Acute Medicine最新文献_第2页

Frontal lobe epilepsy- why it matters in the emergency department. 额叶癫痫-为什么在急诊科很重要

Acute Medicine Pub Date : 2025-01-01 DOI: 10.52964/AMJA.1012

Anoopkumar Kunnumma, Heather Angus-Leppan

引用次数: 0

Procalcitonin use in Acute Medicine in the United Kingdom: a survey of practice, barriers and facilitators. 降钙素原在英国急性医学中的使用：一项实践、障碍和促进因素的调查。

Acute Medicine Pub Date : 2025-01-01 DOI: 10.52964/AMJA.1019

Nick Smallwood, Luke S P Moore, Matthew D Jones, Nick Murch, Neil Powell

{"title":"Procalcitonin use in Acute Medicine in the United Kingdom: a survey of practice, barriers and facilitators.","authors":"Nick Smallwood, Luke S P Moore, Matthew D Jones, Nick Murch, Neil Powell","doi":"10.52964/AMJA.1019","DOIUrl":"10.52964/AMJA.1019","url":null,"abstract":"Introduction: Use of procalcitonin (PCT) across Acute Medical Units (AMUs) in the United Kingdom (UK) post-COVID-19 is not well understood. We aim to explore clinician knowledge and behaviours relating to PCT-guided antimicrobial decision making for patients managed in NHS AMUs across the UK.Methods: A web-based survey was sent via email to members of the Society for Acute Medicine Results: There were 342 individual responses from 133 organisations, of which half (52.6%) had access to PCT. Self-reported knowledge of PCT was rated adequate or good for most respondents (84.3%), despite the majority of respondents reporting non-availability or unawareness of local PCT guidance (66.2% organisations). The greatest influences of PCT use were previous experience, personal review of evidence, and local culture. A majority of respondents (115/211;54.5%) felt PCT often (≥40% of the time) had a role in guiding antimicrobial decision making in the AMU.Conclusions: There is widespread variation in practice, driven in part by inconsistency around local guidelines and a lack of national guidance to inform the use of this biomarker. We recommend the development of national, evidence-based guidance around the use of PCT to ensure consistency of approach and high-quality care for patients with suspected infection.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"24 3","pages":"139-146"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Trends in the diagnosis and management of infective meningitis at a tertiary centre over 10 years: a retrospective cohort study providing further evidence for culture-independent diagnostics. 10年来三级医疗中心感染性脑膜炎的诊断和管理趋势：一项回顾性队列研究为非培养性诊断提供了进一步证据。

Acute Medicine Pub Date : 2025-01-01 DOI: 10.52964/AMJA.1010

Simon C Williams, Oliver Topping, Georgios Tsermoulas, James Scriven, Ghaniah Hassan-Smith

{"title":"Trends in the diagnosis and management of infective meningitis at a tertiary centre over 10 years: a retrospective cohort study providing further evidence for culture-independent diagnostics.","authors":"Simon C Williams, Oliver Topping, Georgios Tsermoulas, James Scriven, Ghaniah Hassan-Smith","doi":"10.52964/AMJA.1010","DOIUrl":"10.52964/AMJA.1010","url":null,"abstract":"Objective: This retrospective study analysed clinical characteristics, diagnosis, and management of infective meningitis in the UK, aiming to identify emerging trends and pitfalls in the patient pathway.Methods: A ten-year review of meningitis patients at a UK tertiary centre was conducted. Inclusion criteria encompassed signs/symptoms of meningitis with CSF WCC ≥4 cells/mm3 or causative pathogen identification.Results: The study included 298 cases (184 viral, 87 bacterial, 22 tuberculosis, 5 fungal). Key findings indicated underutilisation of culture-independent investigations, delayed administration of antibiotics, and lumbar puncture. Viral meningitis cases with a positively identified causative virus had shorter hospital stays.Conclusion: Culture-independent investigations are under-utilised in meningitis diagnosis. Patients experience delays in essential interventions. Future advancements in rapid, point-of-care genomic sequencing could enhance diagnostic accuracy and speed.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"24 2","pages":"75-85"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Editorial - The evolving research landscape in the United Kingdom. 社论-英国不断发展的研究前景。

Acute Medicine Pub Date : 2025-01-01 DOI: 10.52964/AMJA.1007

Ascanio Tridente

{"title":"Editorial - The evolving research landscape in the United Kingdom.","authors":"Ascanio Tridente","doi":"10.52964/AMJA.1007","DOIUrl":"10.52964/AMJA.1007","url":null,"abstract":"Over the current and subsequent few financial years, a set of significant changes will be implemented affecting the research landscape in the United Kingdom. On the 22nd of September 2025 NHS England released the paper \"Increasing research activity in the NHS\". This paper highlights the clear ambitions of decreasing trial set up times, from the current 250 to under 150 days, while doubling commercial interventional trial participants by 2026 and again by 2029 in the UK. The paper also reveals the UK's aspiration to become a more attractive Country for international research and commercial investments from the biotechnology industry sector. The plan builds on the Government's \"Life Science Sector Plan\", published in July 2025, which followed \"Fit for the Future: 10 Year Health Plan for England\". The government has consistently highlighted a commitment for the NHS to support the life sciences industry in the UK. Importantly, research performance will be monitored at both aggregate and individual site level. Furthermore, each NHS organisation's research budget will be allocated based on historical performance, number of studies and recruitment activity (with weighting based on the type of study), and new performance, including study set up times, efficiency of delivery and commercial research activity expansion.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"24 2","pages":"62-63"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147311086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Practice Review: Red cell transfusion in urgent and emergency care. 实践回顾：红细胞输血在急症和急诊护理中的应用。

Acute Medicine Pub Date : 2025-01-01 DOI: 10.52964/AMJA.1003

Samantha C Bonney, Patrick A Nee, Ascanio Tridente

引用次数: 0

Use of PERC/Wells in Combination with Other Clinical Prediction Rules to Reduce CTPA Demand in Same Day Emergency Care: A Retrospective Cohort Study. 使用PERC/井结合其他临床预测规则减少CTPA需求在当天急诊护理：回顾性队列研究

Acute Medicine Pub Date : 2025-01-01 DOI: 10.52964/AMJA.1021

Alexander Russell, Mohamed Salama, Raumesha Biladiwala, Weipu Gao, Pratheek Maligaiah, Alaa Osman, Omar Shaaban, Jasandra Sutanto, Suhani Talwar, Stephen C Bourke, Anna Mushi

{"title":"Use of PERC/Wells in Combination with Other Clinical Prediction Rules to Reduce CTPA Demand in Same Day Emergency Care: A Retrospective Cohort Study.","authors":"Alexander Russell, Mohamed Salama, Raumesha Biladiwala, Weipu Gao, Pratheek Maligaiah, Alaa Osman, Omar Shaaban, Jasandra Sutanto, Suhani Talwar, Stephen C Bourke, Anna Mushi","doi":"10.52964/AMJA.1021","DOIUrl":"https://doi.org/10.52964/AMJA.1021","url":null,"abstract":"Pulmonary embolism (PE) is a common and potentially life-threatening condition encountered in acute medicine. Clinical prediction rules (CPRs), including PERC, Wells, Revised Geneva, YEARS and LEGEND, have been developed to support rational use of computed tomography pulmonary angiography (CTPA). This study evaluated whether retrospective co-application of Revised Geneva, YEARS or LEGEND alongside an existing PERC/Wells-based diagnostic pathway could reduce CTPA utilisation in a Same Day Emergency Care (SDEC) population. We conducted a retrospective cohort study of all patients who had CTPA for suspected PE in a UK SDEC unit between January and June 2024. CPRs were applied retrospectively using documented clinical data. The primary outcomes were the potential reduction in CTPA utilisation and the proportion of scans that would have contained PE. Of 433 CTPAs identified, 362 patients met inclusion criteria. The prevalence of PE among those scanned was 16.6%. Retrospective co-application of Revised Geneva, YEARS and LEGEND would have reduced CTPA utilisation by 5.5%, 29.0% and 39.2% respectively. No PEs were identified among scans potentially avoided using Revised Geneva, whereas PE was present in 4.8% and 5.6% of avoided scans using YEARS and LEGEND. Missed events occurred in a clinically stable ambulatory cohort and were not associated with radiological evidence of right ventricular strain; however, the clinical significance of these findings remains uncertain. In this selected SDEC population, layering additional CPRs onto an existing diagnostic pathway may have the potential to reduce CTPA utilisation, although strategies achieving larger reductions were associated with missed diagnoses. These findings should be regarded as hypothesis-generating and require prospective validation before informing changes to clinical practice.","PeriodicalId":39743,"journal":{"name":"Acute Medicine","volume":"24 4","pages":"152-159"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148473296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The experiences of international medical graduates (IMGs) new to the NHS: an interpretive phenomenological analysis. 国际医学毕业生（IMGs）的经验，新的NHS：解释性现象学分析。

Acute Medicine Pub Date : 2025-01-01 DOI: 10.52964/AMJA.1015

Latif Raiyan Rahman, Nicola Cooper

引用次数: 0

Editorial - How Acute Medicine Journal is changing. 社论-急性医学杂志如何改变。

Acute Medicine Pub Date : 2025-01-01 DOI: 10.52964/AMJA.1000

Ascanio Tridente

引用次数: 0

In-hospital mortality of 121,262 emergency patients according to their National Early Warning Score, alertness and eight physiologic categories on admission to hospital. 根据国家预警评分、警觉性和入院时8个生理类别统计的121,262名急诊患者的住院死亡率。

Acute Medicine Pub Date : 2025-01-01 DOI: 10.52964/AMJA.1002

Mark Holland, John Kellett, Gareth Hughes, Darren Green