Treatment of pulmonary arterial hypertension in patients with connective tissue diseases: a systematic review and meta-analysis
AbstractThe evidence for the treatment of connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH) mostly depends on subgroup or post hoc analysis of randomized controlled trials (RCTs). Thus, we performed a meta-analysis of RCTs that reported outcomes for CTD-PAH. PubMed and EMBASE were searched for CTD-PAH treatment. The selected outcomes were functional class (FC) change, survival rates, 6-min walk distance (6-MWD), clinical worsening (CW), N-terminal prohormone BNP (NT-proBNP), pulmonary vascular resistance (PVR), mean pulmonary arterial pressure (mPAP), right atrial pressure (RAP), and cardiac in...
Source: Internal and Emergency Medicine - February 20, 2024 Category: Emergency Medicine Source Type: research

MAGLIO study: epidemiological analysis on invasive meningococcal disease in Italy: focus on hospitalization from 2015 to 2019 —reply
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - February 20, 2024 Category: Emergency Medicine Source Type: research

Treatment of pulmonary arterial hypertension in patients with connective tissue diseases: a systematic review and meta-analysis
AbstractThe evidence for the treatment of connective tissue disease-associated pulmonary arterial hypertension (CTD-PAH) mostly depends on subgroup or post hoc analysis of randomized controlled trials (RCTs). Thus, we performed a meta-analysis of RCTs that reported outcomes for CTD-PAH. PubMed and EMBASE were searched for CTD-PAH treatment. The selected outcomes were functional class (FC) change, survival rates, 6-min walk distance (6-MWD), clinical worsening (CW), N-terminal prohormone BNP (NT-proBNP), pulmonary vascular resistance (PVR), mean pulmonary arterial pressure (mPAP), right atrial pressure (RAP), and cardiac in...
Source: Internal and Emergency Medicine - February 20, 2024 Category: Emergency Medicine Source Type: research

MAGLIO study: epidemiological analysis on invasive meningococcal disease in Italy: focus on hospitalization from 2015 to 2019 —reply
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - February 20, 2024 Category: Emergency Medicine Source Type: research

The effect of visitation restrictions on ED error
AbstractEDs restricted visitors during the COVID-19 pandemic on the assumption that the risks of disease spread outweighed the psychological benefits of liberal visitation. But data suggest that beyond providing emotional support, family and caregivers can clarify history, improve patient monitoring, and advocate for patients —actions that can improve quality of care. Our objective was to assess whether removing visitors from the bedside contributed to errors in emergency care. We reviewed a database of medical errors covering visits from 11/15/17 to 7/30/22 at an urban, tertiary-care, academic ED for five types of err o...
Source: Internal and Emergency Medicine - February 19, 2024 Category: Emergency Medicine Source Type: research

Serial measurements of SIRS and SEP scores to identify unique phenotypes of sepsis
AbstractUsing scoring systems in discreet microbiologic cohorts in a serial fashion to identify unique phenotypes of sepsis remains unknown. Single-center, retrospective study that screened adults who triggered the hospital ’s SIRS (systemic inflammatory response syndrome) based sepsis alert into culture positive (Cx +) and culture negative (Cx−) groups. Subgroups were based on the location where the SIRS alert fired. SIRS scores and a novel score called SEP were calculated att  = 0 and at 3, 6, 12, and 24  h before and aftert  = 0. Primary outcome was a difference in SIRS/SEP scores in Cx  + or Cx− gr...
Source: Internal and Emergency Medicine - February 19, 2024 Category: Emergency Medicine Source Type: research

Impact of stress hyperglycemia on long-term prognosis in acute pancreatitis without diabetes
AbstractStress hyperglycemia has been confirmed as a strong predictor of poor short-term prognosis in acute pancreatitis. However, whether stress hyperglycemia affects the long-term prognosis of patients with acute pancreatitis is unclear. We aimed to investigate the effect of stress hyperglycemia on the long-term prognosis of non-diabetic patients with acute pancreatitis. This retrospective observational study was conducted on 4055 patients with acute pancreatitis from 1 January 2016 to 31 October 2020. The association between stress hyperglycemia and the prognosis was evaluated using regression modeling. There were 935(7...
Source: Internal and Emergency Medicine - February 19, 2024 Category: Emergency Medicine Source Type: research

Serial measurements of SIRS and SEP scores to identify unique phenotypes of sepsis
AbstractUsing scoring systems in discreet microbiologic cohorts in a serial fashion to identify unique phenotypes of sepsis remains unknown. Single-center, retrospective study that screened adults who triggered the hospital ’s SIRS (systemic inflammatory response syndrome) based sepsis alert into culture positive (Cx +) and culture negative (Cx−) groups. Subgroups were based on the location where the SIRS alert fired. SIRS scores and a novel score called SEP were calculated att  = 0 and at 3, 6, 12, and 24  h before and aftert  = 0. Primary outcome was a difference in SIRS/SEP scores in Cx  + or Cx− gr...
Source: Internal and Emergency Medicine - February 19, 2024 Category: Emergency Medicine Source Type: research

The effect of visitation restrictions on ED error
AbstractEDs restricted visitors during the COVID-19 pandemic on the assumption that the risks of disease spread outweighed the psychological benefits of liberal visitation. But data suggest that beyond providing emotional support, family and caregivers can clarify history, improve patient monitoring, and advocate for patients —actions that can improve quality of care. Our objective was to assess whether removing visitors from the bedside contributed to errors in emergency care. We reviewed a database of medical errors covering visits from 11/15/17 to 7/30/22 at an urban, tertiary-care, academic ED for five types of err o...
Source: Internal and Emergency Medicine - February 19, 2024 Category: Emergency Medicine Source Type: research

Impact of stress hyperglycemia on long-term prognosis in acute pancreatitis without diabetes
AbstractStress hyperglycemia has been confirmed as a strong predictor of poor short-term prognosis in acute pancreatitis. However, whether stress hyperglycemia affects the long-term prognosis of patients with acute pancreatitis is unclear. We aimed to investigate the effect of stress hyperglycemia on the long-term prognosis of non-diabetic patients with acute pancreatitis. This retrospective observational study was conducted on 4055 patients with acute pancreatitis from 1 January 2016 to 31 October 2020. The association between stress hyperglycemia and the prognosis was evaluated using regression modeling. There were 935(7...
Source: Internal and Emergency Medicine - February 19, 2024 Category: Emergency Medicine Source Type: research

Diaphragmatic ultrasound evaluation in acute heart failure: clinical and functional associations
AbstractHeart failure patients often experience respiratory symptoms due to diaphragmatic involvement, but the diaphragmatic motion in heart failure remains understudied. This research aimed to investigate the correlation between ultrasonographically assessed diaphragmatic motion and thickness with cardiac performance indexes in an emergency setting. Seventy-two acutely decompensated heart failure patients and 100 non-heart failure individuals were enrolled. Diaphragmatic motion and thickness were assessed via ultrasound. Cardiac and respiratory parameters were recorded, and regression analysis was performed. Heart failure...
Source: Internal and Emergency Medicine - February 16, 2024 Category: Emergency Medicine Source Type: research

Sodium –glucose cotransporter-2 inhibitors in heart failure patients across the range of body mass index: a systematic review and meta-analysis of randomized controlled trials
AbstractSodium –glucose cotransporter-2 (SGLT2) inhibitors improve outcomes in patients with heart failure, with or without diabetes. We sought to assess whether there is an interaction of these effects with body mass index (BMI). A systematic review of the MEDLINE and Scopus databases (last search: November 15t h, 2022) was performed according to the PRISMA statement. Studies eligible for this review were randomized control trials (RCTs) with patients with chronic heart failure with either preserved or reduced ejection fraction randomly assigned to SGLT2 inhibitors or placebo. Data were extracted independe ntly by two r...
Source: Internal and Emergency Medicine - February 14, 2024 Category: Emergency Medicine Source Type: research

Renal function-adapted D-dimer cutoffs in combination with a clinical prediction rule to exclude pulmonary embolism in patients presenting to the emergency department
AbstractD-dimer levels significantly increase with declining renal function and hence, renal function-adjusted D-dimer cutoffs to rule out pulmonary embolism were suggested. Aim of this study was to"post hoc" validate previously defined renal function-adjusted D-dimer levels to safely rule out pulmonary embolism in patients presenting to the emergency department. In this retrospective, observational analysis, all patients with low to intermediate pre-test probability receiving D-dimer measurement and computed tomography angiography (CTA) to rule out pulmonary embolism between January 2017 and December 2020 were i...
Source: Internal and Emergency Medicine - February 14, 2024 Category: Emergency Medicine Source Type: research