Journal of acute medicine最新文献

{"title":"Pulmonary Arteriovenous Malformation Presenting With Acute Dyspnea: A Case Report.","authors":"Che-Wei Lin, Chee-Fah Chong","doi":"10.6705/j.jacme.202606_16(2).0005","DOIUrl":"10.6705/j.jacme.202606_16(2).0005","url":null,"abstract":"<p><p>A 65-year-old male presented to the emergency department with acute dyspnea and critically low oxygen saturation (77%), which led to the discovery of an unusual pulmonary arteriovenous malformation (PAVM). Computed tomographic pulmonary angiography revealed a 2.5-cm vascular lesion connecting the right inferior pulmonary artery to the left cardiac atrium, resulting in significant right-to-left shunting. The patient's respiratory symptoms resolved completely after video-assisted thoracoscopic surgical resection, demonstrating the value of comprehensive imaging in diagnosing rare vascular anomalies. This case highlights the clinical significance of unexpected vascular malformations in older adults.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"16 2","pages":"79-81"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156644","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":"Doing the Right Thing at the Right Time: Rethinking EMS Priorities.","authors":"Chih-Hsien Chi","doi":"10.6705/j.jacme.202606_16(2).0001","DOIUrl":"10.6705/j.jacme.202606_16(2).0001","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"16 2","pages":"55-56"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156670","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":"First Contact: A Beginner's Guide to FOAMed for Emergency Physicians.","authors":"Floris Vandewoude","doi":"10.6705/j.jacme.202606_16(2).0004","DOIUrl":"10.6705/j.jacme.202606_16(2).0004","url":null,"abstract":"<p><p>Free Open Access Medical Education (FOAMed) has rapidly transformed emergency medicine learning by offering accessible, on-demand educational resources such as blogs, podcasts, and social media content. However, for physicians, the vast and unregulated nature of FOAMed may be overwhelming and difficult to navigate. This brief report introduces FOAMed as a movement, outlines high-quality starting points for newcomers, and offers guidance on evaluating educational quality and managing conflicting information. By critically engaging with FOAMed and applying it critically and appropriately in clinical contexts, emergency physicians can enhance their ongoing education and professional development.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"16 2","pages":"76-78"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156580","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":"Scattered Erythema and Joint Swelling.","authors":"Shuichi Okaya, Hiroshi Ito","doi":"10.6705/j.jacme.202606_16(2).0008","DOIUrl":"10.6705/j.jacme.202606_16(2).0008","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"16 2","pages":"89-90"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156673","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 Association Between the Intensity of Abdominal Pain and a Diagnosis of Acute Appendicitis in Children.","authors":"Or Kaplan, Rotem Shalev Shamay, Adi Shiloh, Gidon Test, Daniel Gelman, Inbal Kestenbom, Michal S Maimon","doi":"10.6705/j.jacme.202606_16(2).0002","DOIUrl":"10.6705/j.jacme.202606_16(2).0002","url":null,"abstract":"<p><strong>Background: </strong>Acute appendicitis is the most common surgical etiology for acute abdominal pain in children. In this study, we examine whether there is a correlation between the intensity of abdominal pain, measured by the Visual Analogue Scale (VAS), and acute appendicitis. Understanding this correlation can facilitate timely diagnosis of acute appendicitis.</p><p><strong>Methods: </strong>We retrospectively reviewed 12,545 cases of children aged 3-18 years who were admitted to the pediatric Emergency Department of University Medical Center between January 2015 and December 2020 with acute abdominal pain (≤ 7 days). A final diagnosis of acute appendicitis was determined in 1,401 patients (15.1%). Of these patients, 1,123 (80.1%) underwent appendectomy and 353 (25.0%) had complicated appendicitis.</p><p><strong>Results: </strong>The results demonstrate significantly higher initial VAS scores in acute appendicitis patients compared to patients with abdominal pain from other etiologies. In addition, being young, male, and Jewish were all found to correlate with a reduced likelihood of acute appendicitis diagnosis in the study cohort. After adjusting for age, sex, and ethnicity, higher initial pain levels were positively correlated with the likelihood of an appendicitis diagnosis.</p><p><strong>Conclusion: </strong>The degree of abdominal pain can serve as a valuable clinical marker for healthcare practitioners in assessing the likelihood of acute appendicitis. This tool can enhance the accuracy of current clinical scoring systems, thereby reducing the rate of appendicitis misdiagnosis and complications.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"16 2","pages":"57-66"},"PeriodicalIF":1.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13227070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148156629","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 Comparison of Bedside Ultrasonography Use by Emergency Medicine Residents With 2D Echocardiography Performed by Sonographers for Assessing Left Ventricular Systolic Function in a Tertiary Hospital: A Single-Center Prospective Study.","authors":"Cihan U Göker, Moira Madelle C Mañalac, Earlyn B Macalinao, Rosita Mae Q Santos, Robert John A Aquino, Stefanie Mei O De Belen, Tedrick Daniel C Flores, Faith Angeli J Ladia, Catherine Maria D Tamesis","doi":"10.6705/j.jacme.202603_16(1).0002","DOIUrl":"10.6705/j.jacme.202603_16(1).0002","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) has become a crucial tool in the emergency department, aiding in rapid patient assessment and diagnosis, particularly in cases of acute dyspnea, which can have life-threatening causes. This study explores the diagnostic accuracy of PoCUS performed by emergency medicine residents, utilizing visual estimation and E-Point Septal Separation (EPSS) methods, in comparison to conventional 2D echocardiograms interpreted by sonographers.</p><p><strong>Methods: </strong>A total of 112 adult patients with acute dyspnea were included in this non-inferiority study. Visual estimation and EPSS measurements were performed by trained emergency medicine residents, with the results compared to 2D echocardiograms for sensitivity, specificity, positive and negative predictive values, likelihood ratios, receiver operating characteristic curve and diagnostic accuracy.</p><p><strong>Results: </strong>The study demonstrated a moderate positive correlation between visual estimation and EPSS methods and 2D echocardiography findings, with a Spearman's correlation coefficient of 0.422 and 0.411, respectively. The visual estimation method showed higher positive likelihood ratios (107) and sensitivity (100%) for detecting severely reduced ejection fraction (EF) < 30%, while EPSS displayed slightly lower positive likelihood ratios (13.4) and sensitivity (100%) in the same category. The diagnostic accuracy for both methods was highest in patients with severely depressed EF and lowest in those with moderately depressed EF. The study revealed some discrepancies in classification between methods, with visual estimation and EPSS sometimes underestimating or overestimating EF, potentially due to patient factors and operator-dependent bias.</p><p><strong>Conclusion: </strong>This study demonstrates that visual estimation and EPSS methods, when performed by emergency medicine residents, exhibit a moderate positive correlation with 2D echocardiography findings. These methods offer a statistically significant diagnostic accuracy in estimating left ventricular ejection fraction, making them valuable tools for initial assessment in time-sensitive situations.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"16 1","pages":"14-28"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498886","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":"Emergency Departments as Early Clinical Sentinels and the Final Operational Buffer.","authors":"Chih-Hsien Chi","doi":"10.6705/j.jacme.202603_16(1).0000","DOIUrl":"10.6705/j.jacme.202603_16(1).0000","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"16 1","pages":"1-2"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498977","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":"Outcomes of Extracorporeal Removal in Acute Barium Poisoning: A Scoping Review.","authors":"Han-Wei Mu, Shih-Hao Wu, Chun-Hung Chen","doi":"10.6705/j.jacme.202603_16(1).0001","DOIUrl":"10.6705/j.jacme.202603_16(1).0001","url":null,"abstract":"<p><p>Acute barium poisoning, though rare, can cause severe hypokalemia, respiratory paralysis, and life-threatening arrhythmias. Conventional treatments, including potassium replacement, may not rapidly resolve severe toxicity. Extracorporeal removal therapies (ECT), such as hemodialysis (HD) and continuous renal replacement therapy (CRRT), have been used to accelerate barium elimination, but their overall clinical outcomes remain unclear. This scoping review systematically summarizes current literature on the clinical outcomes of ECT in acute barium poisoning. We searched Embase, Ovid MEDLINE, and Cochrane Trials databases up to November 30, 2024. Fourteen articles reporting 15 cases were included. Most cases involved intentional oral ingestion, predominantly with barium chloride. Severe hypokalemia, respiratory paralysis, and serious arrhythmia were common. The overall survival rate was high (93.3%), with only one reported mortality. Toxicokinetic data showed that HD significantly reduced the elimination half-life of barium compared to non-dialysis approaches, while CRRT provided slower but sustained toxin removal. No ECT-related adverse events were reported. The findings highlight ECT as an effective method to manage severe barium poisoning symptoms. However, limited case data and publication bias indicate a need for larger comparative studies to determine optimal extracorporeal therapy strategies.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"16 1","pages":"1-13"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13006911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147512261","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":"Pneumomediastinum and Subcutaneous Emphysema as Initial Presentations of <i>Pneumocystis Jirovecii</i> Pneumonia in a Newly Diagnosed HIV-Infected Patient: A Case Report.","authors":"Ying-Wen Lai, Chun-Hung Chen","doi":"10.6705/j.jacme.202603_16(1).0005","DOIUrl":"10.6705/j.jacme.202603_16(1).0005","url":null,"abstract":"<p><p><i>Pneumocystis jirovecii</i> pneumonia (PJP) is a life-threatening opportunistic infection that primarily affects immunocompromised individuals, particularly those with acquired immunodeficiency syndrome caused by human immunodeficiency virus (HIV). The clinical presentation of PJP can be atypical, with symptoms such as spontaneous pneumothorax, pneumomediastinum, and subcutaneous emphysema, complicating diagnosis. In this report, we present a case of a 31-year-old male pharmacist with newly diagnosed HIV and PJP, who presented with persistent cough, dyspnea, intermittent fever, and subcutaneous emphysema. Chest X-ray and CT scans revealed bilateral ground-glass opacities, pneumomediastinum, and subcutaneous emphysema. The patient was diagnosed with HIV and PJP based on clinical findings and laboratory tests. Treatment with levofloxacin, penicillin, Caspofungin, and antiretroviral therapy led to significant improvement. This case highlights the importance of early diagnosis and the need for heightened clinical awareness of PJP in HIV-positive patients presenting with respiratory symptoms, particularly when imaging reveals atypical features.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"16 1","pages":"44-47"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499007","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":"Japan's Emergency Physician Community: Fifteen Years of the Emergency Medicine Alliance.","authors":"Nao Hanaki, Yukari Goto, Yasutake Kobayashi, Yuki Miyamoto, Kotaro Takebe","doi":"10.6705/j.jacme.202603_16(1).0004","DOIUrl":"10.6705/j.jacme.202603_16(1).0004","url":null,"abstract":"<p><strong>Background: </strong>In Japan, few hospitals have emergency physicians who handle all diseases and trauma, regardless of their specialty, and emergency physicians have to work in a variety of settings. The Emergency Medicine Alliance (EMA) was formed in 2009 to address this gap and enhance emergency room-type (ER-type) emergency medicine, where emergency specialists manage all diseases and trauma akin to the approach in the United States. We aimed to examine the EMA's activities, impact, and contributions over the past 15 years.</p><p><strong>Methods: </strong>This descriptive study reviewed the EMA's activities and outcomes from its inception in 2009 to 2024. The EMA is a nonprofit organization in Japan that includes 76 physicians and over 4,400 mailing list participants. Data from the EMA's internal records and publications were analyzed using descriptive statistics and qualitative feedback.</p><p><strong>Results: </strong>The EMA's mission includes developing ER-type emergency medicine, establishing professional identity, supporting networking, providing educational resources, and promoting research. The EMA has successfully increased its mailing list to over 4,200 by 2023 and transitioned to a nonprofit in 2016. It published four books and one journal, created the Choosing Wisely index, and conducted several educational workshops, including 20 EMA meetings and 10 director academies. The EMA's initiatives significantly contributed to the recognition of emergency physicians in Japan. The EMA has also focused on awareness activities, such as surveying burnout among emergency physicians and publishing the results of these surveys.</p><p><strong>Conclusions: </strong>The EMA has contributed to the advancement of emergency medicine in Japan by establishing a robust network, providing comprehensive educational resources, and advocating for the professional status of emergency physicians. Continued support and innovative strategies are essential to sustaining these achievements and addressing future challenges in emergency medical care.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"16 1","pages":"38-43"},"PeriodicalIF":1.1,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13004701/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499045","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}