Archives of Academic Emergency Medicine最新文献

{"title":"Adult Epiglottitis as an Often Overlooked, Life-threatening Condition Requiring Special Airway Consideration; a Case Report.","authors":"Hamzah Adel Ramawad, Robert Seatherton, Jessica Chineme","doi":"10.22037/aaem.v12i1.2351","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2351","url":null,"abstract":"<p><p>After the implementation of vaccination against Haemophilus Influenza Type B (Hib), adult patients comprise the majority of patients with acute epiglottitis. Its presentation with stridor mandates swift recognition and intervention to prevent airway compromise and mortality. Here, we present a case of a 44-year-old male with diabetes mellitus who presented with acute onset of shortness of breath and stridor following days of throat soreness and fever. Initial treatment for suspected anaphylaxis provided partial relief, and emergency department evaluation revealed characteristic signs of acute epiglottitis on lateral soft tissue neck x-ray and nasopharyngoscopy. Treatment was initiated with intravenous ampicillin/sulbactam and dexamethasone, and the patient was discharged home on day 4. This case underscores the critical importance of maintaining a high index of suspicion for acute epiglottitis in adults presenting with stridor and respiratory distress. Prompt recognition, airway management, and appropriate antibiotic therapy are paramount in mitigating the potentially devastating outcomes associated with this condition. As demographics shift and vaccination impacts epidemiology, heightened vigilance in emergency settings is essential to improve outcomes in adult patients with acute epiglottitis.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e69"},"PeriodicalIF":2.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11408896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279627","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":"Associated Factors of Trauma Severity and Mortality in Pediatric Patients Admitted to Intensive Care Unit; a 10-Year Retrospective Study.","authors":"Yiyao Bao, Jing Ye, Lei Hu, Lijun Guan, Caina Gao, Linhua Tan","doi":"10.22037/aaem.v12i1.2413","DOIUrl":"10.22037/aaem.v12i1.2413","url":null,"abstract":"<p><strong>Introduction: </strong>Trauma is a significant global public health concern and the leading cause of morbidity and mortality in children. This study aimed to assess the independent predictors of trauma severity as well as mortality in pediatric patients admitted to the intensive care unit (ICU).</p><p><strong>Methods: </strong>In this cross-sectional study, following the STROBE checklist, we retrospectively analyzed the clinical and baseline characteristics of pediatric patients with trauma injuries admitted to the ICU of Children's Hospital of Zhejiang University School of Medicine, China, over a decade.</p><p><strong>Results: </strong>951 pediatric patients with a mean age of 4.79 ± 3.24 years (60.78% Boys) were studied (mortality rate 8.41%). Significant associations were observed between ISS and place of residence (p = 0.021), location of the injury (p = 0.010), year of injury (p <0.001), and injury mechanism (p <0.001). The two independent factors of trauma severity were the year of injury (β = 0.47; 95%CI: 0.28 - 0.65) and injury mechanism (β = -0.60; 95%CI: -0.88 - -0.31). Significant differences were observed between survived and non-survived regarding age (p <0.001), ISS score (p <0.001), time elapsed from injury to ICU (p <0.001), duration of mechanical ventilation (p <0.001), GCS score (p <0.001), and the proportion of patients requiring mechanical ventilation (p <0.001 ). The results of multivariate analysis indicated that age (OR = 0.805; 95%CI: 0.70 - 0.914; p = 0.001) and GCS score at ICU admission (OR = 0.629; 95%CI: 0.53 - 0.735; p < 0.001) acted as protective factors, whereas mechanical ventilation in the ICU (OR = 7.834; 95%CI: 1.766 - 34.757; p = 0.007) and ISS score at ICU admission (OR = 1.088; 95%CI: 1.047 - 1.130; p < 0.001) served as risk factors for mortality.</p><p><strong>Conclusion: </strong>Automobile-related injuries represent the leading cause of trauma in children, with escalating severity scores year over year among pediatric patients admitted to the ICU with trauma injuries. Based on the findings the independent predictors of mortality of pediatric trauma patients admitted to the ICU were age, GCS score at ICU admission; mechanical ventilation in the ICU, and ISS score at ICU admission. Also, the year of injury and injury mechanism were independent predictors of trauma severity.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e7"},"PeriodicalIF":2.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11420523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339957","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":"Feasibility and Effectiveness of Vaccines for COVID-19: An Umbrella Review.","authors":"SeyedAhmad SeyedAlinaghi, Amirreza Pashapouryeganeh, Soheil Dehghani, Pegah Mirzapour, Faeze Abbaspour, Fatemeh Afroughi, Payman Rahimzadeh, Morvarid Najafi, Hoomaan Ghasemi, Navid Mozafari, Zahra Soltanali, Esmaeil Mehraeen","doi":"10.22037/aaem.v12i1.2357","DOIUrl":"10.22037/aaem.v12i1.2357","url":null,"abstract":"<p><strong>Introduction: </strong>In January 2020, WHO declared the 2019 Coronavirus Disease (COVID-19) a pandemic. Though COVID-19 vaccines are recommended, ongoing surveillance is crucial due to potential unforeseen events. Evaluation of long-term effectiveness and safety and addressing emerging variants are vital. This study integrates systematic reviews to assess COVID-19 vaccine efficacy, immunogenicity, and safety comprehensively.</p><p><strong>Methods: </strong>This study was an umbrella review study on the feasibility and effectiveness of vaccines for COVID-19. We conducted a comprehensive search in PubMed, Web of Sciences, and Scopus, using MeSH terms and keywords related to COVID-19 vaccines. Inclusion criteria comprised peer-reviewed systematic reviews and meta-analyses in English, focusing on feasibility and effectiveness. Exclusion criteria targeted non-systematic reviews exclusively on vaccine safety and duplicates. Two independent reviewers screened and resolved discrepancies. Data extraction included key details. Methodological quality was assessed using the ROBIS tool. Data synthesis involves narrative and, if applicable, quantitative synthesis (meta-analysis). Reporting followed PRISMA guidelines.</p><p><strong>Results: </strong>A total of 32 systematic reviews were included in the study, of which 20 also conducted a meta-analysis. The studies investigated in the included reviews ranged from 7 to 74. The included articles were conducted in various countries around the globe. The findings indicated that COVID-19 vaccines are generally safe and effective for individuals with various medical conditions. The overall risk of bias for the included studies was assessed as low risk.</p><p><strong>Conclusion: </strong>The study outcomes indicated that mRNA vaccines exhibit a higher incidence of adverse events but demonstrate greater efficacy. Conversely, inactivated and protein subunit vaccines are safer but exhibit lower efficiency. Moreover, the vaccine is considered safe for individuals with specific conditions such as inflammatory bowel disease, solid organ transplant recipients, children, pregnant individuals, and those with hematologic problems. Ultimately, the acceptance of the COVID-19 vaccine among individuals is influenced by various factors, including geographic, socioeconomic, and pandemic-related considerations.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e6"},"PeriodicalIF":2.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339960","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":"The Best ECG Lead for Predicting the Risk of Drug-Induced Torsade De Pointes Using Corrected QT Interval: A Comparative Prognostic Study.","authors":"Tharathorn Raicharoen, Suphaphorn Vassasunthorn, Rittirak Othong","doi":"10.22037/aaem.v12i1.2323","DOIUrl":"10.22037/aaem.v12i1.2323","url":null,"abstract":"<p><strong>Introduction: </strong>Torsade de pointes (TdP) is a deadly complication from drug-induced QT prolongation. Each of the 12 lead of an electrocardiogram (ECG) has a different length of QT interval, and thus might have a different performance in TdP prediction. This study aimed to determine the best ECG lead or set of leads in this regard.</p><p><strong>Methods: </strong>This is a comparative prognostic accuracy study using a two-gate data gathering design. The population in this study was from two sources, a case group (Patients who had drug-induced TdP, which were identified through a systematic Medline search) and a control group (those who overdosed on QT-prolonging drugs, which included patients who were under the consultation of Medical Toxicology Services). The areas under the receiver operating characteristic curve (AUROC) of heart rate-corrected QT (QTc) in each single ECG lead and of a mean/median QTc from a set of ECG leads (17 index test) in predicting the risk of TdP were calculated and compared with each other, trying to find the best lead for this propose. QTc Interval measurements were done by four investigators (Interrater reliabilities 0.95).</p><p><strong>Results: </strong>Finally, we included 136 and 148 ECGs from TdP cases and controls, respectively. V3 lead had the highest frequency of longest QTc interval, among the leads. The lead having the longest QTc yielded the greatest AUROC in predicting TdP regardless of QT correction formulas (QTcFRA=0.9915, QTcRTH=0.9893, QTcBZT=0.9904). The mean QTc of 3 leads (lead II, plus any two of leads V2-V4), and a median QTc of 6 leads (I, II, aVF, V2, V4, V6) provided similar overall performance for TdP prediction (regardless of the type of QTc formula).</p><p><strong>Conclusion: </strong>The longest QTc provided the greatest AUROC in predicting drug-induced TdP, however, the longest QTc is not located in a fixed individual lead in any patient. A less time-consuming method with comparable performance to that of the longest QTc was to use a mean QTc from 3 leads (lead II, plus any two of leads V2-V4). The potential clinical impact of this finding needs to be verified in a prospective cohort study.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e5"},"PeriodicalIF":2.9,"publicationDate":"2024-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417636/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339910","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":"Public Comments on social media Regarding Self-management of Foreign Body Airway Obstruction; a Letter to Editor.","authors":"Alexei A Birkun","doi":"10.22037/aaem.v12i1.2489","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2489","url":null,"abstract":"<p><p>Foreign body airway obstruction (FBAO) frequently occurs unwitnessed. In the absence of external assistance and the ability to rapidly reach help, immediate self-management of FBAO could be the only way to avoid impending death from asphyxia. In this letter, relevant evidence of real-life self-management of severe FBAO from public comments posted on social media were gathered and reported. The results indicate that in cases of severe FBAO, laypeople apply self-management maneuvers notwithstanding that self-help is omitted from the current resuscitation guidelines.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e68"},"PeriodicalIF":2.9,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279649","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":"Stem Cell-Derived Exosomes as a Therapeutic Option for Spinal Cord Injuries; a Systematic Review and Meta-Analysis.","authors":"Sajjad Jabermoradi, Parsa Paridari, Hamzah Adel Ramawad, Pantea Gharin, Shayan Roshdi, Amirmohammad Toloui, Mahmoud Yousefifard","doi":"10.22037/aaem.v12i1.2261","DOIUrl":"10.22037/aaem.v12i1.2261","url":null,"abstract":"<p><strong>Introduction: </strong>Exosomes function as cell signaling carriers and have drawn much attention to the cell-free treatments of regenerative medicine. This meta-analysis aimed to investigate the efficacy of mesenchymal stem cell-derived (MSC-derived) exosomes in animal models of spinal cord injuries (SCI).</p><p><strong>Method: </strong>A comprehensive search was conducted in Medline, Embase, Scopus, and Web of Science to attain related articles published by January 31, 2023. The eligible keywords were correlated with the spinal cord injury and MSC-derived exosomes. The evaluated outcomes were locomotion, cavity size, cell apoptosis, inflammation, neuro-regeneration, and microglia activation. A standardized mean difference was calculated for each sample and a pooled effect size was reported.</p><p><strong>Results: </strong>65 papers fully met the inclusion criteria. Treatment with MSC-derived exosomes ultimately improved locomotion and shrunk cavity size (p<0.0001). The administration of MSC-derived exosomes enhanced the expression of beta-tubulin III, NF200, and GAP-43, and increased the number of NeuN-positive and Nissl-positive cells, while reducing the expression of glial fibrillary acidic protein (p<0.0001). The number of apoptotic cells in the treatment group decreased significantly (p<0.0001). Regarding the markers of microglia activation, MSC-derived exosomes increased the number of CD206- and CD68-positive cells (p=0.032 and p<0.0001, respectively). Additionally, MSC-derived exosome administration significantly increased the expression of the anti-inflammatory interleukin (IL)-10 and IL-4 (p<0.001 and p=0.001, respectively) and decreased the expression of the inflammatory IL-1b, IL-6, and TNF-a (p<0.0001).</p><p><strong>Conclusion: </strong>MSC-derived exosome treatment resulted in a significantly improved locomotion of SCI animals through ameliorating neuroinflammation, reducing apoptosis, and inducing neuronal regrowth by facilitating a desirable microenvironment.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e2"},"PeriodicalIF":2.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417640/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339909","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":"Knowledge, Attitudes, and Perceived Barriers of Nurses Regarding Pain Management in Emergency Department; a KAP Study.","authors":"Farzad Bozorgi, Morteza Ghorbani Afrachali, Shiv Kumar Mudgal, Zohreh Hosseini Marznaki, Iraj Goli Khatir, Nipin Kalal, Fatemeh Keshavarzi, Seyed Mohammad Hosseininejad","doi":"10.22037/aaem.v12i1.2356","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2356","url":null,"abstract":"<p><strong>Introduction: </strong>Adequate knowledge and positive attitude among nurses are essential for successful pain management as a fundamental aspect of patients' rights. This study aimed to assess the knowledge, attitude and perceived barriers of nurses regarding acute pain management in emergency department.</p><p><strong>Methods: </strong>In this cross-sectional study, participating nurses were selected using a consecutive sampling technique within a medical university. Data were collected using 4 questionnaires, which consisted of demographic information checklist, Pain Management Principles Assessment Tool (PMPAT), Nurses' Attitude Survey (NAS), and Nurses' practice checklist. The correlation between knowledge, attitude, and barriers with each other and with baseline characteristics of participates were studied.</p><p><strong>Results: </strong>400 nurses with the mean age of 38.26±10.39 years were studied (63% male). The average knowledge score of studied nurses was 7.38 ± 2.16 (range: 1 -14). All 400 (100%) nurses exhibited a low level of knowledge. The mean attitude score of participants was 58.47± 22.08 (range:26-100). 214 (53.5%) cases had low attitude, 44 (11.0 %) average attitude, and 142 (35.5%) cases exhibited a high attitude score. The mean score of barriers about pain management was 36.48 ± 23.52 (range: 0 - 80). 23 (5.8%) participants answered the perceived barriers as never, 113 (28.3%) as seldom, 71 (17.8%) as sometimes, 133 (33.3%) as often, and 60 (15.0%) as routine. There was an reverse relationship between the knowledge score and perceived barriers of pain management (r=-0.164, p<0.001). No significant relationship was found between the average knowledge score and nurses' attitudes (r = 0.092; p > 0.065).</p><p><strong>Conclusions: </strong>The findings of this study highlight the need for ongoing training and the organization of workshops for nurses due to their low levels of knowledge and attitude. These training sessions should focus on the concept of pain, assessment methods, pain relief, as well as pharmacology and the physiology of pain.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e67"},"PeriodicalIF":2.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279645","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":"Early Administration of Apelin Could Prevent Heart Failure Following Myocardial Injury; A Systematic Review and Meta-Analysis.","authors":"Mohammad-Mehdi Hasheminezhad, Mina Mirzad","doi":"10.22037/aaem.v13i1.2414","DOIUrl":"https://doi.org/10.22037/aaem.v13i1.2414","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure (HF) is a prevalent and advancing cardiovascular disorder that impacts 1-2% of the worldwide population, particularly the elderly. Studies indicate that the intravenous administration of apelin may yield advantageous effects in preventing heart failure subsequent to myocardial injury. This meta-analysis aimed to assess the effects of exogenous apelin administration on heart failure in animal models, in light of the lack of a definitive consensus on the matter.</p><p><strong>Method: </strong>An extensive search was performed in the Medline (via PubMed), Web of Science, Embase, and Scopus databases till the end of January 2024. Two independent reviewers screened and summarized the relevant articles. Outcomes related to cardiac function, including ejection fraction (EF), maximum and minimum rate of left ventricle systolic pressure (+dp/dt and -dp/dt, respectively), heart rate, left ventricular end-diastolic pressure (LVEDP), and left ventricular systolic pressure (LVSP) were assessed. Findings were reported as a pooled standardized mean difference (SMD) with a 95% confidence interval (95% CI).</p><p><strong>Results: </strong>12 studies were included. Pooled analysis demonstrated that early treatment with apelin following myocardial injury significantly increases +dp/dt (SMD = 2.36; 95% CI: 1.58 to 3.15; p < 0.001) and decreases -dp/dt (SMD = -3.31; 95% CI: -4.46 to -2.17; p < 0.001). Furthermore, the administration of apelin resulted in a significant increase in EF (SMD = 0.79; 95% CI: 0.15 to 1.44; p = 0.02) and LVSP (SMD = 2.09; 95% CI: 0.82 to 3.36; p < 0.001), while it led to a decrease in LVEDP in the animals (SMD = -1.85; 95% CI: -2.81 to -0.88; p < 0.001). Noteworthy, apelin treatment was shown to have no significant influence on the heart rate of the animals (SMD = -0.12; 95% CI: -0.82 to -0.58; p = 0.73).</p><p><strong>Conclusion: </strong>The current study demonstrated that the early administration of apelin has the potential to improve cardiac function and mitigate the onset of heart failure subsequent to myocardial injury. Further, in vivo research is essential to lay the groundwork for the integration of apelin into clinical practice.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e4"},"PeriodicalIF":2.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143646818","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":"Basic Reproduction Number (R0), Doubling Time, and Daily Growth Rate of the COVID-19 Epidemic: An Echological Study.","authors":"Roya Karimi, Mehrdad Farrokhi, Neda Izadi, Hadis Ghajari, Fatemeh Khosravi Shadmani, Farid Najafi, Ebrahim Shakiba, Manoochehr Karami, Masoud Shojaeian, Ghobad Moradi, Ebrahim Ghaderi, Elham Nouri, Ali Ahmadi, Abdollah Mohammadian Hafshejani, Majid Sartipi, Alireza Zali, Ayad Bahadori Monfared, Raha Davatgar, Seyed Saeed Hashemi Nazari","doi":"10.22037/aaem.v12i1.2376","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2376","url":null,"abstract":"<p><strong>Introduction: </strong>In infectious diseases, there are essential indices used to describe the disease state. In this study, we estimated the basic reproduction number, R0, peak level, doubling time, and daily growth rate of COVID-19.</p><p><strong>Methods: </strong>This ecological study was conducted in 5 provinces of Iran. The daily numbers of new COVID-19 cases from January 17 to February 8, 2020 were used to determine the basic reproduction number (R0), peak date, doubling time, and daily growth rates in all five provinces. A sensitivity analysis was conducted to estimate epidemiological parameters.</p><p><strong>Result: </strong>The highest and lowest number of deaths were observed in Hamedan (657 deaths) and Chaharmahal and Bakhtiari (54 deaths) provinces, respectively. The doubling time of confirmed cases in Kermanshah and Hamedan ranged widely from 18.59 days (95% confidence interval (CI): 17.38, 20) to 76.66 days (95% CI: 56.36, 119.78). In addition, the highest daily growth rates of confirmed cases were observed in Kermanshah (0.037, 95% CI: 0.034, 0.039) and Sistan and Baluchestan (0.032, 95% CI: 0.030, 0.034) provinces.</p><p><strong>Conclusion: </strong>In light of our findings, it is imperative to tailor containment strategies to the unique epidemiological profiles of each region in order to effectively mitigate the spread and impact of COVID-19. The wide variation in doubling times underscores the importance of flexibility in public health responses. By adapting measures to local conditions, we can better address the evolving dynamics of the pandemic and safeguard the well-being of communities.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e66"},"PeriodicalIF":2.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11407535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279629","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":"Diagnostic Value of Chest Computed Tomography Scan for Identification of Foreign Body Aspiration in Children: A Systematic Review and Meta-analysis.","authors":"Babak Goodarzy, Erfan Rahmani, Mehrdad Farrokhi, Reza Tavakoli, Atousa Moghadam Fard, Mohadese Ranjbaran Ghaleh, Yeganeh Ghalichebaf Yazdi, Reza Amani Beni, Erfan Ghadirzadeh, Fatemeh Afrazeh, Yalda Alipour Khabir, Sevda Alipour Khabir, Paria Bakhtiyari, Javaneh Atighi, Mohammad Mahjoubi, Zahra Momeni, Hediyeh Jalayeri, Mohammad Hossein Hosseini, Behnam Hoorshad, Mehdi Tavakoli, Sepideh Seifi, Hamidreza Momeni, Amirhossein Mirbolook, Alireza Esmaili Jobani, Mozhdeh Mohammadi Visroud, Aboulfazl Najafi, Zahrasadat Hosseini, Sobhan Aboulhassanzadeh, Negar Ajami, Sahel Ramezani, Mahdokht Sadat Manavi, Sina Safdari, Amirali Fallahian, Habib Azimi, Reza Zahedpasha, Ehsan Ranjbar, Mohammad Saeed Kahrizi, Lida Zare Lahijan","doi":"10.22037/aaem.v12i1.2431","DOIUrl":"10.22037/aaem.v12i1.2431","url":null,"abstract":"<p><strong>Introduction: </strong>Foreign body aspiration (FBA) is a common, life-threatening pediatric emergency and was shown to be associated with high risk of morbidity and mortality. This systematic review and meta-analysis aimed to investigate the diagnostic value of chest computed tomography (CT) scan for identification of FBA in children.</p><p><strong>Methods: </strong>From inception to May 2024, a systematic search was carried out across multiple databases including Medline, Scopus, and Web of Science, considering published papers in English language. Quality assessment of the included studies was performed using seven domains of Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2).</p><p><strong>Results: </strong>The systematic literature search yielded 7203 articles. The pooled sensitivity and specificity of chest CT scan for identification of FBA were 0.99 (95% CI: 0.98-0.99) and 0.97 (95% CI: 0.96-0.98), respectively. The pooled positive likelihood ratio was 10.12 (95% CI: 4.59-22.20), and pooled negative likelihood ratio was 0.05 (95% CI: 0.02-0.1). Furthermore, the area under the summarized receiver operating characteristic (SROC) curve was 0.98.</p><p><strong>Conclusion: </strong>Our meta-analysis revealed that despite high heterogeneity, in the diagnostic characteristics of chest CT scan among studies, it has high diagnostic value in identifying FBA in suspected pediatric cases.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"13 1","pages":"e3"},"PeriodicalIF":2.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11417639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339959","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}