BACKGROUND:Eosinophilic esophagitis (EoE) is an emerging chronic inflammatory disease of the esophagus, particularly common in atopic children. Diagnosis is based on clinical, endoscopic, and histological signs, but symptoms are often nonspecific and vary by age. To better assess the frequency and severity of symptoms and monitor paediatric patients, the PEESS™ v2.0 score, a standardized validated questionnaire, was developed in 2011 to be completed by parents and children if above 8 years old. OBJECTIVES:We aim to review studies evaluating the correlation between PEESS™ results and clinical symptoms, endoscopic and histological severity, as well as various esophageal functional investigations in children with EoE. METHODS AND SETTING:A bibliographic search was conducted in the PubMed® database using the keywords: "PEESS" and "eosinophilic esophagitis". RESULTS:Sixteen articles discussing PEESS™ and published before August 25 were analysed. The PEESS™ v2.0 completed by parents is correlated with that completed by children according to 3 studies. To date, no positive predictive value has been calculated, and the score itself does not allow for diagnosis. The PEESS™ helps detect residual symptoms, particularly those related to seasonal allergies, and can contribute to treatment adjustments. The correlation between PEESS™ and histological activity is inconsistent. No study has yet evaluated the correlation between PEESS™ v2.0 and other esophageal functional tests (eg: manometry, impedance planimetry, endoscopic ultrasonography). CONCLUSION:PEESS™ is a useful tool to help for diagnosis and follow-up of pediatric EoE. However, it is not specific to EoE, and no threshold is defined. Further research is needed to refine its role in the diagnosis and monitoring of EoE. In the meantime, regular endoscopic follow-up and histological analysis of esophageal biopsies remain essential despite their invasive nature.
Strokes are a neurological emergency whose treatment has been transformed by broader indications and therapeutic windows, pharmacological advances, and endovascular innovations. These developments rely on rigorous coordination of care within the emergency chain. Nurses now play a strategic role in this chain, combining clinical expertise with collective performance.
Abstract Background and aims In acute ischemic stroke due to large vessel occlusion (AIS-LVO) admitted to primary stroke centers (PSCs) in the early time-window, arterial recanalization occurring during inter-hospital transfer for endovascular therapy (EVT) is strongly linked to better outcomes. Whether this applies to late-presenting patients is unknown. Methods Multicenter retrospective study of consecutive AIS-LVO patients admitted between 2020 and 2024 to 20 French PSCs beyond 4.5 hours from the last time seen well and subsequently transferred to a comprehensive center for EVT, with arterial imaging performed both at the PSC and on comprehensive center arrival. Interhospital recanalization was assessed by comparison of the baseline and post-transfer arterial imaging and was defined as mTICI score 2b-3. Results Overall, 578 patients were included (median age 71 years, NIHSS 15, last seen well-to-PSC imaging time 10.5hrs, off-label intravenous thrombolysis prior to transfer used in 40%). Inter-hospital recanalization occurred in 61/578 (11%) patients. Variables independently associated with inter-hospital recanalization were thrombolysis (aOR, 10.6 [95%CI 5.1–21.8]), more distal occlusions (intracranial carotid occlusion as reference: aOR, 1.8 [0.7–5.0] for M1, 5.8 [2.0–16.7] for M2 and 5.6 [1.4–21.6] for basilar), and longer time from PSC imaging-to-recanalization assessment (aOR 1.3 [1.1–1.6]). Inter-hospital recanalization was associated with reduced 3-month disability (adjusted cOR, 3.1 [1.9–5.0]). Conclusions Consistent with findings in the early time window, recanalization occurring during interhospital transfer was associated with reduced disability in the late time window. These results underscore the need for therapeutic strategies aimed at enhancing inter-hospital recanalization in late-presenting stroke patients. Conflict of interest Pierre Seners reports speaker fees from Boerhinger-Ingelheim. Guillaume Turc reports lecturing fees from Guerbet France, consulting fees for Neurologica and AI-Stroke. Other authors have nothing to disclose.
