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 402. Spontaneous pneumothorax in COVID-19

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S269-S269
Author(s):  
Zain Tariq ◽  
Diana Doeing ◽  
Varidhi Nauriyal ◽  
Zohra Sarfraz Chaudhry ◽  
Anita Shallal ◽  
...  
Keyword(s):  
Spontaneous Pneumothorax ◽  
Late Complication ◽  
Tension Pneumothorax ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Hospitalized Patients ◽  
Tube Placement ◽  
Positive Pressure ◽  
Chest Imaging ◽  
Bilateral Pneumothorax

Abstract Background Pneumothorax has been reported with the use of positive pressure ventilation in COVID-19 pneumonia. Literature on spontaneous pneumothorax (PTX) in COVID-19 patients is scant. We present a case series of 7 patients with COVID-19 pneumonia, who developed spontaneous pneumothorax without prior mechanical ventilation. Methods A retrospective chart review of 7 cases was performed from two different hospitals in the US between 4/6/2020–5/15/2020. Hospitalized patients with confirmed COVID-19 by nasopharyngeal RT-PCR who developed spontaneous pneumothorax were included. Collected data included demographics, co-morbidities, inflammatory biomarkers, chest imaging and management strategies. Length of stay, transfer to intensive care unit and death were the assessed outcomes. A descriptive analysis was done. Results There were 3 patients from Henry Ford Health System, Michigan and 4 patients from Silver Cross Hospital, Illinois. Median age was 75 years and 6 out of 7 (85.7%) were males (Table 1). There were no co-morbidities associated with spontaneous pneumothorax except for one patient with COPD. None of the patients’ imaging prior to diagnosis of pneumothorax revealed any underlying blebs. Median time from symptom onset to diagnosis of pneumothorax was 17 days. One of the patients had tension pneumothorax, two had bilateral pneumothorax and three had pneumomediastinum (Figure 1). Four patients required chest tube placement, three required escalation to ICU, of which two died. Table 1. Demographics and Clinical Characteristics of Patients with Spontaneous Pneumothorax Figure 1. CT imaging before (left) and after (right) Spontaneous Pneumothorax Conclusion Spontaneous pneumothorax may be an unrecognized late complication of COVID-19 pneumonia. In hospitalized patients with acute respiratory decompensation, spontaneous pneumothorax should be considered as part of the differential diagnosis. Repeat chest imaging should be considered in these cases. Disclosures All Authors: No reported disclosures

Effectiveness of immunotherapy given to cancer patients in the hospitalized setting.

2020 ◽  
Vol 38 (29_suppl) ◽  
pp. 74-74
Author(s):  
Mojisola O Araoye ◽  
Brian J. Byrne
Keyword(s):  
Hospital Stay ◽  
End Of Life ◽  
Checkpoint Inhibitors ◽  
Hospital Setting ◽  
Retrospective Chart Review ◽  
Family Satisfaction ◽  
Study Data ◽  
Hospitalized Patients ◽  
Inpatient Setting ◽  
Poor Outcomes

74 Background: Immunotherapy is a type of cancer treatment that uses an individual’s immune system to fight cancer. Most clinical trials involving immunotherapy have been done on healthy patients, thus excluding many hospitalized patients. Many oncologists feel there are less significant toxicities to immunotherapy and thus may give them to sicker patients. This may delay discussions regarding goals of care and contribute to increased costs at end of life. This exploratory study focuses specifically on the use of immune checkpoint inhibitors in hospitalized patients to determine outcomes of patients treated in the inpatient setting. Methods: This is a retrospective chart-review study. Data on patients from the Hartford Healthcare system was extracted from EPIC. Patients were eligible if they had received at least one dose of a PD1 or PDL1 inhibitor (pembrolizumab, nivolumab, atezolizumab) during a hospital stay. The number of doses received in total, side effects, as well as discharge status was also recorded. Results: A total of 74 patients received at least one dose of a PD1 or PDL1 inhibitor during a hospital stay. 46% of the total patients treated either died in the hospital (16.2%) or were discharged to hospice (29.3%). 54 percent of patients were discharged with a plan to continue with therapy. For the subgroup of the 27 patients whose treatment was initiated in the hospital, 48% of them received only one cycle of treatment and 74% received less than 4 treatments total. The average number of cycles was 5.3. The percentage of patients who died in the hospital was 11.1% and the percentage of patients discharged to hospice was 33.3%. 55.5% were successfully discharged with a plan to continue with therapy. Conclusions: For patients who receive immunotherapy in the hospital setting there is a questionable benefit with more than 45% dying in the hospital or being discharged to hospice. Further evaluation can be done looking at increasing the cost, delaying palliative care, and patient/family satisfaction with their end of life care by giving immunotherapy in the hospital. A new quality measure looking at time from last immunotherapy to hospice enrollment or death may need to be followed in the future due to these poor outcomes in the hospitalized setting. [Table: see text]

Vocal Fold Injection Augmentation for Post-Airway Reconstruction Dysphonia: A Case Series

2021 ◽  
pp. 000348942110125
Author(s):  
Mathieu Bergeron ◽  
John Paul Giliberto ◽  
Meredith E. Tabangin ◽  
Alessandro de Alarcon
Keyword(s):  
Vocal Fold ◽  
Care Center ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Pediatric Care ◽  
Voice Perception ◽  
Perceptual Evaluation ◽  
Airway Reconstruction ◽  
Vocal Fold Injection ◽  
History Of

Objectives: Post airway reconstruction dysphonia (PARD) is common and has a significant effect on the quality of life of patients. Vocal fold injection augmentation (VFIA) is one treatment that can be used to improve glottic insufficiency in some patients. The goal of this study was to characterize the use and outcomes of VFIA for PARD. Methods: Retrospective chart review from January 2007 to July 2018 at a tertiary pediatric care center. Consecutive patients with PARD who underwent VFIA, who had a preoperative voice evaluation and a follow-up evaluation within 3 months after VFIA (fat, carboxymethylcellulose gel, hyaluronic acid). Results: Thirty-four patients (20 female) underwent VFIA. The mean age at the time of the injection was 13.6 years (SD 6.1). Twenty patients (58.8%) had a history of prematurity and a mean of 1.8 open airway surgeries. After injection, 29/34 patients (85.3%) noted a subjective voice improvement. The baseline Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) overall severity score decreased by a mean of 5.7 (SD = 19.6) points, P = .12. Total pediatric Voice Handicap Index (pVHI) improved by 6.0 (SD = 19.5) points, from 57.4 (SD = 20.0) to 51.4 (SD = 17.2), P = .09. Functional pVHI subscore demonstrated a significant improvement, with a decrease of 3.4 (SD = 7.3) points, P = .02. All procedures were performed as an overnight observation and no complication occurred. Conclusion: Patients with PARD represent a complex subset of patients. VFIA is a straightforward intervention that may improve voice perception. Many patients reported subjective improvement despite minimal objective measurement. Further work is warranted to elucidate the role of injection in management of PARD

scholarly journals A national study of choanal atresia in tertiary care centers in Canada – part I: clinical presentation

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Josee Paradis ◽  
Agnieszka Dzioba ◽  
Hamdy El-Hakim ◽  
Paul Hong ◽  
Frederick K. Kozak ◽  
...  
Keyword(s):  
Respiratory Distress ◽  
Clinical Presentation ◽  
Tertiary Care ◽  
Choanal Atresia ◽  
Case Series ◽  
Retrospective Chart Review ◽  
National Study ◽  
Feeding Difficulties ◽  
Presenting Symptoms ◽  
Tertiary Care Centers

Abstract Background To evaluate the clinical presentation of choanal atresia (CA) in tertiary centers across Canada. Methods Multi-centre case series involving six tertiary care pediatric hospitals across Canada. Retrospective chart review of patients born between 1980 and 2010 diagnosed with CA at a participating center. Results The health charts of 215 patients (59.6% female) with CA were reviewed and included in this study. The mean age of patients at time of CA presentation was 0.4 months (range 0.1 to 7.2 months) for bilateral CA and 37.8 months (range 0.1 to 164.1 months) for unilateral cases. The most common presenting symptoms for bilateral CA in decreasing order were respiratory distress (96.4%), feeding difficulties (68.2%), and rhinorrhea (65.5%), and for unilateral cases in decreasing order were rhinorrhea (92.0%), feeding difficulties (24.7%), and respiratory distress (18.0%). For the majority of patients (73.2%), the obstruction comprised mixed bony and membranous tissue, with only 10.5% presenting with a purely membranous obstruction. Familial history of CA was confirmed in only 3.3% of cases. One half of patients with CA presented with one or more associated anomalies and 30.6% had a syndrome. Conclusions The present investigation is the first national multi-institutional study evaluating the clinical presentation of CA over three decades. The present cohort of CA patients presented with a breadth of co-morbidities with highly variable presentations, with bilateral cases being more severely affected than unilateral cases. Further investigation into hereditary linkages to CA development is warranted. Graphical abstract

scholarly journals Questioning COVID-19 Surface Stability and Fomite Spreading in Three Aeromedical Cases: A Case Series

2020 ◽  
Author(s):  
Sean Horoho ◽  
Stephen Musik ◽  
David Bryant ◽  
William Brooks ◽  
Ian M Porter
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Close Contact ◽  
Small Sample Size ◽  
Case Series ◽  
Small Sample ◽  
Posture Analysis ◽  
Surface Stability ◽  
Single Positive ◽  
Means Of Transmission ◽  
Respiratory Droplets

ABSTRACT It is well established that coronavirus disease 2019 is primarily transmitted through respiratory droplets, and there is mounting research speculation that it may also be transmitted via fomites. Several studies have shown that the virus can persist on both porous and nonporous surfaces for hours to days, depending upon the material. This article examines three cases of polymerase chain reaction–proven severe acute respiratory syndrome coronavirus 2 infection with several additional individuals meeting CDC close contact criteria. In 1 case, 195 downstream contacts were all tested to prevent a mass outbreak in a deployment posture. Analysis of these contacts yielded only a single positive test, which could be reasonably ascribed to respiratory droplet transmission. While these cases and their contacts ultimately represent a small sample size, we suggest fomite spread may not be a significant means of transmission for severe acute respiratory syndrome coronavirus 2 in real-world operational scenarios.

Stereotactic Electroencephalography Is Associated With Reduced Pain and Opioid Use When Compared with Subdural Grids: A Case Series

2021 ◽  
Author(s):  
Jonathan P Scoville ◽  
Evan Joyce ◽  
Joshua Hunsaker ◽  
Jared Reese ◽  
Herschel Wilde ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Chart Review ◽  
Statistical Tests ◽  
Case Series ◽  
Length Of Hospital Stay ◽  
Retrospective Chart Review ◽  
Opioid Use ◽  
Pain Scores ◽  
Surgical Methods ◽  
Significant Difference

Abstract BACKGROUND Minimally invasive surgery (MIS) has been shown to decrease length of hospital stay and opioid use. OBJECTIVE To identify whether surgery for epilepsy mapping via MIS stereotactically placed electroencephalography (SEEG) electrodes decreased overall opioid use when compared with craniotomy for EEG grid placement (ECoG). METHODS Patients who underwent surgery for epilepsy mapping, either SEEG or ECoG, were identified through retrospective chart review from 2015 through 2018. The hospital stay was separated into specific time periods to distinguish opioid use immediately postoperatively, throughout the rest of the stay and at discharge. The total amount of opioids consumed during each period was calculated by transforming all types of opioids into their morphine equivalents (ME). Pain scores were also collected using a modification of the Clinically Aligned Pain Assessment (CAPA) scale. The 2 surgical groups were compared using appropriate statistical tests. RESULTS The study identified 43 patients who met the inclusion criteria: 36 underwent SEEG placement and 17 underwent craniotomy grid placement. There was a statistically significant difference in median opioid consumption per hospital stay between the ECoG and the SEEG placement groups, 307.8 vs 71.5 ME, respectively (P = .0011). There was also a significant difference in CAPA scales between the 2 groups (P = .0117). CONCLUSION Opioid use is significantly lower in patients who undergo MIS epilepsy mapping via SEEG compared with those who undergo the more invasive ECoG procedure. As part of efforts to decrease the overall opioid burden, these results should be considered by patients and surgeons when deciding on surgical methods.

scholarly journals ALS-Like Disorder in Three HIV-Positive Patients: Case Series

2021 ◽  
pp. 59-64
Author(s):  
Zachary Aaron Satin ◽  
Elham Bayat
Keyword(s):  
Antiretroviral Therapy ◽  
Motor Neuron ◽  
Motor Neuron Disease ◽  
Motor Neurons ◽  
Case Series ◽  
Retrospective Chart Review ◽  
Effective Control ◽  
Hiv Positive ◽  
Disease Course ◽  
Retroviral Infection

There appears to be a relationship between retroviruses such as HIV and the development of an ALS-like syndrome. Few cases have been reported; however, there exists evidence of a higher frequency of motor neuron disease in HIV-infected patients, as well as potential slowing and reversibility of disease course with combination antiretroviral therapy. We conducted a retrospective chart review of patients presenting to the George Washington University ALS Clinic from September 2006 to June 2018 to identify patients with HIV receiving HAART who were subsequently diagnosed with ALS or an ALS-like disorder. Our goals were to describe our patients’ disease course and compare them to general characteristics of ALS. We report three cases of HIV-positive individuals, all male, who were subsequently diagnosed with ALS. Each presented with symptoms of limb onset ALS with involvement of upper and lower motor neurons and whose disease originated at the cervical level. All three had been diagnosed with HIV prior to presentation and were presumably compliant with antiretroviral therapy throughout. Our patients demonstrated effective control of their HIV infection. Each experienced relatively slow progression of motor impairment compared to general ALS characteristics. Our study offers a distinct profile of HIV-positive patients compliant with HAART subsequently diagnosed with an ALS-like disorder. Further study should aim to uncover pathophysiological similarities between motor neuron disease both in the presence and absence of retroviral infection and to develop effective medical therapy for each.

scholarly journals Complex Bone Tumors of the Trunk—The Role of 3D Printing and Navigation in Tumor Orthopedics: A Case Series and Review of the Literature

2021 ◽  
Vol 11 (6) ◽  
pp. 517
Author(s):  
Martin Schulze ◽  
Georg Gosheger ◽  
Sebastian Bockholt ◽  
Marieke De Vaal ◽  
Tymo Budny ◽  
...  
Keyword(s):  
3D Printing ◽  
Tumor Resection ◽  
Case Series ◽  
Main Process ◽  
Patient Centered ◽  
Individual Care ◽  
Real Time Visualization ◽  
Bone Tumor Resection ◽  
Virtual Modeling

The combination of 3D printing and navigation promises improvements in surgical procedures and outcomes for complex bone tumor resection of the trunk, but its features have rarely been described in the literature. Five patients with trunk tumors were surgically treated in our institution using a combination of 3D printing and navigation. The main process includes segmentation, virtual modeling and build preparation, as well as quality assessment. Tumor resection was performed with navigated instruments. Preoperative planning supported clear margin multiplanar resections with intraoperatively adaptable real-time visualization of navigated instruments. The follow-up ranged from 2–15 months with a good functional result. The present results and the review of the current literature reflect the trend and the diverse applications of 3D printing in the medical field. 3D printing at hospital sites is often not standardized, but regulatory aspects may serve as disincentives. However, 3D printing has an increasing impact on precision medicine, and we are convinced that our process represents a valuable contribution in the context of patient-centered individual care.

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
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