Background: Non-traumatic Acute Chest pain (NTACP) is a common presentation in the emergency services of many hospitals and a key presenting symptom of acute coronary syndrome (ACS). However, there is a dearth of data on the system of care of ACS patients in our facilities.
Objective: Our objective was to evaluate the process of care of patients presenting with NTACP at a Tertiary Hospital emergency department (ED) in sub-Saharan Africa, using quality indicators of a universal chain of survival to identify any care gaps in the diagnosis and management of those with life-threatening ACS.
Methods: This was a retrospective cross-sectional study of adult patients ≥18 years of age, seen between July 2020 and June 2023 at the ED of the University College Hospital (UCH), Ibadan, Nigeria. We used this information to determine the frequency of ACS amongst those presenting with NTACP. From this subset, we assessed the main domains of quality indicators of the universal chain of survival in ACS care. These were, early symptom recognition and call for help; emergency medical service (EMS) evaluation and treatment; ED evaluation and treatment; and reperfusion therapy.
Results: We assessed a total of 4,306 patients who presented to the ED during the study period. Of these, 225 patients presented with NTACP. The mean ± SD age of these patients was 45.9 ± 18.4 years, with most between the ages of 40-49 years (20.9%) and males (50.7%). More than 80% of the patients presented to ED 12 hours after the onset of chest pain. Only 4.0% presented via an ambulance service which offered no prehospital guideline-directed medical treatment, and 70.7% were non-referred patients. Only 37.3%, 57.8%, 12.4%, and 8.9% had ECG, chest x-ray, echocardiography, and cardiac enzyme evaluation, respectively, in the acute phase of care. There were 29 (12.9%) patients who had a diagnosis of ACS. Two (6.9%) had medical revascularization with thrombolytic agents, while 8 (27.6%) and 19 (65.5%) were referred for primary and secondary PCI respectively.
Conclusion: We found a high burden of late presentation and significant barriers to recommended guideline management of ACS patients, presenting with clinical features of NTACP in our hospital's ED.
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Palliat Support Care
January 2025
Department of Obstetrics and Gynecology, Inova Fairfax Hospital, Falls Church, VA, USA.
Objectives: To incorporate a longitudinal palliative care curriculum into obstetrics and gynecology (Ob-Gyn) residency that could become standardized to ensure competencies in providing end of life (EOL) care.
Methods: This was a prospective cohort study conducted among 23 Ob-Gyn residents at a tertiary training hospital from 2021 to 2022. A curriculum intervention was provided via lecture and simulation.
J Burn Care Res
January 2025
Department of Rehabilitation Medicine, Hangang Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.
Septic arthritis (SA) are rare in patients with burns, but delayed treatment can result in irreversible joint destruction. Early diagnosis and immediate treatment are necessary to prevent joint destruction. Robot training in patients with musculoskeletal diseases and burns, can improve joint range of motion (ROM), muscle strength, and lower extremity function.
View Article and Find Full Text PDFJ Clin Res Pediatr Endocrinol
January 2025
Department of Pediatric Endocrinology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiye.
Prolactinomas are the most common hormone-secreting pituitary adenomas in adolescents. Dopamine agonists (DA) are used as first-line medical treatment. DAs are associated with an array of physical side effects; however, impulse control disorders (ICDs), such as pathological gambling (PG), have also been reported in adults.
View Article and Find Full Text PDFEmerg Microbes Infect
January 2025
Key Laboratory of Jiangxi Province for Transfusion Medicine, Department of Blood Transfusion, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi 330006, China.
The tRNA-derived small RNAs (tsRNAs) are a new class of non coding RNAs, which are stable in body fluids and can be used as potential biomarkers for disease diagnosis. However, the exact value of tsRNAs in the diagnosis of tuberculosis (TB) is still unclear. The objective of the present study was to evaluate the performance of the serum tsRNAs biosignature to distinguish between active TB, healthy controls, latent TB infection, and other respiratory diseases.
View Article and Find Full Text PDFCirc Cardiovasc Interv
January 2025
Division of Cardiology, Department of Medicine, University of Washington Medical Center, Seattle (E.J.S., T. Salahuddin, J.A.D.).
Background: Intravascular imaging (IVI) is widely recognized to improve outcomes after percutaneous coronary intervention (PCI). However, IVI is underutilized and is not yet established as a performance measure for quality PCI.
Methods: We examined temporal trends of IVI use for all PCIs performed at Veterans Affairs hospitals in the United States from 2010 to 2022 using retrospective observational cohorts.
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