Internal and emergency medicine
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Behçet's syndrome (BS) is a multisystemic disorder displaying a marked variability across different geographic areas. The main aim of this study was to analyze demographic and clinical features of a cohort of BS patients diagnosed in three tertiary referral centers in Italy and detect potential associations between the different manifestations. Medical records of 396 patients (218 females, 178 males) were retrospectively analyzed. ⋯ Other negative associations were detected between uveitis and gastrointestinal involvement (p = 0.008), pseudofolliculitis and CNS signs (p = 0.031), vascular involvement (p = 0.002) and erythema nodosum (p = 0.013). Logistic regression identified male gender and genital ulcers, respectively, with a higher (OR 2.199 [1.397-3.461], p < 0.001) and lower risk (OR 0.157 [0.090-0.273], p < 0.0001) of developing major organ involvement. Our evaluations found that the disease had started mostly in the second and third decade with most severe features in the male gender, and that patients presenting with mucocutaneous manifestations were less prone to develop major organ involvement.
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Elderly patients are often excluded from a chest pain unit (CPU)-based evaluation of chest pain due to concern about adverse events and poorer outcomes. The aim of this study was to assess the feasibility and safety of thoroughly evaluating elderly patients ≥ 65 years of age presented with acute chest pain via a CPU. We evaluated 1220 consecutive patients admitted to our CPU, and stratified them according to age: those over and those under 65 years. ⋯ Of those discharged, the primary endpoint at 60 days was observed in 11 (1.5%) and 7 (3.9%) patients in those under and over 65 years, respectively, (p = 0.13). No mortalities were recorded. Comprehensive evaluation via a CPU of patients who are ≥ 65 years of age is feasible and safe with in-hospital and short-term outcomes compared to their younger counterparts.
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Length of stay (LOS) and discharge destination predictions are key parts of the discharge planning process for general medical hospital inpatients. It is possible that machine learning, using natural language processing, may be able to assist with accurate LOS and discharge destination prediction for this patient group. Emergency department triage and doctor notes were retrospectively collected on consecutive general medical and acute medical unit admissions to a single tertiary hospital from a 2-month period in 2019. ⋯ For the prediction of home as a discharge destination (vs any non-home alternative), all models performed similarly with an accuracy of approximately 0.74. This study supports the feasibility of using natural language processing to predict general medical inpatient LOS and discharge destination. Further research is indicated with larger, more detailed, datasets from multiple centres to optimise and examine the accuracy that may be achieved with such predictions.
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Emergency departments (EDs) are high-risk places for Workplace Violence (WPV). In Italy, this phenomenon is scarcely investigated. The aim of this study is to evaluate the incidence, experiencing and perception of WPV in the general ED (GED), paediatric ED (PED) and obstetric-gynaecological ED (OGED) of the teaching hospital Azienda Ospedaliera in Padua (AOP). ⋯ Professionals think there are structural characteristics and risk factors that could be corrected. They do not know how to manage assaults and would deem it useful training meetings with experts. Our results regarding how staff perceive and experience violence in the ED concern a local situation, that nevertheless reflect current evidence about the topic of WPV which plagues EDs across the globe.