Medwave
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Observational Study
[Prevalence of delirium in hospitalized patients from an internal medicine service].
Delirium is a common neurocognitive syndrome that takes place during hospitalizations, associated with worse global outcomes in patients who present it. Despite this, it is usually under-recognized as a disease that needs specific treatment. ⋯ The prevalence of delirium in this specific Hospital is as expected, according to the literature. Considering the diagnostic tools available, it is crucial to train health workers to improve recognition and management of this syndrome.
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The Kikuchi-Fujimoto disease is a rare disease that occurs mostly in young adults, although some cases have been reported in children. It is usually characterized by fever and cervical lymphadenopathy. The etiology of the disease remains unknown. ⋯ It has special histopathological features that allow the differential diagnosis with other entities, which from a clinical point of view can be very complicated. We report a 9 years 11 months old girl with lymphadenopathy and fever with five months evolution, which is the longest evolution among the cases reviewed by the authors in world literature. Given that the presentation of this disease in children is very rare, we estimate that the knowledge of this disease is relevant and pediatricians must consider it in the differential diagnosis of fever of unknown origin in children.
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Comparative Study
Duloxetine for the treatment of painful diabetic peripheral neuropathy in Venezuela: economic evaluation.
Painful diabetic peripheral neuropathy affects 40-50% of patients with diabetic neuropathy, leading to impaired quality of life and substantial costs. Duloxetine and pregabalin have evidence-based support, and are formally approved for controlling painful diabetic peripheral neuropathy. ⋯ This study suggests duloxetine dominates (i.e., is more effective and lead to gains in quality-adjusted life years), remaining less costly than pregabalin for treatment of painful diabetic peripheral neuropathy.
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Meta Analysis
Should we add vancomycin antibiotic powder to prevent post operative infection in spine surgery? - First update.
This Living FRISBEE (Living FRIendly Summary of the Body of Evidence using Epistemonikos) is an update of the summary published in June 2015, based on the detection of a new systematic review not identified in the previous version. Intravenous antibiotic prophylaxis is routinely administered to prevent surgical site infection in spinal surgery. Adding intrawound vancomycin powder before surgical closure might further decrease infection risk. ⋯ Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified seven systematic reviews that considered 16 studies, including one randomized controlled trial. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded vancomycin probably does not decrease the risk of infection in low risk surgery, but there is uncertainty about its effects in populations or surgeries with a higher risk because the certainty of the evidence is very low.
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Meta Analysis
Does vitamin C prevent the occurrence of complex regional pain syndrome in patients with extremity trauma requiring surgery?
The complex regional pain syndrome is a neuroinflammatory pathology that affects the central and peripheral nervous system, characterized by disproportional pain in relation to the trauma experimented by the patient. It has been proposed that vitamin C could prevent the development of this syndrome in patients with limb trauma and surgery. ⋯ We generated a summary of findings table following the GRADE approach. We concluded it is uncertain whether vitamin C prevents complex regional pain syndrome because the certainty of the evidence is very low.