CJEM最新文献

{"title":"The trolley problem in the ED.","authors":"Li Danny Liang","doi":"10.1007/s43678-024-00838-6","DOIUrl":"10.1007/s43678-024-00838-6","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"161-162"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923954","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":"Empowering rural emergency physicians: POCUS as a diagnostic lifeline.","authors":"Frances Williamson, Louise Cullen, Paul Atkinson","doi":"10.1007/s43678-025-00879-5","DOIUrl":"10.1007/s43678-025-00879-5","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":"27 3","pages":"159-160"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607591","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 value of MRI in transient ischemic attack/minor stroke following a negative CT for predicting subsequent stroke.","authors":"Matthieu Robitaille, Marcel Émond, Mukul Sharma, Ariane Mackey, Pierre-Gilles Blanchard, Marie-Joe Nemnom, Marco L A Sivilotti, Ian G Stiell, Grant Stotts, Jacques Lee, Andrew Worster, Judy Morris, Ka Wai Cheung, Albert Y Jin, Demetrios J Sahlas, Heather E Murray, Steve Verreault, Marie-Christine Camden, Samuel Yip, Philip Teal, David J Gladstone, Mark I Boulos, Nicolas Chagnon, Elizabeth Shouldice, Clare Atzema, Tarik Slaoui, Jeanne Teitlebaum, George A Wells, Jeffrey J Perry","doi":"10.1007/s43678-024-00853-7","DOIUrl":"10.1007/s43678-024-00853-7","url":null,"abstract":"<p><strong>Background: </strong>Diffusion weighted magnetic resonance imaging's (MRI) role in predicting subsequent strokes beyond the validated Canadian TIA Score in in transient ischemic attack (TIA)/minor stroke patients with normal CT scans is unknown. In this study, we assessed the incidence of acute cerebral infarction on MRI in these patients, overall and stratified by the Canadian TIA Score levels and then we assessed subsequent stroke rates at 7, 30 and 90 days based on the presence of acute infarct on MRI.</p><p><strong>Methods: </strong>This pre-planned substudy of the Canadian TIA risk score cohort was conducted across 13 Canadian emergency departments over an 11-year period. Eligible patients included adult TIA/minor stroke patients with negative CT scans who underwent MRI within 7 days.</p><p><strong>Results: </strong>Among 11,507 patients, 1048 with negative CT scans had early MRI, which revealed infarction in 330 (31.5%) patients. Acute infarction rates varied by Canadian TIA Score risk group: 130 (15.4%) in low-risk, 754 (30.4%) in medium-risk, and 162 (50.0%) in the high-risk group. At 90 days, the rates of stroke in patients with a positive MRI were 2 (10.0%), 168 (22.3%), and 40 (24.7%) in low-risk, medium-risk, and high-risk groups, respectively. In comparison, in patients with a negative MRI the rate was 1 (0.9%), 7 (1.3%), and 4 (4.9%).</p><p><strong>Conclusions: </strong>Combining the Canadian TIA Risk Score with follow-up MRI improves stroke risk assessment. MRI enhance the accuracy of diagnosis TIA, especially when CT is negative. The risk score helps prioritize MRI, benefiting medium-risk patients most, while high-risk patients need prompt management regardless of MRI results. Low-risk patients benefit from MRI for determining further investigations.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"215-220"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191469","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":"Advancing emergency medicine: embracing new horizons.","authors":"Jace C Bradshaw, Gabor D Kelen","doi":"10.1007/s43678-024-00856-4","DOIUrl":"10.1007/s43678-024-00856-4","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"163-164"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967366","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":"Virtual emergency departments: enabling accessible and compassionate care through inclusive technology.","authors":"Esli Osmanlliu","doi":"10.1007/s43678-025-00878-6","DOIUrl":"10.1007/s43678-025-00878-6","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":"27 3","pages":"157-158"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607533","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":"Isolated leg weakness with painful spasms in an adolescent.","authors":"Jakob M Domm, Sunita Venkateswaran, Rodrick Lim","doi":"10.1007/s43678-024-00798-x","DOIUrl":"10.1007/s43678-024-00798-x","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"221-222"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142549462","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":"Thousands of critical interruptions.","authors":"Valérie Langlois-Carbonneau, François Dufresne, Sophie Gosselin, Katia Hamelin, Djamal Berbiche","doi":"10.1007/s43678-025-00891-9","DOIUrl":"10.1007/s43678-025-00891-9","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"231-232"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450403","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":"CJEM debate: clinical decision rules-thinking beyond the algorithm.","authors":"Justin Morgenstern, Ryan Radecki, Lauren Westafer, Joshua D Niforatos, Paul Atkinson","doi":"10.1007/s43678-025-00870-0","DOIUrl":"10.1007/s43678-025-00870-0","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"165-169"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124193","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":"Physician perspectives on providing virtual emergency department care for equity-deserving populations.","authors":"Justin N Hall, Yomna H E Ahmed, Abirami Vijayakumar, Mariam Ahmer, Shaun Mehta, Umberin Najeeb, Alun Ackery, Sander L Hitzig","doi":"10.1007/s43678-024-00830-0","DOIUrl":"10.1007/s43678-024-00830-0","url":null,"abstract":"<p><strong>Objective: </strong>Patients from equity-deserving populations, such as those who are from racialized communities, the 2SLGBTQIA + community, who are refugees or immigrants, and/or who have a disability, may experience a unique set of challenges accessing and receiving care through virtual models. The objective of this qualitative study was to describe physician perspectives on their experiences providing care to patients from equity-deserving communities and their family members who received care from a Virtual Emergency Department (ED) in Toronto, Canada.</p><p><strong>Methods: </strong>We interviewed 14 Virtual ED physicians from different sites across the Greater Toronto Area. Semi-structured interviews were conducted to explore ED physicians' experiences with treating patients from equity-deserving populations who used the Virtual ED. Inductive thematic analysis was used to identify themes from the interview data.</p><p><strong>Results: </strong>Three themes were identified, which included: (1) Considerations for Virtual ED Inclusivity; (2) Beliefs about Compassionate Virtual ED Care Practices; and (3) Proposed Innovations for Advancing Equity through Virtual ED Care. An overarching and connecting theme was accessibility. Across these themes, providers highlighted factors that influenced Virtual ED accessibility for many equity-deserving populations.</p><p><strong>Conclusions: </strong>The Virtual ED holds many promising applications for the delivery of equitable and compassionate care for equity-deserving populations. There are several patient, provider and system level issues that need to be considered to ensure its inclusivity and accessibility. One suggestion for innovation includes creating community hubs offering access to the Virtual ED to make it easier for equity-deserving populations who may face barriers to using it or need a safe space to do so.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"198-206"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450283","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":"Crowned dens syndrome: a rare differential diagnosis of meningitis.","authors":"Andriko Palmowski, Jan Riedel, Paul Kamieniarz, Hildrun Haibel, Lorenz Bartsch, Eva Diehl-Wiesenecker","doi":"10.1007/s43678-024-00850-w","DOIUrl":"10.1007/s43678-024-00850-w","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"233-234"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11897101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934034","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}