Search results for "emergency"
showing 10 items of 1747 documents
The Oxygen Reserve Index in anesthesiology: a superfluous toy or a tool to individualize oxygen therapy?
2018
Palliative care in intensive care units: Why, where, what, who, when, how
2018
Palliative care is patient and family-centered care that optimizes quality of life by anticipating, preventing, and treating suffering when “curative” therapies are futile. In the Intensive Care Unit (ICU), critically ill patients receive life-sustaining therapies with the goal of restoring or maintaining organ function. Palliative Care in the ICU is a widely discussed topic and it is increasingly applied in clinics. It encompasses symptoms control and end-of-life management, communication with relatives and setting goals of care ensuring dignity in death and decision-making power. However, effective application of Palliative Care in ICU presupposes specific knowledge and training which ane…
Unexpected death on an acute palliative care unit
2015
Although most deaths in patients with advanced cancer are expected, no data are available on unexpected death (UD). This event can be really stressful for physicians who are unable to anticipate, prevent, or discuss UD, and for relatives who are not ready for such an acute emotional burden, despite previous good communication about the short-term prognosis. There is the need for more information, particularly in the setting of an acute palliative care unit where most patients are discharged to follow different therapeutic pathways, including continuing oncologic treatment, home care, or hospice.1,2 The aim of this prospective study was to assess the characteristics of patients who died unex…
Pattern and characteristics of patients admitted to a hospice connected with an acute palliative care unit in a comprehensive cancer center
2022
Purpose: Information about inpatient hospice activity is limited. No data exist about the pattern and the characteristics of advanced cancer patients admitted to a hospice connected to an acute supportive/palliative care unit (ASPCU). Methods: Data of hospice admissions were retrieved from the database where all data were prospectively collected. The Edmonton Symptom Assessment Scale (ESAS) and the use of analgesics and adjuvant were recorded at admission (T0), 1 week (T7), 2 weeks (T14), and the day before death (T-end). The use of palliative sedation and its indication, duration, and drugs end doses used were recorded. The number of hospice deaths, discharges, and hospice staying were rec…
Surgical pathology and the diagnosis of invasive visceral yeast infection: two case reports and literature review
2013
Invasive mycoses are life-threatening opportunistic infections that have recently emerged as a cause of morbidity and mortality following general and gastrointestinal surgery. Candida species are the main fungal strains of gut flora. Gastrointestinal tract surgery might lead to mucosal disruption and cause Candida spp. to disseminate in the bloodstream. Here we report and discuss the peculiar clinical and morphological presentation of two cases of gastrointestinal Candida albicans lesions in patients who underwent abdominal surgery. Although in the majority of cases reported in the literature, diagnosis was made on the basis of microbiological criteria, we suggest that morphological feature…
Efficacy of Different Medical Therapies for the Treatment of Acute Laryngeal Attacks of Hereditary Angioedema due to C1-esterase Inhibitor Deficiency.
2016
Abstract Background Hereditary angioedema (HAE) is a rare disease characterized by C1-esterase inhibitor (C1-INH) deficiency, resulting in periodic attacks of acute edema, which can be life-threatening if they occur in the upper airway. No head-to-head comparisons of different treatment options for acute HAE attacks are available. Because immediate symptom relief is critical for potentially life-threatening laryngeal attacks, it is important to determine the treatment option that provides optimal treatment response. Objective Review and compare data from clinical studies that evaluated the efficacy and safety of treatments for laryngeal HAE attacks. Methods We conducted an indirect comparis…
0133: The Log Book as a new tool for the secondary prevention of coronary artery disease
2016
International audience; IntroductionThe Log book (LB) project was created by a multidisciplinary team of healthcare professionals from a regional care network and aimed to improve secondary prevention (SP) after acute myocardial infarction (MI) in Cote d’Or. LB includes information and advices for increasing self management of risk factors by the patient.MethodsA prospective interventional study on 469 patients hospitalised for an acute MI in the 2 Intensive Coronary Care unit of Côte d’Or (CHU Dijon and Clinique de Fontaine les Dijon) in 2012 and surviving at 1 year follow-up (FU). LB was randomly given at the time of their hospitalisation by the nursing team, also providing oral advices o…
The paradox of the evidence about invasive fungal infections prevention
2016
Invasive fungal infections (IFIs) are characterized by high morbidity and mortality in non-neutropenic critically ill patients. Attributable mortality due to Candida spp. infections ranges from about 42 to 63 % [1, 2]. Data from large observational and retrospective studies show an association between early antifungal treatment and improved survival [3, 4]. Updated clinical practice guidelines for the management of candidiasis have been recently published [5]. In 2006, Playford et al. published a Cochrane systematic review investigating the use of antifungal agents for prevention of IFIs in non-neutropenic critically ill patients [6]. In that review, the outcome of proven IFI was defined as…
Cost-effectiveness of bedaquiline in MDR and XDR tuberculosis in Italy
2016
ABSTRACT Objective: To evaluate the cost-effectiveness of bedaquiline plus background drug regimens (BR) for multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) in Italy. Methods: A Markov model was adapted to the Italian setting to estimate the incremental cost-effectiveness ratio (ICER) of bedaquiline plus BR (BBR) versus BR in the treatment of MDR-TB and XDR-TB over 10 years, from both the National Health Service (NHS) and societal perspective. Cost-effectiveness was evaluated in terms of life-years gained (LYG). Clinical data were sourced from trials; resource consumption for compared treatments was modelled according to advice from an expert c…