1,720,975 research outputs found
Rethinking defibrillation: a viewpoint on alternative strategies for refractory ventricular fibrillation
No full textRefractory ventricular fibrillation (RVF) remains one of the most dramatic and frustrating scenarios in emergency care [1]. Despite timely, high-quality cardiopulmonary resuscitation (CPR) and adherence to advanced cardiovascular life support (ACLS) algorithms, some patients remain in persistent ventricular fibrillation, unresponsive to standard defibrillation and medications [2]. For years, the default approach in such cases has been repetition: same energy, pad placement, and same result [2,3]. Recently, alternative defibrillation strategies (ADS), that is, double sequential external defibrillation (DSED) and vector change defibrillation (VCD), have emerged as promising options [1,4–10]. These techniques offer a potential exit from therapeutic inertia (Fig. 1); however, despite growing enthusiasm, especially in prehospital care, they are inconsistently used and often implemented without protocols or institutional support. The time has come to move from improvisation to integration, transforming scattered efforts into structured escalation pathways
Acute Toxicity by Salvia Officinalis: A Rare Cause of Intestinal Sub-Occlusion
No full textSalvia officinalis is a perennial plant commonly used in culinary and medical preparations. Its large intake is usually related to psychiatric disorders (such as pica) and might induce different symptoms (e.g. vomiting, nausea, diarrhoea, salivation, arterial hypertension, tachycardia, vertigo, flushes, cyanosis and convulsions) likely ascribable to pro-cholinergic effects of various constituents. The identification of this toxicity is challenging because of its rarity and possible underlying psychiatric comorbidities. Herein we describe the case of a schizophrenic 56-year-old male admitted to the Emergency Department for abdominal pain and diarrhea resulted in a rare case of acute toxicity by Salvia officinalis
A double-edged sword: a narrative review on steroids in sepsis and septic shock
No full textSepsis and septic shock are life-threatening conditions characterized by a dysregulated host response to infection. Although corticosteroids, particularly hydrocortisone, promote positive effects on hemodynamic stability in septic shock, the efficacy of these drugs remains controversial. In this narrative review, we aimed at appraising the actual role of corticosteroids focusing specifically on septic shock. We conducted a comprehensive search of the recent literature, including randomized controlled trials, meta-analyses, and current clinical guidelines, to evaluate the role of corticosteroids in the management of septic shock. Studies were evaluated to determine the impact on mortality, hemodynamics, and other clinical outcomes. The studies showed variability in dosing and time of administration as well as patient selection, which highlighted the lack of a standardized treatment approach. While corticosteroids improved short-term hemodynamic outcomes and reduced vasopressor requirement, their effect on long-term survival was minimal. These results led current guidelines to a weak recommendation for hydrocortisone use in septic shock patients with persistent hypotension despite adequate fluid resuscitation and vasopressor therapy. Corticosteroids, e.g. hydrocortisone, can be beneficial in managing septic shock, but their role remains uncertain. Further research is needed to refine treatment protocols and determine the optimal patient selection for corticosteroid therapy
Beware the wrong way! A report on gastrografin inhalation
No full textAn 83-year-old man was admitted to the Emergency Department of St. Anna University Hospital, Cona, Italy, after he had inhaled diatrizoate (gastrografin), a well-known hyperosmolar contrast agent, during an X-ray of the upper gastrointestinal tract. The family physician recommended the patient to take the test in order to demonstrate a possible hiatal hernia. While swallowing gastrografin he had an esophageal spasm (detected at fluoroscopy), which led to the inhalation
of the contrast agent. After the episode, he was completely asymptomatic, eupnoeic, and with a good peripheral oxygen saturation. The physical examination was unremarkable. A chest X-ray of the lungs showed accumulation of the contrast agent in the distal bronchial tree (arrows in Figure 1A and B), with the right part being more involved because of the straight orientation of the right bronchus
Subcutaneous Emphysema as a Life-Threatening Complication of Metastatic Renal Cancer: A Case Report
No full textSubcutaneous emphysema (SE) could present as an emergency situation requiring appropriate management because of possible serious complications. While the diagnosis can be well established, its classification and treatment are not yet standardized. Herein we report the case of SE occurred in a young man after positioning of a thorax drainage because of a hydro-pneumothorax developed as a consequence of pulmonary metastases from clear cell renal carcinoma. Since there are no data correlating anatomo-clinical categorization with outcome and treatment of patients with SE, a "tailored- treatment" may be considered
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Dispelling the Myths Behind First-author Citation Counts
Full text linkWe conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued
use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation
counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more
sophisticated methods
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