Emergency Medicine International最新文献

{"title":"Emergency Endovascular Interventions on Descending Thoracic Aorta: A Single-Center Experience.","authors":"Piotr Buczkowski, Mateusz Puslecki, Marcin Ligowski, Marek Dabrowski, Sebastian Stefaniak, Zuzanna Fryska, Jerzy Kulesza, Robert Juszkat, Marek Jemielity, Bartlomiej Perek","doi":"10.1155/2023/6600035","DOIUrl":"10.1155/2023/6600035","url":null,"abstract":"<p><strong>Background: </strong>Implementation of emergency endovascular aortic repair provides an attractive opportunity in the treatment of complicated acute aortic syndromes involving descending aorta.</p><p><strong>Aim: </strong>The aim of this study was to analyze the effectiveness of thoracic endovascular aortic repair (TEVAR) for the treatment of acute surgical emergencies involving the descending thoracic aorta.</p><p><strong>Methods: </strong>A retrospective review of the medical records of all patients undergoing TEVAR in a single center since 2007 was undertaken. Patients with the aortic disease treated on emergency inclusion criteria were complicated spontaneous acute aortic syndrome (csAAS), traumatic aortic acute injuries (TAIs), and other indications requiring emergent intervention. Technical and clinical success with patient mortality, survival, and reoperation rate was evaluated according to Society for Vascular Surgery reporting standards for thoracic endovascular aortic repair (TEVAR).</p><p><strong>Results: </strong>The emergency interventions were necessary in 74 cases (51.0%), including patients with the complicated spontaneous acute aortic syndrome (csAAS) (64.8%; <i>n</i> = 48) and traumatic aortic acute injuries (TAIs) (31.1%). In addition, in one case aortic iatrogenic dissection (AID) and in 2 other fistulas after the previous stent graft, implantations were diagnosed. All procedures were done through surgically exposed femoral arteries while 2 hybrid procedures required additional approaches. The primary technical success rate was 95.9%, in 3 cases endoleak was reported. The primary clinical success occurred in 94.5%. All patients survived the endovascular interventions, whereas during in-hospital stay one of them died due to multiorgan failure (early mortality 1.3%). During the follow-up period, lasting 6 through 164 months (median 67), 11 patients died. Annual, five- and ten-year probability of survival was 86.4 ± 0.04%, 80.0 ± 0.05%, and 76.6 ± 0.06%, respectively. However, the rate of 5-year survivors was significantly higher after TAI (95.2%) than scAAS (63.4%) (<i>p</i>=0.008). Early after the procedure, one individual developed transient paraparesis (1.3%). No other serious stent-graft-related adverse events were noted within the postdischarge follow-up period.</p><p><strong>Conclusions: </strong>Descending aortic pathologies requiring emergent interventions can be treated by endovascular techniques with optimal results and low morbidity and mortality in an experienced and dedicated team.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9831698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10525841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Canadian Clinical Practice Guidelines Risk Prediction Tool for Acute Aortic Syndrome: The RIPP Score.","authors":"Robert Ohle,&nbsp;Sarah McIsaac,&nbsp;Madison Van Drusen,&nbsp;Aaron Regis,&nbsp;Owen Montpellier,&nbsp;Mackenzie Ludgate,&nbsp;Oluwadamilola Bodunde,&nbsp;David W Savage,&nbsp;Krishan Yadav","doi":"10.1155/2023/6636800","DOIUrl":"https://doi.org/10.1155/2023/6636800","url":null,"abstract":"<p><strong>Introduction: </strong>Acute aortic syndrome (AAS) is a rare clinical syndrome with a high mortality rate. The Canadian clinical practice guideline for the diagnosis of AAS was developed in order to reduce the frequency of misdiagnoses. As part of the guideline, a clinical decision aid was developed to facilitate clinician decision-making (RIPP score). The aim of this study is to validate the diagnostic accuracy of this tool and assess its performance in comparison to other risk prediction tools that have been developed.</p><p><strong>Methods: </strong>This was a historical case-control study. Consecutive cases and controls were recruited from three academic emergency departments from 2002-2020. Cases were identified through an admission, discharge, or death certificated diagnosis of acute aortic syndrome. Controls were identified through presenting complaint of chest, abdominal, flank, back pain, and/or perfusion deficit. We compared the clinical decision tools' C statistic and used the DeLong method to test for the significance of these differences and report sensitivity and specificity with 95% confidence intervals.</p><p><strong>Results: </strong>We collected data on 379 cases of acute aortic syndrome and 1340 potential eligible controls; 379 patients were randomly selected from the final population. The RIPP score had a sensitivity of 99.7% (98.54-99.99). This higher sensitivity resulted in a lower specificity (53%) compared to the other clinical decision aids (63-86%). The DeLong comparison of the C statistics found that the RIPP score had a higher C statistic than the ADDRS (-0.0423 (95% confidence interval -0.07-0.02); <i>P</i> < 0.0009) and the AORTAs score (-0.05 (-0.07 to -0.02); <i>P</i> = 0.0002), no difference compared to the Lovy decision tool (0.02 (95% CI -0.01-0.05 <i>P</i> < 0.25)) and decreased compared to the Von Kodolitsch decision tool (0.04 (95% CI 0.01-0.07 <i>P</i> < 0.008)).</p><p><strong>Conclusion: </strong>The Canadian clinical practice guideline's AAS clinical decision aid is a highly sensitive tool that uses readily available clinical information. It has the potential to improve diagnosis of AAS in the emergency department.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10234704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9637825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Addition of the Geriatric Nutritional Risk Index to the Prognostic Scoring Systems Did Not Improve Mortality Prediction in Trauma Patients in the Intensive Care Unit.","authors":"Cheng-Shyuan Rau,&nbsp;Ching-Hua Tsai,&nbsp;Sheng-En Chou,&nbsp;Wei-Ti Su,&nbsp;Shiun-Yuan Hsu,&nbsp;Ching-Hua Hsieh","doi":"10.1155/2023/3768646","DOIUrl":"https://doi.org/10.1155/2023/3768646","url":null,"abstract":"<p><strong>Background: </strong>Malnutrition is prevalent among critically ill patients and has been associated with a poor prognosis. This study sought to determine whether the addition of a nutritional indicator to the various variables of prognostic scoring models can improve the prediction of mortality among trauma patients in the intensive care unit (ICU).</p><p><strong>Methods: </strong>This study's cohort included 1,126 trauma patients hospitalized in the ICU between January 1, 2018, and December 31, 2021. Two nutritional indicators, the prognostic nutrition index (PNI), a calculation based on the serum albumin concentration and peripheral blood lymphocyte count, and the geriatric nutritional risk index (GNRI), a calculation based on the serum albumin concentration and the ratio of current body weight to ideal body weight, were examined for their association with the mortality outcome. The significant nutritional indicator was served as an additional variable in prognostic scoring models of the Trauma and Injury Severity Score (TRISS), the Acute Physiology and Chronic Health Evaluation (APACHE II), and the mortality prediction models (MPM II) at admission, 24, 48, and 72 h in the mortality outcome prediction. The predictive performance was determined by the area under the receiver operating characteristic curve.</p><p><strong>Results: </strong>Multivariate logistic regression revealed that GNRI (OR, 0.97; 95% CI, 0.96-0.99; <i>p</i>=0.007), but not PNI (OR, 0.99; 95% CI, 0.97-1.02; <i>p</i>=0.518), was independent risk factor for mortality. However, none of these predictive scoring models showed a significant improvement in prediction when the GNRI variable is incorporated.</p><p><strong>Conclusions: </strong>The addition of GNRI as a variable to the prognostic scoring models did not significantly enhance the performance of the predictors.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10247323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9663310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retracted: Aesthetic Effect of Autologous Fat Transplantation on Frontotemporal Depression Filling and Its Influence on SCL-90 and SES of Patients.","authors":"Emergency Medicine International","doi":"10.1155/2023/9830651","DOIUrl":"https://doi.org/10.1155/2023/9830651","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1155/2022/3374780.].</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10470076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10151344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retracted: Application Effect of External and Internal Elevation of Maxillary Sinus in Implant Restoration of Posterior Maxilla.","authors":"Emergency Medicine International","doi":"10.1155/2023/9878673","DOIUrl":"https://doi.org/10.1155/2023/9878673","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1155/2022/7879633.].</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10142889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retracted: Serological Characteristics, Etiological Analysis, and Treatment Prognosis of Children with Congenital Hypothyroidism.","authors":"Emergency Medicine International","doi":"10.1155/2023/9841383","DOIUrl":"https://doi.org/10.1155/2023/9841383","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1155/2022/8005848.].</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10470085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10142890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Prediction of Epilepsy after Encephalitis in Childhood Based on EEG and Clinical Features.","authors":"Xiaojuan Sun,&nbsp;Jinhua Zhao,&nbsp;Chunyun Guo,&nbsp;Xiaoxiao Zhu","doi":"10.1155/2023/8862598","DOIUrl":"https://doi.org/10.1155/2023/8862598","url":null,"abstract":"<p><strong>Objective: </strong>The present study was designed to establish and evaluate an early prediction model of epilepsy after encephalitis in childhood based on electroencephalogram (ECG) and clinical features.</p><p><strong>Methods: </strong>255 patients with encephalitis were randomly divided into training and verification sets and were divided into postencephalitic epilepsy (PE) and no postencephalitic epilepsy (no-PE) according to whether epilepsy occurred one year after discharge. Univariate and multivariate logistic regression analyses were used to screen the risk factors for PE. The identified risk factors were used to establish and verify a model.</p><p><strong>Results: </strong>This study included 255 patients with encephalitis, including 209 in the non-PE group and 46 in the PE group. Univariate and multiple logistic regression analysis showed that hemoglobin (OR = 0.968, 95% CI = 0.951-0.958), epilepsy frequency (OR = 0.968, 95% CI = 0.951-0.958), and ECG slow wave/fast wave frequency (S/F) in the occipital region were independent influencing factors for PE (<i>P</i> < 0.05).The prediction model is based on the above factors: -0.031 × hemoglobin -2.113 × epilepsy frequency + 7.836 × occipital region S/F + 1.595. In the training set and the validation set, the area under the ROC curve (AUC) of the model for the diagnosis of PE was 0.835 and 0.712, respectively.</p><p><strong>Conclusion: </strong>The peripheral blood hemoglobin, the number of epileptic seizures in the acute stage of encephalitis, and EEG slow wave/fast wave frequencies can be used as predictors of epilepsy after encephalitis.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10359137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9856027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retracted: Study on the Influencing Factors of Osteoarthritis in Southern China.","authors":"Emergency Medicine International","doi":"10.1155/2023/9847534","DOIUrl":"https://doi.org/10.1155/2023/9847534","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1155/2022/2482728.].</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10432087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10049972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Situation of Pediatric Patients with Testicular Torsion in Times of COVID-19.","authors":"Marta Komarowska,&nbsp;Małgorzata Kowalska,&nbsp;Kamil Grubczak,&nbsp;Alicja Pawelczyk,&nbsp;Adam Hermanowicz,&nbsp;Wojciech Debek,&nbsp;Ewa Matuszczak","doi":"10.1155/2023/9960452","DOIUrl":"https://doi.org/10.1155/2023/9960452","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether the COVID-19 pandemic had an influence on presentation of testicular torsion and/or increase in the frequency of orchiectomy. <i>Patients and Methods.</i> This retrospective study included boys under 18 years of age with testicular torsion divided in two groups: pre-COVID operated in 2019 vs. COVID-19 group from 2020. We compared demographic data as well as local and general symptoms. We analyzed additional tests, intraoperative findings, length of operation and hospitalization, and followup. <i>Results.</i> We analyzed the data collected from 44 patients (24 boys from first group vs. 20 boys from second group). The median age was 13.4 years vs. 14.5 years in the latter. The median time of symptoms duration was 6.5 hours and 8.5 hours, respectively. The main manifestation was testicular pain without additional signs. The results of the laboratory tests did not reflect local advancement. In the 2019 group, Doppler ultrasound showed absent blood flow in the affected testicle in 62% vs. 80% in 2020. The mean time from admission to surgery was virtually identical: 75 minutes in 2019 vs. 76 minutes in 2020. The mean duration of scrotal revision was similar in both groups. There was only one significant difference: the degree of twisting. In 2019, the mean was 360° vs. 540° in 2020. Incidence of orchiectomy also did not significantly vary between the analyzed time periods, with 21% during the pandemic and 35% during the pre-COVID-19 period. <i>Conclusion.</i> We did not observe an increase in the number of testicular torsion cases during the COVID-19 pandemic. Most importantly, the rates of orchiectomy did not significantly differ between the patients with testicular torsion presenting during the COVID-19 outbreak.</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10185415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9841123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retracted: Efficacy of Modified Nonpneumatic Transaxillary Approach in the Treatment of Thyroid Cancer and Its Effect on Immune Function and Parathyroid Function.","authors":"Emergency Medicine International","doi":"10.1155/2023/9814359","DOIUrl":"https://doi.org/10.1155/2023/9814359","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.1155/2022/3336880.].</p>","PeriodicalId":11528,"journal":{"name":"Emergency Medicine International","volume":null,"pages":null},"PeriodicalIF":1.2,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10469360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10149862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}