scholarly journals Intracardiac Thrombus Revealing Coronavirus Disease 2019 (COVID-19). About a Case, Renaissance University Hospital Center in N’Djamena (Chad)

2020 ◽  
Vol 2 (1) ◽  
pp. 18-22
Author(s):  
Adam Ahamat Ali ◽  
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Medical Treatment ◽  
Laboratory Tests ◽  
Young Subject ◽  
University Hospital ◽  
Intracardiac Thrombus ◽  
Markers Of Inflammation ◽  
Thrombotic Complications ◽  
Hospital Center

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) called COVID-19 is often associated with thrombotic complications, especially in severe cases. We report a case of COVID-19 revealed by a right intraatrial thrombus to emphasize the risk of thromboembolic diseases linked to this pathology. He was a young subject, 41 years old, with no notable history. He complained of asthenia and precordialgia. Echocardiography showed the presence of a right intraatrial thrombus and laboratory tests confirmed COVID-19. Under medical treatment combining antithrombotics, chloroquine and azithromycin, the thrombus regressed, and the markers of inflammation were normalized after 12 days. One month later, the patient remained clinically stable with normal echocardiography.

scholarly journals Catecholaminergic Crisis After a Bleeding Complication of COVID-19 Infection: A Case Report

2021 ◽  
Vol 12 ◽  
Author(s):  
Angel Rebollo-Román ◽  
Maria R. Alhambra-Expósito ◽  
Yiraldine Herrera-Martínez ◽  
F. Leiva-Cepas ◽  
Carlos Alzas ◽  
...  
Keyword(s):  
Case Report ◽  
Severe Acute Respiratory Syndrome ◽  
Medical Treatment ◽  
Bleeding Complication ◽  
Adrenal Mass ◽  
Symptom Control ◽  
Clinical Manifestations ◽  
First Case ◽  
Thrombotic Complications

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) presents in some cases with hemostatic and thrombotic complications. Pheochromocytomas are unusual, though potentially lethal tumors. Herein we describe the first case of hemorrhage in a pheochromocytoma related to SARS-CoV-2 infection. A 62-year-old man consulted for syncope, fever, and palpitations. He was diagnosed with SARS-CoV-2 pneumonia and presented with a hemorrhage in a previously unknown adrenal mass, which resulted in a catecholaminergic crisis. Medical treatment and surgery were required for symptom control and stabilization. We hereby alert clinicians to watch for additional/unreported clinical manifestations in COVID-19 infection.

Critical limb ischemia patients clinically improving with medical treatment have lower neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios

Vascular ◽  
2021 ◽  
pp. 170853812098629
Author(s):  
Sevinç B Erdoğan ◽  
Ümmühan N Selçuk ◽  
Murat Baştopçu ◽  
Gökhan Arslanhan ◽  
Arif Y Çakmak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Medical Treatment ◽  
Critical Limb Ischemia ◽  
Limb Ischemia ◽  
Response To Treatment ◽  
Standard Regimen ◽  
Markers Of Inflammation ◽  
Endovascular Revascularization ◽  
Cardiovascular Center ◽  
Associated Risk Factors

Objectives Inflammation is a component in the pathogenesis of critical limb ischemia. We aimed to assess how inflammation affects response to treatment in patients treated for critical limb ischemia using neutrophil-to-lymphocyte (NLR) and platelet-to-lymphocytes ratios (PLR) as markers of inflammation. Methods Patients in a single tertiary cardiovascular center with critical limb ischemia unsuitable for surgical or interventional revascularization were retrospectively identified. Data were collected on medical history for risk factors, previous surgical or endovascular revascularization, and outcome. A standard regimen of low molecular weight heparin, aspirin, statins, iloprost infusions, and a standard pain medication protocol were applied to each patient per hospital protocol. Patients with improvement in ischemic pain and healed ulcers made up the responders group and cases with no worsening pain or ulcer size or progression to minor or major amputations made up the non-responders group. Responders and Non-responders were compared for risk factors including pretreatment NLR and PLR. Results 268 included patients who were not candidates for surgical or endovascular revascularization were identified. Responders had significantly lower pretreatment NLR (4.48 vs 8.47, p < 0.001) and PLR (162.19 vs 225.43, p = 0.001) values. After controlling for associated risk factors NLR ≥ 4.63 (p < 0.001) and PLR ≥ 151.24 (p = 0.016) were independently associated with no response to treatment. Conclusions Neutrophil-to-lymphocyte ratio and platelet-to-lymphocytes ratio are markers of inflammation that are reduced in patients improving with medical treatment suggesting a decreased state of inflammation before treatment in responding patients.

Evaluation and cost estimation of laboratory tests overuse through a CCDSS in a university hospital

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
D Vallone ◽  
A Tamburrano ◽  
C Carrozza ◽  
A Urbani ◽  
A Cambieri ◽  
...  
Keyword(s):  
Cost Estimation ◽  
Laboratory Tests ◽  
Quality Care ◽  
Clinical Decision Support Systems ◽  
Patient Characteristics ◽  
Clinical Decision ◽  
University Hospital ◽  
Specific Patient ◽  
Global Rate ◽  
Common Laboratory

Abstract Computerized Clinical Decision Support Systems (CCDSS) are information technology-based systems that use specific patient characteristics and combine them with rule-based algorithms. The aim of this study is to conduct a survey to measure and assess the over-utilization rates of laboratory requests and to estimate the monthly cost of inappropriate requests in inpatients of the “Fondazione Policlinico Universitario A. Gemelli IRCCS” Care Units. This observational study is based on the count of rules violations for 43 different types of laboratory tests requested by the Hospital physicians, for a total of 5,716,370 requests, over a continuous period of 20 months (from 1 July 2016 to 28 February 2018). Requests from all the hospital internal departments (except for Emergency, Intensive Care Units and Urgent requests) were monitored. The software intercepted and counted, in silent mode for the operator, all requests and violations for each laboratory test among those identified. During the observation period a mean of 285,819 requests per month were analyzed and 40,462 violations were counted. The global rate of overuse was 15.2% ± 3.0%. The overall difference among sub-groups was significant (p &lt; 0.001). The most inappropriate exams were Alpha Fetoprotein (85.8% ± 30.5%), Chlamydia trachomatis PCR (48.7% ± 8.8%) and Alkaline Phosphatase (20.3% ± 6.5%). All the exams, globally considered, generated an estimated avoidable cost of 1,719,337€ (85,967€ per month) for the hospital. This study reports rates (15.2%) similar to other works. The real impact of inappropriateness is difficult to assess, but the generated costs for patients, hospitals and health systems are certainly high and not negligible. Key messages It would be desirable for international medical communities to produce a complete panel of prescriptive rules for all the most common laboratory exam. That is useful not only to reduce costs, but also to ensure standardization and high-quality care.

Sign in / Sign up

Export Citation Format

Share Document