Efficacy of corticosteroid therapy in the treatment of long- lasting olfactory disorders in COVID-19 patients

2020 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
L.A. Vaira ◽  
C. Hopkins ◽  
M. Petrocelli ◽  
J.R. Lechien ◽  
S. Cutrupi ◽  
...  

BACKGROUND: The growing number of COVID-19 patients with long-lasting olfactory disorders makes it necessary to identify effective treatments that enhance the spontaneous recovery of olfactory function. METHODS: Multicentre randomised case-control study that involved 18 patients with COVID-19 related anosmia or severe hyposmia for more than 30 days. Nine patients were prescribed systemic prednisone and nasal irrigation with betamethasone, ambroxol and rinazine for 15 days. The other 9, untreated, patients were used as controls. The olfactory function was evaluated with CCCRC test at 20 and 40 days from the first evaluation. RESULTS: In the control group, a median olfactory score of 20 (IQR 30) was detected at baseline. At the 20-day control there was no significant improvement in olfactory function. The improvement in olfactory performance became significant at the 40-day follow-up compared to baseline scores [60 (IQR 60) versus 20 (IQR 30)]. In the treatment group, patients had a mean olfactory score of 10 (IQR 15) at initial control. At the 20-day control, a significant im-provement in the olfactory scores, compared to the baseline, was detected [70 (IQR 40) versus 10 (IQR 15)]. Olfactory function further improved at 40 days [median score 90 (IQR 50)]. Patients in the treatment group reported significantly higher improvements of the olfactory scores than the controls at both the 20-day [40 (IQR 45) versus 10 (IQR 15)] and 40-day [60 (IQR 40) versus 30 (IQR 25)] evaluations. CONCLUSIONS: Based on the results of this study, the mix of drugs including steroids could represent a useful specific therapy to reduce the prevalence of this long-term morbidity.

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Binit Vaidya ◽  
Manisha Bhochhibhoya ◽  
Shweta Nakarmi

Objective. To examine the efficacy of vitamin E in methotrexate- (MTX-) induced transaminitis in patients with rheumatoid arthritis (RA). Methods. A case-control study was conducted at a tertiary rheumatology center for 12 months. Patients with RA on MTX and deranged aminotransferases were included. Patients with previous liver diseases, baseline transaminitis before methotrexate initiation, alcohol intake, muscle diseases, under hepatotoxic drugs, and aminotransferases>3 times the upper normal limit were excluded. The patients were divided into treatment (vitamin E 400 mg bid for 3 months) and control groups (no vitamin E) using a random number table. The dose of MTX was unaltered. Follow-up was done after 3 and 6 months. Independent t-test was done to compare means of two groups. Paired t-test was done to compare differences in mean. Results. Among 230 patients, 86.5% were female with a mean BMI of 25.9±4.5 kg/m2. In the treatment group, SGPT and SGOT at baseline were 73.1±20.4 and 60.2±24.5 IU/L, respectively; at 3-month follow-up 44.6±34.2 and 38.3±20.8 IU/L, respectively; and at 6-month follow-up 40.4±35.7 and 34.2±21.9 IU/L, respectively. In the control group, SGPT and SGOT at baseline were 63.4±15.1 and 46.8±13.7 IU/L, respectively, and at 3-month follow-up 55.8±45.9 and 45.5±30.9 IU/L, respectively. Significant decrease in the level of aminotransferases was seen in the treatment group (p value < 0.001) and not in the control group (p values 0.161 and 0.728, respectively). The change in levels of SGPT and SGOT from baseline to 3 months of follow-up was statistically significant in between two study groups (p values 0.007 and <0.001, respectively). From the control group, 29 patients were crossed over to vitamin E for the next 3 months. SGPT and SGOT decreased from 97.6±44.1 to 46.1±40.9 and 69.3±34.9 to 29.1±11.6 IU/L, respectively (p values 0.031 and 0.017, respectively). Conclusion. Vitamin E significantly attenuates MTX-induced transaminitis.


Author(s):  
Angeliki Darma ◽  
Livio Bertagnolli ◽  
Borislav Dinov ◽  
Alireza Sepehri Shamloo ◽  
Federica Torri ◽  
...  

Abstract Introduction Ablation of ventricular tachycardias (VTs) in patients with structural heart disease (SHD) has been associated with advanced heart failure and poor survival. Methods and results This matched case-control study sought to assess the difference in survival after left ventricular assist device (LVAD) implantation and/or heart transplantation (HTX) in SHD patients undergoing VT ablation. From the initial cohort of 309 SHD patients undergoing VT ablation (187 ischemic cardiomyopathy, mean age 64 ± 12 years, ejection fraction of 34 ± 13%), 15 patients received an LVAD and nine patients HTX after VT ablation during a follow-up period of 44 ± 33 months. Long-term survival after LVAD did not differ from the matched control group (p = 0.761), although the cause of lethal events was different. All post-HTX patients survived during follow-up. Conclusion In this matched case-control study on patients with SHD undergoing VT ablation, patients that received LVAD implantation had similar survival compared to the control group after 4‑year follow-up, while the patients with HTX had a significantly better outcome.


2019 ◽  
Author(s):  
Min Xie ◽  
Shuang-Ling Li ◽  
Jia-Xin Pan ◽  
Sai-Nan Zhu ◽  
Dong-Xin Wang

Abstract Background The impact of new-onset postoperative atrial fibrillation (POAF) on long-term outcomes of patients after non-cardiac surgery remains controversial. Here we report the 3-year follow-up of a previous case-control study to determine the relationship between new-onset POAF and long-term outcomes in patients after non-cardiac surgery. Methods In a previous case-control study, 213 patients who were admitted to the intensive care unit (ICU) after non-cardiac surgery were included; of them 71 were in the POAF group and 142 the control group. A telephone interview was performed with patients or their family members at 3 years after surgery. The primary endpoint was the incidence of major adverse cardiovascular events (MACEs) within 3 years, including cardiovascular death, non-fatal cardiac arrest, acute myocardial infarction, congestive heart failure, and ischemic stroke. A logistic regression model was established to assess the association between the occurrence of new-onset POAF and the development of 3-year MACEs. Results 202 patients completed the 3-year follow-up and were included in the analysis; of them 68 were in the POAF group and 134 were in the control group. The incidence of 3-year MACEs was higher in the POAF group than in the control group (64.7% [44/68] vs. 23.1% [31/134], p<0.001). After correction for confounding factors, new-onset POAF was independently associated with an increased risk of 3-year MACEs (odds ratio 5.448, 95% confidence interval 2.202-13.481, p<0.001). Conclusions For adult patients admitted to the ICU after non-cardiac surgery, new-onset POAF was an independent risk factor for the development of MACEs within 3 years.


2017 ◽  
Vol 11 (3) ◽  
pp. 107-112 ◽  
Author(s):  
Georgios Bontzos ◽  
Michail Agiorgiotakis ◽  
Efstathios T Detorakis

ABSTRACT Aim In this study, we reviewed demographics and biometric characteristics among patients receiving chronic β-blockers and prostaglandins (PGs) for primary open-angle glaucoma. We compared the age at the time of cataract surgery in different patient groups and in a control group which was not under any medication. Materials and methods Retrospective chart review of glaucomatous patients who underwent cataract extraction at the Department of Ophthalmology of the University Hospital of Heraklion, Crete, Greece, between January 1998 and December 2016 was done. Age at cataract surgery, axial length (AL), and preoperative and postoperative best-corrected visual acuities (BCVAs) were recorded. A cohort of patients without glaucoma who were operated for cataract extraction was also evaluated. Results In all, 320 patients were reviewed. There were significant results in mean age difference between the beta-antagonist and the PG group [3.05 years, 95% confidence interval (CI) 1.54-4.57] and between the beta-antagonist group with the patients receiving a combined therapy (3.02 years, 95% CI 1.14-4.91). No significant difference was found between the PG and the combination group. All the three treated groups had a significant lower mean age than the control group at the time of cataract surgery. Conclusion Based on our study, we concluded that there might be a possible association between chronic treatment with beta-antagonist agents and earlier cataract surgical time in the treated eye. Clinical significance Intraocular pressure control is often usually achieved using ophthalmic agents. Their topical and systemic effects should be monitored precisely. Earlier cataract formation might be an important side effect which the physician has to keep in mind before choosing the suitable medication. How to cite this article Bontzos G, Agiorgiotakis M, Detorakis ET. Long-term Follow-up of Patients receiving Intraocular Pressure-lowering Medications as Cataract Surgery Candidates: A Case—control Study. J Curr Glaucoma Pract 2017;11(3):107-112.


Trauma ◽  
2020 ◽  
pp. 146040862097814
Author(s):  
Justin Vaida ◽  
Alexander DB Conti ◽  
Justin J Ray ◽  
Daniel A Bravin ◽  
Michelle A Bramer

Introduction Optimal management of lower extremity fractures includes early antibiotics administration, thorough irrigation and debridement, consideration of soft tissue injury, and definitive skeletal management. The purpose of this study was to evaluate the efficacy of topical vancomycin powder in the treatment of open lower extremity fractures. Methods This was a retrospective case control study in which open lower extremity fractures at our institution were reviewed for development of infection (including species and sensitivity if present) and the development of unanticipated wound complications requiring intervention. Patients from 2010-2015 were treated with standard of care consistent with evidence-based literature (IV antibiotics with external fixator, intramedullary nail, etc.). Patients from 2016–18 were additionally treated with vancomycin powder applied directly to the wound before closure. All patients were monitored per the treating surgeon’s standard follow-up protocol and had follow-up of at least two months. Results This retrospective case control study comprised 434 patients. The historical control group (n = 388 patients) and treatment group (n = 46 patients) were similar for age, sex, BMI (body mass index), diabetes, smoking status, and Injury Severity Score (ISS). There were 36 infections (9.28%) in the control group compared to four infections (8.70%) in the vancomycin powder group (p = 0.901). No significant difference was seen after adjusting for age, sex, BMI, diabetes, smoking status, and ISS. The vancomycin powder group experienced significantly more wound complications (15.2%) compared to the control group (6.4%; p = 0.039), which remained significant when adjusting for multiple covariates. Conclusions Topical vancomycin powder did not reduce the infection rate when applied in the surgical site of open lower extremity fractures. Instead, the addition of topical vancomycin powder resulted in significantly more wound complications in patients with open lower extremity fractures.


2020 ◽  
Vol 134 (4) ◽  
pp. 350-353
Author(s):  
M Narayan ◽  
S Limbachiya ◽  
D Balasubramanian ◽  
N Subramaniam ◽  
K Thankappan ◽  
...  

AbstractObjectivesPharyngocutaneous fistulae are dreaded complications following total laryngectomy. This paper presents our experience using 3–5 ml gastrografin to detect pharyngeal leaks following total laryngectomy, and compares post-operative videofluoroscopy with clinical follow-up findings in the detection of pharyngocutaneous fistulae.MethodsA retrospective case–control study was conducted of total laryngectomy patients. The control group (n = 85) was assessed clinically for development of pharyngocutaneous fistulae, while the study group (n = 52) underwent small-volume (3–5 ml) post-operative gastrografin videofluoroscopy.ResultsIn the control group, 24 of 85 patients (28 per cent) developed pharyngocutaneous fistulae, with 6 requiring surgical correction. In the study group, 24 of 52 patients (46 per cent) had videofluoroscopy-detected pharyngeal leaks; 4 patients (8 per cent) developed pharyngocutaneous fistulae, but all cases resolved following non-surgical management. Patients who underwent videofluoroscopy had a significantly lower risk of developing pharyngocutaneous fistulae; sensitivity and specificity in the detection of pharyngocutaneous fistulae were 58 per cent and 100 per cent respectively.ConclusionSmall-volume gastrografin videofluoroscopy reliably identified small pharyngeal leaks. Routine use in total laryngectomy combined with withholding feeds in cases of early leaks may prevent the development of pharyngocutaneous fistulae.


1995 ◽  
Vol 21 (6) ◽  
pp. 541-545 ◽  
Author(s):  
Monica Turner Parker ◽  
Nancy Leggett-Frazier ◽  
Pauline A. Vincent ◽  
Melvin S. Swanson

Nursing staffs from two long-term care facilities attended a multisession educational program about the care of residents with diabetes (treatment group). A control group consisted of the nursing staffs from two other similar facilities who did not participate in the educational program. Both groups were given a knowledge pretest and posttest. A chart review also was conducted following the educational intervention to determine any changes in the diabetes care provided by the treatment group. Following the educational program, the treatment group had a significant increase in their mean score on the knowledge test compared with the control group. However, a. review of the residents' charts revealed no significant increases in specific behaviors related to diabetes care. The findings suggest that, in addition to educational programs, more focused training concerning diabetes care is needed to improve the care of residents with diabetes in long-term care facilities. Implications for diabetes educators are discussed.


2009 ◽  
Vol 34 (4) ◽  
pp. 491-495 ◽  
Author(s):  
Peter M. Bonutti ◽  
Michael G. Zywiel ◽  
Thorsten M. Seyler ◽  
Seung Yong Lee ◽  
Mike S. McGrath ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document