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  1. Article ; Online: What lies beneath a maggot infestation of an ulcerated foot wound?

    Irene Triggia / Erika Poggiali

    Emergency Care Journal (2023)

    2023  

    Abstract: We present here the case of a 55-year-old male patient with a past medical history of HIV infection on appropriate antiretroviral therapy (Bictegravir/Emtricitabine/Tenofovir Alafenamide), previously treated for hepatitis C with sustained viral response, ...

    Abstract We present here the case of a 55-year-old male patient with a past medical history of HIV infection on appropriate antiretroviral therapy (Bictegravir/Emtricitabine/Tenofovir Alafenamide), previously treated for hepatitis C with sustained viral response, who was diagnosed with squamous cell cancer of his right hand 2 years before, and treated with carboplatin and taxol, and surgery (partial amputation) for cancer progression and recurrent infections. He presented to our emergency department for worsening pain (NRS 10/10) of a suppurative and foul-smelling interdigital ulcerated lesion of his left foot, that had been present for 3 months. He reported 100% adherence to his HIV therapy and denied fever or chills. Initial work-up showed 10,690/mm3 leukocytes (8,240/ mm3 neutrophils, 1,560/mm3 lymphocytes), and a C-reactive protein of 2.89 mg/dL (normal value 0-0.5). CD4 count on presentation was 225 cells/µL. The patient was immediately treated with morphine (10 mg iv) and piperacillin/tazobactam (4.5 gr iv). The lesion presented erythematous ulcerated bleeding surface with serous and fetid secretion on which mobile larvae were found inside (as showed in the video). We removed about 20 maggots with blunt pliers, identified as larvae of Musca domestica (housefly).
    Keywords Skin lesions ; neoplastic ulcer ; squamous cell carcinoma ; foot lesions ; myiasis ; Medicine (General) ; R5-920
    Subject code 616
    Language English
    Publishing date 2023-07-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: Necrotic lesions of the hands

    Davide Bastoni / Erika Poggiali

    Emergency Care Journal, Vol 18, Iss

    2022  Volume 1

    Abstract: An 82-year-old man with a history of end-stage renal disease due to glomerulonephritis requiring haemodialysis, hepatitis C-related liver cirrhosis and hypertensive cardiomyopathy presented with painful and necrotic lesions of both his hands. He had no ... ...

    Abstract An 82-year-old man with a history of end-stage renal disease due to glomerulonephritis requiring haemodialysis, hepatitis C-related liver cirrhosis and hypertensive cardiomyopathy presented with painful and necrotic lesions of both his hands. He had no other symptoms. [.]
    Keywords Cryoglobulinemia ; vasculitis ; necrotic skin lesions ; hepatitis C virus ; CryoVas ; Medicine (General) ; R5-920
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  3. Article ; Online: Painful burning lesions on the chest wall of a patient with advanced breast cancer

    Erika Poggiali / Etilda Braho / Raffaella Bertè

    Emergency Care Journal (2023)

    2023  

    Abstract: A 90-year-old woman presented at our emergency department complaining of dyspnea (sO2 88% on room air, respiratory rate 24/min) and severe (NRS 8/10) burning chest pain. Ten years earlier, she had undergone a bilateral radical mastectomy and radio- ... ...

    Abstract A 90-year-old woman presented at our emergency department complaining of dyspnea (sO2 88% on room air, respiratory rate 24/min) and severe (NRS 8/10) burning chest pain. Ten years earlier, she had undergone a bilateral radical mastectomy and radio-chemotherapy for breast cancer. In September 2023, she developed some nodules on her chest skin treated with electrochemotherapy, multiple liver lesions, and a bilateral paraneoplastic pleural effusion.
    Keywords skin lesions ; electrochemotherapy ; palliative care ; pain management ; breast cancer ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-12-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article ; Online: A rapidly progressive painful skin lesion

    Erika Poggiali / Giovanni Santilli / Andrea Vercelli

    Emergency Care Journal, Vol 19, Iss

    2023  Volume 1

    Abstract: A 48-year-old woman presented to our emergency department with fever and a severe painful erythematous and ecchymotic skin lesion on the third finger of the left hand, that rapidly evolved into haemorrhagic bullae with diffuse swelling and edema of all ... ...

    Abstract A 48-year-old woman presented to our emergency department with fever and a severe painful erythematous and ecchymotic skin lesion on the third finger of the left hand, that rapidly evolved into haemorrhagic bullae with diffuse swelling and edema of all her left hand, associated with the onset of lymphangitis in her left arm and crescendo-like pain. She denied trauma or insect bite. Her past medical history was unremarkable, except for chilblains with no sequelae. She did not take any medication. She was not a smoker. Laboratory tests showed neutrophilic leucocytosis (WBC 15,000/mm3; N 14,500/mm3), a slight thrombocytopenia (139,000/mm3), elevated C-reactive protein (12 mg/dL, normal value <0.5), increased procalcitonin (1.3 ng/mL, normal value < 0.5) and transaminases (AST 64 U/L; ALT 70 U/L, normal value 0-31). HIV was excluded.
    Keywords Streptococcus pyogenes ; necrotizing fasciitis ; skin necrosis ; soft tissue infection ; necrotizing cellulites ; streptococcal gangrene ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-03-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  5. Article ; Online: The pain in the Emergency Department

    Erika Poggiali / Fabio De Iaco

    Emergency Care Journal, Vol 17, Iss

    Choosing and treating wisely before and during the COVID-19 era

    2021  Volume 4

    Abstract: Pain is a frequent reason for referral to the Emergency Department (ED). Adequate management of pain is a moral and ethical imperative. If not correctly treated, acute pain can cause physical and psychological complications, and become chronic with ... ...

    Abstract Pain is a frequent reason for referral to the Emergency Department (ED). Adequate management of pain is a moral and ethical imperative. If not correctly treated, acute pain can cause physical and psychological complications, and become chronic with severe consequences such as anxiety, depression, and social isolation. As consequence, emergency clinicians should treat pain as soon as possible, avoiding delays even in case of acute abdominal pain. Pain management is particularly complex in the elderly and emergency clinicians should always consider AGS Beers criteria ® to avoid inappropriate medications, severe side-effects, and drug-drug interactions. Pain is also a common cause of delirium in older patients. The SARS CoV-2 infection not only can cause acute pain, but also exacerbate chronic pain, particularly in the elderly, who are at high risk to be infected. Looking at all this evidence, emergency clinicians should treat pain with different strategies according to their experience and cultural background, making the right choice for each patient. This work is a critical review of the pain management in the ED, with a particular attention on the effects of COVID-19 in the EDs. We conducted a systematic search of the following databases: PubMed, Google Scholar, Science Direct, Medline from 2000 to 2020, using the keywords of “pain”, “emergency”, “COVID19”, “elderly”, “palliative care”, “ketamine”, “dexmedetomidine”, and “post-traumatic stress disorder”. The aim of this review is to help emergency clinicians to correctly manage pain in the ED with a new point of view regarding the pain management in COVID-19 patients.
    Keywords Pain ; pain management ; Emergency Department ; COVID- 19 ; pandemic ; Medicine (General) ; R5-920
    Subject code 170
    Language English
    Publishing date 2021-12-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  6. Article ; Online: Renal artery thrombosis. A case of acute flank pain in a patient with a new onset of renal failure and atrial fibrillation.

    Poggiali, Erika / Ferrari, Maria Giovanna / Botti, Camilla / Michieletti, Emanuele / Vercelli, Andrea

    Acta bio-medica : Atenei Parmensis

    2023  Volume 94, Issue 3, Page(s) e2023140

    Abstract: Renal artery thrombosis is a severe and often misdiagnosed entity, that represents a true medical emergency in which renal infarction can occur. The diagnosis is often a challenge for the emergency physicians since it can mimic other more common diseases, ...

    Abstract Renal artery thrombosis is a severe and often misdiagnosed entity, that represents a true medical emergency in which renal infarction can occur. The diagnosis is often a challenge for the emergency physicians since it can mimic other more common diseases, including renal colic. We report the case of an 82-year-old man who presented to our emergency department for abdominal pain, nausea, and vomiting resulting from right renal artery thrombosis and infarction caused by misdiagnosed atrial fibrillation. Starting from our experience, we recommend to always keep renal thromboembolism in the differential diagnosis in a patient with sudden onset of flank/abdominal pain, high levels of lactate dehydrogenase and/or haematuria since early diagnosis and proper treatment are the keys to rapid recovery.
    MeSH term(s) Male ; Humans ; Aged, 80 and over ; Flank Pain/etiology ; Atrial Fibrillation/complications ; Atrial Fibrillation/diagnosis ; Renal Artery/diagnostic imaging ; Tomography, X-Ray Computed ; Kidney Diseases ; Infarction/complications ; Infarction/diagnosis ; Abdominal Pain/etiology ; Renal Insufficiency/complications ; Thrombosis/complications
    Language English
    Publishing date 2023-06-14
    Publishing country Italy
    Document type Case Reports ; Journal Article
    ZDB-ID 2114240-3
    ISSN 2531-6745 ; 0392-4203
    ISSN (online) 2531-6745
    ISSN 0392-4203
    DOI 10.23750/abm.v94i3.14427
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Anaemia, thrombocytopenia and skin lesions

    Erika Poggiali / Giorgio Orofino / Jacopo Peccatori

    Emergency Care Journal, Vol 18, Iss

    2022  Volume 2

    Abstract: A 73-year-old man affected by hyperuricemia, dyslipidaemia and hypothyroidism presented to the emergency room with a 3-month history of fever, exertional dyspnea, progressive asthenia, and painless not itchy skin lesions. Physical exam showed purplish ... ...

    Abstract A 73-year-old man affected by hyperuricemia, dyslipidaemia and hypothyroidism presented to the emergency room with a 3-month history of fever, exertional dyspnea, progressive asthenia, and painless not itchy skin lesions. Physical exam showed purplish papules and plaques affecting any area of his body, and a slight bilateral oedema of his legs. Laboratory studies revealed a severe macrocytic anaemia (haemoglobin 4.8 g/dL, mean cell volume 119 fL) and thrombocytopenia (34,000/mm3) with hyperferritinemia (1894 ng/mL, normal value <400) and increased serum B12 (1412 pg/mL, normal value 197-771), associated with ESR 71 mm/h (normal value 1-15), CRP 139 mg/L (normal value <6), and procalcitonin 1.05 ng/mL (normal value <0.5).
    Keywords Skin lesions ; paraneoplastic pemphigus ; haematology ; Medicine (General) ; R5-920
    Language English
    Publishing date 2022-06-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  8. Article ; Online: Acute chest pain and dyspnoea as clinical presentation of primary membranous nephropathy. A case report and literature review.

    Poggiali, Erika / Borio, Giorgia / Magnacavallo, Andrea / Vercelli, Andrea / Cervellin, Gianfranco

    Acta bio-medica : Atenei Parmensis

    2022  Volume 93, Issue 5, Page(s) e2022216

    Abstract: Membranous nephropathy (MN) is the commonest cause of nephrotic syndrome (NS) in adult male patients worldwide. Most of the cases (80%) are idiopathic (primary MN, PMN), whereas about 20% are associated with autoimmune diseases, malignancies or exposures ...

    Abstract Membranous nephropathy (MN) is the commonest cause of nephrotic syndrome (NS) in adult male patients worldwide. Most of the cases (80%) are idiopathic (primary MN, PMN), whereas about 20% are associated with autoimmune diseases, malignancies or exposures (secondary MN). PMN is a kidney-specific autoimmune glomerular disease mediated by antibodies to the M-type phospholipase A2 receptor (anti-PLA2R) (85%), thrombospondin type 1 domain containing 7A (THSD7A) (3-5%), or by other still unidentified mechanisms (10%). Most of the patients with PMN present with NS (80%). Clinical course of PMN is characterised by spontaneous remissions (40%) and relapses (15-30%). One third develop end-stage renal disease (ESRD) within 5 to 15 years from the onset. Anti-PLA2R/THSD7A antibodies levels correlate with proteinuria, clinical course, and outcomes. The treatment still remains matter of debate. Hypertension, proteinuria, and hyperlipidaemia must be treated in all patients. Immunosuppressive therapy is indicated in patients with elevated anti-PLA2R/THSD7A levels and proteinuria >3.5 g/d at diagnosis. With proper management, only 10% or less will develop ESRD over the subsequent 10 years. Here we report a case of a 34-year-old male patient with a ten-year history of asymptomatic PMN, treated with ACE-inhibitors, who presented to our emergency room for acute chest pain and exertional dyspnoea due to ESRD that required urgent dialysis. (www.actabiomedica.it).
    MeSH term(s) Adult ; Humans ; Male ; Receptors, Phospholipase A2 ; Glomerulonephritis, Membranous/complications ; Glomerulonephritis, Membranous/diagnosis ; Thrombospondins ; Autoantibodies ; Neoplasm Recurrence, Local ; Proteinuria ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Chest Pain/etiology ; Dyspnea/etiology
    Chemical Substances Receptors, Phospholipase A2 ; Thrombospondins ; Autoantibodies
    Language English
    Publishing date 2022-10-26
    Publishing country Italy
    Document type Review ; Case Reports ; Journal Article
    ZDB-ID 2114240-3
    ISSN 2531-6745 ; 0392-4203
    ISSN (online) 2531-6745
    ISSN 0392-4203
    DOI 10.23750/abm.v93i5.12782
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.B 925: Show issues Location:
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  9. Article ; Online: The Emergency Rooms and Emergency Medicine should not be the answer to the weakness of the Italian National Health System

    Erika Poggiali / Greta Barbieri / Veronica Salvatore / Francesco Salinaro

    Emergency Care Journal, Vol 17, Iss

    2021  Volume 4

    Abstract: Dear Editors, The COVID-19 pandemic has highlighted several and wellknown limits of the Italian national health system, including the weakness of the territorial medical services and the absence of dedicated structures for patients affected by chronic or ...

    Abstract Dear Editors, The COVID-19 pandemic has highlighted several and wellknown limits of the Italian national health system, including the weakness of the territorial medical services and the absence of dedicated structures for patients affected by chronic or end-stage diseases in need of long hospitalization, or with social difficulties. [.]
    Keywords Emergency room ; emergency medicine ; national health system ; health crisis ; COVID-19 ; Medicine (General) ; R5-920
    Language English
    Publishing date 2021-12-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Communicating science in the time of Coronavirus

    Greta Barbieri / Erika Poggiali / Veronica Salvatore / Francesco Salinaro

    Emergency Care Journal, Vol 17, Iss

    What we have learned

    2021  Volume 3

    Abstract: One of the greatest and most famous Greek philosophers, Socrates, believed that “here is only one good, knowledge, and one evil: ignorance”, but nowadays we can tentatively add that knowledge without sharing is like sterile ground. Today, social media ... ...

    Abstract One of the greatest and most famous Greek philosophers, Socrates, believed that “here is only one good, knowledge, and one evil: ignorance”, but nowadays we can tentatively add that knowledge without sharing is like sterile ground. Today, social media play a central role not only in connecting people worldwide, but overall to access news and information, and for decision making. [.]
    Keywords COVID-19 ; communication ; editorial ; Medicine (General) ; R5-920
    Language English
    Publishing date 2021-09-01T00:00:00Z
    Publisher PAGEPress Publications
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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