Fecal calprotectin levels in patients with non-celiac wheat sensitivity: a proof of concept
AbstractSome data suggest the existence of intestinal inflammation in patients with non-celiac wheat sensitivity (NCWS). We aimed to verify whether fecal calprotectin (FCP), a marker of intestinal inflammation, could be used to confirm this inflammatory status and to test its diagnostic performance in differentiating NCWS from irritable bowel syndrome/functional dyspepsia (IBS/FD). We conducted a multicenter study, comparing NCWS patients, diagnosed by a double-blind placebo-controlled wheat challenge, with IBS/FD subjects. In the retrospective phase, FCP values were analyzed to define the prevalence of its positivity an...
Source: Internal and Emergency Medicine - April 12, 2024 Category: Emergency Medicine Source Type: research
Fish bone perforation of the transverse colon
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - April 12, 2024 Category: Emergency Medicine Source Type: research
Development and validation of a nomogram for assessing comorbidity and frailty in triage: a multicentre observational study
The objective of this study was to create and internally validate a nomogram for identifying different levels of patient frailty during triage. Multicenter, prospective, observational exploratory study conducted in two ED. The study was conducted from April 1 to October 31, 2022. Following the triage assessment, the nurse collected variables related to the patient ’s comorbidities and chronic conditions using a predefined form. The primary outcome was the 90-day mortality rate. A total of 1345 patients were enrolled in this study; 6% died within 90 days. In the multivariate analysis, the Charlson Comorbidity Index, an a...
Source: Internal and Emergency Medicine - April 11, 2024 Category: Emergency Medicine Source Type: research
Endovascular therapy for posterior cerebral artery occlusion: systematic review with meta-analysis
AbstractEndovascular therapy (EVT) is a highly effective stroke treatment, but trials validating this intervention did not include patients with posterior cerebral artery (PCA) occlusion. The aim of this systematic review with meta-analysis was to assess the efficacy and safety of EVT for acute PCA occlusion. PubMed, Scopus, ISI, and CENTRAL were searched for studies assessing EVT in adult patients with PCA occlusion. Outcomes of interest were recanalization, symptomatic intracerebral haemorrhage (sICH), mortality, functional independence, and excellent functional outcome at 90 days. Frequencies and odds ratios (ORs) wer...
Source: Internal and Emergency Medicine - April 11, 2024 Category: Emergency Medicine Source Type: research
Management of acute exacerbations of COPD in the emergency department and its associations with clinical variables
AbstractAcute exacerbation of chronic obstructive pulmonary disease (AECOPD) is a common cause for emergency department (ED) visits. Still, large scale studies that assess the management of AECOPD in the ED are limited. Our aim was to evaluate treatment characteristics of AE-COPD in the ED on a national scale. A prospective study as part of the COPD Israeli survey, conducted between 2017 and 2019, in 13 medical centers. Patients hospitalized with AECOPD were included and interviewed. Clinical data related to their ED and hospital stay were collected. 344 patients were included, 38% females, mean age of 70 ± 11 years...
Source: Internal and Emergency Medicine - April 11, 2024 Category: Emergency Medicine Source Type: research
Contrasting obesity: is something missing here? Comment
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - April 11, 2024 Category: Emergency Medicine Source Type: research
Anaphylaxis: first clinical presentation, subsequent referral practise, and suspected elicitor —an observational study
This study aimed to describe the clinical prehospital presentation of first-time anaphylactic patients. To help target educational initiatives, we sought to identify which groups of medical professionals are most likely to encounter first-time anaphylactic patients and investigated the referral pattern for suspected anaphylactic patients for specialised treatment. A retrospective register-based study from the Region of Southern Denmark. Patients referred to the Allergy Centre, Odense University Hospital, from 2019 to 2021 were included. The medical records were manually reviewed for first contact with the emergency departm...
Source: Internal and Emergency Medicine - April 10, 2024 Category: Emergency Medicine Source Type: research
Racial differences in triage assessment at rural vs urban Maine emergency departments
AbstractData continue to accumulate demonstrating that those belonging to racialized groups face implicit bias in the emergency care delivery system across many indices, including triage assessment. The Emergency Severity Index (ESI) was developed and widely implemented across the US to improve the objectivity of triage assessment and prioritization of care delivery; however, research continues to support the presence of subjective bias in triage assessment. We sought to assess the relationship between perceived race and/or need for translator and assigned ESI score and whether this was impacted by hospital geography. We p...
Source: Internal and Emergency Medicine - April 10, 2024 Category: Emergency Medicine Source Type: research
De-escalation of antithrombotic treatment after acute coronary syndrome, a new paradigm
AbstractAfter an acute coronary syndrome (ACS) it is imperative to balance the bleeding vs. the ischemic risk given the similar prognostic impact of the two events. Since the post-discharge bleeding risk is substantially stable over time whereas the ischemic risk accumulates in the first weeks to months, a strategy of de-escalation of antithrombotic treatment, consisting in the reduction of either the duration (i.e., early interruption of one antiplatelet agent) or the intensity (i.e., switching from the more potent P2Y12-inhibitors prasugrel or ticagrelor to clopidogrel) of dual antiplatelet therapy (DAPT), has been propo...
Source: Internal and Emergency Medicine - April 10, 2024 Category: Emergency Medicine Source Type: research
Anaphylaxis: first clinical presentation, subsequent referral practise, and suspected elicitor —an observational study
This study aimed to describe the clinical prehospital presentation of first-time anaphylactic patients. To help target educational initiatives, we sought to identify which groups of medical professionals are most likely to encounter first-time anaphylactic patients and investigated the referral pattern for suspected anaphylactic patients for specialised treatment. A retrospective register-based study from the Region of Southern Denmark. Patients referred to the Allergy Centre, Odense University Hospital, from 2019 to 2021 were included. The medical records were manually reviewed for first contact with the emergency departm...
Source: Internal and Emergency Medicine - April 10, 2024 Category: Emergency Medicine Source Type: research
Racial differences in triage assessment at rural vs urban Maine emergency departments
AbstractData continue to accumulate demonstrating that those belonging to racialized groups face implicit bias in the emergency care delivery system across many indices, including triage assessment. The Emergency Severity Index (ESI) was developed and widely implemented across the US to improve the objectivity of triage assessment and prioritization of care delivery; however, research continues to support the presence of subjective bias in triage assessment. We sought to assess the relationship between perceived race and/or need for translator and assigned ESI score and whether this was impacted by hospital geography. We p...
Source: Internal and Emergency Medicine - April 10, 2024 Category: Emergency Medicine Source Type: research
De-escalation of antithrombotic treatment after acute coronary syndrome, a new paradigm
AbstractAfter an acute coronary syndrome (ACS) it is imperative to balance the bleeding vs. the ischemic risk given the similar prognostic impact of the two events. Since the post-discharge bleeding risk is substantially stable over time whereas the ischemic risk accumulates in the first weeks to months, a strategy of de-escalation of antithrombotic treatment, consisting in the reduction of either the duration (i.e., early interruption of one antiplatelet agent) or the intensity (i.e., switching from the more potent P2Y12-inhibitors prasugrel or ticagrelor to clopidogrel) of dual antiplatelet therapy (DAPT), has been propo...
Source: Internal and Emergency Medicine - April 10, 2024 Category: Emergency Medicine Source Type: research
A novel scoring system for early prediction of massive transfusion requirement in trauma patients
AbstractEarly resuscitation using blood products is critical for patients with severe hemorrhagic shock. We aimed to develop and validate a new scoring system, hemorrhagic shock transfusion prediction (HSTP) score, to predict the need for massive transfusion (MT) in these patients, compared to the widely used Assessment of Blood Consumption (ABC) score. Trauma patients admitted to Emtiaz Hospital in Iran from 2017 to 2021 were retrospectively included. Patients assigned a code 1 or 2 according to the Emergency severity index (ESI) triage system have been divided into MT and non-MT groups. MT was defined as receiving ≥...
Source: Internal and Emergency Medicine - April 7, 2024 Category: Emergency Medicine Source Type: research
Increased epicardial adipose tissue thickness as a sign of subclinical atherosclerosis in patients with rheumatoid arthritis and ıts relationship with disease activity ındices
AbstractEpicardial adipose tissue is a novel cardiometabolic risk factor and indicator of subclinical atherosclerosis. We aimed to evaluate the epicardial adipose tissue thickness in rheumatoid arthritis (RA) patients and its association with disease activity scores. A total of 81 rheumatoid arthritis patients and 70 age- and sex-matched healthy individuals were recruited for this cross-sectional study. Epicardial adipose tissue thickness (EATT) was measured by transthoracic two-dimensional echocardiography. Tender and swollen joint counts were recorded at the time of inclusion. The laboratory tests included erythrocyte se...
Source: Internal and Emergency Medicine - April 5, 2024 Category: Emergency Medicine Source Type: research
