Hock Peng Koh, Jivanraj R Nagarajah, Hasnita Hassan, Noel Thomas Ross
{"title":"Bleeding characteristics and mortality outcomes following ST-elevation myocardial infarction thrombolysis: a 5-year analysis in an Asian population.","authors":"Hock Peng Koh, Jivanraj R Nagarajah, Hasnita Hassan, Noel Thomas Ross","doi":"10.5847/wjem.j.1920-8642.2024.077","DOIUrl":"10.5847/wjem.j.1920-8642.2024.077","url":null,"abstract":"<p><strong>Background: </strong>Bleeding outcomes are crucial primary safety endpoints in studies involving thrombolytic agents. This study aimed to determine the incidence, characteristics and mortality outcomes of bleeding following ST-elevation myocardial infarction (STEMI) thrombolysis in an Asian population.</p><p><strong>Methods: </strong>This single-centre retrospective study included all STEMI patients who received thrombolytic therapy from 2016 to 2020 in a Malaysian tertiary hospital. Total population sampling was used in this study. The primary outcome was bleeding events post-thrombolysis, categorised using the Thrombolysis in Myocardial Infarction (TIMI) bleeding criteria. Inferential statistics were used to determine the associations between relevant variables.</p><p><strong>Results: </strong>Data from 941 patients were analysed. A total of 156 (16.6%) STEMI patients bled post-thrombolysis. Major, minor, and minimal TIMI occurred in 7 (0.7%), 17 (1.8%), and 132 (14.0%) patients, respectively. Age 65 years (<i>P</i>=0.031) and Malaysian Chinese (<i>P</i>=0.008) were associated with a higher incidence of bleeding post-thrombolysis. Conversely, foreigners (<i>P</i>=0.032) and current smoker (<i>P</i>=0.007) were associated with a lower incidence of bleeding. Both TIMI major (<i>P</i><0.001) and TIMI minor (<i>P</i><0.001) were associated with a higher incidence of all-cause in-hospital mortality among STEMI patients. TIMI minor bleeding was significantly higher in the streptokinase recipients. The bleeding sites were comparable between streptokinase and tenecteplase recipients, except for a significantly higher incidence of gastrointestinal bleeding in the streptokinase recipients (<i>P</i>=0.027).</p><p><strong>Conclusion: </strong>In our Asian population, the incidence of total bleeding events following STEMI thrombolysis is comparable to that previously reported. The development of TIMI major and minor bleeding complications is associated with higher mortality.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 6","pages":"433-440"},"PeriodicalIF":2.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11586147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733101","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}
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
{"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 (ETCO<sub>2</sub>) 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, ETCO<sub>2</sub>, 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 ETCO<sub>2</sub> (ΔETCO<sub>2</sub>) 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 ΔETCO<sub>2</sub>, 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 ΔETCO<sub>2</sub> and ΔAUCp showed significant predictive value for unsustained ROSC.</p>","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 1","pages":"16-22"},"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}
Frank Wheeler, Robin Lahr, James Espinosa, Alan Lucerna, Henry Schuitema
{"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":"15 1","pages":"73-74"},"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}
Salvador Gomez-Carro, Ruben R Lozano-Salazar, Kassandra Santos-Zaldívar, Victor Andres Villasuso-Alcocer, Nina Méndez-Domínguez
{"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":"15 1","pages":"56-58"},"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 2×10<sup>8</sup> CFU/mL (total bacterial count: 5×10<sup>6</sup> 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":"15 1","pages":"28-34"},"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":"15 1","pages":"70-72"},"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":"15 1","pages":"64-66"},"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":"Extracorporeal membrane oxygenation as a bridging therapy for patients with thiamine deficiency-induced pulmonary arterial hypertension.","authors":"Fangfang Qiu, Weixing Dai, Tengyue Huang, Min Li","doi":"10.5847/wjem.j.1920-8642.2024.018","DOIUrl":"10.5847/wjem.j.1920-8642.2024.018","url":null,"abstract":"","PeriodicalId":23685,"journal":{"name":"World journal of emergency medicine","volume":"15 2","pages":"147-149"},"PeriodicalIF":2.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10925530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111521","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}