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Case Report-Early Detection of Acute Fatty Liver of Pregnancy in Urgent care department with Nonspecific Symptoms

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Open Journal of Obstetrics and Gynecology 2022年第11期12卷 1176-1182页

作者： Renuka Jangalgi Shabnam Faheem Shakeela Irfan department of Obstetrics and Gynecology Danat Al Emarat Hospital Abu Dhabi United Arab Emirates

Acute fatty liver of pregnancy is a rare but serious disorder affecting pregnancy. The rarity of this situation along with nonspecific symptoms makes it difficult to diagnose and thus causes catastrophic events. Biochemical parameters are required to diagnose this condition and differentiate it from other life threatening causes of pregnancy like HELLP syndrome and Preeclampsia. To avoid complications it is imperative to diagnose this condition at the earliest by doing blood test investigation and symptomatic management and delivery. We present a case in our hospital which came to urgent care with nonspecific symptoms and was diagnosed on blood tests and managed promptly and thus averted a catastrophic event.

关键词： Acute Fatty Liver of Pregnancy (AFLP) Pregnancy Liver Disorder

Epidemiology and Challenges of Neurotraumas care in the Emergency department of a Semi-Urban Hospital in Guinea, West Africa

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Open Journal of Modern Neurosurgery 2021年第3期11卷 129-136页

作者： I. S. Souaré K. Kaba A. B. Bah I. Berete B. D. Tama I. S. Souaré L. K. Beavogui department of Neurosurgery Hopital de l’amitie Sino-Guineenne Conakry Guinea department of Neurosurgery Hopital national Donka Conakry Guinea

Trauma is one of the most common surgical emergencies admitted in the acute care departments of hospitals in Guinea, West Africa. We carried a study to assess the epidemiological pattern and clinical care of neurotrauma in the emergency department of the Kindia regional hospital, a rural secondary hospital catering to the needs of western Guinea and nearby districts. Data were prospectively collected from December 2019 to March 2020 after receiving the required hospital authorization and informed consent from the patients or relatives. We recorded two hundred cases of neurotraumas (64.5% of traumatic brain injury cases and 14.5% of spinal cord injury). Neurotraumas represented 17.7% of all admitted patients in the department in the study period. The mean age was 25.34 ± 16.73, and the age range 16 to 30 was the most affected. The predominance was male, with a sex ratio of 3.43. Motor Vehicle Accident was the leading cause 68.5%, and 73.2% of them involved a motorcycle. Motorcycle-to-motorcycle collision was responsible for more than a third of neurotraumas. We classified the majority of the cases as mild and low risk neurotrauma representing 62.08%. All patients benefited from medical treatment, and 30.7% of patients received surgical treatment for associated abdominal, orthopedic, and minor procedures for scalp dilacerations. No patient was referred to a Neurosurgery department, and all living patients were discharged home during the study period with minimal disability. The mortality was 16.3%. Our results could be biased by the lack of interhospital networking and the fact that severe traumatic brain-injured patient dies before seeking medical attention.

关键词： Neurotrauma Guinea Rural Motor Vehicle Accident Emergency department

Mobile technology:Usage and perspective of patients and caregivers presenting to a tertiary care emergency department

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World Journal of Emergency Medicine 2020年第1期11卷 5-11页

作者： Zhenghong Liu Mingwei Ng Dinesh V.Gunasekeran Huihua Li Kishanti Ponampalam R Ponampalam SingHealth Emergency Medicine Residency Programme Singapore Health ServicesSingapore Ministry of Health Holdings Singapore Health Services Research Unit Singapore General HospitalSingapore University of Newcastle Australia department of Emergency Medicine Singapore General HospitalSingapore

BACKGROUND:Developments in information technology(IT)have driven a push in healthcare innovation in the emergency department(ED).Many of these applications rely on mobile technology(MT)such as smartphones but not everyone is comfortable with MT *** study aims to characterize the technology usage behavior of users in the ED so as to guide the implementation of IT interventions in the ***:A cross-sectional survey was conducted in the emergency department of a tertiary *** and their caregivers aged 21 and above were *** survey collected demographic information,technology usage patterns,and participant reported comfort level in the usage of *** performed descriptive statistics and multivariate logistic regression to identify factors differentially associated with comfort in usage of ***:A total of 498 participants were recruited,and 299(60%)were *** was the most commonly written and read language(66.9%)and 64.2%reported a comfort level of 3/5 or more in using *** that were associated with being comfortable in using MT include having a tertiary education,being able to read and write English,as well as being a frequent user of *** were more likely to display these ***:A large proportion of ED patients are not comfortable in the usage of *** that predicted comfort level in the usage of MT were common amongst *** interventions should take this into consideration in the design of MT interventions.

关键词： Mobile health technology Information technology Emergency department

Suggestions on the prevention of COVID-19 for health care workers in department of otorhinolaryngology head and neck surgery

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World Journal of Otorhinolaryngology-Head and Neck Surgery 2020年第S01期6卷 S2-S5页

作者： Kai Xu Xiaoquan Lai Zheng Liu department of Otorhinolaryngology Head and Neck Surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China department of Nosocomial Infection Management Tongji HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430030China

The epidemic of the Coronavirus Disease 2019(COVID-19)has presented as a grim and complex situation *** than 77,000 cases of COVID-19 has been confirmed in China until February 25th,2020,which are causing great impact on economy and society,as well as seriously interfering with ordinary medical practice in the department of otorhinolar-yngology head and neck *** article discussed medical precautions required in the clinic,inpatient ward and operation room of otorhinolaryngology head and neck department,which aims to protect health care workers from COVID-19.

关键词： Coronavirus disease 2019 SARS-CoV-2 Viral pneumonia Precautions Suggestion

End-of-life care in a cardiology department： have we improved？

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Journal of Geriatric Cardiology 2016年第7期13卷 587-592页

作者： Juan Rulz-Garcia Pablo Dlez-Villanueva Ana Ayesta Vanessa Brufia Lourdes M Figueiras-Graillet Laura Gallego-Parra Francisco Fernandez-Aviles Manuel Martinez-Selles department of Cardiology Hospital General Universitario Gregorio Maranon Calle Doctor Esquerdo Madrid Spain department of Cardiology Hospital Universitario de Torrejon Calle Mateo Inurria Torrejon de Ardoz Madrid Spain Universidad Francisco de Vitoria Carretera Pozuelo a Majadahonda Pozuelo de Alareon Madrid Spain department of Cardiology Hospital Universitario de la Princesa Calle de Diego de Leon Madrid Spain Departmet of Cardiology Hospital Universitario del Sureste Ronda del Sur Arganda del Rey Madrid Spain Universidad Complutense de Madrid Av. Seneca Madrid Spain Universidad Europea de Madrid Urbanizacion E1Bosque Calle Tajo Villaviciosa de Odon Madrid Spain

Background End-of-life care is not usually a priority in cardiology departments. We sought to evaluate the changes in end-of-life care after the introduction of a do-not-resuscitate （DNR） order protocol. Methods ＆ Results Retrospective analysis of all deaths in a cardiology department in two periods, before and after the introduction of the protocol. Comparison of demographic characteristics, use of DNR orders, and end-of-life care issues between both periods, according to the presence in the second period of the new DNR sheet （Group A）, a conven- tional DNR order （Group B） or the absence of any DNR order （Group C）. The number of deaths was similar in both periods （n = 198 vs. n = 197）. The rate of patients dying with a DNR order increased significantly （57.1% vs. 68.5%; P = 0.02）. Only 4% of patients in both periods were aware of the decision taken about cardiopulmonary resuscitation. Patients in Group A received the DNR order one day earlier, and 24.5% received it within the first 24 h of admission （vs. 2.6% in the first period; P 〈 0.001）. All patients in Group A with an implantable cardioverter defibrillator （ICD） had shock therapies deactivated （vs. 25.0% in the first period; P = 0.02）. Conclusions The introduction of a DNR order protocol may improve end-of-life care in cardiac patients by increasing the use and shortening the time of registration of DNR orders. It may also contribute to increase ICD deactivation in patients with these orders in place. However, the introduction of the sheet in late stages of the disease failed to improve patient participation.

关键词： Cardiology Cardiopulmonary resuscitation End-of-life Palliative care

Being a Father of a Premature Newborn: The Parental Experience and the Father/Premature Newborn Relationship: A Study Carried out in the department of Neonatology Intensive care Unit of Mohammed VI University Hospital

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Open Journal of Pediatrics 2024年第2期14卷 412-419页

作者： Hasnae Elhaddadi Sahar Messaoudi Anass Ayyad Rim Amrani department of Neonatology Intensive care Unit Mohammed VI University Hospital Faculty of Medicine and Pharmacy of Oujda Mohammed First University Oujda Morocco

Introduction: Despite advances in obstetrics and pediatrics over the past 20 years, premature birth remains an unpredictable event that can have a devastating impact on parenthood. This study aimed to analyze the psycho-affective experiences of fathers of premature newborns. Methods: This was a descriptive cross-sectional study, carried out in the department of neonatology and neonatal intensive care unit of the CHU Mohamed VI in OUJDA, over 6 months from March 2022 to August 2022. It focused on 30 fathers of premature newborns hospitalized in our department. Results: The majority of fathers described a state of fear and stress, and attributed their negative experience to the unexpected nature of the premature birth. At the first meeting, half the fathers had a positive image of their newborn’s physical appearance, while 22% of fathers reported feeling uncomfortable about their newborn’s low weight. Most fathers reported that they appreciated the welcome they received, the skill with which they cared for their newborn, and the availability of the pediatrician to provide information on their child’s state of health. Two fathers enjoyed skin-to-skin contact with their newborns. None of the fathers met a psychologist. When they returned home, half the fathers had a positive outlook, marked by happiness at being able to fully invest in their role as fathers, the other half reported being torn between the desire to see their child integrated into the family cocoon and the fear of not being able to manage delicate situations properly without a medical team. Conclusion: Bringing a premature baby into the world can be a difficult experience, leading to the development of even minor psychological distress in some fathers, and hence the need for specific psychological care.

关键词： Prematurity Psychiatrist Emotional Disorder Depression

Evaluation of hand infections in the emergency department using point-of-care ultrasound

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World Journal of Emergency Medicine 2024年第4期15卷 283-288页

作者： David Ahmad Haidar David Mintz Brandon M Wubben Omar Rizvi Srikar Adhikari department of Emergency Medicine Michigan MedicineAnn Arbor 48109-1382USA University of Arizona College of Medicine Tucson 85724USA department of Emergency Medicine University of IowaIowa City 52242-1009USA department of Surgery University of Arizona College of MedicineTucson 85724USA department of Emergency Medicine University of Arizona College of MedicineTucson 85724USA

BACKGROUND:We aimed to evaluate the utility of point-of-care ultrasound(POCUS)in the assessment of hand infections that present to the emergency department(ED)and its impact on medical decision making and patient ***:We conducted a retrospective review of patients who presented to two urban academic EDs with clinical presentations concerning for skin and soft tissue infections(SSTI)of the hand between December 2015 and December *** trained POCUS fellowship physicians reviewed an ED POCUS database for POCUS examinations of the *** then reviewed patients’electronic health records(EHR)for demographic characteristics,history,physical examination findings,ED course,additional imaging studies,consultations,impact of POCUS on patient care and final ***:We included a total of 50 cases(28 male,22 female)in the final *** most common presenting symptoms and exam findings were pain(100%),swelling(90%),and erythema(74%).The most common sonographic findings were edema(76%),soft tissue swelling(78%),and fluid surrounding the tendon(57%).POCUS was used in medical decision making 68%of the time(n=34),with the use of POCUS leading to changes in management 38%of the time(n=19).POCUS use led to early antibiotic use(11/19),early consultation(10/19),and led to the performance of a required procedure(8/19).The POCUS diagnosis was consistent with the discharge diagnosis of flexor tenosynovitis 8/12 times,abscess 12/16 times,and cellulitis 14/20 ***:POCUS is beneficial for evaluating of hand infections that present to the ED and can be used as an important part of medical decision making to expedite patient care.

关键词： Ultrasound Point-of-care ultrasound Cellulitis Abscess Flexor tenosynovitis

Optimizing artificial intelligence in sepsis management: Opportunities in the present and looking closely to the future

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Journal of Intensive Medicine 2024年第1期4卷 34-45页

作者： Darragh O’Reilly Jennifer McGrath Ignacio Martin-Loeches department of Intensive care Medicine Multidisciplinary Intensive Care Research Organization(MICRO)St James’HospitalDublinIreland department of Respiratory Intensive care Hospital ClinicUniversitat de BarcelonaIDIBAPSCIBERESBarcelonaSpain

Sepsis remains a major challenge internationally for healthcare *** incidence is rising due to poor public awareness and delays in its recognition and subsequent *** sepsis,mortality increases with every hour left *** intelligence(AI)is transforming worldwide healthcare delivery at *** review has outlined how AI can augment strategies to address this global disease *** and machine learning(ML)algorithms can analyze vast quantities of increasingly complex clinical datasets from electronic medical records to assist clinicians in diagnosing and treating sepsis earlier than traditional *** review highlights how these models can predict the risk of sepsis and organ failure even before it *** gives providers additional time to plan and execute treatment plans,thereby avoiding increasing complications associated with delayed diagnosis of *** potential for cost savings with AI implementation is also discussed,including improving workflow efficiencies,reducing administrative costs,and improving healthcare *** these advantages,clinicians have been slow to adopt AI into clinical *** of the limitations posed by AI solutions include the lack of diverse data sets for model building so that they are widely applicable for routine clinical ***,the subsequent algorithms are often based on complex mathematics leading to clinician hesitancy to embrace such ***,we highlight the need for robust political and regulatory frameworks in this area to achieve the trust and approval of clinicians and patients to implement this transformational technology。

关键词： Artificial intelligence Data science Machine learning Intensive care unit(ICU) Critical care Sepsis

Extracorporeal membrane oxygenation as a bridging therapy for patients with thiamine deficiency-induced pulmonary arterial hypertension

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World Journal of Emergency Medicine 2024年第2期15卷 147-149页

作者： Fangfang Qiu Weixing Dai Tengyue Huang Min Li department of Intensive care Unit the Fourth Affiliated Hospital of Zhejiang University School of MedicineYiwu 322000China department of Intensive care Unit the Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China

Thiamine deficiency is characterized by a deficiency of thiamine(vitamin B1),lactic acidosis,pulmonary arterial hypertension(PAH),right-sided heart failure,and peripheral nerve *** deficiency is easily misdiagnosed and missed during clinical practice and is associated with death in severe cases.[1,2]Here we reported a patient who was admitted to the hospital with severe metabolic acidosis and pulmonary hypertension and finally diagnosed with thiamine deficiency by detecting plasma vitamin B1 *** clinically obvious thiamine deficiency is rare,and cases of thiamine deficiency requiring extracorporeal membrane oxygenation(ECMO)treatment are rarer,we believe that our case will be helpful for emergency clinicians.

关键词： vitamin hypertension arterial