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Article ; Online: Impact of the pandemic on emergency medicine and its future.

Peschanski, Nicolas

European journal of emergency medicine : official journal of the European Society for Emergency Medicine

2022 Volume 29, Issue 2, Page(s) 85

MeSH term(s)	COVID-19/epidemiology ; Emergency Medicine ; Emergency Service, Hospital ; Humans ; Pandemics
Language	English
Publishing date	2022-02-24
Publishing country	England
Document type	Editorial
ZDB-ID	1233544-7
ISSN	1473-5695 ; 0969-9546
ISSN (online)	1473-5695
ISSN	0969-9546
DOI	10.1097/MEJ.0000000000000908
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Article: Anaphylaxie coronaire ou syndrome de Kounis.

Bouillon-Minois, Jean-Baptiste / Saget, François / Peschanski, Nicolas

Revue medicale de Liege

2023 Volume 78, Issue 7-8, Page(s) 399–402

Abstract: Although not well known, Kounis syndrome represents 3.4 % of anaphylactic reactions and has a high level of mortality (7 %). Its main clinical presentation looks like an acute coronary syndrome. We report the case of a 61-year old patient who was ... ...

Title translation	Coronary anaphylaxis or Kounis syndrome.
Abstract	Although not well known, Kounis syndrome represents 3.4 % of anaphylactic reactions and has a high level of mortality (7 %). Its main clinical presentation looks like an acute coronary syndrome. We report the case of a 61-year old patient who was admitted in the emergency department because of a malaise with loss of consciousness due to a Kounis syndrome that occurred after the ingestion of amoxycilline.
MeSH term(s)	Humans ; Middle Aged ; Anaphylaxis/diagnosis ; Anaphylaxis/etiology ; Kounis Syndrome/etiology ; Kounis Syndrome/complications ; Acute Coronary Syndrome/chemically induced ; Acute Coronary Syndrome/diagnosis ; Emergency Service, Hospital ; Hospitalization
Language	French
Publishing date	2023-08-07
Publishing country	Belgium
Document type	Case Reports ; English Abstract
ZDB-ID	414001-1
ISSN	0370-629X ; 0035-3663
ISSN	0370-629X ; 0035-3663
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Article ; Online: Left atrial strain analysis and new-onset atrial fibrillation in patients with ST-segment elevation myocardial infarction: A prospective echocardiography study.

Beyls, Christophe / Hermida, Alexis / Nicolas, Martin / Debrigode, Romain / Vialatte, Alexis / Peschanski, Julia / Bunelle, Camille / Fournier, Alexandre / Jarry, Geneviève / Landemaine, Thomas / Malaquin, Dorothée / Kubala, Maciej / Mahjoub, Yazine / Leborgne, Laurent

Archives of cardiovascular diseases

2024 Volume 117, Issue 4, Page(s) 266–274

Abstract: Background: New-onset atrial fibrillation (NOAF) is a well-known complication of ST-segment elevation myocardial infarction (STEMI), probably due to left atrial (LA) remodelling. LA strain (LAS) can predict NOAF in several cardiovascular diseases.: ... ...

Abstract	Background: New-onset atrial fibrillation (NOAF) is a well-known complication of ST-segment elevation myocardial infarction (STEMI), probably due to left atrial (LA) remodelling. LA strain (LAS) can predict NOAF in several cardiovascular diseases. Objective: To assess whether LAS predicts NOAF in sinus rhythm patients with STEMI during hospitalization. Methods: Adults with a STEMI and transthoracic echocardiography performed within 48hours of admission were included. LAS analysis, performed by automated software, recorded LAS during the reservoir phase (LASr), the conduit phase (LAScd) and the contraction phase (LASct). Results: From May 2021 to November 2022, 175 patients were included, 21 (12%) of whom developed NOAF. NOAF patients were older (median [Q1-Q3]: 67 [59-80] vs 59 [51-67]years; P=0.006) and had a higher Thrombolysis In Myocardial Infarction scores (4 [2-7] vs 3 [1-4]; P=0.005). All LAS parameters were significantly impaired in NOAF patients, especially LASr (13.0% [10.5-28.4] vs 36.6% [29.0-44.9]; P=0.001). An LASr cut-off of 27% had a sensitivity of 81% and a specificity of 80% to identify patients with NOAF. In a multivariable model, LASr was significantly associated with NOAF (odds ratio 1.18, 95% confidence interval 1.09-1.26; P=0.003). The cumulative risk of NOAF during hospital stay was 30% (18-43 with LASr<27% and 4% [1.5-8.5] with LASr≥27% [P<0.0001]). Conclusion: NOAF is a frequent complication of STEMI. LASr seems helpful for identifying patients at high risk of NOAF during hospitalization.
MeSH term(s)	Adult ; Humans ; ST Elevation Myocardial Infarction/diagnostic imaging ; ST Elevation Myocardial Infarction/therapy ; ST Elevation Myocardial Infarction/complications ; Prospective Studies ; Atrial Fibrillation/diagnostic imaging ; Atrial Fibrillation/therapy ; Myocardial Infarction/complications ; Echocardiography
Language	English
Publishing date	2024-02-15
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	2408778-6
ISSN	1875-2128 ; 1875-2136
ISSN (online)	1875-2128
ISSN	1875-2136
DOI	10.1016/j.acvd.2024.01.002
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Article ; Online: Impact of cardiovascular symptoms on short- and long-term prognosis after nonlife-threatening electrical injuries.

Guerin, Anne / Peschanski, Nicolas / Bedossa, Marc / Leurent, Guillaume / Martins, Raphaël P

European journal of emergency medicine : official journal of the European Society for Emergency Medicine

2022 Volume 29, Issue 4, Page(s) 312–314

MeSH term(s)	Electric Injuries/complications ; Electric Injuries/diagnosis ; Humans ; Prognosis
Language	English
Publishing date	2022-06-28
Publishing country	England
Document type	Journal Article
ZDB-ID	1233544-7
ISSN	1473-5695 ; 0969-9546
ISSN (online)	1473-5695
ISSN	0969-9546
DOI	10.1097/MEJ.0000000000000926
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Article: Symptoms of Infarction in Women: Is There a Real Difference Compared to Men? A Systematic Review of the Literature with Meta-Analysis.

Cardeillac, Martin / Lefebvre, François / Baicry, Florent / Le Borgne, Pierrick / Gil-Jardiné, Cédric / Cipolat, Lauriane / Peschanski, Nicolas / Abensur Vuillaume, Laure

Journal of clinical medicine

2022 Volume 11, Issue 5

Abstract: 1) Context: The management of acute coronary syndrome (ACS) is based on a rapid diagnosis. The aim of this study was to focus on the ACS symptoms differences according to gender, in order to contribute to the improvement of knowledge regarding the ... ...

Abstract	(1) Context: The management of acute coronary syndrome (ACS) is based on a rapid diagnosis. The aim of this study was to focus on the ACS symptoms differences according to gender, in order to contribute to the improvement of knowledge regarding the clinical presentation in women. (2) Methods: We searched for relevant literature in two electronic databases, and analyzed the symptom presentation for patients with suspected ACS. Fifteen prospective studies were included, with a total sample size of 10,730. (3) Results: During a suspected ACS, women present more dyspnea, arm pain, nausea and vomiting, fatigue, palpitations and pain at the shoulder than men, with RR (95%CI) of 1.13 [1.10; 1.17], 1.30 [1.05; 1.59], 1,40 [1.26; 1.56], 1.08 [1.01; 1.16], 1.67 [1.49; 1.86], 1.78 [1.02; 3.13], respectively. They are older by (95%CI) 4.15 [2.28; 6.03] years compared to men. The results are consistent in the analysis of the ACS confirmed subgroup. (4) Conclusions: We have shown that there is a gender-based symptomatic difference and a female presentation for ACS. The "typical" or "atypical" semiology of ACS symptoms should no longer be used.
Language	English
Publishing date	2022-02-27
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm11051319
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Article ; Online: Exploratory study: Evaluation of a symptom checker effectiveness for providing a diagnosis and evaluating the situation emergency compared to emergency physicians using simulated and standardized patients.

Abensur Vuillaume, Laure / Turpinier, Julien / Cipolat, Lauriane / Arnaud-Dépil-Duval / Dumontier, Thomas / Peschanski, Nicolas / Kieffer, Yann / Barbat, Boris / Riquier, Thomas / Dinot, Vincent / Galland, Joris

PloS one

2023 Volume 18, Issue 2, Page(s) e0277568

Abstract: Background: The overloading of health care systems is an international problem. In this context, new tools such as symptom checker (SC) are emerging to improve patient orientation and triage. This SC should be rigorously evaluated and we can take a cue ... ...

Abstract	Background: The overloading of health care systems is an international problem. In this context, new tools such as symptom checker (SC) are emerging to improve patient orientation and triage. This SC should be rigorously evaluated and we can take a cue from the way we evaluate medical students, using objective structured clinical examinations (OSCE) with simulated patients. Objective: The main objective of this study was to evaluate the efficiency of a symptom checker versus emergency physicians using OSCEs as an assessment method. Methods: We explored a method to evaluate the ability to set a diagnosis and evaluate the emergency of a situation with simulation. A panel of medical experts wrote 220 simulated patients cases. Each situation was played twice by an actor trained to the role: once for the SC, then for an emergency physician. Like a teleconsultation, only the patient's voice was accessible. We performed a prospective non-inferiority study. If primary analysis had failed to detect non-inferiority, we have planned a superiority analysis. Results: The SC established only 30% of the main diagnosis as the emergency physician found 81% of these. The emergency physician was also superior compared to the SC in the suggestion of secondary diagnosis (92% versus 52%). In the matter of patient triage (vital emergency or not), there is still a medical superiority (96% versus 71%). We prove a non-inferiority of the SC compared to the physician in terms of interviewing time. Conclusions and relevance: We should use simulated patients instead of clinical cases in order to evaluate the effectiveness of SCs.
MeSH term(s)	Humans ; Prospective Studies ; Triage/methods ; Physicians ; Voice ; Remote Consultation
Language	English
Publishing date	2023-02-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0277568
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Point-of-care ultrasonography for risk stratification of non-critical suspected COVID-19 patients on admission (POCUSCO): A prospective binational study.

Morin, François / Douillet, Delphine / Hamel, Jean François / Savary, Dominique / Aubé, Christophe / Tazarourte, Karim / Marouf, Kamélia / Dupriez, Florence / Le Conte, Phillipe / Flament, Thomas / Delomas, Thomas / Taalba, Mehdi / Marjanovic, Nicolas / Couturaud, Francis / Peschanski, Nicolas / Boishardy, Thomas / Riou, Jérémie / Dubée, Vincent / Roy, Pierre-Marie

PloS one

2023 Volume 18, Issue 4, Page(s) e0284748

Abstract: Background: Lung point-of-care ultrasonography (L-POCUS) is highly effective in detecting pulmonary peripheral patterns and may allow early identification of patients who are likely to develop an acute respiratory distress syndrome (ARDS). We ... ...

Abstract	Background: Lung point-of-care ultrasonography (L-POCUS) is highly effective in detecting pulmonary peripheral patterns and may allow early identification of patients who are likely to develop an acute respiratory distress syndrome (ARDS). We hypothesized that L-POCUS performed within the first 48 hours of non-critical patients with suspected COVID-19 would identify those with a high-risk of worsening. Methods: POCUSCO was a prospective, multicenter study. Non-critical adult patients who presented to the emergency department (ED) for suspected or confirmed COVID-19 were included and had L-POCUS performed within 48 hours following ED presentation. The lung damage severity was assessed using a previously developed score reflecting both the extension and the intensity of lung damage. The primary outcome was the rate of patients requiring intubation or who died within 14 days following inclusion. Results: Among 296 patients, 8 (2.7%) met the primary outcome. The area under the curve (AUC) of L-POCUS was 0.80 [95%CI:0.60-0.94]. The score values which achieved a sensibility >95% in defining low-risk patients and a specificity >95% in defining high-risk patients were <1 and ≥16, respectively. The rate of patients with an unfavorable outcome was 0/95 (0%[95%CI:0-3.9]) for low-risk patients (score = 0), 4/184 (2.17%[95%CI:0.8-5.5]) for intermediate-risk patients (score 1-15) and 4/17 (23.5%[95%CI:11.4-42.4]) for high-risk patients (score ≥16). In confirmed COVID-19 patients (n = 58), the AUC of L-POCUS was 0.97 [95%CI:0.92-1.00]. Conclusion: L-POCUS performed within the first 48 hours following ED presentation allows risk-stratification of patients with non-severe COVID-19.
MeSH term(s)	Adult ; Humans ; COVID-19/diagnostic imaging ; Point-of-Care Systems ; Prospective Studies ; Ultrasonography ; Emergency Service, Hospital ; Risk Assessment
Language	English
Publishing date	2023-04-26
Publishing country	United States
Document type	Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0284748
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Article ; Online: Prognostic Value of Right Ventricular Longitudinal Shortening Fraction in Patients With ST-Elevation Myocardial Infarction: A Prospective Echocardiography Study.

Beyls, Christophe / Hermida, Alexis / Martin, Nicolas / Peschanski, Julia / Debrigode, Romain / Vialatte, Alexis / Hanquiez, Thomas / Fournier, Alexandre / Jarry, Geneviève / Landemaine, Thomas / Malaquin, Dorothée / Abou-Arab, Osama / Mahjoub, Yazine / Leborgne, Laurent

The American journal of cardiology

2023 Volume 211, Page(s) 79–88

Abstract: Right ventricular systolic dysfunction (RVsD) frequently occurs in patients with ST-elevation myocardial infarction (STEMI). However, the diagnosis depends on the echocardiographic parameters to define RVsD. The right ventricle longitudinal shortening ... ...

Abstract	Right ventricular systolic dysfunction (RVsD) frequently occurs in patients with ST-elevation myocardial infarction (STEMI). However, the diagnosis depends on the echocardiographic parameters to define RVsD. The right ventricle longitudinal shortening fraction (RV-LSF) is an accurate and reproducible 2-dimensional speckle-tracking parameter associated with clinical events in various pathologies. This study aimed to evaluate the association between RVsD and major adverse cardiovascular event (MACE) occurrence in a cohort of patients with STEMI. Adult patients with STEMI admitted to Amiens University Hospital's cardiovascular intensive care unit between May 2021 and November 2022 who underwent coronary angiography and transthoracic echocardiography within 48 hours of admission were included. RVsD was defined as RV-LSF <20%. The primary outcome was MACE occurrence, including heart failure, myocardial infarction, stroke, and death within 6 months of admission. A multivariable Cox regression analysis with proportional hazard ratio models assessed the association between RVsD and MACEs. In the 164 included patients, 72 (44%) had RVsD and 92 (56%) did not. The RVsD group had a significantly higher proportion of MACEs during the 6-month follow-up (n = 23 of 72, 33%) than the group without RVsD (n = 8 of 92, 9%, p = 0.001). RVsD showed an independent association with MACEs at 6 months (hazard ratio 3.1, 95% confidence interval [CI] 1.35 to 7.30, p = 0.008). Left ventricular ejection fraction <40% and Thrombolysis in Myocardial Infarction score >4 were independently associated with RVsD (odds ratio 2.80, 95% CI 1.34 to 5.98 and odds ratio 2.15, 95% CI 1.18 to 4.39, respectively, p = 0.015). The cumulative risk of MACEs at 6 months was 33% for RV-LSF <20% and 9% for RV-LSF ≥20% (log-rank test p <0.001). RVsD, defined by RV-LSF <20%, is associated with an increased risk of MACEs after STEMI.
MeSH term(s)	Adult ; Humans ; Prognosis ; ST Elevation Myocardial Infarction/complications ; Stroke Volume ; Heart Ventricles/diagnostic imaging ; Prospective Studies ; Ventricular Function, Left ; Echocardiography/methods ; Myocardial Infarction/complications ; Percutaneous Coronary Intervention/adverse effects
Language	English
Publishing date	2023-10-26
Publishing country	United States
Document type	Journal Article
ZDB-ID	80014-4
ISSN	1879-1913 ; 0002-9149
ISSN (online)	1879-1913
ISSN	0002-9149
DOI	10.1016/j.amjcard.2023.10.049
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Article ; Online: Tranexamic acid in non-traumatic intracranial bleeding: a systematic review and meta-analysis.

Bouillon-Minois, Jean-Baptiste / Croizier, Carolyne / Baker, Julien S / Pereira, Bruno / Moustafa, Farès / Outrey, Justin / Schmidt, Jeannot / Peschanski, Nicolas / Dutheil, Frédéric

Scientific reports

2021 Volume 11, Issue 1, Page(s) 15275

Abstract: Non-traumatic intracranial bleeding (NTIB), comprising subarachnoid hemorrhage (SAH) and intra-cranial bleeding (ICH) is a significant public health concern. Tranexamic acid (TXA) is a promising treatment with benefits yet to be fully demonstrated. We ... ...

Abstract	Non-traumatic intracranial bleeding (NTIB), comprising subarachnoid hemorrhage (SAH) and intra-cranial bleeding (ICH) is a significant public health concern. Tranexamic acid (TXA) is a promising treatment with benefits yet to be fully demonstrated. We conducted a systematic review and meta-analysis on the impact of TXA on mortality in NTIB. We searched the PubMed, Cochrane Library, Google Scholar and ScienceDirect databases for studies reporting mortality data following the use of TXA in NTIB for comparisons with a control group. We computed random-effect meta-analysis on estimates of risk and sensitivity analyses. We computed meta-regression to examine the putative effects of the severity of NTIB, sociodemographic data (age, sex), and publication date. Among potentially 10,008 articles, we included 15 studies representing a total of 4883 patients: 2455 receiving TXA and 2428 controls; 1110 died (23%) during the follow-up. The meta-analysis demonstrated a potential of 22% decrease in mortality for patients treated by TXA (RR = 0.78, 95%CI 0.58-0.98, p = 0.002). Meta-regression did not demonstrate any influence of the severity of NTIB, age, sex, length of treatment or date of publication. Sensitivity analyses confirmed benefits of TXA on mortality. TXA appears to be a therapeutic option to reduce non-traumatic intracranial bleeding mortality, particularly in patients with SAH.
MeSH term(s)	Adult ; Aged ; Antifibrinolytic Agents/therapeutic use ; Case-Control Studies ; Female ; Humans ; Intracranial Hemorrhages/drug therapy ; Male ; Middle Aged ; Tranexamic Acid/therapeutic use ; Young Adult
Chemical Substances	Antifibrinolytic Agents ; Tranexamic Acid (6T84R30KC1)
Language	English
Publishing date	2021-07-27
Publishing country	England
Document type	Journal Article ; Meta-Analysis ; Systematic Review
ZDB-ID	2615211-3
ISSN	2045-2322 ; 2045-2322
ISSN (online)	2045-2322
ISSN	2045-2322
DOI	10.1038/s41598-021-94727-y
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Article ; Online: Symptoms of Infarction in Women

Martin Cardeillac / François Lefebvre / Florent Baicry / Pierrick Le Borgne / Cédric Gil-Jardiné / Lauriane Cipolat / Nicolas Peschanski / Laure Abensur Vuillaume

Journal of Clinical Medicine, Vol 11, Iss 1319, p

Is There a Real Difference Compared to Men? A Systematic Review of the Literature with Meta-Analysis

2022 Volume 1319

Abstract	(1) Context: The management of acute coronary syndrome (ACS) is based on a rapid diagnosis. The aim of this study was to focus on the ACS symptoms differences according to gender, in order to contribute to the improvement of knowledge regarding the clinical presentation in women. (2) Methods: We searched for relevant literature in two electronic databases, and analyzed the symptom presentation for patients with suspected ACS. Fifteen prospective studies were included, with a total sample size of 10,730. (3) Results: During a suspected ACS, women present more dyspnea, arm pain, nausea and vomiting, fatigue, palpitations and pain at the shoulder than men, with RR (95%CI) of 1.13 [1.10; 1.17], 1.30 [1.05; 1.59], 1,40 [1.26; 1.56], 1.08 [1.01; 1.16], 1.67 [1.49; 1.86], 1.78 [1.02; 3.13], respectively. They are older by (95%CI) 4.15 [2.28; 6.03] years compared to men. The results are consistent in the analysis of the ACS confirmed subgroup. (4) Conclusions: We have shown that there is a gender-based symptomatic difference and a female presentation for ACS. The “typical” or “atypical” semiology of ACS symptoms should no longer be used.
Keywords	acute coronary syndrome ; cardiovascular disease ; gender-based difference ; women ; Medicine ; R
Subject code	610
Language	English
Publishing date	2022-02-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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