Emergency and critical care medicine最新文献

{"title":"Benefits of international trauma rotation in South Africa: comparison with a trauma center in Tokyo","authors":"Tsuyoshi Nagao, S. Nakahara, T. Fujita, T. Sakamoto, E. Steyn","doi":"10.1097/ec9.0000000000000048","DOIUrl":"https://doi.org/10.1097/ec9.0000000000000048","url":null,"abstract":"","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45851619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute opioid-induced gastroparesis successfully treated with naloxone: a case report","authors":"Hao Rui Seet, J. Rotella","doi":"10.1097/ec9.0000000000000053","DOIUrl":"https://doi.org/10.1097/ec9.0000000000000053","url":null,"abstract":"","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48929943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corticosteroid-resistant Sweet’s syndrome as the first manifestation of myelodysplastic/ myeloproliferative neoplasm-unclassifiable: a case report","authors":"Lina Pan, Jingru Zhang, Peng-Yu Li, Chuanli Zhao, S. Zang, Min Ji, Fei Lu, J. Ye, Chunqing Zhang, C. Ji","doi":"10.1097/ec9.0000000000000034","DOIUrl":"https://doi.org/10.1097/ec9.0000000000000034","url":null,"abstract":"","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49348721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of COVID-19 nationwide control measures on trauma workload at a regional trauma center","authors":"J. R. S. Fun, S. Balasubramaniam, L. Teo","doi":"10.1097/EC9.0000000000000063","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000063","url":null,"abstract":"Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has led to the control of movement and diversion of medical resources in many countries. This affects the provision of care to critically injured patients. Methods We analyzed data from the trauma registry of a regional trauma center in Singapore, looking at patient volume and the pattern of injuries over a 3-month period. This was compared with the same period in the preceding 2 years. Results A total of 93 patients were admitted during this period, compared with 111 in 2019 and 118 in 2018, a drop of 15% to 20%. The proportion of severely injured patients and the mechanism of injury were largely unchanged. Conclusion Although there was a minor decrease in the absolute number of patients, the severity and pattern of injuries remained unchanged. Planners should consider this when planning for the diversion of medical and nursing resources.","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48589618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The optimal anticoagulation strategy for COVID-19, prophylactic or therapeutic?: a meta-analysis, trial sequential analysis, and meta-regression of more than 27,000 participants.","authors":"Mingyue Guo,&nbsp;Qi Han,&nbsp;Jiaxuan Xing,&nbsp;Feng Xu,&nbsp;Jiali Wang,&nbsp;Chuanbao Li,&nbsp;Zechen Shan,&nbsp;Yuan Bian,&nbsp;Hao Wang,&nbsp;Li Xue,&nbsp;Qiuhuan Yuan,&nbsp;Chang Pan,&nbsp;Yanshan De,&nbsp;Xingfang Wang,&nbsp;Panpan Hao,&nbsp;Shengchuan Cao,&nbsp;Jiaojiao Pang,&nbsp;Yuguo Chen","doi":"10.1097/EC9.0000000000000059","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000059","url":null,"abstract":"<p><strong>Background: </strong>Anticoagulants are promising regimens for treating coronavirus disease 2019 (COVID-19). However, whether prophylactic or intermediate-to-therapeutic dosage is optimal remains under active discussion.</p><p><strong>Methods: </strong>We comprehensively searched PubMed, Embase, Scopus, Web of Science, Cochrane Library, ClinicalTrials, and MedRxiv databases on April 26, 2022. Two independent researchers conducted literature selection and data extraction separately according to predetermined criteria. Notably, this is the first meta-analysis on COVID-19, taking serious consideration regarding the dosage overlap between the 2 comparison groups of prophylactic anticoagulation (PA) and intermediate-to-therapeutic anticoagulation (I-TA).</p><p><strong>Results: </strong>We included 11 randomized controlled trials (RCTs) and 36 cohort studies with 27,051 COVID-19 patients. By analyzing all the RCTs, there was no significant difference in mortality between the PA and I-TA groups, which was further confirmed by trial sequential analysis (TSA) (odds ratio [OR]: 0.93; 95% confidence interval [CI]: 0.71-1.22; <i>P</i> = 0.61; TSA adjusted CI: 0.71-1.26). The rate of major bleeding was remarkably higher in the I-TA group than in the PA group, despite adjusting for TSA (OR: 1.73; 95% CI: 1.15-2.60; <i>P</i> = 0.009; TSA adjusted CI: 1.09-2.58). RCTs have supported the beneficial effect of I-TA in reducing thrombotic events. After including all studies, mortality in the I-TA group was significantly higher than in the PA group (OR: 1.38; 95% CI: 1.15-1.66; <i>P</i> = 0.0005). The rate of major bleeding was similar to the analysis from RCTs (OR: 2.24; 95% CI: 1.86-2.69; <i>P</i> < 0.00001). There was no distinct difference in the rate of thrombotic events between the 2 regimen groups. In addition, in both critical and noncritical subgroups, I-TA failed to reduce mortality but increased major bleeding rate compared with PA, as shown in meta-analysis of all studies, as well as RCTs only. Meta-regression of all studies suggested that there was no relationship between the treatment effect and the overall risk of mortality or major bleeding (<i>P</i> = 0.14, <i>P</i> = 0.09, respectively).</p><p><strong>Conclusion: </strong>I-TA is not superior to PA for treating COVID-19 because it fails to lower the mortality rate but increases the major bleeding rate in both critical and noncritical patients.</p>","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/9f/be/eccm-2-148.PMC9555559.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286315","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":"Prognostic value of elevated cardiac and inflammatory biomarkers in patients with severe COVID-19: a single-center, retrospective study.","authors":"Neeraj Kumar,&nbsp;Sarfaraz Ahmad,&nbsp;Mala Mahto,&nbsp;Abhyuday Kumar,&nbsp;Prabhat K Singh","doi":"10.1097/EC9.0000000000000057","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000057","url":null,"abstract":"<p><strong>Background: </strong>The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 in India has been declared a public health emergency. Many patients with COVID-19 experience cardiac injury. Patients with COVID-19 admitted to the intensive care unit (ICU) with acute myocardial injury showed increased high-sensitivity troponin levels. Abnormal troponin levels may indicate myocardial injury and are commonly associated with COVID-19.</p><p><strong>Methods: </strong>We conducted a retrospective observational study of 44 patients with severe COVID-19 in ICU during the second wave. The primary end point of our retrospective study was 28-day mortality, and the time of ICU admission was designated as day 0. We extracted and analyzed cardiac biomarkers, such as creatine kinase (CK), creatine kinase-MB (CK-MB), B-type natriuretic peptide (BNP), and high-sensitivity cardiac troponin I (hs-cTnI), and various inflammatory markers such as C-reactive protein (CRP) level, interleukin 6 (IL-6), d-dimer, ferritin, lactate dehydrogenase, IL-6, and procalcitonin in patients with severe COVID-19 at ICU admission and 72 hours after ICU admission from our electronic medical record system.</p><p><strong>Results: </strong>The best cutoff of BNP were 326.8 and 398.5 pg/mL, CK were 195.95 and 180.12 U/L, CK-MB were 112.10 and 108.5 U/L, and hs-cTnI were 0.035 and 0.025 ng/mL, at ICU admission and 72 hours after ICU admission for predicting 28-day mortality among nonsurvivors.</p><p><strong>Conclusion: </strong>In patients with severe COVID-19, CK and hs-cTnI may be considered effective and valuable predictive cardiac biomarkers among nonsurvivors and predict poor prognosis.</p>","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/04/80/eccm-2-122.PMC9555554.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9910730","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 report on disseminated tuberculosis in the setting of coronavirus disease 2019: cause or consequence?","authors":"Himsikhar Khataniar,&nbsp;Diya Sunil,&nbsp;Lalitha Av","doi":"10.1097/EC9.0000000000000039","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000039","url":null,"abstract":"<p><p>Tuberculosis (TB) is a deadly infection that can lead to disseminated disease in children <15years of age exhibiting risk factors such as low host immunity, concurrent infection(s), and/or malnutrition. A case involving a 14-year-old boy diagnosed with disseminated tuberculosis is reported. On investigation, the patient was positive for coronavirus disease 2019 (COVID-19) antibodies, GeneXpert (Cepheid, Sunnyvale, CA) positive for TB with multisystem involvement, lymphopenia, and highly elevated inflammatory markers, indicating multisystem inflammatory syndrome in children (MIS-C) and disseminated TB. The patient was started on antitubercular treatment (ATT), steroids, and supportive treatment. His condition improved over the ensuing few days, and he was discharged with ATT and antiepileptics. Although a few studies involving adults have established a connection between the progression of TB and COVID-19, this case report establishes a similar clinical picture in a child, which has not yet been reported.</p>","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cc/d4/eccm-2-175.PMC9555600.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9910729","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":"Comparison of the anxiety level between the medical staff and the public during the early phase of the coronavirus disease 2019 pandemic.","authors":"Guanguan Luo,&nbsp;Yumin Liu,&nbsp;Dongai Yao,&nbsp;Shaozhou Ni,&nbsp;Bangsheng Wu,&nbsp;Liting Lin,&nbsp;Yunming Wang","doi":"10.1097/EC9.0000000000000038","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000038","url":null,"abstract":"<p><strong>Background: </strong>A sudden outbreak of the coronavirus disease 2019 (COVID-19) started in December 2019 in Wuhan, China. Up-to-date, there have been limited studies examining the anxiety status of Chinese individuals in the early phase of the pandemic period (January 30, 2020-February 15, 2020). This survey aimed to compare the level of anxiety of the medical staff with that of the public and to provide a theoretical basis for developing an effective psychological intervention.</p><p><strong>Method: </strong>Questionnaires were sent on the Internet (http://www.wjx.cn) during this period. The anxiety levels of Chinese people were investigated using the Self-Rating Anxiety Scale (SAS), and the demographic data were collected simultaneously.</p><p><strong>Results: </strong>A total of 1110 participants were enrolled in this study, with an effective response rate of 100%. A total of 482 respondents were medical staff (43.4%), while 628 were members of the general public (56.6%). The medical staff itself had a higher SAS score than the general public (48.36±13.40 <i>vs</i>. 45.74±11.79, <i>P</i> < 0.01), while the medical staff in Wuhan were more anxious than the public in Wuhan with a higher SAS score (54.17±14.08 <i>vs</i>. 48.53±11.92, <i>P</i> < 0.01).</p><p><strong>Conclusion: </strong>The COVID-19 pandemic has had a significant impact on the anxiety levels of the medical staff and the public, with the medical personnel showing a higher anxiety level than the public, especially female medical staff in Wuhan. Therefore, urgent intervention programs to reduce anxiety should be implemented.</p>","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/98/01/eccm-2-116.PMC9555553.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286316","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":"Septic cardiomyopathy: characteristics, evaluation, and mechanism","authors":"W. Xue, J. Pang, Jiao Liu, Hao Wang, Haipeng Guo, Yuguo Chen","doi":"10.1097/EC9.0000000000000060","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000060","url":null,"abstract":"Abstract Sepsis is a common clinical disease; if there is no early active treatment, it is likely to develop into multiple organ dysfunction syndrome and even cause death. Septic cardiomyopathy is a complication of sepsis-related cardiovascular failure, characterized by reversible left ventricular dilatation and decreased ventricular systolic and/or diastolic function. At present, echocardiography and biomarkers are often used to screen septic cardiomyopathy in clinics. Although there is still a lack of clear diagnostic criteria for septic cardiomyopathy, according to existing studies, the pathogenesis of several septic cardiomyopathy has been clarified, such as immune response caused by infection and mitochondrial dysfunction. This review summarizes the characteristics, pathophysiology, and diagnosis of septic cardiomyopathy and focuses on the mechanisms of infection immunity and mitochondrial dysfunction.","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49568374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features of 162 fatal cases of COVID-19: a multi-center retrospective study.","authors":"Xianlong Zhou,&nbsp;Guoyong Ding,&nbsp;Qing Fang,&nbsp;Jun Guo,&nbsp;Luyu Yang,&nbsp;Ping Wang,&nbsp;Shou-Zhi Fu,&nbsp;Ang Li,&nbsp;Jian Xia,&nbsp;Jiangtao Yu,&nbsp;Jianyou Xia,&nbsp;Min Ma,&nbsp;Zhuanzhuan Hu,&nbsp;Lei Huang,&nbsp;Ruining Liu,&nbsp;Cheng Jiang,&nbsp;Shaoping Li,&nbsp;Mingxia Yu,&nbsp;Xizhu Xu,&nbsp;Yan Zhao,&nbsp;Quan Hu,&nbsp;Weijia Xing,&nbsp;Zhigang Zhao","doi":"10.1097/EC9.0000000000000026","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000026","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) has affected approximately 2 million individuals worldwide; however, data regarding fatal cases have been limited.</p><p><strong>Objective: </strong>To report the clinical features of 162 fatal cases of COVID-19 from 5 hospitals in Wuhan between December 30, 2019 and March 12, 2020.</p><p><strong>Methods: </strong>The demographic data, signs and symptoms, clinical course, comorbidities, laboratory findings, computed tomographic (CT) scans, treatments, and complications of the patients with fatal cases were retrieved from electronic medical records.</p><p><strong>Results: </strong>The median patient age was 69.5 (interquartile range: 63.0-77.25) years, and 80% of the patients were over 61 years. A total of 112 (69.1%) patients were men. Hypertension (45.1%) was the most common comorbidity, while 59 (36.4%) patients had no comorbidity. At admission, 131 (81.9%) patients had severe or critical COVID-19, whereas 39 (18.1%) patients with hypertension or chronic lung disease had moderate COVID-19. In total, 126 (77.8%) patients received antiviral treatment, while 132(81.5%) patients received glucocorticoid treatment. A total of 116 (71.6%) patients were admitted to the intensive care unit (ICU), and 137 (85.1%) patients received mechanical ventilation. Most patients received mechanical ventilation before ICU admission. Approximately 93.2% of the patients developed respiratory failure or acute respiratory distress syndrome. There were no significant differences in the inhospital survival time among the hospitals (<i>P</i>=0.14).</p><p><strong>Conclusion: </strong>Young patients with moderate COVID-19 without comorbidity at admission could also develop fatal outcomes. The in-hospital survival time of the fatal cases was similar among the hospitals of different levels in Wuhan.</p>","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ef/23/eccm-2-109.PMC9555552.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10286320","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}