International Journal of Emergency Medicine最新文献

{"title":"Marburg virus disease outbreak and response in South Ethiopia Region.","authors":"Ayenew A Wolie, Biruk T Mengistie, Chernet T Mengistie, Selamawit Zemene Tadesse, Mikiyas G Teferi, Getachew Worku Bifa, Adey Abebaw Bogale, Abel Jemjem Adnew, Nardos Keyema Admassu, Temesgen Girma Bayu, Demmelash Gezahegn Nigatu, Aman Safewo Gemeda, Elubabor Buno Teko, Estrella Roffe, Getaw W Hassen","doi":"10.1186/s12245-026-01370-3","DOIUrl":"10.1186/s12245-026-01370-3","url":null,"abstract":"<p><strong>Background: </strong>Marburg Virus Disease (MVD) is a highly virulent zoonotic infection associated with high case fatality rates and multi-organ dysfunction. Early recognition, timely supportive care, and appropriate clinical management are important in improving outcomes. We describe the clinical presentation, laboratory features, management strategies, and outcomes of five confirmed MVD survivors.</p><p><strong>Case presentation: </strong>We present a case series of five patients with laboratory-confirmed MVD who recovered following treatment at Jinka General Hospital/MVD Treatment Center between November and December 2025. The cohort included four females and one male (median age: 18 years). All patients presented with fever, headache, and gastrointestinal (GI) symptoms, with three exhibiting hemorrhagic manifestations. Key laboratory findings included leukopenia (White Blood Cell (WBC) nadir 1.55 × 10³/µL), thrombocytopenia (platelet nadir 65 × 10³/µL), and elevated transaminases (Aspartate Aminotransferase (AST) peak 1,153 U/L). One patient developed severe neutropenia (Absolute Neutrophil Count (ANC) 107 cells/µL).</p><p><strong>Management and outcome: </strong>All patients received remdesivir (in varying regimens) and supportive care. Viral clearance was confirmed by two consecutive negative Reverse Transcription Polymerase Chain Reaction (RT-PCR) tests within 48 h, achieved between days 6 and 12. All five patients (100%) achieved complete clinical recovery and were discharged.</p><p><strong>Conclusion: </strong>This case series demonstrates that recovery from confirmed MVD is achievable with early diagnosis, comprehensive supportive care, and antiviral therapy, even in the presence of severe gastrointestinal hemorrhage. Dynamic monitoring of liver enzymes and viral clearance is essential. These findings underscore the potential for favorable outcomes with early diagnosis and antiviral treatment even in resource-limited settings.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13617883/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074580","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":"Meeting people where they are, whenever they are here: the implementation of harm reduction programs in two U.S. emergency departments.","authors":"Karrin Weisenthal, Natalie Strokes, Zoe Weinstein, Samantha Johnson, Glorimar Ruiz-Mercado, Seamus Vahey, James Evans, Jessica L Taylor, Joseph Shay, Laura Welsh, Madeline Palmer, Natalija Farrell, William E Soares, Elizabeth M Schoenfeld","doi":"10.1186/s12245-026-01380-1","DOIUrl":"10.1186/s12245-026-01380-1","url":null,"abstract":"<p><strong>Background: </strong>Complications related to drug use, including overdose, withdrawal, and infection, represent a significant proportion of emergency department (ED) visits in the United States (US). Within addiction medicine, harm reduction focuses on strategies that minimize negative outcomes associated with continued drug use through interventions such as preexposure prophylaxis, naloxone distribution, and safer use supplies. Integration of harm reduction measures into acute care settings may enhance patient trust and engagement in medical care, and may reduce the risk of overdose, viral transmission and serious bacterial infections for patients who use drugs. While there has been an increased interest in incorporation of harm reduction into acute care, data on successful implementation is limited.</p><p><strong>Main body: </strong>We describe the successful implementation of two unique programs designed to decrease risk and stigma for patients who use drugs and access acute care services in two tertiary care ED's in Massachusetts, US. This article details two different implementation strategies utilized to integrate harm reduction into bedside emergency care. We utilize the CFIR framework to identify barriers and facilitators to successful programmatic implementation, and report on reception by ED teams through post-implementation interviews and program utilization data.</p><p><strong>Conclusion: </strong>Integration of harm reduction into acute care can be safe and feasible. Creating partnerships with community organizations, leadership from an ED champion, and pairing implementation with education for ED staff are key for programmatic success.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060626","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":"The Mobile Hospital delivers outreach acute care to nursing homes: healthcare staff interviews.","authors":"Perttu Kontunen, Paulus Torkki, Maaret Castrén, Anu Helkkula","doi":"10.1186/s12245-026-01392-x","DOIUrl":"10.1186/s12245-026-01392-x","url":null,"abstract":"<p><strong>Background: </strong>Nursing home residents often face unnecessary risks when visiting the emergency department (ED). Due to the limited rapid response capabilities of primary care and lack of equipment for acute illnesses, onsite specialized outreach units present a novel alternative. The Mobile Hospital is a nurse-led outreach unit providing onsite acute care to nursing home residents with remote physician support. The unit operates in the suburban area of Espoo, Finland. This study aimed to evaluate the Mobile Hospital from the perspective of healthcare staff.</p><p><strong>Methods: </strong>We interviewed nursing home nurses, emergency medical services (EMS) nurses, emergency physicians, and Mobile Hospital nurses, totaling 21 interviews. We employed inductive thematic analysis to analyze the interviews.</p><p><strong>Results: </strong>The Mobile Hospital was seen as a holistic way to deliver basic hospital-grade treatment to nursing homes, thus avoiding the risks involved in ED visits. However, it also introduced new dependencies on clinical expertise, teleconsultation support, and system coordination, underlining both its potential and its operational challenges. Successful adoption requires careful implementation and ongoing education of stakeholders regarding acute care protocols. Complementing the qualitative findings, the staff Net Promoter Score (NPS) for the Mobile Hospital was 81 (17 promoters, four passives, no detractors).</p><p><strong>Conclusion: </strong>The Mobile Hospital can be described as an interprofessional missing link in the acute care of nursing home residents, which the healthcare staff perceived as a promising model for avoiding unnecessary ED visits when implemented with adequate expertise and system support.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080841","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":"Evaluating the East African point-of-care ultrasound (E-POCUS) training program pilot: lessons learned and best practices.","authors":"Hannah Girdler, Inaya Yousaf, Tigist Worku, Anne Aspler, Temesgen Beyene, Tigist Zewdu, Inderjeet Sahota","doi":"10.1186/s12245-026-01391-y","DOIUrl":"10.1186/s12245-026-01391-y","url":null,"abstract":"<p><strong>Background: </strong>There is a pressing need for a sustainable, longitudinal point-of-care ultrasound (POCUS) education model that is contextually relevant, locally led, and systematically evaluated in East Africa. The Toronto Addis Ababa Academic Collaboration in Emergency Medicine (TAAAC-EM), a long-standing partnership between the University of Toronto and Addis Ababa University, developed the East African POCUS (E-POCUS) Training Program Pilot. This was a one-year, longitudinal, hybrid advanced training program tailored to local needs and interests.</p><p><strong>Methods: </strong>We used reflexive thematic analysis to conduct a qualitative program evaluation of the E-POCUS training program pilot. E-POCUS participants, staff involved with the execution of the training program, and those participants who had to leave the program were all invited to participate in a semi-structured virtual interview, exploring their perceived impact and opinion of the E-POCUS program. Interview transcripts were analyzed using Braun and Clarke's reflexive thematic analysis framework.</p><p><strong>Results: </strong>A total of 13 interviews were conducted, representing participants in the E-POCUS program (n = 2), former participants of the E-POCUS program (n = 3), and staff involved in the teaching of the program (n = 8). The analysis highlighted three main themes: (1) time as a limiting factor, (2) expectations versus reality in program delivery, and (3) motivations for participation and the role of accreditation.</p><p><strong>Conclusion: </strong>This study highlighted the value of flexible, longitudinal, and hybrid curriculums in POCUS education. The E-POCUS pilot also illustrated that the hybrid model of education allowed participants to prioritize hands-on skill development teaching during in-person months. Advancing POCUS education in resource-limited settings is critical to improving patient care, and it is important to evaluate efforts at increasing access and education on the topics that are most relevant to their patient population.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13613624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149060631","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":"Cardiac tamponade caused by effusive-constrictive pericarditis in a patient with common variable immunodeficiency: a case report.","authors":"Abbas Khan, Okasha Tahir, Alina Batool, Jaweria Farman, Muhammad Hassaan Javaid, Abdul Rauf Farhaan","doi":"10.1186/s12245-026-01381-0","DOIUrl":"10.1186/s12245-026-01381-0","url":null,"abstract":"<p><strong>Background: </strong>Common variable immunodeficiency (CVID) is an immunodeficiency syndrome that is marked by impaired antibody formation and chronic infections. However, it is also associated with immune dysregulation and non-infectious inflammatory disorders. Cardiac involvement is not common, but effusive-constrictive pericarditis (ECP) complicated by cardiac tamponade is rarely seen in CVID patients.</p><p><strong>Case presentation: </strong>A 17-year-old male patient with CVID (diagnosis made in 2022) under regular replacement therapy with monthly intravenous immunoglobulin (IVIG) was admitted due to progressive dyspnea, dry cough, weakness, fatigue, and severe hypoxemia lasting for several days. Previous medical history included frequent lower respiratory tract infections, inflammatory bowel disease, celiac disease, malnutrition, and psoas abscess. Admission examination revealed arterial blood pressure 90/60 mmHg, oxygen saturation 75% in room air, increased jugular venous pressure, dullness in auscultation, pulsus paradoxus, bilateral rales and peripheral edema. Echo showed a 12-15 mm thick pericardial effusion, mobile fibrin-rich mass in pericardium, dilatation of inferior vena cava (23 mm with < 50% collapse), respiratory variation of mitral and tricuspid inflow with septal bounce. Left ventricle ejection fraction was 40%. Pericardiocentesis was done in an emergency manner and 320 ml of turbid serosanguineous effusion with fibrinous clots was drained. Microbiologic investigations of the sample including bacteriological cultures, acid-fast bacilli, mycobacteria, and MTB/RIF showed negative results. There were no malignant cells in cytological and cell-block analysis. After pericardiocentesis, central venous pressure remained elevated and Doppler investigation showed signs of constrictive physiology such as more than 25% variation in mitral inflow, expiratory reverse flow in hepatic veins, plethoric IVC, and septal bounce, which helped to confirm ECP. Ventricular function and constrictive physiology gradually improved after supportive therapy and IVIG and nutrition treatment without pericardiectomy.</p><p><strong>Conclusion: </strong>ECP with tamponade is a rare life-threatening complication in CVID patients. In the case of unexplained cardiopulmonary failure in an immunocompromised patient, tamponade cannot be considered only due to the infection. Urgent echocardiography, drainage, and investigation of various infectious, tuberculous, malignant and inflammatory causes is crucial.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13602799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030456","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":"Ethical and responsible use of artificial intelligence in medical education.","authors":"Aryana Sriram, Ethan Nichols, Latha Ganti, Shayne Gue","doi":"10.1186/s12245-026-01389-6","DOIUrl":"10.1186/s12245-026-01389-6","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI) has rapidly transformed medical education through virtual patient simulations, adaptive learning systems, and large language models like ChatGPT, while raising concerns about bias, transparency, reproducibility, and ethical integration into training and assessment. Despite its growing relevance, the ethical and responsible use of AI in medical education remains understudied. This bibliometric analysis aims to characterize the intellectual landscape of this field.</p><p><strong>Methods: </strong>Bibliographic data were obtained from the Web of Science Core Collection using a search strategy combining medical education and AI-related terms, limited to publications from 1995 to 2026. A total of 1403 articles were retrieved. Microsoft Excel was used to generate descriptive figures, and VOSviewer (version 1.6.20) was used to construct bibliometric networks of country, institutional, and keyword co-occurrence relationships.</p><p><strong>Results: </strong>Publication output rose sharply after 2023, from 113 publications to 500 by 2025, coinciding with the rise of ChatGPT and other large language models. The United States led in publication volume (533) and citation influence, followed by China (189) and England (95). Harvard University and its affiliated entities led institutional output, while Harvard Medical School, Stanford, and University of California San Francisco led citation strength. The most-cited publications centered on ChatGPT's performance on medical licensing examinations.</p><p><strong>Conclusions: </strong>This field has grown rapidly but remains concentrated among few countries and institutions, with citation impact dominated by capability-testing studies rather than governance-focused scholarship. Future research should prioritize empirical evaluation of AI governance frameworks and broader institutional and geographic representation.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024481","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":"Hearing loss in HEMS operations: a prospective analysis of audiometric tests for temporary hearing threshold shift of an air rescue helicopter crew during several days of emergency duty.","authors":"Michelle Hohm, Harald Schulze, Sandra Schmidt, Dennis Matthias Ritter, Willi Schmidbauer, Jens Schwietring, Felix Carl Fabian Schmitt, Christoph Walter Jaenig, Tobias Gruebl","doi":"10.1186/s12245-026-01382-z","DOIUrl":"10.1186/s12245-026-01382-z","url":null,"abstract":"<p><strong>Background: </strong>Helicopter Emergency Medical (HEMS) crews are exposed to varying levels of noise at work. Noise levels regularly exceed 85 dB(A) and can be as high as 108 dB(A). Noise exposure can reduce concentration and cause hearing damage. The present study was conducted to assess objective Hearing sensitivity shift of air rescue crews.</p><p><strong>Methods: </strong>Audiometric data of HEMS crew of an Airbus EC 135 were collected during two months of duty at frequencies from 500 to 8000 Hz. Audiometric tests were performed at the beginning and end of a shift and, if possible, thirty minutes after every HEMS operation. Crew members were asked to complete a questionnaire before every measurement on ringing in the ears and exposure to elevated noise levels without hearing protection. Results of the audiometric measurements were analysed using linear mixed models for the whole group and for subgroups of pilots and medical personnel with and without additional hearing protection.</p><p><strong>Results: </strong>On 17 days with a median daily number of 6 HEMS flights, a total of n = 236 audiometric tests were conducted for 18 crew members, of whom four (22%) were pilots and fourteen (78%) were medical personnel. The mean noise exposure duration was 169.9 (± 49.2) minutes. The mean flight duration was 50 (± 40.2) minutes. Across all subgroups, subjects were able to hear a test tone at a mean level of 8.2 (± 11.1) dB(A) at the beginning of a shift and 11.7 (± 12.1) dB(A) at the end of a shift. The initial difference of hearing threshold between the left and the right ear was evened out over the work shift (beginning β = 2.9 p < 0,001vs. after noise exposure 0.2, p = 0.434). Hearing threshold shift was greater in medical personnel who wore no additional hearing protection (6.8 dB(A)) than in pilots (1.9 dB(A)) and medical personnel who used additional hearing protection (0.5 dB(A)). The greatest hearing threshold level occurred at frequencies between 4000 and 8000 Hz.</p><p><strong>Conclusions: </strong>Hearing sensitivity of HEMS crews substantially declines over the course of a shift. Unprotected medical personnel seems more affected than pilots. Hearing threshold level is greater in left ears than in right ears and most severely affects the ability to hear high-frequency sounds. Helmets alone may not provide adequate hearing protection.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149024774","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":"Multiple bee stings leading to a delayed fatal coronary event with probable Kounis syndrome: a case report.","authors":"Mallapu Ajay Kumar, Poonam Arora, Bharatbhushan Bhardwaj, Parina Tejpal, Pavan Anjaiah, Jyoti Chauhan, Parampreet Singh","doi":"10.1186/s12245-026-01348-1","DOIUrl":"10.1186/s12245-026-01348-1","url":null,"abstract":"<p><strong>Background: </strong>Kounis syndrome-an acute coronary syndrome occurring in the setting of allergic or hypersensitivity reactions-remains an under-recognised clinical entity. In many cases, the diagnosis is largely probabilistic, particularly in the absence of confirmatory evidence such as mast-cell activation markers or intracoronary imaging. In the present context, while the clinical history of bee sting strongly supports Kounis syndrome as the most likely differential diagnosis, definitive confirmation is limited by the lack of objective mast-cell-related investigations. We report a 72-year-old man with hypertension and diabetes mellitus, a reformed smoker, who presented following multiple (three to four) bee stings localised to the right shoulder. At presentation, he exhibited features limited to a local allergic reaction, with no evidence of systemic involvement or anaphylaxis. He was managed with sting removal, antihistamines, and analgesics, and remained asymptomatic and stable on continuous monitoring during a 12-hour observation period. He was subsequently discharged in stable condition. Approximately one hour post-discharge, he became unresponsive at home, and bystander cardiopulmonary resuscitation (CPR) was initiated. On arrival at the emergency department, he was found to be in asystole. Advanced cardiac life support was continued, and return of spontaneous circulation (ROSC) was achieved. Post-resuscitation electrocardiography revealed inferior ST-elevation myocardial infarction with reciprocal changes. Bedside echocardiography demonstrated inferior wall hypokinesia with a left ventricular ejection fraction of 40%. Coronary angiography showed complete occlusion of the mid-right coronary artery with a non-obstructive left coronary system. A drug-eluting stent was successfully deployed, restoring TIMI 3 flow. However, approximately four to five hours after successful revascularisation, the patient developed refractory ventricular arrhythmias and succumbed despite ongoing resuscitative efforts.</p><p><strong>Conclusion: </strong>This case highlights a temporally plausible, though not definitively established, instance of delayed probable Type II Kounis syndrome following an apparently mild, local Hymenoptera sting reaction. It underscores the need for continued vigilance for delayed coronary events even after seemingly benign allergic presentations, and emphasises the inherent challenge of distinguishing Kounis syndrome from conventional atherosclerotic ST-elevation myocardial infarction in the absence of confirmatory allergic or mechanistic evidence.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591823/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016764","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":"Ludwig's angina in Somalia: clinical characteristics, emergency management, and outcomes from a tertiary academic referral center.","authors":"Abdullahi Ahmed Ahmed, Salad Mohamud Mohamed Hassan, Ismail Mohamoud Abdullahi, Abdishakur Mohamed Abdirahman, Sahra Ali Yusuf","doi":"10.1186/s12245-026-01383-y","DOIUrl":"10.1186/s12245-026-01383-y","url":null,"abstract":"<p><strong>Background and objectives: </strong>Ludwig's angina is a rapidly progressive cellulitis involving the submandibular, sublingual, and submental spaces bilaterally that can swiftly compromise the airway. Data on deep neck space infections in Somalia remain scarce. This study aimed to describe the demographic profile, etiology, clinical presentation, management, complications, length of hospital stay (LOS), and outcomes of patients with Ludwig's angina treated at Mogadishu Somali-Türkiye Recep Tayyip Erdoğan Training and Research Hospital over a one-year period.</p><p><strong>Materials and methods: </strong>We conducted a retrospective review of 90 patients with clinically confirmed Ludwig's angina presenting between January 1, 2024, and December 31, 2024. Demographic variables, etiology, pre-admission symptom duration, referral source, treatment modality, hospital-acquired complications, LOS, and discharge outcomes were extracted from medical records and analyzed using descriptive and inferential statistics.</p><p><strong>Results: </strong>The cohort was predominantly male (77.8%, n = 70), with a mean age of 39.1 pm 21.4 years. Odontogenic infection was the primary etiology, accounting for 82.2% (n = 74) of cases, led by localized periodontal and periapical abscesses (65.5%, n = 59). Overall surgical intervention was required in 53.3% (n = 48) of patients-comprising deep operative decompression (38.9%, n = 35) and superficial drainage (14.4%, n = 13)-while 46.7% (n = 42) were successfully managed with conservative intravenous antibiotics and close airway observation. Inpatient complications occurred in 48.9% (n = 44) of cases, dominated by septicemia (36.7%, n = 33). Linear regression demonstrated that longer symptom duration prior to admission significantly predicted longer hospitalization (B = 0.500, p < 0.001). Institutional mortality was 0.0%.</p><p><strong>Conclusion: </strong>Ludwig's angina in this Somali cohort was characterized by delayed presentation, a high complication burden, and predominantly odontogenic origin, but low overall mortality when managed with prompt airway surveillance, broad-spectrum antibiotics, and selective surgical drainage. These findings underscore the critical need to enhance primary dental care access and early referral pathways in resource-limited settings.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016823","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":"Knowledge and attitudes toward advanced cardiac life support among healthcare professionals in Addis Ababa, Ethiopia: a multicenter cross-sectional study.","authors":"Hiwot Shewangizaw, Mikiyas G Teferi, Biruk T Mengistie, Chernet T Mengistie, Nardos Belayneh, Yoseph Teshome, Biruk Girma, Yohannes Feleke, Estrella Roffe, Getaw W Hassen","doi":"10.1186/s12245-026-01385-w","DOIUrl":"10.1186/s12245-026-01385-w","url":null,"abstract":"<p><strong>Background: </strong>Advanced Cardiac Life Support (ACLS) supports the management of cardiac arrest and other life-threatening cardiovascular emergencies. Studies from resource-limited settings have identified persistent gaps in ACLS knowledge and attitudes among healthcare professionals.</p><p><strong>Methods: </strong>This multicenter institution-based cross-sectional study was conducted from June to November 2024; data were collected from October to November 2024. Four referral hospitals were selected by convenience, and eligible healthcare professionals within those hospitals were selected by computer-generated simple random sampling. Data were collected using a structured, self-administered questionnaire. Good knowledge was defined as at least 7 correct answers among 14 questions. Attitude was measured with 12 five-point Likert items; participants with an aggregate score at or above the sample mean were classified as having a positive attitude. Data were analyzed using SPSS version 28. Multivariable logistic regression identified factors associated with knowledge and attitude, with adjusted odds ratios (AORs) and 95% confidence intervals (CIs) reported.</p><p><strong>Results: </strong>Of 397 sampled healthcare professionals, 379 completed the survey (response rate, 95.5%). Overall, 178 (47.0%) had good ACLS knowledge and 164 (43.3%) had a positive attitude. Nurses had higher adjusted odds of good knowledge than physicians (AOR, 2.09; 95% CI, 1.26-3.42). Participants with MSc-level education had lower adjusted odds of good knowledge than degree holders (AOR, 0.38; 95% CI, 0.16-0.92). For positive attitude, lower adjusted odds were observed among participants with 0-23 months (AOR, 0.20; 95% CI, 0.049-0.84) or 60-120 months (AOR, 0.17; 95% CI, 0.04-0.71) of experience than among those with more than 120 months, and among diploma holders than among degree holders (AOR, 0.41; 95% CI, 0.21-0.78). Previous ACLS training was not significantly associated with either outcome.</p><p><strong>Conclusion: </strong>Fewer than half of participants had good ACLS knowledge or a positive attitude. These findings identify educational gaps and support consideration of accessible, competency-oriented ACLS education, accompanied by local evaluation of practical performance and patient outcomes.</p><p><strong>Trial registration: </strong>N/A CLINICAL TRIAL NUMBER: Not applicable.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"19 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13591856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016800","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}