Journal of acute medicine最新文献

{"title":"Man With Right Lower Quadrant Abdominal Pain.","authors":"Tzu-Chia Huang, Chao-Bin Yeh, Chia-Ching Chen, Sai-Wai Ho","doi":"10.6705/j.jacme.202306_13(2).0007","DOIUrl":"https://doi.org/10.6705/j.jacme.202306_13(2).0007","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 2","pages":"89-90"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351403/pdf/JACME-13-2-07.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9836889","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 Value of Inflammatory Biomarkers in Determining Severity of COVID-19.","authors":"Gulacti Umut,&nbsp;Lok Ugur,&nbsp;Aydin Irfan,&nbsp;Turgut Kasim,&nbsp;Yavuz Erdal,&nbsp;Kaya Hakan,&nbsp;Kafadar Hüseyin,&nbsp;Arslan Ebru,&nbsp;Sonmez Cihad,&nbsp;Algin Abdullah,&nbsp;Kurt Ercan,&nbsp;Ozdin Mehmet,&nbsp;Cem Yucetas Seyho","doi":"10.6705/j.jacme.202306_13(2).0002","DOIUrl":"https://doi.org/10.6705/j.jacme.202306_13(2).0002","url":null,"abstract":"<p><p><b>Background</b>: COVID-19 infection can occur as a mild, moderate, or severe illness. How patients will be more serious has not been fully revealed so far. To investigate the role of systemic inflammation index (SII), platelet-to-lymphocyte ratio (PLR), mean platelet volume (MPV), mean platelet volume to platelet ratio (MPR), and neutrophil-to-lymphocyte and platelet ratio (NLPR) in determining the severity of COVID-19 patients. <b>Methods</b>: We retrospectively studied 397 patients with confirmed COVID-19 who were admitted to the emergency departments (EDs) between January and June 2020. According to the criteria recommended by World Health Organization, patients were divided into two groups as severe and non-severe cases. Demographic, clinical characteristics, and inflammation parameters of patients were evaluated. <b>Results</b>: The NLPR, SII, MPR, and PLR were significantly increased in severe COVID-19 patients compared to the non-severe patients (<i>p</i> < 0.0001, <i>p</i> = 0.0002, <i>p</i> = 0.0441 , <i>p</i> = 0.0469, respectively). On the other hand, the MPV value did not show a statistically significant difference between cases. In ROC analysis calculated for inflammatory biomarkers in the prediction of COVID-19 severity, NLPR exhibited the largest area under the curve (AUC) at 0.705, with the highest specificity (81.45%) and sensitivity (56.25%) at the optimal cut-off of 0.024 (<i>p</i> < 0.0001). SII (AUC: 0.670) was the second inflammatory parameter with high specificity (63.21%) and sensitivity (66.67%) following NLPR value (<i>p</i> = 0.0002). <b>Conclusion</b>: NLPR and SII may be new inflammatory markers to identify severe COVID-19 patients at the time of admission to the ED.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 2","pages":"58-64"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351405/pdf/JACME-13-2-02.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892137","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":"Taiwanese Guidelines for Molecular Point-of-Care Testing for Influenza in Emergency Medicine From the New Diagnostic Technology Team of the Taiwan Society of Emergency Medicine.","authors":"Chien-Chang Lee, Ye Liu","doi":"10.6705/j.jacme.202306_13(2).0001","DOIUrl":"10.6705/j.jacme.202306_13(2).0001","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 2","pages":"47-57"},"PeriodicalIF":0.8,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351401/pdf/jacme-13-02-01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10195293","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":"Preparation of Medical Supply for Prehospital Emergencies and Disasters: An Internet-Based Simulation Drill.","authors":"Chien-Hao Lin,&nbsp;Joyce Tay,&nbsp;Chu-Lin Tsai,&nbsp;Wei-Kuo Chou,&nbsp;Ming-Tai Cheng,&nbsp;Cheng-Yi Wu,&nbsp;Hung-Chieh Liu,&nbsp;Shu-Hsien Hsu,&nbsp;Chien-Hsin Lu,&nbsp;Frank Fuh-Yuan Shih,&nbsp;Chih-Hao Lin","doi":"10.6705/j.jacme.202303_13(1).0004","DOIUrl":"https://doi.org/10.6705/j.jacme.202303_13(1).0004","url":null,"abstract":"<p><strong>Background: </strong>Mass casualties caused by natural disasters and man-made events may overwhelm local emergency medical services and healthcare systems. Logistics is essential to a successful emergency medical response. Drills have been used in disaster preparedness to validate plans, policies, procedures, and agreements, and identify resource gaps. The application of the internet to facilitate the conduct of exercise was still limited. This study aimed to investigate the optimal preparation of medical supplies by medical emergency response teams (MERTs) during emergencies and disasters using an internet-based drill.</p><p><strong>Methods: </strong>An internet-based drill based on real-life mass casualty incidents (MCIs) was developed and conducted in Taiwan from June 2017 to July 2018. The drill involved an MCI with 50 events delivered under two scenarios: (1) reduced transfer capacity and well-functioning local healthcare facilities (emergency module); (2) severely reduced transfer capacity and dysfunctional local healthcare facilities (disaster module). For each event, medical supplies commonly prepared by local MERTs in Taiwan were listed in structured questionnaires and participants selected the supplies they would use.</p><p><strong>Results: </strong>Forty-three senior medical emergency responders participated in the survey (responding rate of 47.3%). Resuscitation-related supplies increased from emergency to disaster module (e.g., intubation from 9.1% to 13.9%; dopamine from 3.2% to 5.0%; all <i>p</i> < 0.001). In the subgroup analysis of events with life-threatening injuries, the utilization of resuscitation-related supplies (e.g., intubation from 46.6% to 65.3%; <i>p</i> < 0.001) remained higher in the disaster than in the emergency module. Compared to emergency medical technicians, physicians and nurses are more likely to use intravenous/intramuscular analgesics.</p><p><strong>Conclusions: </strong>The severity of scenarios and the professional background of emergency responders have a different utilization of medical supplies in the simulation drill. The internet-based drill may contribute to optimizing the preparedness of medical response to prehospital emergencies and disasters.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 1","pages":"20-35"},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116035/pdf/jacme-13-1-04.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9769701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Dystonia.","authors":"Shang-Chien Li,&nbsp;Shyh-Shyong Sim","doi":"10.6705/j.jacme.202303_13(1).0007","DOIUrl":"https://doi.org/10.6705/j.jacme.202303_13(1).0007","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 1","pages":"44-45"},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116032/pdf/jacme-13-1-07.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9443804","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":"Modernized Crowd Counting Strategies for Mass Gatherings-A Review.","authors":"Miguel Fiandeiro,&nbsp;Thanh Thi Nguyen,&nbsp;Hanting Wong,&nbsp;Edbert B Hsu","doi":"10.6705/j.jacme.202303_13(1).0002","DOIUrl":"https://doi.org/10.6705/j.jacme.202303_13(1).0002","url":null,"abstract":"<p><p>Estimation of crowd size for large gatherings is an indispensable metric for event planners, local authorities, and emergency management. Currently, most crowd counting relies on dated methods such as people counters, entrance sensors, and ticket sales. Over the past decade, there has been rapid development in crowd counting techniques and related technology. Despite progress, theoretical advances in crowd counting technology have outpaced practical applications. The emergence of the vast array of crowd counting techniques has added to the challenge of determining those advances that can be most readily implemented. This article aims to provide an overview of promising crowd counting strategies and recent developments applied within the disaster medicine context along with the best use cases and limitations.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 1","pages":"4-11"},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116033/pdf/jacme-13-1-02.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9392068","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":"High-Dose vs. Low-Dose Dexamethasone in Patients With COVID-19: A Cohort Study in Rural Central America.","authors":"Eleazar Montalvan-Sanchez,&nbsp;Diego Chambergo-Michilot,&nbsp;Aida A Rodriguez-Murillo,&nbsp;Alexandra E Brooks,&nbsp;Dairy Palacios-Argenal,&nbsp;Shery Rivera-Pineda,&nbsp;Jose Ordonez-Montes,&nbsp;Rosa Estevez-Ramirez,&nbsp;Adrian Riva-Moscoso,&nbsp;Dalton A Norwood,&nbsp;Alex Calderon-Rodriguez,&nbsp;Elizabeth Pineda-SanMartin,&nbsp;Roberto Giron,&nbsp;Luis Rivera-Corrales,&nbsp;Balduino Carcamo-Murillo,&nbsp;Orlando Garner","doi":"10.6705/j.jacme.202303_13(1).0005","DOIUrl":"https://doi.org/10.6705/j.jacme.202303_13(1).0005","url":null,"abstract":"<p><p>To compare the clinical outcomes of a low dose dexamethasone strategy vs. a high-dose dexamethasone strategy in hypoxemic COVID-19 patients. A retrospective observational study comparing low-dose (8 mg) and high-dose dexamethasone (24 mg) of COVID-19 patients admitted from September 1, 2020 to October 31, 2020 in a hospital in Honduras. We included 81 patients with confirmed COVID-19 who required oxygen therapy. The mean age was similar between groups (57.49 vs. 56.95 years). There were more male patients in the group of 24 mg ( <i>p</i> = 0.01). Besides, patients on the 24 mg dose had more prevalence of hypertension ( <i>p</i> = 0.052). More patients in the 24 mg group had a higher rate of invasive mechanical ventilation (15.00% vs. 2.56%, <i>p</i> = 0.058). When evaluating the association between the high dose group and outcomes, we find no significant association with mortality, nosocomial infections, high flow mask, invasive mechanical ventilation, or the need for vasopressors. We find no significant differences in the Kaplan-Meier analysis regarding the survival (log-rank <i>p</i> -value = 0.315). We did not find significant differences between the use of 24 mg and 8 mg of dexamethasone in hypoxemic COVID-19 patients.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 1","pages":"36-40"},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116034/pdf/jacme-13-1-05.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9392072","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":"It Is Time to Modernize Disaster Preparedness With Crowd Analysis.","authors":"Kuan-Fu Chen","doi":"10.6705/j.jacme.202303_13(1).0001","DOIUrl":"10.6705/j.jacme.202303_13(1).0001","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 1","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116036/pdf/jacme-13-1-01.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9392066","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":"Spinal Epidural Abscess: Early Suspicion in Emergency Department Using C-Reactive Protein and Erythrocyte Sedimentation Rate Tests.","authors":"Yiu Nam Wong,&nbsp;Hak Suen Li,&nbsp;Sin To Kwok","doi":"10.6705/j.jacme.202303_13(1).0003","DOIUrl":"https://doi.org/10.6705/j.jacme.202303_13(1).0003","url":null,"abstract":"<p><strong>Background: </strong>Spinal epidural abscess (SEA) is an uncommon but serious differential diagnosis of acute spinal pain with high paralysis and mortality rate. This study aims to provide local data on its bioclinical characteristics and evaluate potential strategies to enhance its diagnostic rate in accident and emergency department (AED).</p><p><strong>Methods: </strong>A retrospective case study from 2013 to 2019 was conducted in United Christian Hospital. SEA cases were classified as study group, spinal pain due to non-SEA cases were classified as control group. Data collected from study group included symptoms, radiological diagnosis, microbiological culture, treatment, and outcome. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) of both groups were compared to analyze their diagnostic power.</p><p><strong>Results: </strong>In the study group (n = 42), 93% of patients had spinal pain, 55% had fever, 60% had neurological deficits, and only 26% had the classic triad on presentation. Seventy-four percent of patients presented with spinal cord or cauda equina compression in their first magnetic resonance imaging. Mortality rate was 23.8%, and paralysis rate was 7.1%. Diagnostic accuracy in AED was 12%. Admission to orthopedic ward (n = 23) resulted in a significantly lower mean time-to-imaging (4.39 days vs. 14.58 days) and mean time-to-treatment (6.56 days vs. 16.9 days) as compared to other specialties. The area under curves of CRP and ESR were 0.893 and 0.874 respectively, the optimal threshold levels were 45.9 mg/L (sensitivity 82.9%, specificity 79%) and 59.5 mm/hr (sensitivity 87.2%, specificity 80.4%), respectively.</p><p><strong>Conclusion: </strong>Diagnosis of SEA in emergency department based on clinical symptomatology is not reliable due to low incidence of the classic triad, despite a more advanced disease on presentation. We proposed incorporating CRP and ESR tests into evaluation of patients with spinal pain since both tests demonstrated excellent discriminative power in diagnosing SEA.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 1","pages":"12-19"},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116031/pdf/jacme-13-1-03.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9387858","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 Common Fruit but Potentially Hidden Crisis: A Case Report of Betel Nut Intoxication.","authors":"Chao-Yen Huang,&nbsp;Cheng-Hsun Chuang","doi":"10.6705/j.jacme.202303_13(1).0006","DOIUrl":"https://doi.org/10.6705/j.jacme.202303_13(1).0006","url":null,"abstract":"<p><p>This case involves a 41-year-old male experiencing agitation and confusion due to betel nut intoxication. The diagnosis was made by identifying the toxidrome through physical examination. Removing the residual betel nut with a finger and brushing it with water resulted in a significant improvement in consciousness and orientation within one hour. In addition to recognizing the toxidrome, prompt and effective treatment for the intoxicated patient is essential. Given the prevalence of betel nut chewing in Taiwan, emergency physicians should be particularly vigilant of arecoline toxicity.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 1","pages":"41-43"},"PeriodicalIF":0.6,"publicationDate":"2023-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10116037/pdf/jacme-13-1-06.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9387855","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}