387 results match your criteria: "Servicio de Urgencias. Hospital Clínico San Carlos[Affiliation]"

This document provides a comprehensive analysis of the use of point-of-care ultrasound in heart failure (HF), offering detailed recommendations on echocardiography, lung ultrasound, and venous ultrasound. These advanced imaging techniques allow for an accurate, detailed, and non-invasive evaluation of heart failure, facilitating rapid and effective clinical decision-making. Echocardiography enables a rapid assessment of cardiac function at the point of care, enhancing traditional physical examination and being essential for the management of heart failure (HF).

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Objective: To describe the characteristics of patients diagnosed with acute heart failure (AHF) in emergency departments (EDs) who develop cardiogenic shock (CS) not associated with ST-segment elevation acute coronary syndrome (STACS).

Methods: Information for patients diagnosed with AHF in 23 Spanish EDs and registered between 2009 and 2019 were included for analysis if the patients developed symptoms consistent with CS. We described baseline clinical characteristics related to cardiac decompensation and CS, as well as 30-day mortality.

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Diagnostic and Prognostic Performance of High-Sensitivity Cardiac Troponin T vs I.

J Am Coll Cardiol

November 2024

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; GREAT Network, Rome, Italy. Electronic address:

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Adherence to periprocedural antithrombotic treatment recommendations and its prognostic impact in patients with high ischemic and hemorrhagic risk.

Rev Esp Cardiol (Engl Ed)

November 2024

Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario Reina Sofía, Instituto Maimónides para la Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain.

Introduction And Objectives: To analyze the clinical impact of the inappropriate use of antithrombotic treatment in patients with high ischemic or hemorrhagic risk during the periprocedural/perisurgical period in Spain.

Methods: Prospective multicenter observational registry of patients receiving antiplatelet and/or anticoagulant therapy who required an intervention. The incidence of 30-day events was compared based on the peri-intervention management of antithrombotic treatment and the patients' risk classification (high vs.

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The prevalence of active hepatitis C virus (HCV) infection is higher in hospital emergency departments (EDs) than in the general population. Numerous patients who seek emergency care are unaware that they have detectable viremia, yet they fall outside established ED protocols for HCV screening. Often they belong to groups with difficult access to health care who use the ED as their point of entry to the system.

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Concordance between risk scales for venous thromboembolism in patients treated in emergency departments.

Emergencias

June 2024

Departamento de Medicina Interna, Clínica Universidad de Navarra, Madrid, España. CIBER Enfermedades Respiratorias (CIBERES), Madrid, España. Interdisciplinar Teragnosis and Radiosomics (INTRA) Research Group, Universidad de Navarra, España.

Objective: To evaluate agreement between risk-assessment models for venous thromboembolism (VTE) in patients hospitalized for medical conditions and to analyze variables associated with the decision to prescribe pharmacological thromboprophylaxis in hospital emergency departments (EDs). Conclusions.

Methods: Prospective observational multicenter cohort study.

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Objective: To study factors associated with hospitalization in an unselected population of patients aged 65 years or older treated for syncope in Spanish hospital emergency departments (EDs). To determine the prevalence of adverse events at 30 days in patients discharged home and the factors associated with such events.

Methods: We included all patients aged 65 years or older who were diagnosed with syncope during a single week in 52 Spanish EDs, recording patient clinical and ED case management data.

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Objective: To analyze gender-related differences in patient and care characteristics and in toxicology findings in suspected cases of drug facilitated crime (DFC).

Methods: Observational cross-sectional study of all patients in suspected DFC cases attended in the emergency department of Hospital Clínico San Carlos and of their blood or urine samples analyzed by the National institute of Toxicology and Forensics in Madrid between March 1, 2015, and March 1, 2023. We analyzed variables from patient records and the toxicology reports according to gender.

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Clinical and Analytical Performance of a Novel Point-of-Care High-Sensitivity Cardiac Troponin I Assay.

J Am Coll Cardiol

August 2024

Cardiovascular Research Institute Basel, and Department of Cardiology, University Hospital Basel, University of Basel, Basel, Switzerland; GREAT Network, Rome, Italy. Electronic address:

Background: Point-of-care (POC) high-sensitivity cardiac troponin assays may further accelerate the diagnosis of myocardial infarction (MI).

Objectives: This study sought to assess the clinical and analytical performance of the novel high-sensitivity cardiac troponin I (hs-cTnI)-SPINCHIP POC test.

Methods: Adult patients presenting with acute chest discomfort to the emergency department were enrolled in an international, diagnostic, multicenter study.

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Objective: Analyse the association between the use of diagnostic tests and the characteristics of older patients 65 years of age or more who consult the emergency department (ED).

Methods: We performed an analysis of the EDEN cohort that includes patients who consulted 52 Spanish EDs. The association of age, sex, and ageing characteristics with the use of diagnostic tests (blood tests, electrocardiogram (ECG), microbiological cultures, X-ray, computed tomography, ultrasound, invasive techniques) was studied.

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Incidence and clinical impact of inappropriate periprocedural and perioperative management of antiplatelet therapy.

Med Clin (Barc)

October 2024

Servicio de Cardiología, Hospital Universitario Reina Sofía, Instituto Maimónides para la Investigación Biomédica de Córdoba (IMIBIC), Universidad de Córdoba, Córdoba, Spain; Servicio de Cardiología, Hospital Clínico Universitario Virgen de la Arrixaca, Universidad de Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB)-Arrixaca, El Palmar, Murcia, Spain.

Background And Aims: There is little evidence on the impact of current recommendations on the use of antiplatelet therapy during the perioperative and periprocedural period in our setting. The aim of this study was to analyze the incidence and clinical impact of inappropriate use of antiplatelet therapy in a population of patients undergoing surgery or a diagnostic or therapeutic procedure in "real life" in Spain.

Methods: A prospective multicenter observational study of patients treated with antiplatelet agents requiring intervention was conducted.

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The elderly population frequently consults the emergency department (ED). This population could have greater use of EDs and hospital health resources. The EDEN cohort of patients aged 65 years or older visiting the ED allowed this association to be investigated.

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[Elder abuse: a challenge for all health professionals].

Semergen

September 2024

Comisión contra la Violencia, Hospital Clínico San Carlos, Madrid, España; Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España. Electronic address:

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Appropriate use of venous thromboembolism prophylaxis in Spanish emergency departments: the PROTESU II study.

Emergencias

June 2024

Departamento Medicina Interna, Clínica Universidad de Navarra, Madrid, España. CIBER de Enfermedades Respiratorias, CIBERES, Madrid, España. Interdisciplinar Teragnosis and Radiosomics (INTRA) Research Group, Universidad de Navarra, España.

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COVID-19 continues to pose a significant threat: mortality stands at nearly twice that of influenza, and the incidence rate is growing as the population's vaccination rate decreases, particularly in Spain and other areas of Europe. Given this situation, it is vitally important know whether medical protocols are consistent and appropriately implemented by health care staff in the interest of preventing possible inefficiency or inequity. Physicians from hospital emergency departments met to study their hospitals' usual clinical practices for managing SARS-CoV-2 infection and to determine their expert opinions on the use of antiviral agents.

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Migraine is a disease with a high prevalence and incidence, in addition to being highly disabling, causing a great impact on the patient's quality of life at a personal, family and work level, but also social, given its high expense due to its direct (care) and indirect (presenteeism and work absenteeism) costs. The multiple and recent developments in its pathophysiological knowledge and in its therapy require updating and, therefore, in this article the Spanish scientific societies most involved in its study and treatment (SEN, SEMFYC and SEMERGEN), together with the Association Spanish Association for Patients with Migraine and other Headaches (AEMICE), we have developed these updated care recommendations. We reviewed the treatment of migraine attacks, which consisted mainly of the use of NSAIDs and triptans, to which ditans and gepants have been added.

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The comfort perception in the critically ill patient from the Kolcaba theoretical model.

Enferm Intensiva (Engl Ed)

November 2024

Unidad de Apoyo a la Investigación en Enfermería, Hospital General Universitario Gregorio Marañon, Madrid, Escuela de Enfermería Cruz Roja, Universidad Autónoma de Madrid, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain. Electronic address:

Background: The stay in a critical care unit (CCU) has a serious impact on physical condition causing numerous discomfort factors such as pain or difficulty in communicating. All of these are associated with possible sequelae following discharge from the Intensive Care Unit (ICU) named post-ICU syndrome. The Kolcaba Comfort Theory allows, from a holistic approach, to identify care needs from the patient's perspective using instruments such as the General Comfort Questionnaire (GCQ).

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Analysis of the reasons for requesting HIV serology in the emergency department other than those defined in the targeted screening strategy of the "Urgències VIHgila" program and its potential inclusion in a future consensus document.

Enferm Infecc Microbiol Clin (Engl Ed)

November 2024

Societat Catalana de Medicina d'Urgències i Emergències (SoCMUE), Acadèmia de Ciències Mèdiques i de la Salut de Catalunya i de Balears, Barcelona, Spain; Servicio de Urgencias, Hospital Parc Taulí, Sabadell, Barcelona, Spain.

Objective: To describe other reasons for requesting HIV serology in emergency departments (ED) other than the 6 defined in the SEMES-GESIDA consensus document (DC-SEMES-GESIDA) and to analyze whether it would be efficient to include any of them in the future.

Methods: Review of all HIV serologies performed during 2 years in 20 Catalan EDs. Serologies requested for reasons not defined by the DC-SEMES-GESIDA were grouped by common conditions, the prevalence (IC95%) of seropositivity for each condition was calculated, and those whose 95% confidence lower limit was >0.

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Objective: To estimate the incidence of acute heart failure (AHF) diagnosis in elderly patients in emergency departments (ED), diagnostic confirmation in hospitalized patients, and short-term adverse events.

Methods: All patients aged ≥65 years attended in 52 Spanish EDs during 1 week were included and those diagnosed with AHF were selected. In hospitalized patients, those diagnosed with AHF at discharge were collected.

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Article Synopsis
  • The study estimates pneumonia incidence in elderly patients in Spanish emergency departments, finding an annual rate of 18.4 cases per 1000 inhabitants.
  • A significant 78% of these patients required hospitalization, with 30-day mortality at 14.2% and in-hospital mortality at 12.9%.
  • Factors like functional dependency and severe comorbidity were closely linked to adverse events, while common biomarkers showed only moderate predictive ability for outcomes.
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Machine Learning for Myocardial Infarction Compared With Guideline-Recommended Diagnostic Pathways.

Circulation

April 2024

Cardiovascular Research Institute Basel (CRIB) and Department of Cardiology (J.B., P.L.-A., L.K., K.W., T.N., R.B., I.S., M.R.G., C.M.), University Hospital Basel, University of Basel, Switzerland.

Article Synopsis
  • CoDE-ACS is a machine learning-based clinical decision support tool designed to assess the likelihood of myocardial infarction (MI) using cardiac troponin measurements at various time points.
  • A study involving 4,105 patients across multiple countries found that CoDE-ACS effectively identified a high percentage of low-probability cases for MI, surpassing the performance of established guidelines such as the European Society of Cardiology pathways.
  • The tool maintained a negative predictive value of 99.7% across different time points, suggesting its accuracy in ruling out MI and its potential to improve diagnostic processes in acute coronary syndrome evaluations.
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Objectives: Blood cultures are ordered in emergency departments for 15% of patients with suspected infection. The diagnostic yield varies from 2% to 20%. Thirty-day mortality in patients with bacteremia is high, doubling or tripling the rate in patients with the same infection but without bacteremia.

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Objectives: To determine the value of the soluble urokinase-type plasminogen activator receptor (suPAR) for predicting outcomes in emergency department (ED) patients. Secondary objectives were 1) to measure the predictive value of the usual decision points, 2) to identify patients at low risk for mortality who could be safely discharged from the ED, and 3) to measure the correlation between suPAR and other biomarkers.

Material And Methods: Prospective observational cohort study of patients attended in the EDs of participating hospitals.

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