Clinical and Experimental Emergency Medicine最新文献

{"title":"Rethinking artificial intelligence in medicine: from tools to agents.","authors":"Yeong Chan Lee","doi":"10.15441/ceem.25.125","DOIUrl":"10.15441/ceem.25.125","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"12 2","pages":"101-103"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607696","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multicenter retrospective cohort study on incidence and diagnostics in emergency department patients with acute vestibular syndrome.","authors":"Renske Eveline Henriëtte Maria Bijl, Domenique Wilhelmina Antonia Maria Zaunbrecher, Petra Mathilda de Muynck, Ryanne Eggink, Ronique Timmer, Evian Willems, Sam Koning, Marieke Saskia Sanders, Kim Ellis Jie","doi":"10.15441/ceem.24.225","DOIUrl":"10.15441/ceem.24.225","url":null,"abstract":"<p><strong>Objective: </strong>Acute vestibular syndrome (AVS) is a common symptom experienced by emergency department (ED) patients. Differentiating a peripheral from central etiology poses a challenge, and clinical practice lacks a uniform diagnostic approach. This study aims to provide insight on incidence and diagnostics in ED patients presenting with AVS in the Netherlands.</p><p><strong>Methods: </strong>This was a multicenter retrospective cohort study of ED patients presenting with AVS in one of two hospitals during a 3-year period. The primary endpoints were incidence, diagnostics, and diagnosis at ED presentation versus follow-up. The secondary endpoint was type of therapy.</p><p><strong>Results: </strong>Among the 500 AVS cases included, the annual incidence was 0.1%. Eighty-five ED patients (17.0%) were diagnosed with stroke, 285 (57.0%) did not experience stroke, and 130 (26.0%) exhibited an unsure etiology. At follow-up, diagnosis was revised in 145 patients (29.0%), with stroke missed in 29 (5.8%). A triad of clinical tests (head impulse test, observation of nystagmus, test of skew; HINTS) was completed for 106 patients (21.2%), computed tomography (CT) scans were collected in 342 patients (68.4%), and magnetic resonance imaging scans were collected for 153 patients (30.6%). Antiplatelet therapy was prescribed in 135 cases. In 69% of these, the initial diagnosis was revised to no stroke. Among eight patients who received thrombolysis, the initial diagnosis was revised for three. Of those patients in whom stroke was initially not identified, 23 (79%) received suboptimal treatment in lieu of antiplatelet therapy.</p><p><strong>Conclusion: </strong>The annual incidence of AVS in this Dutch ED cohort is 0.1%. ED diagnosis is often uncertain, with one-third of diagnoses later revised. This study substantiates that clinical practice lacks a uniform diagnostic pathway, with an overuse of CT imaging and underuse of HINTS. Further research on an optimal diagnostic approach is warranted to improve treatment of AVS.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"148-155"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245650/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723138","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Plasmalyte beneficial in the resuscitation of diabetic ketoacidosis patients? A narrative review.","authors":"Resshme Kannan Sudha, Kinza Moin, Falaah Abdul Hameed, Hamid Aizaz Chatha","doi":"10.15441/ceem.24.209","DOIUrl":"10.15441/ceem.24.209","url":null,"abstract":"<p><p>Fluid resuscitation is vital in the treatment of diabetic ketoacidosis (DKA) patients. The purpose of this narrative review is to analyze the role of Plasmalyte in the fluid resuscitation of adult DKA patients. A thorough search was conducted in PubMed, MEDLINE, and Embase. Studies conducted between January 1, 2010, and March 31, 2023, were collected. Of 123 results, five pertinent randomized controlled trials were included. The close resemblance of Plasmalyte's electrolyte composition to that of human plasma, and its role in the prevention of hyperchloremic metabolic acidosis are some of its key benefits in patients with diabetic ketoacidosis. Plasmalyte's role in length of stay, time to resolution of diabetic ketoacidosis, and mortality in DKA patients varied among studies. Hence, further research on these topics is needed.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"104-109"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academic articles with public health perspectives as a potential tool for Korean doctors in addressing health policy concerns.","authors":"Gabyong Jeong","doi":"10.15441/ceem.24.349","DOIUrl":"10.15441/ceem.24.349","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"173-174"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of good prognosis for pediatric drowning patients.","authors":"Hyunseok Cho, Sang Hoon Lee, Jun Hwi Cho","doi":"10.15441/ceem.24.240","DOIUrl":"10.15441/ceem.24.240","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated prognostic factors for pediatric drowning patients. The association between functional outcomes and clinical factors was investigated.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using data for pediatric drowning patients from the Korean Community-based Severe Trauma Survey from 2016 to 2020. The primary outcome was a good prognosis at discharge, defined as a Glasgow Outcome Scale score of 5. A multivariable logistic regression analysis was performed to evaluate independent factors associated with the primary outcome.</p><p><strong>Results: </strong>From 237,616 patients, we identified 406 drowning patients aged ≤19 years (mean age, 8.8 years). At discharge, 41.0% of those patients had a good recovery. The absence of prehospital cardiac arrest (adjusted odds ratio [aOR], 98.7; 95% confidence interval [CI], 32.9-295.8), indoor location (aOR, 4.0; 95% CI, 1.7-9.3), and transfer to a high-volume hospital (aOR, 2.5; 95% CI, 1.1-5.8) were significant independent factors associated with a good outcome. Age, sex, the intent of injury, and prehospital time were not associated with the outcome.</p><p><strong>Conclusion: </strong>Our study identified independent prognostic factors for drowning patients, highlighting the importance of prehospital conditions and hospital care settings in determining outcomes. These findings could be useful in developing clinical strategies for managing such patients.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"156-163"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the efficacy of electrocardiogram for heart rate evaluation during newborn resuscitation at birth: a prospective observational study.","authors":"Kee Hyun Cho, Hyun Su Lee, Eun Sun Kim","doi":"10.15441/ceem.24.245","DOIUrl":"10.15441/ceem.24.245","url":null,"abstract":"<p><strong>Objective: </strong>This study assessed the efficacy of electrocardiogram (ECG) compared to pulse oximetry (PO) in detecting heart rate (HR) during high-risk newborn resuscitation.</p><p><strong>Methods: </strong>A prospective observational study was performed with high-risk delivery cases to measure the time required for HR detection. A conventional PO and a standard ECG monitor were used for HR assessment.</p><p><strong>Results: </strong>Forty-one infants were analyzed in the study, and 11 needed resuscitation. The study population was divided according to gestational age (GA): 9 were GA <32 weeks, 28 were GA 32-35 weeks, and 4 were GA ≥36 weeks. Time from ECG placement to HR detection (median, 30 seconds; interquartile range [IQR], 20-43.5 seconds) was significantly faster than that from PO placement (median, 125 seconds; IQR, 100-175 seconds; P<0.001). Time from ECG placement to HR detection was shortest in infants with GA <32 weeks at birth (19 seconds [IQR, 11.5-30.0] for GA <32 weeks vs. 34.5 seconds [IQR, 25.0-44.3] for GA 32-35 weeks vs. 39.5 seconds [IQR, 30.0-64.8] for GA ≥36 weeks; P=0.039).</p><p><strong>Conclusion: </strong>ECG effectively evaluated HR during neonatal resuscitation compared to PO. Low- GA infants who require resuscitation may benefit from HR evaluation with nearby standard ECG.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"164-168"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Computed tomography images of acute iodinate contrast medium reaction.","authors":"Annapaola Truono, Nicola Romano, Lorenzo Bacigalupo, Antonio Castaldi","doi":"10.15441/ceem.24.295","DOIUrl":"10.15441/ceem.24.295","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"175-176"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245648/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young woman with recurrent paroxysmal stridor after extubation.","authors":"Dong Eun Lee, Jong Kun Kim, Sin-Youl Park","doi":"10.15441/ceem.24.311","DOIUrl":"10.15441/ceem.24.311","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"177-179"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing community awareness and survival rates through a systemic approach to cardiac arrest.","authors":"Guglielmo Imbriaco, Donatella Del Giudice, Federico Semeraro, Lorenzo Gamberini","doi":"10.15441/ceem.25.014","DOIUrl":"10.15441/ceem.25.014","url":null,"abstract":"","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":"12 2","pages":"180-182"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245652/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tricuspid annular plane systolic excursion (TAPSE) in chronic obstructive pulmonary disease patients: a systematic review and meta-analysis.","authors":"Maria Groussis, Quincy K Tran, Megan Hoffer, Jalil Ahari, Ali Pourmand","doi":"10.15441/ceem.24.228","DOIUrl":"10.15441/ceem.24.228","url":null,"abstract":"<p><strong>Objective: </strong>Tricuspid annular plane systolic excursion (TAPSE) is an echocardiographic parameter that serves as a prognostic indicator for the severity of chronic obstructive pulmonary disease (COPD) clinical course. This study, consisting of a systematic review and meta-analysis, evaluates the current literature to elucidate the relationship between TAPSE measurement in COPD patients versus control subjects to discern baseline evidence of right heart strain.</p><p><strong>Methods: </strong>PubMed, Scopus, CINAHL, Web of Science, and Cochrane Library databases were searched from their beginnings through November 1, 2023, for eligible studies. Outcomes included the difference of TAPSE measurement and right ventricular (RV) wall thickness between COPD patients and control patients. The Newcastle-Ottawa Scale was applied to assess risk of bias, Q-statistics and I2 values were used to assess for heterogeneity, and Egger and Begg tests were used to assess publication bias.</p><p><strong>Results: </strong>The search yielded 11 studies reporting TAPSE values involving 1,671 patients, 800 (47.9%) of which had COPD. The unadjusted mean TAPSE value for COPD patients was 18.9±4.0 mm, while the mean TAPSE value for control patients was 22.2±0.8 mm. The presence of COPD was significantly associated with decreased TAPSE values, with the meta-analysis reporting the mean difference in TAPSE value at -3.0 (95% confidence interval, -4.3 to -1.7; P=0.001) between COPD and control patients. Six studies reported the RV free wall thickness. The unadjusted mean RV free wall thickness for COPD patients was 4.9±1.2 mm, and for control patients was 3.4±0.7 mm.</p><p><strong>Conclusion: </strong>This meta-analysis demonstrated statistically significant lower TAPSE values and thicker RV free wall among COPD patients as compared with control patients.</p>","PeriodicalId":10325,"journal":{"name":"Clinical and Experimental Emergency Medicine","volume":" ","pages":"121-131"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142139481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}