The use of NDYAG laser combined with pulsed light in the treatment of rosacea

Rosacea is a chronic inflammatory skin disease with a complex pathogenesis that mainly affects the central part of the face, with a global incidence of 5.46%. The present study was performed on a group of 68 patients with rosacea 1 and 2 subtypes, patients between 34-63 years old. The treatments were performed using a Cutera Xeo laser, using 2 types of probes: NdYag 1064nm for telangiectasias and LimeLight 520-1100nm for diffuse facial erythema, papules, and pustules, having an 10x30mm window. For patients with diffuse facial erythema, etc., the optimal number of sessions was between 3 and 6 with or without anesthetic cream, using energies between 14-19J / cm. The average recovery time was 5 days. Registered effects included bruises, pustules, burning sensation, transient stinging, and hypopigmentation. For patients with telangiectasia, the optimal number of sessions was two, performed at an average interval of once per month/ monthly

The role of sodium glucose cotransporter or glucagon-like peptide-1 receptor agonists in treating heart failure with preserved ejection fraction in patients with type 2 diabetes mellitus

Background. Heart failure with preserved ejection fraction is not a single disease but a clinical syndrome secondary to important comorbidities, is increasing in prevalence, and is associated with high functional impairment. This study aimed to compare the results of treating patients with heart failure with preserved ejection fraction and type 2 diabetes mellitus with sodium-glucose cotransporter inhibitors (SGLT-2 inhibitors) or Glucagon-like peptide-1 receptor agonists (GLP-1 RAs). Methods. Observational trial in one medical center with assessments at baseline and 6 months. Participants were patients with type 2 diabetes mellitus and heart failure with preserved ejection fraction. The primary endpoint was to measure the impact of treatment on weight loss, diastolic dysfunction, Kansas City Cardiomyopathy Questionnaire. We performed anthropometric measurements, blood samples and transthoracic echocardiography for systolic and diastolic dysfunction. Results. After 6 months of intervention, both groups had a significant increase in results of Kansas City Cardiomyopathy Questionnaire, and the mean change in the group treated with GLP-1 Ras was 15.88 ± 7.7 points (95% confidence interval[CI], 19.7-12.7, p<0.01) while in the group treated with sodium-glucose cotransporter inhibitors was 13.57 ± 7.96 points (95% confidence interval[CI], 16.22-10.91, p<0.01) so the quality of life was better. The weight loss was more important in the group with GLP-1 Ras with 5.8 ± 1.8 kg (95% confidence interval [CI], 4.7-7.0, p<0.01) while in the other group was 1.37 ± 1.4 kg (95% confidence interval [CI], 0.54-2.21, p<0.01). Diastolic dysfunction was improved in monitoring E/E' lateral and was 3.28 ±1.27 less (95% confidence interval [CI], 2.75-3.80, p<0.01) in the GLP-1 Ras group and 2.93 ± 2.15 less (95% confidence interval [CI], 2.21-3.64, p<0.01) in the SGLT-2 inhibitors group. Conclusions. The present study establishes an improvement in symptoms, diastolic dysfunction, and weight loss in patients with type 2 diabetes mellitus and heart failure with preserved ejection fraction and treatment with GLP-1 Ras or SGLT-2 inhibitors

Early mobilisation in critically ill COVID-19 patients: a subanalysis of the ESICM-initiated UNITE-COVID observational study

Background Early mobilisation (EM) is an intervention that may improve the outcome of critically ill patients. There is limited data on EM in COVID-19 patients and its use during the first pandemic wave. Methods This is a pre-planned subanalysis of the ESICM UNITE-COVID, an international multicenter observational study involving critically ill COVID-19 patients in the ICU between February 15th and May 15th, 2020. We analysed variables associated with the initiation of EM (within 72 h of ICU admission) and explored the impact of EM on mortality, ICU and hospital length of stay, as well as discharge location. Statistical analyses were done using (generalised) linear mixed-effect models and ANOVAs. Results Mobilisation data from 4190 patients from 280 ICUs in 45 countries were analysed. 1114 (26.6%) of these patients received mobilisation within 72 h after ICU admission; 3076 (73.4%) did not. In our analysis of factors associated with EM, mechanical ventilation at admission (OR 0.29; 95% CI 0.25, 0.35; p = 0.001), higher age (OR 0.99; 95% CI 0.98, 1.00; p ≤ 0.001), pre-existing asthma (OR 0.84; 95% CI 0.73, 0.98; p = 0.028), and pre-existing kidney disease (OR 0.84; 95% CI 0.71, 0.99; p = 0.036) were negatively associated with the initiation of EM. EM was associated with a higher chance of being discharged home (OR 1.31; 95% CI 1.08, 1.58; p = 0.007) but was not associated with length of stay in ICU (adj. difference 0.91 days; 95% CI − 0.47, 1.37, p = 0.34) and hospital (adj. difference 1.4 days; 95% CI − 0.62, 2.35, p = 0.24) or mortality (OR 0.88; 95% CI 0.7, 1.09, p = 0.24) when adjusted for covariates. Conclusions Our findings demonstrate that a quarter of COVID-19 patients received EM. There was no association found between EM in COVID-19 patients' ICU and hospital length of stay or mortality. However, EM in COVID-19 patients was associated with increased odds of being discharged home rather than to a care facility. Trial registration ClinicalTrials.gov: NCT04836065 (retrospectively registered April 8th 2021)

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

IDENTIFYING TOURISTS INTERESTED IN ECO-CERTIFIED ACCOMMODATION UNITS FROM BRASOV, ROMANIA

<p><em>Ecolabels are key</em><em> instruments for a sustainable tourism development and implementation of environmental certification of tourist accommodation facilities and services. </em><em>The present paper aimes to analyze whether eco-certification is considered by tourists in the choice of accommodation in Romanian destinations. We have chosen as a case study the city of Brasov in order to evaluate if certification as a sustainability policy tool is needed for accommodation facilities. A survey was conducted among 940 tourists from the analyzed destination. </em><em>Data collected in the survey was analyzed using the Statistical Package for Social Sciences (SPSS) and several statistical methods have been used: descriptive analysis, crosstabs, Cluster Analysis. </em><em>T</em><em>he results of the research outline the necessity for Brasov’s accommodation managers to consider the eco-certification of their businesses. </em><em>However, since some tourists remain unaware regarding the existence</em><em> of tourism certification programs and far fewer understand their meaning, they would have to consider educating tourists with respect to the utility and scope of tourism ecolabels alongside efforts towards creating or adopting tourism ecolabeling programs.</em></p

Non-invasive laboratory, imaging and elastography markers in predicting varices with high risk of bleeding in cirrhotic patients

Introduction. Upper digestive tract endoscopy remains the gold-standard for detecting esophageal or gastric varices and assessment of bleeding risk, but this method is invasive. The aim of the study was to identify non-invasive factors that could be incorporated into an algorithm for estimating the risk of variceal bleeding