Journal of acute medicine最新文献

{"title":"Woman With Hematochezia.","authors":"Tai-Hung Ho,&nbsp;Pei-Ying Lin","doi":"10.6705/j.jacme.202309_13(3).0005","DOIUrl":"10.6705/j.jacme.202309_13(3).0005","url":null,"abstract":"<p><p>As a consequence of cirrhosis, portal hypertension causes resistance to blood flow and leads to the formation of varices. However, colonic variceal hemorrhages are rarely reported but could be a lethal cause of lower gastrointestinal hemorrhage. Currently, there is no consensus on the management of colonic variceal hemorrhage. Variceal ligation, injection sclerotherapy, transjugular intrahepatic portosystemic shunt placement, and balloon-occluded retrograde transvenous obliteration or a combination of the above therapies have been reported with inconsistent success rates. We advocate considering colonic variceal bleeding as a crucial differential diagnosis of lower gastrointestinal bleeding in cirrhotic patients and initiating time-sensitive, definite operative treatment or combination therapy as soon as possible in colonic variceal patients with life-threatening bleeding events, which are often refractory to conservative treatment.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 3","pages":"125-128"},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568636/pdf/jacme-13-3-05.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235502","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":"Designing 3D-Printed Mesh-Covered Fluid Collecting Racks (MFCRs) to Prevent Moisture-Related COVID-19 Sampling Interruptions in Taiwan.","authors":"Chien-Chieh Hao,&nbsp;Pei-You Hsieh,&nbsp;Chih-Pei Su,&nbsp;Tsung-Han Lee,&nbsp;Wen-Liang Chen,&nbsp;Chien-Chun Liao,&nbsp;Chu-Chung Chou,&nbsp;Yan-Ren Lin","doi":"10.6705/j.jacme.202309_13(3).0002","DOIUrl":"10.6705/j.jacme.202309_13(3).0002","url":null,"abstract":"<p><p><b>Background:</b> A sampling platform (or table) set at the patient's side in a zero-exposure screening center (booth) might be used for specimen collection during public health crises such as the COVID-19 pandemic. However, repeated sanitization causes moisture problems. Such moisture problems would not only be noted by patients but also interrupt the sampling process. In this study, we aimed to develop 3D-printed mesh-covered fluid collecting racks (MFCRs) to address surface moisture problems to determine whether MFCRs can shorten the sampling time. <b>Methods:</b> This was an observational, descriptive, and cross-sectional study. We observed the reasons for sampling interruptions related to surface moisture problems among patients who used MFCRs or did not (April 28-30, 2022). We used a 3D printer to make an MFCR, which measured 14.5 cm in width and length and 1.0 cm in height. The MFCR allows the ethanol to drain through the mesh into the fluid collection rack below to leave a relatively dry surface on the mesh. Finally, we calculated the median time to finish sampling between MFCRs and non-MFCRs. <b>Results:</b> A total of 400 patients were randomly observed (using MFCRs, n = 200; non-MFCRs, n = 200). Patients in the non-MFCR group were more likely to interrupt the sampling process (n = 39, 19.5%) by noting surface moisture problems than those in the MFCR group (n = 3, 1.5%). Two of the major interruptions, \"asking questions about the moist surface\" (from 12% to 1%) and \"slowing down their actions\" (from 4.5% to 0.5%), were obviously improved by using MFCRs. Overall, the median sampling time was significantly shorter (<i>p</i> < 0.001) in the group using MFCRs (0.6 min) than in the group using non-MFCRs (1.5 min). The MFCRs shortened the sampling time by 60%, which might be associated with decreasing interruptions caused by surface moisture problems. <b>Conclusions:</b> The 3D printed MFCRs are suitable for handling surface moisture problems caused by repeated sanitizations. More importantly, the MFCRs might be associated with decreasing interruptions caused by moisture problems.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 3","pages":"104-113"},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568638/pdf/jacme-13-3-02.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235498","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 Man With Acute Diplopia.","authors":"Caiza-Zambrano Francisco,&nbsp;Maximiliano Gonzalez Fabio,&nbsp;César Galarza Julio,&nbsp;Bustos Ariel,&nbsp;Martín Ferraro Fernando,&nbsp;Klass Ingrid,&nbsp;Ribero Ayerza Dolores,&nbsp;Reisin Ricardo,&nbsp;Bonardo Pablo","doi":"10.6705/j.jacme.202309_13(3).0007","DOIUrl":"10.6705/j.jacme.202309_13(3).0007","url":null,"abstract":"","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 3","pages":"134-136"},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568633/pdf/jacme-13-3-07.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235496","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":"Smoking as a Risk or Protective Factor in Developing and Severity of COVID-19?","authors":"Mahheidari Naimeh,&nbsp;Ahansaz Afsaneh,&nbsp;Azizabadi Zahra,&nbsp;Dadgari Ali,&nbsp;Barkhordari Abdullah,&nbsp;Rohani-Rasaf Marzieh","doi":"10.6705/j.jacme.202309_13(3).0003","DOIUrl":"10.6705/j.jacme.202309_13(3).0003","url":null,"abstract":"<p><p><b>Background:</b> Many studies have discussed the relationship between COVID-19 and smoking, but they include many contradictory findings. This study evaluates the relationship between smoking and the incidence and severity of COVID-19 patients in Shahroud City, Iran. <b>Methods:</b> We conducted a cross-sectional analytical study using COVID-19 data. All suspected cases were referred to the registered centers at Shahroud University of Medical Sciences from 21 January 2020 to 20 March 2021. Multivariable logistic regression was conducted to evaluate the relationship between smoking and SARS-COV 2 confirmed cases, and its severity. <b>Results:</b> Overall, it was confirmed that 22.6% of smokers had positive COVID-19 PCR tests compared to 42.1% of non-smokers. COVID-19 is a public health problem, and the results showed that there was a relationship between smoking and COVID-19 confirmed cases and severity. The results showed that smoking, adjusting for other related factors, reduces the odds of COVID-19 by 58%, but increases the odds of severe disease by 89%. <b>Conclusions:</b> In this study, smoking was significantly associated with a low chance of developing COVID-19 disease but higher odds of severity. These significant results were reported even in the presence of under-reporting of smoking by patients, which underestimates the association. These results should not be ignored, and further studies are needed.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 3","pages":"114-121"},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568632/pdf/jacme-13-3-03.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235501","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":"Aspirin-Induced Small-Bowel Injury Presenting Portal Venous Gas.","authors":"Ito Hiroshi,&nbsp;Shimojo Nobutake","doi":"10.6705/j.jacme.202309_13(3).0006","DOIUrl":"10.6705/j.jacme.202309_13(3).0006","url":null,"abstract":"<p><p>Aspirin is well known to damage small intestinal mucosa; however, little is known about the extra-intestinal manifestations of this aspirin-induced small-bowel injury. Herein, we report a case of aspirin-induced small-bowel injury in an 84-year-old Japanese man who presented with portal venous gas. Six weeks after the aspirin was stopped, his abdominal pain gradually resolved. Various intestinal disorders can manifest portal venous gas, and understanding the pathophysiology in such situations can help physicians to avoid anchoring bias in diagnosis.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 3","pages":"129-133"},"PeriodicalIF":0.6,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10568637/pdf/jacme-13-3-06.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41235497","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 Rare Case of Young Pregnant Woman With Central Venous Thrombosis Presenting With Headache, Nausea, and Vomiting.","authors":"Min-Yi Hsieh,&nbsp;Yueh-Shuang Chen,&nbsp;Chi-Ying Lo,&nbsp;Pao Chien Chen,&nbsp;Ichih Lin","doi":"10.6705/j.jacme.202306_13(2).0005","DOIUrl":"https://doi.org/10.6705/j.jacme.202306_13(2).0005","url":null,"abstract":"<p><p>Cerebral venous thrombosis (CVT) is a rare type of stroke, most often observed in young women. This is a case of a young, pregnant woman who presented to the emergency department with a complaint of sudden onset of headache and was diagnosed with CVT. This report discusses how to approach the diagnosis of CVT in pregnant women, including clinical manifestations, investigation tools, treatments, and prognosis from the literature, in comparison to this case.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 2","pages":"79-83"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351399/pdf/JACME-13-2-05.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10213624","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 Distribution Trend and Antimicrobial Susceptibility of Uropathogens in Taiwan: Retrospective Analysis of a 10-Year Study.","authors":"Szu-Cheng Huang,&nbsp;Chung-Hsien Chaou,&nbsp;Chip-Jin Ng,&nbsp;Shi-Ying Gao,&nbsp;Chen-June Seak,&nbsp;Chih-Huang Li","doi":"10.6705/j.jacme.202306_13(2).0003","DOIUrl":"https://doi.org/10.6705/j.jacme.202306_13(2).0003","url":null,"abstract":"<p><p><b>Background</b>: The prevalence and antimicrobial susceptibility of uropathogens can vary with time and geographical location. Empirical antibiotic treatment is frequently started before the urine culture reports are received; thus, the correct selection of antibiotics is imperative, as inappropriate use could increase resistance rates. This study evaluates the distribution trends and antimicrobial susceptibility of common uropathogens in Taiwan to help predict causative pathogens, prevent overly broad antibiotic use, and guide the optimal prescription of empirical antibiotic therapy to improve prognosis. <b>Methods</b>: This retrospective study extracted 5,672,246 urine culture sample data, including outpatient, emergency, and inpatient departments, during 2007-2017 from the Chang Gung Research Database. We examined the trend and susceptibility of uropathogens. <b>Results</b>: The three leading microorganisms were <i>Escherichia coli (E. coli)</i>, <i>Klebsiella pneumoniae (K. pneumoniae)</i>, and <i>Pseudomonas aeruginosa (P. aeruginosa)</i>. <i>E. coli</i>. was more common among females (42.7%) than males (24.7%), while <i>P. aeruginosa</i> was more common among males (10.2%) than females (4.42%). <i>E. coli</i> and <i>K. pneumoniae</i> were highly susceptible to carbapenems, followed by aminoglycosides. Nevertheless, an increased antimicrobial resistance trend was observed in cephalosporins and quinolones. <b>Conclusions</b>: This study establishes <i>E. coli</i> and <i>K. pneumoniae</i> as the predominant uropathogens. Age and gender of patients result in distribution variations of uropathogens, but geographical location does not. In addition, <i>P. aeruginosa</i> occurs more in the sample of elderly and that too among males. Overall, this study could help clinicians choose appropriate antibiotics to treat urinary tract infections per the prevalent uropathogens and local antimicrobial susceptibility patterns.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 2","pages":"65-74"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351400/pdf/JACME-13-2-03.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892135","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 Case of Rhabdomyolysis and Weaning Failure in a Patient With Severe SARS CoV-2 Infection.","authors":"Kakavas Sotirios,&nbsp;Nanou Vasiliki,&nbsp;Tsikrika Stamatoula,&nbsp;Alexikou Alexia,&nbsp;Magkas Nikolaos,&nbsp;Raftopoulou Sylvia","doi":"10.6705/j.jacme.202306_13(2).0004","DOIUrl":"https://doi.org/10.6705/j.jacme.202306_13(2).0004","url":null,"abstract":"<p><p>Rhabdomyolysis is an uncommon complication in patients with severe SARS CoV-2 infection. This report presents a case of rhabdomyolysis in a critically ill patient with acute respiratory distress syndrome owing to COVID-19. The clinical manifestations included fever, tea-colored urine because of myoglobinuria, and elevated serum creatine kinase (CK). Muscle weakness was present and hindered successful weaning from mechanical ventilation. Prompt and aggressive fluid resuscitation was initiated in combination with alkalization of urine and furosemide administration. Treatment was titrated to maintain an adequate urine output with excellent clinical response. Severe COVID-19 infection may be accompanied by the late occurrence of rhabdomyolysis. CK levels should be monitored regularly and patients should be treated promptly with the adequate expansion of the extracellular volume. In our case, the intensive treatment proved to be effective in preventing acute kidney injury and related metabolic complications.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 2","pages":"75-78"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351404/pdf/JACME-13-2-04.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892130","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":"Scrub Typhus Complicated With Fulminant Perimyocarditis.","authors":"Nien-Jung Lee,&nbsp;Hsin-I Shih,&nbsp;Chih-Hao Lin,&nbsp;Hsiang-Chin Hsu","doi":"10.6705/j.jacme.202306_13(2).0006","DOIUrl":"https://doi.org/10.6705/j.jacme.202306_13(2).0006","url":null,"abstract":"<p><p>A 62-year-old woman with no systemic disease presented to the emergency department (ED) with acute febrile illness for three days. During her ED course, she developed respiratory distress and refractory cardiogenic shock with ST-elevation on electrocardiography. No occluded coronary vessel was found in angiography, and perimyocarditis was impressed. The serum indirect immunofluorescence assay was positive for scrub typhus. Hemopericardium and subsequently intracranial hemorrhage occurred on the 4th hospital day even under intensive care, and the patient expired. Perimyocarditis is a rare but fatal complication of scrub typhus. Through this case report, we aim to convey the genuine possibility that a fulminant perimyocarditis may occur in a previously healthy adult as a potential complication of scrub typhus. By recognizing the risk factors of scrub typhus-related myocarditis, an ED physician can maintain a high index of suspicion for the cardiac complication and intervene in a timely manner.</p>","PeriodicalId":14846,"journal":{"name":"Journal of acute medicine","volume":"13 2","pages":"84-88"},"PeriodicalIF":0.6,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10351402/pdf/JACME-13-02-06.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10213622","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":"Man With Right Lower Quadrant Abdominal Pain.","authors":"Tzu-Chia Huang,&nbsp;Chao-Bin Yeh,&nbsp;Chia-Ching Chen,&nbsp;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}