International Journal of Emergency Medicine最新文献

{"title":"Epidemiological analysis of self-harm and suicide attempts in Iran: a cross-sectional study in Kurdistan's emergency hospitals.","authors":"Armin Saedi, Bakhtiar Piroozi, Ghobad Moradi, Media Babahajiani, Kourosh Akhbari, Leila Azizkhani","doi":"10.1186/s12245-025-00913-4","DOIUrl":"10.1186/s12245-025-00913-4","url":null,"abstract":"<p><strong>Background: </strong>Self-harm and suicide are major global public health issues, especially in low- and middle-income nations. Finding trends and risk factors is essential to creating successful solutions. The purpose of this study was to look into the risk factors and epidemiological characteristics of self-harm and suicide attempts among patients who were hospitalized to the emergency rooms at Kurdistan hospitals in 2021-2022.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 604 cases of self-harm and suicide attempts. Data were extracted from medical records, including demographic, clinical, and social variables. Statistical analysis was performed using SPSS (version 24), employing chi-square tests to determine associations between variables and outcomes.</p><p><strong>Results: </strong>The majority of patients (48.8%) were male, and the most affected age group was 17-40 years. Recovery or fatality outcomes were significantly associated with gender (p < 0.05), age group (p < 0.01), and method of self-harm (p < 0.001). Drug overdose (71%) was the most common method, with a recovery rate of 88% (p < 0.01), while hanging had the highest fatality rate at 40% (p < 0.001). Among the cases, 83.6% were discharged after treatment, while 16.4% resulted in death due to suicide attempts.</p><p><strong>Conclusion: </strong>The study identifies important clinical and demographic trends linked to suicide attempts and self-harm. Young adults, people with long-term medical or mental health issues, and those who are struggling financially should all be the focus of preventive programs. To lower the suicide rate, public health initiatives must give mental health services and community awareness campaigns first priority.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"127"},"PeriodicalIF":2.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12247375/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608304","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":"Nipah virus: a summary for clinicians.","authors":"Corri B Levine, Lauren M Sauer, Susan L F McLellan, Jared D Evans","doi":"10.1186/s12245-025-00916-1","DOIUrl":"10.1186/s12245-025-00916-1","url":null,"abstract":"<p><strong>Objectives: </strong>This article is one of a series on acute, severe diseases of humans caused by emerging viruses for which there are limited or no licensed medical countermeasures. Nipah virus (NiV) is recognized as a pathogen of concern by health experts and is included on the WHO list of emerging pathogens with pandemic concern. However, NiV is a relatively poorly understood pathogen, due to the small number of outbreaks and human clinical studies. The primary objective of this summary on NiV is to provide a global understanding of clinical perspectives, providing overviews of pathogenesis, clinical features, and diagnostics while emphasizing medical countermeasures. The focus is on potential therapies and vaccines that have demonstrated potential efficacy to combat NiV infection to provide clinicians candidates for use in an emergency situation or clinical research settings.</p><p><strong>Methods: </strong>A literature review was conducted for NiV vaccines and therapeutics tested in animal models of disease.</p><p><strong>Results: </strong>We identified two antiviral medications approved by the U.S. FDA with potential benefit for the off-label treatment of NiV infection, and a larger number of potential candidates are currently being evaluated in early development. Multiple vaccine platforms are in pre-clinical development for NiV prevention, but data from human clinical trials are not yet available.</p><p><strong>Conclusion: </strong>We provide specific background information on NiV and disease manifestations along with succinct summaries of medical countermeasures against NiV to provide clinicians a rapid reference to review the literature if faced with a patient in whom NiV infection is suspected. Moreover, the information provides several candidates for human clinical research studies in outbreak settings.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"126"},"PeriodicalIF":2.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600343","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":"Ambulance diversion and its use as an ED overcrowding mitigation strategy: Does it work? A scoping review.","authors":"Jin Han Malcolm Ong, Bernard J W Lim, Muhammad Ariffin B M Zahrin, Isaac J S Yong, Luke L L Tan, Ren Hao Desmond Mao, Marcus E H Ong, Fahad Javaid Siddiqui","doi":"10.1186/s12245-025-00933-0","DOIUrl":"10.1186/s12245-025-00933-0","url":null,"abstract":"<p><strong>Objective: </strong>Emergency department (ED) overcrowding is a worldwide issue with significant negative consequences, including increased patient mortality. Ambulance diversion (AD) is sometimes used as an intervention to momentarily relieve overcrowded EDs, however, jury is still out about the negative consequences both for emergency medical services (EMS) who are required to divert to an alternative destination, and for patients whose care is delayed. Additionally, there is no operational guidance to best operationalize AD. The objective of this scoping review was to collate and organize the peer-reviewed published literature on the effects of both diversion and diversion aversion measures, on emergency medical services (EMS) and patient outcomes.</p><p><strong>Method: </strong>A systematic, comprehensive search was conducted in various databases to identify relevant studies. Medline, Embase, CINAHL, Psychinfo, Cochrane and ClinicalTrials.gov databases were searched. Online ACEP and NAEMSP portals were also searched. Included studies discussed AD in the setting of ED overcrowding that reported either EMS or patient outcomes. The effects of interventions implemented to reduce AD were also reported. Two independent reviewers screened the articles and consensus was reached when disagreements arose.</p><p><strong>Results: </strong>Out of 10,061 identified records, 95 papers meeting the inclusion criteria contributed to the results. 51 were observational, 16 simulation, 15 interventional, 10 descriptive, 2 systematic reviews and 1 mixed method. 12 articles reported negative EMS outcomes compared to only 2 neutral or positive EMS outcomes. 19 articles reported negative patient outcomes, whereas 9 reported neutral or positive outcomes. 34 articles reporting on intervention attempts to reduce diversion found overall positive results with diversion aversion. Only 7 articles studied the qualitative effects of diversion.</p><p><strong>Conclusion: </strong>There is no conclusive evidence on the effects of AD on EMS and patient outcomes. 31 articles reported negative EMS or patient outcomes with 11 articles reporting neutral or positive outcomes. Measures to reduce or avoid diversion, however, showed overall positive trend in the results when diversion was averted. More research to ascertain accurate effects with standardised criteria for outcomes is required. Qualitative outcomes were also not well reported and further research should be conducted to determine the psychological impact on both staff and patients.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"125"},"PeriodicalIF":2.0,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12239308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591129","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":"Validation of Emergency Surgery Score (ESS) as outcome prediction score in Egyptian patients undergoing emergency laparotomy.","authors":"Mina Montasser, Doaa Ahmed Mohamed Ellisy, Jehan Ahmed Sayed, Momen Mostafa Makkey","doi":"10.1186/s12245-025-00934-z","DOIUrl":"10.1186/s12245-025-00934-z","url":null,"abstract":"<p><strong>Background: </strong>Emergency laparotomy is an exploratory procedure for many surgical situations. Proper prognostic prediction helps recognize high-risk patients who benefit from further therapy. The Emergency Surgery Score (ESS) was developed as a preoperative risk evaluation assessment that predicts patient outcomes after emergency laparotomy.</p><p><strong>Objective: </strong>This study is to validate the ESS in Egyptian patients by evaluating its predictive ability for 30-day mortality, surgical complications, and ICU admission rates.</p><p><strong>Methods: </strong>This prospective observational cohort study was performed out from May 2022 to November 2023 at two tertiary centers in Egypt. Patients aged 18 and above undergoing emergency laparotomy were included, whereas pregnant women and individuals with vascular or gynecological indications were eliminated. Preoperative, intraoperative, and postoperative data were thoroughly collected, and ESS was calculated for all patients. The primary desired outcome was 30-day death, while secondary outcomes included surgical complications and ICU admission. Standard definitions from the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) were used.</p><p><strong>Results: </strong>This study included a diverse cohort, with a mean age of the patients 48.66 ± 19.37 years. The 30-day totally mortality rate was 28%. The most common complication was pneumonia (60%), followed by sepsis and acute kidney injury. Higher ESS scores were significantly associated with increased mortality and complication rates, confirming its predictive validity.</p><p><strong>Conclusion: </strong>ESS effectively categorized Egyptian patients who more reliable to complications of emergency laparotomy. Its use may improve clinical decision-making, optimize resource allocation, and facilitate patient and family counseling. Further research is recommended to refine its applicability across different populations.</p><p><strong>Trial registration: </strong>NCT05639920 registration date on (26/10/2021).</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"124"},"PeriodicalIF":2.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144583856","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 large language models for renal colic imaging recommendations: a comparative analysis of Gemini, copilot, and ChatGPT-4.0.","authors":"Yavuz Yigit, Asım Enes Ozbek, Betul Dogru, Serkan Gunay, Baha AlKahlout","doi":"10.1186/s12245-025-00895-3","DOIUrl":"10.1186/s12245-025-00895-3","url":null,"abstract":"<p><strong>Background: </strong>The field of natural language processing (NLP) has evolved significantly since its inception in the 1950s, with large language models (LLMs) now playing a crucial role in addressing medical challenges.</p><p><strong>Objectives: </strong>This study evaluates the alignment of three prominent LLMs-Gemini, Copilot, and ChatGPT-4.0-with expert consensus on imaging recommendations for acute flank pain.</p><p><strong>Methods: </strong>A total of 29 clinical vignettes representing different combinations of age, sex, pregnancy status, likelihood of stone disease, and alternative diagnoses were posed to the three LLMs (Gemini, Copilot, and ChatGPT-4.0) between March and April 2024. Responses were compared to the consensus recommendations of a multispecialty panel. The primary outcome was the rate of LLM responses matching the majority consensus. Secondary outcomes included alignment with consensus-rated perfect (9/9) or excellent (8/9) responses and agreement with any of the nine panel members.</p><p><strong>Results: </strong>Gemini aligned with the majority consensus in 65.5% of cases, compared to 41.4% for both Copilot and ChatGPT-4.0. In scenarios rated as perfect or excellent by the consensus, Gemini showed 69.5% agreement, significantly higher than Copilot and ChatGPT-4.0, both at 43.4% (p = 0.045 and < 0.001, respectively). Overall, Gemini demonstrated an agreement rate of 82.7% with any of the nine reviewers, indicating superior capability in addressing complex medical inquiries.</p><p><strong>Conclusion: </strong>Gemini consistently outperformed Copilot and ChatGPT-4.0 in aligning with expert consensus, suggesting its potential as a reliable tool in clinical decision-making. Further research is needed to enhance the reliability and accuracy of LLMs and to address the ethical and legal challenges associated with their integration into healthcare systems.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"123"},"PeriodicalIF":2.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12232162/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564778","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":"Case of scombroid syndrome mimicking an anaphylactic fish allergy.","authors":"Véronique Gingras, Louis Marois","doi":"10.1186/s12245-025-00930-3","DOIUrl":"10.1186/s12245-025-00930-3","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"122"},"PeriodicalIF":2.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12224635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560105","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":"Correction: Comparison of T-POD and SAM Pelvic Sling II and the influence of attachment level in the initial management of unstable pelvic type C injuries - a cadaveric study.","authors":"Maxim Privalov, Malte Junge, Matthias Karl Jung, Sven Yves Vetter, Jochen Franke, Svetlana Hetjens, Paul Alfred Grützner, Holger Stadthalter, Niko R E Schneider","doi":"10.1186/s12245-025-00939-8","DOIUrl":"10.1186/s12245-025-00939-8","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"121"},"PeriodicalIF":2.0,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553496","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":"Clinical characteristics and factors influencing hospitalization in pediatric patients with foreign body aspiration: a comprehensive analysis in an emergency department.","authors":"Piyadarat Asawasakulchokedee, Rattapon Uppala, Phanthila Sitthikarnkha, Sirapoom Niamsanit, Leelawadee Techasatian, Suchaorn Saengnipanthkul, Pornthep Kasemsiri","doi":"10.1186/s12245-025-00923-2","DOIUrl":"10.1186/s12245-025-00923-2","url":null,"abstract":"<p><strong>Background: </strong>Foreign body aspiration (FBA) in children is a potentially life-threatening event, especially in those under 3 years of age. This study aimed to identify clinical factors associated with hospitalization in pediatric FBA and to highlight innovative retrieval methods used in a tertiary care setting.</p><p><strong>Methods: </strong>A retrospective analysis was conducted of pediatric patients (< 18 years) presenting with confirmed airway FBA between January 2015 and September 2023 at Srinagarind Hospital, Khon Kaen University. Demographic information, clinical characteristics, and procedural data were collected. Univariate and multivariate logistic regression analyses identified predictors of hospitalization.</p><p><strong>Results: </strong>Among 297 pediatric patients with FBA, 39 (13.1%) required hospitalization. Hospitalized children were younger (median age: 3 years; interquartile range [IQR] 2-7) compared with non-hospitalized children (median age: 4 years; IQR 3-7, p = 0.018). FBA involving the larynx-trachea-bronchus significantly increased the likelihood of admission (adjusted odds ratio [AOR] = 22.0; 95% confidence interval [CI]: 6.64-72.63; p < 0.001). Delayed presentation to the emergency department more than two hours after onset was also associated with hospitalization (OR = 2.77; 95% CI: 1.08-7.09; p = 0.033). Although rigid bronchoscopy remained the mainstay treatment, flexible bronchoscopy was successfully utilized in nine cases. Notably, a novel technique using a 3 mm gold-plated neodymium magnet under fluoroscopic guidance enabled the safe retrieval of distal metallic foreign bodies. Complete removal of the aspirated objects was achieved in all patients; however, one patient died following prolonged hypoxia prior to hospital arrival.</p><p><strong>Conclusions: </strong>Younger age, delayed emergency department presentation, and location of the foreign body in the larynx-trachea-bronchus are significant predictors of hospitalization in pediatric FBA. Rigid bronchoscopy remains the primary management strategy, while flexible bronchoscopy and innovative retrieval methods, including magnet-assisted approaches, offer effective alternatives in specific scenarios. Emphasizing early diagnosis and rapid intervention is essential to reduce complications and improve outcomes in children with FBA.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"115"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540135","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 stitch in time saves nine! A case report of spontaneous duodenal perforation in advanced pancreatic cancer.","authors":"Isha Jatin Shah, Raghu Sudarshan Thota, Jayita Deodhar, Shamali Poojary","doi":"10.1186/s12245-025-00918-z","DOIUrl":"10.1186/s12245-025-00918-z","url":null,"abstract":"<p><p>Acute abdomen is a common presentation in the emergency department, requiring prompt evaluation, diagnosis, and treatment. This case report highlights how simple diagnostic tools can facilitate early detection of abdominal pain caused by duodenal perforation-a rare complication in patients with locally advanced pancreatic cancer. We present a novel case of a 62-year-old male with locally advanced pancreatic cancer who developed acute abdominal pain. The diagnosis of intestinal perforation was made at a Specialist Palliative Care clinic within a tertiary cancer centre. An erect abdominal X-ray revealed free air under the diaphragm, pointing to bowel perforation. The patient underwent emergency surgical exploration, which confirmed a duodenal perforation and was managed with a palliative gastrojejunostomy. While point-of-care ultrasound (POCUS) was not used in this case, we emphasize its potential utility as a bedside tool in the emergency setting for early evaluation of acute abdomen. It can aid in differentiating between conditions such as bowel obstruction, perforation, intussusception, abscesses, or large masses compressing vital structures-many of which may not be visible on a plain abdominal X-ray. This case underscores the importance of early clinical evaluation and the use of accessible diagnostic tools (POCUS) in the timely management of acute abdomen, particularly in complex cancer cases.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"118"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12219444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540134","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":"Successful endoscopic removal of sewing needle and flat metal: a case report.","authors":"Yohannes Birhanu, Wudassie Melak, Zelalem Mulu, Habtewold Shibiru, Sisay Admassu","doi":"10.1186/s12245-025-00910-7","DOIUrl":"10.1186/s12245-025-00910-7","url":null,"abstract":"","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"18 1","pages":"119"},"PeriodicalIF":2.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12220266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540140","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}