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Relationships between blood chromium exposure and liver injury:Exploring the mediating role of systemic inflammation in a chromate-exposed population

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Journal of Environmental Sciences 2024年第9期143卷 224-234页

作者： Zekang Su Yali Zhang Shiyi Hong Qiaojian Zhang Jiayu Xu Guiping Hu Xiaojun Zhu Fang Yuan Shanfa Yu Tianchen Wang Guang Jia department of occupational and Environmental Health Sciences School of Public HealthPeking UniversityBeijing 100191China School of Engineering medicine and Beijing Advanced Innovation Center for Big Data-Based Precision medicine Beihang UniversityBeijing 100191China National Center for occupational Safety and Health Beijing 102308China department of occupational Health and Radiological Health Chongqing Centers for Disease Control and PreventionChongqing 400042China Henan Institute for occupational medicine Zhengzhou 450052China department of Clinical Laboratory Third Hospital of Peking UniversityBeijing 100191China

Hexavalent chromium and its compounds are prevalent pollutants,especially in the work environment,pose a significant risk for multisystem toxicity and *** it is known that chromium accumulation in the liver can cause damage,the dose-response relationship between blood chromium(Cr)and liver injury,as well as the possible potential toxic mechanisms involved,remains poorly *** address this,we conducted a follow-up study of 590 visits from 305 participants to investigate the associations of blood Cr with biomarkers for liver injury,including serum alanine aminotransferase(ALT),aspartate aminotransferase(AST),total bilirubin(TBIL),and direct bilirubin(DBIL),and to evaluate the mediating effects of systemic ***(PLT)and the platelet-to-lymphocyte ratio(PLR)were utilized as biomarkers of systemic *** the linear mixed-effects analyses,each 1-unit increase in blood Cr level was associated with estimated effect percentage increases of 0.82%(0.11%,1.53%)in TBIL,1.67%(0.06%,3.28%)in DBIL,0.73%(0.04%,1.43%)in ALT and 2.08%(0.29%,3.87%)in AST,***,PLT mediated 10.04%,11.35%,and 10.77%increases in TBIL,DBIL,and ALT levels induced by chromate,*** addition,PLR mediated 8.26%and 15.58%of the association between blood Cr and TBIL or *** findings shed light on the mechanisms underlying blood Cr-induced liver injury,which is partly due to worsening systemic inflammation.

关键词： Blood chromate Liver injury Systemic inflammation Mediation analysis

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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

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Approach to traumatic cardiac arrest in the emergency department: a narrative literature review for emergency providers

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World Journal of Emergency medicine 2024年第1期15卷 3-9页

作者： Rashed Alremeithi Quincy K.Tran Megan T.Quintana Soroush Shahamatdar Ali Pourmand department of Emergency medicine George Washington University School of Medicine and Health SciencesWashington DC 20037USA department of Emergency medicine University of Maryland School of MedicineBaltimore 21201USA Program in Trauma the R Adams Cowley Shock Trauma CenterUniversity of Maryland School of MedicineBaltimore 21201USA Center for Trauma and Critical Care Department of Surgerythe George Washington University School of Medicine&Health SciencesWashington DC 20037USA

BACKGROUND:Traumatic cardiac arrest(TCA)is a major contributor to mortality and morbidity in all age groups and poses a significant burden on the healthcare *** there have been advances in treatment modalities,survival rates for TCA patients remain *** narrative literature review critically examines the indications and eff ectiveness of current therapeutic approaches in treating ***:We performed a literature search in the PubMed and Scopus databases for studies published before December 31,*** search was refi ned by combining search terms,examining relevant study references,and restricting publications to the English *** the search,943 articles were retrieved,and two independent reviewers conducted a screening ***:A review of various studies on pre-and intra-arrest prognostic factors showed that survival rates were higher when patients had an initial shockable *** were conflicting results regarding other prognostic factors,such as witnessed arrest,bystander cardiopulmonary resuscitation(CPR),and the use of prehospital or in-hospital *** thoracotomy was found to result in more favorable outcomes in cases of penetrating trauma than in those with blunt *** endovascular balloon occlusion of the aorta(REBOA)provides an advantage to emergency thoracotomy in terms of occupational safety for the operator as an alternative in managing hemorrhagic *** implemented in the setting of aortic occlusion,emergency thoracotomy and REBOA resulted in comparable mortality ***-venous extracorporeal life support(V-V ECLS)and veno-arterial extracorporeal life support(V-A ECLS)are viable options for treating respiratory failure and cardiogenic shock,*** the context of traumatic injuries,V-V ECLS has been associated with higher rates of survival to discharge than V-A ***:TCA remains a signifi cant challenge for emergency medical services due to its high m

关键词： Traumatic cardiac arrest Emergency thoracotomy Resuscitative endovascular balloon occlusion of the aorta

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Early endotracheal intubation is not associated with the rate of return of spontaneous circulation following cardiac arrest at the emergency department:an exploratory analysis

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World Journal of Emergency medicine 2024年第4期15卷 297-300页

作者： Siwat Neamjun Phichayut Phinyo Borwon Wittayachamnankul Wachira Wongtanasarasin department of Emergency medicine Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand department of Family medicine Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand Center for Clinical Epidemiology and Clinical Statistics Faculty of MedicineChiang Mai UniversityChiang Mai 50200Thailand department of Emergency medicine University of California Davis School of MedicineSacramento 95817USA

Cardiac arrest poses a significant global public health challenge,manifesting in approximately 550,000 cases annually within the United States.[1]In-hospital cardiac arrest(IHCA)is commonly attributed to airways and respiratory issues.[2]Recommendations emphasize the expertise of responders in airway management.[3]Various options exist,such as chest compression-only cardiopulmonary resuscitation(CPR),bag-mask ventilation(BMV),and advanced *** BMV and advanced airways are not deemed equivalent or superior based on previous evidence.[4]Achieving consistency in choosing and timing the optimal airway approach during IHCA is *** current American Heart Association guidelines suggest an advanced airway strategy when endotracheal intubation(ETI)success rates are high,but the optimal time for advanced airway management remains unclear.[5]Wong et al[6]revealed that survival improved by less than 5 min with advanced airway *** to a subgroup analysis of IHCA patients in emergency departments(EDs),early intubation was associated with a 1.5-fold greater rate of return of spontaneous circulation(ROSC)than in other locations.[7]ED patients’constant monitoring and immediate management,with readily available intubation equipment,enhance early intubation and survival rates.[6]Nonetheless,IHCA patients intubated within the first 15 min had a lower ROSC rate.

关键词： intubation return annually

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Beware of the serious harm of veterinary drug poisoning:a case report

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World Journal of Emergency medicine 2024年第2期15卷 153-155页

作者： Ping Dai Jin Sun Tongyue Zhang Zhiqiang Zhou Zixi Wen Tianzi Jian Aerbusili Genjiafu Baotian Kan Xiangdong Jian department of Poisoning and occupational Diseases Emergency MedicineQilu HospitalCheeloo College of MedicineShandong UniversityJinan 250012China Emergency department Affiliated the Jianhu Clinical Medical College of Yangzhou UniversityYancheng 224700China department of occupational and Environmental Health School of Public HealthCheeloo College of MedicineShandong UniversityJinan 250012China School of Nursing and Rehabilitation Cheeloo College of MedicineShandong UniversityNursing Theory&Practice Innovation Research Center of Shandong UniversityJinan 250012China department of Geriatric medicine Qilu HospitalNursing Theory Innovation and Research Center of Shandong UniversityCheeloo College of MedicineShandong UniversityJinan 250012China

Veterinary drugs are substances(including pharmaceutical feed additives)used to prevent,treat,and diagnose diseases or regulate the physiological functions of *** drug poisoning in humans is relatively rare both in China and the rest of the ***,we report a case of death from veterinary drug poisoning from ***-closantel is a broad-spectrum antiparasitic drug,which has high efficacy against a variety of trematodes and nematodes.

关键词： drug drugs diseases

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Emergency department management of acute agitation in the reproductive age female and pregnancy

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World Journal of Emergency medicine 2024年第2期15卷 83-90页

作者： Ariella Gartenberg Kayla Levine Alexander Petrie department of Emergency medicine Jacobi Medical Center and Montefiore Medical CenterNY 10461USA department of Psychiatry and Behavioral Sciences Albert Einstein College of Medicine and Montefiore Medical CenterNY 10461USA department of Emergency medicine Jacobi Medical Center and North Central Bronx HospitalNY 10461USA

BACKGROUND:Agitation is a common presentation within emergent departments(EDs).Agitation during pregnancy should be treated as an obstetric emergency,as the distress may jeopardize both the patient and *** safety of psychotropic medications in the reproductive age female has not been well *** review aimed to explore a summary of general agitation recommendations with an emphasis on ED management of agitation during ***:A literature review was conducted to explore the pathophysiology of acute agitation and devise a preferred treatment plan for ED management of acute agitation in the reproductive age or pregnant ***:While nonpharmacological management is preferred,ED visits for agitation often require medical *** should be selected based on the etiology of agitation and the clinical setting to avoid major adverse *** effects are common in pregnant *** mild to moderate agitation in pregnancy,diphenhydramine is an effective sedating agent with minimal adverse *** moderate to severe agitation,high-potency typical psychotropics are preferred due to their neutral effects on *** has become the most frequently utilized psychotropic for agitation during *** generation psychotropics are often utilized as second-line therapy,including *** and ketamine have demonstrated adverse fetal ***:While randomized control studies cannot be ethically conducted on pregnant patients requiring sedation,animal models and epidemiologic studies have demonstrated the effects of psychotropic medication exposure in *** the fetal risk associated with multiple doses of psychotropic medications remains unknown,weighing the risks and benefits of each agent,while utilizing the lowest effective dose remains critical in the treatment of acute agitation within the EDs.

关键词： Agitation Pregnancy Haloperidol Ketamine Benzodiazepines

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Comparing 11 early warning scores and three shock indices in early sepsis prediction in the emergency department

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World Journal of Emergency medicine 2024年第4期15卷 273-282页

作者： Rex Pui Kin Lam Zonglin Dai Eric Ho Yin Lau Carrie Yuen Ting Ip Ho Ching Chan Lingyun Zhao Tat ChiTsang Matthew Sik Hon Tsui Timothy Hudson Rainer department of Emergency medicine School of Clinical MedicineLi Ka Shing Faculty of Medicinethe University of Hong KongHong KongChina School of Public Health Li Ka Shing Faculty of Medicinethe University of Hong KongHong KongChina Accident and Emergency department Queen Mary HospitalHong KongChina

BACKGROUND:This study aimed to evaluate the discriminatory performance of 11 vital sign-based early warning scores(EWSs)and three shock indices in early sepsis prediction in the emergency department(ED).METHODS:We performed a retrospective study on consecutive adult patients with an infection over 3 months in a public ED in Hong *** primary outcome was sepsis(Sepsis-3 definition)within 48 h of ED *** c-statistics and the DeLong test,we compared 11 EWSs,including the National Early Warning Score 2(NEWS2),Modified Early Warning Score,and Worthing Physiological Scoring System(WPS),etc.,and three shock indices(the shock index[SI],modified shock index[MSI],and diastolic shock index[DSI]),with Systemic Inflammatory Response Syndrome(SIRS)and quick Sequential Organ Failure Assessment(qSOFA)in predicting the primary outcome,intensive care unit admission,and mortality at different time ***:We analyzed 601 patients,of whom 166(27.6%)developed ***2 had the highest point estimate(area under the receiver operating characteristic curve[AUROC]0.75,95%CI 0.70-0.79)and was significantly better than SIRS,qSOFA,other EWSs and shock indices,except WPS,at predicting the primary ***,the pooled sensitivity and specificity of NEWS2≥5 for the prediction of sepsis were 0.45(95%CI 0.37-0.52)and 0.88(95%CI 0.85-0.91),*** discriminatory performance of all EWSs and shock indices declined when used to predict mortality at a more remote time ***:NEWS2 compared favorably with other EWSs and shock indices in early sepsis prediction but its low sensitivity at the usual cut-off point requires further modification for sepsis screening.

关键词： Sepsis Emergency department Clinical prediction rule Early warning score Shock index

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Prognostic Nutritional Index Associates with the Severity of Silicosis:A Study from a Tertiary Class A Prevention and Treatment Institute for occupational Diseases in China

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Biomedical and Environmental Sciences 2024年第1期37卷 122-126页

作者： HE La Gu LIANG Yun Lai YANG Lu Qi YUAN Hua Min Medical laboratory department Hunan Prevention and Treatment Institute for Occupational DiseasesChangsha 410000HunanChina Laboratory medicine department Xiangya HospitalCentral South UniversityChangsha 410013HunanChina

Pneumoconiosis is a group of heterogeneous fibrotic lung diseases caused by inorganic mineral dust and includes coal workers’pneumoconiosis and *** involves diffuse or nodular interstitial pulmonary fibrosis caused by exposure to asbestos or silica *** is thought to have the highest number of silicosis cases,with 6,000 new cases reported annually^([1]).Currently,the clinical diagnosis and monitoring of silicosis relies mainly on a history of occupational exposure and radiological abnormalities^([2]).Therefore,determining further indicators is crucial to reflect the severity of silicosis.

关键词： diagnosis lung diseases

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Low skeletal muscle mass and high visceral adiposity are associated with recurrence of acute cholecystitis after conservative management:A propensity score-matched cohort study

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Hepatobiliary & Pancreatic Diseases International 2024年第1期23卷 64-70页

作者： Yudai Koya Michihiko Shibata Yuki Maruno Yoshitaka Sakamoto Shinji Oe Koichiro Miyagawa Yuichi Honma Masaru Harada department of Gastroenterology Kyushu Rosai HospitalMoji Medical Center3-1 HigashiminatomachiMoji-kuKitakyushu 801-8502Japan Third department of Internal medicine School of MedicineUniversity of Occupational and Environmental HealthKitakyushu 807-8555Japan department of Surgery Kyushu Rosai Hospital Moji Medical CenterKitakyushu 801-8502Japan

Background:Recurrent acute cholecystitis(RAC)can occur after non-surgical treatment for acute cholecystitis(AC),and can be more severe in comparison to the first episode of *** skeletal muscle mass or adiposity have various effects in several *** aimed to clarify the relationship between RAC and body ***:Patients with AC who were treated at our hospital between January 2011 and March 2022 were *** psoas muscle mass and adipose tissue area at the third lumbar level were measured using computed tomography at the first episode of *** areas were divided by height to obtain the psoas muscle mass index(PMI)and subcutaneous/visceral adipose tissue index(SATI/VATI).According to median VATI,SATI and PMI values by sex,patients were divided into the high and low PMI *** performed propensity score matching to eliminate the baseline differences between the high PMI and low PMI groups and analyzed the cumulative incidence and predictors of ***:The entire cohort was divided into the high PMI(n=81)and low PMI(n=80)*** the propensity score-matched cohort there were 57 patients in each *** Kaplan-Meier analysis,the low PMI group and the high VATI group had a significantly higher cumulative incidence of RAC than their counterparts(log-rank P=0.001 and 0.015,respectively).In a multivariate Cox regression analysis,the hazard ratios of low PMI and low VATI for RAC were 5.250(95%confidence interval 1.083-25.450,P=0.039)and 0.158(95%confidence interval:0.026-0.937,P=0.042),***:Low skeletal muscle mass and high visceral adiposity were independent risk factors for RAC.

关键词： Acute cholecystitis Low skeletal muscle mass Recurrent acute cholecystitis Sarcopenia Visceral adiposity

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Outcome of Nurses with occupational Dermatitis

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Open Journal of Nursing 2024年第6期14卷 239-251页

作者： Amira Omrane Chayma Harrathi Asma Kheder Maher Maoua Malek Ben Abdelkader Taoufik Khalfallah Najib Mrizak Mohamed Akrout Mohamed Adnene Henchi Hichem Bel Hadj Ali department of occupational medicine and Ergonomics Taher Sfar Teaching Hospital Mahdia Tunisia department of occupational medicine Houcine Bouzaiene Teaching Hospital Gafsa Tunisia department of occupational medicine Farhat Hached Teaching Hospital Sousse Tunisia department of occupational medicine and Ergonomics Fattouma Bourguiba Teaching Hospital Monastir Tunisia department of Dermatology Fattouma Bourguiba Teaching Hospital Monastir Tunisia

Background: occupational dermatitis is considered as the second most common occupational disease. It accounts for 25% of all lost workdays. Several international studies reported a prevalence of occupational dermatitis in healthcare workers between 17% and 55%. This study aims to identify factors that affect the professional outcome of nurses suffering from occupational dermatitis. Methods: This was a multicenter cross-sectional study concerning nurses declared having occupational dermatitis in the central region of Tunisia. A synoptic sheet related to socio-professional and administrative data was completed. A self-administered Questionnaire going over medical and occupational characteristics was completed during a direct interview. Results: The study involved forty nurses working in four public hospitals in the center of Tunisia. Only 37 workers were included in the study. A professional reclassification was introduced among 19 workers (51% of study population). Work-station adaptation was requested in 14 cases (38%). Exposure to allergens in the workplace was eliminated in 20 cases. Two study participants were transferred to other departments (5.4%) and three people retired (8.1%). A statistically significant association was found between professional reclassification and a history of allergic manifestations (p = 0.003). Similarly, a significant association was found between professional reclassification and the allergic agent (p = 0.014). Workstation layout was significantly associated with a history of allergic manifestations (p = 0.039), the palm hand location (p = 0.04), professional eviction (p Conclusion: This study identified the main factors influencing the occupational outcome of nurses suffering from occupational dermatitis. This outcome depended on a history of atopy (especially allergic rhinitis) and sensitization to allergens (thiuram mix).

关键词： Nursing occupational Dermatitis Hospital

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