QJM : monthly journal of the Association of Physicians
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Randomized Controlled Trial Clinical Trial
Clinical predictors of acute coronary syndromes in patients with undifferentiated chest pain.
Patients with acute, undifferentiated chest pain present a frequent diagnostic challenge to clinicians. Clinical features are often used to determine which patients may have acute coronary syndrome (ACS). ⋯ In addition to previously recognized predictors of ACS, it appears that indigestion or burning type pain predicts ACS in patients attending the emergency department with acute, undifferentiated chest pain. Diagnosis of acute 'gastro-oesophageal' chest pain should be avoided in this setting.
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Cerebral infarction is an important neurological complication of childhood bacterial meningitis, but little is known about its epidemiology and outcomes. ⋯ There was a high prevalence of cerebral infarctions when the disease was caused by S. pneumoniae and Salmonella species. Occurrence was highest in the first year of life, and the prognosis in this patient group is poor. Risk factors associated with cerebral infarction in our patients included age 28-365 days, seizures, hydrocephalus, disturbed consciousness on admission, and high CSF lactate concentrations.