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Aims  The aim of this study was to determine the contemporary use of reperfusion therapy in the European Society of Cardiology (ESC) member and affiliated countries and adherence to ESC clinical practice guidelines in patients with ST-elevation myocardial infarction (STEMI). Methods and results  Prospective cohort (EURObservational Research Programme STEMI Registry) of hospitalized STEMI patients with symptom onset <24 h in 196 centres across 29 countries. A total of 11 462 patients were enrolled, for whom primary percutaneous coronary intervention (PCI) (total cohort frequency: 72.2%, country frequency range 0–100%), fibrinolysis (18.8%; 0–100%), and no reperfusion therapy (9.0%; 0–75%) were performed. Corresponding in-hospital mortality rates from any cause were 3.1%, 4.4%, and 14.1% and overall mortality was 4.4% (country range 2.5–5.9%). Achievement of quality indicators for reperfusion was reported for 92.7% (region range 84.8–97.5%) for the performance of reperfusion therapy of all patients with STEMI <12 h and 54.4% (region range 37.1–70.1%) for timely reperfusion. Conclusions  The use of reperfusion therapy for STEMI in the ESC member and affiliated countries was high. Primary PCI was the most frequently used treatment and associated total in-hospital mortality was below 5%. However, there was geographic variation in the use of primary PCI, which was associated with differences in in-hospital mortality.

Background Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to an infection. Objective To assess the prevalence and outcome of sepsis in RICU Patients and methods The study was conducted upon 403 patients admitted at RICU of the Abbassia Chest Hospital, Cairo, Egypt; 100 of them had sepsis either on admission or acquired in the RICU during the period from May 2019 to November 2019. Severity of illness was assessed by Acute Physiology and Chronic Health Evaluation II (APACHE II score), which was recorded within 24 h from patient admission. Quick sepsis-related organ failure assessment (qSOFA) score was recorded in emergency room, and sepsis-related organ failure assessment (SOFA) score was recorded on ICU admission and on the 3rd and 7th day of ICU stay. Type of infection (community or hospital acquired), infection site, and pathogenic organisms, all were recorded. Assessment was done also regarding mechanical ventilation, length of RICU stay, the presence of comorbidities, survived patients, and dead ones, as regards causes of death and risk factors. Results The study included 100 cases with sepsis out of 403 admitted cases in the same duration with frequency 24%. Among sepsis patients, 72% were males and 28%were females, with mean age 51.62 ± 18.62 years. The main diagnosis was pneumonia (62%), and the main comorbidity was diabetes mellitus (23%). There was significant increase in age among non-survivors when compared with survivors. There was significant increase in number of mechanically ventilated patients and a highly significant incidence of complications and need for vasoactive drugs among non-survivors when compared with survivors. There was a highly significant higher APACHE II score on the 1st day of admission among non-survivor patients. The SOFA score was significantly higher on the 1st day of admission and significantly higher on the 3rd and 7th day of admission among non-survivor patients when compared to survived patients. Conclusion The current study showed that sepsis affects nearly one quarter of cases admitted at RICU, and it is usually associated with higher mortality rate in those patients. Trial registration ClinicalTrials.gov NCT05240157. Registered February 15, 2022. Retrospectively registered.

Socioeconomically disadvantaged people are more frequent users of healthcare, as are the elderly. This situation is now disrupted with the rapid onset COVID-19 pandemic and its effect on the health system. Amidst a great deal of uncertainty and mixed messages from the WHO, Ministries of health and scientific communities, a methodology to keep the standard operating procedures of the school needs to be in place in order to allow the hospital to respond to its catchment area requirements. A number of focus groups and planning sessions were conducted using a purposeful sample of service providers in Ain Shams University Hospitals. A set of three guiding documents were generated and tested for agreeability and utility. All hospitals need to join forces to systematically organize the chaotic situation we are living with this post COVID-19 pandemic.

Tracheal stenosis (TS) is abnormal tracheal lumen narrowing that can impair sufficient airflow and cause severe morbidity. Any level of the trachea can be affected from the cricoid cartilage to the main carina.TS may be congenital or idiopathic but most commonly is secondary to a variety of pathologies including tracheal trauma, malignancy, extrinsic compression or iatrogenic. Endotracheal intubation and tracheostomy are considered the most common causes of TS. 1 Historically, surgical management has been the mainstay of treatment in such cases, while endoscopic procedures are often viewed as a bridge to definitive surgical intervention either in simple stenosis or in high-risk patients. However, with the recent advances in the field of interventional pulmonology, definitive management of TS using multiple endoscopic methods became increasingly common especially in patients deemed non-operable. 2 We aimed to prospectively investigate the role of bronchoscopic management either by mechanical dilatation and