BMC research notes
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Tobacco use is a serious public health challenge in North Africa, and health professionals play a vital role in tobacco control. In Egypt, limited data are available on the knowledge and attitudes of health care providers regarding tobacco control policies. Such data are especially relevant due to Egypt's tobacco control laws, adopted in 2007, prohibiting smoking in hospitals and other public places. This study surveyed 49 senior administrative staff, 267 physicians, 254 nurses, and 109 administrative employees working in El-Kasr El-Aini Hospital in Cairo, assessing their knowledge and attitudes regarding Egypt's tobacco control laws and barriers to their effective implementation in health care facilities. We also investigated the hospital's compliance with smoke-free policies. ⋯ Overall, smoke-free policies were poorly enforced in this large teaching hospital in Cairo, Egypt. Interventions to address the identified barriers to their implementation could include the provision of cessation training and services as well as effective communication programs to educate health care workers at all levels regarding the dangers of second-hand smoke exposure and effective measures for protection.
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In adult population with community acquired pneumonia high levels of pro-adrenomedullin (pro-ADM) have been shown to be predictors of worse prognosis. The role of this biomarker in pediatric patients had not been analyzed to date. The objective of this study is to know the levels of pro-ADM in children with community acquired pneumonia (CAP) and analyze the relation between these levels and the patients' prognosis. ⋯ In our sample of patients admitted to hospital with CAP, pro-ADM levels are related to the development of complications during hospitalization.
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The high prevalence of pain reported in many epidemiological studies, and the degree to which this prevalence reflects severe pain is under discussion in the literature. The aim of the present study was to evaluate use of the simple neck pain questions commonly included in large epidemiological survey studies with respect to aspects of health. We investigated if and how an increase in number of days with pain is associated with reduction in health outcomes. ⋯ This study of young university students has demonstrated that simple neck pain survey questions capture features of pain that affect aspects of health such as perceived general health, sleep disturbance, mood in terms of stress and energy. Simple pain questions are more useful for group descriptions than for describing or following pain in an individual.
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Acute mesenteric ischemia due to an embolism of the superior mesenteric artery is associated with a high mortality rate. Over 20 percent of acute mesenteric embolism cases consist of multiple emboli, and the long-term prognosis depends on the incidence of subsequent embolic events at other sites. The incidence of emboli in the upper extremity associated with a superior mesenteric arterial embolism has rarely been described. The signs and symptoms of ischemic change in the upper limb can be masked by other circumstances, such as postoperative conditions or complications. In these cases, a late presentation or delayed diagnosis and treatment can result in limb loss. ⋯ When treating a superior mesenteric arterial embolism in a patient with atrial fibrillation, the possibility of recurrent or multiple arterial thromboembolic events should be considered, even after the procedure is completed.
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Computed tomographic pulmonary angiography (CTPA) is increasingly being used as first investigation for suspected pulmonary embolism (PE). The investigation has high predictive value, but is resource and time intensive and exposes patients to considerable radiation. Our aim was to assess the potential value of a negative d-dimer assay to exclude pulmonary emboli and reduce the number of performed CTPAs. ⋯ We found that a low d-dimer score excluded all pulmonary embolisms, after a further specialist panel review identified initial false positive reports. However, current evidence-based guidelines still recommend that clinicians combine a d-dimer result with a validated clinical risk score when selecting suitable patients for CTPA. This may result in better use of limited resources, prevent patients being exposed to unnecessary irradiation and prevent potential complications as a result of iodinated contrast.