Acta bio-medica : Atenei Parmensis
-
Multicenter Study
A first contribution to the validation of the Italian version of the Behavioral Pain Scale in sedated, intubated, and mechanically ventilated paediatric patients.
Numerous negative outcomes of inadequate pain management among children have been cited in the literature. Inadequate pain management may be particularly detrimental to children and adolescents facing life-threatening injury or illness on a Paediatric Intensive Care Unit (PICU). It is therefore absolutely necessary that professionals utilize effective and efficient tools in order to evaluate a person's sensations of pain in the most objective way possible. The COMFORT-B scale is recognised as the gold standard in such patients. However, the use of this instrument in the clinical PICU setting is disputed. It requires long periods of observation to ensure an adequate utilization. Boerlage et al. noted that nurses are often impatient and do not always observe the patient for the recommended 2 minutes period. The Behavioral Pain Scale (BPS), instead, is considered to be the gold standard for pain assessment in deeply sedated, mechanically ventilated adult patients. This observational pain scale requires shorter observation time compared to the COMFORT-B. Moreover, BPS three subscales are included in other observational pain scales for paediatric patients. Therefore, the objective of this study was to assess the applicability of the BPS for use with paediatric patients. ⋯ Although the current study is based on a small sample of participants, these first results encourage us to continue working in the validation of the BPS in paediatric patients.
-
Multicenter Study Observational Study
Chronic pain treatment and scrambler therapy: a multicenter retrospective analysis.
Scrambler Therapy is a novel neuromodulation that works by electrocutaneous stimulation in a non-invasive manner through C fibers surface receptors. It substitutes pain information with synthetic "non pain" information. The primary aim of this study was to analyze the efficacy and safety of Scrambler Therapy after ten sessions related to different usage conditions and different learning curves that occur in a multi-center study. ⋯ Scrambler Therapy is an efficient and safe alternative for several different types of refractory chronic neuropathic pain, with a very rare possibility of adverse events.
-
Multicenter Study
Overcrowding and clinical risk in Emergency Departments. A model for the reduction in NEDOCS: preliminary results.
Overcrowding in Emergency Departments represents one of the main concerns in effective hospital management today. In order to reduce this phenomenon, this study experimented with a new organizational model that exploited available resources, without incurring additional costs. Through the redistribution of hospital beds, it was possible to reduce access blocks in the Emergency Department of the test hospital. ⋯ Currently, it is known that the principle cause of overcrowding is attributed to a lack of hospital beds for inpatients. Numerous studies have shown that through the lengthening of inpatient hospitalizations it is possible to improve crowding levels in Emergency Department. This findings of this study robustly demonstrate that a small increase in the number of available beds available in emergency department leads to a decrease in all variables of the NEDOCS, and in particular, that of the severely and dangerous overcrowding score.
-
Randomized Controlled Trial Multicenter Study
72-hour epidural infusion of 0.125% levobupivacaine following total knee replacement: a prospective, randomized, controlled, multicenter evaluation.
To evaluate the efficacy in terms of pain relief and degree of motor impairment of a continuous epidural infusion of 0.125% levobupivacaine in patients undergoing total knee replacement surgery. ⋯ Continuing the epidural infusion of a concentration of levobupivacaine as low as 0.125% improves pain relief with a 50% reduction of hourly morphine consumption after total knee replacement even during the second and third postoperative days, and does not result in a gross impairment of motor function.
-
Respiratory Syncytial Virus (RSV) is the leading cause of emergency visits and hospitalization for acute lower respiratory tract infections (LRTI) in infants and young children worldwide. To collect specific epidemiological data on the incidence of RSV infection among infants referred to Emergency Departments (ED) for LRTI in a Mediterranean country, an Italian multicenter epidemiological surveillance program was established. ⋯ These data confirm that the patterns of RSV infection in Italy are similar to those reported for other countries in the northern hemisphere: RSV is associated with a higher risk of hospitalization and clinically evident LRTI involvement than respiratory infections of other etiologies, especially in infants.