Search

Objective: To compare the perception by naive patients, emergency services clinicians and nurses, of healthcare-induced pain for procedures performed frequently by accident and emergency services., Methods: A prospective, three-part anonymous survey, given to caregivers and patients at arrival accident and emergency services. The primary endpoint was the a priori estimated pain score for 10 procedures performed frequently by accident and emergency services. The same estimation was performed with the 'willingness to pay' method (amount allocated a priori to avoid this pain)., Results: Fifty surveys were analyzed in each group, with a significant difference for pain perception between caregivers and patients concerning four procedures: local anesthesia, fracture or dislocation reduction, dressing change and abscess incision. Caregivers always overestimated pain scores compared with patients. No difference was noted for the remaining five procedures: intravenous line insertion and removal, urethral catheterization, wound suture and nasogastric intubation., Conclusion: Caregivers should be aware of the most feared procedures by patients to establish pre-emptive analgesia when possible, inform patients and achieve reassurance.

Systemic Capillary Leak Syndrome (SCLS) is a rare disease with poor prognosis, characterized by the occurrence of mucocutaneous and visceral edema with hypotension, hemoconcentration, and unexpected hypoalbuminemia. The disease can be idiopathic (Clarkson syndrome) or secondary to other diseases and treatments. We describe this syndrome in a prehospitalized, 63-year-old patient with chronic lymphocytic leukemia and an idiopathic form of SCLS manifesting as hypovolemic shock. Initial care is hospitalization in intensive care. In addition to etiological treatment if fluid replacement is necessary, treatment must be closely monitored for secondary overload complications. Catecholamine rather than arrhythmogenic support may be associated.

Plasmonics is a rapidly emerging platform for quantum state engineering with the potential for building ultra-compact and hybrid optoelectronic devices. Recent experiments have shown that despite the presence of decoherence and loss, photon statistics and entanglement can be preserved in single plasmonic systems. This preserving ability should carry over to plasmonic metamaterials, whose properties are the result of many individual plasmonic systems acting collectively, and can be used to engineer optical states of light. Here, we report an experimental demonstration of quantum state filtering, also known as entanglement distillation, using a metamaterial. We show that the metamaterial can be used to distill highly entangled states from less entangled states. As the metamaterial can be integrated with other optical components this work opens up the intriguing possibility of incorporating plasmonic metamaterials in on-chip quantum state engineering tasks.