Pub Date : 2025-12-09DOI: 10.1016/j.annemergmed.2025.10.009
Aria C Shi,Thomas Taylor,Chuan-Chin Huang,Aneesh B Singhal,Joshua N Goldstein,Matthew B Bevers,Peter C Hou
STUDY OBJECTIVEBlood pressure (BP) control is thought to be critical in acute intracerebral hemorrhage management. Here, we investigated whether reducing systolic BP ≤150 mm Hg within 2 hours of emergency department (ED) arrival is associated with improved outcomes and assessed the effect of excessive BP lowering ("overshooting") on functional recovery.METHODSWe conducted a retrospective cohort study of adult patients with spontaneous intracerebral hemorrhage (ICH) who presented to 2 academic medical centers between 2017 and 2023. We assessed the associations between blood pressure (BP) indicators, including BP control (≤150 mm Hg within 2 hours) and overshooting (<120 mm Hg), and the modified Rankin scale (mRS) score at discharge, dichotomized as a good (0 to 3) or poor (4 to 6) outcome, using logistic regression adjusted for ICH score, time from last seen well, and arrival BP.RESULTSAmong 420 included patients, 323 (76.9%) had arrival BP>150 mm Hg. Of these, 62.8% received antihypertensive medications within 1 hour of ED arrival, and 71.2% achieved goal BP within 2 hours. Achieving goal BP within 2 hours of ED arrival was associated with worse outcomes (OR 2.32, 95% CI 1.17 to 4.57). Overshooting within 6 hours was associated with worse outcomes (OR 2.55, 95% CI 1.27 to 5.13). Antihypertensive medication type (bolus versus infusion) did not influence overshooting risk.CONCLUSIONSAlthough successful early BP reduction is common in ICH care, excessive lowering is also common and is associated with worse functional outcome. Caution is warranted to avoid overshooting during acute BP management.
研究目的：血压（BP）控制被认为是急性脑出血治疗的关键。在这里，我们研究了在急诊科（ED）到达2小时内降低收缩压≤150 mm Hg是否与改善预后有关，并评估了过度降低血压（“过调”）对功能恢复的影响。方法对2017年至2023年在2个学术医疗中心就诊的自发性脑出血（ICH）成年患者进行回顾性队列研究。我们评估了血压（BP）指标之间的关系，包括血压控制（2小时内≤150毫米汞柱）和超调（150毫米汞柱）。其中，62.8%的患者在ED到达1小时内接受降压药物治疗，71.2%的患者在2小时内达到目标血压。在ED到达2小时内达到目标血压与较差的结果相关（OR 2.32, 95% CI 1.17至4.57）。6小时内的超调与较差的结果相关（OR 2.55, 95% CI 1.27至5.13）。抗高血压药物类型（丸剂与输注）不影响超调风险。结论：早期降压成功在脑出血治疗中很常见，但过度降压也很常见，并与较差的功能预后相关。在急性血压管理期间，必须谨慎避免过调。
{"title":"Early Intensive Blood Pressure Reduction After Intracerebral Hemorrhage Is Associated With Worse Functional Outcome: The Risk of Overshooting Blood Pressure Goals.","authors":"Aria C Shi,Thomas Taylor,Chuan-Chin Huang,Aneesh B Singhal,Joshua N Goldstein,Matthew B Bevers,Peter C Hou","doi":"10.1016/j.annemergmed.2025.10.009","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.10.009","url":null,"abstract":"STUDY OBJECTIVEBlood pressure (BP) control is thought to be critical in acute intracerebral hemorrhage management. Here, we investigated whether reducing systolic BP ≤150 mm Hg within 2 hours of emergency department (ED) arrival is associated with improved outcomes and assessed the effect of excessive BP lowering (\"overshooting\") on functional recovery.METHODSWe conducted a retrospective cohort study of adult patients with spontaneous intracerebral hemorrhage (ICH) who presented to 2 academic medical centers between 2017 and 2023. We assessed the associations between blood pressure (BP) indicators, including BP control (≤150 mm Hg within 2 hours) and overshooting (<120 mm Hg), and the modified Rankin scale (mRS) score at discharge, dichotomized as a good (0 to 3) or poor (4 to 6) outcome, using logistic regression adjusted for ICH score, time from last seen well, and arrival BP.RESULTSAmong 420 included patients, 323 (76.9%) had arrival BP>150 mm Hg. Of these, 62.8% received antihypertensive medications within 1 hour of ED arrival, and 71.2% achieved goal BP within 2 hours. Achieving goal BP within 2 hours of ED arrival was associated with worse outcomes (OR 2.32, 95% CI 1.17 to 4.57). Overshooting within 6 hours was associated with worse outcomes (OR 2.55, 95% CI 1.27 to 5.13). Antihypertensive medication type (bolus versus infusion) did not influence overshooting risk.CONCLUSIONSAlthough successful early BP reduction is common in ICH care, excessive lowering is also common and is associated with worse functional outcome. Caution is warranted to avoid overshooting during acute BP management.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"212 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710997","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 : 2025-12-09DOI: 10.1016/j.annemergmed.2025.10.012
Kathryn F Hawk,Arjun K Venkatesh,Craig Rothenberg,Dhruv Sharma,Pawan Goyal,Zhuohui Lin,Cindy Mendez-Hernandez,Prateek Sharma,Megan Sambell,Scott G Weiner
STUDY OBJECTIVEWe sought to characterize changes in the proportion of key capabilities related to the emergency care of patients with opioid use disorder among emergency departments (EDs) participating in all years of the 2020 to 2024 the American College of Emergency Physicians Emergency Quality Network Opioid Initiative.METHODSAt the beginning of each annual quality improvement collaborative, EDs completed an online survey regarding capabilities on services for patients presenting to their ED with opioid use disorder or opioid overdose, including provision of outpatient naloxone after overdose, presence of a clinician who prescribes buprenorphine in the ED, an adopted protocol for buprenorphine initiation, and use of clinical support tools to guide opioid use disorder treatment.RESULTSA total of 174 unique EDs participated in all E-QUAL opioid collaboratives from 2020 to 2024. More than half of participating EDs were rural and saw less than 20,000 visits per year. EDs reported an increase in the naloxone provision to patients presenting after opioid overdose from 39.1% (68/174) in 2020 to 89.7% (156/174) in 2024. The number of EDs reporting a clinician who prescribes buprenorphine in their ED also increased (16.7% [29/174] in 2022 to 52.87% [92/174] in 2024). Protocols for ED-initiated buprenorphine and use of clinical support tools to guide the treatment of opioid use disorder remained similar (4.0% [7/174] to 5.8% [10/174] and 46.0% [80/174] to 48.9% [85/174]).CONCLUSIONSThese trends demonstrate increasing acceptance and incorporation of naloxone provision after opioid overdose and ED clinicians who prescribe buprenorphine among a group of mostly rural, small community EDs participating in a quality improvement-based learning collaborative.
{"title":"Capabilities Among Emergency Departments Participating in a Nationwide Quality Improvement Learning Collaborative to Care for Patients With Opioid Use Disorder: 2020 to 2024.","authors":"Kathryn F Hawk,Arjun K Venkatesh,Craig Rothenberg,Dhruv Sharma,Pawan Goyal,Zhuohui Lin,Cindy Mendez-Hernandez,Prateek Sharma,Megan Sambell,Scott G Weiner","doi":"10.1016/j.annemergmed.2025.10.012","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.10.012","url":null,"abstract":"STUDY OBJECTIVEWe sought to characterize changes in the proportion of key capabilities related to the emergency care of patients with opioid use disorder among emergency departments (EDs) participating in all years of the 2020 to 2024 the American College of Emergency Physicians Emergency Quality Network Opioid Initiative.METHODSAt the beginning of each annual quality improvement collaborative, EDs completed an online survey regarding capabilities on services for patients presenting to their ED with opioid use disorder or opioid overdose, including provision of outpatient naloxone after overdose, presence of a clinician who prescribes buprenorphine in the ED, an adopted protocol for buprenorphine initiation, and use of clinical support tools to guide opioid use disorder treatment.RESULTSA total of 174 unique EDs participated in all E-QUAL opioid collaboratives from 2020 to 2024. More than half of participating EDs were rural and saw less than 20,000 visits per year. EDs reported an increase in the naloxone provision to patients presenting after opioid overdose from 39.1% (68/174) in 2020 to 89.7% (156/174) in 2024. The number of EDs reporting a clinician who prescribes buprenorphine in their ED also increased (16.7% [29/174] in 2022 to 52.87% [92/174] in 2024). Protocols for ED-initiated buprenorphine and use of clinical support tools to guide the treatment of opioid use disorder remained similar (4.0% [7/174] to 5.8% [10/174] and 46.0% [80/174] to 48.9% [85/174]).CONCLUSIONSThese trends demonstrate increasing acceptance and incorporation of naloxone provision after opioid overdose and ED clinicians who prescribe buprenorphine among a group of mostly rural, small community EDs participating in a quality improvement-based learning collaborative.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"364 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145711015","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}
STUDY OBJECTIVEDiagnosis of deep neck space infections is challenging in children due to subtle symptoms and examination findings. However, delays in diagnosis can contribute to increased morbidity in pediatric deep neck space infection. We aimed to determine (1) the most frequent discharge diagnoses associated with emergency department (ED) visits in the 10 days before deep neck space infection diagnosis and (2) use cohorts of pediatric ED visits with these frequent diagnoses to determine factors associated with return admission with deep neck space infection.METHODSCross-sectional analysis of ED and inpatient visits for ages less than 18 years from the State Emergency Department and State Inpatient Datasets from 2018-2019. We linked deep neck space infection admissions (identified by primary International Classification of Diseases, Tenth Revision diagnosis J390) to 10-day antecedent ED visits and identified the most frequent discharge diagnoses in these visits. We then analyzed cohorts of ED encounters with these frequent discharge diagnoses: 1) localized neck symptoms (pain, mass, or torticollis), and 2) pharyngitis or tonsillitis; and compared patient and hospital characteristics of visits with and without a subsequent 10-day admission for deep neck space infection using descriptive statistics. Firth logistic regression was used to assess patient and hospital predictors of a deep neck space infection revisit.RESULTSAmong 799 pediatric deep neck space infection admissions included in the study, 146 (18.3%) patients had more than or equal to 1 treat-and-release ED visits in the 10-day window before deep neck space infection admission. In the cohorts of ED treat-and-release visits for pharyngitis/tonsillitis (n=419,660) and localized neck symptoms (n=54,779), 10-day return visits for deep neck space infection were rare, representing 0.01% and 0.07% of visits, respectively. ED visits with neck imaging were associated with deep neck space infection revisit for both cohorts. Predictors of deep neck space infection in the localized neck symptoms cohort also included younger age and an ED diagnosis of fever, whereas in the pharyngitis cohort, deep neck space infection revisit was associated with ED diagnosis of localized neck symptoms, and negatively associated with a diagnosis of upper respiratory infection or respiratory symptoms.CONCLUSIONSIn ED encounters where patients were discharged with neck pain/mass or torticollis, younger age and a diagnosis of fever were associated with a subsequent deep neck space infection admission. Among ED patients discharged with pharyngitis/tonsillitis, absence of upper respiratory infection/respiratory diagnosis, and neck pain/mass/or torticollis were associated with increased risk of return admission for deep neck space infection. Increased clinical suspicion for deep neck space infection (as manifested by laboratory findings/neck imaging at initial ED visit) was associated with increased risk of deep neck space
{"title":"Risk Factors for Pediatric Deep Neck Infection Revisit After Emergency Department Discharge for Pharyngitis or Localized Neck Symptoms.","authors":"Kaileen Jafari,Derya Caglar,Apeksha Gupta,Emily Hartford","doi":"10.1016/j.annemergmed.2025.10.007","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.10.007","url":null,"abstract":"STUDY OBJECTIVEDiagnosis of deep neck space infections is challenging in children due to subtle symptoms and examination findings. However, delays in diagnosis can contribute to increased morbidity in pediatric deep neck space infection. We aimed to determine (1) the most frequent discharge diagnoses associated with emergency department (ED) visits in the 10 days before deep neck space infection diagnosis and (2) use cohorts of pediatric ED visits with these frequent diagnoses to determine factors associated with return admission with deep neck space infection.METHODSCross-sectional analysis of ED and inpatient visits for ages less than 18 years from the State Emergency Department and State Inpatient Datasets from 2018-2019. We linked deep neck space infection admissions (identified by primary International Classification of Diseases, Tenth Revision diagnosis J390) to 10-day antecedent ED visits and identified the most frequent discharge diagnoses in these visits. We then analyzed cohorts of ED encounters with these frequent discharge diagnoses: 1) localized neck symptoms (pain, mass, or torticollis), and 2) pharyngitis or tonsillitis; and compared patient and hospital characteristics of visits with and without a subsequent 10-day admission for deep neck space infection using descriptive statistics. Firth logistic regression was used to assess patient and hospital predictors of a deep neck space infection revisit.RESULTSAmong 799 pediatric deep neck space infection admissions included in the study, 146 (18.3%) patients had more than or equal to 1 treat-and-release ED visits in the 10-day window before deep neck space infection admission. In the cohorts of ED treat-and-release visits for pharyngitis/tonsillitis (n=419,660) and localized neck symptoms (n=54,779), 10-day return visits for deep neck space infection were rare, representing 0.01% and 0.07% of visits, respectively. ED visits with neck imaging were associated with deep neck space infection revisit for both cohorts. Predictors of deep neck space infection in the localized neck symptoms cohort also included younger age and an ED diagnosis of fever, whereas in the pharyngitis cohort, deep neck space infection revisit was associated with ED diagnosis of localized neck symptoms, and negatively associated with a diagnosis of upper respiratory infection or respiratory symptoms.CONCLUSIONSIn ED encounters where patients were discharged with neck pain/mass or torticollis, younger age and a diagnosis of fever were associated with a subsequent deep neck space infection admission. Among ED patients discharged with pharyngitis/tonsillitis, absence of upper respiratory infection/respiratory diagnosis, and neck pain/mass/or torticollis were associated with increased risk of return admission for deep neck space infection. Increased clinical suspicion for deep neck space infection (as manifested by laboratory findings/neck imaging at initial ED visit) was associated with increased risk of deep neck space","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"2 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680614","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 : 2025-12-05DOI: 10.1016/j.annemergmed.2025.10.008
Lauren M Westafer,Patrick Walsh,Ron Helderman,Natalie Strokes,Colin F Greineder,Geoffrey D Barnes,David R Vinson,William B Stubblefield
STUDY OBJECTIVESTo explore physicians' interpretation and decisionmaking when encountering computed tomographic pulmonary angiogram (CTPA) reports communicating diagnostic uncertainty about the presence of pulmonary embolism (PE).METHODSWe conducted semistructured interviews from February 1 to June 3, 2024 among purposively sampled emergency medicine and hospital medicine physicians in the United States. Interviews were recorded, transcribed, and analyzed in an iterative process using reflexive thematic analysis.RESULTSWe analyzed interviews from 25 emergency physicians and 17 hospitalists. The median age was 41 years and 33% identified as women. Participants were diverse in practice setting and years of practice. Central themes included a lack of organized approach to diagnostic uncertainty, a perception that empiric anticoagulation would represent "erring on the side of caution," a tendency to defer additional testing and ascertainment of diagnostic certainty to downstream decision makers, and a disinclination to engage in repeat testing due to time pressures and local culture. Although many participants expressed support for the general idea of standardized communication of diagnostic uncertainty, most resisted its quantification in the context of CTPA reports. Many voiced concern that quantification of uncertainty left them without a clear course of action.CONCLUSIONAlthough diagnostic uncertainty regarding the presence of PE is commonly encountered in CTPA reports, most physicians report a lack of an organized approach to this scenario, often defaulting to empiric anticoagulation and deferring additional diagnostic testing. Future efforts are needed to develop data-driven guidance for encountering diagnostic uncertainty in radiographic imaging reports for PE.
{"title":"Physician Perspectives on Diagnostic Uncertainty in Radiographic Imaging Reports for Pulmonary Embolism: A Qualitative Study.","authors":"Lauren M Westafer,Patrick Walsh,Ron Helderman,Natalie Strokes,Colin F Greineder,Geoffrey D Barnes,David R Vinson,William B Stubblefield","doi":"10.1016/j.annemergmed.2025.10.008","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.10.008","url":null,"abstract":"STUDY OBJECTIVESTo explore physicians' interpretation and decisionmaking when encountering computed tomographic pulmonary angiogram (CTPA) reports communicating diagnostic uncertainty about the presence of pulmonary embolism (PE).METHODSWe conducted semistructured interviews from February 1 to June 3, 2024 among purposively sampled emergency medicine and hospital medicine physicians in the United States. Interviews were recorded, transcribed, and analyzed in an iterative process using reflexive thematic analysis.RESULTSWe analyzed interviews from 25 emergency physicians and 17 hospitalists. The median age was 41 years and 33% identified as women. Participants were diverse in practice setting and years of practice. Central themes included a lack of organized approach to diagnostic uncertainty, a perception that empiric anticoagulation would represent \"erring on the side of caution,\" a tendency to defer additional testing and ascertainment of diagnostic certainty to downstream decision makers, and a disinclination to engage in repeat testing due to time pressures and local culture. Although many participants expressed support for the general idea of standardized communication of diagnostic uncertainty, most resisted its quantification in the context of CTPA reports. Many voiced concern that quantification of uncertainty left them without a clear course of action.CONCLUSIONAlthough diagnostic uncertainty regarding the presence of PE is commonly encountered in CTPA reports, most physicians report a lack of an organized approach to this scenario, often defaulting to empiric anticoagulation and deferring additional diagnostic testing. Future efforts are needed to develop data-driven guidance for encountering diagnostic uncertainty in radiographic imaging reports for PE.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"20 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145680613","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 : 2025-12-04DOI: 10.1016/j.annemergmed.2025.09.035
David A Talan,Gregory J Moran,David Machado-Aranda,William K Chiang,Brett A Faine,Ross Fleischman,David B Hoyt,Alan E Jones,Amber Sabbatini,Donald M Yealy,Julianna T Yu,Darin J Saltzman
For more than 100 years, physicians and patients considered appendicitis a surgical emergency requiring hospitalization for urgent removal of the obstructed and inflamed appendix to prevent rupture and sepsis. With the advent of modern imaging, uncomplicated appendicitis is identifiable, and later evidence showed that surgical delay does not increase the risk of appendiceal perforation. Perforation appears to be a separate disease, with uncomplicated appendicitis likely related to infection, which sometimes self-resolves. Most recently, studies compared nonoperative treatment of uncomplicated appendicitis with antibiotics and observation followed by selective surgery to urgent appendectomy, including 4 multicenter trials involving more than 2,000 adults and 2,000 children. The results led the American College of Surgeons to endorse nonoperative treatment of uncomplicated appendicitis as a safe alternative treatment. Furthermore, emergency department discharge and outpatient management appears feasible in as many as 90% of nonoperative treatment of uncomplicated appendicitis-treated patients. We review methods and results of these trials and evaluate implications for emergency care.
{"title":"Nonoperative Treatment of Appendicitis and Implications for Emergency Department Management: A Narrative Review.","authors":"David A Talan,Gregory J Moran,David Machado-Aranda,William K Chiang,Brett A Faine,Ross Fleischman,David B Hoyt,Alan E Jones,Amber Sabbatini,Donald M Yealy,Julianna T Yu,Darin J Saltzman","doi":"10.1016/j.annemergmed.2025.09.035","DOIUrl":"https://doi.org/10.1016/j.annemergmed.2025.09.035","url":null,"abstract":"For more than 100 years, physicians and patients considered appendicitis a surgical emergency requiring hospitalization for urgent removal of the obstructed and inflamed appendix to prevent rupture and sepsis. With the advent of modern imaging, uncomplicated appendicitis is identifiable, and later evidence showed that surgical delay does not increase the risk of appendiceal perforation. Perforation appears to be a separate disease, with uncomplicated appendicitis likely related to infection, which sometimes self-resolves. Most recently, studies compared nonoperative treatment of uncomplicated appendicitis with antibiotics and observation followed by selective surgery to urgent appendectomy, including 4 multicenter trials involving more than 2,000 adults and 2,000 children. The results led the American College of Surgeons to endorse nonoperative treatment of uncomplicated appendicitis as a safe alternative treatment. Furthermore, emergency department discharge and outpatient management appears feasible in as many as 90% of nonoperative treatment of uncomplicated appendicitis-treated patients. We review methods and results of these trials and evaluate implications for emergency care.","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"1 1","pages":""},"PeriodicalIF":6.2,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145674416","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 : 2025-11-19DOI: 10.1016/j.annemergmed.2025.04.038
Megan Musselman PharmD, MS, Anna Schaben PharmD
{"title":"Naloxone in Out-of-Hospital Cardiac Arrest Should Be the Exception Not the Standard","authors":"Megan Musselman PharmD, MS, Anna Schaben PharmD","doi":"10.1016/j.annemergmed.2025.04.038","DOIUrl":"10.1016/j.annemergmed.2025.04.038","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"86 6","pages":"Pages 686-688"},"PeriodicalIF":5.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145536776","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 : 2025-11-19DOI: 10.1016/j.annemergmed.2025.06.624
Alper Mengi MD
{"title":"Comment on Trigger Point Injection for Myofascial Pain Syndrome of the Low Back","authors":"Alper Mengi MD","doi":"10.1016/j.annemergmed.2025.06.624","DOIUrl":"10.1016/j.annemergmed.2025.06.624","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"86 6","pages":"Page 703"},"PeriodicalIF":5.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145537369","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 : 2025-11-19DOI: 10.1016/j.annemergmed.2025.07.028
Zhihao Lei PhD
{"title":"“No Difference or Missed Difference?” Revisiting Functional Gains in Low Back Pain","authors":"Zhihao Lei PhD","doi":"10.1016/j.annemergmed.2025.07.028","DOIUrl":"10.1016/j.annemergmed.2025.07.028","url":null,"abstract":"","PeriodicalId":8236,"journal":{"name":"Annals of emergency medicine","volume":"86 6","pages":"Pages 704-705"},"PeriodicalIF":5.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145537024","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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