A5052914974- Cardiovascular Syncope and Autonomic Disorders
- Emergency and Acute Care Studies
- Acute Myocardial Infarction Research
- Psychosomatic Disorders and Their Treatments
- Heart Rate Variability and Autonomic Control
- Sepsis Diagnosis and Treatment
- Cardiac Arrhythmias and Treatments
- Venous Thromboembolism Diagnosis and Management
- Cardiac Imaging and Diagnostics
- Clinical Laboratory Practices and Quality Control
- Takotsubo Cardiomyopathy and Associated Phenomena
- Interpreting and Communication in Healthcare
- Potassium and Related Disorders
- Atrial Fibrillation Management and Outcomes
- Cardiac electrophysiology and arrhythmias
- Renal function and acid-base balance
- Reproductive Health and Contraception
- Maternal and fetal healthcare
- Pregnancy and Medication Impact
- Chronic Lymphocytic Leukemia Research
- Reliability and Agreement in Measurement
- Oral health in cancer treatment
- Hyperglycemia and glycemic control in critically ill and hospitalized patients
- Clinical Reasoning and Diagnostic Skills
- Nosocomial Infections in ICU
Academy of Emergency Medicine and Care
2018-2024
University of Pavia
1991-2022
Azienda Ospedaliera Nazionale SS. Antonio e Biagio e Cesare Arrigo
2011-2020
Azienda Sanitaria Locale Alessandria
1998-2017
Ospedale Sant Antonio
1992-2014
Respons
2006-2008
Ospedale Civile di Giaveno
1993
The optimal emergency department (ED) evaluation of syncope is uncertain. Research reports from multiple countries suggest extensive practice variation, high costs, and questionable benefit associated with current approaches.1–5 Moreover, only a few the recommendations international guidelines deal ED management.6–8 For example, European Society Cardiology guidelines, which are most inclusive do not address management. This could be due to limited evidence on how stratify risk decide...
AimsAlthough an organizational model for syncope management facilities was proposed in the 2004 guidelines of European Society Cardiology (ESC), its implementation clinical practice and effectiveness are largely unknown.
Study objectivesThere is limited evidence to guide the emergency department (ED) evaluation and management of syncope. The First International Workshop on Syncope Risk Stratification in Emergency Department identified key research questions methodological standards essential advancing science ED-based syncope research.MethodsWe recruited a multinational panel experts. A preconference survey priorities, which were refined during after conference through an iterative review...
Procalcitonin (PCT) is a useful biomarker of bacterial infection and its use associated to reduced duration antibiotic therapy in the setting intensive care medicine. To address need practical guidance for PCT various clinical settings, group experts was invited participate at consensus process with aims defining rationale appropriate improving management critically ill patients sepsis.A 14 from anesthesiology critical care, infectious diseases, internal medicine, pulmonology, microbiology,...
The XII Italian National Congress of GIMSI (Italian Multidisciplinary Syncope Group) has taken place in Milan on February 6-7, 2025. This report summarizes a practice teaching from the congress regarding role yoga and physical exercise managing Vasovagal (VVS). VVS is very common clinical condition with an estimated lifetime prevalence 35%1 frequent reason for emergency department visits.2 Although not associated increased rate mortality, there significant deterioration Quality Of Life (QoL)...
In a cohort of 378 emergency department (ED) syncopal patients, we evaluated the arrival mode and efficacy triage evaluation in predicting cardiac syncope, acute underlying diseases, need for admission. Less than half patients (48.4%) arrived ED with medical services (EMS), small minority cases (12.4%), an electrocardiogram (ECG) was performed at triage, even syncope (44% 8%, respectively). Most (67.4%) received white, green, or blue code; priority code associated presence diseases when...
D-dimer testing is currently considered a cornerstone in the diagnostic approach of patients with suspected venous thromboembolism (VTE) across different health-care settings, including emergency department (ED). Nevertheless, inappropriate or incorrect activities developing throughout total process may substantially impair clinical usefulness this test and delay even challenge fast rule out diagnosis VTE. The leading problem represented by poor specificity for diagnosing VTE, wherein...
The purpose of this document is to develop recommendations on the use latest generation cardiac troponins in emergency room settings for diagnosis myocardial infarction patients with suspected acute coronary syndrome (ACS) without persistent ST-segment elevation (NSTE-ACS). main points which have been addressed reaching a consensus are represented by: Suitability and appropriateness terminology. Appropriateness request. Confirmation (rule-in). Exclusion (rule-out).Each point has analyzed by...
Acute portal vein thrombosis (PVT) is un uncommon disease that can be seen in the Emergency Department. In emergency department setting diagnosis difficult because of variety clinical presentation but some patterns should suspected. Regard to appropriate radiological abdominal images, color flow Doppler ultrasonography diagnose fresh thrombus and spiral CT may complementary diagnosis. The differentiation between acute chronic important for therapeutic management prognosis. stable patient...
There is no universally accepted tool for the risk stratification of syncope patients in Emergency Department. The aim this study was to investigate short-term predictive accuracy an artificial neural network (ANN) stratifying patient group.We analysed individual level data from three prospective studies, with a cumulative sample size 1844 subjects. Each dataset reanalysed reduce heterogeneity among studies defining abnormal electrocardiogram (ECG) and serious outcomes according previous...
Abstract Background: The mainstay of patient-oriented laboratory testing in emergency settings entails selecting a number and the type tests according to valid criteria appropriateness. Since pattern urgent requesting is variable across different institutions, we designed joined survey between Academy Emergency Medicine Care (AcEMC) Italian Society Clinical Biochemistry Molecular Biology (SIBioC) for reaching tentative consensus about most informative diagnostic settings. Methods: A survey,...
The Canadian Syncope Risk Score (CSRS) has been proposed for syncope risk stratification in the emergency department (ED). aim of this study is to perform an external multicenter validation CSRS and compare it with clinical judgement.Using patients previously included SyMoNE database, we enrolled subjects older than 18 years who presented reporting at ED. For each patient, estimated recorded physician judgement on patients' adverse events. We performed a 30-day follow-up.From 1 September...
An implantable loop recorder (ILR) is indicated in patients with unexplained syncope after complete conventional work-up. Data from the literature imply that, clinical practice, ILR underused. The aim of study was to verify if there any discrepancy between use ILRs practice and potential indications based on most potentially appropriate guideline indications. We compared prevalence actually implanted Syncope Unit Project (SUP) one using standard given by guidelines. In SUP study, 28 (18%)...
The world is facing a new pandemic that sets the national health systems, their structures and professionals in crisis never experienced before. (...)
Background: COVID-19 is an emerging infectious disease, that heavily challenging health systems worldwide. Admission Arterial Blood Gas (ABG) and Lung Ultrasound (LUS) can be of great help in clinical decision making, especially during the current pandemic consequent overcrowding Emergency Department (ED). The aim study was to demonstrate capability alveolar-to-arterial oxygen difference (AaDO2) predicting need for subsequent support survival patients with infection, presence baseline normal...
Increasing evidence is emerging that the measurement of circulating biomarkers may be clinically useful for diagnosing and monitoring sepsis. Eight members AcEMC (Academy Emergency Medicine Care) eight SIBioC (Italian Society Clinical Biochemistry Laboratory Medicine) were identified by two scientific societies producing a consensus document aimed to define practical recommendations about use sepsis managing antibiotic therapy in emergency department (ED). The cumulative opinions allowed...
Abstract Background Arrhythmia is one of the most worrisome causes syncope. Electrocardiographic ( ECG ) monitoring crucial for management non–low‐risk patients in emergency department ED ). However, its diagnostic accuracy and optimal duration are unknown. We aimed to assess with syncope . Methods This prospective multicenter observational study included adult presenting after Patients without an obvious etiology evaluation who were classified by physicians as being at non–low risk adverse...
The purpose of this document is to develop recommendations on the use latest generation cardiac troponins in emergency room settings for diagnosis myocardial infarction patients with suspected acute coronary syndrome without persistent ST-segment elevation (NSTE-ACS). main points which have been addressed reaching a consensus are: i) suitability and appropriateness terminology; ii) request; iii) confirmation (rule-in); iv) exclusion (rule-out). Each point has analyzed by taking into account...