Acute non-traumatic headache is a frequent complaint in emergency primary care. In the majority of cases, the cause is a primary headache, which can be invalidating, but should not lead to additional investigations. Secondary headaches are rare but their diagnosis is essential to avoid potentially lethal consequences. In practice, a primary headache may be difficult to differentiate from a secondary headache, especially if the initial management does not follow a systematic approach. We have adapted evidence-based guidelines to improve the diagnostic management of patients presenting acute headache. We propose an algorithm that facilitates the systematic screening of alert signs with a focused patient history and clinical exam. In the presence of red flags, appropriate complementary exams are needed to rule out a secondary headache.
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Background: Age-related macular degeneration (AMD), a condition of multifactorial origin, is a major cause of irreversible vision loss in industrialized countries. The dry late stage of the disease, known as geographic atrophy (GA), is characterized by progressive loss of photoreceptor cells and retinal pigment epithelial cells in the central retina. An estimated 300 000 to 550 000 people in Germany suffer from GA.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Surgery, University of Washington, Seattle.
Importance: Timely access to care is a key metric for health care systems and is particularly important in conditions that acutely worsen with delays in care, including surgical emergencies. However, the association between travel time to emergency care and risk for complex presentation is poorly understood.
Objective: To evaluate the impact of travel time on disease complexity at presentation among people with emergency general surgery conditions and to evaluate whether travel time was associated with clinical outcomes and measures of increased health resource utilization.
JAMA Netw Open
January 2025
Department of Medicine, Harvard Medical School, Boston, Massachusetts.
Importance: Disease characteristics of genetically mediated coronary artery disease (CAD) on coronary angiography and the association of genomic risk with outcomes after coronary angiography are not well understood.
Objective: To assess the angiographic characteristics and risk of post-coronary angiography outcomes of patients with genomic drivers of CAD: familial hypercholesterolemia (FH), high polygenic risk score (PRS), and clonal hematopoiesis of indeterminate potential (CHIP).
Design, Setting, And Participants: A retrospective cohort study of 3518 Mass General Brigham Biobank participants with genomic information who underwent coronary angiography was conducted between July 18, 2000, and August 1, 2023.
Invest Ophthalmol Vis Sci
January 2025
Vitreous Retina Macula Consultants of New York, New York, United States.
Purpose: The purpose of this study was to develop ground-truth histology about contributors to variable fundus autofluorescence (FAF) signal and thus inform patient selection for treating geographic atrophy (GA) in age-related macular degeneration (AMD).
Methods: One woman with bilateral multifocal GA, foveal sparing, and thick choroids underwent 535 to 580 nm excitation FAF in 6 clinic visits (11 to 6 years before death). The left eye was preserved 5 hours after death.
Minerva Anestesiol
December 2024
Pain Management Center, Neurocenter of Southern Switzerland, EOC, Lugano, Switzerland -
Background: Surgical fear is present in many patients awaiting surgery. However, a validated Italian version of the Surgical Fear Questionnaire (SFQ) was not available yet. Therefore, the aim of this study was to translate the SFQ into Italian and to test its reliability and validity.
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