Multidimensional versus unidimensional pain scales for the assessment of analgesic requirement in the emergency department: a systematic review
AbstractPain is a multidimensional experience, potentially rendering unidimensional pain scales inappropriate for assessment. Prior research highlighted their inadequacy as reliable indicators of analgesic requirement. This systematic review aimed to compare multidimensional with unidimensional pain scales in assessing analgesic requirements in the emergency department (ED). Embase, Medline, CINAHL, and PubMed Central were searched to identify ED studies utilizing both unidimensional and multidimensional pain scales. Primary outcome was desire for analgesia. Secondary outcomes were amount of administered analgesia and pati...
Source: Internal and Emergency Medicine - April 25, 2024 Category: Emergency Medicine Source Type: research
Role of triglyceride-glucose index in metabolic assessment of sarcoidosis patients
AbstractSarcoidosis is a rare granulomatous disease that can affect any organ. It leads to an increased risk of metabolic syndrome and insulin resistance, due to biochemical pathways involved in low-grade inflammation in both diseases. The aim of our retrospective case –control study was to evaluate the utility of triglyceride-glucose (TyG) index, a surrogate of insulin resistance, for metabolic assessment of sarcoidosis patients. A cohort of 90 sarcoidosis patients and a cohort of 90 control subjects were enrolled. Clinical, anamnestic, and biochemical data wer e collected. Results showed that TyG index values were high...
Source: Internal and Emergency Medicine - April 24, 2024 Category: Emergency Medicine Source Type: research
A COVID-19 specific multiparametric and ECG-based score for the prediction of in-hospital mortality: ELCOVID score
AbstractWe aimed to develop and validate a COVID-19 specific scoring system, also including some ECG features, to predict all-cause in-hospital mortality at admission. Patients were retrieved from the ELCOVID study (ClinicalTrials.govidentifier: NCT04367129), a prospective, multicenter Italian study enrolling COVID-19 patients between May to September 2020. For the model validation, we randomly selected two-thirds of participants to create a derivation dataset and we used the remaining one-third of participants as the validation set. Over the study period, 1014 hospitalized COVID-19 patients (mean age 74 years, 61% males...
Source: Internal and Emergency Medicine - April 23, 2024 Category: Emergency Medicine Source Type: research
Gut microbiota, intestinal permeability, and systemic inflammation: a narrative review. Comment
AbstractIn this letter to the Editor, the author reports his comment on the review article entitled “Gut microbiota, intestinal permeability, and systemic inflammation: a narrative review”, published in this Journal. (Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - April 23, 2024 Category: Emergency Medicine Source Type: research
Treating colonic diverticula with rifaximin: a call to action
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - April 20, 2024 Category: Emergency Medicine Source Type: research
Metabolic risks remain a serious threat to cardiovascular disease: findings from the Global Burden of Disease Study 2019
AbstractMetabolic factors are major and controllable risk factors for cardiovascular diseases (CVD), and few studies have described this burden. We aim to assess it from 1990 to 2019 and predict the trends through 2034. Global Burden of Disease (GBD) provides data on sex, age, and socio-demographic index (SDI) levels. Numbers, age-standardized death rates (ASDR) and estimated annual percentage change (EAPC) were used. Future trends were estimated by NORDPRED model. The deaths cases of metabolic-related CVD increased from 8.61 million (95% UI: 7.91 –9.29) to 13.71 million (95% UI: 12.24–14.94) globally. The ASDR continu...
Source: Internal and Emergency Medicine - April 20, 2024 Category: Emergency Medicine Source Type: research
Inpatient opioid withdrawal: a qualitative study of the patient perspective
In this study, we aimed to capture the patient-reported experience of opioid withdrawal during hospitalization and its impact on the desire to continue treatment for opioid use disorder after discharge. We performed a single-center qualitative study involving semi-structured interviews of hospitalized patients with opioid use disorder (OUD) experiencing opioid withdrawal. Investigators conducted in-person interviews utilizing a combination of open-ended and dichotomous questions. Interview transcripts were then analyzed with open coding for emergent themes. Nineteen interviews were performed. All participants were linked t...
Source: Internal and Emergency Medicine - April 20, 2024 Category: Emergency Medicine Source Type: research
When pulmonary arterial hypertension complicates connective tissue diseases: we still have not found what we are looking for
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - April 18, 2024 Category: Emergency Medicine Source Type: research
Evaluation of use and identification of predictive factors for nonuse of peripheral venous catheters in the emergency department
AbstractThe placement of peripheral venous catheters (PVC) is a frequent procedure in the emergency department (ED), which exposes patients to complications (hematoma, fluid leakage, phlebitis, edema, infection), increases hemolysis of blood samples, is time-consuming and costly. The main aim of this study is to analyze the rate of PVC nonuse in the ED and to identify predictive factors of their nonuse. This prospective single-center observational study was conducted in the ED of the Saint-Antoine Hospital in Paris, France between February and March 2022. Adult patients receiving a PVC were included. In addition to demogra...
Source: Internal and Emergency Medicine - April 17, 2024 Category: Emergency Medicine Source Type: research
High early mortality rate among Nursing Home residents treated by Mobile Intensive Care Unit
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - April 17, 2024 Category: Emergency Medicine Source Type: research
High versus low chloride load in adult hyperglycemic emergencies with acute kidney injury, a multicenter retrospective cohort study: COMMENT
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - April 16, 2024 Category: Emergency Medicine Source Type: research
Is pulmonary hypertension protective against cardiac tamponade? A systematic review
AbstractThe presence of pulmonary hypertension (PH) may affect whether cardiac tamponade physiology develops from a pericardial effusion. Specifically, the increased intracardiac pressure and right ventricular hypertrophy associated with PH would seemingly increase the intrapericardial pressure threshold at which the right-sided chambers collapse. In this systematic review, we examined the impact of PH on the incidence, in-hospital and long-term mortality, and echocardiographic findings of patients with cardiac tamponade. Using the PRISMA guideline, a systematic search was conducted in PubMed, Academic Search Premier, Web ...
Source: Internal and Emergency Medicine - April 15, 2024 Category: Emergency Medicine Source Type: research
Heart failure, recurrent vascular events and death in patients with ischemic stroke —results of the MonDAFIS study
AbstractHeart failure (HF) is associated with poor outcome after stroke, but data from large prospective trials are sparse.We assessed the impact of HF on clinical endpoints in patients hospitalized with acute ischemic stroke or transient ischemic attack (TIA) enrolled in the prospective, multicenterSystematic Monitoring for Detection of Atrial Fibrillation in Patients with Acute Ischemic Stroke (MonDAFIS) trial. HF was defined as left ventricular ejection fraction (LVEF) < 55% or a history of HF on admission. The composite of recurrent stroke, major bleeding, myocardial infarction, and all-cause death, and its co...
Source: Internal and Emergency Medicine - April 15, 2024 Category: Emergency Medicine Source Type: research
Enhancing discharge decision-making through continuous monitoring in an acute admission ward: a randomized controlled trial
In conclusion, continuous monitoring did not have an effect on the proportion of patients safely discharged from an Acute Admission Ward. Implementation challenges of c ontinuous monitoring may have contributed to the lack of effect observed.Trial registration:https://clinicaltrials.gov/ct2/show/NCT05181111. Registered: January 6, 2022. (Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - April 15, 2024 Category: Emergency Medicine Source Type: research
Clinical outcomes of clostridioides difficile infection in the very elderly
ConclusionsIn our cohort, the duration of hospital stay seemed to be shorter in the very elderly with no increase of in-hospital and post-discharge mortality. Although admitted less frequently to ICU, the in-hospital survival of the very elderly was not adversely affected compared to the elderly, suggesting that very advanced age per se should not be a major factor to consider in determining the prognosis of a patient with CDI. (Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - April 14, 2024 Category: Emergency Medicine Source Type: research
