Rosechapman1952

004) were signifi cantly associated with ROSC in OHCA. In logistic regression, bystander witnessed (OR 3.15, 95% CI 1.59-6.27;

= 0.001) and prehospital epinephrine use (OR 2.15, 95% CI 1.10-4.23;

= 0.026) were signifi cantly associated with ROSC in OHCA. NLR and smudge cell count were also seemingly related to ROSC in OHCA, but without statistical signifi cance. In survival analysis, neither NLR nor smudge cell count was associated with patient survival to discharge in OHCA.

NLR and smudge cell count at ED arrival could be potential indicators of ROSC in OHCA.

NLR and smudge cell count at ED arrival could be potential indicators of ROSC in OHCA.Atrial fibrillation (Af) is frequently seen in the emergency department (ED), and the main concern of which is the potential to lead to blockage of blood flow. Cardiac tumors can also present with Af, which are often overlooked due to the rarity but clinically significant. A 70-year-old woman presented at our ED with intermittent palpitation and dizziness for several weeks. She has an underlying disease of right thyroid follicular carcinoma status-post surgery many years ago, but no history of heart disease. Her electrocardiogram (ECG) showed Af, and the transthoracic echocardiography showed a huge mass occupying the left atrium. The patient underwent an open-heart surgery with tumor excision. The pathology revealed metastatic thyroid follicular carcinoma. The patient recovered smoothly, and her ECG showed normal sinus rhythm after the operation. Most cardiac secondary tumors remain clinically silent and are often diagnosed postmortem. These conditions are rare but clinically significant; therefore, the physician should always raise suspicion of metastatic cardiac tumor as the differential diagnosis when patient presents with an unexplained Af.About 1-5 % of cases of tuberculosis (TB) have uncommon abdominal conditions, and affect primarily young adults. The clinical diagnosis is challenging and often delayed due to the symptoms being non-specific and may be confused with other bowel diseases, therefore resulting in significant morbidity and mortality. A 27-year-old man was brought to our emergency department with the complaints a fever and abdominal pain. According to the chest X-ray findings taken 24 hours previously, pulmonary TB was suspected. Abdominal TB associated intestinal obstruction, ascites and lymphadenopathy were found by computed tomography and exploratory laparotomy. He was treated surgically by segmental resection, however passed away due to severe bleeding caused by the recurrence of perforation of the small intestine and sepsis. This case of systemic TB highlights the difficulties in diagnosis and treatment in time. The early diagnosis and timely treatment are both necessary to manage the disease successfully.

Epistaxis is the most common cause of otorhinolaryngologic emergencies. There is a longstanding controversy regarding the relationship between epistaxis and hypertension (HTN), in terms of blood pressure (BP) control in the emergency department (ED) setting. The objective of this study is to evaluate the association between HTN, BP control, and recurrent epistaxis among patients initially admitted to the ED for epistaxis.

This retrospective cohort study was conducted in the EDs of three different hospitals in Taiwan and included a total of 739 patients admitted for epistaxis.

Among ED patients with epistaxis, older age was significantly associated with a history of HTN, and a statistically significant difference in age was noted between groups classified according to the systolic BP/diastolic BP (SBP/DBP) at triage. Patients with a history of HTN had higher BP values at triage than did patients without a history of HTN (SBP 175.68 ± 32.30 mmHg vs. 148.00 ± 26.26 mmHg, DBP 95.04 ± 20.98 mmHg vs. 83.30 ± agents before achieving hemostasis in patients admitted to the ED for epistaxis warrants further study.

Emergency department (ED) revisits may be associated with a higher percentage of adverse events and increased costs. Our hospital is a university affiliation hospital accepted regional referral patients, and located in the region in Taiwan with the highest percentage of elderly people. In this study, we attempted to identify whether old age was a risk factor of ED revisit.

Patients who visited the ED from July 2011 to June 2016 were included. Withaferin A molecular weight associated with revisit were collected from medical information database. A total of 239,405 patients were included in our study, with 13,272 having ED revisits within 72 hours. Chi square and independent t test were applied for univariable factors, and a logistic regression model was used for multivariable analysis.

Old age (age ≥ 65 years) was found to be a risk factor for ED revisit (odds ratio [OR] 1.14; 95% confidence interval [CI] 1.09-1.19). #link# Diagnosis, pulse rate, diastolic blood pressure, fever, pain management, paracentesis, triage level, registration category, male gender, discharge status, and major illness may have some effect on ED revisit.

In our patients, old age is a risk factor for ED revisit; however, only a weak association was found.

In our patients, old age is a risk factor for ED revisit; however, only a weak association was found.

The gray-white-matter ratio (GWR) measured on cerebral non-contrasted computed tomography (NCCT) has been reported to help the prognostication of mortality or comatose status of out-of-hospital cardiac arrest (OHCA) victims. Since the etiologies and resuscitative process differ significantly between patients with OHCA and in-hospital cardiac arrest (IHCA), the predictive ability of GWR in IHCA survivors remains unclear.

This retrospective observational study conducted in a single tertiary medical center in Taiwan enrolled all the non-traumatic IHCA adults with sustained return of spontaneous circulation (ROSC) and had received cerebral NCCT examination within 24 hours following cardiac arrest. The GWR of survivor and non-survivor as well as good and poor neurological outcome were analyzed.

A total of 79 IHCA patients with 68.4% in male gender and mean age of 66-year-old were enrolled in the current study. 34 patients (43.0%) survived to hospital discharge and 20 patients (25.3%) were discharged with good neurological outcome.