Utility of Procalcitonin (PCT) and Mid regional pro-Adrenomedullin (MR-proADM) in risk stratification of critically ill febrile patients in Emergency Department (ED). A comparison with APACHE II score.

Background: The aim of our study was to evaluate the prognostic value of MR-proADM and PCT levels in febrile patients in the ED in comparison with a disease severity index score, the APACHE II score. We also evaluated the ability of MR-proADM and PCT to predict hospitalization.

Methods: This was an observational, multicentric study.

Comparison of diagnostic accuracy between three different rules of interpreting high sensitivity troponin T results.

With the introduction of high sensitivity troponin-T (hs-TnT) assay, clinicians face more patients with 'positive' results but without myocardial infarction. Repeated hs-TnT determinations are warranted to improve specificity. The aim of this study was to compare diagnostic accuracy of three different interpretation rules for two hs-TnT results taken 6 h apart.

Prospective evaluation of epidemiological, clinical, and microbiological features of pandemic influenza A (H1N1) virus infection in Italy.

Since several characteristics of pandemic influenza A (H1N1) virus infection remain to be determined, this study aimed to describe clinical features and complications of patients infected with H1N1. Subjects affected by influenza-like illnesses and a control group of asymptomatic patients were enrolled prospectively at an Emergency Department from October 2009 to April 2010. At enrollment, clinical data and nasopharyngeal swabs for virological analyses were obtained.

Prevalence of virulent Helicobacter pylori strains in patients affected by idiopathic dysrhythmias.

Helicobacter pylori virulent strains have been shown to affect cardiovascular diseases through molecular mimicry mechanisms. Silent autoimmune myocarditis has been hypothesized to be the cause of idiopathic dysrhythmias (IA). The aim of this study is to assess the prevalence of virulent H.

Disparities in management of new-onset atrial fibrillation in the emergency department despite adherence to the current guidelines: data from a large metropolitan area.

Atrial Fibrillation management is still a matter for debate. Past research has largely been based on the outpatient setting in which patients are followed during ambulatory visits. Very little data exist on the optimal management of AF in the Emergency Department (ED).

Predictive value of NT-proBNP for cardioversion in a new onset atrial fibrillation.

Objective: To detect the clinical use of N-terminal pro B-type natriuretic peptide (NT-proBNP) values for predicting cardioversion in a new onset atrial fibrillation (AF) in the emergency department.

Methods: NT-proBNP was measured in 200 patients admitted to the emergency department, in the observational unit with primary diagnosis of a new onset AF (<2 weeks). Cohort was divided into rate-control and rhythm-control groups according to the strategy used by the admitting physician.

[Evaluation of gastric emptying and gastrointestinal symptoms in dyspeptic patients before and after hydropinic therapy].

Dispepsy is one of the most diffuse syndromes in general population. The high number of subjects affected from this pathology and the very annoying symptomatology does so as that the pharmaceutical costs of antacids and of prokinetics are very high. Aim of the study is to assess if a hydropinic therapy is able to facilitate digestive processes of the dispeptic patients accelerating gastric emptying.

Utility of routine thyroid-stimulating hormone determination in new-onset atrial fibrillation in the ED.

Introduction: Hyperthyroidism is a relative uncommon but important cause of atrial fibrillation. The aim of this study was to investigate the utility of routine thyroid-stimulating hormone (TSH) determination in the emergency department (ED) in patients presenting to the ED with stable, new-onset atrial fibrillation. We derive a set of clinical criteria in which TSH is likely to be normal and therefore thyroid function evaluation deferrable to a different time from ED visit.

Anti-tissue transglutaminase antibodies from celiac patients are responsible for trophoblast damage via apoptosis in vitro.

Objectives: The association between maternal celiac disease (CD) and both reduced fertility and increased risk of adverse pregnancy-related events has been long documented. However, no evidences are available regarding the pathogenic mechanisms of this link. The aim of this study was to determine whether anti-tissue transglutaminase (anti-tTG) antibodies are involved in the damage of trophoblastic cells in vitro.

Coronary atherosclerotic burden in patients with infection by CagA-positive strains of Helicobacter pylori.

Objectives: Cytotoxic associated gene-A (CagA)-positive strains of Helicobacter pylori emerged as a possible atherosclerotic stimulus. Nevertheless, whether CagA-positivity is associated with more extensive or severe atherosclerotic coronary burden has never been studied.

Methods: Forty consecutive patients with coronary artery disease (CAD) and twenty consecutive patients with normal coronary arteries undergoing coronary angiography were enrolled.

[Helicobacter pylori and atherosclerosis. A review of the literature].

Several studies have investigated potential role of Helicobacter pylori (Hp) in the pathogenesis of atherosclerosis. Postulated mechanisms are various, even though results are still controversial. Here we propose an overview of actual knowledge about this topic, comparing studies in favour with those against the relationship between Hp and atherosclerosis.

The role of H. pylori infection in diabetes.

Helicobacter pylori [H. pylori], one of the most common chronic infections worldwide, is the main etiologic agent of gastritis, peptic ulcer and gastric cancer. Patients with diabetes mellitus are often affected by chronic infections.

Occult traumatic pneumothorax: diagnostic accuracy of lung ultrasonography in the emergency department.

Background: The role of chest ultrasonography (US) in the diagnosis of pneumothorax (PTX) has been established, but how it compares with lung CT scanning in the diagnosis of radiooccult PTX and in the determination of its topographic extension has not yet been completely evaluated.

Objective: To determine the diagnostic accuracy of chest US in the emergency department (ED) in the diagnosis of occult PTX in trauma patients and to define its ability to determine PTX extension.

Design: An 18-month prospective study.

Chest ultrasonography in lung contusion.

Study Objective: Despite the high prevalence of chest trauma and its high morbidity, lung contusion (LC) often remains undiagnosed in the emergency department (ED). The present study investigates the possible clinical applicability of chest ultrasonography for the diagnosis of LC in the ED in comparison to radiography and CT.

Materials And Methods: One hundred twenty-one patients admitted to the ED for blunt chest trauma were investigated using ultrasonography by stage III longitudinal scanning of the anterolateral chest wall to detect LC.

The ultrasonographic deep sulcus sign in traumatic pneumothorax.

A series of 186 patients with blunt chest trauma was studied with transthoracic ultrasonography to diagnose pneumothorax and to evaluate its size and location. The results were compared with bedside chest radiography and spiral CT scan. The prevalence of pneumothorax on CT scan was 56/186 (30.

[Asthma: current therapeutic approach].

Asthma is a chronic reversible respiratory disease characterized by inflammation and bronchial smooth muscle contraction. The therapeutic approach must improve the acute symptoms, avoid disease exacerbations and prevent the pulmonary functional decay.

Cardiopulmonary bypass in man: role of the intestine in a self-limiting inflammatory response with demonstrable bacterial translocation.

Background: Cardiopulmonary bypass provokes a systemic inflammatory reaction that, in 1% to 2% of all cases, leads to multiorgan disfunction. The aim of this study was to evaluate the possible role of the intestine in the pathogenesis and development of this reaction.

Methods: Eleven selected patients scheduled for elective coronary artery bypass graft surgery were enrolled in a open, prospective clinical study.

HCV infection and extrahepatic manifestations.

Hepatitis C virus infection is associated with various extrahepatic manifestations such as mixed cryoglobulinemia, membranoproliferative glomerulonephritis and porphyria cutanea tarda. The link between mixed cryoglobulinemia and hepatitis C virus infection is actually well known. Interferon alpha therapy decreases hepatitis C viremia and improves the clinical signs and biochemical abnormalities of cryoglobulinemia.

Helicobacter pylori, gastrointestinal symptoms, and metabolic control in young type 1 diabetes mellitus patients.

Objective: The role of Helicobacter pylori infection in metabolic control and gastrointestinal symptoms in type 1 diabetes mellitus (DM1) patients has been debated. The aim of this study was to investigate the prevalence of H pylori, of the more cytotoxic Cag-A-positive strains, and the effects of infection on gastrointestinal symptoms and metabolic control in young DM1 patients. Research Design and Methods.

Saccharomyces cerevisiae-associated diarrhea in an immunocompetent patient with ulcerative colitis.

Infectious diarrhea is common in cases of ulcerative colitis (UC), caused by resistance to treatment. In particular, it has been associated with cytomegalovirus or infection has rarely been observed in human beings, but has never been seen in immunocompetent patients. We report a case of intestinal infection presenting as acute diarrhea in a patient with a 10-year history of UC who was never treated with immunosuppressants.

Cross-reactivity of anti-CagA antibodies with vascular wall antigens: possible pathogenic link between Helicobacter pylori infection and atherosclerosis.

Background: Helicobacter pylori-CagA positive strains have been shown to be associated with atherosclerosis. However, the pathogenesis is still undetermined. The aim of this study was to determine whether anti-CagA antibodies cross-react with antigens of normal and atherosclerotic arteries.