European journal of internal medicine
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Eur. J. Intern. Med. · Jul 2020
Short-term mortality risk score for de novo acute heart failure (ESSIC-FEHF).
Different variables are playing a role in prognosis of acute heart failure. ⋯ Our ESSIC-FEHF risk score showed excellent properties in the derivation cohort and also in a cohort from a different time period. This score is expected to help decision making in patients diagnosed with heart failure for the first time.
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Probably it does.
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Eur. J. Intern. Med. · Jul 2020
Impact of pre-hospital renal function on the detection of acute kidney injury in acute decompensated heart failure.
Acute kidney injury (AKI) is a serious complication in patients hospitalized for decompensated heart failure (HF). Currently, AKI definitions consider creatinine levels at admission as reference of baseline renal function (RF). However, renal impairment may already be present at admission. We aimed to study the impact on AKI detection of considering outpatient RF as reference. ⋯ Evaluation of AKI in patients admitted with HF should consider pre-hospital RF, since it improves early identification of AKI and has implications for risk assessment.
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Eur. J. Intern. Med. · Jul 2020
Abnormal ankle-brachial index (ABI) predicts primary and secondary cardiovascular risk and cancer mortality.
An abnormal ankle-brachial pressure index (ABI) is a marker of the risk for increased total and cardiovascular (CV) mortality. However, it is not clear whether it is associated with an even worse prognosis in patients with previous CV events or with cancer mortality. ⋯ The co-existence of abnormal ABI and a history of CV events identifies subjects at higher risk, who call for a more aggressive approach. Abnormal ABI is also a predictor of cancer mortality.
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Eur. J. Intern. Med. · Jul 2020
Clinical practice guidelines adaptation for internists - An EFIM methodology.
The rising number of clinical guidelines poses a new challenge to the internists. The main problems are: 1) available documents suffer from heterogeneous methodological quality, and 2) most of clinical guidelines target an 'ideal' patient affected by a single condition, while in real practice internists must face with comorbid patients typically undergoing a polypharmacy. ⋯ The project started with the creation of a research protocol containing details about all the steps needed to write the Clinical Practice Guideline Summary. In particular, this methodological document specifies the rules: 1) to select topics and clinical questions; 2) to build up a panel of experts, carefully managing eventual conflict of interests; 3) to critically appraise clinical guidelines (using a validated tool as AGREE II), selecting the most valid and applicable to the common clinical practice (using ADAPTE; 4) to address and solve potential disagreements among the selected documents.