Internal and emergency medicine
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The AABB Choosing Wisely Campaign recommends "don't transfuse for iron deficiency without hemodynamic instability". However, the management of iron deficiency anemia (IDA) in the emergency department (ED) is heterogeneous and patients are often over-transfused. Intravenous iron is effective in correcting anemia and new formulations, including ferric carboxymaltose (FCM), allow the administration of high doses with low immunogenicity. ⋯ Sixteen FCM1 patients were evaluated at 52 ± 28 days (median 42, range 27-122): the average Hb increase was 5.3 ± 1.4 g/dL. In summary, we showed that FCM administration in the ED in hemodynamically stable patients was associated with fewer transfusions and hospital admissions compared to the FCM0 group; moreover, it succeeded in safely, effectively and rapidly increasing Hb levels after discharge from the ED. Further studies are needed to develop recommendations for IDA in the ED and to identify transfusion thresholds for non-hospitalized patients.
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The History, Electrocardiogram, Age, Risk Factors, Troponin (HEART) score is a useful tool in the Emergency Department setting to identify those patients safe for outpatient evaluation of chest pain. Its utility for predicting cardiac interventions is unclear. Our objective was to evaluate the prognostic accuracy of the HEART score to predict the need for cardiac stent or coronary artery bypass grafting (CABG). ⋯ The area under the receiver operator curve reported as c-statistics was 0.877 [95% confidence interval (CI) 0.806-0.949] for the HEART score's ability to predict cardiac stent and 0.921 (95% CI 0.858-0.984) for CABG. There is a strong association between increasing HEART scores and the need for revascularization which may provide emergency physicians justification for expedited cardiology consultation and admission for these patients. These findings require further prospective validation.
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Correction to: Reversal agents for oral anticoagulant-associated major or life-threatening bleeding.
The article Reversal agents for oral anticoagulant-associated major or life-threatening bleeding, written by Marco Moia, Alessandro Squizzato was originally published electronically on the publisher's internet portal (currently SpringerLink) on 24 August 2019 without open access.
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Recent studies have established the role of residual congestion evaluated by lung ultrasound in estimating short-term risk of readmission or death in patients admitted for heart failure (HF) decompensation. However, if lung ultrasounds maintain a prognostic role of in long-term survival is still unknown. Aim of our study was to evaluate if residual congestion could predict all-cause mortality during 4 year follow up in a cohort of unselected patients admitted for acute decompensated HF. ⋯ Our results suggest the role of LUS in the identification of more congested HF patients, that will be at risk for worse long term outcome.
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Correction to: Incidence of hyperkalemia in the emergency department: a 10-year retrospective study.
In the original publication of the article, the 3rd author name was swapped. The correct author name should read as Damien Masson.