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Response to comment on "An unusual cause of giant T waves". 对 "巨 T 波的不寻常原因 "评论的回应
IF 2.7 3区 医学 Q1 EMERGENCY MEDICINE Pub Date : 2024-08-06 DOI: 10.1016/j.ajem.2024.08.006
Laszlo Littmann
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引用次数: 0
Lactate-to-albumin ratio in predicting neurological outcomes in patients who have survived cardiac arrest. 预测心脏骤停患者神经系统预后的乳酸白蛋白比值。
IF 2.7 3区 医学 Q1 EMERGENCY MEDICINE Pub Date : 2024-08-05 DOI: 10.1016/j.ajem.2024.08.002
Lukasz Szarpak, Krzysztof Kurek, Monika Tomaszewska, Michal Pruc
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引用次数: 0
Info for authors 作者信息
IF 2.7 3区 医学 Q1 EMERGENCY MEDICINE Pub Date : 2024-08-05 DOI: 10.1016/S0735-6757(24)00355-3
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引用次数: 0
Predicting severe outcomes in pediatric trauma patients: Shock index pediatric age-adjusted. 预测小儿创伤患者的严重后果:根据年龄调整的儿科休克指数。
IF 2.7 3区 医学 Q1 EMERGENCY MEDICINE Pub Date : 2024-08-05 DOI: 10.1016/j.ajem.2024.08.008
Chien-Chieh Hsieh, Fu-Shan Jaw, Ching-Tang Hsu, Chien-Chieh Hsieh, Hung-Wei Chen
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引用次数: 0
Comment on "An unusual cause of giant T waves". 就 "巨 T 波的不寻常原因 "发表评论
IF 2.7 3区 医学 Q1 EMERGENCY MEDICINE Pub Date : 2024-08-05 DOI: 10.1016/j.ajem.2024.08.005
Selim Degirmenci, Hasan Kara
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引用次数: 0
Missing the mark: The importance of depth for measuring optic nerve sheath diameter with point-of-care ultrasound 失之毫厘,差之千里:使用床旁超声波测量视神经鞘直径时深度的重要性。
IF 2.7 3区 医学 Q1 EMERGENCY MEDICINE Pub Date : 2024-08-05 DOI: 10.1016/j.ajem.2024.07.057
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引用次数: 0
Depth, diameter, and the sub millimetric distinctions 深度、直径和毫米以下的区别。
IF 2.7 3区 医学 Q1 EMERGENCY MEDICINE Pub Date : 2024-08-05 DOI: 10.1016/j.ajem.2024.08.003
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引用次数: 0
TOC 技术选择委员会
IF 2.7 3区 医学 Q1 EMERGENCY MEDICINE Pub Date : 2024-08-05 DOI: 10.1016/S0735-6757(24)00354-1
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引用次数: 0
Droperidol administration among emergency department patients with abdominal pain, nausea, and vomiting 急诊科腹痛、恶心和呕吐患者的屈哌醇用药情况
IF 2.7 3区 医学 Q1 EMERGENCY MEDICINE Pub Date : 2024-08-05 DOI: 10.1016/j.ajem.2024.07.060

Study objective

The primary objective of this study was to examine the common usage patterns of droperidol in the relatively unrestricted environment of an urban, academic medical center. We focused specifically on the most common use of droperidol in our department: patients with a chief complaint of abdominal pain, nausea, and/or vomiting.

Methods

For this retrospective, observational, single-center study, we extracted records of all administrations of droperidol from August 2019 to August 2020. Patients with a chief complaint of abdominal pain, nausea, or vomiting, or any combination thereof, were included in data analysis.

Results

Between April 2019 to August 2020, 830 discrete patient visits involving droperidol administration were identified, comprising 706 patients. The average age was 39 years old with a range of 15 to 80. Seven patients (0.08%) were younger than 18, and 35 (4%) were older than 65. Five hundred sixty-five patients (68%) were female. Droperidol doses ranged from 0.625 mg to 5 mg intravenous (IV), with a median dose of 0.625 mg (interquartile range 0.625–1.25 mg), with 590 patients (71%) receiving a dose of 0.625 mg. Only 19 patients (2.3%) had a documented adverse event. Seven had akathisia or restlessness, 7 had anxiety or agitation, 3 had dystonia or stiffness, 1 had fatigue, and 1 had dizziness. For the entire cohort, there were no cardiac dysrhythmias, syncope, seizures, other major adverse events, or fatalities recorded.

Conclusion

At one institution, droperidol is being used commonly for the chief complaints of abdominal pain, nausea, and/or vomiting. The preferred dosing is nearly universally below the 2.5 mg IV dose for which the FDA warning applies. Similar to previous studies, identification of adverse events was rare, and no major adverse outcomes such as dysrhythmia or death were identified.

研究目的本研究的主要目的是在城市学术医疗中心相对不受限制的环境中研究屈培多的常见使用模式。我们特别关注了我们科室最常见的屈培多使用情况:主诉为腹痛、恶心和/或呕吐的患者。方法在这项回顾性、观察性、单中心研究中,我们提取了 2019 年 8 月至 2020 年 8 月期间屈培多的所有用药记录。结果在 2019 年 4 月至 2020 年 8 月期间,共确定了 830 次涉及屈培利多用药的不连续患者就诊,其中包括 706 名患者。平均年龄为 39 岁,年龄范围为 15 至 80 岁。7名患者(0.08%)小于18岁,35名患者(4%)大于65岁。565名患者(68%)为女性。屈培利多的剂量从 0.625 毫克到 5 毫克不等,中位剂量为 0.625 毫克(四分位间范围为 0.625-1.25 毫克),其中 590 名患者(71%)的剂量为 0.625 毫克。只有 19 名患者(2.3%)发生了有记录的不良事件。其中 7 人出现了运动障碍或烦躁不安,7 人出现了焦虑或激动,3 人出现了肌张力障碍或僵硬,1 人出现了疲劳,1 人出现了头晕。结论在一家机构中,屈培利多常用于主诉腹痛、恶心和/或呕吐的患者。首选剂量几乎普遍低于 2.5 毫克静脉注射剂量,美国食品及药物管理局对此发出了警告。与之前的研究类似,不良事件的发现很少,也未发现心律失常或死亡等重大不良后果。
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引用次数: 0
A novel imaging biomarker for prediction of cerebrovascular ischemic events: Pericarotid fat density 预测脑血管缺血事件的新型成像生物标志物:颈动脉周围脂肪密度
IF 2.7 3区 医学 Q1 EMERGENCY MEDICINE Pub Date : 2024-08-05 DOI: 10.1016/j.ajem.2024.08.004

Background

To investigate the relationship between pericarotid fat density measured in carotid CTA and vulnerable carotid plaque.

Methods

This retrospective study included 374 participants who underwent carotid CTA between June 1, 2021, and December 1, 2021 (234 males, median age 68 years [interquartile range: 61–75]). Two groups, symptomatic and asymptomatic, were defined based on either diffusion-weighted MRI or a clinical history of acute ischemia or TIA within 6 months before or after CTA. The relationship between pericarotid fat density and cerebrovascular ischemic events was assessed using receiver operating characteristic analysis and binary logistic regression analysis.

Results

In the symptomatic group (n = 135), mean pericarotid fat density (−63.3 ± 21.7 vs. -81.7 ± 16.9 HU, respectively; p < 0.001) and median maximum plaque thickness (4 [interquartile range: 3–6] vs. 3.7 [interquartile range: 2.6–4.7] mm, respectively; p = 0.002) were higher, while plaque density (42.1 ± 19.6 vs. 50.6 ± 20.4 HU, respectively; p = 0.001) was lower compared to the asymptomatic group. Pericarotid fat density (OR: 1.038, 95% CI: 1.023–1.053, p < 0.001) was identified as an independent predictor for symptomatic patients. The optimal cut-off value for pericarotid fat density predicting symptomatic patients was estimated as −74 HU (area under the curve: 0.753, 95% CI:0.699–0.808, p < 0.001). Inter-reader agreement for pericarotid fat density was found to be almost perfect (intraclass correlation coefficient: 0.818, 95% CI: 0.770–0.856, p < 0.001).

Conclusion

Pericarotid fat density may serve as an imaging biomarker in predicting acute cerebrovascular ischemic events.

背景:研究颈动脉CTA测量的颈动脉周围脂肪密度与易损颈动脉斑块的关系:研究颈动脉CTA测量的颈动脉周围脂肪密度与易损颈动脉斑块之间的关系:这项回顾性研究纳入了 2021 年 6 月 1 日至 2021 年 12 月 1 日期间接受颈动脉 CTA 检查的 374 名参与者(234 名男性,中位年龄 68 岁[四分位间范围:61-75])。根据弥散加权磁共振成像或 CTA 前后 6 个月内急性缺血或 TIA 的临床病史定义了无症状和无症状两组。采用接收器操作特征分析和二元逻辑回归分析评估了颈动脉周围脂肪密度与脑血管缺血事件之间的关系:结果:在无症状组(n = 135)中,平均颈动脉周围脂肪密度(分别为-63.3 ± 21.7 vs. -81.7 ± 16.9 HU; p 结论:颈动脉周围脂肪密度可能与脑血管缺血性事件有关:颈动脉周围脂肪密度可作为预测急性脑血管缺血事件的影像生物标志物。
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引用次数: 0
期刊
American Journal of Emergency Medicine
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