World journal of emergency medicine最新文献

{"title":"Lamotrigine-induced hemophagocytic lymphohistiocytosis associated with takotsubo cardiomyopathy, renal failure, encephalitis, and hemorrhagic shock.","authors":"Ariella Gartenberg, Juan Esteban Munoz Eusse, Alexander Petrie, Tsui Yuen","doi":"10.5847/wjem.j.1920-8642.2025.005","DOIUrl":"10.5847/wjem.j.1920-8642.2025.005","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 1","pages":"88-90"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190729","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":"Circulating circular RNAs act as potential novel biomarkers for sepsis secondary to pneumonia: a prospective cohort study.","authors":"Chunxue Wang, Dianyin Yang, Yuxin Zhu, Qian Yang, Tong Liu, Xiandong Liu, Dongyang Zhao, Xiaowei Bao, Tiancao Dong, Li Shao, Lunxian Tang","doi":"10.5847/wjem.j.1920-8642.2025.033","DOIUrl":"10.5847/wjem.j.1920-8642.2025.033","url":null,"abstract":"<p><strong>Background: </strong>Circulating biomarkers for sepsis are lacking, and research on circular RNAs (circRNAs) as potential biomarkers of pneumonia-induced sepsis is limited. This study aims to investigate the diagnostic and prognostic potential of circRNAs in patients with pneumonia-induced sepsis.</p><p><strong>Methods: </strong>This prospective cohort study included 40 healthy individuals, 60 patients with pneumonia, and 80 patients with pneumonia-induced sepsis. CircRNAs identified through RNA-sequencing were validated using quantitative real-time polymerase chain reaction (qRT-PCR). Spearman correlation analysis was used to evaluate the associations between circRNAs, inflammatory markers, Sequential Organ Failure Assessment (SOFA) scores, and Acute Physiology and Chronic Health Evaluation II (APACHE II) scores. Receiver operating characteristic (ROC) curves analysis were used to assess the diagnostic performance of circRNAs, while ROC curves and Kaplan-Meier survival analysis were used to evaluate their prognostic value of 28-day mortality.</p><p><strong>Results: </strong>qRT-PCR confirmed the significant upregulation of Circ-CTD-2281E23.2 and downregulation of Circ-0075723 and Circ-0008679 in sepsis patients. Spearman correlation analysis showed that Circ-CTD-2281E23.2 was positively correlated with inflammatory markers and severity scores, whereas Circ-0075723 and Circ-0008679 were negatively correlated with these parameters. The area under the curve (AUC) values for Circ-CTD-2281E23.2, Circ-0075723, and Circ-0008679 in diagnosing pneumonia-induced sepsis were 0.728, 0.706, and 0.793, respectively. The combination of these circRNAs (AUC=0.846) and the combination with other clinical indicators (AUC=0.990) demostrated enhanced AUC values. The AUC values for Circ-CTD-2281E23.2 and Circ-0075723 in predicting 28-day mortality were 0.664 and 0.765, respectively.</p><p><strong>Conclusion: </strong>This study suggest the additional diagnostic and prognostic value of circRNAs in pneumonia-induced sepsis. Circ-CTD-2281E23.2, Circ-0075723, and Circ-0008679 exhibit diagnostic potential, with Circ-CTD-2281E23.2 and Circ-0075723 showing positive prognostic value for 28-day mortality in sepsis patients.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 2","pages":"144-152"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711399","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":"Feasibility of telemedicine in civil protection: a prospective observational study during a music festival.","authors":"Anna Müller, Robert Arimond, Janosch Kunczik, Rolf Rossaint, Michael Czaplik, Andreas Follmann","doi":"10.5847/wjem.j.1920-8642.2025.027","DOIUrl":"10.5847/wjem.j.1920-8642.2025.027","url":null,"abstract":"<p><strong>Background: </strong>As disasters intensify and professional deficits persist, civil protection is reliant on medical volunteers. With limited physician availability, telemedicine is promising. No system currently empowers lower-qualified paramedics for physician-delegated telemedicine. Existing telemedicine technology unfits for civil protection. This study aimed to evaluate a modified system at a music festival to simulate disaster situations.</p><p><strong>Methods: </strong>A tablet-based telemedicine system, integrating vital sign monitoring, was deployed at the \"Summerjam\" music festival characterized by various medical emergencies. A physician could be contacted via telemedicine or requested onsite. Medical feasibility was rated by patient condition changes, with National Advisory Committee of Aeronautics (NACA) score and Primary Ranking for Initial Orientation in the Rescue service (PRIOR) algorithm for triaging. Technical feasibility was assessed by connection stability, communication, and vital sign transmission.</p><p><strong>Results: </strong>Of 404 treatments, 34 (8.4%) were performed using telemedicine, 49 (12.1%) were carried out with a physician onsite. Telemedicine treatments accounted for 40.9% of all treatment in which a physician was involved. Patient conditions varied up to NACA III (moderate disturbance). A variety of internal medical (76.5%) and surgical (23.5%) conditions were addressed, some of which required invasive measures or application of medication. No patients experienced a deterioration in their condition. Despite technical difficulties, treatment was not significantly impacted, confirming technical feasibility.</p><p><strong>Conclusion: </strong>The study shows that lower-qualified paramedics can effectively use telemedicine for physician-delegated treatment, suggesting potential applicability to civil protection. Nonetheless, further system robustness improvements and research are needed.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 2","pages":"121-128"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711441","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":"Mild diarrhea leading to tacrolimus toxicity in an immunocompromised patient with suspected community-acquired pneumonia: a case report.","authors":"Xueying Chen, Jianbo Ding, Jiali Zhang, Hongyan Jiang, Haibin Dai, Lingyan Yu","doi":"10.5847/wjem.j.1920-8642.2025.021","DOIUrl":"10.5847/wjem.j.1920-8642.2025.021","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 2","pages":"174-176"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711443","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":"Comparison of respiratory mechanics measurement between pressure-controlled ventilation and volume-controlled ventilation.","authors":"Zhi'ang Li, Peifang Li, Yiling Jiang, Jianjun Zhu, Jianliang Zhu, Zhiping Xu, Lijun Liu","doi":"10.5847/wjem.j.1920-8642.2025.009","DOIUrl":"10.5847/wjem.j.1920-8642.2025.009","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 1","pages":"78-81"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190564","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":"Chinese clinical practice consensus for device-supported treatment in adults with post-cardiac arrest syndrome (2024 Edition).","authors":"Chuanbao Li, Shengchuan Cao, Yue Zheng, Mengzhi Zong, Haitao Zhang, Xuezhong Yu, Feng Xu, Yuguo Chen","doi":"10.5847/wjem.j.1920-8642.2025.019","DOIUrl":"10.5847/wjem.j.1920-8642.2025.019","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 1","pages":"3-9"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190558","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":"Application of myxovirus resistance protein A in the etiological diagnosis of infections in adults.","authors":"Tianpeng Hu, Yan Li, Shengtao Yan, Lichao Sun, Rui Lian, Jieqiong Yu, Jie Chen, Xiaoyu Liu, Guoqiang Zhang","doi":"10.5847/wjem.j.1920-8642.2025.011","DOIUrl":"10.5847/wjem.j.1920-8642.2025.011","url":null,"abstract":"<p><strong>Background: </strong>Inappropriate antibiotic treatment for patients with viral infections has led to a surge in antimicrobial resistance, increasing mortality and healthcare costs. Viral and bacterial infections are often difficult to distinguish. Myxovirus resistance protein A (MxA), an essential antiviral factor induced by interferon after viral infection, holds promise for distinguishing between viral and bacterial infections. This study aimed to determine the ability of MxA to distinguish viral from bacterial infections.</p><p><strong>Methods: </strong>We quantified MxA in 121 infected patients via dry immunofluorescence chromatography. The Kruskal-Wallis test and receiver operating characteristic (ROC) curve analysis were used to determine the diagnostic value of MxA, either alone or in combination with C-reactive protein (CRP) or procalcitonin (PCT), in patients with viral, bacterial, or co-infections.</p><p><strong>Results: </strong>The value of MxA (ng/mL) was significantly higher in patients with viral infections than in those with bacterial and co-infections (82.3 [24.5-182.9] vs. 16.4 [10.8-26.5], <i>P</i><0.0001) (82.3 [24.5-182.9] vs. 28.5 [10.2-106.8], <i>P</i>=0.0237). The area under the curve (AUC) of the ROC curve for distinguishing between viral and bacterial infections was 0.799 (95% confidence interval [95% <i>CI</i>] 0.696-0.903), with a sensitivity of 68.9% (95% <i>CI</i> 54.3%-80.5%) and specificity of 90.0% (95% <i>CI</i> 74.4%-96.5%) at the threshold of 50.3 ng/mL. Combining the MxA level with the CRP or PCT level improved its ability. MxA expression was low in cytomegalovirus (15.8 [9.6-47.6] ng/mL) and Epstein-Barr virus (12.9 [8.5-21.0] ng/mL) infections.</p><p><strong>Conclusion: </strong>Our study showed the diagnostic efficacy of MxA in distinguishing between viral and bacterial infections, with further enhancement when it was combined with CRP or PCT. Moreover, Epstein-Barr virus and human cytomegalovirus infections did not elicit elevated MxA expression.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 1","pages":"35-42"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190552","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":"Prehospital critical care drug-therapy and 30-day mortality in patients with acute respiratory disease.","authors":"Jesús Jurado-Palomo, José Luis Martín-Conty, Begoña Polonio-López, Cristina Rivera Picón, Raúl López-Izquierdo, Carlos Del Pozo Vegas, Pedro Ángel de Santos Castro, Ancor Sanz-García, Francisco Martín-Rodríguez","doi":"10.5847/wjem.j.1920-8642.2025.008","DOIUrl":"10.5847/wjem.j.1920-8642.2025.008","url":null,"abstract":"<p><strong>Background: </strong>Prehospital medication is a reality, and the role of these therapies must be explored to assess their validity, especially for acute respiratory diseases, which are usually associated with increased morbidity. The aim of this study was to examine the association of prehospital medication use with mortality in patients with acute respiratory disease.</p><p><strong>Methods: </strong>A prospective, multicenter, emergency medical service (EMS) delivery cohort study was carried out in adults with unselected respiratory diseases managed by EMS who were transferred to the emergency department. From January 1, 2019, to October 31, 2023, six advanced life support units, thirty-eight basic life support units, and four hospitals in Spain participated in the study. Demographic data, vital signs, use of mechanical ventilation, prehospital respiratory diagnosis, and prehospital medication were collected. The primary outcome was 30-day in-hospital mortality.</p><p><strong>Results: </strong>A total of 961 patients were included, with a mortality rate of 17.5% (168 patients). Age, an increasing number of comorbidities, the use of invasive mechanical ventilation (IMV), the use of major analgesics, hypnotics, and bicarbonate were risk factors. In contrast, elevated systolic blood pressure and Glasgow Coma Scale scores were found to be protective factors against mortality. The predictive capacity of the model reached an area under the curve (AUC) of 0.857 (95% confidence interval [95% <i>CI</i>] 0.827-0.888).</p><p><strong>Conclusion: </strong>Our data revealed that IMV, major analgesics, hypnotics and bicarbonate administration were associated with elevated mortality. Adding prehospital drug therapy information to demographic variables and vital signs could improve EMS decision-making, allowing a better characterization of patients at risk of clinical worsening.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 1","pages":"43-50"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190733","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":"Comment on \"Impact of the COVID-19 pandemic on research publications in emergency medicine\".","authors":"Bharat Gurnani, Kirandeep Kaur","doi":"10.5847/wjem.j.1920-8642.2025.026","DOIUrl":"10.5847/wjem.j.1920-8642.2025.026","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 2","pages":"172-173"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11930556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711402","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":"Adult split liver transplantation to treat liver cancer: a single-center retrospective study.","authors":"Qiang Sun, Haoze Cao, Xuesong Bai, Xin Han, Wanlu You, Zhongquan Sun, Yixin Zhang, Xiaochang Wu, Feng Fang, Fan Wu, Lianyue Yang, Sheng Yan, Yuan Ding, Weilin Wang","doi":"10.5847/wjem.j.1920-8642.2024.098","DOIUrl":"10.5847/wjem.j.1920-8642.2024.098","url":null,"abstract":"<p><strong>Background: </strong>The increasing morbidity of liver cancer has led to a growing demand for transplantation. Split liver transplantation (SLT) is a promising way to ameliorate organ shortages. However, the safety and efficacy of SLT are still controversial. The aim of this study was to assess the clinical outcome of SLT in liver cancer patients at our center.</p><p><strong>Methods: </strong>A total of 74 patients who received liver transplantation at a tertiary hospital from March 2019 to July 2023 were retrospectively studied, of whom 37 recipients underwent SLT and 37 recipients underwent whole-graft liver transplantation (WGLT). Clinical data were analyzed and compared between patients who underwent SLT and WGLT.</p><p><strong>Results: </strong>SLT and WGLT were successfully performed, with no intraoperative transplant-related mortality. Postoperatively, no significant differences in total bilirubin (TB, <i>P</i>=0.266), alanine transaminase (ALT, <i>P</i>=0.403) and aspartate transaminase (AST, <i>P</i>=0.160) levels within 30 d were detected between the two groups. The transplant-related mortality rates were 8.1% in the SLT group and 5.4% in the WGLT group within 30 d of surgery (<i>P</i>=1.000), and 10.8% and 8.1%, respectively, at 90 d after surgery (<i>P</i>=1.000). There were no significant differences in overall survival (OS) and progress-free survival (PFS) between the SLT and WGLT groups (<i>P</i>=0.910, <i>P</i>=0.190).</p><p><strong>Conclusion: </strong>Our results show that SLT does not imply additional risks in treating liver cancer compared with WGLT.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 1","pages":"57-62"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788118/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190549","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}