Journal of acute medicine最新文献

{"title":"International Collaboration in Taiwan Emergency Department Publications: A Social Network Analysis.","authors":"Wen-Mei Cheng, Ching-Hsing Lee","doi":"10.6705/j.jacme.202409_14(3).0002","DOIUrl":"10.6705/j.jacme.202409_14(3).0002","url":null,"abstract":"<p><strong>Background: </strong>Emergency medicine (EM) is a growing specialty both clinically and academically. Academic EM development can be measured by number of scientific publications. This study aimed to evaluate the academic international cooperation trend of Taiwan emergency departments (EDs) in the past two decades using social network analysis (SNA).</p><p><strong>Methods: </strong>The study population were publications with first author affiliated with Taiwan EDs and the study duration was publication year before 2021. The enrolled publications were categorized into two groups: Group one, all authors were affiliated with Taiwan (domestic publications) and Group two, authors were affiliated with Taiwan and other countries (international publications). The primary outcome measurement was the degree centrality of Taiwan before 2021. The secondary outcome measurements included the trend in annual publication number of Group one and Group two, the trend in country number of each year in Group two, the top five countries that collaborate with Taiwan, the difference between the median of citation numbers in Group one and Group two, and the difference between the median of author numbers in Group one and Group two.</p><p><strong>Results: </strong>A total 4,363 publications were enrolled, of which 4,046 publications were classified in Group one and 317 publications were in Group two. The annual publication number of both groups increased significantly. The annual country number of collaboration with Taiwan ED publications had also significantly increased. The median of citation number and author number in Group two were both significantly higher than Group one. The top five countries collaborating with Taiwan were the United States, China, Malaysia, Japan, and Australia.</p><p><strong>Conclusions: </strong>Taiwan EDs' growing international collaboration in the past two decades indicated a capacity to conduct multi-country research. International collaboration publications obtained higher citations compared to domestic publications. Researchers should enhance international collaborations for academic advancement.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"14 3","pages":"108-115"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125786","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":"Left Ventricular Perforation Following Transcutaneous Pigtail Catheter Placement Mimicking Anterior Wall Myocardial Infarction: An Unusual Complication.","authors":"Tien-Lung Po, Huei-Fong Hung, Yu-Tong Yen, Cheng-Yen Chuang","doi":"10.6705/j.jacme.202409_14(3).0004","DOIUrl":"10.6705/j.jacme.202409_14(3).0004","url":null,"abstract":"<p><p>In modern medical practice, procedures that involve the use of catheters are common. These procedures can range from percutaneous coronary and peripheral vascular interventions to using catheters to drain fluid. However, complications associated with catheter usage can arise, and the most severe one is the puncture of a vital organ due to catheter misplacement. In this case, we present a rare complication related to the use of a pigtail catheter, which caused perforation of the left ventricular free wall. The patient presented with an electrocardiogram showing ST segment elevation in the anterior wall, indicative of a heart attack. The patient underwent coronary angiography, which showed that the coronary arteries were unblocked. However, during the procedure, the medical team suspected that the pigtail catheter was stuck in the left ventricle chamber, based on the use of fluoroscopy. This suspicion was later confirmed using computer tomography. To address the issue, the patient underwent an emergent cardiorrhaphy, which was performed immediately. Fortunately, the patient survived the complication.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"14 3","pages":"125-129"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366694/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125787","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":"Review of Emamectin Benzoate Poisoning.","authors":"Chi-Syuan Pan, Chun-Hung Chen, Han-Wei Mu, Kai-Wei Yang","doi":"10.6705/j.jacme.202409_14(3).0001","DOIUrl":"10.6705/j.jacme.202409_14(3).0001","url":null,"abstract":"<p><p>Emamectin Benzoate, a potent pesticide extensively used in agriculture, has raised concerns due to its potential for severe poisoning. While its safety in mammals is attributed to limited blood-brain barrier penetration and reduced affinity for specific channels, Emamectin Benzoate Poisoning can unexpectedly manifest with severe symptoms. Predominantly resulting from intentional ingestion, clinical presentations involve central nervous system depression, respiratory distress, gastrointestinal symptoms, and sore throat. Formulation solvents enhance toxicity, leading to corrosive injuries and metabolic imbalances. Skin contact induces irritation. Diagnosis relies on clinical evaluation, lacking specific laboratory data. Treatment lacks a designated antidote; hence, decontamination and cautious symptomatic management play pivotal roles. Severe cases require vigilant monitoring, with intensive care unit admission calling for altered consciousness and respiratory distress.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"14 3","pages":"101-107"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125788","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 Effect of a Separate Flow of Patients With Small Traumatic Injuries on Consult Time and Patient Satisfaction: A Retrospective Cohort Study During COVID-19 in the Emergency Department.","authors":"Poorvi Narwade, Loes Walraven, Djoke Douma-Den Hamer","doi":"10.6705/j.jacme.202409_14(3).0003","DOIUrl":"10.6705/j.jacme.202409_14(3).0003","url":null,"abstract":"<p><strong>Background: </strong>With emergency department (ED) crowding and high workloads burdening healthcare, efficient patient flow management becomes increasingly crucial. A significant portion of this crowding is attributed to patients with minor traumatic injuries. The objective of this study is to investigate to what extent a separate patient flow for patients with small traumatic injuries influences consult times and patient satisfaction.</p><p><strong>Methods: </strong>During COVID-19, patients with small traumatic injuries in the ED were redirected to an outpatient clinic (the Fracture Clinic). The Fracture Clinic was maintained for seven weeks during which the consult time and patient satisfaction were recorded for every individual. Retrospectively, the same procedure was followed for the seven weeks prior to the outbreak of COVID, with the regular procedure in place.</p><p><strong>Results: </strong>In total, 922 patients were included in the research: 415 patients in the intervention group (Fracture Clinic) and 507 patients in the control group (ED group). The consult time in the Fracture Clinic (median = 30 min) is significantly lower compared to the ED group (median = 86 min) (U = 25,147.500, z = 19.9, <i>p</i> < 0.001). The overall consult in terms of patient satisfaction scored higher for the Fracture Clinic Group than the ED group (T[df] = -4.449 [479], <i>p</i> < 0.001).</p><p><strong>Conclusions: </strong>The Fracture Clinic resulted in shorter consult times and an increased patient satisfaction compared to the usual patient flow for patients with small traumatic injuries in the ED. These patients could be redirected to an outpatient clinical setting to improve efficiency in patient flow, while avoiding a negative impact from the triage system in which they usually are the lowest priority.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"14 3","pages":"116-124"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125789","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":"Woman With Recurrent Syncope.","authors":"Chee-Seong Phan, Sai-Wai Ho","doi":"10.6705/j.jacme.202409_14(3).0006","DOIUrl":"10.6705/j.jacme.202409_14(3).0006","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"14 3","pages":"134"},"PeriodicalIF":0.8,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11366692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142125790","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":"Fatality Rates After Infection With the Omicron Variant (B.1.1.529): How Deadly has it been? A Systematic Review and Meta-Analysis.","authors":"Suhaib Js Ahmad, Jason R Degiannis, Joseph Borucki, Sjaak Pouwels, David Laith Rawaf, Anil Lala, Graham S Whiteley, Marion Head, Angharad Simpson, Rami Archid, Ahmed R Ahmed, J Agustin Soler, Doerte Wichmann, Mohanarangam Thangavelu, Mohamed Abdulmajed, Mahmoud Elmousili, Yan-Ren Lin, Edgar Gelber, Aristomenis K Exadaktylos","doi":"10.6705/j.jacme.202406_14(2).0001","DOIUrl":"10.6705/j.jacme.202406_14(2).0001","url":null,"abstract":"<p><strong>Background: </strong>Since late 2019, the global community has been gripped by the uncertainty surrounding the SARS-CoV-2 pandemic. In November 2021, the emergence of the Omicron variant in South Africa added a new dimension. This study aims to assess the disease's severity and determine the extent to which vaccinations contribute to reducing mortality rates.</p><p><strong>Methods: </strong>A systematic review and meta-analysis of the epidemiological implications of the omicron variant of SARS-CoV-2 were performed, incorporating an analysis of articles from November 2021that address mortality rates.</p><p><strong>Results: </strong>The analysis incorporated data from 3,214,869 patients infected with omicron, as presented in 270 articles. A total of 6,782 deaths from the virus were recorded (0.21%). In the analysed articles, the pooled mortality rate was 0.003 and the pooled in-house mortality rate was 0.036. Vaccination is an effective step in preventing death (odds ratio: 0.391, <i>p</i> < 0.01).</p><p><strong>Conclusion: </strong>The mortality rates for the omicron variant are lower than for the preceding delta variant. mRNA vaccination affords secure and effective protection against severe disease and death from omicron.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"14 2","pages":"51-60"},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296096","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":"Left Shoulder Pain After a Motorcycle Accident.","authors":"Hao-Hsuan Wang, Choon-Bing Chua","doi":"10.6705/j.jacme.202406_14(2).0006","DOIUrl":"10.6705/j.jacme.202406_14(2).0006","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"14 2","pages":"98-99"},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296098","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":"Fenitrothion (Sumithion) Poisoning-Related Fasciculations Successfully Managed With Levetiracetam: A Case Report.","authors":"Hiroshi Ito, Toshiya Nakashima, Satoshi Kobanawa, Jura Oshida, Taisuke Kodama, Sayato Fukui, Daiki Kobayasi","doi":"10.6705/j.jacme.202406_14(2).0004","DOIUrl":"10.6705/j.jacme.202406_14(2).0004","url":null,"abstract":"<p><p>Fenitrothion is one of the most globally used organophosphorus pesticides, which can cause neurological symptoms, including involuntary movements. However, due to the limited number of case report, information on its treatment is also scarce. Here we presented a 74-year-old Japanese woman who was admitted to our hospital due to a persistent nausea and vomiting after ingesting 200 mL of 50% fenitrothion for a suicidal attempt. She received continuous intravenous infusion of atropine and 2-pyridine aldoxime methiodide under mechanical ventilation and continuous hemodiafiltration. However, she developed fasciculations of the face and right arm on day 11, which raised suspicions of delayed neuropathy associated with organophosphorus poisoning. To reduce the risk of respiratory depression, she received intravenous levetiracetam at a dosage of 1,000 mg/day. However, as her fasciculations persisted, the levetiracetam dosage was adjusted to 2,000 mg/day on day 14. On the following day, her fasciculations subsided. Neurologic symptoms of lipid-soluble organophosphorus poisoning, including fenitrothion, can sometimes delay following ingestion. Temporary administration of levetiracetam may prove effective in alleviating fasciculations.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"14 2","pages":"90-93"},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153314/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296097","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":"Toxic Epidermal Necrolysis After COVID-19 Vaccination: A Case Report and Review of Literature.","authors":"Sachin Wali, Shreyas Gutte, Gaurav Pandey, Ajit Kumar, Mohan Gurjar, Jitendra Singh Chahar","doi":"10.6705/j.jacme.202406_14(2).0005","DOIUrl":"10.6705/j.jacme.202406_14(2).0005","url":null,"abstract":"<p><p>Following vaccination for COVID-19, various cutaneous adverse reactions (CARs) are reported. Here is an Asian male in late 50's who developed necrotic skin with mucosal involvement 10 days following booster dose of ChAdOx1 nCov-19 vaccination. Based on disease course and morphology, toxic epidermal necrolysis (TEN) was suspected. The patient developed respiratory distress and was intubated, intravenous immunoglobulin (IVIG) administered at 2 g/kg body weight following which skin lesions healed in fourth week, the patient was discharged after 50 days of intensive care unit (ICU) stay. Severe CARs are rare following vaccination, of two components in ChAdOx1nCoV-19 adenoviral vector vaccine, virotopes cause T-cell mediated granulysin and granzyme B release leading to epidermal detachment and mucosal involvement of conducting airways causing respiratory failure. CARs can also occur in whom first and second dose was uneventful. Supportive therapy and prevention of sepsis are mainstay of management. Though the use of IVIG has shown conflicting results, our case was successfully managed with IVIG.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"14 2","pages":"94-97"},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11153313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296100","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":"Point-of-Care Ultrasound in the Emergency Department: Training, Perceptions, Applications, and Barriers from Different Healthcare Professionals.","authors":"Jack Healy, Ching-Fang Tiffany Tzeng, Jon Wolfshohl, Andrew Shedd, Judy Lin, Chinmay Patel, Eric H Chou","doi":"10.6705/j.jacme.202406_14(2).0003","DOIUrl":"10.6705/j.jacme.202406_14(2).0003","url":null,"abstract":"<p><strong>Background: </strong>Point-of-care ultrasound (POCUS) is a valuable tool that assists in diagnosis and management of patients in the emergency department (ED) while being cost-efficient and without the use of ionizing radiation. To discern the opinions and perceptions of ED staff about POCUS applications and barriers, we conducted a cross-sectional survey of employees of 12 EDs in North Texas.</p><p><strong>Methods: </strong>Participants completed a 20-item online survey about POCUS with questions pertaining to four domains: (1) employee and training information, (2) perceived benefits, (3) common applications, and (4) barriers to use. Out of 805 eligible ED employees, 103 completed the survey (16.1% response rate).</p><p><strong>Results: </strong>The results indicated a generally positive perception of POCUS among all employee types. Physician had significant exposure and training of POCUS than non-physician group ( <i>p</i> < 0.001). Physicians tend to find cardiac assessments more useful for clinical management than non-physicians (47% vs. 23%, <i>p</i> = 0.01), while non-physicians find soft tissue/abscess assessments more useful (27% vs. 9%, <i>p</i> = 0.01).</p><p><strong>Conclusion: </strong>The most significant barriers to POCUS use were time constraints for physicians and a lack of training for non-physician employees. Our study provides valuable insights into the perceptions of multiple ED professionals, serving as a foundation for promoting POCUS use in the ED.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"14 2","pages":"74-89"},"PeriodicalIF":0.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11163417/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300720","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}