International Journal of Emergency Medicine最新文献

{"title":"Neuron-specific enolase: a potential biomarker in the prediction of pediatric head trauma outcomes: a systematic review and meta-analysis.","authors":"Amir Behforouz, Masoud Arabfard, Mohammad Javad Behzadnia","doi":"10.1186/s12245-025-00932-1","DOIUrl":"10.1186/s12245-025-00932-1","url":null,"abstract":"<p><strong>Background: </strong>Traumatic brain injury (TBI) is the most common type of brain injury and significantly contributes to morbidity and mortality in both adults and children. Diagnosing pediatric head trauma with precision is difficult, particularly for youngsters displaying mild symptoms. Contemporary research has investigated the capacity of biomarkers, including neuron-specific enolase (NSE), to enhance the precision of diagnosis.</p><p><strong>Objective: </strong>The objective of this systematic review and meta-analysis was to assess the levels of NSE in pediatrics with head trauma.</p><p><strong>Methods: </strong>A comprehensive literature search was performed among PubMed, Scopus, and Embase databases, from the inception to August 17^th, 2024, identifying 963 articles. Any article that evaluated the levels of NSE with any source of sampling in the pediatric population was considered as a possible inclusion. The Standard Mean Difference and confidence intervals of the pooled data were calculated. Also, the robustness of the data was confirmed using sensitivity analysis, and the presence of publication bias was evaluated using funnel plots.</p><p><strong>Results: </strong>Following the screening and eligibility validation process, 12 studies were selected, which evaluated 806 participants. Meta-analyses revealed markedly elevated NSE levels in patients as compared to controls (p-value < 0.001), indicating its potential as a biomarker for head injury. Further subgroup analyses demonstrated more pronounced correlations between increased NSE levels and severe trauma (p-value < 0.001). In addition, cerebrospinal fluid samples had significantly higher NSE levels than other sample origins (p-value < 0.001). Elevated levels of NSE were also associated with unfavorable results, as assessed by the Glasgow Outcome Scale (p-value < 0.001).</p><p><strong>Conclusion: </strong>The findings emphasize the capacity of NSE as a diagnostic and predictive instrument for pediatric head injury, justifying additional research into its clinical uses.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"113"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12211948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540139","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":"Acute phase reactants in the diagnosis of soft tissue infections of the upper extremity.","authors":"John A Buchan, Andrew Burkhart, Phillip R Ross, Peter J Stern","doi":"10.1186/s12245-025-00905-4","DOIUrl":"10.1186/s12245-025-00905-4","url":null,"abstract":"<p><strong>Background: </strong>Upper extremity soft tissue infections are commonly encountered in emergency department settings and often require timely interventions. Acute phase reactants, such as C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and white blood cell count (WBC), are commonly used in diagnostic workups. However, the utility of these biomarkers in the management of upper extremity infections remains uncertain. This study evaluates the diagnostic value of these acute phase reactants in a broad cohort of patients requiring intervention for upper extremity infections.</p><p><strong>Results: </strong>A retrospective review over five years identified 103 patients with upper extremity infections who required incision and drainage. The study found variable sensitivity and reliability of acute phase reactants, particularly for infections distal to the wrist. The average ESR was 42 mm/hr, CRP 64.1 mg/L, and WBC 10.5 × 10³/uL. Of patients with normal acute phase reactants, all had infections located at or distal to the wrist. Notably, patients with culture-negative infections did not exhibit significant differences in laboratory values compared to those with positive cultures.</p><p><strong>Conclusions: </strong>Our study highlights the limitations of acute phase reactants as diagnostic tools for upper extremity infections, particularly in cases involving infections distal to the wrist. Despite the frequent elevation of these markers in infections requiring surgical intervention, they should not be relied upon as sole determinants of management. A thorough clinical examination and history remain critical in guiding treatment decisions. This study underscores the need for caution when using these biomarkers to rule in or rule out infection in the emergency department.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"112"},"PeriodicalIF":2.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12186381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475117","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":"Sepsis in patients with severe TBI: a retrospective CT scoring study.","authors":"Guang-Sheng Wang, Da-Zhi Zhou, Shao-Dan Wang, Ye-Ting Zhou, Dao-Ming Tong","doi":"10.1186/s12245-025-00911-6","DOIUrl":"10.1186/s12245-025-00911-6","url":null,"abstract":"<p><strong>Background: </strong>Multiple organ failure (MOF) is a severe complication associated with high mortality in sepsis after severe TBI (sTBI).</p><p><strong>Objective: </strong>To investigate the usefulness of a rapid computed tomography (CT) screening score for predicting of mortality and outcomes of sepsis after sTBI.</p><p><strong>Methods: </strong>We retrospectively analyzed those data of patients who were admitted to the ICU. All sTBI patients with or without sepsis underwent rapid CT screening before ICU admission and were admitted to the ICU for > 24 h were included in this study. The main outcome was sepsis-related the mortality after sTBI. The secondary outcome was the GOSE score during the first 60 days.</p><p><strong>Results: </strong>Among a random sample of 412 adult patients with sTBI, we found 249 sepsis after sTBI (60.4%) and 163 (39.6%) non- sepsis after sTBI events. The main organ failure was early brain (94.8%) and lung injury(91.2%) caused by community-acquired pnumonia (CPA). The CT score was higher in the sTBI with sepsis group than in the sTBI without sepsis group(wean 3.5 score vs. 0.9 score, p < 0.001).The SOFA score was also higher in the sTBI with sepsis group than in the sTBI without sepsis group(wean 5.9 score vs. 3.6 score, p < 0.001). The risk of death for sepsis after sTBI was an elevated CT score (hazard ratio[HR], 4.6; 95% confidence interval[CI], 3.373-10.49; p < 0.001) and an elevated SOFA score (HR,3.0; 95% CI, 2.054-4.826; p < 0.001).The area under the ROC curve for mortality was significantly larger for the elevated CT score (0.90, 95%CI 0.86-0.97 ) than for the elevated score (0.85, 95%CI 0.81-0.89 ) (P < 0.001). The elevated CT score in the area under the ROC curve for mortality was with 97.0% of sensitivity and 100.0% of specificity. At 60 days follow-up, the risk of death for sepsis after sTBI was higher than those non- sepsis after sTBI (p < 0.001).</p><p><strong>Conclusions: </strong>Elevated CT score is a well indicator of high incidence and mortality for sepsis after sTBI in the ICU, which suggests that this very current and practical event is involved to a global health care problem. But it could still need further verification in future investigation.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"111"},"PeriodicalIF":2.0,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12183873/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475118","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":"Effectiveness of mobile stroke units in reducing time to thrombolysis in acute ischemic stroke: a scoping review.","authors":"Nicholas Aderinto, Gbolahan Olatunji, Emmanuel Kokori","doi":"10.1186/s12245-025-00903-6","DOIUrl":"10.1186/s12245-025-00903-6","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"109"},"PeriodicalIF":2.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336463","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":"Frequent callers vs. frequent users - a scoping review of frequent contacts to the emergency medical services.","authors":"Astrid Karina Valås Harring, Maria Kjærgaard, Tine Bennedsen Gehrt","doi":"10.1186/s12245-025-00925-0","DOIUrl":"10.1186/s12245-025-00925-0","url":null,"abstract":"<p><strong>Background: </strong>A significant limitation in the literature on frequent callers and frequent users of prehospital Emergency Medical Services (EMS) is the lack of consistent and thus, comparable definitions, as well as inconsistent use of terminology. Here we aim to summarise and address discrepancies in the existing literature, contributing to the ongoing discussion.</p><p><strong>Method: </strong>We conducted a systematic search of available literature from 2000 up until February 2024 in the PubMed database. Search terms related to both frequent callers and frequent users of the prehospital EMS.</p><p><strong>Result: </strong>A total of 19 articles were included in our analysis of definitions of frequent callers and users of prehospital EMS. The average minimum number of calls required to be defined as a frequent caller was 42.5 calls per year (range: 4-120). For frequent users, an average minimum number of ambulance responses was 4.7 per year (range: 3-10).</p><p><strong>Conclusion: </strong>Our findings emphasise both the possibility and the need to distinguish between frequent users and frequent callers of prehospital EMS. Existing definitions in the literature vary widely, making comparisons difficult. Standardised definitions and consistent terminology are essential to address underlying issues and enable further research synthesis.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"108"},"PeriodicalIF":2.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336464","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":"Accessory spleens, mixed hiatal hernia, and incisional hernias: a complex case of multidisciplinary surgical management.","authors":"Hamdah Hanifa, Mohi Alddin Moustafa Mahouk, Fadiah Hazem Albaroudi, Enas Saleem Khallouf, Dana Abu Nokta, Ranim Alrihani, Basil Alsaleh, Youssef Zeeb, Ramez Altair, Malek AlBalkhi, Rawad Asami, Abdullah Shekh Najjaren","doi":"10.1186/s12245-025-00917-0","DOIUrl":"10.1186/s12245-025-00917-0","url":null,"abstract":"<p><strong>Background: </strong>Accessory spleens, arising from incomplete fusion during embryogenesis, are frequent developmental anomalies detected incidentally in abdominal imaging studies. Despite surgical advancements, post-laparotomy incisional hernias persist, while hiatal hernias, common in older adults, often present asymptomatically.</p><p><strong>Case presentation: </strong>A 55-year-old male presented with abdominal pain, chronic vomiting, and gastrointestinal bleeding. Evaluation unveiled a mixed hiatal hernia alongside multiple accessory spleens, necessitating surgical intervention. A midline incision facilitated adhesion release, hernia repair, and a 360-degree Nissen fundoplication. Postoperatively, the patient stabilized, discharged with a liquid diet and medications. Histopathological analysis confirmed benign findings, emphasizing successful complex abdominal condition management.</p><p><strong>Conclusion: </strong>Comprehensive assessment is vital for patients with intricate gastrointestinal symptoms and surgical histories. Accurate diagnosis and intervention, encompassing accessory spleen excision and hernia repair, resulted in notable clinical enhancement devoid of complications.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"110"},"PeriodicalIF":2.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336421","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":"Sex-stratified patterns in geriatric patients with mild traumatic brain injury and intracranial bleeding: a retrospective cohort study.","authors":"Marian Sedlak, Kornelia Hutnanova, Tomas Petras, Eva Sedlakova, Robert Kremen, Denis Marko, Radoslav Morochovic, Rastislav Burda","doi":"10.1186/s12245-025-00915-2","DOIUrl":"10.1186/s12245-025-00915-2","url":null,"abstract":"<p><strong>Background: </strong>Mild traumatic brain injury (mTBI) is a common diagnosis among elderly patients treated in emergency departments. It is often complicated by age-related physiological changes such as brain atrophy, cognitive impairment, and frailty. While sex differences are increasingly recognized in TBI pathophysiology and clinical management, limited research has explored their impact on geriatric mTBI complicated by intracranial bleeding. This study aimed to investigate sex-stratified patterns in injury mechanisms, clinical presentation, and associated injuries among older adults with mTBI.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center cohort study of geriatric patients (≥ 65 years) hospitalized at the Louis Pasteur University Hospital in Košice, Slovakia with mTBI complicated by intracranial bleeding over a 30-month period (July 2022- December 2024). Patient data were extracted from electronic health records, including demographic characteristics, injury mechanisms, symptomatology, radiological findings, and clinical outcomes. Statistical analysis was performed using descriptive and comparative methods.</p><p><strong>Results: </strong>A total of 117 patients (55 females, 62 males) met the inclusion criteria. The median age was 77.0 years (IQR: 12.0), with females presenting at a higher median age than males (80 vs. 75.5 years). Causes of injury differed significantly between sexes (p < 0.001); while mechanical falls were predominant in both groups, alcohol-related injuries were significantly more common in males (37.1% vs. 7.3%). Symptom presentation also varied, with females exhibiting a higher prevalence of multiple symptoms, while males more frequently reported amnesia or loss of consciousness (p = 0.029). Additional injuries showed sex-related differences, with skull fractures more prevalent in males (41.9% vs. 21.8%) and pelvic (0 vs. 7.3%) or upper limb fractures (0 vs. 12.7%) more common in females (p = 0.005).</p><p><strong>Conclusion: </strong>Sex-based differences in the presentation and symptomatology of geriatric patients with mTBI and intracranial bleeding highlight the need for tailored diagnostic and management approaches. Recognizing these differences could improve clinical assessment and individualized care. Further research is needed to refine sex-specific diagnostic and therapeutic strategies in this vulnerable population.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"107"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12178007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333088","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":"Evolving trends in psychiatric emergency services in Southern China: a seven-year retrospective analysis.","authors":"Cuiling Zhang, Suiyun Weng, Xiaoyu Zhang, Songkang Liu, Min Yu, Miaoling Jiang","doi":"10.1186/s12245-025-00904-5","DOIUrl":"10.1186/s12245-025-00904-5","url":null,"abstract":"<p><strong>Background: </strong>The Affiliated Brain Hospital, Guangzhou Medical University is an important provider of psychiatric emergency services (PES) in southern China. Revealing the evolution trend of the psychiatric emergency services of this hospital can help decision-makers formulate relevant policies. However, at present, there is a lack of large-scale, long-term retrospective studies.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patient records from the psychiatric emergency room (PER) of the Affiliated Brain Hospital, Guangzhou Medical University. Data included demographic and clinical variables were aggregated annually and described using percentages from 2018 to 2024. Chi-square and Fisher's exact test were used to confirm significance of the trends.</p><p><strong>Results: </strong>More voluntary health-seeking behaviors, broader medical insurance coverage, more cautious use of restraint measures, and more precise diagnoses were observed from 2018 to 2024. Besides, there were an increasing number of younger, highly educated, unmarried, and unemployed visitors. We also found that the gender gap is widening and medical resources are increasingly strained. There are differences between judicial and medical personnel in making compulsory decisions. During Covid-19, the demographic and clinical variables show significant changes.</p><p><strong>Conclusions: </strong>PES in southern China have developed to a certain extent, but they are also confronted with obstacles at the same time. These trends underscore the need for enhanced referral systems, expanded community-based psychiatric care, ethical guidelines for managing coercive measures and strengthening the response strategies for public event crises.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"106"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12177968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325640","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":"Ventricular double rupture following myocardial infarction: a case report and literature review.","authors":"Camilo Andres Calderon-Miranda, Carlos Enrique Vesga-Reyes, Pastor Olaya, Maria Juliana Reyes-Cardona, Jairo Sanchez-Blanco, Jorge Alexander Zambrano-Franco, Gustavo Adolfo Cruz-Suarez, Alvaro Diego Peña-Gonzalez","doi":"10.1186/s12245-025-00907-2","DOIUrl":"10.1186/s12245-025-00907-2","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"105"},"PeriodicalIF":2.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12175461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325641","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":"Incidence of and risk factors for mortality in children with mushroom poisoning.","authors":"Jie Cheng, Ya Liu, Shaojun Li, Kaibin Pu, Junming Huo, Liping Tan","doi":"10.1186/s12245-025-00906-3","DOIUrl":"10.1186/s12245-025-00906-3","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to evaluate the incidence of and risk factors for mortality in children with mushroom poisoning.</p><p><strong>Methods: </strong>Sixty-seven children with mushroom poisoning who were hospitalized at the Children's Hospital of Chongqing Medical University were retrospectively enrolled. The clinical characteristics of the children in the surviving and non-surviving groups were compared. Variables with a P value < 0.1 in the univariate logistic regression analysis were included in the multivariate logistic regression analysis. A receiver operating characteristic (ROC) curve was generated to determine the optimal cutoff point.</p><p><strong>Results: </strong>The mortality rate of children with mushroom poisoning was 23.88% (16/67), and the incidence of death during hospitalization was 35.02 per 1,000 person-days. The median pediatric sequential organ failure assessment (pSOFA) score was 1.00 (interquartile range [IQR] 0.00-3.00). Logistic regression analysis revealed that the pSOFA score was independently associated with mortality (odds ratio [OR] 4.92, 95% confidence interval [CI] 1.59-62.21; P = 0.040). The optimal cutoff point of the pSOFA score for predicting mortality was 2.00, with an area under the curve (AUC) of 0.84 (95% CI 0.71-0.88, P < 0.001*).</p><p><strong>Conclusions: </strong>In this study, the incidence of death among children with mushroom poisoning was retrospectively evaluated. The pSOFA score may serve as a good prognostic indicator in children with mushroom poisoning, and children with a pSOFA score ≥ 2 have a significantly increased risk of mortality.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"103"},"PeriodicalIF":2.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12172370/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316862","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}