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World Journal of emergency medicine 2017年第2期8卷 121-125页

作者： Chang-Chih Tsai Chien-Chin Hsu Kuo-Tai Chen emergency Department Chi-Mei Medical Center Department of Biotechnology Southern Tainan University of Technology Department of emergency medicine Taipei Medical University

BACKGROUND: Accurate diagnosis of infected aortic and iliac aneurysms is often delayed, hampering timely treatment and potentially resulting in a fatal consequence. The aim of this study was to discover useful clinical features that can help physicians to identify these ***: We reviewed the discharge notes from two hospitals and identifi ed all patients who had a diagnosis of infected aneurysms of the thoracoabdominal aorta and iliac arteries between July 2009 and December 2013. Eighteen patients, aged from 41 to 93, were reviewed. Only 6 patients were diagnosed accurately in their fi rst visit to our ***: Most patients had at least one underlying illness, and it took 1 to 30(9.9±6.5) days for physicians to diagnose their infected aneurysm. Localized pain and fever were the two most commonly presented symptoms. The majority(92%) of isolated microorganisms were gram-negative bacilli, including Salmonella spp, Klebsiella pneumoniae, and Escherichia coli. Two of the 3 patients who underwent non-operative therapy died, and all of the patients who underwent a combination of medical and operative therapies ***: We suggest that physicians liberally use computed tomography scans on patients with unknown causes of pain and inflammatory processes. A combination of surgical and medical treatments is indicated for all patients with infected aortic and iliac aneurysms.

关键词： Infected aneurysm Salmonella Misdiagnosis emergency department Clinical manifestation

Trends in point-of-care ultrasound protocols in the emergency department and intensive care unit:a review

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emergency and Critical Care medicine 2023年第2期3卷 64-69页

作者： Xinhui Fan Yuan Bian Guoying Wang Weikang Liu Luyao Gao Yuhui Pan Shengchuan Cao Qiuhuan Yuan Shujian Wei Feng Xu Yuguo Chen Department of emergency and Chest Pain Center Shandong Provincial Clinical Research Center for Emergency and Critical Care MedicineInstitute of Emergency and Critical Care Medicine of Shandong UniversityKey Laboratory of Emergency and Critical Care Medicine of Shandong ProvinceKey Laboratory of Cardiopulmonary-Cerebral Resuscitation Research of Shandong ProvinceQilu Hospital of Shandong UniversityJinanChina.

Together with the development of the focused assessment with sonography for trauma protocol for ultrasound in trauma patients,point-of-care ultrasound is widely used in the field of emergency and critical care *** have established several classic operating protocols for different diseases,such as acute respiratory failure,shock,and cardiac arrest,in the emergency department and intensive care *** further development in the portability and popularity of ultrasonic equipment,it is expected to be used as a new type of technology for physical examination,including inspection,palpation,percussion,auscultation,and insonation,which will improve the clinical medicine practice in the future.

关键词： Auscultation and insonation Inspection Palpation Percussion Point-of-care ultrasound Protocol Seven-point and nineplane protocol

Presepsin as a biomarker for risk stratification for acute cholangitis in emergency department: A single-center study

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World Journal of Clinical Cases 2021年第32期9卷 9857-9868页

作者： Han-Yu Zhang Zhao-Qing Lu Guo-Xing Wang Miao-Rong Xie Chun-Sheng Li Department of emergency medicine Beijing Friendship HospitalCapital Medical UniversityBeijing 100050China

BACKGROUND Acute cholangitis is caused by bacterial infection and has high morbidity and mortality *** grade of cholangitis can guide clinical treatment from single antibiotic treatment to biliary *** the introduction of white blood cell(WBC)count,C-reactive protein(CRP),and total bilirubin(T-Bil)into the diagnostic criteria and severity grading for acute cholangitis,the diagnosis rate and grading have significantly ***,early risk stratification assessments are challenging in the emergency ***,we hope to find an ideal predictive biomarker for cholangitis *** is a promising biomarker for the early diagnosis,severity,and prognosis of acute bacterial *** To assess the grading value of presepsin in patients with acute *** This clinical study was conducted at the Beijing Friendship Hospital,a 2000-bed teaching hospital with approximately 200000 emergency admissions per *** this prospective observational study,336 patients with acute cholangitis meeting the Tokyo Guidelines 2018 diagnostic criteria in the emergency department from May 2019 to December 2020 were *** count,CRP,procalcitonin(PCT),presepsin,T-Bil,and blood culture results were *** values were compared using the Pearsonχ2 test,Fisher’s exact test,or Mann-Whitney U *** area under the receiver operating characteristic curve(AUC)of the value was examined using the Delong *** correlations among the key research indicators were determined using Pearson *** In total,336 patients were examined,which included 107,106,and 123 patients classified as having mild,moderate,and severe cholangitis,*** count,CRP,PCT,presepsin,T-Bil,direct bilirubin,and sequential organ failure assessment scores of moderate and severe cholangitis patients were higher than those of mild cholangitis patients(P=0.000).The AUC of presepsin in predicting moderate acute cholangitis was 0.728,which was high

关键词： C-reactive protein Procalcitonin Presepsin Acute cholangitis Risk stratification

Potential impact of early physiotherapy in the emergency department for non-traumatic neck and back pain

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World Journal of emergency medicine 2017年第2期8卷 110-115页

作者： Pothiawala Sohil Pua Yong Hao Leong Mark Department of emergency medicine Singapore General Hospital Singapore Department of Physiotherapy Singapore GeneralHospital Singapore

BACKGROUND: Musculoskeletal complaints, especially non-traumatic neck and back pain, are routinely encountered in the emergency department(ED) and lead to ED overcrowding, a burgeoning wait time for physiotherapy and outpatient orthopedic reviews. The study aimed to evaluate the impact of early physiotherapy evaluation and treatment(EPET) vs. standard care(SC) on clinical outcomes for patients presenting to the ED with non-traumatic neck and back ***: A retrospective observational study of 125 patients who presented to the ED with non-traumatic neck and back pain with/without peripheral symptoms from July 2010 to February 2011. Neck Disability Index(NDI), Modifi ed Oswestry Low Back Pain Disability Questionnaire(MODI) and 11-point Numeric Pain Rating Scale were used as outcome measures and compared between groups at a mean of 34 days from their initial ED ***: We identifi ed a total of 125 patients. EPET group comprised 62 patients(mean age, 45 years; men, 63%) and SC group comprised 63 patients(mean age, 45 years; men, 43%). The EPET and SC groups received physiotherapy at a median of 4 and 34 days respectively from their fi rst ED visit. EPET patients had signifi cantly lower levels of disability(9.0% vs. 33.4%, Welch t-test, P<0.001) and pain(median value, 1 vs. 4 points, Mann-Whitney U-test, P<0.001) compared with SC ***: Early access to physiotherapy in ED was associated with reduced pain and disability levels. EPET protocol can potentially decrease the demand on outpatient orthopedic services, thereby freeing up available resources to treat patients who are more likely to benefi t from it.

关键词： Physiotherapy emergency department Non-traumatic neck and back pain

emergency department patient experience:Same location,same provider,different scores by different survey methods

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World Journal of emergency medicine 2019年第3期10卷 138-144页

作者： Wirachin Hoonpongsimanont Preet Kaur Sahota Yanjun Chen Maria Nguyen Christine Louis Jonathan Pena Andrew Wong Maxwell Jen Department of emergency medicine University of California Orange CA USA Institute for Clinical and Translational Sciences University of California Irvine CA USA

BACKGROUND: Recent findings on emergency department (ED) patient experience surveys and concerns for the low response rates challenge the quality and reliability of the survey reports. We assessed the consistency of an ED patient experience survey report and identifi ed the effects of patient demographics on ED patient experiences. METHODS: We conducted a prospective, cross-sectional study at a university-based ED from July to December 2017. We obtained ED patient experience scores from an institutional version (IS) survey and the Press Ganey Associates-distributed survey (PGA). We compared top box scores from the two reports using frequency analysis and performed multivariable logistic regressions to identify associations between IS patient demographics and scores. RESULTS: We obtained 289 PGA and 234 IS responses. The IS reported signifi cant, higher top box scores in doctor-specifi c patient questions compared to PGA (all four P-values < 0.01). Female, Christian and White patients were more likely to give top box scores (OR 3.07, OR 2.22 and OR 2.41, P-value < 0.05, respectively). CONCLUSION: We found significant differences in ED patient experience scores between the IS and PGA surveys. We recommend that healthcare providers consider patient demographic variables when interpreting ED experience score reports. Multiple survey techniques and distribution methods may be adopted to best capture ED patient experiences.

关键词： Patient experience emergency department Patient satisfaction Press Ganey Survey methodology

A case of thyroid emergency with cardiac arrest supported by extracorporeal membrane oxygenation

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World Journal of emergency medicine 2018年第4期9卷 288-290页

作者： Gan-nan Wang Xu-fcng Chen Gang Zhang Yong Mei Zhe Wang Qin Zhang Jin-song Zhang Department of emergency medicine the First Affiliated Hospital of Nanjing Medical University Nanjing China

Dear editor,Thyroid emergency is a rare but potentially life-threatening condition if not recognized early and managed *** is usually due to a severe exacerbation of a preexisting thyrotoxicosis,which later leads to decompensation in different organ *** treatment of thyroid emergency remains challenging even with the armamentarium of modern intensive care technologies,especially in patients with cardiac

关键词：小学英语课外阅读阅读材料

Assessment of knowledge, attitude and practice regarding oxygen therapy at emergency departments in Riyadh in 2017: A cross-sectional study

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World Journal of emergency medicine 2019年第2期10卷 88-93页

作者： Amairah Fahad Aloushan Faisal Abdullah Almoaiqel Raid Naysh Alghamdi Fatmah Ismail Alnahari Abdulaziz Fahad Aldosari Nazish Masud Nawfal Abdullah Aljerian College of medicine King Saud Bin Abdulaziz University for Health Sciences Department of Medical Education College of Medicine King Saud bin Abdulaziz University for Health Sciences Riyadh Department of emergency medicine King Abdulaziz Medical City

BACKGROUND: Administering oxygen therapy(OT) has an essential role in preventing/managing hypoxemia in both acute and chronic conditions. It should be adjusted to achieve the normal oxygen saturation of 94%–98% in most cases. This study aims to evaluate knowledge, attitude and practice(KAP) of nurses, paramedics, emergency medical technicians(EMTs) and emergency Medical Services(EMS) physicians working at emergency departments(ED) in Riyadh, Saudi Arabia. METHODS: In this cross-sectional study, a structured questionnaire was used to assess KAP related to OT of nurses, paramedics, EMTs and EMS physicians currently working at an ED of a tertiary care hospital. Knowledge and attitude were assessed using a Likert scale from 1–5, whereas practice was assessed as a yes/no categorical ***: A total of 444 emergency health-care workers(EHCWs) participated, of which 225(50.7%) were male, with the majority(77%) in the age group of 20–35 years. Over half of the sample were nurses(266; 59.9%). The mean score for knowledge about OT was 5.51±1.45, attitude was 26.31±3.17 and for practices 4.55±1.76. The main factors which were associated with poor KAP were workload and lack of local guidelines. The distribution of overall practice score was signifi cantly better among paramedics – nurses group and EMT – nurses ***: This study demonstrates that there is a gap in EHCWs' KAP, particularly regarding when to provide OT to a patient. This gap can affect patients' safety. Extensive educational and training programs about OT are needed to raise awareness among health-care providers.

关键词： emergency medicine Oxygen therapy Knowledge Attitude Practice

Early identification of stroke through deep learning with multi-modal human speech and movement data

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Neural Regeneration Research 2025年第1期20卷 234-241页

作者： Zijun Ou Haitao Wang Bin Zhang Haobang Liang Bei Hu Longlong Ren Yanjuan Liu Yuhu Zhang Chengbo Dai Hejun Wu Weifeng Li Xin Li School of Computer Science and Engineering Sun Yat-sen UniversityGuangzhouGuangdong ProvinceChina Department of Neurology Guangdong Neuroscience InstituteGuangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouGuangdong ProvinceChina Department of emergency medicine Guangdong Provincial People’s Hospital(Guangdong Academy of Medical Sciences)Southern Medical UniversityGuangzhouGuangdong ProvinceChina

Early identification and treatment of stroke can greatly improve patient outcomes and quality of *** clinical tests such as the Cincinnati Pre-hospital Stroke Scale(CPSS)and the Face Arm Speech Test(FAST)are commonly used for stroke screening,accurate administration is dependent on specialized *** this study,we proposed a novel multimodal deep learning approach,based on the FAST,for assessing suspected stroke patients exhibiting symptoms such as limb weakness,facial paresis,and speech disorders in acute *** collected a dataset comprising videos and audio recordings of emergency room patients performing designated limb movements,facial expressions,and speech tests based on the *** compared the constructed deep learning model,which was designed to process multi-modal datasets,with six prior models that achieved good action classification performance,including the I3D,SlowFast,X3D,TPN,TimeSformer,and *** found that the findings of our deep learning model had a higher clinical value compared with the other ***,the multi-modal model outperformed its single-module variants,highlighting the benefit of utilizing multiple types of patient data,such as action videos and speech *** results indicate that a multi-modal deep learning model combined with the FAST could greatly improve the accuracy and sensitivity of early stroke identification of stroke,thus providing a practical and powerful tool for assessing stroke patients in an emergency clinical setting.

关键词： artificial intelligence deep learning diagnosis early detection FAST screening stroke

Role of urine studies in asymptomatic febrile neutropenic patients presenting to the emergency department

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World Journal of emergency medicine 2021年第2期12卷 99-104页

作者： Hady Zgheib Aline El Zakhem Cynthia Wakil Mohamad Ali Cheaito Rola Cheaito Antoine Finianos Ralphe Bou Chebl Rima Kaddoura Nader Al Souky Imad El Majzoub Department of emergency medicine American University of Beirut Medical CenterBeirut 11-0236Lebanon Department of Internal medicine American University of Beirut Medical CenterBeirut 11-0236Lebanon

BACKGROUND: The role of urine studies in the detection of urinary tract infection(UTI) in febrile neutropenic patients with urinary symptoms(having a urinary catheter or having a positive urine analysis) is inarguable. However, the evidence is scarce regarding the indication for urine studies in asymptomatic(i.e., without urinary symptoms) patients with febrile neutropenia(FN) presenting to the emergency department(ED). The aim of this study is to evaluate the need for obtaining urine studies in asymptomatic febrile neutropenic ***: This was a retrospective cohort study conducted on adult cancer patients who presented to the ED with FN and had no urinary symptoms. We included all ED presentations of eligible patients between January 2013 and September 2018. Student's t-test and Wilcoxon rank-sum test were used for continuous data, while Chi-square and Fisher's exact tests were used for categorical data. Participants were divided into two groups based on their urine culture(UC) results: negative and positive UCs. Two cut-offs were used for positive UC results: ≥10~5 cfu/m L and ≥10~4 cfu/m ***: We included 284 patients in our study. The age of our patient population was 48.5±18.5 years. More than two-thirds(68.7%) of patients had severe neutropenia, while only 3.9% and 9.9% of the patients had positive UCs at ≥10~5 cfu/m L and ≥10~4 cfu/m L, respectively. UCs were expectedly positive in most patients with urinalysis(UA) abnormalities. However, 27.3% and 32.1% of patients with positive UCs at ≥10~5 cfu/m L and ≥10~4 cfu/m L respectively had a normal UA. CONCLUSIONS: In our study, the incidence of UTI in adult febrile neutropenic cancer patients who present to the ED without urinary symptoms is low. Consequently, routine urine testing may not be warranted in this population, as it adds unnecessary financial burdens on the patients and delays timely management.

关键词： Adult Cancer emergency department Febrile neutropenia Urine testing

emergency admissions due to swallowed foreign bodies in adults

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World Journal of Gastroenterology 2013年第38期19卷 6447-6452页

作者： Bülent Erbil Mehmet Ali Karaca Mehmet Ali Aslaner Zaur Ibrahimov Mehmet Mahir Kunt Erhan Akpinar Mehmet Mahir zmen Department of emergency medicine Faculty of MedicineHacettepe University06100 AnkaraTurkey Department of Radiology Faculty of MedicineHacettepe University06100 AnkaraTurkey Department of General Surgery Faculty of MedicineHacettepe University06100 AnkaraTurkey

AIM:To study a retrospective analysis of patients who presented to the emergency departments(ED)with complaints related to foreign body ***:Patients older than 16 years of age who presented to the ED between January 1stand December 31stof 2010 with complaints related to swallowed foreign bodies were identified from electronic health records and patient ***:A total of 100 patients presented with a complaint of foreign body ingestion during the study ***,an X-ray was performed on 75 patients,and a fiberoptic evaluation was performed on45 patients.A foreign body was detected in 46(46%)*** diagnostic yield of the X-ray was 27(36%)out of 75 patients,while the diagnostic yield of the fiberoptic evaluations was 21(47%)out of 45 *** detected foreign bodies were mostly located in the esophagus(17 out of 46 foreign bodies detected).When the types of ingested foreign bodies were evaluated,52(52%)patients reported ingesting food,and19(19%)patients reported swallowing *** X-ray was performed on 33 patients with accidental food ingestions but yielded a positive result in only two *** 12 out of 21 patients with accidental food ingestion who underwent fiberoptic evaluation,the foreign material was detected and ***:Plain radiography is helpful in the localization of radiopaque swollen foreign bodies,while fiberoptic methods are useful as both diagnostic and therapeutic tools,regardless of radiopacity.

关键词： Foreign body Ingestion Gastrointestinal tract Endoscopy emergency