European journal of internal medicine
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Amyotrophic lateral sclerosis (ALS) is the most common rapidly progressive adult-onset neurodegenerative disorder. There have been great advances in the management of patients with ALS over the past decade. It starts with the giving of the diagnosis and continues to the terminal phase of the disease. This review will examine the impact of medical and non-medical interventions on improving survival and quality of life in these patients, emphasizing the importance of a multidisciplinary approach.
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Eur. J. Intern. Med. · Jul 2009
Risk assessment study of the pressure ulcers in intensive care unit patients.
In this research, we studied the incidence of pressure ulcer and risk factors and screening of the patients for pressure ulcers at intensive care unit on the first day of admission in 142 patients. All patients were evaluated according to National Pressure Ulcer Advisory Panel during the ICU period strictly. Pressure ulcer risk evaluation was performed according to Norton Scale. ⋯ Results of this study show us the PU incidence of ICU patients may be low if we perform PU screening all patients at the admission and put into practice NPUAP strictly. Age, low Norton score, hospitalization period, high APACHE-II score, hypotension, malnutrition and hypoalbuminemia were significant in patients with PU; however, BMI and hemoglobin were not significant. The studies focusing on the relation between the effect of optimization of these parameters from the first day of admittance and pressure ulcer are required.
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Eur. J. Intern. Med. · May 2009
The additive value of N-terminal pro-B-type natriuretic peptide testing at the emergency department in patients with acute dyspnoea.
B-type natriuretic peptide (BNP) and its inactive counterpart NT-proBNP can help to identify or rule out heart failure in patients presenting with acute dyspnoea. It is not well known whether measurement of these peptides can be omitted in certain patient groups. ⋯ NT-proBNP measurement has additive value in a substantial number of patients presenting with acute dyspnoea, but can possibly be omitted in patients with a clinical probability of heart failure of >70%.
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Eur. J. Intern. Med. · May 2009
A French national research project to the creation of an auscultation's school: the ASAP project.
Auscultation of pulmonary sounds provides valuable clinical information but has been regarded as a tool of low diagnostic value due to the inherent subjectivity in the evaluation of these sounds. This paper describes an ambitious study of in the so-called ASAP project or "Analyse de Sons Auscultatoires et Pathologiques". ⋯ ASAP aims at making evolve the auscultation technics: by 1) the development objective tools for the analyse of auscultation sounds: electronic stethoscopes paired with computing device; 2) the creation of an auscultation sounds' database in order to compare and identify the acoustical and visual signatures of the pathologies; and 3) the capitalisation of these new auscultation techniques around the creation of a teaching unit: "Ecole de l'Auscultation". This auscultation's school will be destined to the initial and continuous formation of the medical attendants.