). A similar number of women delivered vaginally in the buccal group (88.2%) and vaginal misoprostol group (86.8%, p = 0.835). The proportion of women who experienced uterine tachysystole or chorioamnionitis did not significantly differ by route of administration. Conclusion We found no significant differences in time to delivery or other labor outcomes between buccal or vaginal dosing of misoprostol in women undergoing labor induction at term.

“Floating” MMPI Profiles and DSM-III Diagnoses

1983 ◽  
Vol 53 (3_suppl) ◽  
pp. 1119-1122
Author(s):  
Charles S. Newmark ◽  
Pamela Chassin ◽  
Lee Gentry ◽  
Dwight L. Evans
Keyword(s):  
Major Depressive Disorder ◽  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Chart Review ◽  
Psychiatric Patients ◽  
Retrospective Chart Review ◽  
Borderline Personality ◽  
Major Depressive ◽  
Male Patients ◽  
A Prospective Study

DSM-III diagnoses of 55 hospitalized psychiatric male patients who produced “floating” MMPI profiles were obtained via retrospective chart review. A prospective study of 16 then was conducted to cross-validate the initial diagnostic findings The results from both investigations suggested that at least half of these hospitalized psychiatric patients received a DSM-III diagnosis of either borderline personality disorder or major depressive disorder. A paucity of schizophrenic diagnoses was noted.

scholarly journals The Impact of COVID-19 on Adolescents with Eating Disorders: A Cohort Study

2021 ◽  
Author(s):  
Wendy Spettigue ◽  
Nicole Obeid ◽  
Madison Erbach ◽  
Stephen Feder ◽  
Natalie Finner ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Chart Review ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Time Frame ◽  
Lower Percentage ◽  
Average Percentage ◽  
Psychological Measures ◽  
One Year ◽  
The Impact

Abstract Background: There is a noticeable lack of evidence regarding the impact of COVID-19 and the associated lockdown on young people with eating disorders. The goals of this study were 1) to examine characteristics of adolescents presenting for eating disorder (ED) assessment since the onset of the COVID-19 pandemic; 2) to compare adolescents presenting for ED assessment since the onset of the COVID-19 pandemic to those that presented for assessment one year previously; 3) to examine implications of the pandemic on the system of care. Methods: A retrospective chart review was completed on all patients assessed at a pediatric tertiary care ED program during the pandemic between April 1 and October 31, 2020, and on youth assessed during the same time frame one year previously. Data including body measurements and results of psychological measures was extracted from patients’ charts. Clinician reports were utilized for accounts of ED symptoms. Referrals to our program were also compared for the two time periods.Results: Of the 48 youth assessed between April and October 2020, average age was 14.6 years and average percentage of treatment goal weight was 77.7%. 40% cited the pandemic as a trigger for their ED; of these youth, 78.9% were medically unstable compared to 55.2% of those whose ED was not triggered by the pandemic. When comparing the 2020 cohort to those assessed in 2019, youth who presented for assessment during the pandemic trended towards having lower percentage of goal weights and higher rates of self-reported impairment, and were significantly more likely to be medically unstable and to require hospitalization. Higher rates of inpatient admissions, emergency room consultation requests and outpatient referrals deemed “urgent” were likewise associated with the pandemic period.

One year analysis of the cost of uveitis treatment in France: a retrospective chart review

2008 ◽  
Vol 86 ◽  
pp. 0-0
Author(s):  
B BODAGHI ◽  
G KOBELT ◽  
B RICHARD ◽  
C PLESNILLA ◽  
P BUCHHOLZ ◽  
...  
Keyword(s):  
Chart Review ◽  
Retrospective Chart Review ◽  
One Year ◽  
The Cost

scholarly journals Therapeutic Challenges for Elderly Patients with Primary Hyperparathyroidism

2019 ◽  
Vol 2019 ◽  
pp. 1-3 ◽  
Author(s):  
Kenneth Sluis ◽  
Hyon Kim ◽  
Yuling He ◽  
Beatrice Wong ◽  
Xiangbing Wang
Keyword(s):  
Primary Hyperparathyroidism ◽  
Chart Review ◽  
Treatment Options ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Long Term Stability ◽  
Feasible Option ◽  
One Year

Primary hyperparathyroidism (PHPT) predominantly affects older adults, and parathyroidectomy can achieve definitive cure in symptomatic PHPT and asymptomatic meeting surgical criteria. As the population continues to age, the treatment of PHPT in octogenarians and nonagenarians presents a clinical conundrum. This case series presents the management of eight patients 85 years of age and older diagnosed with PHPT. A retrospective chart review of patients diagnosed with primary hyperparathyroidism were identified in a single institution. Those patients 85 years of age and older who were followed up for over one year were included in this case series. The literature on treatment options for this age group was also reviewed. Eight cases of PHPT patients aged 88 ± 2.5 years old with a follow-up average of 5.6 ± 4.4 years were reported in our case series. Six PHPT patients were medically managed and two PHPT patients underwent parathyroid resection. Most of the medically managed PHPT patients except for one had long-term stability of disease for over five years. The treatment of PHPT diagnosed in patients over 85 years of age presents a clinical challenge for which there is no clear consensus guideline. Our case series supports that medical therapy is a feasible option for PHPT patients over 85 years old.

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