Archives of Academic Emergency Medicine最新文献

{"title":"Traditional Spinal Immobilization versus Spinal Motion Restriction in Cervical Spine Movement; a Randomized Crossover Trial.","authors":"Promphet Nuanprom, Chaiyaporn Yuksen, Welawat Tienpratarn, Parunchaya Jamkrajang","doi":"10.22037/aaem.v12i1.2263","DOIUrl":"10.22037/aaem.v12i1.2263","url":null,"abstract":"<p><strong>Introduction: </strong>Proper cervical spine immobilization is essential to prevent further injury following trauma. This study aimed to compare the cervical range of motion (ROM) and the immobilization time between traditional spinal immobilization (TSI) and spinal motion restriction (SMR).</p><p><strong>Methods: </strong>This study was a randomized 2x2 crossover design in healthy volunteers. Participants were randomly assigned by Sequential numbered, opaque, sealed envelopes (SNOSE) with permuted block-of-four randomization to TSI or SMR. We used an inertial measurement unit (IMU) sensor to measure the cervical ROM in three dimensions focusing on flexion-extension, rotation, and lateral bending. The immobilization time was recorded by the investigator.</p><p><strong>Results: </strong>A total of 35 healthy volunteers were enrolled in the study. The SMR method had cervical spine movement lower than the TSI method about 3.18 degrees on ROM in flexion-extension (p < 0.001). The SMR method had cervical spine movement lower than the TSI method about 2.01 degrees on ROM in lateral bending (p = 0.022). The immobilization time for the SMR method was 11.88 seconds longer than for the TSI method (p < 0.001) but not clinically significant.</p><p><strong>Conclusion: </strong>SMR that used scoop stretcher resulted in significantly less cervical spine movement than immobilization with a TSI that used long spinal board. We recommend implementing the SMR protocol for transporting trauma patients, as minimizing cervical motion may enhance patient outcomes.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e36"},"PeriodicalIF":5.4,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11088786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140911276","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":"Patients' Knowledge and Pharmacists' Practice Regarding the Long-Term Side Effects of Proton Pump Inhibitors; a Cross-sectional Study.","authors":"Aisha Juma Alblooshi, Mirza R Baig, Hanan S Anbar","doi":"10.22037/aaem.v12i1.2305","DOIUrl":"10.22037/aaem.v12i1.2305","url":null,"abstract":"<p><strong>Introduction: </strong>Proton pump inhibitors (PPI) are a commonly prescribed medication, but recent evidence suggests that their long-term use may lead to several adverse events. To address this issue, our study aims to assess patient awareness and pharmacist practices in educating patients about the potential risks associated with prolonged PPI use.</p><p><strong>Methods: </strong>Two questionnaires were developed by researchers and administered in the United Arab Emirates from June to August 2021 to gather insights from patients and pharmacists about the use of PPIs, their knowledge of potential side effects, and their experiences and attitudes toward receiving education about PPI side effects. The patients' knowledge was evaluated based on their cumulative correct answers to questions related to PPI's long-term adverse effects including increased fracture risk and hypocalcemia, vitamin B12 deficiency, hypomagnesemia, and the caution of abrupt withdrawal. All statistical analyses were conducted using SPSS 25.0 software.</p><p><strong>Results: </strong>Overall, 348 participants with a median age of 40 years participated in the survey, among them, 91 (26.14%) used various forms of PPI with 38% of users taking PPI as over-the-counter drugs. Patients had low knowledge about PPI side effects and their proper discontinuation with a median knowledge score of 0 (Interquartile range: 0-2) and only 22.2% of patients were familiar with at least three out of five asked harms. Those with lower knowledge were more likely to be Emirati compared to other nations (p=0.004) and aged over 30 years compared to their younger counterparts (p = 0.016). Few patients have obtained the relevant information from their physicians (25%) or pharmacists (7%). Inquiring 136 pharmacists, it was shown that the most common education was concerning vitamin B12 deficiency (62.5%) followed by fracture risk (58.09%) yet less than half (48%) of pharmacists instructed patients about the potential risk of hypomagnesemia. Almost all pharmacists (99%) agreed that there is a requirement for additional education on the possible harmful consequences of PPIs.</p><p><strong>Conclusion: </strong>The present study has established that a considerable proportion of PPI users in the UAE lack the necessary awareness about the potential adverse effects of PPI despite their extensive use in this country. The current pharmacist practice is inefficient for inculcating the potential harms of chronic PPI use and they are required to optimize their efforts to educate patients and bridge the knowledge gaps.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e35"},"PeriodicalIF":5.4,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891071","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 Performance of Ultrasonography for Identification of Small Bowel Obstruction; a Systematic Review and Meta-analysis.","authors":"Mohsen Motavaselian, Mehrdad Farrokhi, Parisa Jafari Khouzani, Atousa Moghadam Fard, Fatemeh Daeizadeh, Mahya Pourrahimi, Reyhaneh Mehrabani, Reza Amani-Beni, Masoud Farrokhi, Faezeh Jalayer Sarnaghy, Asal Mir, Reza Tavakoli, Heidar Fadavian, Reza Mehdinezhad, Parisa Masoudikabir, Maoumeh Moallem, Tohid Karami, Roozbeh Roohinezhad, Yalda Yazdani, Didar Ghasemi, Farideh Rezaeizadeh, Alireza Hadizadeh, Rojin Sarallah, Ashkan Shafigh, Solmaz Aminpour, Amirhossein Esfahani, Seyedsaber Mirabdali, Zahrasadat Hosseini, Farahnaz Saharkhiz, Mehrzad Khodsiani, Fahimeh Ebrahimi Tirtashi, Shabnam Esmailian Dehkordi, Nafise Sadat Amini, Mahsa Aran, Zohreh Abolghasemfard, Nazanin Sanjarinia, Zeynab Abdollahi, Fatemeh Abediankenari, Erfan Ghadirzadeh, Mehran Khodashenas, Ali Jahanshahi","doi":"10.22037/aaem.v12i1.2265","DOIUrl":"10.22037/aaem.v12i1.2265","url":null,"abstract":"<p><strong>Introduction: </strong>Small bowel obstruction (SBO) is known as a common cause of acute abdominal complaints in the emergency department (ED). The modality of choice for the diagnosis of SBO has not yet been established. This systematic review and meta-analysis aimed to investigate the accuracy of ultrasonography for the diagnosis of SBO.</p><p><strong>Methods: </strong>Systematic search was performed on five electronic databases including Medline, Scopus, Web of Sciences, Embase, and Cochrane Library, and the retrieval period was from the inception of each database to November 2023. The quality of the included studies were investigated using the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). The pooled values of diagnostic characteristics for ultrasonography were estimated using meta-Disc and Stata statistical software.</p><p><strong>Results: </strong>Twenty-one studies with a total of 1977 patients were included in the meta-analysis. The pooled estimate for sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary ROC curve of ultrasonography for diagnosing SBO were 0.93 (95% CI: 0.91-0.95), 0.8 (95% CI: 0.77-0.83), 5.69 (95% CI: 3.64-8.89), 0.1 (95% CI: 0.07-0.16), 83.51 (95% CI: 18.12-182.91) and 0.96, respectively.</p><p><strong>Conclusion: </strong>The findings of this meta-analysis showed that the utilization of ultrasonography holds promise as a diagnostic imaging for SBO with high accuracy. However, additional worldwide studies are essential to get more evidence on the value of ultrasonography for the diagnosis of SBO.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e33"},"PeriodicalIF":5.4,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891004","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 Indicators of ECG for Coronary Slow Flow Phenomenon; a Systematic Review and Meta-Analysis.","authors":"MohammadHossein MozafaryBazargany, Parham Samimisedeh, Niloofar Gholami, Elmira Jafari Afshar, Amirhossein Memari, Shahrooz Yazdani, Hadith Rastad","doi":"10.22037/aaem.v12i1.2202","DOIUrl":"10.22037/aaem.v12i1.2202","url":null,"abstract":"<p><strong>Introduction: </strong>Currently, epicardial coronary angiography is still the only diagnostic tool for Coronary Slow Flow Phenomenon (CSFP). This study aimed to systematically review studies that compared Electrocardiogram (ECG) findings between patients with and without CSFP.</p><p><strong>Methods: </strong>Using relevant key terms, we systematically searched MEDLINE, Scopus, Embase, and Web of Science to find relevant studies up to February 5^th, 2023. Effect sizes in each study were calculated as mean differences and crude odds ratio; then, random-effect models using inverse variance and Mantel-Haenszel methods were used to pool standardized mean differences (SMD) and crude odds ratios, respectively.</p><p><strong>Results: </strong>Thirty-two eligible articles with a total sample size of 3,937 patients (2,069 with CSFP) were included. CSFP patients had higher P-wave maximum (Pmax) (SMD: 1.02 (95% confidence interval (CI): 0.29 - 1.76); p=0.006) and P-dispersion (Pd) (SMD: 1.63 (95% CI: 0.99 - 2.27); p<0.001) compared to the control group. CSFP group also showed significantly longer QT wave maximum duration (SMD: 0.69 (95% CI: 0.33 - 1.06); p<0.001), uncorrected QTd (SMD: 1.89(95% CI: 0.67 - 3.11); p=0.002), and corrected dispersion (QTcd) (SMD: 1.63 (95% CI: 1.09 - 2.17), p<0.001). The frontal QRS-T angle was significantly higher in the CSFP group in comparison with the control group (SMD: 1.18 (95% CI: 0.31 - 2.04; p=0.007). While CSFP patients had a significantly higher T-peak to T-end (Tp-e) (SMD:1.71 (95% CI: 0.91, 2.52), p<0.001), no significant difference was noted between groups in terms of Tp-e to QT (p=0.16) and corrected QT ratios (p=0.07).</p><p><strong>Conclusion: </strong>Our findings suggest several ECG parameters, such as P max, Pd, QT, QTc, QTd, QTcd, Tp-e, and frontal QRS-T angle, may be prolonged in CSFP patients, and they could be employed as diagnostic indicators of CSFP before angiography.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e34"},"PeriodicalIF":5.4,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077394/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140890993","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, Attitude and Perceptions of Healthcare Workers in Arab Countries Regarding Basic Life Support; a Systematic Review and Meta-Analysis.","authors":"Mohammed Alsabri Hussein Alsabri, Sarah Makram Elsayed, Alaa Ahmed Elshanbary, Mohamed Sayed Zaazouee, Basel F Alqeeq, Syeda Alishah Zehra, Khaled Mohammed Al-Sayaghi, Sameer A Alkubati, Gamil Ghaleb Alrubaiee","doi":"10.22037/aaem.v12i1.2223","DOIUrl":"10.22037/aaem.v12i1.2223","url":null,"abstract":"<p><strong>Introduction: </strong>Effective Basic Life Support (BLS) interventions, including cardiopulmonary resuscitation (CPR), are essential for enhancing survival rates. This review aimed to evaluate the knowledge, attitudes, and perceptions (KAP) of healthcare professionals regarding BLS in Arab countries.</p><p><strong>Methods: </strong>We conducted a systematic search on PubMed, Cochrane, Scopus, Web of Science, and EMBASE, to identify relevant studies. We included studies performed in Arab countries that included healthcare workers' KAP assessment towards BLS. The meta-analysis was carried out utilizing the OpenMeta Analyst Software, and a subgroup analysis was performed for Nursing staff category. The quality of the included cross-sectional studies was assessed through Newcastle-Ottawa quality assessment scale.</p><p><strong>Results: </strong>A total of 18 studies were included in our study, and eight of them entered the analysis. The study showed that 61.3% (95% confidence interval (CI): 48.9%, 73.7%, p<0.001) of health care workers were knowledgeable about the correct CPR ratio, and 62.1% (95% CI: 51.7%, 72.5%, p<0.001) answered the location of chest compression correctly. While, only 36.5% (95% CI: 23.5%, 49.6%, p<0.001) had correct answers regarding the compression rate, 48.1% (95% CI: 38.1%, 58.0%, p<0.001) were aware of the compression depth, and 34.8% (95% CI: 22.9%, 46.7%, p<0.001) answered the sequence correctly.</p><p><strong>Conclusion: </strong>The study revealed a gap regarding the BLS KAP of healthcare workers in different Arab countries, which crucially requires taking actions, in terms of frequent certified training sessions, assessments, and clear protocols.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e32"},"PeriodicalIF":5.4,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891052","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":"Hypo-attenuating Berry Sign as a Novel Imaging Marker of Ruptured Aneurysm in Patients with Subarachnoid Hemorrhage; a Diagnostic Accuracy Study.","authors":"Xin-Wei Zhou, Shu-Feng Cai, De-Qing Zhang, Gang Xiao, Jing Liu, Wen-Jie Yang, Yi Li, Si-Yu Chen, Hao-Chen Liu, Zhong-Qing Huang","doi":"10.22037/aaem.v12i1.2154","DOIUrl":"10.22037/aaem.v12i1.2154","url":null,"abstract":"<p><strong>Introduction: </strong>Aneurysmal subarachnoid hemorrhage (SAH) constitutes a life-threatening condition, and identifying the ruptured aneurysm is essential for further therapy. This study aimed to evaluate the diagnostic accuracy of hypo-attenuating berry sign (HBS) observed on computed tomography (CT) scan in distinguishing ruptured aneurysms.</p><p><strong>Methods: </strong>In this diagnostic accuracy study, patients who had SAH and underwent non-enhanced brain CT scan were recruited. The HBS was defined as a hypo-attenuating area with an identifiable border in the blood-filled hyper-dense subarachnoid space. The screening performance characteristics of HBS in identifying ruptured aneurysms were calculated considering the digital subtraction angiography (DSA) as the gold standard.</p><p><strong>Results: </strong>A total of 129 aneurysms in 131 patients were analyzed. The overall sensitivity and specificity of HBS in the diagnosis of aneurysms were determined to be 78.7% (95%CI: 73.1% - 83.4%) and 70.7% (95%CI: 54.3% - 83.4%), respectively. Notably, the sensitivity increased to 90.9% (95%CI: 84.3% - 95.0%) for aneurysms larger than 5mm. The level of inter-observer agreement for assessing the presence of HBS was found to be substantial (kappa=0.734). The diagnostic accuracy of HBS in individuals exhibited enhanced specificity, sensitivity, and reliability when evaluating patients with a solitary aneurysm or assessing ruptured aneurysms. The multivariate logistic regression analysis revealed a statistically significant relationship between aneurysm size and the presence of HBS (odds ratios of 1.667 (95%CI: 1.238 - 2.244; p < 0.001) and 1.696 (95%CI: 1.231 - 2.335; p = 0.001) for reader 1 and reader 2, respectively).</p><p><strong>Conclusions: </strong>The HBS can serve as a simple and easy-to-use indicator for identifying a ruptured aneurysm and estimating its size in SAH patients.   .</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e31"},"PeriodicalIF":5.4,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11077386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891010","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 Cardiopulmonary Resuscitation Outcomes; a Cohort Study on an Adult In-hospital Cardiac Arrest Registry.","authors":"Parin Rattananon, Welawat Tienpratarn, Chaiyaporn Yuksen, Supassorn Aussavanodom, Natthaphong Thiamdao, Phatcha Termkijwanich, Suraphong Phongsawad, Parama Kaninworapan, Kanda Tantasirin","doi":"10.22037/aaem.v12i1.2227","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2227","url":null,"abstract":"<p><strong>Introduction: </strong>In-hospital cardiac arrest (IHCA) remains a substantial cause of morbidity and mortality for hospitalized patients worldwide. This study aimed to identify associated factors of return of spontaneous circulation (ROSC) and survival with favorable neurological outcomes of IHCA patients.</p><p><strong>Method: </strong>A two-year retrospective cohort study was conducted at a university-based tertiary care hospital in Bangkok, Thailand, studying adult patients aged ≥ 18 years with IHCA from January 2021 to December 2022. The primary endpoint was sustained ROSC, and the secondary endpoint was survival with favorable neurological outcomes defined as Cerebral Performance Categories (CPC) Scale of 1 or 2 at discharge. Pre-arrest and intra-arrest variables were collected and analyzed using multivariable logistic regression to identify independent factors associated with the outcomes.</p><p><strong>Results: </strong>During the study period, 156 patients were included in the study. 105 (67.3%) patients achieved sustained ROSC after the CPR, 28 patients (18.0%) were discharged alive, and 15 patients (9.6%) survived with a favorable neurological outcome at hospital discharge. Overall, sustained ROSC was higher in patients who had IHCA during the day shift (odds ratio (OR): 4.11; 95% confidence interval (CI): 1.05-16.06) and electrocardiogram (ECG) monitoring prior to arrest (OR: 6.38; 95% CI: 1.18-34.54). In contrast, higher adrenaline doses administrated, and increased CPR duration reduced the odds of sustained ROSC (OR: 0.72; 95% CI: 0.54-0.94 and OR: 0.92; 95% CI: 0.85-0.98, respectively). Arrest due to cardiac etiology was associated with increased discharged survival with favorable neurological outcomes (OR: 13.43; 95% CI: 2.00-89.80), while a higher Good Outcome Following Attempted Resuscitation (GO-FAR) score reduced the odds of the secondary outcome (OR: 0.89; 95% CI: 0.81-0.98).</p><p><strong>Conclusion: </strong>The sustained ROSC was higher in IHCA during the daytime shift and under prior ECG monitoring. The administration of higher doses of adrenaline and prolonged CPR durations decreased the likelihood of achieving sustained ROSC. Furthermore, patients with cardiac-related causes of cardiac arrest exhibited a higher rate of survival to hospital discharge with favorable neurological outcomes.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e30"},"PeriodicalIF":5.4,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988187/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861813","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 and Prognostic Values of S100B versus Neuron Specific Enolase for Traumatic Brain Injury; a Systematic Review and Meta-analysis.","authors":"Hamed Zarei, Shayan Roshdi Dizaji, Amirmohammad Toloui, Mahmoud Yousefifard, Alireza Esmaeili","doi":"10.22037/aaem.v12i1.2222","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2222","url":null,"abstract":"<p><strong>Introduction: </strong>Traumataic brain injury (TBI) represents a significant global health burden. This systematic review delves into the comparison of S100B and Neuron-Specific Enolase (NSE) regarding their diagnostic and prognostic accuracy in TBI within the adult population.</p><p><strong>Methods: </strong>Conducted on October 21, 2023, the search identified 24 studies encompassing 6454 adult patients. QUADAS-2 and QUAPAS tools were employed to assess the risk of bias. The analyses aimed to evaluate the diagnostic and prognostic performance of S100B and NSE based on sensitivity, specificity, and area under the curve (AUC). The outcomes were detecting intracranial injury, mortality, and unfavorable outcome.</p><p><strong>Results: </strong>Pooled data analysis tended towards favoring S100B for diagnostic and prognostic purposes. S100B exhibited a diagnostic AUC of 0.74 (95% confidence interval (CI): 0.70-0.78), sensitivity of 80% (95% CI: 63%-90%), and specificity of 59% (95% CI: 45%-72%), outperforming NSE with an AUC of 0.66 (95% CI: 0.61-0.70), sensitivity of 74% (95% CI: 53%-88%), and specificity of 46% (95% CI: 24%-69%). Notably, both biomarkers demonstrated enhanced diagnostic value when blood samples were collected within 12 hours post-injury. The analyses also revealed the excellent diagnostic ability of S100B with a sensitivity of 99% (95% CI: 4%-100%) and a specificity of 76% (95% CI: 51%-91%) in mild TBI patients (AUC = 0.89 [0.86-0.91]). In predicting mortality, S100B showed a sensitivity of 90% (95% CI: 65%-98%) and specificity of 61% (95% CI: 39%-79%), slightly surpassing NSE's performance with a sensitivity of 88% (95% CI: 76%-95%) and specificity of 56% (95% CI: 47%-65%). For predicting unfavorable outcomes, S100B exhibited a sensitivity of 83% (95% CI: 74%-90%) and specificity of 51% (95% CI: 30%-72%), while NSE had a sensitivity of 80% (95% CI: 64%-90%) and specificity of 59% (95% CI: 46%-71%).</p><p><strong>Conclusion: </strong>Although neither biomarker has shown promising diagnostic performance in detecting abnormal computed tomography (CT) findings, they have displayed acceptable outcome prediction capabilities, particularly with regard to mortality.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e29"},"PeriodicalIF":5.4,"publicationDate":"2024-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988180/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853027","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":"Characteristics of Hospitalized Pediatric Patients Following Traumatic Open Globe Injuries; a Cross-sectional Study.","authors":"Alireza Peyman, Alireza Dehghani, Alireza Hoghooghi, Kazhaal Sheykhi, Mehri Khoshhali, Mahdi Abounoori, Hajar Khosrropour, Mohsen Pourazizi","doi":"10.22037/aaem.v12i1.2175","DOIUrl":"https://doi.org/10.22037/aaem.v12i1.2175","url":null,"abstract":"<p><strong>Introduction: </strong>One of the main causes of acquired blindness and impairment in children is ocular trauma. This study aimed to evaluate the epidemiological and clinical characteristics of pediatric patients hospitalized with open globe injuries (OGI).</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted on children diagnosed with OGI at a referral Hospital affiliated with Isfahan University of Medical Sciences, Isfahan, Iran, from 2014 to 2018.</p><p><strong>Results: </strong>375 OGI medical records were detected during the study period. The common culprits for OGI in boys were knives (21.3%), wood (19.7%), metal bodies (12.2%), and glass (11.8%). In girls, the common causes were knives (28.7%), glass (24.3%), pencils (11.3%), and wood (10.4%). Boys had a greater rate of Intraocular foreign body (IOFB) (p= 0.052) but had lower odds of blindness compared to girls (OR=0.48; 95% CI: (0.24, 0.98); p = 0.04). Patients with corneal lacerations had lower chances of long-term admission than those with corneal and scleral lacerations (OR= 0.35, 95% CI: (0.17, 0.69); p = 0.02).</p><p><strong>Conclusion: </strong>Most pediatric OGIs occur in boys. knives were the principal culprit for OGI, followed by glass and wood. Boys had a greater IOFB rate but lower blindness odds than girls.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e28"},"PeriodicalIF":5.4,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988179/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847408","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":"11-Year Trend of Mortality from Fatal Road Traffic Injuries in The Center of Iran; a Cross-sectional Study.","authors":"Maziyar Mollaei Pardeh, Mohammad Hosain Yarmohammadian, Golrokh Atighecian, Afshin Ebrahimi, Mohamad Reza Maracy","doi":"10.22037/aaem.v12i1.2205","DOIUrl":"10.22037/aaem.v12i1.2205","url":null,"abstract":"<p><strong>Introduction: </strong>Road traffic injuries (RTIs) are one of the major health problems in developed and developing countries. In Iran, RTIs are the first leading cause of years of life lost (YLL). So, the present study investigated the 11-year trend of RTI- related mortalities in Iran.</p><p><strong>Methods: </strong>This study was a population-based cross-sectional study. All-cause deaths as well as RTI-related mortalities' data were collected from the Civil Registration Organization (CRO) and Legal medical organization (LMO) of Isfahan during 2011-2021. The mid-year population, number of deaths due to RTIs, the crude and age-standardized mortality (per 100,000) of RTIs, and the percentage of proportional mortality by sex and year of accident during the study period were calculated and reported. Also, trend analysis was done using join point regression program.</p><p><strong>Results: </strong>During the study period, 11,248 deaths occurred due to RTIs in Isfahan province. 8,894 cases were male (79.03%), the highest number of deaths in both male and female cases was reported in those aged 15-39 years. Among the males, trend of standardized mortality in 2011-2015 was decreasing (annual percentage changes = -6.76(CI 95%: -2.53, -15.03)), while in 2015-2021 it was increasing (annual percentage changes = 3.00 (CI 95%: 0.63, 9.87)). However, no significant trend was observed among females.</p><p><strong>Conclusion: </strong>The findings of the present study showed that the number and standardized mortality rate of RTIs decreased during the 11-year period. It seems that applying stricter policies, improving the quality of the roads of the province, improving the quality of cars, and increasing the number of hospital and pre-hospital medical facilities can play an effective role in reducing RTIs.</p>","PeriodicalId":8146,"journal":{"name":"Archives of Academic Emergency Medicine","volume":"12 1","pages":"e27"},"PeriodicalIF":4.6,"publicationDate":"2024-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10988176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847359","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}