Abstract:
:During the influenza season, most patients suspected of having influenza undergo rapid influenza diagnostic tests (RIDTs) in Japan despite their low sensitivity. However, the physician's actual rationale for prescribing antivirals, besides the results of RIDTs, remains poorly understood. Our study sought to identify the role of clinical information and physicians' experience in the initiation of anti-influenza agents. We retrospectively reviewed 380 patients who underwent RIDTs at the emergency department of our hospital from September 2018 to May 2019. Data regarding sex, age, etc., which could affect the decision of prescribing antivirals, were extracted from medical records. We performed logistic regression analysis to analyze the concurrent effect of potentially relevant clinical factors, results of RIDTs, and the physician's status on antiviral prescription. Multivariable analysis revealed that a positive RIDT had the largest effect on antiviral prescription, followed by physician status, high regional influenza activity, and patients' presentation within 12 h of symptom onset. Patient's age, comorbidities, and presentation after 48 h of symptom onset were not associated with antiviral treatment. Physicians with more years of experience were significantly more likely to prescribe antivirals for patients with low risk of complications. Our findings revealed the physicians' rationale for initiating antiviral treatment and the discrepancy with guideline indications of antivirals, which is the patient's age and comorbidities. Physicians, especially those with more than 3 years of experience, frequently prescribed antivirals for patients with low risk of complications; thus, educational interventions against this population could be useful to improve this situation.
journal_name
Intern Emerg Medjournal_title
Internal and emergency medicineauthors
Nakajima K,Akebo H,Tsugihashi Y,Ishimaru H,Sada Rdoi
10.1007/s11739-020-02570-2subject
Has Abstractpub_date
2021-01-02 00:00:00eissn
1828-0447issn
1970-9366pii
10.1007/s11739-020-02570-2pub_type
杂志文章abstract::Nowadays, amiodarone is the most commonly used antidysrhythmic drug in clinical practice. It is highly effective in the management of recurrent ventricular dysrhythmias, paroxysmal supraventricular dysrhythmias, including atrial fibrillation and flutter, and in the maintenance of sinus rhythm after electrical cardiove...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-014-1140-1
更新日期:2014-12-01 00:00:00
abstract::Although chronic hypertension is associated with long-term complications, few studies directly examine the effects of in-hospital acute hypertensive episodes in trauma patients. The aim was to determine whether there is an association between in-hospital acute hypertension and morbidity. We included trauma patients be...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-013-0984-0
更新日期:2014-08-01 00:00:00
abstract::The treatment of polycythemia vera in young adults is challenging, requiring one to run a balance between the increased risk of vascular complications, if left untreated, versus the potential of promoting secondary leukemia/myelodysplasia or cancer, if actively managed with chemotherapy. We report the results of a 20-...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-010-0429-y
更新日期:2010-10-01 00:00:00
abstract::The article Reversal agents for oral anticoagulant-associated major or life-threatening bleeding, written by Marco Moia, Alessandro Squizzato was originally published electronically on the publisher's internet portal (currently SpringerLink) on 24 August 2019 without open access. ...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,已发布勘误
doi:10.1007/s11739-019-02232-y
更新日期:2020-06-01 00:00:00
abstract::In older people, revisit to the emergency department (ED) in the short period after discharge is not entirely avoidable, but in a proportion of cases is preventable, and should ideally be minimised. We have previously derived a risk probability nomogram to predict the likelihood of revisit. In this study, we sought to...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-015-1219-3
更新日期:2015-06-01 00:00:00
abstract::The direct oral anticoagulants (DOACs) are drugs used in clinical practice since 2009 for the prevention of stroke or systemic embolism in non-valvular atrial fibrillation, and for the treatment and secondary prevention of venous thromboembolism. The four DOACs, including the three factor Xa inhibitors (rivaroxaban, a...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-017-1628-6
更新日期:2017-04-01 00:00:00
abstract::The primary study objective is to compare the outcomes of patients taking oral anticoagulant medications in two distinct populations treated according to different management models (comprehensive vs. usual care). (Design: regional prospective cohort study; setting: hospital admission data from two regions). Eligible ...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-019-02148-7
更新日期:2019-11-01 00:00:00
abstract:OBJECTIVE:In marathon runners changes in red blood cell count, haematocrit and haemoglobin in relation to haemodilution have been reported. Moreover, it has been hypothesized that strenuous exercise induces oxidant stress through several different mechanisms. This study investigated the haematological variables, iron s...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/BF02934717
更新日期:2006-01-01 00:00:00
abstract::Rapid diagnostic tools for Helicobacter pylori are important in endoscopy. To assess the accuracy of a new 5-min rapid urease test (UFT300, ABS Cernusco, sul Naviglio, Italy) compared with the 1-h Pyloritek (Serim Laboratories, Elkhart, IN) and the 24-h CLO test (Kimberly-Clark Ballard Medical Products, Roswell, GA), ...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-009-0344-2
更新日期:2010-02-01 00:00:00
abstract::Prescription of non-vitamin K antagonist oral anticoagulants (NOACs) requires an assessment of renal function (RF) and the Cockcroft-Gault (CG) equation is traditionally recommended. The objective of the study was to evaluate the potential changes in NOACs management using different equations for estimating RF. In a p...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-018-1857-3
更新日期:2018-10-01 00:00:00
abstract::The recent position paper of the European Society of Cardiology (ESC) on cardiovascular toxicity of cancer treatments has attracted considerable interest by healthcare professionals, since it is the first concrete help in the difficult task of monitoring and approaching cardiovascular side effects of anticancer treatm...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-017-1755-0
更新日期:2018-01-01 00:00:00
abstract::In the original publication, the given name and family name of the fifth author Dr Margherita Migone De Amicis were incorrectly published. The correct given name and family name should read as 'Margherita' and 'Migone De Amicis', respectively. ...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,已发布勘误
doi:10.1007/s11739-018-1921-z
更新日期:2018-09-01 00:00:00
abstract::Diuretic resistance (DR) is common in patients with decompensated heart failure (HF), and is associated with adverse outcomes. To determine the prevalence of DR and its impact on survival among patients with decompensated HF, we prospectively evaluated the prevalence and influence on prognosis of DR (defined as persis...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-018-02019-7
更新日期:2019-06-01 00:00:00
abstract::Thrombosis is "haemostasis in the wrong place", and there is increasing evidence that haemostatic factors are associated with increased risk of atherothrombotic events. Increasing plasma levels of fibrinogen are associated with increased risks of coronary heart disease, stroke and peripheral arterial disease, and with...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11739-011-0536-4
更新日期:2011-12-01 00:00:00
abstract::Chronic thromboembolic pulmonary hypertension (CTPH) is a potential complication of pulmonary embolism (PE). Only few studies have assessed the role of brain natriuretic peptide (BNP) in patients with chronic pulmonary hypertension, and there are no data on the potential utility of BNP as a preclinical biomarker of CT...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-009-0231-x
更新日期:2009-04-01 00:00:00
abstract::We evaluated the effect of body mass index (BMI) on intubation success rates and complications during emergency airway management. We retrospectively analyzed an airway registry at an academic medical center. The primary outcomes were the incidence of difficult intubation and complication rates, stratified by BMI. We ...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-012-0874-x
更新日期:2013-02-01 00:00:00
abstract::The predisposition, infection/insult, response, and organ dysfunction (PIRO) staging system for septic patients allows grouping of heterogeneous patients into homogeneous subgroups. The purposes of this single-center, prospective, observational cohort study were to create a PIRO system for patients with community-acqu...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-013-0969-z
更新日期:2013-09-01 00:00:00
abstract::The idea of using small RNA fragments (oligonucleotides) for therapeutic purposes dates back to the 1990s, following the landmark discoveries on the mechanisms of gene silencing and RNA-interference (RNA-i). However, the first applications in medicine were hampered by difficulties in chemical stabilization and efficie...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-018-1810-5
更新日期:2018-04-01 00:00:00
abstract::In patients with the novel coronavirus (COVID-19) infection, the echocardiographic assessment of the right ventricle (RV) represents a pivotal element in the understanding of current disease status and in monitoring disease progression. The present manuscript is aimed at specifically describing the echocardiographic a...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-020-02494-x
更新日期:2021-01-01 00:00:00
abstract::A meta-analysis to determine the impact of gender on mortality in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS): PubMed, EMBASE, and Cochrane Library, was systematically searched. Two investigators independently reviewed retrieved articles and assessed eligibility. Unadjusted mortality rat...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s11739-017-1684-y
更新日期:2018-03-01 00:00:00
abstract::Septic arthritis (SA) is commonly associated with Staphylococcal or Streptococcal infections. Overtime, there has been a global increase in the distribution of antimicrobial resistance within both Gram-positive bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and Gram-negative bacteria such as exten...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-019-02244-8
更新日期:2020-06-01 00:00:00
abstract::Anthracyclines are extensively used in oncologic patients, in particular for breast cancer and hematological malignancies. Cardiac injury is a potentially dangerous side effect of these drugs. In this systematic review, we analyzed published randomized controlled trials (RCTs) to assess if potential cardioprotective d...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,评审
doi:10.1007/s11739-020-02508-8
更新日期:2020-10-03 00:00:00
abstract::Objective measurement of simulation performance requires a validated and reliable tool. However, no published Italian language assessment tool is available. Translation of a published English language tool, the Ottawa Crisis Resource Management Global Rating Scale (GRS), may lead to a validated and reliable tool. Afte...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-016-1486-7
更新日期:2017-08-01 00:00:00
abstract::Intracranial bruits (ICB) are faint, high-pitched, and mostly heard on the orbit in the systolic phase of the cardiovascular cycle. This report discusses a case of Listeria monocytogenes meningitis in a 17-month-old male patient in whom ICB were auscultated. ICB is thought to be caused by compression of blood vessels ...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-020-02579-7
更新日期:2021-01-03 00:00:00
abstract::Assessing the effects of an antimicrobial stewardship program (ASP) implemented in a 78-bed Internal Medicine ward of an Italian mid-sized acute care hospital of 296 beds (26,820 bed days/year in 2015 and 26,653 in 2016). The ASP, implemented in May 2016, included: (a) formulation and dissemination of local guidelines...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-018-1916-9
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To determine the feasibility of using the internet to track the spread of emergency medicine internationally. METHODS: OVERVIEW:This was an attempt to perform a descriptive cross-sectional study employing a web-based survey. SUBJECTS:Potential respondents were identified from multiple sources. OBSERVATION...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-007-0083-1
更新日期:2007-12-01 00:00:00
abstract::Inflammation plays a pivotal role in all stages of atherosclerosis from endothelial dysfunction and plaque formation to plaque destabilization and disruption. Inflammatory biomarkers, originally studied to better understand the pathophysiology of atherosclerosis, have generated increasing interest among clinicians, be...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,评审
doi:10.1007/s11739-010-0361-1
更新日期:2010-06-01 00:00:00
abstract::Despite its rarity, infliximab-related hepatitis constitutes a cutting edge and challenging problem. In December 2004, a drug warning was issued by the Food and Drug Administration to alert healthcare professionals to the risk of hepatotoxicity in course of infliximab therapy. Subsequently, several reports of probable...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,评审
doi:10.1007/s11739-009-0342-4
更新日期:2010-06-01 00:00:00
abstract::Pulmonary hypertension (PH) is defined as an elevated mean pulmonary artery pressure at rest (mPAP ≥ 25 mmHg), evaluated by right heart catheterization (RHC). The aim of the present study was to evaluate HRCT findings in relation to transthoracic echocardiographic data to better characterize PH in IPF patients and to ...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-020-02539-1
更新日期:2020-11-05 00:00:00
abstract::The purpose of this investigation was to investigate the association between first attempt success and intubation-related complications in the Intensive Care Unit after the widespread adoption of video laryngoscopy. We further sought to characterize and identify the predictors of complications that occur despite first...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-016-1549-9
更新日期:2017-12-01 00:00:00