The American journal of emergency medicine
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Multicenter Study Observational Study
Value of integrated pulmonary index to predict exacerbation of chronic obstructive pulmonary Disease's severity.
In this study, we aimed to examine the correlation between current prognostic scores and the integrated pulmonary index (IPI) in patients admitted to the emergency department (ED) with exacerbation of chronic obstructive pulmonary disease (COPD), and the diagnostic value of using the IPI in combination with other scores in determining patients who can be discharged safely. ⋯ We found that the IPI has good predictive value in the detection of mild COPD exacerbations, and its predictive value increases when used in combination with CURB-65. We think that the CURB-IPI score can be a guide when deciding whether patients with exacerbation of COPD can be discharged.
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Acute COVID-19 infection may be associated with electrocardiogram (EKG) abnormalities in pediatric patients. We have anecdotally observed EKG abnormalities in patients without MIS-C or significant cardiac disease requiring intervention or further follow-up. Our aim was to determine the incidence of abnormal EKG findings and correlate with evidence of significant cardiac pathology in pediatric patients who present to the emergency department during an acute COVID-19 infection. ⋯ Despite a high incidence of abnormal EKG repolarization patterns in pediatric patients presenting with acute (non-MIS-C) COVID-19 infections, these patients generally do not have abnormal cardiac biomarkers or echocardiograms, and the risk for adverse cardiac events is low.
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to determine diagnostic accuracy of an US-MRI clinical diagnostic pathway to detect appendicitis in the emergency department (ED). ⋯ this study demonstrated high clinical accuracy of the US-rapid-MRI pathway in suspected pediatric appendicitis after non-diagnostic US.
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Previous evidence demonstrated that several biomarkers involved in the pathological process of coagulation/hemostasis dysfunction, impairment of brain vascular integrity and inflammation are associated with hematoma expansion (HE) after intracerebral hemorrhage (ICH). We aimed to explore whether there were unreported laboratory biomarkers associated with HE that were readily and commonly available in clinical practice. ⋯ DBil is a predictor of HE and poor 3-month outcomes after ICH. DBil's metabolic process and involvement in the pathological mechanism of HE are likely to contribute to the association between DBil and HE. Interventions targeting DBil to improve post-ICH prognosis may be meaningful and worthy of further exploration.
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The recommended target temperature in the treatment of comatous patients after cardiac arrest has recently changed. We analyzed the impact on the neurological outcome of a change in the target temperature from July 2021. ⋯ In our series of patients, the temperature control target temperature change from 33 °C to 36.5 °C was associated with worse neurological outcome. Further studies are needed to evaluate the outcome of a generalized modification of temperature control targets in comatose patients after cardiac arrest in our postpandemic era.