scholarly journals Evaluation of Clinical Features and Outcomes of Patients with Coronavirus (COVID-19) Admitted to ICU in Southeastern Iran in 2020

2022 ◽  
Vol 18 (4) ◽  
Author(s):  
Hanieh Hosseinnezhad ◽  
Seyyed Morteza Hozhabrossadati ◽  
Ali Reza Khalesi ◽  
Mahmoud Ganjifard
Keyword(s):  
Clinical Outcomes ◽  
Clinical Features ◽  
Clinical Symptoms ◽  
Demographic Data ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Chronic Obstructive ◽  
Main Role ◽  
Radiological Findings ◽  
High Resolution Computed Tomography

Background: Coronavirus, coronavirus disease 2019 (COVID-19), in humans, mainly causes respiratory and gastrointestinal manifestations that can range from a simple cold to severe clinical symptoms or death. On the other hand, COVID-19 patients’ hospitalization in the intensive care unit (ICU) have serious problems, which can affect their mortality; therefore, the awareness of these problems has a main role in decision-making in the early stages. Objectives: This study aimed to evaluate the clinical features and outcomes of patients with COVID-19 admitted to the ICU. Methods: This cross-sectional (descriptive-analytical) study was conducted on patients with COVID-19 pneumonia admitted to the ICU of Valiasr Hospital, Birjand, Iran, in 2020. A total of 111 patients, including 51 female and 63 male subjects, were enrolled in this study using convenience sampling. Demographic data, comorbidities, signs and symptoms, radiological findings, supportive methods of oxygen therapy, and clinical outcomes were collected using a checklist and compared between two groups (i.e., survivors and nonsurvivors). Results: Among 111 patients (including 59 nonsurvivors and 52 survivors), the numbers of mortalities within the age ranges of ≥ 75 and ≤ 44 years were the highest and lowest, respectively. In the survived patients, hypertension (50.8%), diabetes mellitus (47.5%), heart disease (44.1%), and chronic obstructive lung disease (23.7%) were the most common comorbidities. Moreover, dyspnea (81.1%), fever and chills (73%), cough (64.9%), muscle pain (45%), and weakness, and lethargy (42.3%) were the most common symptoms of the patients. Based on the comparison of survived and nonsurvived groups, diarrhea (P < 0.001), sore throat (P < 0.001), nausea (P < 0.001), and vomiting (P < 0.0001) were significantly higher in the group of survived patients. Among the radiological findings (i.e., chest X-ray and high-resolution computed tomography), bronchoalveolar markings (P = 0.05) and pleural effusion (P = 0.02) were higher in the nonsurvived patients. The average Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 16 was reported with a higher mortality rate. Conclusions: Risk factors, including dyspnea, older age, comorbidities, and high APACHE II score, could increase the risk of poor clinical outcomes and help identify ill patients with a poor prognosis at the beginning of ICU admission.

scholarly journals Clinical Features, Diagnosis and Management of Patients with Suspicion of Fascioliasis in Kohgiluyeh and Boyer-Ahmad Province, Southwestern Iran

2020 ◽  
Author(s):  
Abdolali MOSHFE ◽  
Arash ARIA ◽  
Najme ERFANI ◽  
Ali JAMSHIDI ◽  
Bahador SARKARI ◽  
...  
Keyword(s):  
Clinical Features ◽  
Clinical Symptoms ◽  
Epigastric Pain ◽  
Serological Test ◽  
Demographic Data ◽  
Clinical Signs ◽  
Signs And Symptoms ◽  
Diagnosis And Management ◽  
History Of ◽  
Clinical Signs And Symptoms

Background: In the current study, we described the epidemiological features, clinical presentation, diagnosis and management of patients with suspicion of fascioliasis in Kohgiluyeh and Boyer-Ahmad Province in southwest of Iran.    Methods: Overall, 56 patients with suspicion of fascioliasis, based on their clinical signs and symptoms that referred to Clinic of Internal Medicine in Yasuj city, from 2014 to 2016 were enrolled. Demographic data, history of eating aquatic local plants, the chief complains, and laboratory findings were recorded for each patient. Stool samples were obtained from each case for detection of Fasciola eggs. Moreover, blood samples were taken from each patient and evaluated for detection of anti-Fasciola antibodies by an indirect ELISA. Patients who defined as having fascioliasis were treated with triclabendazole and were followed for at least three months for clinical improvement. Results: Serological test was positive in 5 patients. Of these 5 cases, three cases had a history of ingesting raw aquatic vegetables. The main clinical signs and symptoms in positive cases were; abdominal pain (60%), epigastric pain (40%), anemia (60%), and dermal pruritus (20%). Hypereosinophilia was seen in all of 5 positive cases. No Fasciola egg was found in stool specimens of any of the patients. The fascioliasis cases were treated by triclabendazole and clinical symptoms disappeared in all of 5 cases. Conclusion: Our observation further confirmed Yasuj district as a human endemic area for fascioliasis in Iran. The study also highlighted the importance of clinical features together with eosinophilia, as key parameters, in the diagnosis of human fascioliasis. Clinicians need to be aware of this disease and should keep in mind fascioliasis when hypereosinophilia present in patients in such endemic areas.

scholarly journals Radiological findings and clinical features for the diagnosis of adenoid hypertrophy: a study from Iraq

2021 ◽  
Vol 7 (6) ◽  
pp. 1040
Author(s):  
Abdulla Alnakshabandi ◽  
Khaled Hashim Sultan
Keyword(s):  
Clinical Features ◽  
Sensitivity And Specificity ◽  
Clinical Symptoms ◽  
Clinical Findings ◽  
Endoscopic Examination ◽  
Lateral View ◽  
Adenoid Hypertrophy ◽  
Radiological Findings ◽  
Accuracy Rate ◽  
X Ray

<p><strong>Background: </strong>Adenoid is a prevalent condition among children. Adenoidectomy has been done based on clinical symptoms. The purpose of this study is to determine the agreement between clinical features of adenoid enlargement, X-ray and adenoid size.</p><p><strong>Methods:</strong> Hundred symptomatic children were enrolled into this study at ENT. Department of Al-Bin Sina teaching hospital in Mosul city of Iraq. History was taken, clinical examination for adenoid enlargement and skull X-ray (lateral view) were performed for all children with assessment of adenoid size 1 day before operation.</p><p><strong>Results: </strong>The respondent composed of 5% male children and 46% females with average age of 6 years. Adenoid facies were the most frequent presentation followed by snoring then nasal obstruction. Around 64% had positive otoscopic findings and another 58% had hearing impairment and only 22% had ear discharge. All of the clinical findings showed (100%) sensitivity and specificity vary from (64%) to (90%). The accuracy rate for clinical   features ranged from 92% to 98%. X-ray findings show a low accuracy rate (92%) in comparison to others.</p><p><strong>Conclusions: </strong>Clinical findings could be used to select children for adenoidectomy, especially when endoscopic examination is not available or cannot be performed.</p><p><strong> </strong></p>

scholarly journals A retrospective study of sepsis-associated encephalopathy: epidemiology, clinical features and adverse outcomes

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Jiayi Chen ◽  
Xiaobei Shi ◽  
Mengyuan Diao ◽  
Guangyong Jin ◽  
Ying Zhu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Retrospective Study ◽  
Clinical Features ◽  
Sofa Score ◽  
Adverse Outcomes ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Gastrointestinal Infections ◽  
Independent Risk Factors ◽  
Poor Outcomes

Abstract Background Sepsis-associated encephalopathy (SAE) is a common complication of sepsis that may result in worse outcomes. This study was designed to determine the epidemiology, clinical features, and risk factors of SAE. Methods This was a retrospective study of all patients with sepsis who were admitted to the Critical Care Medicine Department of Hangzhou First People’s Hospital Affiliated with Zhejiang University School of Medicine from January 2015 to December 2019. Results A total of 291 sepsis patients were screened, and 127 (43.6%) were diagnosed with SAE. There were significant differences in median age, proportion of underlying diseases such as hypertension, Sequential Organ Failure Assessment (SOFA) score, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, gastrointestinal infections, detection rate of Enterococcus, and 28-day mortality between the SAE and non-SAE groups. Both the SOFA score and APACHE II score were independent risk factors for SAE in patients with sepsis. All 127 SAE patients were divided into survival and non-survival groups. The age, SOFA score, and APACHE II score were independently associated with 28-day mortality in SAE patients. Conclusion In the present retrospective study, nearly half of patients with sepsis developed SAE, which was closely related to poor outcomes. Both the SOFA score and APACHE II score were independent risk factors for predicting the occurrence and adverse outcome of SAE.

Characterization of Clinical and Radiological Features of Quasi-Moyamoya Disease among European Caucasians Including Surgical Treatment and Outcome

2016 ◽  
Vol 42 (5-6) ◽  
pp. 464-475 ◽  
Author(s):  
Güliz Acker ◽  
Susanne Goerdes ◽  
Peter Schmiedek ◽  
Marcus Czabanka ◽  
Peter Vajkoczy
Keyword(s):  
Rare Disease ◽  
Clinical Features ◽  
Moyamoya Disease ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
Pediatric Population ◽  
Demographic Data ◽  
Associated Diseases ◽  
Wide Range

Background: Moyamoya disease (MMD) associated with a potentially underlying disease, such as genetic disorders or other coexisting hematological pathologies, is called quasi-MMD. This very rare disease has been characterized mainly in Asian countries, so far. As MMD reveals several significant ethnic differences, the question is raised whether characteristics of quasi-MMD would also vary among different ethnic backgrounds. Here, we report a series of 61 patients with quasi-MMD and highlight the specific clinical features of this rare disease among European Caucasians. Methods: We retrospectively identified 61 European Caucasians with quasi-MMD who were treated in our institution between 1997 and 2014. We analyzed demographic data, clinical symptoms, associated diseases, angiographic characteristics and functional hemodynamic studies. Results: Thirty-three percent of our patients were juvenile. We observed an overall female predominance of 2.8:1. Seventy-nine percent presented with a typical quasi-MMD with more pronounced unilateral and atypical quasi-MMD in pediatric population (unilateral/atypical: pediatric patients 20/15%, adults 7/7%). We identified a wide range of associated diseases. Overall, 84 and 8% of our cohort presented initially with ischemic and hemorrhagic manifestation, respectively. The hemorrhagic manifestation of quasi-MMD occurred however only in adults. Angiographic analysis revealed steno-occlusive involvement of the posterior circulation (in addition to the anterior circulation) in 31% with a higher involvement in pediatric patients (40%) compared to adults (27%). Conclusions: The characterization of our European Caucasian cohort reveals several differences when compared to reported Asian quasi-MMD cohorts and also compared to European Caucasian MMD cohort. We conclude that quasi-MMD represents a distinct disease with different ethnic clinical features.

scholarly journals P.107 Acute thrombectomy in patients of 80 years and older: a retrospective analysis of radiological and clinical outcomes with an intention to treat analysis

2018 ◽  
Vol 45 (s2) ◽  
pp. S44-S44
Author(s):  
EA Cora ◽  
V Demetriou ◽  
F Essbaiheen ◽  
H Alqahtani ◽  
B Drake ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Demographic Data ◽  
Age Group ◽  
Limited Data ◽  
Radiological Findings ◽  
Endovascular Thrombectomy ◽  
Intention To Treat ◽  
Group Methods ◽  
Timely Fashion ◽  
Treat Analysis

Background: The safety and clinical outcomes of thrombectomy in the 80 years or older age group are not yet clear. Our aim is to provide data from clinical practice to assess the safety and efficacy of endovascular thrombectomy in this age group. Methods: We retrospectively reviewed consecutive patients of age ≥80 referred for thrombectomy procedures at our institutions from 01/01/2015 to 01/09/2015. We collected demographic data, risk factors, clinical and radiological findings, treatment details, clinical and radiological outcomes. Results: Data for 75 patients was included. Baseline clinical characteristics are similar to previous trials. There were MCA occlusions in 49% (37/75) and tandem occlusions in 15% (11/75) patients. 67% (50/75) patients received IVtPA. Good reperfusion (mTICI 2b/3) was achieved in 60% (45/75) patients within 224 minutes. Good clinical outcome (mRS 0-2) at 90 days was achieved in 31% (23/75) patients. Results are similar to HERMES data on patients of age ≥80 and differences will be discussed. Conclusions: Our study adds valuable evidence to the limited data on safety and clinical outcomes in patients 80 years of age and older who undergo thrombectomy. Our findings support the data from clinical trials and confirm that mechanical thrombectomy can be performed safely and in a timely fashion outside of trials with similar results.

scholarly journals Impact of Extended Duration of Polymyxin B-Immobilized Fiber Column Direct Hemoperfusion on Hemodynamics, Vasoactive Substance Requirement, and Pulmonary Oxygenation in Patients with Sepsis: An Observational Study

2021 ◽  
pp. 1-8
Author(s):  
Chieko Mitaka ◽  
Makio Kusao ◽  
Izumi Kawagoe ◽  
Daizoh Satoh ◽  
Toshiaki Iba ◽  
...  
Keyword(s):  
Septic Shock ◽  
Sofa Score ◽  
Demographic Data ◽  
Polymyxin B ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Standard Group ◽  
Direct Hemoperfusion ◽  
Group 2 ◽  
Extended Group

<b><i>Introduction:</i></b> Polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) is used for patients with septic shock, and the recommended hemoperfusion period is 2 h. However, it remains unclear whether the optimal duration is 2 h or longer. The purpose of this study was to compare the effects of PMX-DHP between conventional and longer duration of PMX-DHP. <b><i>Methods:</i></b> We retrospectively investigated 103 patients with sepsis who underwent PMX-DHP. The demographic data, routine biochemistry, microbiological data, and primary infection site were reviewed in the medical chart. The acute physiology and chronic health evaluation (APACHE) II score, sequential organ failure assessment (SOFA) score, heart rate, mean arterial pressure (MAP), vasoactive-inotropic score (VIS), and PaO<sub>2</sub>/FiO<sub>2</sub>, at baseline and day 3, were compared between the standard group (2 h of PMX-DHP) and the extended group (&#x3e;2 h of PMX-DHP). <b><i>Results:</i></b> Median MAP was significantly lower and median VIS was significantly higher in the extended group at baseline (<i>p</i> &#x3c; 0.05, 0.01, respectively) There were no significant differences in APACHE II score, SOFA score, and PaO<sub>2</sub>/FiO<sub>2</sub> at baseline between the 2 groups. The increase of MAP and the decrease in VIS from baseline to day 3 were significantly greater in the extended group (<i>p</i> &#x3c; 0.01, respectively). In the extended group, increase in PaO<sub>2</sub>/FiO<sub>2</sub> was significantly larger in the patients who underwent ≥8 h duration than that in patients who underwent &#x3c;8 h duration (<i>p</i> &#x3c; 0.01). The ventilator-free days, the incidence of continuous renal replacement therapy, and the 28-day mortality were not different between the groups. <b><i>Discussion/Conclusions:</i></b> Longer duration of PMX-DHP was associated with the improved MAP and decreased volume of vasoactive-inotropic agents compared with the conventional duration. Eight and longer hours duration of PMX-DHP was associated with the improvement in the pulmonary oxygenation. Further studies are needed to confirm the efficacy of longer duration of PMX-DHP in patients with septic shock.

scholarly journals Validation of the modified nutric score on critically ill patients with acute exacerbations of chronic obstructive pulmonary disease: A retrospective study

2021 ◽  
Vol 8 (9) ◽  
pp. 546-550
Author(s):  
Guler Doganay ◽  
Mustafa Ozgur Cirik ◽  
Gulsah Yurtseven ◽  
Ali Alagoz
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Critically Ill ◽  
Apache Ii ◽  
Nutritional Risk ◽  
Apache Ii Score ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Icu Admission ◽  
Copd Patients

Objective: In critical care patients, the nutritional status is related to many factors such as existing co-morbidities, nutritional history, and the current disease. It is crucial to apply a comprehensive nutritional assessment and to start nutritional support as soon as possible in intensive care unit(ICU) where malnutrition is common. There are many studies on the association between modified Nutritional Risk in Critical Patients (mNUTRIC) score and outcome in ICU patients but the effectiveness of tools for risk assessment is still remains unclear. We aimed to define the correlation between the mNUTRIC score and 28-day mortality in patients with chronic obstructive pulmonary disease (COPD) in ICU. Materials and Methods: The admission of COPD patients to the respiratory ICU in 2018 were determined retrospectively. Demographic data of all patients, body mass index (BMI), mNUTRIC scores, Acute Physiology and Chronic Health Assessment II (APACHE II), Sequential Organ Failure Assessment (SOFA) scores, Charlson Comorbidity Index (CCI), time from patient ward to ICU admission, sepsis parameters including C-reactive protein (CRP) and procalcitonin,  ICU length of stay (LOS ICU), vasopressor use, and 28-day mortality were recorded. Results: 159 COPD patients were involved in the study. Age, CCI, day from patient ward to ICU admission, SOFA score, APACHE II score and 28-day mortality were detected to be statistically higher in patients with mNUTRIC ≥ 5 (p < 0.05). Conclusion: The mNUTRIC score could be an proper method for nutritional risk to predict prognosis in critically ill COPD patients.

scholarly journals 123. Impact of Enterococcal Bacteremia on Clinical Outcomes in Patients with Liver Cirrhosis

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S91-S92
Author(s):  
Kady Phe ◽  
Isabel Won ◽  
Travis J Carlson ◽  
Hannah Ryan Russo ◽  
Raymond Yau
Keyword(s):  
Risk Factors ◽  
Liver Cirrhosis ◽  
Clinical Outcomes ◽  
Multivariable Analysis ◽  
Meld Score ◽  
Apache Ii ◽  
Apache Ii Score ◽  
Inpatient Mortality ◽  
Increased Risk ◽  
Enterococcal Bacteremia

Abstract Background Patients with liver cirrhosis are at an increased risk for bacterial infections due to bacteria overgrowth and dysregulation of the intestinal barrier function. These infectious complications are associated with significant morbidity and mortality. Currently, there is a paucity of literature evaluating the clinical outcomes of patients with enterococcal bacteremia and cirrhosis. We hypothesized that patients with cirrhosis and subsequent enterococcal bacteremia would have a higher odds of mortality. Methods This was a retrospective, case–control study including adult patients (>18 years) with liver cirrhosis and >1 positive blood culture with Enterococcus species (ENT) admitted from June 2013 through August 2018. These cases were then matched with cirrhotic patients without enterococcal bacteremia (NO ENT) in a 1:1 ratio based on the Model for End-Stage Liver Disease (MELD) score. The primary endpoint was all-cause inpatient mortality. Multivariable logistic regression was used to control for other patient covariates. Results A total of 136 patients were identified during the study period (68 ENT and 68 NO ENT). The median length of stay was significantly longer in ENT patients (24.5 vs. 9 days, P < 0.001), while NO ENT patients were more likely to have renal dysfunction (55.9% vs. 83.8%, P < 0.001). All other baseline characteristics between the two groups were similar. Inpatient mortality was found to be significantly higher in ENT patients than NO ENT patients (51.5% vs. 29.4%, P = 0.009). In the multivariable analysis, risk factors found to be independently associated with mortality included enterococcal bacteremia (OR 3.96, 95% CI 1.61–9.73), MELD score (OR 1.11, 95% CI 1.05–1.19), and APACHE II score (OR 1.14, 95% CI 1.06–1.23). Conclusion Enterococcal bacteremia, MELD score, and APACHE II score were found to be independent risk factors for all-cause inpatient mortality in patients with liver cirrhosis. Future studies are needed to elucidate how treatment choice and bacterial characteristics might also influence patient outcomes. Disclosures All authors: No reported disclosures.

scholarly journals Validation of the modified NUTRIC Score on Critically Ill Patients with Acute Excacerbations of Chronic Obstructive Pulmonary Disease: A retrospective study

2021 ◽  
Author(s):  
Guler Eraslan Doganay ◽  
Mustafa Ozgur Cirik ◽  
Ali Alagoz ◽  
Gulsah Yurtseven
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Critically Ill ◽  
Apache Ii ◽  
Nutritional Risk ◽  
Apache Ii Score ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Icu Admission ◽  
Copd Patients

Background In critical care patients, the nutritional status is related to many factors such as existing co-morbidities, nutritional history, and the current disease. It is crucial to apply a comprehensive nutritional assesment and to start nutritional support as soon as possible in intensive care unit(ICU) where malnutrition is common. There are many studies on association between modified Nutritional Risk in Critical Patients (mNUTRIC) score and outcome in ICU patients but the effectiveness of tools for risk assesment isn’t still remains unclear. We aimed to define the correlation between the mNUTRIC score and 28-day mortality in patients with chronic obstructive pulmonary disease (COPD) in ICU. Materials and Methods The admission of COPD patients to the respiratory ICU in 2018 were determined retrospectively. Demograpic data of all patients, body mass index (BMI), mNUTRIC scores, Acute Physiology and Chronic Health Assessment II (APACHE II), Sequential Organ Failure Assessment (SOFA) scores, Charlson Comorbidity Index (CCI), time from patient ward to ICU admission, sepsis parameters including C-reactive protein (CRP) and procalcitonin, ICU length of stay (LOS ICU), vasopressor use, and 28-day mortality were recorded. Results 159 COPD patients involved the study. Age, CCI, day from patient ward to ICU admission, SOFA score, APACHE II score and 28-day mortality were detected to be statistically higher in patients with mNUTRIC ≥ 5 (p < 0.05). Conclusion The mNUTRIC score could be an proper method for nutritional risk to predict prognosis in critically ill COPD patients.

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