Incidence and factors associated with out-of-hospital peri-intubation cardiac arrest: a secondary analysis of the CURASMUR trial
The objectives of this study were to assess the incidence and factors associated with PICA (cardiac arrest occurring within 15  min of intubation) in an out-of-hospital emergency setting, wherein emergency physicians perform standardized airway management using a rapid sequence intubation technique in adult patients. This was a secondary analysis of the “Succinylcholine versus Rocuronium for out-of-hospital emergency int ubation” (CURASMUR) trial, which compared the first attempt intubation success rate between succinylcholine and rocuronium in adult patients requiring emergency tracheal intubation for any...
Source: Internal and Emergency Medicine - January 17, 2022 Category: Emergency Medicine Source Type: research

Impact of COVID-19 in emergency medicine literature: a bibliometric analysis
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - January 17, 2022 Category: Emergency Medicine Source Type: research

Diver bubble self-monitoring with audio Doppler echography: a way to know own response to dive
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - January 15, 2022 Category: Emergency Medicine Source Type: research

Vitamin B12 levels in patients with retinal vein occlusion and their relation with clinical outcome: a retrospective study
AbstractRetinal vein occlusion (RVO) is the second most common retinal vascular disorder, after diabetic retinopathy. Most patients suffering RVO develop some degree of visual loss consequent to retinal complications such as edema and microhemorrhages. Even if some risk factors for RVO have been identified, the clinical outcome of RVO remains highly unpredictable because studies investigating potential prognostic markers for visual improvement are lacking. Cyanocobalamin belongs to the group of B vitamins and plays a role in homocysteine metabolism; however, cyanocobalamin deficiency associates with an increase of some tox...
Source: Internal and Emergency Medicine - January 14, 2022 Category: Emergency Medicine Source Type: research

Prevalence and duration of symptoms among moderate and severe COVID-19 patients 12  months after discharge
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - January 13, 2022 Category: Emergency Medicine Source Type: research

Secondary prophylaxis of venous thromboembolism with direct oral anticoagulants: comparison between patients with major congenital thrombophilia versus non-thrombophilic patients
AbstractDirect oral anticoagulants (DOACs) are widely used for the treatment and secondary prophylaxis of venous thromboembolism (VTE). Congenital thrombophilia is a condition that predisposes to a higher incidence of VTE and often requires long-term anticoagulation for secondary prophylaxis. It is less clear the efficacy of DOACs in patients with major thrombophilia. The aim of our study was to evaluate the efficacy and safety of full and reduced DOACs dose for VTE secondary prophylaxis, in patients affected by major congenital thrombophilia compared to a control group of patients with idiopathic recurrent VTE without thr...
Source: Internal and Emergency Medicine - January 11, 2022 Category: Emergency Medicine Source Type: research

Patients with end-stage renal disease requiring hemodialysis benefit from percutaneous coronary intervention after non-ST-segment elevation myocardial infarction
AbstractPercutaneous coronary intervention (PCI) treatment significantly improves outcomes after acute myocardial infarction (AMI). It remains unclear whether the benefits of PCI exist in patients with end-stage renal disease (ESRD) and non-ST-segment elevation myocardial infarction (NSTEMI). The present study was designed to investigate the effects of PCI on the short- and long-term prognosis of patients with ESRD and NSTEMI. We conducted a retrospective study from 1 January 2015 to 1 January 2020, which includes 148 consecutive patients with ESRD and NSTEMI. All patients were estimated glomerular filtration rate (eGFR)  
Source: Internal and Emergency Medicine - January 11, 2022 Category: Emergency Medicine Source Type: research

“Smoke on the water”: a challenging case of pneumonia
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - January 10, 2022 Category: Emergency Medicine Source Type: research

Response to BNT162b2 mRNA COVID-19 vaccine among healthcare workers in Italy: a 3-month follow-up: comment
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - January 10, 2022 Category: Emergency Medicine Source Type: research

Response to BNT162b2 mRNA COVID-19 vaccine among healthcare workers in Italy: a 3-month follow-up —Reply
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - January 10, 2022 Category: Emergency Medicine Source Type: research

Sixteen years with Internal and Emergency Medicine: farewell of the Editor-in-Chief
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - January 10, 2022 Category: Emergency Medicine Source Type: research

Vitamin D deficiency is associated with higher risks for SARS-CoV-2 infection and COVID-19 severity: a retrospective case –control study
AbstractRobust evidence of whether vitamin D deficiency is associated with COVID-19 infection and its severity is still lacking. The aim of the study was to evaluate the association between vitamin D levels and the risks of SARS-CoV-2 infection and severe disease in those infected. A retrospective study was carried out among members of Clalit Health Services (CHS), the largest healthcare organization in Israel, between March 1 and October 31, 2020. We created two matched case –control groups of individuals for which vitamin D levels and body mass index (BMI) were available before the pandemic: group (A), in which 41,...
Source: Internal and Emergency Medicine - January 9, 2022 Category: Emergency Medicine Source Type: research

Clinical reasoning in dire times. Analysis of cognitive biases in clinical cases during the COVID-19 pandemic
AbstractCognitive biases are systematic cognitive distortions, which can affect clinical reasoning. The aim of this study was to unravel the most common cognitive biases encountered in in the peculiar context of the COVID-19 pandemic. Case study research design. Primary care. Single centre (Division of General Internal Medicine, University Hospitals of Geneva, Geneva, Switzerland). A short survey was sent to all primary care providers (N = 169) taking care of hospitalised adult patients with COVID-19. Participants were asked to describe cases in which they felt that their clinical reasoning was “disrupt...
Source: Internal and Emergency Medicine - January 8, 2022 Category: Emergency Medicine Source Type: research

Aging underlies heterogeneity between comorbidity and multimorbidity frameworks
AbstractStudies exploring differences between comorbidity (i.e., the co-existence of additional diseases with reference to an index condition) and multimorbidity (i.e., the presence of multiple diseases in which no one holds priority) are lacking. In this single-center, observational study conducted in an academic, internal medicine ward, we aimed to evaluate the prevalence of patients with two or more multiple chronic conditions (MCC), comorbidity, or multimorbidity, correlating them with other patients ’ characteristics. The three categories were compared to the Cumulative Illness Rating Scale (CIRS) comorbidity in...
Source: Internal and Emergency Medicine - January 7, 2022 Category: Emergency Medicine Source Type: research

Increased plasma PCSK-9 is associated with restenosis in patients undergoing carotid endarterectomy
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - January 7, 2022 Category: Emergency Medicine Source Type: research

Aging underlies heterogeneity between comorbidity and multimorbidity frameworks
AbstractStudies exploring differences between comorbidity (i.e., the co-existence of additional diseases with reference to an index condition) and multimorbidity (i.e., the presence of multiple diseases in which no one holds priority) are lacking. In this single-center, observational study conducted in an academic, internal medicine ward, we aimed to evaluate the prevalence of patients with two or more multiple chronic conditions (MCC), comorbidity, or multimorbidity, correlating them with other patients ’ characteristics. The three categories were compared to the Cumulative Illness Rating Scale (CIRS) comorbidity in...
Source: Internal and Emergency Medicine - January 7, 2022 Category: Emergency Medicine Source Type: research

Increased plasma PCSK-9 is associated with restenosis in patients undergoing carotid endarterectomy
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - January 7, 2022 Category: Emergency Medicine Source Type: research

Length of stay as quality indicator in emergency departments: analysis of determinants in the German Emergency Department Data Registry (AKTIN registry)
This study analyzed the fixed and influenceable determinants of LOS by evaluating data from the German Emergency Department Data Registry (AKTIN registry). We performed a retrospective evaluation of all adult (age  ≥ 18 years) ED patients enrolled in the AKTIN registry for the year 2019. Primary outcome was LOS for the whole cohort; secondary outcomes included LOS stratified by (1) patient-related, (2) organizational-related and (3) structure-related factors. Overall, 304,606 patients from 12 EDs were included. Average LOS for all patients was 3 h 28 min (95% CI 3 h 27 min–3&...
Source: Internal and Emergency Medicine - January 6, 2022 Category: Emergency Medicine Source Type: research

Contemporary clinical management of acute pulmonary embolism: the COPE study
ConclusionsCOPE will provide contemporary data on in-hospital and 30-day mortality of patients with documented PE as well as information on guidelines adherence and its impact on clinical outcomes.Trail registrationNCT number: NCT03631810. (Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - January 4, 2022 Category: Emergency Medicine Source Type: research

Low in-hospital mortality rate in patients with COVID-19 receiving thromboprophylaxis: data from the multicentre observational START-COVID Register
AbstractCOVID-19 infection causes respiratory pathology with severe interstitial pneumonia and extra-pulmonary complications; in particular, it may predispose to thromboembolic disease. The current guidelines recommend the use of thromboprophylaxis in patients with COVID-19, however, the optimal heparin dosage treatment is not well-established.  We conducted a multicentre, Italian, retrospective, observational study on COVID-19 patients admitted to ordinary wards, to describe clinical characteristic of patients at admission, bleeding and thrombotic events occurring during hospital stay. The strategies used for thrombo...
Source: Internal and Emergency Medicine - January 1, 2022 Category: Emergency Medicine Source Type: research

Correction to: Management of patients with cervical spine trauma in the emergency department: a systematic critical appraisal of guidelines with a view to developing standardized strategies for clinical practice
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - December 20, 2021 Category: Emergency Medicine Source Type: research

Rhythm- or rate-control strategies according to 4S-AF characterization scheme and long-term outcomes in atrial fibrillation patients: the FAMo (Fibrillazione Atriale in Modena) cohort
AbstractThe 4S-AF scheme [Stroke risk, Symptom severity, Severity of atrial fibrillation (AF) burden, Substrate severity] was recently proposed to characterize AF patients. In this post hoc analysis we evaluated the agreement between the therapeutic strategy (rate or rhythm control, respectively), as suggested by the 4S-AF scheme, and the actual strategy followed in a patients cohort. Outcomes of interest were as follows: all-cause death, a composite of all-cause death/any thromboembolism/acute coronary syndrome, and a composite of all-cause death, any thrombotic/ischemic event, and major bleeding (net clinical outcome). W...
Source: Internal and Emergency Medicine - December 2, 2021 Category: Emergency Medicine Source Type: research

Various effects of nutritional status on clinical outcomes after intracerebral hemorrhage
AbstractAlthough the assessment of nutrition is essential for stroke patients, detailed associations between nutritional status at admission, subsequent complications, and clinical outcomes in patients with acute intracerebral hemorrhage (ICH) are unclear. We aimed to elucidate these associations using the Controlling Nutritional Status (CONUT) score. Consecutive patients with acute ICH were investigated. Nutritional status was evaluated using the CONUT score, calculated from the serum albumin level, lymphocyte count, and total cholesterol level. Subsequent complications, such as hemorrhage expansion (HE) during the acute ...
Source: Internal and Emergency Medicine - December 1, 2021 Category: Emergency Medicine Source Type: research

Prognostic value of fibrinogen to albumin ratios among critically ill patients with acute kidney injury
This study explores FAR's prognostic significance in critically ill patients with acute kidney injury (AKI). All clinical data were extracted from the Multiparameter Intelligent Monitoring in Intensive Care Database III version 1.4. All patients were divided into four groups based on FAR quartiles. The primary endpoint was in-hospital mortality. A generalized additive model was applied to explore a nonlinear association between FAR and in-hospital mortality. The Cox proportional hazards models were used to determine the association between FAR and in-hospital mortality. A total of 5001 eligible subjects were enrolled. Mult...
Source: Internal and Emergency Medicine - November 30, 2021 Category: Emergency Medicine Source Type: research

Does admission acetylsalicylic acid uptake in hospitalized COVID-19 patients have a protective role? Data from the Spanish SEMI-COVID-19 Registry
AbstractAcetylsalicylic acid (ASA) is widely used in the treatment and prevention of cardiovascular disorders. Our objective is to evaluate its possible protective role, not only in mortality but also in other aspects such as inflammation, symptomatic thrombosis, and intensive care unit (ICU) admission in hospitalized COVID-19 patients. We realized an observational retrospective cohort study of 20,641 patients with COVID-19 pneumonia collected and followed-up from Mar 1st, 2020 to May 1st, 2021, from the nationwide Spanish SEMI-COVID-19 Registry. Propensity score matching (PSM) was performed to determine whether treatment ...
Source: Internal and Emergency Medicine - November 29, 2021 Category: Emergency Medicine Source Type: research

Barriers associated with emergency medical service activation in patients with ST-segment elevation acute coronary syndromes
AbstractMany ST-segment elevation acute coronary syndrome (STEACS) patients fail to activate the Emergency Medical System (EMS), with possible dramatic consequences. Prior studies focusing on barriers to EMS activation included patients with any acute coronary syndrome (ACS) without representation of southern European populations. We aimed to investigate the barriers to EMS call for patients diagnosed for STEACS in Italy. A prospective, single-center, survey administered to all patients treated with primary percutaneous coronary intervention for STEACS in a tertiary hospital in northern Italy from 01/06/2018 to 31/05/2020....
Source: Internal and Emergency Medicine - November 26, 2021 Category: Emergency Medicine Source Type: research

Emergency department length of stay (ED-LOS) as synonymous with critical and clinical risk
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 25, 2021 Category: Emergency Medicine Source Type: research

The dual relationship between polypharmacy and frailty in nursing home residents: polypharmacy as a cause or a consequence?
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 25, 2021 Category: Emergency Medicine Source Type: research

Emergency department length of stay (ED-LOS) as synonymous with critical and clinical risk
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 25, 2021 Category: Emergency Medicine Source Type: research

The dual relationship between polypharmacy and frailty in nursing home residents: polypharmacy as a cause or a consequence?
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 25, 2021 Category: Emergency Medicine Source Type: research

Development and validation of a prediction model for estimating one-month mortality of adult COVID-19 patients presenting at emergency department with suspected pneumonia: a multicenter analysis
AbstractThere are only a few models developed for risk-stratifying COVID-19 patients with suspected pneumonia in the emergency department (ED). We aimed to develop and validate a model, the COVID-19 ED pneumonia mortality index (CoV-ED-PMI), for predicting mortality in this population. We retrospectively included adult COVID-19 patients who visited EDs of five study hospitals in Texas and who were diagnosed with suspected pneumonia between March and November 2020. The primary outcome was 1-month mortality after the index ED visit. In the derivation cohort, multivariable logistic regression was used to develop the CoV-ED-PM...
Source: Internal and Emergency Medicine - November 23, 2021 Category: Emergency Medicine Source Type: research

CT score in COVID-19-related pneumonia, the radiologist, and the internist. Trying to unmask who is “the good”, who is “the bad” and who is “the ugly”
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 23, 2021 Category: Emergency Medicine Source Type: research

Urgent need of novel biomarkers of acute dyspnea
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 23, 2021 Category: Emergency Medicine Source Type: research

Education to increase efficiency in senior emergency medicine residents: too little, too late?
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 23, 2021 Category: Emergency Medicine Source Type: research

Development and validation of a prediction model for estimating one-month mortality of adult COVID-19 patients presenting at emergency department with suspected pneumonia: a multicenter analysis
AbstractThere are only a few models developed for risk-stratifying COVID-19 patients with suspected pneumonia in the emergency department (ED). We aimed to develop and validate a model, the COVID-19 ED pneumonia mortality index (CoV-ED-PMI), for predicting mortality in this population. We retrospectively included adult COVID-19 patients who visited EDs of five study hospitals in Texas and who were diagnosed with suspected pneumonia between March and November 2020. The primary outcome was 1-month mortality after the index ED visit. In the derivation cohort, multivariable logistic regression was used to develop the CoV-ED-PM...
Source: Internal and Emergency Medicine - November 23, 2021 Category: Emergency Medicine Source Type: research

CT score in COVID-19-related pneumonia, the radiologist, and the internist. Trying to unmask who is “the good”, who is “the bad” and who is “the ugly”
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 23, 2021 Category: Emergency Medicine Source Type: research

Urgent need of novel biomarkers of acute dyspnea
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 23, 2021 Category: Emergency Medicine Source Type: research

Education to increase efficiency in senior emergency medicine residents: too little, too late?
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 23, 2021 Category: Emergency Medicine Source Type: research

An educational intervention to reduce unjustified peripheral intravenous infusions in the emergency department
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 20, 2021 Category: Emergency Medicine Source Type: research

Left gastric artery pseudoaneurysm mimicking a giant gastric subepithelial lesion
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 20, 2021 Category: Emergency Medicine Source Type: research