Latest Articles
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Pediatric emergency care · Jan 2025
Multicenter StudyThe Impact of COVID-19 on Patterns of Fractures Presenting to Pediatric Emergency Departments.
To examine differences in pediatric fracture prevalence, severity, and mechanisms of injury before and during the COVID-19 pandemic. ⋯ Despite a decrease in fracture-related visits to urban pediatric EDs during the early COVID-19 pandemic, there was an increase in the proportion of ED visits for children younger than 5 years and higher severity injuries. These findings highlight injury epidemiology pattern shifts that occurred during the pandemic. Identifying higher-risk populations for fracture may help guide targeted education and prevention efforts.
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Multicenter Study Observational Study
Complete versus culprit-lesion-only percutaneous coronary intervention after out-of-hospital cardiac arrest in patients with multivessel disease.
Multivessel coronary artery disease (MVD) represents a common finding at invasive coronary angiography (ICA) among out-of-hospital cardiac arrest (OHCA) survivors. However, optimal invasive treatment strategy for MVD in OHCA remains unknown. Our study aims to assess if complete revascularization improves one-year clinical outcomes in these patients. ⋯ Our findings suggest that a complete percutaneous coronary revascularization strategy is associated with improved one-year survival rates in patients with MVD resuscitated from OHCA.
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Multicenter Study Observational Study
End-Tidal Oxygen as an Effective Noninvasive Measure of Preoxygenation during Rapid Sequence Intubation in the Emergency Department.
Preoxygenation is intended to extend the duration of apnea until desaturation occurs. End-tidal oxygen (ETO2) is the standard for measuring preoxygenation, however, peripheral capillary oxygen saturation (SpO2) is used more commonly within the emergency department. ⋯ Preoxygenation success was similar when measured by strict ETO2 and SpO2 criteria. ETO2 is more sensitive to periods of apnea than SpO2 and may serve as an early indicator of an imminent desaturation event.
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Multicenter Study
Risk factors for acute appendicitis among adult patients with indeterminate ultrasound.
Abdominal ultrasound is used for diagnosing appendicitis in patients with right lower quadrant abdominal pain. Between 45 and 82% of radiology performed ultrasounds are indeterminate for appendicitis and computed tomography is required for diagnostic confirmation. Our study aims to determine predictors to rule out appendicitis when ultrasound is indeterminate. ⋯ For patients suspected of appendicitis and indeterminate ultrasound, the absence of an elevated neutrophil count and secondary signs of inflammation are associated with a low probability of appendicitis.
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Multicenter Study Comparative Study
Vestibular Schwannoma Koos Grade I International Study of Active Surveillance Versus Stereotactic Radiosurgery: The VISAS-K1 Study.
This investigation evaluates the safety and efficacy of stereotactic radiosurgery (SRS) vs observation for Koos grade I vestibular schwannomas (VS). ⋯ SRS management of patients with Koos grade I VS was associated with superior tumor control and reduced odds for cranial nerve dysfunction, while not compromising hearing preservation compared with observation. These findings support the safety and efficacy of SRS as a primary care approach for this patient population.