CJEM最新文献

{"title":"Language-appropriate care: an overview for the busy emergency clinician.","authors":"Camron Ford, Michele James, Mayoorendra Ravichandiran, Peter Reardon, Christopher J Yarnell","doi":"10.1007/s43678-025-01013-1","DOIUrl":"https://doi.org/10.1007/s43678-025-01013-1","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145042578","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":"Timeframe for suspecting typhoid fever post-travel in Canadian children.","authors":"Alino Demean Loghin, Brandon Noyon, Charlotte Grandjean-Blanchet, Émilie Vallières, Jocelyn Gravel","doi":"10.1007/s43678-025-01006-0","DOIUrl":"https://doi.org/10.1007/s43678-025-01006-0","url":null,"abstract":"<p><strong>Objectives: </strong>Typhoid fever, caused by Salmonella enterica serotype Typhi, remains a concern in non-endemic regions, particularly for travelers returning from endemic areas, as it can cause severe systemic infections. Complications, such as gastrointestinal bleeding, could be avoided with timely diagnosis and management, and the optimal timeframe for clinical suspicion post-travel remains debated. This study aimed to determine the post-travel period during which clinicians should suspect typhoid fever in children returning to Canada.</p><p><strong>Methods: </strong>This was a secondary analysis of two cohort studies conducted in a tertiary care pediatric hospital in Montreal, Canada between 2018 and 2024. The full cohorts included all children with positive blood cultures from the emergency department (ED), while this study focusses on Salmonella Typhi bacteremia. The primary outcome was the number of days between return to Canada and positive blood culture. Independent variables included age, sex, fever at triage, country visited, and medical history. For participants who had traveled, the analysis focused on the time, in days, between the date of return from travel and presentation at the ED.</p><p><strong>Results: </strong>Out 38,541 blood cultures drawn, 368 bacteremia cases were identified. Of these, seven (1.9%) were caused by Salmonella Typhi. The median delay between return and presentation was 23 days (range: 7-49 days). Four patients had traveled to India and two to Pakistan, with four of the six cases presented to the ED more than 3 weeks post-travel. One patient had not traveled but had exposure to a potential carrier returning from Ivory Coast. Of note, most cases were initially misdiagnosed as viral illness.</p><p><strong>Conclusion and relevance: </strong>Our small study demonstrated delays up to 7 weeks between travel and clinical presentation of typhoid fever in a cohort of children in a Canadian ED. This emphasizes the importance of collecting travel history in febrile children.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145056463","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":"Implementation of a patient-centered, peer support model of care for young adults presenting to the emergency department with mental health and substance use challenges.","authors":"Shelley L McLeod, Rhiannon Thomas, Allison Dunning, Chloe Chalmers, Stef Figueiredo, Mahfam Nikoo, Bjug Borgundvaag","doi":"10.1007/s43678-025-00978-3","DOIUrl":"https://doi.org/10.1007/s43678-025-00978-3","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":""},"PeriodicalIF":2.0,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145002125","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":"Socioeconomic and rural-urban inequalities in emergency department utilization during the perinatal period.","authors":"Ruben Ohanian, Jesus Serrano-Lomelin, Brian H Rowe, Susan Crawford, Susan Jelinski, Maria B Ospina","doi":"10.1007/s43678-025-00945-y","DOIUrl":"10.1007/s43678-025-00945-y","url":null,"abstract":"<p><strong>Objective: </strong>To assess inequalities in emergency department utilization during the perinatal period across socioeconomic and rural-urban gradients in Alberta, Canada.</p><p><strong>Methods: </strong>We conducted a secondary analysis of a population-based cohort study of live-birth pregnancies in Alberta between 2011 and 2017. Emergency department visits during pregnancy and up to 1-year postpartum were analyzed. Socioeconomic position was assessed using 25 combined groups derived from quintiles of material and social deprivation. Rural-urban residence was categorized into seven geographic groups based on Alberta Health Services' classification. Concentration indexes quantified inequalities in emergency department utilization, categorized as low (≤ 0.05), medium (0.06-0.19), or high (≥ 0.20). Multilevel negative binomial regression models estimated adjusted rate ratios and 95% confidence intervals to measure differences in emergency department visit rates across socioeconomic and rural-urban groups, accounting for individual-level covariates.</p><p><strong>Results: </strong>Among 242,514 pregnancies, 366,241 emergency department visits were identified. Moderate inequality was observed across socioeconomic groups (concentration index = - 0.17, 95% confidence interval - 0.18 to - 0.16). Rates of emergency department visits were 1.7 times higher among the most deprived groups compared to the least deprived groups (adjusted rate ratio = 1.7; 95% confidence interval 1.6 to 1.8). Inequality across the rural-urban continuum was more pronounced (concentration index of - 0.31 (95% confidence interval - 0.32 to - 0.30), with rural residents experiencing significantly higher emergency department use. Compared to metropolitan areas, emergency department visits were nearly three times higher in rural centers (adjusted rate ratio = 2.9; 95% confidence interval 2.8 to 3.0) and near six times higher in rural remote areas (adjusted rate ratio = 5.5; 95% confidence interval 5.3 to 5.7).</p><p><strong>Conclusion: </strong>Significant inequalities in perinatal emergency department utilization are evident across both socioeconomic and urban-rural gradients. These findings highlight the need for targeted health-system interventions to improve access to appropriate, continuous perinatal care among disadvantaged and rural populations.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"701-710"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217859","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":"Beyond the emergency department: the use of mobile health discharge interventions-a scoping review.","authors":"Courtney Price, Omar Anjum, Maxim Ben-Yakov, Ani Orchanian-Cheff, Venkatesh Thiruganasambandamoorthy","doi":"10.1007/s43678-025-00932-3","DOIUrl":"10.1007/s43678-025-00932-3","url":null,"abstract":"<p><strong>Objectives: </strong>Mobile health interventions can enhance post-emergency department (ED) care by improving care transitions and optimizing patient follow-up, yet their utility remains underexplored. Our objective was to review mobile health discharge interventions from the ED and to characterize these interventions by technology types, patient and clinical populations studied, and outcomes assessed.</p><p><strong>Methods: </strong>We performed a scoping review of mobile health interventions supporting post-ED care following Joanna Briggs Institute and PRISMA Extension for Scoping Reviews guidelines. Four databases (Medline, Embase, Cochrane Central and Systematic Reviews) were searched for studies in English from 2007 to 2024. Included studies were mobile health interventions administered within ED settings focused on the clinical encounter. Abstract and full-text screening were performed by two independent reviewers. Data were charted by technology type, intended clinical use, and outcomes.</p><p><strong>Results: </strong>Of 4,313 records identified, 43 studies were included. Most articles were published between 2021 and 2024 (28, 65%), were pilot studies (18, 42%) and in single academic site with adult patients. Technologies included text messaging (18, 42%), remote patient monitoring (16, 37%), and mobile phone applications (9, 21%). Common conditions studied included respiratory disease (12, 28%), general post-ED care across all presenting complaints (8, 19%), and infectious disease (6, 14%). Among primary outcomes, health systems outcomes were frequently assessed (18, 42%), followed by feasibility (13, 30%) and clinical outcomes (10, 23%). Across all outcomes, most studies reported improved outpatient follow-up adherence (78%, 7/9) and clinical disease states (54%, 6/11). ED revisit rates varied in the 17 studies that reported it (41% [7] no change, 29% [5] reduced, 29% [5] no comparator group).</p><p><strong>Conclusions: </strong>Mobile health interventions have been introduced to support post-ED care with emerging, yet limited evidence of their impact on ED revisit rates, follow-up care, and enhanced clinical outcomes.</p>","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"729-743"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144762678","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":"Where trauma and trauma-informed care collide: ethical considerations for emergency medicine.","authors":"Jeanne Webber","doi":"10.1007/s43678-025-00933-2","DOIUrl":"10.1007/s43678-025-00933-2","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"686-688"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153135","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":"Fly doc.","authors":"Panagiotis G Kyrtatos","doi":"10.1007/s43678-025-00975-6","DOIUrl":"10.1007/s43678-025-00975-6","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"744-746"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144556180","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":"Reply to comments on \"Treating intractable pain with the erector spinae plane block (ESPB): preventing recurrent emergency department visits and psychological distress in elderly population with acute zoster pain. A case report\".","authors":"Mauricio Forero, Laura Olejnik","doi":"10.1007/s43678-025-00969-4","DOIUrl":"10.1007/s43678-025-00969-4","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"753-754"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651523","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":"Comment on \"Treating intractable pain with the erector spinae plane block: preventing recurrent emergency department visits and psychological distress in seniors with acute zoster pain-a case report.","authors":"Amiya Kumar Barik, Anju Gupta, Chitta Ranjan Mohanty, Rakesh Vadakkethil Radhakrishnan, Ranganatha Praveen","doi":"10.1007/s43678-025-00967-6","DOIUrl":"10.1007/s43678-025-00967-6","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":" ","pages":"751-752"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144628006","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":"Software as medicine: the mobile health revolution.","authors":"Puneet Kapur, Bryan Renne, James Stempien","doi":"10.1007/s43678-025-01004-2","DOIUrl":"https://doi.org/10.1007/s43678-025-01004-2","url":null,"abstract":"","PeriodicalId":93937,"journal":{"name":"CJEM","volume":"27 9","pages":"674-675"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202302","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}