Emergencias
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Multicenter Study Observational Study
Clinical course in older patients diagnosed with syncope treated in Spanish emergency departments: results from the Emergency Department and Elder Needs-17 study.
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. ⋯ The majority of patients aged 65 years or older are discharged home from EDs, and 30-day adverse events, while infrequent, are difficult to predict. Hospitalization was related to comorbidity and an absence of cognitive decline.
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Practice Guideline
Hepatitis C virus detection in hospital emergency departments.
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. ⋯ Experts from the Spanish Society of Emergency Medicine (SEMES), the Spanish Association for Study of the Liver (AEEH), and the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) met to establish criteria to guide health care professionals' decisions. The experts' review of the literature and discussion in consensus-building meetings resulted in evidence-based recommendations that consider the following aspects: 1) the population to target for HCV screening in the ED, 2) how to inform patients of the process, 3) how to carry out HCV screening, 4) how to order an HCV test, and 5) additional issues such as bundling HCV with other viral tests for comprehensive diagnosis, recording results in medical records, and implementing ways to retain and follow all patients with positive results. This consensus report provides guidelines and tools to facilitate emergency physicians' work and ensure effective detection of HCV infections and subsequent incorporation of patients into the health care system.
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Comparative Study
Comparing answers of artificial intelligence systems and clinical toxicologists to questions about poisoning: Can their answers be distinguished?
To present questions about poisoning to 4 artificial intelligence (AI) systems and 4 clinical toxicologists and determine whether readers can identify the source of the answers. To evaluate and compare text quality and level of knowledge found in the AI and toxicologists' responses. ⋯ Luzia and ChatGPT answers to the toxicology questions were often thought to resemble those of clinical toxicologists. ChatGPT answers were judged to be very well-written and reflect a very high level of knowledge.
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To determine survival to discharge and neurological outcomes on long-term follow-up of pediatric patients attended for out of-hospital cardiac arrest (OHCA). ⋯ In spite of the low incidence of shockable rhythm in pediatric OHCA, survival with a good neurological outcome is comparable to survival in adults. Children who are discharged after OHCA maintained or improved their neurological function over the long term.
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Observational Study
Differences in toxicology reports and hospital emergency care for patients suspected of experiencing drug-facilitated crimes: an analysis according to gender.
To analyze gender-related differences in patient and care characteristics and in toxicology findings in suspected cases of drug facilitated crime (DFC). ⋯ The majority of victims of DFCs were female, and the crimes were mixed, involving involve alcohol, psychopharmaceuticals or street drugs. Female victims were more likely to be under the age of 25 years, be referred to the emergency service by a physician, be attended by a forensic physician for sexual assault, and have an alcoholpositive toxicology report. Women were also less likely to report a robbery or have a toxicology report identifying drugs or an unknown substance.