Search results for "emergency medicine"
showing 10 items of 914 documents
Performance of PSI, CURB-65, and SCAP scores in predicting the outcome of patients with community-acquired and healthcare-associated pneumonia
2011
The objective was to compare three score systems, pneumonia severity index (PSI), the Confusion-Urea-Respiratory Rate-Blood pressure-65 (CURB-65), and severe community-acquired pneumonia (SCAP), for prediction of the outcomes in a cohort of patients with community-acquired (CAP) and healthcare-associated pneumonia (HCAP). Large multi-center, prospective, observational study was conducted in 55 hospitals. HCAP patients were included in the high classes of CURB-65, PSI and SCAP scores have a mortality rate higher than that of CAP patients. HCAP patients included in the low class of the three severity rules have a significantly higher incidence of adverse events, including development of septi…
Le drainage thoracique aux urgences dans la prise en charge d’un épanchement pleural non traumatique
2019
Le drainage thoracique est un geste classique en médecine d’urgence. En dehors du traumatisé thoracique, les indications de drainage thoracique aux urgences sont essentiellement le pneumothorax spontané primitif ou secondaire et les épanchements pleuraux liquidiens en cas d’épanchement parapneumonique compliqué. La technique doit être connue des médecins urgentistes qui sont confrontés à la prise en charge initiale de ces patients. Le matériel de drainage ou « drainage pleural catheter », selon la terminologie proposée par Baumann, regroupe l’ensemble des matériels de thoracocentèse laissés en place au décours du geste. Il existe une multiplicité de matériel à disposition des cliniciens qui…
Techniques d’exsufflation d’un pneumothorax
2019
Les pneumothorax rencontrés aux urgences peuvent être d’origine spontanée ou traumatique. L’exsufflation est une méthode thérapeutique simple du pneumothorax spontané primitif. Cette technique consiste à réaliser une aspiration par l’intermédiaire d’un cathéter, sans que le matériel soit laissé en place. Elle permet une prise en charge ambulatoire du patient et répond à des enjeux de qualité des soins (efficacité, simplicité, sécurité) et d’économie de la santé (diminution de la durée et du taux d’hospitalisation). L’exsufflation peut être réalisée via différents dispositifs tout simples d’utilisation, par voie antérieure ou axillaire. L’exsufflation à l’aiguille avec des cathéters de perfu…
Retarder une épuration extrarénale dans l’insuffisance rénale aiguë : la nuit nous appartient
2019
Les indications de l’épuration extrarénale (EER) dans le contexte d’insuffisance rénale aiguë en réanimation sont débattues avec une certaine passion. Il est évident que les situations qui peuvent menacer immédiatement le pronostic vital (hyperkaliémie ou acidose métabolique réfractaire et sévère ou oedème pulmonaire de surcharge chez le patient anurique) nécessitent un recours urgent à l’EER. Hormis ces situations extrêmes, des études de haut niveau de preuve ont récemment montré que retarder l’indication de l’EER n’affecte pas la survie des patients et pourrait même favoriser la récupération de la fonction rénale par comparaison à une EER trop précoce. Cette mise au point se propose de di…
Varhaiskasvatuspalvelut koronapandemian aikana
2021
Raportissa esitellään varhaiskasvatuksen lähiesihenkilöille syksyllä 2020 toteutetun kyselyn tuloksia varhaiskasvatuspalveluiden tuottamisesta koronaviruspandemian aikana. Normaalioloissa kansallinen lainsäädäntö määrittelee varhaiskasvatustoiminnan reunaehdot. Keväällä 2020 koronaviruspandemian vuoksi voimaan astuneen poikkeustilan aikana kunnat kuitenkin vapautettiin varhaiskasvatuslain mukaisesta varhaiskasvatuksen järjestämisvastuusta, mikäli lapsen vanhempien tai huoltajien oli mahdollista järjestää lapsen hoito muulla tavalla. Tässä tilanteessa kunnissa ja varhaiskasvatusyksiköissä tehtiin erilaisia ratkaisuja varhaiskasvatuksen toteuttamisesta ja tarjoamisesta kotihoitoon siirtyneill…
Subarachnoid Haemorrhage in an Elderly Patient with Comorbidities
2020
Abstract Subdural hemorrhage is usually caused by a traumatic injury. Other risk factors that may lead to subdural hemorrhage include: hypertension, anticoagulants, elderly, alcohol abuse, vascular abnormalities etc. Mortality range is between 50% and 90% depending on age, admission Glasgow Coma Scale (GCS) and anticoagulant treatment. We present a case of 74-year old patient, female, known for diabetes, high blood pressure, obesity, chronic heart failure, receiving anticoagulant treatment, bronchial asthma who develops a posttraumatic massive chronic subdural hematoma accompanied by comorbidities.
Effect of Occupational Exposure on A(H1N1)pdm09 Infection and Hospitalization.
2016
OBJECTIVE To analyze relationships between occupational exposure and influenza infection and hospitalization during the 2009-2010 pandemic wave and the 2010-2011 influenza seasonal epidemic in Spain. METHODS Occupations were classified as high, medium, or low risk of influenza exposure. To assess the risk of infection, 588 outpatient cases of influenza confirmed by reverse-transcription polymerase-chain-reaction (RT-PCR) were compared with 588 outpatients without influenza symptoms. To assess the risk of hospitalization, 337 outpatient influenza cases were compared with 337 inpatient influenza cases. RESULTS The high risk of occupational exposure group was composed only of health care worke…
THE EFFICACY AND SAFETY OF INFLUENZA VACCINATION IN OLDER PEOPLE: AN UMBRELLA REVIEW OF EVIDENCE FROM META-ANALYSES OF BOTH OBSERVATIONAL AND RANDOMI…
2020
Vaccination is the main public health intervention to prevent influenza. We aimed to evaluate the efficacy and safety of influenza vaccination including systematic reviews and meta-analyses of observational studies and randomized controlled trials (RCTs). Peer-reviewed systematic reviews with meta-analyses of prospective studies that investigated the association of influenza vaccination with any health-related outcome, as well as RCTs that investigated the efficacy and safety of influenza vaccination, were included. Among 1240 references, 6 meta-analyses were included. In cohort studies of community-dwelling older people influenza vaccination was associated with a lower risk of hospitalizat…
Dying with or because of invasive fungal infection? The role of immunity exhaustion on patient outcome
2016
De Rosa et al. considered clinical scores, biomarkers and their combination as useful aids for an early antifungal treatment and advocated the adoption of de-escalation therapy in an antifungal stewardship approach as a possible key for a better management of these patients. Authors considered the high burden of invasive fungal infections in terms of patient outcomes and costs and focused on current strategies for their optimization.
Changes in the spatial distribution of the Purkinje network after acute myocardial infarction in the pig
2018
Purkinje cells (PCs) are more resistant to ischemia than myocardial cells, and are suspected to participate in ventricular arrhythmias following myocardial infarction (MI). Histological studies afford little evidence on the behavior and adaptation of PCs in the different stages of MI, especially in the chronic stage, and no quantitative data have been reported to date beyond subjective qualitative depictions. The present study uses a porcine model to present the first quantitative analysis of the distal cardiac conduction system and the first reported change in the spatial distribution of PCs in three representative stages of MI: an acute model both with and without reperfusion; a subacute …