24 research outputs found
Rapid referral for headache management from emergency department to headache centre. four years data
Background: Headache is one of the most common reason for medical consultation to emergency department (ED). The inappropriate use of ED for non-emergency conditions is a problem in terms of overcrowding of emergency facilities, unnecessary testing and treatment, increased medical costs, burden on medical service providers and weaker relationships between patient and primary care provider. The aim of this study was to analyze the different stages of ED management of headache to identify those deficiencies that can be overcome by a fast referral to a headache clinic. Methods: The study is a retrospective analysis of the electronic medical records of patients discharged from an academic ED between January 1, 2015 and December 31, 2018 and referred to the tertiary level headache centre of the same hospital. We analyzed all aspects related to the permanence in ED and also assessed whether there was a match between the diagnosis made in ED and ours. Results: Among our sample of 244 patients, 76.2% were admitted as "green tag", 75% underwent a head computed tomography, 19.3% received a neurological consultation, 43% did not receive any pharmacological treatment and 62.7% still had headache at discharge. The length of stay in ED was associated with reporting the first aura ever (p = 0.014) and whether patients received consultations (p < 0.001). The concordance analysis shown a significant moderate agreement only for the diagnosis of migraine and only between triage and headache centre. Conclusions: Most patients who went to ED complaining of headache received the same treatment regardless of their diagnosis and in many cases the headache had not yet resolved at the time of discharge. Given the many shortcomings in headache management in ED, rapid referral to the headache centre is of paramount importance to help the patient achieve a definiteve diagnosis and appropriate treatment
The Josephson effect throughout the BCS-BEC crossover
We study the stationary Josephson effect for neutral fermions across the
BCS-BEC crossover, by solving numerically the Bogoliubov-de Gennes equations at
zero temperature. The Josephson current is found to be considerably enhanced
for all barriers at about unitarity. For vanishing barrier, the Josephson
critical current approaches the Landau limiting value which, depending on the
coupling, is determined by either pair-breaking or sound-mode excitations. In
the coupling range from the BCS limit to unitarity, a procedure is proposed to
extract the pairing gap from the Landau limiting current.Comment: 4 pages, 3 figures; improved version to appear in Phys. Rev. Let
Recurrent COVID-19 pneumonia in the course of chemotherapy: consequence of a weakened immune system?
Letter to the Editor - We report a case of recurrent COVID‐19 pneumonia in a
vulnerable patien
Grey solitons in a strongly interacting superfluid Fermi Gas
The Bardeen-Cooper-Schrieffer to Bose-Einstein condensate (BCS to BEC)
crossover problem is solved for stationary grey solitons via the Boguliubov-de
Gennes equations at zero temperature. These \emph{crossover solitons} exhibit a
localized notch in the gap and a characteristic phase difference across the
notch for all interaction strengths, from BEC to BCS regimes. However, they do
not follow the well-known Josephson-like sinusoidal relationship between
velocity and phase difference except in the far BEC limit: at unitary the
velocity has a nearly linear dependence on phase difference over an extended
range. For fixed phase difference the soliton is of nearly constant depth from
the BEC limit to unitarity and then grows progressively shallower into the BCS
limit, and on the BCS side Friedel oscillations are apparent in both gap
amplitude and phase. The crossover soliton appears fundamentally in the gap; we
show, however, that the density closely follows the gap, and the soliton is
therefore observable. We develop an approximate power law relationship to
express this fact: the density of grey crossover solitons varies as the square
of the gap amplitude in the BEC limit and a power of about 1.5 at unitarity.Comment: 10 pages, 6 figures, part of New Journal of Physics focus issue
"Strongly Correlated Quantum Fluids: From Ultracold Quantum Gases to QCD
Plasmas," in pres
Using INTERCheck® to Evaluate the Incidence of Adverse Events and Drug–Drug Interactions in Out- and Inpatients Exposed to Polypharmacy
Background: Polypharmacy exposes patients with comorbidities (particularly elderly patients) to an increased risk of drug-specific adverse events and drug–drug interactions. These adverse events could be avoided with the use of a computerized prescription support system in the primary care setting. The INTERCheck® software is a prescription support system developed with the aim of balancing the risks and benefits of polytherapy and examining drug–drug interactions. Objectives: This observational study used the INTERCheck® software to evaluate the incidence of adverse events and of drug–drug interactions in outpatients and inpatients receiving multiple medications. Methods: Patients were randomly enrolled from the outpatient department (n = 98) and internal medicine ward (n = 46) of S. Andrea Hospital of Rome. Polypharmacological treatment was analyzed using INTERCheck® software, and the prevalence of risk indicators and adverse events was compared between the two groups. Results: Polypharmacy (use of five or more drugs) applied to all except three cases among outpatients and one case among inpatients. A significant positive correlation was found between the number of medications and the INTERCheck® score (ρ = 0.67; p < 0.000001), and a significant negative correlation was found between the drug-related anticholinergic burden and cognitive impairment (r = − 0.30 p = 0.01). Based on the INTERCheck® analysis, inpatients had a higher score for class D (contraindicated drug combination should be avoided) than did outpatients (p = 0.01). The potential class D drug–drug interactions were associated with adverse events that caused hospitalization (χ2 = 7.428, p = 0.01). Conclusions: INTERCheck® analysis indicated that inpatients had a high risk of drug–drug interactions and a high percentage of related adverse drug events. Further prospective studies are necessary to evaluate whether the INTERCheck® software may help reduce polypharmacy-related adverse events when used in a primary care setting and thus potentially avoid related hospitalization and severe complications such as physical and cognitive decline
Strongly Correlated Quantum Fluids: Ultracold Quantum Gases, Quantum Chromodynamic Plasmas, and Holographic Duality
Strongly correlated quantum fluids are phases of matter that are
intrinsically quantum mechanical, and that do not have a simple description in
terms of weakly interacting quasi-particles. Two systems that have recently
attracted a great deal of interest are the quark-gluon plasma, a plasma of
strongly interacting quarks and gluons produced in relativistic heavy ion
collisions, and ultracold atomic Fermi gases, very dilute clouds of atomic
gases confined in optical or magnetic traps. These systems differ by more than
20 orders of magnitude in temperature, but they were shown to exhibit very
similar hydrodynamic flow. In particular, both fluids exhibit a robustly low
shear viscosity to entropy density ratio which is characteristic of quantum
fluids described by holographic duality, a mapping from strongly correlated
quantum field theories to weakly curved higher dimensional classical gravity.
This review explores the connection between these fields, and it also serves as
an introduction to the Focus Issue of New Journal of Physics on Strongly
Correlated Quantum Fluids: from Ultracold Quantum Gases to QCD Plasmas. The
presentation is made accessible to the general physics reader and includes
discussions of the latest research developments in all three areas.Comment: 138 pages, 25 figures, review associated with New Journal of Physics
special issue "Focus on Strongly Correlated Quantum Fluids: from Ultracold
Quantum Gases to QCD Plasmas"
(http://iopscience.iop.org/1367-2630/focus/Focus%20on%20Strongly%20Correlated%20Quantum%20Fluids%20-%20from%20Ultracold%20Quantum%20Gases%20to%20QCD%20Plasmas
Eptinezumab for the treatment of migraine
Introduction: Migraine is one of the most common illnesses in the world, with severe economical and subjective implications. Nowadays specific and nonspecific drugs are used for migraine chronic therapy, but a portion of patients have no benefit from these administrations. CGRP receptor antagonists are a good preventive treatment for episodic and chronic migraine. Areas covered: This article reviews both preclinical and clinical studies on eptinezumab as a potential preventive therapy for migraine, as well as pharmacokinetic and pharmacodynamic features. Thus, it summarizes safety and tolerability data based on human studies. Expert opinion: Eptinezumab had good results in several trials, making this molecule a promising migraine preventive drug. Although preclinical and clinical studies showed a significant efficacy, there are no data on the use of Eptinezumab during pregnancy or breastfeeding. There are still some knowledge limits about its pharmacokinetics and metabolism. This is a matter of concern that should be addressed in future studies
Evaluating and managing severe headache in the emergency department
Introduction: Headache is the fifth most common reason to visit an emergency department (ED). In most of the cases, headache is benign and has a primary origin, with migraine as the most common diagnosis. Inappropriate use of ED for non-emergency conditions causes overcrowding, unnecessary testing, and increased medical costs. Areas covered: All stages of headache management in ED, from the reasons to go there, the diagnosis that is made and the investigations necessary to make it, to get to the therapies administered and those prescribed at discharge, if there were any. Finally, the authors evaluated the habit of recommending medical follow-up and how often the headache is still present at discharge or returns within 24 hours. Expert Opinion: Primary headaches are underdiagnosed, misdiagnosed, and the majority do not receive drug therapy either in ED or on discharge, and in cases where the therapy is prescribed is not specific. Increase the number of primary care medical services, spread the ‘headaches culture’ among GPs and ED doctors, the adoption of ICHD in the diagnostic protocols used in EDs and a fast referral to a headache center could decrease the inappropriate use of ED and improve the headache management in the emergency units