International Journal of Emergency Medicine最新文献

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Neuro-ophthalmology and migraine: visual aura and its neural basis. 神经眼科学与偏头痛:视觉先兆及其神经基础。
IF 2
International Journal of Emergency Medicine Pub Date : 2025-08-11 DOI: 10.1186/s12245-025-00924-1
Hajar Nasir Tukur, Olivier Uwishema, Dalal Sheikhah, Hatice Akbay
{"title":"Neuro-ophthalmology and migraine: visual aura and its neural basis.","authors":"Hajar Nasir Tukur, Olivier Uwishema, Dalal Sheikhah, Hatice Akbay","doi":"10.1186/s12245-025-00924-1","DOIUrl":"10.1186/s12245-025-00924-1","url":null,"abstract":"<p><strong>Background: </strong>Migraine, a chronic neurological condition often accompanied by visual aura, which affects 15-33% of migraineurs, often presents as transient visual disturbances such as scintillating scotoma and teichopsia. These symptoms arise primarily from cortical spreading depression (CSD) within the occipital cortex and significantly impacts the quality of life, with chronic and episodic migraineurs consistently scoring lower scores in vision-specific quality of life questionnaires. Therefore, this narrative review explores the pathophysiology pertaining to visual aura in migraines, focusing on the role of CSD while evaluating current diagnostic and therapeutic approaches employed.</p><p><strong>Methods: </strong>A narrative literature review was conducted using PubMed and ScienceDirect, focusing on studies published between 2000 and 2025. Search terms related to \"migraine\", \"visual aura\", and \"cortical spreading depression\" were used to identify relevant original research, reviews, and clinical studies addressing the pathophysiology, diagnosis, and treatment of migraine-related visual aura.</p><p><strong>Results: </strong>Findings indicate that CSD drove transient visual symptoms by triggering waves of neuronal depolarization and hypoperfusion in the visual cortex. Contemporaneous treatment modalities target the headache phase of migraine, with limited alternatives for aura-specific intervention.</p><p><strong>Conclusion: </strong>Advancement in neuroimaging and genetic research offer promising avenues for early diagnosis alongside focused therapeutics for migraine with aura. However, current treatment strategies remain largely focused on the headache phase, with limited efficacy for aura-specific symptoms. Future therapeutic approaches targeting cortical spreading depression may offer more precise interventions for managing visual aura in migraine.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"148"},"PeriodicalIF":2.0,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12337509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821394","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}
引用次数: 0
Comparative performance of ChatGPT, Gemini, and final-year emergency medicine clerkship students in answering multiple-choice questions: implications for the use of AI in medical education. ChatGPT、Gemini和最后一年急诊医学见习学生在回答多项选择题方面的比较表现:人工智能在医学教育中应用的意义
IF 2
International Journal of Emergency Medicine Pub Date : 2025-08-07 DOI: 10.1186/s12245-025-00949-6
Shaikha Nasser Al-Thani, Shahzad Anjum, Zain Ali Bhutta, Sarah Bashir, Muhammad Azhar Majeed, Anfal Sher Khan, Khalid Bashir
{"title":"Comparative performance of ChatGPT, Gemini, and final-year emergency medicine clerkship students in answering multiple-choice questions: implications for the use of AI in medical education.","authors":"Shaikha Nasser Al-Thani, Shahzad Anjum, Zain Ali Bhutta, Sarah Bashir, Muhammad Azhar Majeed, Anfal Sher Khan, Khalid Bashir","doi":"10.1186/s12245-025-00949-6","DOIUrl":"10.1186/s12245-025-00949-6","url":null,"abstract":"<p><strong>Background: </strong>The integration of artificial intelligence (AI) into medical education has gained significant attention, particularly with the emergence of advanced language models, such as ChatGPT and Gemini. While these tools show promise for answering multiple-choice questions (MCQs), their efficacy in specialized domains, such as Emergency Medicine (EM) clerkship, remains underexplored. This study aimed to evaluate and compare the accuracy of ChatGPT, Gemini, and final-year EM students when it comes to answering text-only and image-based MCQs, in order to assess AI's potential for use as a supplementary tool in the field of medical education.</p><p><strong>Methods: </strong>In this proof-of-concept study, a comparative analysis was conducted using 160 MCQs from an EM clerkship curriculum, comprising 62 image-based questions and 98 text-only questions. The performance of the free versions of ChatGPT (4.0) and Gemini (1.5), as well as that of 125 final-year EM students, was assessed. Responses were categorized as \"correct\", \"incorrect\", or \"unanswered\". Statistical analysis was then performed using IBM SPSS Statistics (Version 26.0) to compare accuracy across groups and question types.</p><p><strong>Results: </strong>Significant performance differences were observed across the three groups (χ² = 42.7, p < 0.001). Final-year EM students demonstrated the highest overall accuracy at 79.4%, outperforming both ChatGPT (72.5%) and Gemini (54.4%). Students excelled in text-only MCQs, with an accuracy of 89.8%, and performed robustly on image-based questions (62.9%). ChatGPT showed strong performance on text-only items (83.7%) but had reduced accuracy on image-based questions (54.8%). Gemini performed moderately on text-only questions (73.5%) but struggled significantly with image-based content, achieving only 24.2% accuracy. Pairwise comparisons confirmed that students outperformed both AI models across all formats (p < 0.01), with the widest performance gap observed in image-based questions between students and Gemini (+ 38.7% points). All AI \"unable to answer\" responses were treated as incorrect for analysis.</p><p><strong>Conclusion: </strong>This proof-of-concept study demonstrates that while AI shows promise as a supplementary educational tool, it cannot yet replace traditional training methods-particularly in domains requiring visual interpretation and clinical reasoning. ChatGPT' s strong performance on text-based questions highlights its utility, but its limitations in image-based tasks emphasize the need for improvement. Gemini's lower accuracy further highlights the challenges current AI models face in processing visually complex medical content. Future research should focus on enhancing AI's multimodal capabilities to improve its applicability in medical education and assessment.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"146"},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12329864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799033","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}
引用次数: 0
Utilization of acute medical services in general practice: a retrospective routine data analysis. 利用急诊医疗服务在一般做法:回顾性常规数据分析。
IF 2
International Journal of Emergency Medicine Pub Date : 2025-08-07 DOI: 10.1186/s12245-025-00943-y
Christoph Strumann, Wolfgang C G von Meißner, Paul-Georg Blickle, Johannes Rieken, Jost Steinhäuser
{"title":"Utilization of acute medical services in general practice: a retrospective routine data analysis.","authors":"Christoph Strumann, Wolfgang C G von Meißner, Paul-Georg Blickle, Johannes Rieken, Jost Steinhäuser","doi":"10.1186/s12245-025-00943-y","DOIUrl":"10.1186/s12245-025-00943-y","url":null,"abstract":"<p><strong>Background: </strong>The increasing utilization of emergency departments by patients with acute but non-emergency medical needs contributes to overcrowding in emergency care. Previous research has mainly focused on hospitals and out-of-hours care centres. The role of general practitioners providing primary care during office hours for emergency and acutely ill patients has not yet been considered intensively. This analysis aimed to quantify and describe the documented outpatient utilization behaviour of patients with acute care needs in primary care practices during office hours.</p><p><strong>Methods: </strong>The retrospective cohort study used routine data from 16 German primary care practices in 2022 and 2023 from the Supraregional Health Service Research Network. Acute care cases were identified as consultations without a prior appointment or those with a same-day appointment. Statistical analyses included bivariate and multivariate analyses.</p><p><strong>Results: </strong>A total of 873,732 consultations involving 90,020 patients were analysed. When considering only the first visit of an acute episode, 60.6% of cases were classified as acute. Patients seeking acute care were younger (51.9 vs. 58.3 years, p < 0.001) and more likely to visit the practice on Mondays (Odds Ratio: 1.48, p < 0.001) or at the weekend (Odds Ratio: 13.91, p < 0.001). Nonspecific health factors, respiratory-, musculoskeletal- and cardiovascular reasons for encounter dominated. The majority of acute cases (80%) did not seek any further health service on the same day, while approximately 19% of patients were referred to a specialist and 3% were admitted to a hospital within 14 days.</p><p><strong>Conclusion: </strong>The effective management of acute cases by primary care practices highlights the potential for strengthening this sector to enhance the quality and efficiency of emergency care.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"147"},"PeriodicalIF":2.0,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799034","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}
引用次数: 0
Life-threatening recurrent pulmonary embolism following anticoagulation withdrawal: a case report emphasising the management dilemma in resource-constrained settings. 抗凝停药后危及生命的复发性肺栓塞:一个强调资源受限环境下管理困境的病例报告。
IF 2
International Journal of Emergency Medicine Pub Date : 2025-08-06 DOI: 10.1186/s12245-025-00941-0
Pradana Pratomo Raharjo, Alice Valeria Wiyono, Ulrike Panjaitan, Iwan Cahyo Santosa Putra, Katherine Hermanto, Triwedya Indra Dewi, Miftah Pramudyo
{"title":"Life-threatening recurrent pulmonary embolism following anticoagulation withdrawal: a case report emphasising the management dilemma in resource-constrained settings.","authors":"Pradana Pratomo Raharjo, Alice Valeria Wiyono, Ulrike Panjaitan, Iwan Cahyo Santosa Putra, Katherine Hermanto, Triwedya Indra Dewi, Miftah Pramudyo","doi":"10.1186/s12245-025-00941-0","DOIUrl":"10.1186/s12245-025-00941-0","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"145"},"PeriodicalIF":2.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794370","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}
引用次数: 0
Stem cell therapies and glioma stem cells in glioblastoma: a systematic review of current challenges and research directions. 胶质母细胞瘤中的干细胞治疗和胶质瘤干细胞:当前挑战和研究方向的系统综述。
IF 2
International Journal of Emergency Medicine Pub Date : 2025-08-06 DOI: 10.1186/s12245-025-00921-4
Olivier Uwishema, Sanobar Shariff, Magda Wojtara, Judy Ahmad El Chakik, Shankhaneel Ghosh, Kehinde Obamiro, Syed Ather Enam
{"title":"Stem cell therapies and glioma stem cells in glioblastoma: a systematic review of current challenges and research directions.","authors":"Olivier Uwishema, Sanobar Shariff, Magda Wojtara, Judy Ahmad El Chakik, Shankhaneel Ghosh, Kehinde Obamiro, Syed Ather Enam","doi":"10.1186/s12245-025-00921-4","DOIUrl":"10.1186/s12245-025-00921-4","url":null,"abstract":"<p><strong>Background: </strong>Glioblastoma is the most aggressive tumor of glial origin and the most common, as established by the World Health Organization. GBM has been one of the most intractable tumors with minimal progress in prognosis despite decades of research. Stem cell therapy (SCT) has raised hopes with regard to possibly targeting tumor progression and recurrence. Glioma stem cells (GSCs) are directly involved in gliomagenesis and chemoresistance, thus constituting potential valuable therapeutic targets for improving treatment outcomes.</p><p><strong>Objective: </strong>The objective of this review article is to assess and consider the potential therapeutic benefits, challenges, and prospective research directions for SCTs for glioblastoma with a particular focus on GSCs as key therapeutic targets.</p><p><strong>Materials and methods: </strong>A literature review was performed using search terms and Boolean operators pertinent to SCT and glioblastomas to gather all existing literature. The databases PubMed/MEDLINE, Scopus, and the Cochrane Library were searched in accordance with the standard guidelines of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020.</p><p><strong>Results and conclusions: </strong>The review established that the main mesenchymal stem cells (MSCs), neural stem cells (NSCs), induced pluripotent stem cells (iPSCs), and hematopoietic stem cells are the first SCTs evaluated in terms of their potential as a glioblastoma therapy. While SCTs were found to be effective in tumor targeting and immune modulation, they face certain restrictions, including death of stem cells inside the body, tumor heterogeneity, and transformation to malignancy. Research must now focus on the combination of stem cell therapy with molecular-targeted therapy and advanced delivery systems for improved tumor targeting, better overcoming resistance, and enhancing both efficacy and safety for patients undergoing treatment for glioblastoma.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"144"},"PeriodicalIF":2.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794371","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}
引用次数: 0
Application of contrast-enhanced ultrasonography in evaluating acute testicular lesions: a retrospective analysis. 超声造影在评估睾丸急性病变中的应用:回顾性分析。
IF 2
International Journal of Emergency Medicine Pub Date : 2025-08-05 DOI: 10.1186/s12245-025-00944-x
Bin Zou, Yuling Yang, Lusheng Zhang, Huabin Chen, Fuqiang Zeng, Biwei Chen
{"title":"Application of contrast-enhanced ultrasonography in evaluating acute testicular lesions: a retrospective analysis.","authors":"Bin Zou, Yuling Yang, Lusheng Zhang, Huabin Chen, Fuqiang Zeng, Biwei Chen","doi":"10.1186/s12245-025-00944-x","DOIUrl":"10.1186/s12245-025-00944-x","url":null,"abstract":"<p><strong>Background: </strong>Acute complete testicular torsion, acute incomplete testicular torsion, acute testicular ischemia, acute testicular appendage torsion, and acute epididymo-orchitis are common scrotal emergencies in urology. An accurate diagnosis of the cause of acute scrotal pain is crucial for selecting the appropriate treatment. This study aimed to explore the application of high-frequency ultrasonography (HFUS) and contrast-enhanced ultrasonography (CEUS) in the evaluation of acute scrotal lesions.</p><p><strong>Results: </strong>This study included 46 patients with acute scrotal pain. All patients underwent HFUS and CEUS prior to treatment. The ultrasonographic features of the affected and contralateral (healthy) testes were compared to evaluate the application of HFUS and CEUS for the assessment of acute scrotal lesions. Two patients with testicular ischemia were correctly diagnosed using both HFUS and CEUS. Among the nine patients with complete testicular torsion, eight were correctly diagnosed using HFUS, while one was only diagnosed as having an abnormal testis. In the cohort of 11 patients with incomplete testicular torsion, eight were accurately identified using HFUS, whereas three were erroneously diagnosed as having complete testicular torsion. Among the 15 patients with testicular appendage torsion, 14 were correctly diagnosed using HFUS, while one was misdiagnosed as having testicular torsion. Among the nine patients with epididymitis, seven were correctly diagnosed using HFUS, one was misdiagnosed as having testicular appendage torsion, and one was misdiagnosed as normal. However, CEUS results were consistent with the final confirmed diagnoses. The diagnostic accuracy of HFUS for acute scrotal lesions was 84.8%, whereas that of CEUS was 100%. The discrepancy between the two methods was statistically significant (χ<sup>2</sup> = 3.50; P = 0.018, P < 0.05, respectively).</p><p><strong>Conclusion: </strong>CEUS has higher accuracy in evaluating acute scrotal lesions. This can prevent misjudgment of the degree of testicular torsion, prevent misdiagnosis of testicular appendage torsion and epididymitis as testicular torsion, and avoid misjudgment of abnormal testes or epididymitides as normal. This helps prevent adverse outcomes such as delayed treatment and testicular removal.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"143"},"PeriodicalIF":2.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12326580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788942","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}
引用次数: 0
Clinical features and prognostic predictors for patients admitted to trauma intensive care unit due to fall from height in South Xinjiang. 南疆地区因高空坠落而入住创伤重症监护病房患者的临床特征及预后预测因素
IF 2
International Journal of Emergency Medicine Pub Date : 2025-08-04 DOI: 10.1186/s12245-025-00959-4
Yong Chen, Wenwen Li, Xiaohong Wang, Qifu Zhong, Alimujiang Abudurexiti, Qinye Qiu, Jianwei Li, Junyang Luo
{"title":"Clinical features and prognostic predictors for patients admitted to trauma intensive care unit due to fall from height in South Xinjiang.","authors":"Yong Chen, Wenwen Li, Xiaohong Wang, Qifu Zhong, Alimujiang Abudurexiti, Qinye Qiu, Jianwei Li, Junyang Luo","doi":"10.1186/s12245-025-00959-4","DOIUrl":"10.1186/s12245-025-00959-4","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"142"},"PeriodicalIF":2.0,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12323124/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784201","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}
引用次数: 0
Epidemiological characteristics of elderly population receiving pre-hospital emergency care after road traffic injuries in Punjab, Pakistan. 巴基斯坦旁遮普省道路交通伤害后接受院前急救的老年人口的流行病学特征
IF 2
International Journal of Emergency Medicine Pub Date : 2025-08-01 DOI: 10.1186/s12245-025-00898-0
Kantesh Kumar, Sheza Hassan, Muhammad Bazil Musharraf, Komal Abdul Rahim, Sijal Akhtar Sheikh, Huba Atiq, Muhammad Waqas Ahmed, Rameez-Ur-Rehman Siddiqui, Rizwan Naseer, Shahnaz Akhter, Yasir Shafiq, Junaid Razzak
{"title":"Epidemiological characteristics of elderly population receiving pre-hospital emergency care after road traffic injuries in Punjab, Pakistan.","authors":"Kantesh Kumar, Sheza Hassan, Muhammad Bazil Musharraf, Komal Abdul Rahim, Sijal Akhtar Sheikh, Huba Atiq, Muhammad Waqas Ahmed, Rameez-Ur-Rehman Siddiqui, Rizwan Naseer, Shahnaz Akhter, Yasir Shafiq, Junaid Razzak","doi":"10.1186/s12245-025-00898-0","DOIUrl":"10.1186/s12245-025-00898-0","url":null,"abstract":"<p><strong>Background: </strong>Every year, 1.3 million lives are lost to road traffic injuries (RTIs). 90% of these deaths disproportionately occur in Lower-Middle Income Countries (LMICs). Due to frailty and reduced physiological resilience, elderly populations are at higher risk of RTIs and poor outcomes, versus younger populations. Further, according to the World Health Organization (WHO), the global elderly population will double by 2050, indicating that this group will be at an even higher risk of RTIS.</p><p><strong>Objectives: </strong>Our study aims to utilize Emergency Medical Services (EMS) data to better understand the trends, types, injuries, patient characteristics, and outcomes of RTIs involving the elderly, ultimately contributing to more targeted and effective road safety policies and interventions.</p><p><strong>Methods: </strong>We analyzed secondary EMS data during 2022 and 2023 from the Emergency Services Department (Rescue 1122) in the province of Punjab, Pakistan. RTI data in patients aged ≥ 65 years was extracted from the database for age, gender, education, response time, injury type, RTI victim type, location of injury, and victim outcome. Multivariable analysis was carried out using multiple logistic regression to obtain an adjusted odds ratio with a 95% confidence interval for on-scene mortality.</p><p><strong>Results: </strong>From 4.2 million EMS activations, data on 34,345 RTIs in elderly patients was analyzed. Patients had a mean age of 70.12 years, and 77% (26,608) were males. The most common injury type was soft tissue injury (24,166; 70.36%), followed by limb injury (5,126; 14.9%), and head injury (2,590; 7.5%). Most victims suffered injuries as passengers (11,396; 37.2%). The mean response time was 7.19 minutes, and the on-scene mortality rate was 1.3% (443). The odds of on-scene mortality increased with increasing response time (AOR: 1.05, CI: 1.04-1.07), while an increase in the degree of urbanization was associated with decreasing odds of on-scene mortality (AOR: 0.99, CI: 0.98-0.99). Head injuries (OR: 24.49, CI: 20.11-29.93) and pedestrian injuries (Adjusted OR: 1.40, CI: 1.06-1.84) were strongly associated with on-scene mortality.</p><p><strong>Conclusion: </strong>Our study revealed that head and pedestrian injuries emerged as key factors for on-scene mortality in elderly patients of Punjab, Pakistan. These findings necessitate targeted interventions to encourage a rapid pre-hospital response to lower on-scene mortality rates.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"140"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764812","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}
引用次数: 0
Effectiveness and safety of vernakalant vs flecainide for cardioversion of atrial fibrillation in the emergency department: the VERITA study. vernakalant与氟氯胺在急诊科房颤复律中的有效性和安全性:VERITA研究
IF 2
International Journal of Emergency Medicine Pub Date : 2025-08-01 DOI: 10.1186/s12245-025-00951-y
Giuseppe Dominijanni, Antonio F Caballero-Bermejo, Ana Sainz-Herrero, Álvaro Pineda-Torcuato, Rosa Capilla-Pueyo, Belén Ruiz-Antorán
{"title":"Effectiveness and safety of vernakalant vs flecainide for cardioversion of atrial fibrillation in the emergency department: the VERITA study.","authors":"Giuseppe Dominijanni, Antonio F Caballero-Bermejo, Ana Sainz-Herrero, Álvaro Pineda-Torcuato, Rosa Capilla-Pueyo, Belén Ruiz-Antorán","doi":"10.1186/s12245-025-00951-y","DOIUrl":"10.1186/s12245-025-00951-y","url":null,"abstract":"<p><strong>Background: </strong>Vernakalant is authorized in several countries, except in the U.S., where the FDA denied its commercialization due to safety concerns, generating debate about its use.</p><p><strong>Objective: </strong>To compare the effectiveness and safety of intravenous (iv) vernakalant and iv flecainide in the conversion of atrial fibrillation (AF) to sinus rhythm (SR) in a hospital emergency department (ED).</p><p><strong>Design, settings and participants: </strong>A retrospective observational study was conducted, including all AF episodes treated with vernakalant or iv flecainide in the ED between January 2012 and December 2022. Clinical characteristics of each episode were analyzed following routine clinical practice.</p><p><strong>Outcomes measure and analysis: </strong>The primary outcome was the percentage of episodes achieving conversion to sinus rhythm during the emergency department stay. Secondary outcomes included clinical evolution, emergency department re-presentations, and outpatient cardiology consultations recorded over a 6-month period. Subgroup analyses evaluated the effectiveness of vernakalant and flecainide by age, sex, treatment timing, heart failure history, previous atrial fibrillation episodes, AF type, and CHADS-VAS score.</p><p><strong>Main findings: </strong>A total of 289 patients and 414 AF episodes were included, with 151 treated with flecainide and 263 with vernakalant. The median age was 62 years, and 57.5% were male. Vernakalant converted 76.4% of episodes to SR during the ED stay, compared to 69.5% with flecainide (p = 0.124). AF recurrence at six months was lower in the vernakalant group (20.1% vs. 29.1%; p = 0.043), with fewer ED visits for recurrent AF (0.24 vs. 0.48; p = 0.001). Vernakalant was more effective in early treatment (< 12 h after symptom onset) (82.2% vs. 70.7%; p = 0.014) and in AF with rapid ventricular response (78.1% vs. 68.0%; p = 0.044). Both drugs were well tolerated, although flecainide was associated with higher rates of bradycardia, dizziness, and hypotension.</p><p><strong>Conclusions: </strong>Vernakalant and flecainide demonstrated similar effectiveness and safety; however, vernakalant showed superior effectiveness in early treatment, faster conversion to SR, lower AF recurrence rates, and fewer ED visits within six months.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"141"},"PeriodicalIF":2.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317465/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144764799","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}
引用次数: 0
A rare cause of acute upper airway obstruction: a case report. 急性上气道梗阻的罕见病因1例。
IF 2
International Journal of Emergency Medicine Pub Date : 2025-07-31 DOI: 10.1186/s12245-025-00908-1
Jane Harding, Csaba Dioszeghy
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