Pub Date : 2026-01-22DOI: 10.1016/j.annemergmed.2025.12.004
Michael J Lynch,Anthony F Pizon,Donald M Yealy
The US illicit drug supply continues to evolve with increasingly dangerous adulterants, with medetomidine a new agent seen in acute care and other practice settings. We reviewed available literature on illicit drug adulterants, medetomidine intoxication, and sequelae. Although little is known about withdrawal and the clinical manifestations are stark, we reviewed the best available literature on dexmedetomidine withdrawal and suggest approaches for treatment.
{"title":"Emergence of Medetomidine in the Illicit Drug Supply: Implications for Emergency Care and Withdrawal Management.","authors":"Michael J Lynch,Anthony F Pizon,Donald M Yealy","doi":"10.1016/j.annemergmed.2025.12.004","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.004","url":null,"abstract":"The US illicit drug supply continues to evolve with increasingly dangerous adulterants, with medetomidine a new agent seen in acute care and other practice settings. We reviewed available literature on illicit drug adulterants, medetomidine intoxication, and sequelae. Although little is known about withdrawal and the clinical manifestations are stark, we reviewed the best available literature on dexmedetomidine withdrawal and suggest approaches for treatment.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"66 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1016/j.annemergmed.2025.12.010
Shivam Dave,Israel Green-Hopkins,Naomi S Bardach,Jacqueline Grupp-Phelan,Daniel J Shapiro
STUDY OBJECTIVESTo detail variation in the number of doses of dexamethasone used to treat children with asthma exacerbations discharged from the emergency department (ED) and to assess whether treatment with 1 dose versus 2 doses was associated with different clinical outcomes. We hypothesized that clinical outcomes would not differ between groups.METHODSWe conducted a retrospective cohort study of children aged 2 to 20 years discharged from either of 2 EDs after treatment with dexamethasone for an asthma exacerbation. The primary outcome was an ED revisit, and the secondary outcome was a hospitalization, each measured within 14 days. The primary exposure was prescription of a second dose of dexamethasone at discharge. Propensity score adjustment with inverse probability of treatment weighting was used to mitigate confounding.RESULTSAmong 2,063 children included, 1,277 (61.9%) were prescribed a second dose of dexamethasone. In the propensity score-weighted cohort, the risk of an ED revisit was 5.2% for children who received 1 dose and 5.7% for children who received 2 doses (risk difference, 0.45%, 95% confidence interval [CI]: -1.4% to 2.3%). The risk of hospitalization was 0.85% in the 1-dose group and 0.83% in the 2-dose group (risk difference 0.02%, 95% CI: -0.93% to 0.89%).CONCLUSIONNearly two-thirds of children with asthma exacerbations were treated with 2 doses of dexamethasone rather than a single dose, even though treatment with 2 doses was not associated with improved outcomes. These results suggest that 1 dose of dexamethasone may be sufficient to treat many children with asthma exacerbations discharged from the ED.
{"title":"Dexamethasone Treatment Regimen and Clinical Outcomes in Children With Asthma Exacerbations.","authors":"Shivam Dave,Israel Green-Hopkins,Naomi S Bardach,Jacqueline Grupp-Phelan,Daniel J Shapiro","doi":"10.1016/j.annemergmed.2025.12.010","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.010","url":null,"abstract":"STUDY OBJECTIVESTo detail variation in the number of doses of dexamethasone used to treat children with asthma exacerbations discharged from the emergency department (ED) and to assess whether treatment with 1 dose versus 2 doses was associated with different clinical outcomes. We hypothesized that clinical outcomes would not differ between groups.METHODSWe conducted a retrospective cohort study of children aged 2 to 20 years discharged from either of 2 EDs after treatment with dexamethasone for an asthma exacerbation. The primary outcome was an ED revisit, and the secondary outcome was a hospitalization, each measured within 14 days. The primary exposure was prescription of a second dose of dexamethasone at discharge. Propensity score adjustment with inverse probability of treatment weighting was used to mitigate confounding.RESULTSAmong 2,063 children included, 1,277 (61.9%) were prescribed a second dose of dexamethasone. In the propensity score-weighted cohort, the risk of an ED revisit was 5.2% for children who received 1 dose and 5.7% for children who received 2 doses (risk difference, 0.45%, 95% confidence interval [CI]: -1.4% to 2.3%). The risk of hospitalization was 0.85% in the 1-dose group and 0.83% in the 2-dose group (risk difference 0.02%, 95% CI: -0.93% to 0.89%).CONCLUSIONNearly two-thirds of children with asthma exacerbations were treated with 2 doses of dexamethasone rather than a single dose, even though treatment with 2 doses was not associated with improved outcomes. These results suggest that 1 dose of dexamethasone may be sufficient to treat many children with asthma exacerbations discharged from the ED.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"58 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1016/j.annemergmed.2025.12.020
Thomas H Chun,Peter C Minneci
{"title":"Nonoperative Management of Uncomplicated Appendicitis: The Elephant in the (Emergency) Room?","authors":"Thomas H Chun,Peter C Minneci","doi":"10.1016/j.annemergmed.2025.12.020","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.020","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"30 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-22DOI: 10.1016/j.annemergmed.2025.12.005
Linda Papa
{"title":"Can We Pioneer a Traumatic Brain Injury Blood Test in Trauma Patients Being Considered for Computed Tomography Scanning of the Head?","authors":"Linda Papa","doi":"10.1016/j.annemergmed.2025.12.005","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.005","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"48 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146021607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1016/j.annemergmed.2025.12.009
Lauren K Law,Akash Manes,Nilita Sood,Javed Siddiqi,Starr Knight,Faisal Khosa
{"title":"Trends in Sex, Race, and Ethnicity in Academic Emergency Medicine From 1978 to 2024 in the United States.","authors":"Lauren K Law,Akash Manes,Nilita Sood,Javed Siddiqi,Starr Knight,Faisal Khosa","doi":"10.1016/j.annemergmed.2025.12.009","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.12.009","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"31 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146005330","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1016/j.annemergmed.2025.08.009
Kangrui Fu MD, Binglin Song MD, Yuan Luo MD, Chun Liu MSc
{"title":"Troponin Testing in the Emergency Department","authors":"Kangrui Fu MD, Binglin Song MD, Yuan Luo MD, Chun Liu MSc","doi":"10.1016/j.annemergmed.2025.08.009","DOIUrl":"10.1016/j.annemergmed.2025.08.009","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 278-279"},"PeriodicalIF":5.0,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-20DOI: 10.1016/j.annemergmed.2025.08.025
Steve Goodacre PhD, FRCEM, Matthew J. Reed MD, FRCEM
{"title":"Using the Aortic Dissection Detection Risk Score and D-dimer in Patients With Suspected Acute Aortic Syndrome","authors":"Steve Goodacre PhD, FRCEM, Matthew J. Reed MD, FRCEM","doi":"10.1016/j.annemergmed.2025.08.025","DOIUrl":"10.1016/j.annemergmed.2025.08.025","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"87 2","pages":"Pages 287-288"},"PeriodicalIF":5.0,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145996212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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