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Internal and Emergency Medicine

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https://www.readbyqxmd.com/read/27913917/network-meta-analysis-an-introduction-for-clinicians
#1
Benjamin Rouse, Anna Chaimani, Tianjing Li
Network meta-analysis is a technique for comparing multiple treatments simultaneously in a single analysis by combining direct and indirect evidence within a network of randomized controlled trials. Network meta-analysis may assist assessing the comparative effectiveness of different treatments regularly used in clinical practice and, therefore, has become attractive among clinicians. However, if proper caution is not taken in conducting and interpreting network meta-analysis, inferences might be biased. The aim of this paper is to illustrate the process of network meta-analysis with the aid of a working example on first-line medical treatment for primary open-angle glaucoma...
December 2, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27909859/sofa-score-and-left-ventricular-systolic-function-as-predictors-of-short-term-outcome-in-patients-with-sepsis
#2
Francesca Innocenti, Vittorio Palmieri, Aurelia Guzzo, Valerio Teodoro Stefanone, Chiara Donnini, Riccardo Pini
In a group of septic patients, we assess the short-term prognostic value of LV systolic performance, evaluated through conventional left ventricular ejection fraction (LVEF) and left ventricular global longitudinal strain (LV GLS). One hundred forty-seven patients with sepsis were recruited; LVEF by planimetry and peak GLS by 2D speckle tracking could be assessed within 24 h. The study population was stratified according to SOFA tertiles assessed at the time of the echocardiogram (G1: SOFA score <5; G2: SOFA score 5-7; G3: SOFA score >7)...
December 1, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27905006/guidelines-on-the-management-of-atrial-fibrillation-in-the-emergency-department-a-critical-appraisal
#3
Giorgio Costantino, Gian Marco Podda, Lorenzo Falsetti, Primiano Iannone, Ana Lages, Alberto M Marra, Maristella Masala, Olaug Marie Reiakvam, Florentia Savva, Jan Schovanek, Sjoerd van Bree, Inês João da Silva Chora, Graziella Privitera, Silvio Ragozzino, Matthias von Rotz, Lycke Woittiez, Christopher Davidson, Nicola Montano
Several guidelines often exist on the same topic, sometimes offering divergent recommendations. For the clinician, it can be difficult to understand the reasons for this divergence and how to select the right recommendations. The aim of this study is to compare different guidelines on the management of atrial fibrillation (AF), and provide practical and affordable advice on its management in the acute setting. A PubMed search was performed in May 2014 to identify the three most recent and cited published guidelines on AF...
November 30, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27900604/assessment-of-interstitial-lung-disease-in-sj%C3%A3-gren-s-syndrome-by-lung-ultrasound-a-pilot-study-of-correlation-with-high-resolution-chest-tomography
#4
Pablo Guisado Vasco, Gonzalo de Luna Cardenal, Isabel Martín Garrido, José Manuel Luque Pinilla, Guadalupe Fraile Rodríguez, Juan José Nava Mateo, Daniel Carnevalli Ruiz
The background of this study is to assess the accuracy of lung ultrasound (LUS) to diagnose interstitial lung disease (ILD) in Sjögren's syndrome (Sjs), in patients who have any alterations in pulmonary function tests (PFT) or respiratory symptoms. LUS was correlated with chest tomography (hrCT), considering it as the imaging gold standard technique to diagnose ILD. This is a pilot, multicenter, cross-sectional, and consecutive-case study. The inclusion criteria are ≥18 years old, Signs and symptoms: according to ACEG 2002 criteria, respiratory symptoms (dyspnea, cough), or any alterations in PFR...
November 29, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27888395/utility-of-fvc-dlco-ratio-to-stratify-the-risk-of-mortality-in-unselected-subjects-with-pulmonary-hypertension
#5
Lacedonia Donato, Carpagnano Giovanna Elisiana, Galgano Giuseppe, Schino Pietro, Correale Michele, Natale Daniele Brunetti, Ventura Valentina, Di Biase Matteo, Foschino Barbaro Maria Pia
In patients with systemic sclerosis, a ratio between forced vital capacity (FVC) and diffusing capacity of carbon monoxide (DLCO, FCV%/DLCO%) >1.5 might be a predictor of pulmonary hypertension (PH). The aim of this study is, therefore, to evaluate whether this index can be used in patients with PH, regardless of etiology. 83 consecutive outpatients with suspected PH at non-invasive work-up underwent spirometry and DLCO test before right heart catheterization (RHC); FVC%/DLCO% ratio was then calculated and compared with mean pulmonary-artery-pressure (mPAP) and mortality at 5-year follow-up...
November 25, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27878663/prevention-and-treatment-of-venous-thromboembolism-in-patients-with-solid-brain-neoplasms-results-of-a-survey-among-italian-physicians
#6
Nicola Mumoli, Stefano Barco, Marco Cei, Matteo Giorgi-Pierfranceschi, Mauro Campanini, Andrea Fontanella, Walter Ageno, Francesco Dentali
The decision concerning the introduction of primary and secondary prophylaxis of venous thromboembolism (VTE) in patients with solid brain neoplasms and brain metastases is often challenging due to the concomitant increased risk of intracranial hemorrhage and to limited evidence from available literature. A standardized questionnaire composed of nine multiple-choice questions regarding primary VTE prevention in non-surgical patients during high-risk conditions and VTE secondary prevention in patients with a solid brain neoplasm or cerebral metastases was sent via electronic mail to all the members (n = 2420) of the Italian Federation of the Internal Medicine Hospital Executives' Associations (FADOI) in June 2015...
November 23, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27878662/a-thrombotic-storm
#7
Sarah Damanti, Andrea Artoni, Tiziano Lucchi, Pier Mannuccio Mannucci, Daniela Mari, Luigi Bergamaschini
No abstract text is available yet for this article.
November 23, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27878445/can-non-invasive-ventilation-modify-central-venous-pressure-comparison-between-invasive-measurement-and-ultrasonographic-evaluation
#8
Maurizio Zanobetti, Alessio Prota, Alessandro Coppa, Laura Giordano, Sofia Bigiarini, Peiman Nazerian, Francesca Innocenti, Alberto Conti, Federica Trausi, Simone Vanni, Giuseppe Pepe, Riccardo Pini
Central venous pressure (CVP) is primarily measured to assess intravascular volume status and heart preload. In clinical practice, the measuring device most commonly used in emergency departments and intensive care units, is an electronic transducer that interconnects a central venous catheter (CVC) with a monitoring system. Non-invasive ventilation (NIV) consists in a breathing support that supplies a positive pressure in airways through a mask or a cask though not using an endotracheal prosthesis. In emergency settings, non-invasive ultrasonography evaluation of CVP, and hence of intravascular volume status entail the measurement by a subxiphoid approach of inferior vena cava diameter and its variations in relation to respiratory activity...
November 22, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27878444/is-a-mobile-emergency-severity-index-esi-triage-better-than-the-paper-esi
#9
Sorravit Savatmongkorngul, Chaiyaporn Yuksen, Chanakarn Suwattanasilp, Kittisak Sawanyawisuth, Yuwares Sittichanbuncha
This study aims to evaluate the mobile emergency severity index (ESI) tool in terms of validity compared with the original ESI triage. The original ESI and mobile ESI were used with patients at the Department of Emergency Medicine, Ramathibodi Hospital, Thailand. Eligible patients were evaluated by sixth-year medical students/emergency physicians using either the original or mobile ESI. The ESI results for each patient were compared with the standard ESI. Concordance and kappa statistics were calculated for pairs of the evaluators...
November 22, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27873159/are-too-many-inferior-vena-cava-filters-used-controversial-evidences-in-different-clinical-settings-a-narrative-review
#10
REVIEW
Michele Dalla Vestra, Elisabetta Grolla, Luca Bonanni, Raffaele Pesavento
The use of inferior vena cava filters to prevent pulmonary embolism is increasing mainly because of indications that appear to be unclearly codified and recommended. The evidence supporting this approach is often heterogeneous, and mainly based on observational studies and consensus opinions, while the insertion of an IVC filter exposes patients to the risk of complications and increases health care costs. Thus, several proposed indications for an IVC filter placement remain controversial. We attempt to review the proof on the efficacy and safety of IVC filters in several "special" clinical settings, and assess the robustness of the available evidence for any specific indication to place an IVC filter...
November 21, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27864665/risk-factors-for-bacteremia-in-urinary-tract-infections-attended-in-the-emergency-department
#11
Antonio Lalueza, Leticia Sanz-Trepiana, Noé Bermejo, Beatriz Yaiza, Alejandra Morales-Cartagena, María Espinosa, Rita García-Jiménez, Olga Jiménez-Rodríguez, Beatriz Ponce, David Lora, María Ángeles Orellana, Mario Fernández-Ruiz, Santiago Bermejo, José María Aguado
Urinary tract infections (UTI) are common in emergency departments (ED), and at least 15% of them are bacteremic. However, there are few data on how to predict which patients are at high risk of developing bacteremic UTI (b-UTI). We performed a retrospective observational cohort study including patients diagnosed with UTI who were admitted to the ED of a tertiary-care hospital in Spain. We included only those patients in whom blood cultures were performed. A nomogram for b-UTI was developed as visualizations of a logistic regression model...
November 18, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27832465/ethnographic-analysis-on-the-use-of-the-electronic-medical-record-for-clinical-handoff
#12
Philippa Nelson, Anthony J Bell, Larry Nathanson, Leon D Sanchez, Jonathan Fisher, Philip D Anderson
The objective of this study was to understand the social elements of clinical and organizational interactions of the key stakeholders in the specific context of an electronic dashboard used by the emergency department (ED) and inpatient medicine teams at the time of clinical referral and handover. An electronic handover function is utilised at the ED-inpatient interface at this institution and has given clinicians the ability to better communicate, monitor the department and strive to improve patient safety in streamline the delivery of care in the acute phase...
November 10, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27830491/obituary
#13
Domenico Prisco, Peter Rosen
No abstract text is available yet for this article.
November 9, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27817124/tumor-necrosis-factor-inhibitors-in-tumor-necrosis-factor-receptor-associated-periodic-syndrome-still-a-chance-to-work
#14
LETTER
Donato Rigante
No abstract text is available yet for this article.
November 5, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27815809/prevalence-of-thoracic-spine-lesions-masquerading-as-cauda-equina-syndrome-yield-of-a-novel-magnetic-resonance-imaging-protocol
#15
Katherine Stolper, James Clark Haug, Chad Todd Christensen, Kathleen Michelle Samsey, Michael David April
Our objective was to describe the yield of actionable thoracic spine lesions for a novel magnetic resonance imaging (MRI) protocol including evaluation of the thoracic spine among patients presenting to the Emergency Department (ED) with symptoms consistent with epidural compression syndrome. Our ED and Department of Radiology together designed a novel rapid MRI protocol entailing 3D volumetric T2 weighted sequences through both the thoracic and lumbar spine obtained in the sagittal plane to assess for both lumbar and thoracic spine lesions...
November 4, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27815808/oral-anticoagulants-for-stroke-prevention-in-patients-with-atrial-fibrillation-and-previous-intracranial-hemorrhage
#16
Simone Birocchi, Gian Marco Podda
No abstract text is available yet for this article.
November 4, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27804076/the-predictive-value-of-the-modified-early-warning-score-with-rapid-lactate-level-views-l-for-mortality-in-patients-of-age-65-or-older-visiting-the-emergency-department
#17
Hasan Basri Cetınkaya, Ozlem Koksal, Deniz Sigirli, Emrah Habip Leylek, Ozlem Karasu
The purpose of this study is to detect the predictive power of the modified early warning score with rapid lactate level (ViEWS-L) on mortality in critical patients over the age of 65 years admitted to the emergency department (ED). A total of 616 non-traumatic patients admitted to the Uludag University Faculty of Medicine ED who were 65 years of age or older were included in this study (Ethics board number: 2015-4/8). In this prospective study; the ViEWS-L score of the patients were calculated. The results have been evaluated with rate of mortality in the first 24 h starting from submission...
November 1, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27804075/erratum-to-niv-by-an-interdisciplinary-respiratory-care-team-in-severe-respiratory-failure-in-the-emergency-department-limited-to-day-time-hours
#18
Christian Michael Horvath, Martin Hugo Brutsche, Otto Dagobert Schoch, Bernarde Schillig, Florent Baty, Dieter vonOw, Jochen Julius Rüdiger
No abstract text is available yet for this article.
November 1, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27796708/erratum-to-nursing-home-acquired-pneumonia-presenting-at-the-emergency-department
#19
Rui Pereira, Sara Oliveira, André Almeida
No abstract text is available yet for this article.
October 31, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27796707/comparison-of-clinical-based-and-ecg-based-triage-of-acute-chest-pain-in-the-emergency-department
#20
Melanie Dechamps, Diego Castanares-Zapatero, Patrick Vanden Berghe, Philippe Meert, Alessandro Manara
In the Emergency Department, chest pain triage systems are based on either clinical features or ECG recording. In this prospective, single-center, observational study, we aimed to compare the diagnostic performance of these triage systems in distinguishing acute coronary syndromes (ACS) from diseases of mild severity. Patients were sorted into the triage systems based on collected data at admission and on a systematic 12-lead ECG performed at triage. The final diagnosis was determined after a 30-day follow-up...
October 28, 2016: Internal and Emergency Medicine
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