scholarly journals Clinical Findings in Albanian Patients with 2009 Influenza AH1N1 Admitted at the Intensive Care Unit

2013 ◽  
Vol 2013 ◽  
pp. 1-6
Author(s):  
Arben Ndreu ◽  
Dhimitër Kraja ◽  
Silva Bino ◽  
Artan Simaku ◽  
Iris Hatibi ◽  
...  
Keyword(s):  
Critical Illness ◽  
Infectious Diseases ◽  
Prolonged Mechanical Ventilation ◽  
Demographic Data ◽  
Clinical Findings ◽  
University Hospital ◽  
Hypoxemic Respiratory Failure ◽  
Laboratory Findings ◽  
2009 H1n1 ◽  
Influenza Ah1n1

Due to the ease of cross-continent spread of infectious diseases, the 2009 influenza AH1N1 (H1N1) affected many countries. This observational prospective study looked at Albanian patients admitted with 2009 H1N1 at the ICU of the Department of Infectious Diseases at the University Hospital Center of Tirana, from November 2009 to March 2010. Demographic data, symptoms, comorbidities, and clinical outcomes were collected from each patient. The number of days spent in the ICU was recorded for each patient along with their radiological and laboratory findings, and outcome at discharge. Critical illness occurred in 31 patients admitted with confirmed 2009 H1N1. The median age of patients was 35 years. Five (16.1%) patients required endotracheal intubation; noninvasive oxygen therapy (NIV) was used in 15 (48.4%) patients via nasal tube; and continuous positive airway pressure (CPAP) and pressure support ventilation (PSV) oxygen masks were used in 11 (35.5%) patients. All patients were treated with oseltamivir. Four patients admitted and treated did not survive. Critical illness in the setting of 2009 H1N1 admitted in the ICU predominantly affected young adults. NIV could play a role in treating 2009 influenza H1N1 infection-related hypoxemic respiratory failure that was associated with severe hypoxemia, pneumonia, requirement for prolonged mechanical ventilation, and the frequent use of antiviral therapy.

scholarly journals Clinical findings in critically ill patients infected with SARS-CoV-2 in Guangdong Province, China: a multi-center, retrospective, observational study

2020 ◽  
Author(s):  
Yonghao Xu ◽  
Zhiheng Xu ◽  
Xuesong Liu ◽  
Lihua Cai ◽  
Haichong Zheng ◽  
...  
Keyword(s):  
Critical Illness ◽  
Observational Study ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Demographic Data ◽  
Guangdong Province ◽  
Clinical Findings ◽  
Human Infection ◽  
Retrospective Observational Study ◽  
Laboratory Findings

AbstractBackgroundIn December 2019, human infection with a novel coronavirus, known as SARS-CoV-2, was identified in Wuhan, China. The mortality of critical illness was high in Wuhan. Information about critically ill patients with SARS-CoV-2 infection outside of Wuhan is scarce. We aimed to provide the clinical features, treatment, and prognosis of the critically ill patients with SARS-CoV-2 infection in Guangdong Province.MethodsIn this multi-centered, retrospective, observational study, we enrolled critically ill patients with SARS-CoV-2 pneumonia who were admitted to the intensive care unit (ICU) in Guangdong Province. Demographic data, symptoms, laboratory findings, comorbidities, treatments, and prognosis were collected. Data were compared between patients with and without intubation.ResultsForty-five critically ill patients with SARS-CoV-2 pneumonia were identified in 7 ICUs in Guangdong Province. The mean age was 56.7 years, and 29 patients (64.4%) were men. The most common symptoms at the onset of illness were high fever and cough. Majority of patients presented with lymphopenia and elevated lactate dehydrogenase. Treatment with antiviral drugs was initiated in all the patients. Thirty-seven patients (82.2%) had developed acute respiratory distress syndrome, and 13 (28.9%) septic shock. A total of 20 (44.4%) patients required intubation and 9 (20%) required extracorporeal membrane oxygenation. As of February 28th 2020, only one patient (2.2%) had died and half of them had discharged of ICU.ConclusionsInfection with SARS-CoV-2 in critical illness is characterized by fever, lymphopenia, acute respiratory failure and multiple organ dysfunction. Compared with critically ill patients infected with SARS-CoV-2 in Wuhan, the mortality of critically ill patients in Guangdong Province was relatively low. These data provide some general understandings and experience for the critical patients with SARS-CoV-2 outside of Wuhan.

scholarly journals The mRNA Distribution of Cancer Stem Cell Marker CD90/Thy-1 Is Comparable in Hepatocellular Carcinoma of Eastern and Western Populations

Cells ◽  
2020 ◽  
Vol 9 (12) ◽  
pp. 2672
Author(s):  
An B. Luong ◽  
Huy Q. Do ◽  
Paola Tarchi ◽  
Deborah Bonazza ◽  
Cristina Bottin ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Demographic Data ◽  
Clinical Findings ◽  
Stem Cell Marker ◽  
Ho Chi Minh City ◽  
Tumor Diameter ◽  
Laboratory Findings ◽  
Tissue Samples ◽  
Single Laboratory ◽  
Pcr Conditions

Epidemiology of hepatocellular carcinoma (HCC) showed a correlation between incidence and geographical-relevant risk factors. This study aims to compare the distributions of cancer stem cells (CSC) in two distant populations in Asia and Europe. We analyzed 52 and 43 selected HCC patients undergoing hepatectomy in Ho Chi Minh City (Vietnam) and Trieste (Italy). Each patient sample consisted of HCC, peri-HCC, and non-tumoral (distal) tissue. Demographic data were recorded together with clinical findings. The protocol for the collection of tissue samples and RNA was standardized in both laboratories and gene expression analysis was performed in a single laboratory with identical PCR conditions. Baseline data showed comparable laboratory findings between the two cohorts. mRNA distribution showed a comparable pattern of all CSC markers analyzed with the expression of CD90 progressively increasing from distal and peri-HCC to be highest in HCC (p < 0.001), confirmed by immunofluorescence data. CD90 mRNA distribution was related to HBV-related HCC and a tumor diameter less than 5 cm. Patients with high tumoral CD90 mRNA had a shorter time (p < 0.05) to tumor recurrence compared to patients with lower CD90. This comparative study showed that CD90 mRNA expressions are comparable between Eastern and Western HCC cases.

scholarly journals Spread of the SARS-CoV-2 UK-variant in the South East of France: impact on COVID-19 patients’ age, comorbidity profiles and clinical presentation

2021 ◽  
Author(s):  
Johan Courjon ◽  
Julie Contenti ◽  
Elisa Demonchy ◽  
Jacques Levraut ◽  
Pascal Barbry ◽  
...  
Keyword(s):  
Infectious Diseases ◽  
Demographic Data ◽  
Clinical Signs ◽  
Clinical Severity ◽  
University Hospital ◽  
The South ◽  
Pcr Screening ◽  
The Uk ◽  
Turn Over ◽  
The University

AbstractObjectivesThe variant 20I/501Y.V1, associated to a higher risk of transmissibility, emerged in Nice city (South East of France, French Riviera) during January 2021. The pandemic has resumed late December 2020 in this aera. A high incidence rate together with a fast turn-over of the main circulating variants, provided us the opportunity to analyze modifications in clinical profile and outcome traits.MethodsObservational study in the University hospital of Nice from December 2020 to February 2021. We analyzed data of sequencing of SARS-CoV-2 from the sewage collector and PCR screening from all positive samples at the hospital. Then, we described the characteristics of all COVID-19 patients admitted in the emergency department (ED) (n=1247) and those hospitalized in the infectious diseases ward or ICU (n=232). Demographic data, clinical signs and severity were recorded by the NEWS-2, SAPS-2 and SOFA scores were recorded and analyzed.Resultsthe UK-variant was absent in the area in December, then increasingly spread in January representing 59% of the PCR screening performed mid-February. The rate of patients over 65 years admitted to the ED decreased from 63% to 50% (p=0.001). The mean age of hospitalized patients in the infectious diseases ward decreased from 70.7 to 59.2 (p<0.001) while the proportion of patients without comorbidity increased from 16% to 42% (p=0.007). Neither the NEWS-2 score nor the main signs of clinical severity have changed over time.ConclusionSpread of the UK-variant in the South East of France affects younger and healthier patients.

scholarly journals Socio-demographic Characteristics of Patients Diagnosed with Advanced Chronic Venous Insufficiency (C4-C6) Correlated with Clinical and Para-clinical Findings

2015 ◽  
Vol 61 (2) ◽  
pp. 94-99
Author(s):  
Imre Eniko Reka ◽  
M Imre
Keyword(s):  
Risk Factors ◽  
Therapeutic Approach ◽  
Venous Insufficiency ◽  
Metabolic Diseases ◽  
Demographic Data ◽  
Clinical Stage ◽  
Signs And Symptoms ◽  
Clinical Findings ◽  
Laboratory Findings ◽  
Peripheral Arterial Diseases

Abstract Chronic venous insufficiency’s frequency reaches almost 25% in European countries. The aim of this present study was to assess the correlation between sociodemographic characteristics as well as clinical findings and para-clinical findings of aCVI patients. A total number of 2636 patients diagnosed with CVI were evaluated for over an 8 year time period (2006-2013). In case of 795 of them, diagnosis of aCVI (C4-C6) has been established. The following variables have been evaluated: demographic data, etiology, risk factors, chronic diseases as risk factors, signs and symptoms, laboratory findings and even the therapeutic approach. All the assessed data has been evaluated using descriptive statistics, t-Student test, and chi square test. Also the relative risk (RR) and Odds ratio (OR) has been calculated. The mean age of aCVI patients was significantly higher (p=0.001) than the age of patients with stage C1-3 CVI. A positive correlation (p<0.0001) between combined venous disorders and clinical stage of CVI has been found. Deep vein thrombosis proved to be correlated (p=0.02) with evolution of CVI to venous ulcer (stage C6). Worsening of advanced venous insufficiency was also correlated with presence of peripheral arterial diseases, and/or metabolic diseases (p<0.0001, and p=0.02). Based on our results, the typical profile of a patient with aCVI has been outlined. Using this profile, the general practitioner and even the internal medicine specialist can recognize in advance patients with an elevated risk of developing aCVI, and accordingly can choose a more appropriate therapeutic approach.

scholarly journals 0612 Validation of NEMS-BG Score in Screening of Patients with Obstructive Sleep Apnea

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A234-A234
Author(s):  
H Gharraf ◽  
A Baess
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Demographic Data ◽  
Screening Strategy ◽  
Clinical Findings ◽  
University Hospital ◽  
Berlin Questionnaire ◽  
Anthropometric Measures ◽  
Obstructive Sleep ◽  
And Gender

Abstract Introduction Obstructive sleep apnea (OSA) is one of the most prevalent diseases worldwide. Diagnosis of OSA is still a dilemma despite our well known disease-related impact on human body health. Under-diagnosis of OSA is still a problem despite the well-established clinical and laboratory criteria of diagnosis. Over-diagnosis may lead to exhaustion of our limited health-care resources. Therefore, an efficient screening tool that is well validated and easily applied, will be an ideal solution for the over or under-diagnosis of OSA. NAMES-BG score was suggested to efficiently screen for OSA depending on neck circumference, airway classification, comorbidities, Epworth sleepiness scale, snoring score, body mass index and gender Methods The aim of the work was to validate NEMS-BG score in screening of patients with obstructive sleep apnea (OSA). Patients and Methods This is a retrospective single center clinical study. Records of patients with documented obstructive sleep apnea were collected. Those records were collected from the database of department of chest diseases in Alexandria Main University Hospital (AMUH). The records of included patients included demographic data, clinical findings, anthropometric measures and polysomnographic records. Statistics were formulated to validate the sensitivity and specificity of this score in our cohort of patients. The significance of the results were at the 5% level of significance. Results The cutoff value for the composite NAMES tool was calculated at ≥3 points. In the validation group, NAMES demonstrated similar test characteristics to the Berlin questionnaire, and sensitivity was statistically significantly better than that seen with the Epworth scale. The addition of BMI and gender to the tool improved screening characteristics Conclusion The NAMES assessment is an effective, inexpensive screening strategy for moderate to severe OSA. Support no support

Follow-up of Osteomyelitis of Infants with Systemic Serum Parameters and Bone Scintigraphy

1996 ◽  
Vol 35 (04) ◽  
pp. 116-121 ◽  
Author(s):  
G. E Fueger ◽  
M. Vejda ◽  
R. M. Aigner
Keyword(s):  
Bone Scintigraphy ◽  
Antibiotic Treatment ◽  
Diagnostic Value ◽  
Clinical Findings ◽  
Laboratory Findings ◽  
Radiographic Findings ◽  
Serum Parameters ◽  
Wbc Count ◽  
Differential White Blood Cell

Summary Aim: To prevent orthopedic sequelae in acute hematogenous pyogenic osteomyelitis (AHPO) of infants early diagnosis, recognition of recurrence and effective therapy is needed. This retrospective study of 47 infants with bacteriologically confirmed AHPO concerned with an analysis of the diagnostic value of systemic serum parameters compared to bone scintigraphy (BSC). Methods: AHPO was characterized initially and during the course of disease by clinical findings, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), total and differential white blood cell (WBC) count, BSC, and plain radiography. Results: CRP was the most effective serum parameter for follow- up of disease. The first sign of BSC to signal adequate response to antibiotic treatment was the decrease or normalization of hyperperfusion. Escape from therapy or poor prognosis, even when the serum parameters were normalized, was signaled by the recurrence of focal hyperperfusion and the persistent or increasing local uptake ratios on the 3-h-image over 6 weeks during a course of antibiotic treatment. Conclusion: Antibiotic treatment masks the clinical presentation, and the radiographic findings, causes non-characteristic laboratory findings, but do not prevent the scintigraphic visualization; BSC and serum parameters used in the right completion are the most successful and efficient modalities for follow-up of AHPO. Maintenance of antibiotic therapy should be done until BSC findings have reverted to normal.

scholarly journals Health-related quality of life in different trimesters during pregnancy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Huailiang Wu ◽  
Weiwei Sun ◽  
Hanqing Chen ◽  
Yanxin Wu ◽  
Wenjing Ding ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pregnant Women ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Health Related Quality ◽  
Cross Sectional ◽  
Related Quality ◽  
Health Related

Abstract Background Pregnant women experience physical, physiological, and mental changes. Health-related quality of life (HRQoL) is a relevant indicator of psychological and physical behaviours, changing over the course of pregnancy. This study aims to assess HRQoL of pregnant women during different stages of pregnancy. Methods This cross-sectional study was performed using the The EuroQoL Group’s five-dimension five-level questionnaire (EQ-5D-5L) to assess the HRQoL of pregnant women, and demographic data were collected. This study was conducted in a regional university hospital in Guangzhou, China. Results A total of 908 pregnant women were included in this study. Pregnant women in the early 2nd trimester had the highest HRQoL. The HRQoL of pregnant women rose from the 1st trimester to the early 2nd trimester, and dropped to the bottom at the late 3rd trimester due to some physical and mental changes. Reports of pain/discomfort problem were the most common (46.0%) while self-care were the least concern. More than 10% of pregnant women in the 1st trimester had health-related problems in at least one dimension of whole five dimensions. In the whole sample, the EuroQoL Group’s visual analog scale (EQ-VAS) was 87.86 ± 9.16. Across the gestational stages, the HRQoL remained stable during the pregnancy but the highest value was observed in the 1st trimester (89.65 ± 10.13) while the lowest was in the late 3rd trimester (87.28 ± 9.13). Conclusions During pregnancy, HRQoL were associated with gestational trimesters in a certain degree. HRQoL was the highest in the early 2nd trimester and then decreased to the lowest in the late 3rd trimester due to a series of physical and psychological changes. Therefore, obstetric doctors and medical institutions should give more attention and care to pregnant women in the late 3rd trimester.

scholarly journals Pharmacist-Driven Antibiotic Stewardship Program in Febrile Neutropenic Patients: A Single Site Prospective Study in Thailand

Antibiotics ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 456
Author(s):  
Kittiya Jantarathaneewat ◽  
Anucha Apisarnthanarak ◽  
Wasithep Limvorapitak ◽  
David J. Weber ◽  
Preecha Montakantikul
Keyword(s):  
Infectious Diseases ◽  
Antibiotic Stewardship ◽  
Empirical Therapy ◽  
University Hospital ◽  
Control Group ◽  
Great Opportunity ◽  
Stewardship Program ◽  
Determine Role ◽  
Neutropenic Patients ◽  
Infectious Diseases Consultation

The antibiotic stewardship program (ASP) is a necessary part of febrile neutropenia (FN) treatment. Pharmacist-driven ASP is one of the meaningful approaches to improve the appropriateness of antibiotic usage. Our study aimed to determine role of the pharmacist in ASPs for FN patients. We prospectively studied at Thammasat University Hospital between August 2019 and April 2020. Our primary outcome was to compare the appropriate use of target antibiotics between the pharmacist-driven ASP group and the control group. The results showed 90 FN events in 66 patients. The choice of an appropriate antibiotic was significantly higher in the pharmacist-driven ASP group than the control group (88.9% vs. 51.1%, p < 0.001). Furthermore, there was greater appropriateness of the dosage regimen chosen as empirical therapy in the pharmacist-driven ASP group than in the control group (97.8% vs. 88.7%, p = 0.049) and proper duration of target antibiotics in documentation therapy (91.1% vs. 75.6%, p = 0.039). The multivariate analysis showed a pharmacist-driven ASP and infectious diseases consultation had a favorable impact on 30-day infectious diseases-related mortality in chemotherapy-induced FN patients (OR 0.058, 95%CI:0.005–0.655, p = 0.021). Our study demonstrated that pharmacist-driven ASPs could be a great opportunity to improve antibiotic appropriateness in FN patients.

scholarly journals Effective Treatment of Neurological Symptoms with Normal Doses of Botulinum Neurotoxin in Wilson’s Disease: Six Cases and Literature Review

Toxins ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 241
Author(s):  
Harald Hefter ◽  
Sara Samadzadeh
Keyword(s):  
Botulinum Neurotoxin ◽  
Wilson’S Disease ◽  
Animal Experiments ◽  
Symptomatic Treatment ◽  
Wilson's Disease ◽  
University Hospital ◽  
Laboratory Findings ◽  
Dose Information ◽  
High Doses ◽  
The University

Background: Recent cell-based and animal experiments have demonstrated an effective reduction in botulinum neurotoxin A (BoNT/A) by copper. Aim: We aimed to analyze whether the successful symptomatic BoNT/A treatment of patients with Wilson’s disease (WD) corresponds with unusually high doses per session. Methods: Among the 156 WD patients regularly seen at the outpatient department of the university hospital in Düsseldorf (Germany), only 6 patients had been treated with BoNT/A during the past 5 years. The laboratory findings, indications for BoNT treatment, preparations, and doses per session were extracted retrospectively from the charts. These parameters were compared with those of 13 other patients described in the literature. Results: BoNT/A injection therapy is a rare (<4%) symptomatic treatment in WD, only necessary in exceptional cases, and is often applied only transiently. In those cases for which dose information was available, the dose per session and indication appear to be within usual limits. Conclusion: Despite the evidence that copper can interfere with the botulinum toxin in preclinical models, patients with WD do not require higher doses of the toxin than other patients with dystonia.

scholarly journals 472. The Utility of Infectious Diseases E-consults in the Era of COVID-19

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S302-S303
Author(s):  
Hala Saad ◽  
Kruti Yagnik ◽  
Helen King ◽  
Roger Bedimo ◽  
Richard J Medford
Keyword(s):  
Health Care ◽  
Infectious Diseases ◽  
Infection Prevention ◽  
Panel Member ◽  
University Hospital ◽  
North Texas ◽  
Review Panel ◽  
The North ◽  
Time To Completion ◽  
Texas Health

Abstract Background During the COVID-19 pandemic, rapid Infectious Diseases (ID) consultation has been required to answer novel questions regarding SARS-CoV-2 testing and infection prevention. We sought to evaluate the utility of e-consults to triage and provide rapid ID recommendations to providers. Methods We performed a retrospective study reviewing ID e-consults in three institutions in the North Texas region: Clements University Hospital (CUH), Parkland Hospital and Health System (PHHS), and the VA North Texas Health Care System (VA) from March 1, 2020 to May 15, 2020. Variables collected include age, sex, ethnicity, comorbidities, time to completion, reason for consult and outcome of consult (initiation or removal of personal protective equipment (PPE) and recommendation to test or retest for COVID-19). Results We performed all analysis using R studio (Version 1.3.959). Characteristics of 198 patients included: 112(57%) male, 86(43%) female, 86(43%) Caucasian, 71(36%) Hispanic, 42(21%) African American, 6(3%) Asian and mean(sd) age of 55.1(15.9). Patient comorbidities included: 89(45%) with a heart condition, 77(39%) diabetes, 30(15%) asthma and 14(7%) liver disease. Median time to completion for all hospitals was 4 hours(h); ((CUH (4h) vs PHHS (2h), p&lt; 0.05; VA (5.5h) vs PHHS (2h) p&lt; 0.05)). Most common reasons for e-consult included: (63)32% regarding re-testing ((CUH 14(21%) vs PHHS 43(50%), p&lt; 0.05; CUH vs VA 14(27%), p&lt; 0.05; PHHS vs VA, p&lt; 0.05)), (61)31% testing ((CUH 25(37%) vs PHHS 39(45%), p&lt; 0.05; CUH vs VA 7(16%), p&lt; 0.05; PHHS vs VA, p&lt; 0.05)) and 61(31%) infection prevention (IP). Based on the e-consult recommendation, 53(27%) of patients were tested ((CUH 31(45%) vs PHHS 11(13%), p&lt; 0.05, CUH vs VA 11(25%), PHHS vs VA, p&lt; 0.05)), 45(23%) were re-tested, 44(22%) of patients had PPE started on and 19% had PPE removed ((CUH 0(0%) vs PHHS 16(19%), p&lt; 0.05; CUH vs VA 21(48%), p&lt; 0.05; PHHS vs VA, p&lt; 0.05)). Reason for Consult Conclusion E-consult services can provide prompt ID input during the COVID-19 pandemic, minimizing the risk of infection to the patient and health care workers while preserving PPE and testing supplies. Disclosures Roger Bedimo, MD, MS, Gilead Sciences (Consultant)Merck & Co. (Advisor or Review Panel member)ViiV Healthcare (Advisor or Review Panel member, Research Grant or Support)

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