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Mahjoub, Mohamed / Gallas, Meriem / Chelly, Souhir / Mezgar, Zied / Khrouf, Meriem

2023 Volume 101, Issue 4, Page(s) 426–432

Abstract: Introduction: Despite the spread of COVID-19 in Tunisia and its impact on people, health and economy, few studies have investigated the profile of COVID-19 Tunisian patients.: Aim: Determine the epidemiological, clinical, para-clinical and ... ...

Title translation	Risk factors of COVID-19 severity among Tunisian patients in the Emergency Department of Sousse, Tunisia.
Abstract	Introduction: Despite the spread of COVID-19 in Tunisia and its impact on people, health and economy, few studies have investigated the profile of COVID-19 Tunisian patients. Aim: Determine the epidemiological, clinical, para-clinical and therapeutic characteristics patients and identify the associated factors of severity. Methods: This is a retrospective study, conducted among confirmed COVID-19 patients consulting the hospital emergency department. We collected Data using from the patients' computerized files. We performed Data entry and analysis using SPSS 22. Results: We included 375 patients. The average age was 66.7±11.43 years with a sex ratio of 1.6. The most frequent comorbidities were diabetes (100%), hypertension (64.5%), and chronic heart disease (25.9%). The most frequent clinical signs were dyspnea (75.2%), asthenia (66.9%), cough (66.7%) and fever (60.3%). The most frequent biological abnormalities were biological inflammatory syndrome (96%) and elevation of troponin (69.3%). CT scans revealed lung damage in 34.1% of patients. As for treatments, 91.7% received antibiotics, 89% received corticosteroids, 89.3% received anticoagulants, and 85.1% received ventilation (42.6% non-invasive ventilation and 1.9% were intubated). Risk factors of severity were age, chronic heart disease and hypertension. Conclusion: Knowing the particularities of Tunisian patients will help to install recommendations to improve the process of care and prevention.
MeSH term(s)	Humans ; Middle Aged ; Aged ; COVID-19/epidemiology ; SARS-CoV-2 ; Retrospective Studies ; Tunisia/epidemiology ; Comorbidity ; Risk Factors ; Hypertension/epidemiology ; Chronic Disease ; Emergency Service, Hospital ; Heart Diseases ; Hospitalization
Language	French
Publishing date	2023-04-05
Publishing country	Tunisia
Document type	English Abstract ; Journal Article
ZDB-ID	128627-4
ISSN	2724-7031 ; 0041-4131
ISSN (online)	2724-7031
ISSN	0041-4131
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Article ; Online: Pulse amplitude ratio under noninvasive ventilation as a new method in the diagnosis of left heart failure in patients with acute exacerbation of chronic obstructive pulmonary disease.

Bel Haj Ali, Khaoula / Sekma, Adel / Chamtouri, Ikram / Beltaief, Kaouthar / Msolli, Mohamed Amine / Mezgar, Zied / Bouida, Wahid / Boukef, Riadh / Boubaker, Hamdi / Grissa, Mohamed Habib / Nouira, Semir

BMC cardiovascular disorders

2023 Volume 23, Issue 1, Page(s) 105

Abstract: Background: Left heart failure (LHF) is commonly associated with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) but its role is often underestimated.: Aim of study: To evaluate the performance of a new diagnostic technique based ...

Abstract	Background: Left heart failure (LHF) is commonly associated with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) but its role is often underestimated. Aim of study: To evaluate the performance of a new diagnostic technique based on the measurement of the pulse amplitude ratio (PAR) using non-invasive ventilation (NIV) for the early identification LHF in patients admitted to the emergency department (ED) for AECOPD. Results: 73 patients were included in this study: 32 in LHF group and 41 in non LHF- group. The two groups had comparable demographic and clinical characteristics at admission. The mean values of PAR Conclusion: Measurement of PAR Clinicaltrials: gov/prs/app/action/SelectProtocol?sid=S000BOO4&selectaction=Edit&uid=U0000QAM&ts=2&cx=qrmluh .
MeSH term(s)	Humans ; Noninvasive Ventilation/methods ; Respiration, Artificial ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Predictive Value of Tests ; Heart Failure
Language	English
Publishing date	2023-02-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2059859-2
ISSN	1471-2261 ; 1471-2261
ISSN (online)	1471-2261
ISSN	1471-2261
DOI	10.1186/s12872-023-03089-y
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Article ; Online: Melatonin, vitamins and minerals supplements for the treatment of Covid-19 and Covid-like illness: A prospective, randomized, double-blind multicenter study.

Mahjoub, Lobna / Youssef, Rym / Yaakoubi, Hajer / Salah, Houda Ben / Jaballah, Rahma / Mejri, Moez / Sekma, Adel / Trabelsi, Imen / Nouira, Semir / Khrouf, Mariem / Soltane, Houda Ben / Mezgar, Zied / Boukadida, Lotfi / Zorgati, Asma / Boukef, Riadh

Explore (New York, N.Y.)

2023 Volume 20, Issue 1, Page(s) 95–100

Abstract: Background: Melatonin, zinc, and multivitamins are among most recommended supplements in the fight against coronavirus disease 2019 (COVID-19). We aimed to examine the efficacy and safety of this association in the treatment of COVID-19 and COVID-like ... ...

Abstract	Background: Melatonin, zinc, and multivitamins are among most recommended supplements in the fight against coronavirus disease 2019 (COVID-19). We aimed to examine the efficacy and safety of this association in the treatment of COVID-19 and COVID-like illnesses. Methods: We conducted a multicenter prospective, randomized, double-blind, controlled trial. Patients with no medical history consulting the emergency department for covid and covid-like illness and who were not hospitalized were included. Patients were assigned in a 1:1 ratio to the treatment or the placebo group. The primary outcome was studying the effectiveness of zinc multivitamin supplement and melatonin in the treatment of COVID and -like illnesses symptoms' according to the time from randomization to clinical improvement. The pre-specified secondary outcomes were date of disappearance of symptoms present on admission, appearance of an adverse effect due to the administration of the treatment, number of patients developing complications, requiring hospitalization, requiring respiratory support. Results: One hundred sixty four patients were eligible for the study and were randomized to either the treatment group or the placebo group. Overall, 128 of the 164 patients had a PCR for SARS-CoV-2, yielding a positive PCR result in 49.1% of them. Regarding the disappearance of all initial presenting symptoms: on the Conclusions: Our results showed that daily doses of Melatonin, zinc and vitamins did significantly reduce the duration of symptoms accelerating its disappearance among patients consulting with COVID-19 or COVID-19 like illness.
MeSH term(s)	Humans ; COVID-19 ; SARS-CoV-2 ; Melatonin/therapeutic use ; Vitamins/therapeutic use ; Prospective Studies ; Treatment Outcome ; Minerals/therapeutic use ; Zinc/therapeutic use
Chemical Substances	Melatonin (JL5DK93RCL) ; Vitamins ; Minerals ; Zinc (J41CSQ7QDS)
Language	English
Publishing date	2023-06-20
Publishing country	United States
Document type	Randomized Controlled Trial ; Multicenter Study ; Journal Article
ZDB-ID	2183945-1
ISSN	1878-7541 ; 1550-8307
ISSN (online)	1878-7541
ISSN	1550-8307
DOI	10.1016/j.explore.2023.06.009
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Article ; Online: Value of inferior vena cava collapsibility index as marker of heart failure in chronic obstructive pulmonary disease exacerbation.

Kouraichi, Cyrine / Sekma, Adel / Bel Haj Ali, Khaoula / Chamtouri, Ikram / Sassi, Sarra / Toumia, Marwa / Yaakoubi, Hajer / Youssef, Rym / Msolli, Mohamed Amine / Beltaief, Kaouthar / Mezgar, Zied / Khrouf, Mariem / Bouida, Wahid / Dridi, Zohra / Boukef, Riadh / Boubaker, Hamdi / Grissa, Mohamed Habib / Nouira, Semir

BMC cardiovascular disorders

2023 Volume 23, Issue 1, Page(s) 579

Abstract: Introduction: Inferior vena cava (IVC) diameter variability with respiration measured by ultrasound was found to be useful for the diagnosis of heart failure (HF) in ED patients with acute dyspnea. Its value in identifying HF in acute exacerbation of ... ...

Abstract	Introduction: Inferior vena cava (IVC) diameter variability with respiration measured by ultrasound was found to be useful for the diagnosis of heart failure (HF) in ED patients with acute dyspnea. Its value in identifying HF in acute exacerbation of chronic obstructive pulmonary disease exacerbation (AECOPD) was not specifically demonstrated. Objective: To determine the value of ΔIVC in the diagnosis of HF patients with AECOPD. Methods: This is a prospective study conducted in the ED of three Tunisian university hospitals including patients with AECOPD. During this period, 401 patients met the inclusion criteria. The final diagnosis of HF is based on the opinion of two emergency experts after consulting the data from clinical examination, cardiac echocardiography, and BNP level. The ΔIVC was calculated by two experienced emergency physicians who were blinded from the patient's clinical and laboratory data. A cut off of 15% was used to define the presence (< 15%) or absence of HF (≥ 15%). Left ventricular ejection fraction (LVEF) was also measured. The area under the ROC curve, sensitivity, specificity, and positive and negative predictive values were calculated to determine the diagnostic and predictive accuracy of the ΔIVC in predicting HF. Results: The study population included 401 patients with AECOPD, mean age 67.2 years with male (68.9%) predominance. HF was diagnosed in 165 (41.1%) patients (HF group) and in 236 patients (58.9%) HF was excluded (non HF group). The assessment of the performance of the ΔIVC in the diagnosis of HF showed a sensitivity of 37.4% and a specificity of 89.7% using the threshold of 15%. The positive predictive value was 70.9% and the negative predictive value was 66.7%. The area under the ROC curve was 0.71(95%, CI 0.65-0.76). ΔIVC values were not different between HF patients with reduced LVEF and those with preserved LVEF. Conclusion: Our results showed that ΔIVC has a good value for ruling out HF in ED patients consulting for AECOPD.
MeSH term(s)	Humans ; Male ; Aged ; Stroke Volume ; Vena Cava, Inferior/diagnostic imaging ; Prospective Studies ; Ventricular Function, Left ; Heart Failure/diagnostic imaging ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/diagnostic imaging
Language	English
Publishing date	2023-11-24
Publishing country	England
Document type	Journal Article
ZDB-ID	2059859-2
ISSN	1471-2261 ; 1471-2261
ISSN (online)	1471-2261
ISSN	1471-2261
DOI	10.1186/s12872-023-03585-1
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Article ; Online: Comparison of simulation and video-based training for acute asthma.

Grissa, Mohamed Habib / Dhaoui, Randa / Bel Haj Ali, Khaoula / Sekma, Adel / Toumia, Maroua / Sassi, Sarra / Sakly, Abdel Karim / Zorgati, Asma / Bouraoui, Hajer / Ben Soltane, Houda / Mezgar, Zied / Boukef, Riadh / Boubaker, Hamdi / Bouida, Wahid / Beltaief, Kaouthar / Nouira, Semir

BMC medical education

2023 Volume 23, Issue 1, Page(s) 873

Abstract: Background: Emergency medicine is particularly well suited to simulation training. However, evidence for the efficacy of simulation-based medical training remains limited especially to manage high-risk cases such as acute asthma.: Objective: The ... ...

Abstract	Background: Emergency medicine is particularly well suited to simulation training. However, evidence for the efficacy of simulation-based medical training remains limited especially to manage high-risk cases such as acute asthma. Objective: The objective of our study was to compare the performance of high-fidelity simulation (HFS) and interactive video-case challenge-based training (IVC) for final-year medical students in the management of acute asthma. Methods: This was a prospective randomized controlled study conducted at the emergency department (ED) of Monastir University hospital ( Tunisia). 69 final-year medical students were randomized to HFS (n = 34) and IVC (n = 35) training on acute asthma topic. The study was conducted over a 1-week period. Efficacy of each teaching method was compared through the use of multiple-choice questionnaires (MCQ) before (pre-test), after (post-test) training and a simulation scenario test conducted 1 week later. The scenario was based on acute asthma management graded on predefined critical actions using two scores: the checklist clinical score (range 0 to 30), and the team skills score (range 0 to 16). Student satisfaction was also evaluated with the Likert 5 points scale. Two years after the post-test, both groups underwent a third MCQ testing to assess sustainability of knowledge. Results: There were no differences in age between groups. There was no statistically significant difference between the HFS and IVC groups pre-test scores (p = 0.07). Both groups demonstrated improvement in MCQ post-test from baseline after training session; the HFS MCQ post-test score increased significantly more than the IVC score (p < 0.001). The HFS group performed better than the IVC group on the acute asthma simulation scenario (p < 0.001). Mean checklist clinical score and mean team skills score were significantly higher in HFS group compared to IVC group (respectively 22.9 ± 4.8 and 11.5 ± 2.5 in HFS group vs 19.1 ± 3 and 8.4 ± 3.1 in IVC group) (p < 0.001). After 2 years, MCQ post-test scores decreased in both groups but the decrease was lower in HFS group compared to the IVC group. Conclusion: High-fidelity simulation-based training was superior to interactive video-case challenge for teaching final year medical students,and led to more long-term knowledge retention in the management of simulated acute asthma patients. Trial registration: The study was registered at www. Clinicaltrials: gov NCT02776358 on 18/05/2016.
MeSH term(s)	Humans ; Prospective Studies ; Simulation Training/methods ; High Fidelity Simulation Training ; Asthma/therapy ; Education, Medical, Undergraduate/methods ; Clinical Competence
Language	English
Publishing date	2023-11-16
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2044473-4
ISSN	1472-6920 ; 1472-6920
ISSN (online)	1472-6920
ISSN	1472-6920
DOI	10.1186/s12909-023-04836-7
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Article ; Online: Mobile Phone-Based Telemonitoring for Improving Adherence to Analgesic Treatment in Trauma Patients After Emergency Department Discharge: A Randomized Controlled Trial.

Romdhane, Khouloud / Sekma, Adel / Sassi, Sarra / Yaakoubi, Hajer / Youssef, Rym / Msolli, Mohamed Amine / Beltaief, Kaouthar / Grissa, Mohamed Habib / Boubaker, Hamdi / Ben Soltane, Houda / Mezgar, Zied / Boukef, Riadh / Bouida, Wahid / Belghith, Asma / Bel Haj Ali, Khaoula / Zorgati, Asma / Nouira, Semir

The Clinical journal of pain

2023 Volume 39, Issue 10, Page(s) 546–550

Abstract: Objective: To determine the impact of mobile-phone telemonitoring on patients' adherence and satisfaction with posttrauma pain treatment.: Materials and methods: We conducted a prospective randomized clinical trial including patients with minor ... ...

Abstract	Objective: To determine the impact of mobile-phone telemonitoring on patients' adherence and satisfaction with posttrauma pain treatment. Materials and methods: We conducted a prospective randomized clinical trial including patients with minor trauma discharged from the emergency department (ED) with analgesic treatment. Patients were randomized to one of 3 groups, the control group, where patients received a phone call on day-7, the short message service (SMS) group, where patients received a daily text message to remind them to take their treatment during 7 days, and the mobile-phone based telemonitoring (TLM) group. Patients' adherence to analgesic treatments using the Morisky Medication Adherence Scale, current pain by using a visual analogue scale, and patients' satisfaction were assessed. For the TLM group, the assessment was performed at day-2, 4 and 7. Results: Good adherence was observed in 418 patients (92.9%) in the TLM group versus 398 patients (88.6%) in the SMS group and 380 patients (84.8%) in the control group ( P <0.001). The factor mostly associated with adherence was telemonitoring (OR 2.40 95% CI 1.55-3.71). The decrease in pain visual analogue scale was highest in the TLM group compared with SMS and control groups ( P <0.001). The percentage of patients' satisfaction at 7 days post-ED discharge was 93% in the TLM group versus 88% in the SMS group and 84% in the standard group ( P =0.02). Discussion: Our findings suggest that mobile-phone-based telemonitoring is beneficial in the treatment of pain in trauma patients after ED discharge. This approach improved patients' adherence and satisfaction.
MeSH term(s)	Humans ; Patient Discharge ; Prospective Studies ; Cell Phone ; Text Messaging ; Analgesics/therapeutic use ; Emergency Service, Hospital ; Pain ; Medication Adherence
Chemical Substances	Analgesics
Language	English
Publishing date	2023-10-01
Publishing country	United States
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	632582-8
ISSN	1536-5409 ; 0749-8047
ISSN (online)	1536-5409
ISSN	0749-8047
DOI	10.1097/AJP.0000000000001145
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Article ; Online: Appropriateness of antibiotic treatment of acute respiratory tract infections in Tunisian primary care and emergency departments: a multicenter cross-sectional study.

Bel Haj Ali, Khaoula / Sekma, Adel / Messous, Selma / Trabelsi, Imen / Ben Youssef, Jalel / Maghraoui, Hamida / Razgallah, Rabie / Walha, Adel / Grissa, Mohamed Habib / Beltaief, Kaouthar / Mezgar, Zied / Coubantini, Ahmed / Bouida, Wahid / Msolli, Mohamed Amine / Boukef, Riadh / Boubaker, Hamdi / Nouira, Semir

BMC primary care

2022 Volume 23, Issue 1, Page(s) 295

Abstract: Background: Little is known about the pattern and appropriateness of antibiotic prescriptions in patients with acute respiratory tract infections (ARTIs).: Objective: Describe the antibiotics used to treat ARTIs in Tunisian primary care offices and ... ...

Abstract	Background: Little is known about the pattern and appropriateness of antibiotic prescriptions in patients with acute respiratory tract infections (ARTIs). Objective: Describe the antibiotics used to treat ARTIs in Tunisian primary care offices and emergency departments (EDs), and assess the appropriateness of their use. Methods: It was a prospective multicenter cross-sectional observational clinical study conducted at 63 primary care offices and 6 EDS during a period of 8 months. Appropriateness of antibiotic prescription was evaluated by trained physicians using the medication appropriateness index (MAI). The MAI ratings generated a weighted score of 0 to 18 with higher scores indicating low appropriateness. The study was conducted in accordance with the Declaration of Helsinki and national and institutional standards. The study was approved by the Ethics committee of Monastir Medical Faculty. Results: From the 12,880 patients screened we included 9886 patients. The mean age was 47.4, and 55.4% were men. The most frequent diagnosis of ARTI was were acute bronchitis (45.3%), COPD exacerbation (16.3%), tonsillitis (14.6%), rhinopharyngitis (12.2%) and sinusitis (11.5%). The most prescribed classes of antibiotics were penicillins (58.3%), fluoroquinolones (17.6%), and macrolides (16.9%). Antibiotic therapy was inappropriate in 75.5% of patients of whom 65.2% had bronchitis. 65% of patients had one or more antibiotic prescribing inappropriateness criteria as assessed by the MAI. The most frequently rated criteria were with expensiveness (75.8%) and indication (40%). Amoxicillin-clavulanic acid and levofloxacin were the most inappropriately prescribed antibiotics. History of cardiac ischemia ([OR] 3.66; 95% [CI] 2.17-10.26; p < 0.001), asthma ([OR] 3.29, 95% [CI] 1.77-6.13; p < 0.001), diabetes ([OR] 2.09, 95% [CI] 1.54-2.97; p = 0.003), history of COPD ([OR] 1.75, 95% [CI] 1.43-2.15; p < 0.001) and age > 65 years (Odds Ratio [OR] 1.35, 95% confidence interval [CI] 1.16-1.58; p < 0.001) were associated with a higher likelihood of inappropriate prescribing. Conclusion: Our findings indicate a high inappropriate use of antibiotics in ARTIs treated in in primary care and EDs. This was mostly related to antibiotic prescription in acute bronchitis and overuse of expensive broad spectrum antibiotics. Future interventions to improve antibiotic prescribing in primary care and EDs is needed. Trial registration: the trial is registered at Clinicaltrials.gov registry (NCT04482231).
MeSH term(s)	Male ; Humans ; Aged ; Female ; Cross-Sectional Studies ; Prospective Studies ; Respiratory Tract Infections/drug therapy ; Anti-Bacterial Agents/therapeutic use ; Emergency Service, Hospital ; Bronchitis/drug therapy ; Pulmonary Disease, Chronic Obstructive ; Primary Health Care
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2022-11-22
Publishing country	England
Document type	Multicenter Study ; Journal Article
ISSN	2731-4553
ISSN (online)	2731-4553
DOI	10.1186/s12875-022-01904-7
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Messous, Salma / Trabelsi, Imen / Bel Haj Ali, Khaoula / Abdelghani, Ahmed / Ben Daya, Yosra / Razgallah, Rabie / Grissa, Mohamed Habib / Beltaief, Kaouthar / Mezgar, Zied / Belguith, Asma / Bouida, Wahid / Boukef, Riadh / Boubaker, Hamdi / Msolli, Mohamed Amine / Sekma, Adel / Nouira, Semir

Therapeutic advances in respiratory disease

2022 Volume 16, Page(s) 17534666221099729

Abstract: Introduction: Duration of antibiotic treatment in acute exacerbation of COPD (AECOPD) is most commonly based on expert opinion. Typical administration periods range from 5 to 7 days. A 2-day course with levofloxacin was not previously assessed. We ... ...

Abstract	Introduction: Duration of antibiotic treatment in acute exacerbation of COPD (AECOPD) is most commonly based on expert opinion. Typical administration periods range from 5 to 7 days. A 2-day course with levofloxacin was not previously assessed. We performed a randomized clinical trial to evaluate the efficacy of 2-day Methods and analysis: Patients with AECOPD were randomized to receive levofloxacin for 2 days and 5 days placebo ( Results: 310 patients were randomized to receive 2-day course of levofloxacin ( Conclusion: Levofloxacin once daily for 2 days is not inferior to 7 days with respect to cure rate, need for additional antibiotics and hospital readmission in AECOPD. Our findings would improve patient compliance and reduce the incidence of bacterial resistance and adverse effects.
MeSH term(s)	Administration, Intravenous ; Anti-Bacterial Agents/adverse effects ; Humans ; Levofloxacin/adverse effects ; Patient Readmission ; Pulmonary Disease, Chronic Obstructive/diagnosis ; Pulmonary Disease, Chronic Obstructive/drug therapy
Chemical Substances	Anti-Bacterial Agents ; Levofloxacin (6GNT3Y5LMF)
Language	English
Publishing date	2022-06-05
Publishing country	England
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2476459-0
ISSN	1753-4666 ; 1753-4658
ISSN (online)	1753-4666
ISSN	1753-4658
DOI	10.1177/17534666221099729
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Article ; Online: Analgesic Effect of Topical Piroxicam vs Phytotherapy Gel in the Treatment of Acute Soft Tissue Injuries: A Randomized Controlled Noninferiority Study.

Bel Haj Ali, Khaoula / Sekma, Adel / Ben Abdallah, Saoussen / Yaakoubi, Hajer / Trabelsi, Imen / Frikha, Nourzed / Ben Soltane, Houda / Grissa, Mohamed Habib / Boubaker, Hamdi / Msolli, Mohamed Amine / Mezgar, Zied / Beltaief, Kaouthar / Boukef, Riadh / Nouira, Semir

Pain medicine (Malden, Mass.)

2022 Volume 24, Issue 6, Page(s) 586–592

Abstract: Objective: The study compared the efficacy and tolerability of piroxicam gel and a new topical combination of medicinal plant products (Soulagel®; Belpharma Tunisia) to treat pain caused by soft tissue injuries.: Methods: Patients (n = 1,525) were ... ...

Abstract	Objective: The study compared the efficacy and tolerability of piroxicam gel and a new topical combination of medicinal plant products (Soulagel®; Belpharma Tunisia) to treat pain caused by soft tissue injuries. Methods: Patients (n = 1,525) were assigned to receive piroxicam gel or Soulagel. Efficacy assessments included a change of at least 50% in the pain-on-movement visual numeric scale rating from emergency department discharge (baseline) to day 7 final assessment, as well as the time required to reach pain resolution criteria, the need for rescue analgesia, patients' satisfaction, and the rate of adverse effects. Results: At day 7, 1,216 patients (79.7%) achieved at least 50% reduction in visual numeric scale rating from baseline: 623 patients (82.4%) in the Soulagel group vs 593 patients (77.1%) in the piroxicam group (P = 0.01). Time to decrease pain on movement by 50% was significantly higher with piroxicam gel than with Soulagel (34 ± 1 vs 33 ± 1 days, respectively; P = 0.54). At day 7, 96.4% of patients in the Soulagel group declared being "very satisfied" to "satisfied," vs 68% in the piroxicam group (P < 0.001). There were no major adverse events in either group. Conclusions: Soulagel is not inferior to piroxicam gel for managing pain related to a soft tissue injuries. Further studies will help ascertain whether this new gel offers an alternative treatment option for this common emergency department condition.
MeSH term(s)	Humans ; Piroxicam/therapeutic use ; Piroxicam/adverse effects ; Pain/drug therapy ; Soft Tissue Injuries/drug therapy ; Phytotherapy ; Analgesics/therapeutic use ; Anti-Inflammatory Agents, Non-Steroidal/adverse effects
Chemical Substances	Piroxicam (13T4O6VMAM) ; Analgesics ; Anti-Inflammatory Agents, Non-Steroidal
Language	English
Publishing date	2022-11-20
Publishing country	England
Document type	Randomized Controlled Trial ; Journal Article
ZDB-ID	2015903-1
ISSN	1526-4637 ; 1526-2375
ISSN (online)	1526-4637
ISSN	1526-2375
DOI	10.1093/pm/pnac176
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Article ; Online: 30 day predicted outcome in undifferentiated chest pain: multicenter validation of the HEART score in Tunisian population.

Khalil, Mohamed Hassene / Sekma, Adel / Yaakoubi, Hajer / Bel Haj Ali, Khaoula / Msolli, Mohamed Amine / Beltaief, Kaouthar / Grissa, Mohamed Habib / Boubaker, Hamdi / Sassi, Mohamed / Chouchene, Hamadi / Hassen, Youssef / Ben Soltane, Houda / Mezgar, Zied / Boukef, Riadh / Bouida, Wahid / Nouira, Semir

BMC cardiovascular disorders

2021 Volume 21, Issue 1, Page(s) 555

Abstract: Background: Chest pain remains one of the most challenging serious complaints in the emergency department (ED). A prompt and accurate risk stratification tool for chest pain patients is paramount to help physcian effectively progrnosticate outcomes. ... ...

Abstract	Background: Chest pain remains one of the most challenging serious complaints in the emergency department (ED). A prompt and accurate risk stratification tool for chest pain patients is paramount to help physcian effectively progrnosticate outcomes. HEART score is considered one of the best scores for chest pain risk stratification. However, most validation studies of HEART score were not performed in populations different from those included in the original one. Objective: To validate HEART score as a prognostication tool, among Tunisian ED patients with undifferentiated chest pain. Methods: Our prospective, multicenter study enrolled adult patients presenting with chest pain at chest pain units. Patients over 30 years of age with a primary complaint of chest pain were enrolled. HEART score was calculated for every patient. The primary outcome was major cardiovascular events (MACE) occurrence, including all-cause mortality, non-fatal myocardial infarction (MI), and coronary revascularisation over 30 days following the ED visit. The discriminative power of HEART score was evaluated by the area under the ROC curve. A calibration analysis of the HEART score in this population was performed using Hosmer-Lemeshow goodness of test. Results: We enrolled 3880 patients (age 56.3; 59.5% males). The application of HEART score showed that most patients were in intermediate risk category (55.3%). Within 30 days of ED visit, MACE were reported in 628 (16.2%) patients, with an incidence of 1.2% in the low risk group, 10.8% in the intermediate risk group and 62.4% in the high risk group. The area under receiver operating characteristic curve was 0.87 (95% CI 0.85-0.88). HEART score was not well calibrated (χ Conclusion: HEART score showed a good discrimination performance in predicting MACE occurrence at 30 days for Tunisian patients with undifferentiated acute chest pain. Heart score was not well calibrated in our population.
MeSH term(s)	Adult ; Age Factors ; Aged ; Angina Pectoris/diagnosis ; Angina Pectoris/etiology ; Angina Pectoris/mortality ; Angina Pectoris/therapy ; Biomarkers/blood ; Cardiology Service, Hospital ; Clinical Decision-Making ; Decision Support Techniques ; Electrocardiography ; Emergency Service, Hospital ; Female ; Hospitals, Teaching ; Humans ; Male ; Middle Aged ; Myocardial Ischemia/complications ; Myocardial Ischemia/diagnosis ; Myocardial Ischemia/mortality ; Myocardial Ischemia/therapy ; Myocardial Revascularization ; Predictive Value of Tests ; Prospective Studies ; Reproducibility of Results ; Risk Assessment ; Risk Factors ; Time Factors ; Treatment Outcome ; Troponin/blood ; Tunisia
Chemical Substances	Biomarkers ; Troponin
Language	English
Publishing date	2021-11-19
Publishing country	England
Document type	Journal Article ; Multicenter Study ; Validation Study
ZDB-ID	2059859-2
ISSN	1471-2261 ; 1471-2261
ISSN (online)	1471-2261
ISSN	1471-2261
DOI	10.1186/s12872-021-02381-z
Database	MEDical Literature Analysis and Retrieval System OnLINE

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