Emergency and critical care medicine最新文献_第9页

Effect on surgery outcomes owing to the interval between onset of symptoms and surgery of patients with acute type A aortic dissection 急性A型主动脉夹层患者症状发作与手术时间间隔对手术效果的影响

Emergency and critical care medicine Pub Date : 2022-02-21 DOI: 10.1097/EC9.0000000000000032

Shouming Li, D. Wei, Zhenhua Wang, Han Song, Shaopeng Cheng, Xin Zhao

{"title":"Effect on surgery outcomes owing to the interval between onset of symptoms and surgery of patients with acute type A aortic dissection","authors":"Shouming Li, D. Wei, Zhenhua Wang, Han Song, Shaopeng Cheng, Xin Zhao","doi":"10.1097/EC9.0000000000000032","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000032","url":null,"abstract":"Abstract Background: This study aimed to identify whether the interval from onset of symptoms to surgery affects the outcomes of surgery in patients with acute type A aortic dissection (AAAD). Methods: This study retrospectively examined 249 patients with AAAD who underwent Sun's procedure. All patients were divided into 2 groups, hyperacute and acute, according to the interval from onset of symptoms to surgery. The primary endpoint was all-cause early mortality, and the secondary endpoint was early reoperation. Results: The surgery time, cardiopulmonary bypass time, clamp time, and selective cerebral perfusion time were not significantly different between the 2 groups. The intensive care unit length of stay and duration of mechanical ventilation of the 2 groups were 185.50 hours versus 185.00 hours (P = 0.970) and 41.50 hours versus 44.00 hours (P = 0.678), respectively. There were 52 early deaths: 29 in the hyperacute group and 23 in the acute group (21.6% vs. 20.0%, P = 0.751). The incidence of reoperation was 0.7% and 0.9% (P > 0.999), respectively. The incidence rates of postoperative acute heart failure (AHF), acute respiratory failure (ARF), nervous dysfunction, and acute kidney injury were 37.3% versus 25.2% (P = 0.041), 51.5% versus 51.3% (P = 0.976), 13.4% versus 7.0% (P = 0.096), and 37.3% versus 37.4% (P = 0.990), respectively. Multivariable analysis indicated that surgery in the hyperacute phase might be an independent risk factor for AHF (OR: 1.765; 95% CI: 1.021–3.052; P = 0.042). Conclusion: Surgery in the hyperacute phase of AAAD was associated with postoperative AHF. Therefore, early medical management or interventional therapy for complications before surgery performed by experienced surgeons is recommended, especially in the hyperacute phase.","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44169799","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}

引用次数: 1

Exploring attendance at emergency departments for children with non-urgent conditions in Turkey: a qualitative study of parents and healthcare staff perspectives 探索土耳其非紧急情况儿童在急诊科的就诊情况:对父母和医护人员观点的定性研究

Emergency and critical care medicine Pub Date : 2022-02-09 DOI: 10.1097/EC9.0000000000000027

Ahmet Butun, F. Lynn, J. McGaughey, K. McLaughlin, M. Linden

{"title":"Exploring attendance at emergency departments for children with non-urgent conditions in Turkey: a qualitative study of parents and healthcare staff perspectives","authors":"Ahmet Butun, F. Lynn, J. McGaughey, K. McLaughlin, M. Linden","doi":"10.1097/EC9.0000000000000027","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000027","url":null,"abstract":"Abstract Background: Overcrowding in Emergency Departments (EDs) is a significant global concern with negative consequences for patients, healthcare staff, and healthcare systems. The use of EDs by parents of children with non-urgent conditions is associated with overcrowding, higher healthcare costs, lower quality of care, and longer waiting times. Research in this area has largely been conducted in high-income countries, with a dearth of work originating in middle and low-income regions. The aim of this study was to explore the reasons for parents attending EDs with their child for non-urgent conditions in Turkey. Method: Semi-structured interviews were conducted with 13 parents, 15 ED staff, and 10 General Practitioners (GPs) in 2 regions of Turkey between March and May 2017. Data were analyzed using the principles of grounded theory. Results: The findings were classified into 5 core categories: (1) parents’ feelings, knowledge, and perceived inability to provide self-care; (2) perceived limitations of healthcare services, system, and staff; (3) parents’ preferences for hospital and ED services; (4) adverse impact on ED services; and (5) perceived needs for care. Conclusion: This is the first study conducted in a middle-income country regarding parental reasons for using the ED for nonurgent conditions. Greater efforts must be made to reduce unnecessary visits to the ED to better meet service user needs and to increase the satisfaction of both parents and healthcare staff. The findings of this study may inform healthcare providers, policymakers, healthcare staff, and researchers to design interventions in order to mitigate overcrowding in the ED.","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41772952","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}

引用次数: 2

Construction and application of time-effect assessment database for experiments on war-traumatized animals 战争创伤动物实验时间效应评估数据库的构建与应用

Emergency and critical care medicine Pub Date : 2022-01-28 DOI: 10.1097/EC9.0000000000000030

Junkang Wang, Jing Wang, Hongliang Zhang, Chengyu Guo, Yanbiao Wang, Bing Lu, C. Feng, F. Pan, Tanshi Li

{"title":"Construction and application of time-effect assessment database for experiments on war-traumatized animals","authors":"Junkang Wang, Jing Wang, Hongliang Zhang, Chengyu Guo, Yanbiao Wang, Bing Lu, C. Feng, F. Pan, Tanshi Li","doi":"10.1097/EC9.0000000000000030","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000030","url":null,"abstract":"Abstract Background High-quality real war trauma data are important, but they are still lacking. Using the database to realize the networked, systematic, standardized, and dynamic management of war injury animal experimental data can provide a real and reliable supplement for the research of war injury treatment. Methods Through demand analysis, module design, architecture design, compilation and debugging, and other processes, JAVA language development tools were used to develop a time-effect assessment database for experiments on war-traumatized animals, where the browser/server architecture (B/S architecture) is used as the technical architecture and SQL Server as the database management system. Results A time-effect assessment database for experiments on war-traumatized animals that features reasonable structural design, rich data resources, and convenient use has been established, in which case efficient collection, storage, display, retrieval, and management of animal experimental data have been achieved. At present, the database is running well and has good data quality.","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46888116","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}

引用次数: 0

COVID-19 and atherosclerosis COVID-19与动脉粥样硬化

Emergency and critical care medicine Pub Date : 2022-01-27 DOI: 10.1097/ec9.0000000000000031

Zhangbo Shi, Yuanliang Jiang, J. Weir-McCall, Ximing Wang, Z. Teng

引用次数: 2

Corneal foreign body and rust ring removal in a remote setting 在远程设置中去除角膜异物和铁锈环

Emergency and critical care medicine Pub Date : 2022-01-27 DOI: 10.1097/ec9.0000000000000028

Matthew M Wilson, J. Mathan

引用次数: 0

Inhibition of cathepsin B protects pancreatic acinar cells against apoptosis in early pancreatic trauma in rats 组织蛋白酶B对大鼠早期胰腺损伤胰腺腺泡细胞凋亡的抑制作用

Emergency and critical care medicine Pub Date : 2022-01-12 DOI: 10.1097/EC9.0000000000000025

C. Feng, Li-li Wang, Jingyang Peng, Xiang Cui, Xuan Zhou

{"title":"Inhibition of cathepsin B protects pancreatic acinar cells against apoptosis in early pancreatic trauma in rats","authors":"C. Feng, Li-li Wang, Jingyang Peng, Xiang Cui, Xuan Zhou","doi":"10.1097/EC9.0000000000000025","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000025","url":null,"abstract":"Abstract Objectives: To observe the protective effect of cathepsin B inhibition against apoptosis of acinar cells in the early management of pancreatic contusion and laceration in rats, which would provide evidence of a potential early therapeutic for pancreatic contusion and laceration. Methods: Twenty-four rats were assigned to 2 groups: 1) Model (n = 12) with an induced pancreatic injury of severity I–II and 2) CA074-V (n = 12): an induced pancreatic injury, severity I–II treated with the cathepsin B inhibitor CA074-me (0.01 mg/g) by intravenous administration through the caudal vein at 5 minutes post model establishment. The mice in these two groups were further randomly divided into 4 subgroups containing 3 rats each that were sacrificed for quantitation of apoptosis, immunohistochemistry of cathepsin B, and serum amylase and lipase measurements at different time points after model establishment (0, 3, 6, and 12 hours). Results: The percentage of apoptotic pancreatic acinar cells collected from the injured tissues were much lower in the CA074-V group than the Model group at 3 hours [9.25 ± 3.94% vs. 64.76 ± 26.47%, P < 0.10] and 6 hours [14.71 ± 8.22% vs. 66.60 ± 13.54%, P < 0.10] post model establishment. The percentage of cathepsin B-positive pancreatic acinar cells were much lower in the CA074-V group than in the Model group at 3 hours [31.07 ± 12.02% vs. 69.16 ± 5.71%, P < 0.10], 6 hours [24.84 ± 0.93% vs. 47.06 ± 0.91%, P < 0.10], and 12 hours [28.33 ± 9.14% vs. 52.72 ± 1.25%, P < 0.10] post model establishment. Conclusions: Early cathepsin B inhibition effectively blocked acinar cell apoptosis in an experimental rat model of pancreatic contusion and laceration.","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49551964","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}

引用次数: 0

The role of lipotoxicity in cardiovascular disease 脂肪毒性在心血管疾病中的作用

Emergency and critical care medicine Pub Date : 2022-01-11 DOI: 10.1097/EC9.0000000000000024

Chuanbao Li, Huiruo Liu, F. Xu, Yuguo Chen

引用次数: 0

Nocturnal urine 6-hydroxy sulfate melatonin is associated with the outcome of subjects with sepsis 夜间尿6-羟基硫酸褪黑素与脓毒症患者的预后有关

Emergency and critical care medicine Pub Date : 2021-12-23 DOI: 10.1097/EC9.0000000000000007

Wenjie Li, Jiameng Chen, Shuming Pan, Chengjin Gao

{"title":"Nocturnal urine 6-hydroxy sulfate melatonin is associated with the outcome of subjects with sepsis","authors":"Wenjie Li, Jiameng Chen, Shuming Pan, Chengjin Gao","doi":"10.1097/EC9.0000000000000007","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000007","url":null,"abstract":"Abstract Background It is imperative to identify potential biomarkers for early diagnosis and intervention of severe sepsis. This study investigated the relationship between melatonin secretion and outcome of sepsis after 28-day admission. Methods Patients with sepsis were randomly divided into an eye mask group and a control group. Blood and urine samples were collected from day 0 to 4. Relevant clinical data and 28-day survival data were obtained. Serum melatonin and urine 6-hydroxy sulfate melatonin (6-SMT) levels were measured. Results The outcome of sepsis did not differ between the eye mask and control groups. Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores were significantly higher and monocyte human leukocyte antigen-DR (mHLA-DR), serum melatonin, nocturnal urine 6-SMT, and 24-hour urine 6-SMT levels were significantly lower in the nonsurvivors than in the survivors. The outcome at day 28 after admission was significantly associated with APACHE II and SOFA scores and mHLA-DR, nocturnal urine 6-SMT, and 24-hour urine 6-SMT levels. The areas under the receiver operating characteristic curve were 0.785, 0.740, 0.774, and 0.858 for APACHE II score, SOFA score, mHLA-DR expression, and nocturnal urine 6-SMT amount, respectively. The optimal thresholds for mHLA-DR and nocturnal urine 6-SMT were 30.13% and 43.60%, respectively. Nocturnal urine 6-SMT level was significantly and positively correlated with mHLA-DR expression. Conclusion Nocturnal urine 6-SMT level may be a feasible biomarker to predict the outcome of patients with sepsis. The use of a night-time eye mask has no significant effect on the outcome of sepsis. Clinical trials This study was registered at clinicaltrials.gov (NCT02304224).","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44096227","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}

引用次数: 0

Non-alcoholic fatty liver disease: a multidisciplinary clinical practice approach—the institutional adaptation to existing Clinical Practice Guidelines 非酒精性脂肪性肝病:多学科临床实践方法-对现有临床实践指南的机构适应

Emergency and critical care medicine Pub Date : 2021-12-10 DOI: 10.1097/EC9.0000000000000016

Z. Gluvić, R. Tomasevic, Ksenija Bojović, M. Obradović, E. Isenovic

{"title":"Non-alcoholic fatty liver disease: a multidisciplinary clinical practice approach—the institutional adaptation to existing Clinical Practice Guidelines","authors":"Z. Gluvić, R. Tomasevic, Ksenija Bojović, M. Obradović, E. Isenovic","doi":"10.1097/EC9.0000000000000016","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000016","url":null,"abstract":"Abstract Non-alcoholic fatty liver disease (NAFLD) is among the most frequently encountered chronic liver diseases in everyday clinical practice. It is considered the hepatic manifestation of metabolic syndrome. Today, liver biopsy is still the gold standard for NAFLD confirmation and assessing NAFLD's possible progression to non-alcoholic steatohepatitis, fibrosis, cirrhosis, and hepatocellular carcinoma. Because of the high prevalence of NAFLD and potential associated risks of invasive diagnostic procedures, it is of great interest to recruit the patients for liver biopsy. However, as the presence of liver fibrosis determines the further clinical course, liver biopsy is expectedly reserved for those with increased fibrosis risk. The quality of liver biopsy recruitment and patient monitoring could be significantly improved by using non-invasive tools to assess liver fibrosis presence and interactive collaboration between general practitioners, gastroenterologists, and endocrinologists. As a result, the quality of liver biopsy recruitment and patients monitoring could be significantly improved. Here, we proposed clinical practice guidelines that could be implemented for everyday clinical practice in NAFLD patients.","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44550886","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}

引用次数: 2

COVID-19 induced renal injury differs from that in other viral-infections 新冠肺炎引起的肾损伤与其他病毒感染不同

Emergency and critical care medicine Pub Date : 2021-12-07 DOI: 10.1097/EC9.0000000000000021

Rachel Parise, Manoj Govindarajulu, S. Ramesh, Tonya L Thomas, Timothy Moore, M. Dhanasekaran

{"title":"COVID-19 induced renal injury differs from that in other viral-infections","authors":"Rachel Parise, Manoj Govindarajulu, S. Ramesh, Tonya L Thomas, Timothy Moore, M. Dhanasekaran","doi":"10.1097/EC9.0000000000000021","DOIUrl":"https://doi.org/10.1097/EC9.0000000000000021","url":null,"abstract":"Abstract Background: Kidney injuries caused by several viral diseases have been reported worldwide among all age groups, races, and genders. Of particular importance is coronavirus disease 2019 (COVID-19), and its prevalence in communities infecting all patient populations with symptoms ranging from asymptomatic to severe, including complications and mortality. Methods: Data were acquired from PubMed, Scopus, Google Scholar, Centers for Disease Prevention and Control (CDC), and Lexi-Comp using the following search terms: “COVID-19 and renal pathology,” “COVID-19 induced kidney disease,” “Viral infection induced kidney disease,” and “Viral infection induced renal damage.” Titles and abstracts were manually analyzed as per the exclusion and inclusion criteria of relevant articles; relevance of articles included studies on the pathology of a specific viral infection and the impact of the virus on the adult renal system. Results: The mechanisms for renal disease due to COVID-19 include direct renal tubular injury, cytokine storm, inflammation, thrombosis vs. acute tubular necrosis, thrombotic events, and direct renal injury. Although some mechanisms behind renal dysfunction among the studied viral infections are similar, the prevalence rates of kidney injury or damage differ. This might be described by recommended prophylactic and therapeutic approaches that can alter the viral infection characteristics and possibly the impact a particular organ system. Conclusion: The patient population at risk was old in age and had a high body mass index. The mechanisms associated with renal dysfunction are similar, including direct renal injury through angiotensin converting enzyme 2 (ACE2) entry, inflammation, and thrombosis. The renal pathology of coronaviruses that differs from that of other prevalent viral infections is the activation of cytokine storm, which causes elevations of a greater number and different kinds of cytokines than other viral infections.","PeriodicalId":72895,"journal":{"name":"Emergency and critical care medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43981559","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}

引用次数: 2