Swiss medical weekly
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Swiss medical weekly · Jan 2014
Observational StudyPrognostic value of nucleated red blood cells in critically ill children.
Is there an association between the presence of nucleated red blood cells (NRBCs) in the peripheral blood and outcomes in critically ill children? ⋯ NRBCs are not an independent risk factor for bad outcomes in paediatric intensive care. However, NRBCs may have some prognostic value in the first month of life. In children >1 month of age, the association between NRBC and outcome is much less pronounced.
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Swiss medical weekly · Jan 2014
Intensive care without walls - introduction of a Medical Emergency Team system in a Swiss tertiary care centre.
To improve the response of deteriorating patients during their hospital stay, the University Hospital Bern has introduced a Medical Emergency Team (MET). Aim of this retrospective cohort study is to review the preceding factors, patient characteristics, process parameters and their correlation to patient outcomes of MET calls since the introduction of the team. ⋯ The VSS is a significant predictor of mortality in patients assessed by the MET. Increasing MET utilisation coincided with a decrease in cardiac arrest calls in the MET perimeter.
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Swiss medical weekly · Jan 2014
Observed costs and health care use of children in a prospective cohort study on community-acquired pneumonia in Geneva, Switzerland.
Despite various efforts to estimate cost-effectiveness of pneumococcal conjugate vaccines, only scarce information on the cost burden of paediatric community acquired pneumonia (CAP) exists. The objective of this study was to prospectively calculate direct and indirect costs associated with treatment of CAP from a society perspective in children between 2 months and 16 years of age seeking care at a tertiary hospital in Geneva, Switzerland between December 2008 and May 2010. ⋯ Childhood CAP results in a significant medical cost burden that may have been underestimated in previous cost-effectiveness analyses of pneumococcal vaccine strategies.
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Swiss medical weekly · Jan 2014
Randomized Controlled TrialButorphanol pre-treatment prevents myoclonus induced by etomidate: a randomised, double-blind, controlled clinical trial.
Myoclonic movements are common problems during induction of anaesthesia with etomidate. The myoclonus occurring after etomidate administration may represent a form of seizure. Agonistic modulation of the κ opiate receptor may reduce seizures, and butorphanol acts in such a manner. The aim of this randomised, double-blind, placebo-controlled clinical trial was to test our hypothesis that pre-treatment with butorphanol might reduce the incidence and severity of myoclonus induced by etomidate. ⋯ Infusion of 0.015 mg/kg butorphanol 2 minutes before etomidate administration is effective for suppressing myoclonus induced by etomidate during induction of general anaesthesia.
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Aneurysmal subarachnoid haemorrhage (aSAH) occurs as a result of rupture of an intracranial aneurysm and affects a younger population compared with ischaemic stroke or intracerebral haemorrhage. Although it makes up only about 5% of all cerebrovascular events, it accounts for over a quarter of the productive life-years lost to stroke. Its surgical and medical treatment represents a multidisciplinary effort. We herein provide an overview of current management options for aSAH.