1,720,968 research outputs found
Anxiety is Prevailing in Non-Cardiac Chest Pain Subjects, while Somatisation is Not A Comparative Study in the Emergency Department
Full text linkObjective:
The main purpose of this study was to verify if non-cardiac chest pain (NCCP) subjects recruited in
an Emergency Department were more anxious, depressive or burdened by somatoform symptoms as compared with
cardiac chest pain (CCP) subjects, and with subjects without chest pain (WOCP).
Methods:
We included patients with chest pain not attributable to a gastro-oesophageal reflux disorder. NCCP
subjects were negative at ECG examination and at troponin test at baseline and after three months. A number of
instruments were administered, measuring anxiety and depression (HADS), somatisation (somatisation scale of SCL-
90, TAS-20), and the health-related QoL (SF-12), along with other scales measuring the social and experiential profile.
Results:
We recruited 435 subjects (of which NCCP were 44.8%) in the Emergency Department, while other 147
subjects were recruited in a primary care clinic. The logistic regression showed that the levels of HADS anxiety in
the three groups were dissimilar, even when adjusted for confounding variables: taking NCCP as reference category,
adjusted ORs were 0.64 for CCP (IC95% 0.42 – 0.96) and 0.23 for WOCP (IC95% 0.13 – 0.40). When considering the
somatisation construct, CCP and NCCP subjects reported similar somatic symptom complaints, higher than WOCP
subjects. Moreover, even if NCCP subjects showed higher TAS-20 scores than WOCP subjects, these scores were
below the range of a possible alexithymia. As for the physical health-related QoL (SF-12, subscale PCS-12), regression
analyses showed that the PCS-12 mean score of NCCP was higher than that of CCP (ß -2.31; IC95% -4.14 to -0.48)
and lower than that of WOCP (ß 2.24; IC95% 0.12 – 4.37).
Conclusion
: NCCP subjects are characterised from an elevated anxiety, together with a better physical well-being,
when compared with subjects who have a cardiac failure. The somatisation construct seems less useful to distinguish
NCCP from CCP subjects. Consequently, anxiety should be the major target of our mental-health intervention when
treating subjects with chest pain
Reducing the risk of hospital admission: A call to action from the Italian Society of Internal Medicine
No full textThe belief that hospital stays may constitute per se a risk for patients is not widespread among patients and health care professionals. In the balance between advantages and disadvantages of admission, we rarely take into account the impact of the hospital stay itself on the well-being of the patient. In a society that is getting older the hospital may become a hostile environment for the complex and frail patient. Reducing the risks associated with hospital admission implies a radical cultural change accepted and shared by all health care professionals. The critical reconsideration of admission is a way of reasoning not only on hospitalisation but also on what the correct health outcome paradigms should be
- An hybrid, wireless and wired system for clinical data collection in the ECOSSED trial
No full textRoad traffic crashes, alcohol, meals, sleep and work hours: a case-crossover study at the Emergency Room of Udine, Italy
No full textEmerging Concepts in Acute Heart Failure: From the Pathophysiology to the Clinical Case Based Approach
No full textAcute heart failure (AHF) represents a heterogeneous clinical syndrome, comprising new or worsening signs and symptoms on a background of stable chronic heart failure (HF), as well as new-onset HF. In either clinical picture, urgent care is crucial. Given the variety of clinical scenario, stratifying patient subgroups on a pathophysiologic base can help direct appropriate therapy. This manuscript recapitulates the current indication, with the aim to define a rational basis for a patient-oriented approach to treatment of AH
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
Implementation of a Meningitis Care Bundle in the Emergency Room Reduces Mortality Associated With Acute Bacterial Meningitis
No full textBackground: Prompt administration of antibiotics, adjunctive steroid therapy, and optimization of antibiotic delivery to cerebrospinal fluid (CSF) are factors associated with improved outcome of patients hospitalized for acute bacterial meningitis (ABM). However, the impact of a bundle of these procedures has not been reported. Objective: To assess mortality and neurological sequelae at hospital discharge in a cohort of patients with ABM managed according to a predefined bundle. Methods: Prospective study of all the patients hospitalized for ABM in two provinces of Northern Italy, over two consecutive periods (2005-2009, 2010-2013). The bundle included: i) supportive care if needed; ii) immediate administration of dexamethasone and 3rd generation cephalosporin; and iii) addition of levofloxacin if turbid CSF. Patients managed according to the bundle were compared with a historical group of patients cared for ABM before the bundle was implemented. Results: Overall, 85 patients with ABM were managed according to the bundle and were compared with 92 historical controls. In-hospital mortality rates for bundle and control group were 4.7% and 14.1% (p=0.04). Among survivors, 13.5% and 18.9% (p=0.4) of bundle and control-group patients presented neurological sequelae. The only variable associated with mortality at multivariate analysis was ICU admission (HR 3.65). After adjusting for ICU admission, patients managed according with the ABM bundle had significantly lower mortality rate compared to historical controls. Conclusions: Use of a bundled protocol and antibiotics with excellent CSF penetration for the initial management of ABM in emergency department is feasible and associated with significant reduction in mortality
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
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