World journal of emergency medicine最新文献

{"title":"Bacteria and host: what does this mean for sepsis bottleneck?","authors":"Azzah S Alharbi, Raghad Hassan Sanyi, Esam I Azhar","doi":"10.5847/wjem.j.1920-8642.2025.001","DOIUrl":"10.5847/wjem.j.1920-8642.2025.001","url":null,"abstract":"<p><strong>Background: </strong>Sepsis is a life-threatening inflammatory condition in which the invading pathogen avoids the host's defense mechanisms and continuously stimulates and damages host cells. Consequently, many immune responses initially triggered for protection become harmful because of the failure to restore homeostasis, resulting in ongoing hyperinflammation and immunosuppression.</p><p><strong>Methods: </strong>A literature review was conducted to address bacterial sepsis, describe advances in understanding complex immunological reactions, critically assess diagnostic approaches, and emphasize the importance of studying bacterial bottlenecks in the detection and treatment of sepsis.</p><p><strong>Results: </strong>Diagnosing sepsis via a single laboratory test is not feasible; therefore, multiple key biomarkers are typically monitored, with a focus on trends rather than absolute values. The immediate interpretation of sepsis-associated clinical signs and symptoms, along with the use of specific and sensitive laboratory tests, is crucial for the survival of patients in the early stages. However, long-term mortality associated with sepsis is now recognized, and alongside the progression of this condition, there is an in vivo selection of adapted pathogens.</p><p><strong>Conclusion: </strong>Bacterial sepsis remains a significant cause of mortality across all ages and societies. While substantial progress has been made in understanding the immunological mechanisms underlying the inflammatory response, there is growing recognition that the ongoing host-pathogen interactions, including the emergence of adapted virulent strains, shape both the acute and long-term outcomes in sepsis. This underscores the urgent need for novel high-throughput diagnostic methods and a shift toward more pre-emptive, rather than reactive, treatment strategies in sepsis care.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 1","pages":"10-17"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788106/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190556","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":"ICU-acquired muscle weakness in COVID-19 patients who underwent lung transplantation.","authors":"Juan Chen, Bingqing Yue, Jingyu Chen, Man Huang","doi":"10.5847/wjem.j.1920-8642.2025.006","DOIUrl":"10.5847/wjem.j.1920-8642.2025.006","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"16 1","pages":"94-96"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11788104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190724","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":"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":"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":"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":"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}