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There are few studies in Spain on cannabinoid hyperemesis syndrome (CHS), as well as on the use of topical capsaicin as a treatment. Methods Retrospective study of patients over 14 years of age seen in a hospital emergency department during 2018 and 2019 with a diagnosis of CHS based on the following criteria: compatible clinical picture, cannabis use less than 48h and positive urine cannabis test. Epidemiological and clinical variables, attendance times and treatment (including use of topical capsaicin 0.075%) were collected. Results Fifty-nine attendances were studied, from 29 patients (4.4 cases/10,000 visits, 95% CI 2.8-4.7). Fifty per cent returned for CHS, differing only in more tobacco (P=.01) and cocaine (P=.031) use. Capsaicin was used in 74.6% of visits. The mean time to resolution of vomiting after application was 17.87min. Conclusions Although probably underdiagnosed, CHS has a low incidence in the emergency department in Spain, with high patient recurrence. The use of capsaicin ointment is efficient and safe.

espanolFundamento. Describir el numero de consultas, total y por COVID-19, atendidas en servicios de urgencias hospitalarios (SUH) espanoles durante marzo y abril de 2020, compararlo con el mismo periodo del ano anterior, cuantificar el cambio de actividad asistencial e investigar la posible influencia del tamano del hospital y de la seroprevalencia provincial de COVID-19. Metodos. Estudio transversal. Se envio una encuesta a todos los responsables de SUH espanoles del sistema publico de salud sobre el numero de consultas atendidas durante marzo y abril de 2019 y de 2020. Se calculo el cambio de actividad asistencial por comunidad autonoma, y se comparo en funcion del tamano del hospital y del impacto provincial de la pandemia. Resultados. Participaron el 66 % de los 283 SUH. Se observo un descenso del 49,2 % de las consultas totales (solo los SUH de Castilla-La Mancha mostraron un descenso inferior al 30 %) y del 60 % de las consultas no-COVID-19 (solo los SUH de Asturias y Extremadura mostraron un descenso inferior al 50 %). el cambio de actividad asistencial no difirio en funcion del tamano del hospital, pero si en relacion al impacto provincial de la pandemia, con una correlacion directa respecto al descenso de actividad no-COVID-19 (a mayor impacto, mayor descenso; R2 = 0,05; p = 0,002) e inversa en relacion a la actividad global (a mayor impacto, menor descenso; R2 = 0,05; p = 0,002). Conclusiones. Durante la primera ola pandemica descendio el numero de consultas en los SUH, si bien dicho descenso no se explica unicamente por la incidencia local de la pandemia. EnglishBackground. To describe the number of visits (total and per COVID-19) attended by the Spanish hospital emergency departments (EDs) during March and April 2020 compared to the same period in 2019, and to calculate the quantitative changes in healthcare activity and investigate the possible influence of hospital size and regional COVID-19 seroprevalence. Method. Cross-sectional study that analyzes the number of visits to Spanish public EDs, reported through a survey of ED chiefs during the study periods. Changes in healthcare activity were described in each autonomous community and compared according to hospital size and the regional impact of the pandemic. Results. The 66% of the 283 Spanish EDs participated in the study. The total number of patients attended decreased to 49.2 % ( Conclusion. There was a very significant decrease in the number of ED visits during the first pandemic wave, although this decrease cannot be explained solely by the local incidence of the pandemic.

Aims We investigated the incidence, risk factors, clinical characteristics, and outcomes of pulmonary embolism (PE) in patients with COVID-19 attending emergency departments (EDs), before hospitalization. Methods and Results We retrospectively reviewed all COVID-19 patients diagnosed with PE in 62 Spanish EDs (20% of Spanish EDs, case group) during the first COVID-19 outbreak. COVID-19 patients without PE and non-COVID-19 patients with PE were included as control groups. Adjusted comparisons for baseline characteristics, acute episode characteristics, and outcomes were made between cases and randomly selected controls (1:1 ratio). We identified 368 PE in 74 814 patients with COVID-19 attending EDs (4.92‰). The standardized incidence of PE in the COVID-19 population resulted in 310 per 100 000 person-years, significantly higher than that observed in the non-COVID-19 population [35 per 100 000 person-years; odds ratio (OR) 8.95 for PE in the COVID-19 population, 95% confidence interval (CI) 8.51–9.41]. Several characteristics in COVID-19 patients were independently associated with PE, the strongest being D-dimer >1000 ng/mL, and chest pain (direct association) and chronic heart failure (inverse association). COVID-19 patients with PE differed from non-COVID-19 patients with PE in 16 characteristics, most directly related to COVID-19 infection; remarkably, D-dimer >1000 ng/mL, leg swelling/pain, and PE risk factors were significantly less present. PE in COVID-19 patients affected smaller pulmonary arteries than in non-COVID-19 patients, although right ventricular dysfunction was similar in both groups. In-hospital mortality in cases (16.0%) was similar to COVID-19 patients without PE (16.6%; OR 0.96, 95% CI 0.65–1.42; and 11.4% in a subgroup of COVID-19 patients with PE ruled out by scanner, OR 1.48, 95% CI 0.97–2.27), but higher than in non-COVID-19 patients with PE (6.5%; OR 2.74, 95% CI 1.66–4.51). Adjustment for differences in baseline and acute episode characteristics and sensitivity analysis reported very similar associations. Conclusions PE in COVID-19 patients at ED presentation is unusual (about 0.5%), but incidence is approximately ninefold higher than in the general (non-COVID-19) population. Moreover, risk factors and leg symptoms are less frequent, D-dimer increase is lower and emboli involve smaller pulmonary arteries. While PE probably does not increase the mortality of COVID-19 patients, mortality is higher in COVID-19 than in non-COVID-19 patients with PE.

Adding attention-awareness to an Augmented Reality setting by using a Brain-Computer Interface promises many interesting new applications and improved usability. The possibly complicated setup and relatively long training period of EEG-based BCIs however, reduce this positive effect immensely. In this study, we aim at finding solutions for person-independent, training-free BCI integration into AR to classify internally and externally directed attention. We assessed several different classifier settings on a dataset of 14 participants consisting of simultaneously recorded EEG and eye tracking data. For this, we compared the classification accuracies of a linear algorithm, a non-linear algorithm, and a neural net that were trained on a specifically generated feature set, as well as a shallow neural net for raw EEG data. With a real-time system in mind, we also tested different window lengths of the data aiming at the best payoff between short window length and high classification accuracy. Our results showed that the shallow neural net based on 4-second raw EEG data windows was best suited for real-time person-independent classification. The accuracy for the binary classification of internal and external attention periods reached up to 88% accuracy with a model that was trained on a set of selected participants. On average, the person-independent classification rate reached 60%. Overall, the high individual differences could be seen in the results. In the future, further datasets are necessary to compare these results before optimizing a real-time person-independent attention classifier for AR.

• Several cardiovascular/hemostatic disturbances haves been reported in patients with COVID-19, but the real frequency and their potential association with the pathogenic mechanisms of SARS-CoV-19 still remain to be defined. • We investigated the relative frequency of acute coronary syndrome, deep venous thrombosis, pulmonary embolism, stroke and upper gastrointestinal bleeding in COVID patents attending emergency departments (EDs), before hospitalization and compared them with frequencies in the general ED population attending 50 Spanish EDs. • We found that the risk of pulmonary embolism is clearly increased in COVID patients, with an OR of 4.53 with respect to non-COVID patients (95% confidence interval 4.03- 5.10). Additionally, the diagnosis of pulmonary embolism was 2 fold more frequent among ED comers in 2020 compared to 2019, suggesting a SARS-CoV-2 role in such increment of cases.. The remaining entities studied were not found to be unequivocally increased in the present study and need further investigation.

Objective: The authors investigated the incidence, risk factors, clinical characteristics, and outcomes of upper gastrointestinal bleeding (UGB) in patients with coronavirus disease 2019 (COVID-19), who were attending the emergency department (ED), before hospitalization. Methods: We retrospectively reviewed all COVID-19 patients diagnosed with UGB in 62 Spanish EDs (20% of Spanish EDs, case group) during the first 2 months of the COVID-19 outbreak. We formed 2 control groups: COVID-19 patients without UGB (control group A) and non-COVID-19 patients with UGB (control group B). Fifty-three independent variables and 4 outcomes were compared between cases and controls. Results: We identified 83 UGB in 74,814 patients with COVID-19 who were attending EDs (1.11%, 95% CI=0.88-1.38). This incidence was lower compared with non-COVID-19 patients [2474/1,388,879, 1.78%, 95% confidence interval (CI)=1.71-1.85; odds ratio (OR)=0.62; 95% CI=0.50-0.77]. Clinical characteristics associated with a higher risk of COVID-19 patients presenting with UGB were abdominal pain, vomiting, hematemesis, dyspnea, expectoration, melena, fever, cough, chest pain, and dysgeusia. Compared with non-COVID-19 patients with UGB, COVID-19 patients with UGB more frequently had fever, cough, expectoration, dyspnea, abdominal pain, diarrhea, interstitial lung infiltrates, and ground-glass lung opacities. They underwent fewer endoscopies in the ED (although diagnoses did not differ between cases and control group B) and less endoscopic treatment. After adjustment for age and sex, cases showed a higher in-hospital all-cause mortality than control group B (OR=2.05, 95% CI=1.09-3.86) but not control group A (OR=1.14, 95% CI=0.59-2.19) patients. Conclusions: The incidence of UGB in COVID-19 patients attending EDs was lower compared with non-COVID-19 patients. Digestive symptoms predominated over respiratory symptoms, and COVID-19 patients with UGB underwent fewer gastroscopies and endoscopic treatments than the general population with UGB. Inhospital mortality in COVID-19 patients with UGB was increased compared with non-COVID patients with UGB, but not compared with the remaining COVID-19 patients.

Mobile users rely on typing assistant mechanisms such as prediction and autocorrect. Previous studies on mobile keyboards showed decreased performance for heavy use of word prediction, which identifies a need for more research to better understand the effectiveness of predictive features for different users. Our work aims at such a better understanding of user interaction with autocorrections and the prediction panel while entering text, in particular when these approaches fail. We present a crowd-sourced mobile text entry study with 170 participants. Our mobile web application simulates autocorrection and word prediction to capture user behaviours around these features. We found that using word prediction saves an average of 3.43 characters per phrase but also adds an average of two seconds compared to actually typing the word, resulting in a negative effect on text entry speed. We also identified that the time to fix wrong autocorrections is on average 5.5 seconds but that autocorrection does not have a significant effect on typing speed.

Background: There is a lack of knowledge about the real incidence of acute coronary syndrome (ACS) in patients with COVID-19, their clinical characteristics, and their prognoses. Objective: We investigated the incidence, clinical characteristics, risk factors, and outcomes of ACS in patients with COVID-19 in the emergency department. Methods: We retrospectively reviewed all COVID-19 patients diagnosed with ACS in 62 Spanish emergency departments between March and April 2020 (the first wave of COVID-19). We formed 2 control groups: COVID-19 patients without ACS (control A) and non-COVID-19 patients with ACS (control B). Unadjusted comparisons between cases and control subjects were performed regarding 58 characteristics and outcomes. Results: We identified 110 patients with ACS in 74,814 patients with COVID-19 attending the ED (1.48% [95% confidence interval {CI} 1.21-1.78%]). This incidence was lower than that observed in non-COVID19 patients (3.64% [95% CI 3.54-3.74%]; odds ratio [OR] 0.40 [95% CI 0.33-0.49]). The clinical characteristics of patients with COVID-19 associated with a higher risk of presenting ACS were: previous coronary artery disease, age >= 60 years, hypertension, chest pain, raised troponin, and hypoxemia. The need for hospitalization and admission to intensive care and in-hospital mortality were higher in cases than in control group A (adjusted OR [aOR] 6.36 [95% CI 1.8422.1], aOR 4.63 [95% CI 1.88-11.4], and aOR 2.46 [95% CI 1.15-5.25]). When comparing cases with control group B, the aOR of admission to intensive care was 0.41 (95% CI 0.210.80), while the aOR for in-hospital mortality was 5.94 (95% CI 2.84-12.4). Conclusions: The incidence of ACS in patients with COVID-19 attending the emergency department was low, around 1.48%, but could be increased in some circumstances. Patients with COVID-19 with ACS had a worse prognosis than control subjects with higher in-hospital mortality. (C) 2021 Elsevier Inc. All rights reserved.

Objective Investigate whether there are differences in the drugs involved, symptomatology and severity of drug intoxication in patients with co-ingestion of alcohol attended in hospital emergency departments (ED). Method Patients attended in 11 Spanish EDs due to drug intoxication were included. Sociodemographic and clinical characteristics were collected. A combined adverse event of cardiorespiratory arrest, need for intubation, and admission to intensive care or death was considered as the primary indicator of severity. The symptomatology and severity were compared adjusted for age, sex and type of drug based on whether or not ethanol had been co-ingested. Results 3925 patients (alcohol co-ingestion: 2290, 58.3%) with a mean age of 33 (±11) years were included, and 25% were women. Co-ingestion of alcohol was observed in younger patients, in EDs in areas with high leisure tourism, on holidays and during the early morning hours. It was also more frequent in individuals intoxicated by amphetamine derivatives (66.2%) and cocaine (65.7%), and was more frequently associated with a reduction in consciousness (odds ratio [OR] = 2.13, 95% confidence interval [CI] 1.69–2.67) and agitation/aggressiveness (OR = 1.22, 95% = 1.04–1.43). A combined adverse event was observed in 114 patients (2.9%) with no differences between individuals co-ingesting or not ethanol (3.1% vs. 2.7%; OR = 1.11, 95% CI = 0.74–1.65). Conclusion Co-ingestion of alcohol is more frequent in individuals intoxicated by cocaine and amphetamines and predisposes a greater reduction in the level of consciousness or agitation, although there are no differences in the severity of the episodes of drug intoxication.

Objective We investigated the incidence, predictor variables, clinical characteristics, and stroke outcomes in patients with COVID-19 seen in emergency departments (EDs) before hospitalization. Methods We retrospectively reviewed all COVID-19 patients diagnosed with stroke during the COVID-19 outbreak in 62 Spanish EDs. We formed two control groups: COVID-19 patients without stroke (control A) and non-COVID-19 patients with stroke (control B). We compared disease characteristics and four outcomes between cases and controls. Results We identified 147 strokes in 74,814 patients with COVID-19 seen in EDs (1.96 parts per thousand, 95% confidence interval [CI] = 1.66 parts per thousand to 2.31 parts per thousand), being lower than in non-COVID-19 patients (6,541/1,388,879, 4.71 parts per thousand, 95% CI = 4.60 parts per thousand to 4.83 parts per thousand; odds ratio [OR] = 0.42, 95% CI = 0.35 to 0.49). The estimated that standardized incidences of stroke per 100,000 individuals per year were 124 and 133 for COVID-19 and non-COVID-19 individuals, respectively (OR = 0.93 for COVID patients, 95% CI = 0.87 to 0.99). Baseline characteristics associated with a higher risk of stroke in COVID-19 patients were hypertension, diabetes mellitus, and previous cerebrovascular and coronary diseases. Clinically, these patients more frequently presented with confusion, decreased consciousness, and syncope and higher D-dimer concentrations and leukocyte count at ED arrival. After adjustment for age and sex, the case group had higher hospitalization and intensive care unit (ICU) admission rates (but not mortality) than COVID-19 controls without stroke (OR = 3.41, 95% CI = 1.27 to 9.16; and OR = 3.79, 95% CI = 1.69 to 8.50, respectively) and longer hospitalization and greater in-hospital mortality than stroke controls without COVID-19 (OR = 1.55, 95% CI = 1.24 to 1.94; and OR = 1.77, 95% CI = 1.37 to 2.30, respectively). Conclusions The incidence of stroke in COVID-19 patients presenting to EDs was lower than that in the non-COVID-19 reference sample. COVID-19 patients with stroke had greater need for hospitalization and ICU admission than those without stroke and longer hospitalization and greater in-hospital mortality than non-COVID-19 patients with stroke.

BACKGROUND Case reports suggest a link between energy drinks (EDs) and adverse events, including deaths. OBJECTIVES We examined cardiovascular and metabolic effects of EDs and mixtures providing relevant ingredients of EDs compared to a similarly composed control product (CP) without these components. METHODS This randomized, crossover trial comprised 38 adults (19 women, mean BMI 23 kg/m2, mean age 22 y). We examined effects of a single administration of a commercial ED, the CP, and the CP supplemented with major ED-ingredients at the same concentrations as in the ED. The study products were administered at 2 volumes, 750 or 1000 mL. RESULTS Both volumes of the study products were acceptably tolerated with no dose-dependent effects on blood pressure (BP, primary outcome), heart rate, heart rate corrected duration of QT-segment in electrocardiography (QTc interval), and glucose metabolism. After ED consumption, 11% of the participants reported symptoms, in contrast to 0-3% caused by other study products. After 1 h, administration of an ED caused an increase in systolic BP (116.9 ± 10.4 to 120.7 ± 10.7 mmHg, mean ± SD, P

We introduce the concept ofLabLinking: a technology-based interconnection of experimental laboratories across institutions, disciplines, cultures, languages, and time zones - in other wordsexperiments without borders. In particular, we introduce LabLinking levels (LLL), which define the degree of tightness of empirical interconnection between labs. We describe the technological infrastructure in terms of hard- and software required for the respective LLLs and present examples of linked laboratories along with insights about the challenges and benefits. In sum, we argue that linked labs provide a unique platform for a continuous exchange between scientists and experimenters, thereby enabling a time synchronous execution of experiments performed with and by decentralized user and researchers, improving outreach and ease of subject recruitment, allowing to establish new experimental designs and to incorporate a panoply of complementary biosensors, devices, hard- and software solutions.

OBJECTIVE: We investigated the incidence, risk factors, clinical characteristics and outcomes of acute pancreatitis (AP) in patients with COVID-19 attending the emergency department (ED), before hospitalization. METHODS: We retrospectively reviewed all COVID patients diagnosed with AP in 62 Spanish EDs (20% of Spanish EDs, COVID-AP) during the COVID outbreak. We formed two control groups: COVID patients without AP (COVID-non-AP) and non-COVID patients with AP (non-COVID-AP). Unadjusted comparisons between cases and controls were performed regarding 59 baseline and clinical characteristics and 4 outcomes. RESULTS: We identified 54 AP in 74,814 patients with COVID-19 attending the ED (frequency=0.72‰, 95%CI=0.54-0.94‰). This frequency was lower than in non-COVID patients (2,231/1,388,879, 1.61‰, 95%CI=1.54-1.67; OR=0.44, 95%CI=0.34-0.58). Etiology of AP was similar in both groups, being biliary origin in about 50%. Twenty-six clinical characteristics of COVID patients were associated with a higher risk of developing AP: abdominal pain (OR=59.4, 95%CI=23.7-149), raised blood amylase (OR=31.8; 95%CI=1.60-632) and vomiting (OR=15.8, 95%CI=6.69-37.2) being the strongest, and some inflammatory markers (C-reactive protein, procalcitonin, platelets, D-dimer) were more increased. Compared to non-COVID-AP, COVID-AP patients differed in 23 variables; the strongest ones related to COVID symptoms, but less abdominal pain was reported, pancreatic enzymes raise was lower, and severity (estimated by BISAP and SOFA score at ED arrival) was higher. The in-hospital mortality (adjusted for age and sex) of COVID-AP did not differ from COVID-non-AP (OR=1.12, 95%CI=0.45-245) but was higher than non-COVID-AP (OR=2.46, 95%CI=1.35-4.48). CONCLUSIONS: Acute pancreatitis as presenting form of COVID-19 in the ED is unusual (

We investigated the incidence, clinical characteristics, risk factors, and outcome of meningoencephalitis (ME) in patients with COVID-19 attending emergency departments (ED), before hospitalization. We retrospectively reviewed all COVID patients diagnosed with ME in 61 Spanish EDs (20% of Spanish EDs, COVID-ME) during the COVID pandemic. We formed two control groups: non-COVID patients with ME (non-COVID-ME) and COVID patients without ME (COVID-non-ME). Unadjusted comparisons between cases and controls were performed regarding 57 baseline and clinical characteristics and 4 outcomes. Cerebrospinal fluid (CSF) biochemical and serologic findings of COVID-ME and non-COVID-ME were also investigated. We identified 29 ME in 71,904 patients with COVID-19 attending EDs (0.40 parts per thousand, 95%CI=0.27-0.58). This incidence was higher than that observed in non-COVID patients (150/1,358,134, 0.11 parts per thousand, 95%CI=0.09-0.13; OR=3.65, 95%CI=2.45-5.44). With respect to non-COVID-ME, COVID-ME more frequently had dyspnea and chest X-ray abnormalities, and neck stiffness was less frequent (OR=0.3, 95%CI=0.1-0.9). In 69.0% of COVID-ME, CSF cells were predominantly lymphocytes, and SARS-CoV-2 antigen was detected by RT-PCR in 1 patient. The clinical characteristics associated with a higher risk of presenting ME in COVID patients were vomiting (OR=3.7, 95%CI=1.4-10.2), headache (OR=24.7, 95%CI=10.2-60.1), and altered mental status (OR=12.9, 95%CI=6.6-25.0). COVID-ME patients had a higher in-hospital mortality than non-COVID-ME patients (OR=2.26; 95%CI=1.04-4.48), and a higher need for hospitalization (OR=8.02; 95%CI=1.19-66.7) and intensive care admission (OR=5.89; 95%CI=3.12-11.14) than COVID-non-ME patients. ME is an unusual form of COVID presentation (

Objetivo: Describir las características demográficas y de comorbilidad de los pacientes con COVID-19 fallecidos en hospitales españoles durante el brote pandémico de 2020 y compararlas según si ingresaron o no en una unidad de cuidados intensivos (UCI) antes del fallecimiento. Métodos: Análisis secundario de los pacientes de la cohorte SIESTA (formada por pacientes COVID de 62 hospitales españoles) fallecidos durante la hospitalización. Se recogió su características demográficas y comorbilidades, individuales y globalmente estimada mediante el índice de Charlson (IC). Se identificaron los factores independientes relacionados con ingreso en UCI, y se realizaron diversos análisis de sensibilidad para contrastar la consistencia de los hallazgos del análisis principal. Resultados: Se incluyeron los 338 pacientes de la cohorte SIESTA fallecidos; de ellos, 77 (22.8%) accedieron a una UCI previamente al fallecimiento. En el análisis multivariable, 3 de las 20 características basales analizadas se asociaron independientemente con ingreso en UCI de los pacientes fallecidos: demencia (no hubo pacientes fallecidos con demencia que ingresasen en UCI; OR=0, IC95%=no calculable), cáncer activo (OR=0,07, IC95%=0,02-0,21) y edad (2 puntos: OR=0,09, 95%CI=0,04-0,23). Los análisis de sensibilidad no mostraron diferencias destacables respecto al análisis principal. Conclusiones: El perfil de los pacientes COVID fallecidos sin ingresar en UCI se ajustó a lo observado en la práctica médica habitual antes de la pandemia, y las características basales que limitaron su ingreso fueron la edad y la carga de comorbilidad global, especialmente la demencia y el cáncer activo.

Background and importance A higher incidence of venous thromboembolism [both pulmonary embolism and deep vein thrombosis (DVT)] in patients with coronavirus disease 2019 (COVID-19) has been described. But little is known about the true frequency of DVT in patients who attend emergency department (ED) and are diagnosed with COVID-19. Objective We investigated the incidence, risk factors, clinical characteristics and outcomes of DVT in patients with COVID-19 attending the ED before hospitalization. Methods We retrospectively reviewed all COVID patients diagnosed with DVT in 62 Spanish EDs (20% of Spanish EDs, case group) during the first 2 months of the COVID-19 outbreak. We compared DVT-COVID-19 patients with COVID-19 without DVT patients (control group). Relative frequencies of DVT were estimated in COVID and non-COVID patients visiting the ED and annual standardized incidences were estimated for both populations. Sixty-three patient characteristics and four outcomes were compared between cases and controls. Results We identified 112 DVT in 74 814 patients with COVID-19 attending the ED [1.50 parts per thousand; 95% confidence interval (CI), 1.23-1.80 parts per thousand]. This relative frequency was similar than that observed in non-COVID patients [2109/1 388 879; 1.52 parts per thousand; 95% CI, 1.45-1.69 parts per thousand; odds ratio (OR) = 0.98 [0.82-1.19]. Standardized incidence of DVT was higher in COVID patients (98,38 versus 42,93/100,000/year; OR, 2.20; 95% CI, 2.03-2.38). In COVID patients, the clinical characteristics associated with a higher risk of presenting DVT were older age and having a history of venous thromboembolism, recent surgery/immobilization and hypertension; chest pain and desaturation at ED arrival and some analytical disturbances were also more frequently seen, d-dimer >5000 ng/mL being the strongest. After adjustment for age and sex, hospitalization, ICU admission and prolonged hospitalization were more frequent in cases than controls, whereas mortality was similar (OR, 1.37; 95% CI, 0.77-2.45). Conclusions DVT was an unusual form of COVID presentation in COVID patients but was associated with a worse prognosis.

Recently, the idea of using BCIs in Augmented Reality settings to operate systems has emerged. One problem of such head-mounted displays is the distraction caused by an unavoidable display of control elements even when focused on internal thoughts. In this project, we reduced this distraction by including information about the current attentional state. A multimodal smart-home environment was altered to adapt to the user's state of attention. The system only responded if the attentional orientation was classified as "external". The classification was based on multimodal EEG and eye tracking data. Seven users tested the attention-aware system in comparison to the unaware system. We show that the adaptation of the interface improved the usability of the system. We conclude that more systems would benefit from awareness of the user's ongoing attentional state.

Auto-correction is a standard feature of mobile text entry. While the performance of state-of-the-art auto-correct methods is usually relatively high, any errors that occur are cumbersome to repair, interrupt the flow of text entry, and challenge the user's agency over the process. In this paper, we describe a system that aims to automatically identify and repair auto-correction errors. This system comprises a multi-modal classifier for detecting auto-correction errors from brain activity, eye gaze, and context information, as well as a strategy to repair such errors by replacing the erroneous correction or suggesting alternatives. We integrated both parts in a generic Android component and thus present a research platform for studying self-repairing end-to-end systems. To demonstrate its feasibility, we performed a user study to evaluate the classification performance and usability of our approach.

Questionnaires are among the most common research tools in virtual reality (VR) user studies. Transitioning from virtuality to reality for giving self-reports on VR experiences can lead to systematic biases. VR allows to embed questionnaires into the virtual environment which may ease participation and avoid biases. To provide a cohesive picture of methods and design choices for questionnaires in VR (inVRQ), we discuss 15 inVRQ studies from the literature and present a survey with 67 VR experts from academia and industry. Based on the outcomes, we conducted two user studies in which we tested different presentation and interaction methods of inVRQs and evaluated the usability and practicality of our design. We observed comparable completion times between inVRQs and questionnaires outside VR (nonVRQs) with higher enjoyment but lower usability for \inVRQs. These findings advocate the application of inVRQs and provide an overview of methods and considerations that lay the groundwork for inVRQ design.

Sin financiación 1.556 JCR (2020) Q3, 110/167 Medicine, General & Internal 0.253 SJR (2020) Q3, 1788/2446 Medicine (miscellaneous) No data IDR 2020 UEC

Developments in social robotics raise the prospect of robots coaching and interacting with patient during rehabilitation training assuming a role of a trainer. This raises questions regarding the acceptance of robots in this role and more specifically, to what extent the robot should be anthropomorphic. This paper presents the results of an online experiment designed to evaluate the user acceptance of Socially Assistive Robots (SARs) as rehabilitation trainers, and the effect of anthropomorphism on this matter. User attitudes were surveyed with regards to variations of the robot’s anthropomorphism as a rehabilitation trainer. The results show that 1) participants are accepting towards SAR-assisted rehabilitation therapies, 2) higher anthropomorphism is generally preferred but does not affect patient’s acceptance towards such therapy and technology. Qualitative data brings insight to patient technology acceptance, needs for rehabilitation training and the effect of anthropomorphism.

Despite SARS-CoV-19 infection has a stereotypical clinical picture, isolated cases with unusual manifestations have been reported, some of them being well-known to be triggered by viral infections. However, the real frequency in COVID-19 is unknown. Analysing data of 63 822 COVID patients attending 50 Spanish emergency department (ED) during the COVID outbreak, before hospitalisation, we report frequencies of (myo)pericarditis (0.71‰), meningoencephalitis (0.25‰), Guillain–Barré syndrome (0.13‰), acute pancreatitis (0.71‰) and spontaneous pneumothorax (0.57‰). Compared with general ED population, COVID patients developed more frequently Guillain–Barré syndrome (odds ratio (OR) 4.55, 95% confidence interval (CI) 2.09–9.90), spontaneous pneumothorax (OR 1.98, 95% CI 1.40–2.79) and (myo)pericarditis (OR 1.45, 95% CI 1.07–1.97), but less frequently pancreatitis (OR 0.44, 95% CI 0.33–0.60).

The Everyday Activities Science and Engineering (EASE) Collaborative Research Consortium’s mission to enhance the performance of cognition-enabled robots establishes its foundation in the EASE Human Activities Data Analysis Pipeline. Through collection of diverse human activity information resources, enrichment with contextually relevant annotations, and subsequent multimodal analysis of the combined data sources, the pipeline described will provide a rich resource for robot planning researchers, through incorporation in the OpenEASE cloud platform.

The automatic measurement of external physical traits (i.e. phenotyping) of plant organs, such as root length –which is highly correlated with plant viability– is one of the current bottlenecks in academic and agricultural research. Although many root length measurement software tools are available to the community, plant scientists often find their usability is limited, the measurements they provide are not accurate enough or they are too limited to specific image characteristics. In response to that, this work describes MyROOT 2.0, an automatic software tool jointly developed by plant scientists and computer vision engineers to create a high throughput root length measurement tool that reduces user intervention to a minimum. Using Arabidopsis thaliana seedlings grown on agar plates as a case study, MyROOT 2.0 is capable of detecting the root regions of interest in a fully automatic manner with an accuracy of 98%. Furthermore, this work also presents previously unreported experiments to evaluate several constituting modules of MyROOT 2.0, such as the ability to determine image scale automatically with subpixel accuracy, or the influence of training the hypocotyl detector using wildtype or mutant samples. Finally, when compared to state-of-the-art root length measurement software tools, MyROOT 2.0 achieves the highest root detection rate, obtaining measurements which are four times more accurate than its competitors. This makes MyROOT 2.0 an attractive tool for high throughput root phenotyping., A.I.C-D. is a recipient of a BIO2016-78955 grants from the Spanish Ministry of Economy and Competitiveness and a European Research Council, ERC Consolidator Grant (ERC-2015-CoG - 683163). I.B-P. is funded by the FPU15/02822 grant from the Spanish Ministry of Education, Culture and Sport. D.B-E. is contracted with the BIO2016-78955 grant in the A.I.C-D laboratory. CRAG is funded by “Severo Ochoa Programme” from Centers of Excellence in R&D 2016–2019 (SEV-2015-485 0533).

Two recent publications in this journal regarding cannabinoid hyperemesis syndrome (CHS) reflect a common fact in the clinical practice. Although the syndrome is increasingly well-known, patients still receive a late diagnosis, sometimes after years of delay. This entails multiple visits to the ER, as well multiple outpatient visits and diagnostic tests in gastroenterology departments. Furthermore, there are many unnecessary hospital admissions that are often accompanied by an uncertain discharge diagnosis (psychogenic vomiting, etc.).

Cannabinoid hyperemesis syndrome (CHS) is still relatively unknown among Spanish clinicians of any specialty, a situation highlighted in studies such as that by Ochoa-Mangado and Madoz-Gurpide (2021), and to which we would like to contribute other aspects for consideration.

Sin financiación 1.755 JCR (2017) Q4, 28/33 Critical Care Medicine UEC

Diagnosis and treatment of atrial fibrillation can benefit from various signal processing approaches employed on atrial electrograms. However, the performance and interpretation of these approaches get highly degraded by far-field ventricular activities (VAs) that distort the morphology of the pure atrial activities (AAs). In this study, we aim to remove VAs from the recorded unipolar electrogram while preserving the AA components. To do so, we have developed a framework which first removes the VA-containing segments and interpolates the remaining samples. This will also partly remove the atrial components that overlap with VA signals, e.g., during atrial fibrillation. To reconstruct the AA components, we estimate them from the removed VA-containing segments based on a low-rank and sparse matrix decomposition and add them back to the electrograms. The presented framework is of rather low complexity, preserves AA components, and requires only a single EGM recording. Instrumental comparison to template matching and subtraction and independent component analysis shows that the proposed approach leads to smoother results with better similarity to the true atrial signal.

Multimodal data is increasingly used in cognitive prediction models to better analyze and predict different user cognitive processes. Classifiers based on such data, however, have different performance characteristics. We discuss in this paper an intervention-free selection task using multimodal data of EEG and eye tracking in three different models. We show that a sequential model, LSTM, is more sensitive but less precise than a static model SVM. Moreover, we introduce a confidence-based Competition-Fusion model using both SVM and LSTM. The fusion model further improves the recall compared to either SVM or LSTM alone, without decreasing precision compared to LSTM. According to the results, we recommend SVM for interactive applications which require minimal false positives (high precision), and recommend LSTM and highly recommend Competition-Fusion Model for applications which handle intervention-free selection requests in an additional post-processing step, requiring higher recall than precision.

In this paper, we extract features of head pose, eye gaze, and facial expressions from video to estimate individual learners' attentional states in a classroom setting. We concentrate on the analysis of different definitions for a student's attention and show that available generic video processing components and a single video camera are sufficient to estimate the attentional state.

Root analysis is essential for both academic and agricultural research. Despite the great advances in root phenotyping and imaging however, calculating root length is still performed manually and involves considerable amounts of labor and time. To overcome these limitations, we have developed MyROOT, a novel software for the semi-automatic quantification of root growth of seedlings growing directly in agar plates. Our method automatically determines the scale from the image of the plate, and subsequently measures the root length of the individual plants. To this aim, MyROOT combines a bottom-up root tracking approach with a hypocotyl detection algorithm. At the same time as providing accurate root measurements, MyROOT also significantly minimizes the user intervention required during the process. Using Arabidopsis, we tested MyROOT with seedlings from different growth stages. Upon comparing the data obtained using this software with that of manual root measurements, we found that there are no significant differences (t-test, p-value < 0.05). Thus, MyROOT will be of great aid to the plant science community by permitting high-throughput root length measurements while saving on both labor and time.

A memory-based interaction obstacle is a condition which impedes human memory during Human-Computer Interaction, for example a memory-loading secondary task. In this paper, we present an approach to detect the presence of such memory-based interaction obstacles from logged user behavior during system use. For this purpose, we use a recurrent neural network which models the resulting temporal sequences. To acquire a sufficient number of training episodes, we employ a cognitive user simulation. We evaluate the approach with data from a user test and on which we outperform a non-sequential baseline by up to 42% relative.

International audience; In Ref. (GAMBIT Collaboration: Athron et. al., Eur. Phys. J. C. arXiv:1705.07908, 2017) we introduced the global-fitting framework GAMBIT. In this addendum, we describe a new minor version increment of this package. GAMBIT 1.1 includes full support for Mathematica backends, which we describe in some detail here. As an example, we backend SUSYHD (Vega and Villadoro, JHEP 07:159, 2015), which calculates the mass of the Higgs boson in the MSSM from effective field theory. We also describe updated likelihoods in PrecisionBit and DarkBit, and updated decay data included in DecayBit.

ResumenAntecedentesEl íleo biliar recurrente es una obstrucción intestinal mecánica infrecuente, secundaria a la oclusión del intestino por un cálculo biliar intraluminal.Casos clínicosMujer de 75años, portadora de endoprótesis cardiaca, que acudió con dolor abdominal y vómitos, evidenciándose en la tomografía computada (TC) un íleo biliar. Se realizó enterolitotomía urgente. Tres meses después presenta el mismo cuadro clínico y la TC evidencia nuevo íleo biliar, por lo que se le practicó enterolitotomía, colecistectomía y cierre de fístula colecistoduodenal.Caso 2. Hombre de 71años de edad, con cardiopatía isquémica y pontaje aortocoronario, que acudió con cuadro de vómitos, evidenciándose en TC aerobilia e íleo biliar. Se realizó enterolitotomía urgente. Acudió 7meses más tarde con el mismo cuadro clínico, visualizándose en la TC nuevo íleo biliar, y se le realizó nueva enterolitotomía, colecistectomía y cierre de fístula colecistoduodenal. En el postoperatorio el paciente falleció por disfunción multiorgánica.ConclusiónEn pacientes de edad avanzada con enfermedades concomitantes con riesgo de una segunda laparotomía se justifica reconsiderar la reparación definitiva del íleo biliar. La enterolitotomía en el momento agudo seguido de colecistectomía temprana (4-8semanas) puede ser un método seguro, eliminando la posibilidad de íleo biliar recurrente, y probablemente la necesidad de una segunda laparotomía. Aunque el desarrollo de un carcinoma de vesícula es excepcional, también se evita su aparición.AbstractBackgroundRecurrent gallstone ileus is an uncommon mechanical intestinal obstruction secondary to occlusion of the intestine by an intraluminal biliary calculus.Clinical caseFemale, 75 years old, ischaemic heart disease (stent), arrived in our department complaining of abdominal pain and vomiting. Computed tomography showed gallstone ileus. The patient underwent an enterotomy with gallstone removal. Three months later, the patient came back with the same clinical symptoms and signs. A new computed tomography highlighted a gallstone ileus again. Enterolithotomy and gallstone removal, cholecystectomy and closure of cholecystoduodenal fistula were performed. The patient had a prolonged hospital stay due to the development of congestive heart failure.Case 2. Male, 71 years old, ischaemic heart disease and aortocoronary bypass, seen in our department complaining of vomiting. Computed tomography showed aerobilia and gallstone ileus. The patient underwent an urgent enterolithotomy. Seven months later, the patient came back with the same clinical symptoms and signs. Computed tomography showed a new gallstone ileus. An enterotomy and gallstone removal, cholecystectomy and closure of cholecystoduodenal fistula were performed. The patient died due to multi-organ failure in post-surgery period.ConclusionIn the elderly patients with concomitant medical illnesses with the risk of a second laparotomy, it is justifiable to reconsider the definitive repair in the treatment of gallstone ileus. The enterolithotomy in acute phase followed by early cholecystectomy (4-8 weeks) may be a safe method for eliminating, not only the possibility of recurrent gallstone ileus, and probably the need for a second laparotomy, but also the exceptional possibility of developing a gallbladder carcinoma.

As in many other research areas the material sciences produce vast amounts of experimental data. The corresponding findings are then published, albeit the data remains in heterogeneous formats within institutes and is neither shared nor reused by the scientific community. To address this issue we have developed and deployed a scientific data management environment for the material sciences at various test facilities. Unlike other systems this one explicitly models every facet of the experiment and the materials used therein - thereby supporting the initial design of the experiment, its execution and the ensuing results. Consequently, the collection of the structured data becomes an integral part of the research workflow rather than a post hoc nuisance. In this paper we report on an empirical study that was performed to test the effects of a paradigm change in the data model to align it better with the actual scientific practice at hand.

Sin financiación 1.982 JCR (2018) Q3, 24/33 Critical Care Medicine 0.334 SJR (2018) Q2, 44/91 Critical Care and Intensive Care Medicine No data IDR 2018 UEC

Introduction: Cannabinoid hyperemesis syndrome is a clinical disorder that has become more prevalent with increasing use of cannabis and synthetic cannabinoids, and which is difficult to treat. Standard antiemetics commonly fail to alleviate the severe nausea and vomiting characteristic of the syndrome. Curiously, cannabinoid hyperemesis syndrome patients often report dramatic relief of symptoms with hot showers and baths, and topical capsaicin. Objectives: In this review, we detail the pharmacokinetics and pharmacodynamics of capsaicin and explore possible mechanisms for its beneficial effect, including activation of transient receptor potential vanilloid 1 and neurohumoral regulation. Putative mechanisms responsible for the benefit of hot water hydrotherapy are also investigated. Methods: An extensive search of PubMed, OpenGrey, and Google Scholar from inception to April 2017 was performed to identify known and theoretical thermoregulatory mechanisms associated with the endocannabinoid system. The searches resulted in 2417 articles. These articles were screened for relevant mechanisms behind capsaicin and heat activation having potential antiemetic effects. References from the selected articles were also hand-searched. A total of 137 articles were considered relevant and included. Capsaicin: Topical capsaicin is primarily used for treatment of neuropathic pain, but it has also been used successfully in some 20 cases of cannabinoid hyperemesis syndrome. The pharmacokinetics and pharmacodynamics of capsaicin as a transient receptor potential vanilloid 1 agonist may explain this effect. Topical capsaicin has a longer half-life than oral administration, thus its potential duration of benefit is longer. Capsaicin and transient receptor potential vanilloid 1: Topical capsaicin binds and activates the transient receptor potential vanilloid 1 receptor, triggering influx of calcium and sodium, as well as release of inflammatory neuropeptides leading to transient burning, stinging, and itching. This elicits a novel type of desensitization analgesia. Transient receptor potential vanilloid 1 receptors also respond to noxious stimuli, such as heat (>43 °C), acids (pH

We present the GAMBIT modules SpecBit, DecayBit and PrecisionBit. Together they provide a new framework for linking publicly available spectrum generators, decay codes and other precision observable calculations in a physically and statistically consistent manner. This allows users to automatically run various combinations of existing codes as if they are a single package. The modular design allows software packages fulfilling the same role to be exchanged freely at runtime, with the results presented in a common format that can be easily passed to downstream dark matter, collider and flavour codes. These modules constitute an essential part of the broader GAMBIT framework, a major new software package for performing global fits. In this paper we present the observable calculations, data, and likelihood functions implemented in the three modules, as well as the conventions and assumptions used in interfacing them with external codes. We also present 3-BIT-HIT, a command-line utility for computing mass spectra, couplings, decays and precision observables in the MSSM, which shows how the three modules can be easily used independently of GAMBIT., 67 pages, 9 figures, updated to match version published in EPJC

The European physical journal / C 77(12), 831 (2017). doi:10.1140/epjc/s10052-017-5155-4, We introduce DarkBit, an advanced software code for computing dark matter constraints on various extensions to the Standard Model of particle physics, comprising both new native code and interfaces to external packages.This release includes a dedicated signal yield calculator for gamma-ray observations, which significantly extends current tools by implementing a cascade decay Monte Carlo, as well as a dedicated likelihood calculator for current and future experiments (gamLike). This provides a general solution for studying complex particle physics models that predict dark matter annihilation to a multitude of final states. We also supply a direct detection package that models a large range of direct detection experiments (DDCalc), and provides the corresponding likelihoods for arbitrary combinations of spin-independent and spin-dependent scattering processes. Finally, we provide custom relic density routines along with interfaces to DarkSUSY, micrOMEGAs,and the neutrino telescope likelihood package nulike. DarkBit is written in the framework of the Global And Modular Beyond the Standard Model Inference Tool (GAMBIT), providing seamless integration into a comprehensive statistical fitting framework that allows users to explore new models with both particle and astrophysics constraints, and a consistent treatment of systematic uncertainties. In this paper we describe its main functionality, provide a guide to getting started quickly, and show illustrative examples for resultsobtained with DarkBit (both as a standalone tool and as a GAMBIT module). This includes a quantitative comparison between two of the main dark matter codes (DarkSUSY and micrOMEGAs), and application ofDarkBit’s advanced direct and indirect detection routines to a simple effective dark matter model., Published by Springer, Berlin

State-of-the-art auto-correction methods for predictive text entry systems work reasonably well, but can never be perfect due to the properties of human language. We present an approach for the automatic detection of erroneous auto-corrections based on brain activity and text-entry-based context features. We describe an experiment and a new system for the classification of human reactions to auto-correction errors. We show how auto-correction errors can be detected with an average accuracy of 85%.

Objectives The aim of this study was to evaluate the evolution of the citation of articles from the European Journal of Emergency Medicine (EJEM) from 1994 (EJEM foundation) to 2015 and identify highly cited articles and their principal characteristics and determine a possible correlation between the citations counted in different databases. Materials and methods We obtained the articles published in EJEM from 1994 to 2015 in ISI-WoS (main source) and Scopus, Google Scholar, and Medline databases (accessory sources). The citations were quantified and their annual evolution and the bibliometric indices derived (impact factor and SCImago Journal Rank) were evaluated. We identified and analyzed the highly cited EJEM articles and evaluated the possible correlation between the citations counted for these articles in the databases. Results Overall, 1705 EJEM articles were cited 9422 times in 8122 different articles. The evolution of the global citation, impact factor, and SCImago Journal Rank from 1994 to 2015 increased significantly. The h-index of EJEM was 30, and 31 articles were considered highly cited (≥30 citations), 16.1% of them being clinical trials. By subjects, 22.5% corresponded to cardiology, 19.3% to emergency department management, and 12.9% to pediatrics; by countries, 81% were from Europe, with Belgian authors publishing four (12.9%) highly cited articles, and French, Spanish, British, and Swedish authors having three (9.7%) each. Two studies in the EJEM achieved the definition of 'citation classics' (more than 100 citations). The number of citations in all the databases, except Medline, showed statistically significant correlations. Conclusion Citation of EJEM articles has progressively increased and EJEM bibliometric indicators have improved; most highly cited articles are mainly by European authors.

The field of astroparticle physics is currently the focus of prolific scientific activity. In the last decade, this field has undergone significant developments thanks to several experimental results from CREAM, PAMELA, Fermi, and H.E.S.S. Moreover, the next generation of instruments, such as AMS-02 (launched on 16 May 2011) and CTA, will undoubtedly facilitate more sensitive and precise measurements of the cosmic-ray and γ -ray fluxes. To fully exploit the wealth of high precision data generated by these experiments, robust and efficient statistical tools such as Markov Chain Monte Carlo algorithms or evolutionary algorithms, able to handle the complexity of joint parameter spaces and datasets, are necessary for a phenomenological interpretation. The Grenoble Analysis Toolkit (GreAT) is an user-friendly and modular object orientated framework in C++, which samples the user-defined parameter space with a pre- or user-defined algorithm. The functionality of GreAT is presented in the context of cosmic-ray physics, where the boron-to-carbon (B/C) ratio is used to constrain cosmic-ray propagation models.

Cocaine is the second most consumed illegal drug in the western world, following cannabis. Since 1998, it is also the drug that more attendances generate in different emergency devices, and it is responsible for more of 60% of the emergencies directly related to drug consumption. This work reviews the main Spanish scientific articles published in the last 10 years, in which different factors related to the use of this drug have been analyzed in relation to the use of emergency by cocaine users. A total of 8,795 patients were included (interval 57-1,755), with an average age of 32.64 years (SD 3.02), and an average percentage of positives to cocaine of 54.78% (SD 47.03); there were 7 works with 100% of subjects being positive to cocaine. Males predominated with an average of 78.69% (SD 12). They presented cardiovascular symptoms in 30% cases (SD 22.7), neurological symptoms in 11.6% cases (SD 4.28) and psychiatric symptoms in 49.32% cases (SD 23.87). There was a multiple consumption in 49.02% of patients (interval 4.3-76.2), fundamentally associated with alcohol (57.78%, SD 6.18) and cannabis (21.56%, SD 10.72). Two hundred and forty-six patients (2.8%) needed admission and 8 died (0.09%).

Resumen Introduccion y objetivos El objetivo es determinar la frecuencia de uso y la disponibilidad en funcion del tiempo de las citas electronicas recogidas en R evista E spanola de C ardiologia y otras tres revistas biomedicas espanolas, asi como los factores que pueden influir en la disponibilidad y la recuperabilidad de los enlaces. Metodos Estudio descriptivo transversal que incluyo todas las citas de los trabajos publicados en el primer numero del ano de las revistas seleccionadas en los anos pares desde 2002 hasta 2012. Se recogieron datos de revista, publicacion, citas y enlaces. Las variables resultado fueron: porcentaje de articulos con al menos una cita electronica, porcentaje de cita electronica respecto al total de citas y porcentaje de accesibilidad y recuperabilidad de los enlaces. Resultados Se incluyeron 377 trabajos, de los que 73 (19,4%; intervalo de confianza del 95%, 15,2-23,5) incluyeron al menos una cita electronica, y 7.077 citas bibliograficas, de las que 164 (2,3%; intervalo de confianza del 95%, 2,0-2,7) fueron citas electronicas. R evista E spanola de C ardiologia incluyo 17 (15,2%) y 38 (1,3%) respectivamente. La frecuencia de uso se incremento significativamente con el tiempo (tendencia lineal, p Conclusiones Se esta haciendo un uso cada vez mas frecuente de citas electronicas en ciertas revistas biomedicas espanolas. La disponibilidad se pierde con el tiempo, y la probabilidad de recuperarla se relaciona con la informacion adicional.

Monitoring the affective states of a person can be highly relevant for numerous disciplines, including adaptive user interfaces, entertainment, ergonomics, medicine and therapy. In many situations, the affective state of a user is not easily observable from outside by audio or video, but may be identified by a brain-computer interface (BCI). Functional near-infrared spectroscopy (fNIRS) is a brain imaging modality gaining rising attention in the BCI community. However, fNIRS emotion recognition studies have only analyzed stimulus-locked effects. For realistic human-machine interaction scenarios, the point of time of an emotion-triggering event and the time span of an affective state are unknown. In this paper, we investigate a BCI that monitors the affective states of the user continuously over time (i.e. asynchronous BCI). In our study, fNRIS signals from eight subjects have been recorded at eight prefrontal locations in response to three different classes of affect induction by emotional audio-visual st...

Gallstone ileus is an uncommon type of mechanical intestinal obstruction caused by an intraluminal gallstone, and preoperative diagnosis is difficult in the Emergency department. This study is a retrospective analysis of the clinical presentation of 5 patients with gallstone ileus treated between 2000-2010. Clinical features, diagnostic testing, and surgical treatment were analyzed. Five patients were included: 2 cases showed bowel obstruction; 2 patients presented a recurrent gallstone ileus with prior surgical intervention; and one patient presented acute peritonitis due to perforation of an ileal diverticula. In all cases CT confirmed the preoperative diagnosis. In our experience, gallstone ileus may present with clinical features other than intestinal obstruction. In suspicious cases CT may be useful to decrease diagnostic delay, which is associated with more complications.