International Journal of Emergency Medicine最新文献

{"title":"Neuroimaging in traumatic brain injury: a bibliometric analysis.","authors":"Sidhartha R Ramlatchan, Benjamin Colaco Jamal, Latha Ganti, Samiya Natesan-Torres, Sreeja Natesan","doi":"10.1186/s12245-025-00991-4","DOIUrl":"10.1186/s12245-025-00991-4","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"168"},"PeriodicalIF":2.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12447602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145086004","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":"Grayanotoxin poisoning following fresh rhododendron flower ingestion: a rare case report from rural Nepal.","authors":"Ashal Timalsina, Arjun Gaire, Roshan Acharya, Anupa Subedi, Rojee Shrestha, Aayusha Suwal","doi":"10.1186/s12245-025-00999-w","DOIUrl":"10.1186/s12245-025-00999-w","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"167"},"PeriodicalIF":2.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12442277/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145080621","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":"Characteristics of emergency department visits in Jordanian public hospitals.","authors":"Mustafa Rawshdeh, Shahed Obeidat, Mazen Alwadi, Ahmad Alrawashdeh","doi":"10.1186/s12245-025-00952-x","DOIUrl":"10.1186/s12245-025-00952-x","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"166"},"PeriodicalIF":2.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12439396/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075257","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 necrotizing encephalopathy in a young adult triggered by adenovirus: a rare etiology of a devastating neurological syndrome.","authors":"Sarah AlMuammar","doi":"10.1186/s12245-025-00988-z","DOIUrl":"10.1186/s12245-025-00988-z","url":null,"abstract":"<p><strong>Background: </strong>Acute necrotizing encephalopathy is a rare but severe neurological disorder characterized by rapid onset of fever, altered mental status, seizures, and multifocal brain lesions, particularly involving the thalami and brainstem. Often triggered by viral infections, its pathogenesis involves a hyperinflammatory response, resulting in blood-brain barrier disruption and necrosis of neural tissue. While influenza and herpesviruses are common etiological agents, adenovirus is a less frequently reported cause.</p><p><strong>Case presentation: </strong>A 19-year-old previously healthy male presented with a two-day history of fever, headache, altered mental status, and seizures. On admission, he was febrile, with impaired consciousness. Initial investigations showed leukocytosis, elevated C-reactive protein, and cerebrospinal fluid analysis indicative of inflammation without bacterial or fungal pathogens. Brain MRI revealed bilateral symmetrical lesions in the thalami, putamen, and brainstem, consistent with acute necrotizing encephalopathy. Polymerase chain reaction testing of cerebrospinal fluid and nasopharyngeal swabs confirmed adenovirus as the causative agent. The patient was managed with seizure control, corticosteroids for cerebral edema, and supportive care, including mechanical ventilation and physiotherapy. Follow-up imaging demonstrated regression of thalamic and pontine lesions. The patient showed partial neurological recovery but required transfer to a long-term care facility for rehabilitation, with persistent functional disability.</p><p><strong>Conclusion: </strong>This case highlights adenovirus as a rare etiological agent of acute necrotizing encephalopathy, emphasizing the importance of molecular diagnostics in identifying atypical pathogens in severe neurological conditions.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"165"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418643/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023270","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 Guillain Barre Syndrome (GBS): a case report.","authors":"Sara Timerga, Aynalem Befkadu","doi":"10.1186/s12245-025-00937-w","DOIUrl":"10.1186/s12245-025-00937-w","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"164"},"PeriodicalIF":2.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12418637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145029739","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":"Characteristics of patients with ruptured abdominal aortic aneurysm who contacted out-of-hours primary care: a case-control study.","authors":"Carline J van den Dries, Dave A Dongelmans, Maarten J van der Laan, Sonja Oomkens, Eva Ouwendijk, Annelies Visser, Frans H Rutten, Dorien L M Zwart","doi":"10.1186/s12245-025-00974-5","DOIUrl":"10.1186/s12245-025-00974-5","url":null,"abstract":"<p><strong>Background: </strong>Ruptured abdominal aortic aneurysm (rAAA) is rare but it is the second most frequently missed diagnosis reported as sentinel adverse event ('calamity') at out-of-hours services in primary care (OHS-PC). We aimed to identify characteristics that could be useful for telephone triage of suspected rAAA at the OHS-PC.</p><p><strong>Methods: </strong>In a matched case-control study (1:4 ratio), we compared patients with a missed rAAA (cases) to patients with the same age and sex, and with similar entrance complaint (controls). Data were collected from OHS-PC triage call recordings that were re-assessed by researchers blinded to the case-control status. Patient and call characteristics were univariably assessed with conditional logistic regression analysis.</p><p><strong>Results: </strong>Twenty cases of missed rAAA between 2013 and 2023 were matched to 80 controls. 40% of the cases presented with abdominal pain, and 35% with back pain. Cases compared to controls more often had a pain onset < 12 h (odds ratio (OR) 15.2; 95%CI 1.9-123.8), reported more sweating (OR 10.1; 95% CI 1.2-86.9, p = 0.035), more often verbally expressed their concern (OR 13.6; 95%CI 3.0-61.3, p = 0.001), and more often called during the night (OR 3.8; 95% CI 1.1-12.7, p = 0.029).</p><p><strong>Conclusions: </strong>Recognition of rAAA at the OHS-PC remains challenging given its rare occurrence and lack of specific symptoms. Nevertheless, this case-control study identified factors that could be useful in triage of patients calling the OHS-PC with symptoms possibly indicating rAAA.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"163"},"PeriodicalIF":2.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12403838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953227","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 experience of local emergency care staff on stroke recognition and acute care in the United Arab Emirates.","authors":"Mohammed Alkuwaiti, Azhar Talal, Emad Masuadi, Ghada Albluwi, Abdulla Alkuwaiti, David Olukolade Alao","doi":"10.1186/s12245-025-00970-9","DOIUrl":"10.1186/s12245-025-00970-9","url":null,"abstract":"<p><strong>Introduction: </strong>Cerebrovascular diseases are among the top three causes of death in the United Arab Emirates. The acute stroke care survey among emergency care personnel in Alain City aims to assess the experience, knowledge and attitude of emergency department staff about acute stroke care to identify areas for educational and training interventions.</p><p><strong>Method: </strong>This is an observational cross-sectional Face-to-Face electronic survey of the Emergency care doctors and nurses across four emergency/urgent care centres in Alain, the United Arab Emirates. The survey was completed between 4th August 2023 to 15th October 2024 using a locally validated survey questionnaire.</p><p><strong>Results: </strong>Of the 215 participants in the study, 178 (83%) completed the survey of which 56% were Physicians. Two-thirds (66.1%) of the responders work in a tertiary care centre and about a third 49 (35.4%) of the responders personally cared for more than ten stroke or TIA patients in the past three months. Over 75% of the responders identified facial droop, unilateral arm or leg weakness and slurred speech as symptoms of acute stroke. Only 61% of the responders recognised atrial fibrillation as a risk factor. The overall mean (SD) knowledge score was 59.76 (23.74) for physicians compared with 52.9 (21.35) for nurses (P = 0.054). There was a significant difference in the overall mean (SD) knowledge score between responders from tertiary and secondary centres. (59.9 (21.8) versus 51.8 (21.9) respectively, P = 0.019. Responders with < 2 years of experience achieved a significantly lower mean (SD) score compared with responders with > 2 years of experience in all domains (47.1 (27.34) compared with 60.54 (20.1) for those with > 10 years of experience, P = 0.008).</p><p><strong>Conclusions: </strong>This study identified significant knowledge gaps among staff working in our stroke care system. These can be addressed by regular stroke update training for all front-line staff including those working at secondary centres with limited experience of daily stroke care.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"162"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12400690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953196","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":"Frequency of ED visits and mortality among the adults with ESRD on twice-weekly maintenance hemodialysis at tertiary care hospital in Bhutan.","authors":"Ugyen Rinzin, Shankar LeVine, Melanie Watts, Ugyen Tshering, Kipchu Tshering","doi":"10.1186/s12245-025-00894-4","DOIUrl":"10.1186/s12245-025-00894-4","url":null,"abstract":"<p><strong>Background: </strong>The burden of end-stage renal disease (ESRD) is increasing in Bhutan but there is limited data on the emergency department (ED) visits among ESRD patients. This study aims to study the frequency of ED visits and one-year mortality among ESRD patients on twice-weekly maintenance haemodialysis (HD).</p><p><strong>Methods: </strong>A prospective cohort study was conducted over the span of year from 1st October 2021 to 30th September 2022 at emergency department of national referral hospital of Bhutan. The ESRD patients were approached for enrollment upon presentation to the ED and followed to hospital discharge or until the end of the study period.</p><p><strong>Results: </strong>There was a total of 633 ED visits among the 193 ESRD patients, resulting in an overall mean of 3.3 ED visits per year. The reasons for ED visit were due to renal emergencies in 48.0%, non-renal medical illnesses in 41.2%, and both in 10.8%. Out of the 633 ED visits, 46.4% required emergent HD. The majority (80.4%) of the patients were discharged from the ED after receiving various treatments, including emergent HD. Only 17.4% required admission to the ward or intensive care unit. During the one-year follow-up of the 193 ESRD patients, there were 18 deaths resulting in a one-year mortality rate of 9.3% of which out-of-hospital cardiac arrest (OHCA) accounted for 44.4% (n = 8).</p><p><strong>Conclusion: </strong>There was high frequency of ED visits due to renal emergencies among ESRD patients undergoing twice-weekly HD at our tertiary care hospital. Additionally, there was high one-year mortality rate and incidence of OHCA among ERSD patients.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"161"},"PeriodicalIF":2.0,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12392477/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953244","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":"Delayed diagnosis of aortic dissection: the overlooked clues on chest X-ray.","authors":"Yao Chen, Wenjin Wang, Lian Lin, Zhankai Tang","doi":"10.1186/s12245-025-00971-8","DOIUrl":"10.1186/s12245-025-00971-8","url":null,"abstract":"<p><strong>Background: </strong>Acute aortic dissection (AD) is a life-threatening vascular emergency requiring immediate intervention, with mortality rates increasing by 1-2% per hour post-onset. The pathophysiology involves an intimal tear that permits blood to enter the medial layer, forming a false lumen that may expand and compromise branch vessels and end-organ perfusion. Current guidelines from the European Society of Cardiology (ESC), American College of Cardiology (ACC), and American Heart Association (AHA) highlight the necessity of risk stratification based on clinical features (e.g., tearing pain, pulse deficits), predisposing factors (e.g., hypertension), and D-dimer levels, followed by confirmatory imaging with transthoracic echocardiography (TTE) or computed tomography angiography (CTA). Despite advancements in imaging, chest radiography (CXR) remains underutilized; however, key findings-such as mediastinal widening (≥ 5 cm at the aortic knob), abnormal aortic contour, and displaced intimal calcifications-can offer critical diagnostic information.</p><p><strong>Case report: </strong>A young male patient presented with acute chest pain following strenuous exertion. Initial outpatient evaluation, including complete blood count (CBC), liver function tests (LFTs), renal function tests (RFTs), cardiac enzymes, and chest X-ray (CXR), yielded nondiagnostic results, leading to his discharge with analgesics. Three days later, during a national holiday when outpatient clinics were closed, the patient returned to the emergency department (ED) with persistent chest pain. A meticulous review of the initial CXR by the emergency physician revealed mediastinal widening (measuring 8.5 cm) and an abnormal contour of the aorta. Subsequent emergency computed tomography angiography (CTA) confirmed the diagnosis of a Stanford type B aortic dissection.</p><p><strong>Conclusions: </strong>This case underscores two critical learning points: (1) the diagnostic pitfalls associated with atypical early presentations of aortic dissection, and (2) the often underappreciated value of meticulous interpretation of chest X-rays in the evaluation of acute chest pain, particularly when initial studies yield unremarkable results. The three-day diagnostic delay emphasizes the necessity of maintaining a high index of suspicion for aortic dissection, even in young patients lacking classic risk factors.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"158"},"PeriodicalIF":2.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953193","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":"Determining the need for stabilising therapy of cervical spine injuries on CT: towards standardising decision-making in the emergency department.","authors":"Brigitta Y M van der Kolk, Gaby J van den Wittenboer, Ingrid M Nijholt, Martin Podlogar, Wimar A van den Brink, Gerrit Joan Bouma, Lonneke N Buijteweg, Boudewijn A A M van Hasselt, Niels W L Schep, Mario Maas, Martijn F Boomsma","doi":"10.1186/s12245-025-00965-6","DOIUrl":"10.1186/s12245-025-00965-6","url":null,"abstract":"<p><strong>Background: </strong>In clinical practice, currently no standardised approach exists to determine which patients with cervical spine injury (CSI) on CT scan should receive continued cervical spine immobilisation and a neurosurgeon is generally consulted. Insights into the contribution of CT assessment and classification of CSI in determining the need for stabilising therapy could aid in standardising clinical practice in the emergency department. Standardising clinical practice for cervical spine immobilisation could potentially improve the patient flow in the emergency department by reducing delay in decision-making, particularly in hospitals without availability of immediate neurosurgical consultation. Therefore the aim of this study was to investigate if CT assessment and classification of CSI, without clinical information, can determine whether a patients' injury is an injury in need of stabilising therapy (IST).</p><p><strong>Methods: </strong>In this observational, retrospective study, a database with a multidisciplinary, extensively validated reference standard was used. Consecutive patients screened for CSI using CT (2007-2014) in a level-one trauma centre in the Netherlands were included. Actual therapy that has been provided was compared to the assessment of CSI by three neurosurgeons on CT for presence of ISTs. Clinical information was not provided during initial CT assessment. Injury types were classified according to the AOSpine Injury Classification System. Concordance rates of CT assessment by the neurosurgeons compared to actual therapy provided for presence of ISTs with 95% confidence intervals (95% CI) were calculated.</p><p><strong>Results: </strong>Of the 273 patients in the database with a CSI, 262 were included. CT assessment of CSIs led to assignment as IST in 155/262 cases (59.2%). Based on the actual therapy provided, 124/262 cases (47.3%) were an IST. CT assessment by the neurosurgeons was concordant with the therapy provided for presence of ISTs in 91.9% [95% CI 85.3-95.9%], and for absence of ISTs in 70.3% [95% CI 61.8-77.6%]. After allocation of the AO-subtypes to IST and non-IST, 168/171 (98.2%) of A0-injury subtype cases were non-IST.</p><p><strong>Conclusion: </strong>CT scan assessment and injury classification without clinical information allows identification of most injuries in need of stabilising therapy, with a low miss rate of ISTs, particularly for the A0-injury subtype.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"159"},"PeriodicalIF":2.0,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12382177/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953230","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}