Articles: treatment.
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Traumatic cardiac arrest is associated with poor prognosis, and timely evidence-based treatment is paramount for increasing survival rates. Physician-staffed helicopter emergency medical service use in major trauma has demonstrated improved outcomes. However, the sparsity of data highlights the necessity for a comprehensive understanding of the epidemiology of traumatic cardiac arrest. ⋯ This study highlights the low survival rates observed among patients with traumatic cardiac arrest assessed by helicopter emergency medical services. The findings support the positive impact of an initial shockable cardiac rhythm and endotracheal intubation in improving the likelihood of ROSC. The study contributes to the limited literature on traumatic cardiac arrests assessed by physician-staffed helicopter emergency services. Finally, the findings emphasise the need for further research to understand and improve outcomes in this subgroup of cardiac arrest.
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Despite declining numbers - older people in particular - often die from pulmonary embolism. A rapid assessment of the risk in the event of a suspected embolism, the exclusion of comorbidities and the appropriate therapy are the focus of the current guidelines. Early and subsequent outpatient treatment of a patient with acute PE generally requires 3 criteria: low risk of early complications, the absence of serious comorbidities and the highest possible safety at home and, in the event of a complication, rapid access to acute care in the hospital. ⋯ In patients at moderate risk of VTE recurrence, low-dose secondary prophylaxis can be used to reduce the risk of bleeding. Outpatient pulmonary embolism follow-up care is becoming increasingly important, because studies have shown several times that serious long-term consequences can occur. In pulmonary embolism patients with persistent dyspnea, reduced performance or risk of CTEPH, an outpatient evaluation of the right ventricle using echocardiography, if necessary, in combination with the determination of natriuretic peptides or spiroergometry, is recommended.
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Eosinophilic esophagitis (EoE) is a common cause of swallowing difficulties in both children and adults. The incidence of EoE has been increasing over the past decades, which cannot be solely attributed to improved diagnostic techniques. ⋯ Many patients respond to treatment with proton pump inhibitors, but those with severe EoE may require dietary modifications, topical steroids, and/or dilation of esophageal strictures. This review covers the incidence, risk factors, natural course, diagnosis, and treatment options for EoE, both within the Icelandic healthcare system andi n a broader context.
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Parents may seek out health information online when their adolescent has nonspecific back pain to better understand treatment options. Such information directed towards consumers has not been previously analysed. ⋯ This analysis reveals that public-facing websites with recommendations for treating adolescent nonspecific back pain do not cite the most recent, high-quality research. Although web pages correctly encourage physical activity and exercise over surgery and prescription medications, they do not reflect the psychologically informed or interdisciplinary care emphasized in recently published treatment recommendations. Clinicians must be aware that caregivers of their adolescent patients with nonspecific back pain may be exposed to online messages that encourage them to keep seeking a diagnosis.
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Critical care medicine · Oct 2024
Quality Evaluation of Guidelines for the Diagnosis and Treatment of Liver Failure.
This study aimed to systematically assess the methodological quality and key recommendations of the guidelines for the diagnosis and treatment of liver failure (LF), furnishing constructive insights for guideline developers and equipping clinicians with evidence-based information to facilitate informed decision-making. ⋯ There are high differences in methodological quality and recommendations among LF guidelines. Improving these existing problems and controversies will benefit existing clinical practice and will be an effective way for developers to upgrade the guidelines.