World journal of emergency medicine最新文献

{"title":"The value of toxicological analysis in acute poisoning patients with uncertain exposure histories: a retrospective and descriptive study from an institute of poisoning.","authors":"Qifang Shi, Gen Ba, Zhenyu Xia, Zhengsheng Mao, Hao Sun, Jinsong Zhang","doi":"10.5847/wjem.j.1920-8642.2024.022","DOIUrl":"10.5847/wjem.j.1920-8642.2024.022","url":null,"abstract":"<p><strong>Background: </strong>In clinical practice, some patients might not be able or unwilling to provide a thorough history of medication and poison exposure. The aim of this study was to use toxicological analysis to examine the clinical characteristics of patients with acute poisoning whose exposure history was uncertain from a toxicological analysis perspective.</p><p><strong>Methods: </strong>This was a retrospective and descriptive study from an institute of poisoning. Patient registration information and test reports spanning the period from April 1, 2020 to March 31, 2022, were obtained. Patients with uncertain exposure histories and who underwent toxicological analysis were included. Clinical manifestations and categories of toxics were analyzed.</p><p><strong>Results: </strong>Among the 195 patients with positive toxicological analysis results, the main causes of uncertain exposure history was disturbance of consciousness (62.6%), unawareness (23.6%) and unwillingness or lack of cooperation (13.8%). The predominant clinical manifestations were disturbed consciousness (62.6%), followed by vomiting and nausea (14.4%) and liver function abnormalities (8.7%). A comparison of clinical manifestations between patients with positive and negative (<i>n</i>=99) toxicological analyses results revealed significantly different proportions of disturbances in consciousness (63% vs. 21%), dizziness (1.5% vs. 5.1%), multi-organ failure (1.5% vs. 7.1%), and local pain (0 vs 4%). The main categories of substances involved were psychiatric medications (23.1%), sedatives (20.5%), insecticides (13.8%), and herbicides (12.8%).</p><p><strong>Conclusion: </strong>The clinical manifestations of acute poisoning in patients with an uncertain exposure history are diverse and nonspecific, and toxicological analysis plays a pivotal role in the diagnosis and differential diagnosis of such patients.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel predictor of unsustained return of spontaneous circulation in cardiac arrest patients through a combination of capnography and pulse oximetry: a multicenter observational study.","authors":"Jing Yang, Hanqi Tang, Shihuan Shao, Feng Xu, Yangyang Fu, Shengyong Xu, Chen Li, Yan Li, Yang Liu, Joseph Harold Walline, Huadong Zhu, Yuguo Chen, Xuezhong Yu, Jun Xu","doi":"10.5847/wjem.j.1920-8642.2023.186","DOIUrl":"10.5847/wjem.j.1920-8642.2023.186","url":null,"abstract":"<p><strong>Background: </strong>Unsustained return of spontaneous circulation (ROSC) is a critical barrier to survival in cardiac arrest patients. This study examined whether end-tidal carbon dioxide (ETCO₂) and pulse oximetry photoplethysmogram (POP) parameters can be used to identify unsustained ROSC.</p><p><strong>Methods: </strong>We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to 2014. Patients' general information, ETCO₂, and POP parameters were collected and statistically analyzed.</p><p><strong>Results: </strong>The included 105 ROSC episodes (from 80 cardiac arrest patients) comprised 51 sustained ROSC episodes and 54 unsustained ROSC episodes. The 24-hour survival rate was significantly higher in the sustained ROSC group than in the unsustained ROSC group (29.2% vs. 9.4%, <i>P</i><0.05). The logistic regression analysis showed that the difference between after and before ROSC in ETCO₂ (ΔETCO₂) and the difference between after and before ROCS in area under the curve of POP (ΔAUCp) were independently associated with sustained ROSC (odds ratio [<i>OR</i>]=0.931, 95% confidence interval [95% <i>CI</i>] 0.881-0.984, <i>P</i>=0.011 and <i>OR</i>=0.998, 95% <i>CI</i> 0.997-0.999, <i>P</i><0.001). The area under the receiver operating characteristic curve of ΔETCO₂, ΔAUCp, and the combination of both to predict unsustained ROSC were 0.752 (95% <i>CI</i> 0.660-0.844), 0.883 (95% <i>CI</i> 0.818-0.948), and 0.902 (95% <i>CI</i> 0.842-0.962), respectively.</p><p><strong>Conclusion: </strong>Patients with unsustained ROSC have a poor prognosis. The combination of ΔETCO₂ and ΔAUCp showed significant predictive value for unsustained ROSC.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Handheld bedside ultrasound in the diagnosis of myocarditis.","authors":"Frank Wheeler, Robin Lahr, James Espinosa, Alan Lucerna, Henry Schuitema","doi":"10.5847/wjem.j.1920-8642.2024.010","DOIUrl":"10.5847/wjem.j.1920-8642.2024.010","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hepatic rupture secondary to HELLP syndrome: outcomes in three cases.","authors":"Salvador Gomez-Carro, Ruben R Lozano-Salazar, Kassandra Santos-Zaldívar, Victor Andres Villasuso-Alcocer, Nina Méndez-Domínguez","doi":"10.5847/wjem.j.1920-8642.2024.003","DOIUrl":"10.5847/wjem.j.1920-8642.2024.003","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective effect and mechanism of nanoantimicrobial peptide ND-C14 against <i>Streptococcus pneumoniae</i> infection.","authors":"Yangyang Guo, Yaqi Sun, Hongxia Wu, Jian Lu, Yuan Lin, Jiaqing Zhu, Meihong Lai, Meiqi Zhang, Jun Wang, Jungang Zheng","doi":"10.5847/wjem.j.1920-8642.2024.014","DOIUrl":"10.5847/wjem.j.1920-8642.2024.014","url":null,"abstract":"<p><strong>Background: </strong><i>Streptococcus pneumoniae</i> (<i>S. pneumoniae</i>) is a common pathogen that causes bacterial pneumonia. However, with increasing bacterial resistance, there is an urgent need to develop new drugs to treat <i>S. pneumoniae</i> infections. Nanodefensin with a 14-carbon saturated fatty acid (ND-C14) is a novel nanoantimicrobial peptide designed by modifying myristic acid at the C-terminus of human α-defensin 5 (HD5) via an amide bond. However, it is unclear whether ND-C14 is effective against lung infections caused by <i>S. pneumoniae</i>.</p><p><strong>Methods: </strong><i>In vitro</i>, three groups were established, including the control group, and the HD5 and ND-C14 treatment groups. A virtual colony-count assay was used to evaluate the antibacterial activity of HD5 and ND-C14 against <i>S. pneumoniae</i>. The morphological changes of <i>S. pneumoniae</i> treated with HD5 or ND-C14 were observed by scanning electron microscopy. <i>In vivo</i>, mice were divided into sham, vehicle, and ND-C14 treatment groups. Mice in the sham group were treated with 25 μL of phosphate-buffered saline (PBS). Mice in the vehicle and ND-C14 treatment groups were treated with intratracheal instillation of 25 μL of bacterial suspension with 2×10⁸ CFU/mL (total bacterial count: 5×10⁶ CFU), and then the mice were given 25 μL PBS or intratracheally injected with 25 μL of ND-C14 (including 20 μg or 50 μg), respectively. Survival rates were evaluated in the vehicle and ND-C14 treatment groups. Bacterial burden in the blood and bronchoalveolar lavage fluid were counted. The lung histology of the mice was assessed. A propidium iodide uptake assay was used to clarify the destructive effect of ND-C14 against <i>S. pneumoniae</i>.</p><p><strong>Results: </strong>Compared with HD5, ND-C14 had a better bactericidal effect against <i>S. pneumoniae</i> because of its stronger ability to destroy the membrane structure of <i>S. pneumoniae in vitro</i>. <i>In vivo</i>, ND-C14 significantly delayed the death time and improved the survival rate of mice infected with <i>S. pneumoniae</i>. ND-C14 reduced bacterial burden and lung tissue injury. Moreover, ND-C14 had a membrane permeation effect on <i>S. pneumoniae</i>, and its destructive ability increased with increasing ND-C14 concentration.</p><p><strong>Conclusion: </strong>The ND-C14 may improve bactericidal effects on <i>S. pneumoniae</i> both <i>in vitro</i> and <i>in vivo</i>.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrent malignant hyperthermia after scoliosis correction surgery.","authors":"Junfeng Su, Man Huang","doi":"10.5847/wjem.j.1920-8642.2024.006","DOIUrl":"10.5847/wjem.j.1920-8642.2024.006","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-adhesive pads in defibrillation or cardioversion: risks due to unfamiliarity and recommendations.","authors":"Hansol Chung","doi":"10.5847/wjem.j.1920-8642.2024.007","DOIUrl":"10.5847/wjem.j.1920-8642.2024.007","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":null,"pages":null},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10765083/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A case of post traumatic mitral chordae rupture mimicking acute respiratory distress syndrome.","authors":"Hülya Deniz Misir, Nalan Demir, Ferit Kasimzade, Cansu Yahşi","doi":"10.5847/wjem.j.1920-8642.2024.054","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.054","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11265627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141761270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Strongyloides stercoralis</i>-induced sepsis and acute respiratory distress syndrome in a patient with Guillain-Barré syndrome.","authors":"Juhao Zeng, Yin Wen, Hongguang Ding, Dongxin Li, Hongke Zeng","doi":"10.5847/wjem.j.1920-8642.2024.063","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.063","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402879/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shared diagnostic genes and potential mechanisms between COVID-19 and sepsis revealed by bioinformatics analysis.","authors":"Weifei Wang, Zhong Chen, Wenyuan Zhang, Yuan Lin, Yaqi Sun, Qi Yao, Jian Lu, Jungang Zheng","doi":"10.5847/wjem.j.1920-8642.2024.064","DOIUrl":"https://doi.org/10.5847/wjem.j.1920-8642.2024.064","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11402875/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142296707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}