scholarly journals Case Series: Limited Opioid Withdrawal With Use of Transdermal Buprenorphine to Bridge to Sublingual Buprenorphine in Hospitalized Patients

2019 ◽  
Vol 29 (1) ◽  
pp. 73-76 ◽  
Author(s):  
Victor M. Tang ◽  
Jessica Lam‐Shang‐Leen ◽  
Thomas D. Brothers ◽  
Keith Hansen ◽  
Alexander Caudarella ◽  
...  
Keyword(s):  
Case Series ◽  
Opioid Withdrawal ◽  
Hospitalized Patients ◽  
Sublingual Buprenorphine

scholarly journals Clinical Frailty Score (CFS) versus Hospital Frailty Risk Score (HFRS) for predicting mortality and other adverse outcome in hospitalized patients with COVID‐19: Spanish case series

2021 ◽  
Author(s):  
Jose‐Manuel Ramos‐Rincon ◽  
Oscar Moreno‐Perez ◽  
Hector Pinargote‐Celorio ◽  
Jose‐Manuel Leon‐Ramirez ◽  
Mariano Andres ◽  
...  
Keyword(s):  
Risk Score ◽  
Adverse Outcome ◽  
Case Series ◽  
Hospitalized Patients ◽  
Frailty Score

scholarly journals Connecting Hospitalized Patients with Their Families: Case Series and Commentary

2011 ◽  
Vol 2011 ◽  
pp. 1-7
Author(s):  
Kourosh Parsapour ◽  
Alexander A. Kon ◽  
Madan Dharmar ◽  
Amy K. McCarthy ◽  
Hsuan-Hui Yang ◽  
...  
Keyword(s):  
Close Contact ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Family Satisfaction ◽  
Hospital Length ◽  
Hospitalized Patients ◽  
Patient Centered ◽  
Family Presence ◽  
Telemedicine Service ◽  
Personal Cost

The overall aim of this project was to ascertain the utilization of a custom-designed telemedicine service for patients to maintain close contact (via videoconference) with family and friends during hospitalization. We conducted a retrospective chart review of hospitalized patients (primarily children) with extended hospital length of stays. Telecommunication equipment was used to provide videoconference links from the patient's bedside to friends and family in the community. Thirty-six cases were managed during a five-year period (2006 to 2010). The most common reasons for using Family-Link were related to the logistical challenges of traveling to and from the hospital—principally due to distance, time, family commitments, and/or personal cost. We conclude that videoconferencing provides a solution to some barriers that may limit family presence and participation in care for hospitalized patients, and as a patient-centered innovation is likely to enhance patient and family satisfaction.

scholarly journals Symptomatic Bradycardia in Covid-19 Hospitalized Patients: a Case Series

2021 ◽  
Author(s):  
Muzakkir Amir ◽  
Hendry Yoseph ◽  
Aulia Thufael Al Farisi ◽  
James Klemens Phieter Phie ◽  
Andi Tiara Salengke Adam
Keyword(s):  
Case Series ◽  
Hospitalized Patients ◽  
Symptomatic Bradycardia

scholarly journals Low albumin levels are associated with poorer outcomes in a case series of COVID-19 patients in Spain: a retrospective cohort study

2020 ◽  
Author(s):  
Roberto de la Rica ◽  
Marcio Borges ◽  
María Aranda ◽  
Alberto del Castillo ◽  
Antonia Socias ◽  
...  
Keyword(s):  
Disease Severity ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Case Series ◽  
Hospitalized Patients ◽  
University Hospital ◽  
Limited Information ◽  
Icu Patients ◽  
Epidemiological Features ◽  
Initial Symptoms

ABSTRACTOBJECTIVETo describe the clinical characteristics and epidemiological features of severe (non-ICU) and critically patients (ICU) with COVID-19 at triage, prior hospitalization, in one of the main hospitals in The Balearic Islands health care system.DESIGNRetrospective observational studySETTINGSon Llatzer University Hospital in Palma de Mallorca (Spain)PARTICIPANTSAmong a cohort of 52 hospitalized patients as of 31 March 2020, 48 with complete demographic information and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive test, were analyzed. Data were collected between March 15th, 2020, and March 31th 2020, inclusive of these dates.MAIN OUTCOMESClinical, vital signs and routine laboratory outcomes at the time of hospitalization, including symptoms reported prior to hospitalization. Demographics and baseline comorbidities were also collected. Mortality was reported at the end of the study.RESULTS48 patients (27 non-ICU and 21 ICU) resident in Mallorca, Spain (mean age, 66 years, [range, 33-88 years]; 67% males) with positive SARS-CoV-2 infection were analyzed. There were no differences in age or sex among groups (p >.05). Initial symptoms included fever (100%), coughing (85%), dyspnea (76%), diarrhea (42%) and asthenia (21%). The majority of patients in this case series were hospitalized because of low SpO2 (SpO2 below 90%) and presentation of bilateral pneumonia (94%) at triage. ICU patients had a higher prevalence of dyspnea compared to non-ICU patients (95% vs 61%, p = .022). Acute respiratory syndrome (ARDS) was presented in 100% of the ICU-patients. All the patients included in the study required oxygen therapy. ICU-patients had lymphopenia as well as hypoalbuminemia. Inflammatory markers such as lactate dehydrogenase (LDH), C-reactive protein (CRP), and procalcitonin were significantly higher in ICU patients compared to non-ICU (p < .001).Lower albumin levels were associated with poor prognosis measured as longer hospital length (r= −0.472, p <.001) and mortality (r= −0.424, p=.003). Interestingly we also found, that MCV was lower among of those patients who died (p=.0002). As of April 28, 2020, 10 patients (8 ICU and 2 non-ICU) had died (21% mortality) and while 100% of the non-ICU patients had been discharged, 33% of ICU patients still remained hospitalized (5 in ICU and 2 had been transferred to ward).CONCLUSIONCritically ill patients with COVID-19 present lymphopenia, hypoalbuminemia as well high levels of inflammation. Lower levels of albumin were associated with poorer outcomes in COVID-19 patients. Albumin might be of importance because of its association with disease severity in patients infected with SARS-CoV-2.WHAT IS ALREADY KNOWN IN THIS TOPICSpain has been hit particularly hard by the pandemic. By the time that this manuscript was written more than 25.000 deaths related to COVID-19 have been confirmed. There is limited information available describing the clinical and epidemiological features of Spanish patients requiring hospitalization for COVID-19. Also, it is important to know the characteristics of the hospitalized patients who become critically illWHAT THIS STUDY ADDSThis small case series provides the first steps towards a comprehensive clinical characterization of severe and critical COVID-19 adult patients in Spain. The overall mortality in our patients was 21%. To our knowledge this is the first report with reporting these features in Spain. At triage the majority of patients had lower SpO2 (<90%) and bilateral pneumonia. The most common comorbidities were hypertension (70%), dyslipidemia (62%) and cardiovascular disease (30%). Critically ill patients present hypoalbuminemia and lymphopenia, as well as higher levels of inflammation. Albumin might be of importance because of its association with disease severity and mortality in patients infected with SARS-CoV-2.

scholarly journals Lofexidine for acute opioid withdrawal: A clinical case series

2020 ◽  
Vol 10 (5) ◽  
pp. 259-263
Author(s):  
Mandy L. Renfro ◽  
Lindsey J. Loera ◽  
Carlos F. Tirado ◽  
Lucas G. Hill
Keyword(s):  
Addiction Treatment ◽  
Case Series ◽  
Retrospective Chart Review ◽  
The United States ◽  
Opioid Withdrawal ◽  
Withdrawal Symptoms ◽  
Total Daily Dose ◽  
Opioid Use ◽  
Management Protocol ◽  
Patient Reported

Abstract Introduction Maintaining abstinence through the opioid withdrawal period is a substantial barrier to treatment for patients with opioid use disorder. The alpha-2 agonist lofexidine has demonstrated efficacy and safety in clinical trials, but pragmatic studies describing its use in clinical practice are lacking. This case series describes the use of lofexidine for opioid withdrawal symptoms in an inpatient addiction treatment facility. Methods Seventeen patients receiving at least 1 dose of lofexidine during inpatient treatment for opioid withdrawal were included in this study. A retrospective chart review was conducted for clinical, subjective, and objective data. Adverse events, total daily dose, clinical opioid withdrawal scale (COWS) scores, vital signs, and reasons for early discontinuation of lofexidine are reported. Results Patients treated with lofexidine experienced mild withdrawal symptoms throughout treatment. Most patients (65%) experienced a decrease in their average daily COWS scores from intake to discharge. Two patients (12%) left treatment against medical advice, and 5 patients (29%) discontinued treatment prior to day 7 due to resolution of symptoms. Average daily blood pressure readings remained stable, and daily average heart rate decreased over time. Discussion Lofexidine can be successfully incorporated into a conventional withdrawal management protocol. The cost of lofexidine and its recent introduction to the market remain barriers to accessibility in the United States. Studies evaluating patient-reported outcomes as well as direct comparisons with other alpha-2 agonists are needed to inform optimal clinical use of lofexidine.

Successful Use of Intravenous Methylnaltrexone for Opioid-Induced Constipation in Critically Ill Pediatric Patients

2021 ◽  
Author(s):  
Kimberly P. Mills ◽  
Christopher C. McPherson ◽  
Ahmed S. Said ◽  
Michael A. Lahart
Keyword(s):  
Adverse Events ◽  
Critically Ill ◽  
Primary Outcome ◽  
Pediatric Patients ◽  
Case Series ◽  
Opioid Withdrawal ◽  
Limited Data ◽  
Serious Adverse Events ◽  
Patient Response ◽  
Hospital Patients

Abstract Objectives Methylnaltrexone is U.S. Food and Drug Administration (FDA) approved as a subcutaneous injection for adults with opioid-induced constipation (OIC). Case series have described the use of methylnaltrexone for OIC in the pediatric oncology population. There are limited data describing its intravenous use in critically ill pediatric patients. Methods We conducted a retrospective observational study at St. Louis Children's Hospital. Patients less than 18 years old who received at least one dose of intravenous methylnaltrexone while admitted to an intensive care unit between January 2016 and August 2019 were included. The primary outcome was documented laxation within 24 hours of methylnaltrexone administration. Results Sixteen patients received a total of 34 doses of intravenous methylnaltrexone. Patients received a median of 1.69 (interquartile range [IQR], 0.9–4.86) morphine milligram equivalents per kilogram per 24 hours, over a median of 14 days (IQR, 11–30), before methylnaltrexone administration. The median dose of methylnaltrexone was 0.15 mg/kg (IQR, 0.15–0.16). Ten patients (63%) responded to the first dose of methylnaltrexone, and 14 patients (88%) responded to at least one dose. Overall, 26 doses (76%) led to patient response. Four patients (25%) experienced adverse events (emesis, abdominal pain) after methylnaltrexone administration. No signs or symptoms of opioid withdrawal were documented. Conclusions Intravenous methylnaltrexone appears to be safe and effective in treating OIC in critically ill pediatric patients. No serious adverse events or signs of opioid withdrawal were observed after single and repeat dosing. Patients responded to methylnaltrexone with varying opioid dosing and durations prior to administration.

scholarly journals Perioperative opioid requirements of patients receiving sublingual buprenorphine-naloxone: a case series

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Yvette N. Martin ◽  
Atousa Deljou ◽  
Toby N. Weingarten ◽  
Darrell R. Schroeder ◽  
Juraj Sprung
Keyword(s):  
Case Series ◽  
Sublingual Buprenorphine

scholarly journals Reply to: “Characterization of acute acro-ischemic lesions in non-hospitalized patients: A case series of 132 patients during the COVID-19 outbreak”

2020 ◽  
Vol 83 (3) ◽  
pp. e237-e239
Author(s):  
Giuseppe Ruggiero ◽  
Fabio Arcangeli ◽  
Torello Lotti ◽  
Orsola Ametrano ◽  
Cosimo Ruggiero ◽  
...  
Keyword(s):  
Case Series ◽  
Hospitalized Patients

scholarly journals Concordance of Vancomycin Population-Predicted Pharmacokinetics with Patient-Specific Pharmacokinetics in Adult Hospitalized Patients: A Case Series

Drugs in R&D ◽  
2020 ◽  
Vol 20 (2) ◽  
pp. 83-93
Author(s):  
IfeanyiChukwu O. Onor ◽  
Alison Neuliep ◽  
Kieu Anh Tran ◽  
Jennifer Lambert ◽  
Christopher J. Gillard ◽  
...  
Keyword(s):  
Case Series ◽  
Hospitalized Patients ◽  
Patient Specific
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