Stormhu3324

A-a O

gradient (AUC 0.78), A-a O

difference (AUC 0.74) and albumin (AUC 0.80) showed highest 30-day mortality prediction. NLR (AUC 0.58) and PLR (AUC 0.55) showed lowest 30-day mortality estimation. Procalcitonin (AUC 0.65), PSI class (AUC 0.81) and PSI score (AUC 0.86) indicated statistically significant higher 30-day mortality prediction.

A-a O

gradient, A-a O

difference and albumin are potent predictors of 30-day mortality in CAP patients in the ED.

A-a O2 gradient, A-a O2 difference and albumin are potent predictors of 30-day mortality in CAP patients in the ED.

Currently, ≤5% of bystanders witnessing an opioid overdose (OD) in the US administer antidote to the victim. A possible model to mitigate this crisis would be a system that enables 9-1-1 dispatchers to both rapidly deliver naloxone by drone to bystanders at a suspected opioid OD and direct them to administer it while awaiting EMS arrival.

A simulated 9-1-1 dispatcher directed thirty subjects via 2-way radio to retrieve naloxone nasal spray from atop a drone located outside the simulation building and then administer it using scripted instructions. The primary outcome measure was time from first contact with the dispatcher to administration of the medication.

All subjects administered the medication successfully. The mean time interval from 9 -1-1 contact until antidote administration was 122 [95%CI 109-134] sec. There was a significant reduction in time interval if subjects had prior medical training (p = 0.045) or had prior experience with use of a nasal spray device (p = 0.030). Five subjects had difficulty using the nasal spray and four subjects had minor physical impairments, but these barriers did not result in a significant difference in time to administration (p = 0.467, p = 0.30). A significant number of subjects (29/30 [97%], p = 0.044) indicated that they felt confident they could administer intranasal naloxone to an opioid OD victim after participating in the simulation.

Our results suggest that bystanders can carry out 9-1-1 dispatcher instructions to fetch drone-delivered naloxone and potentially decrease the time interval to intranasal administration which supports further development and testing of a such a system.

Our results suggest that bystanders can carry out 9-1-1 dispatcher instructions to fetch drone-delivered naloxone and potentially decrease the time interval to intranasal administration which supports further development and testing of a such a system.

Although dog ownership may provide health benefits, interactions with dogs and their leashes can result in injuries. The intent of this study was to describe dog leash-related injuries treated at United States (US) emergency departments (EDs).

Cases were dog leash-related injuries during 2001-2018 reported to the National Electronic Injury Surveillance System (NEISS), from which national estimates of dog leash-related injuries treated at US EDs were calculated. The distribution of the cases and estimated number of dog leash-related injuries was determined for selected variables, such as the circumstances of the injury, patient demographics, and diagnosis.

A dog leash was involved in 8189 injuries, resulting in a national estimate of 356,746 injuries and an estimated rate of 63.4 injuries per 1,000,000 population. Of these injuries, 193,483 resulted from a pull, 136,767 from a trip/tangle, and 26,496 from other or unknown circumstances. The total injury rate per 1,000,000 population increased from 25.4 in 2001 to 105.5 in 2018. Adults accounted for 314,712 (88.2%) of the patients; 260,328 (73.0%) of the patients were female. The injury occurred at home in 133,549 (37.4%) cases. The most common injuries were 95,677 (26.8%) fracture, 92,644 (26.0%) strain or sprain, and 62,980 (17.7%) contusions or abrasions.

The most common type of dog leash-related injuries resulted from a pull followed by a trip/tangle. The number of dog leash-related injuries increased during the time period. The majority of the persons sustaining such injuries were adults and female. Over one-third of the injuries occurred at home.

The most common type of dog leash-related injuries resulted from a pull followed by a trip/tangle. The number of dog leash-related injuries increased during the time period. The majority of the persons sustaining such injuries were adults and female. Over one-third of the injuries occurred at home.

Thromboelastography (TEG) provides a rapid assessment of the hemostatic processes of a patient in emergency settings. There are limited data on TEG as a predictive tool for hemorrhagic transformation in patients with acute ischemic stroke. We investigated whether TEG values on admission could predict hemorrhagic transformation in patients with acute ischemic stroke.

TEG was performed prospectively in 772 patients who satisfied the criteria of the critical pathway for acute stroke that have neurologic symptoms in 6 h at the emergency department between March and December 2018. After excluding 114 patients, 628 patients were evaluated, and finally, 205 patients with acute ischemic stroke were included. The primary outcome is hemorrhagic transformation, defined as the presence of blood in brain on follow-up imaging study and secondary outcome is neurological deterioration, defined as a 2-point increase on the National Institutes of Health Stroke Scale (NIHSS) within 72 h of stroke onset.

Of the 205 ischemic stroke patients (mean age 67 ± 13 years, 66.3% male), hemorrhagic transformation was identified in 28 (13.7%) patients, and neurological deterioration was occurred in 24 (11.7%), and both events in 9 (4.4%). The TEG value of R (reaction time) <5 min was significantly higher in patients with hemorrhagic transformation than in patients without hemorrhagic transformation (81.1% vs. 60.5%, p = 0.027), and based on multivariable analysis, this was an independent predictor of hemorrhagic transformation (odds ratio 3.215 [95% confidence interval 1.153-8.969]).

In patients with acute ischemic stroke, TEG value of R < 5 min can identify patients who have an increased risk of hemorrhagic transformation during hospitalization.

In patients with acute ischemic stroke, TEG value of R  less then  5 min can identify patients who have an increased risk of hemorrhagic transformation during hospitalization.

This study aimed to compare the analgesic efficacy of topical capsaicin and topical piroxicam in acute musculoskeletal injuries.

This is a prospective, randomized, controlled, double-blinded study. The data for the 67 patients in the piroxicam group and the 69 in the capsaicin group were examined. The initial visual analog scale (VAS) scores were compared with the 60th and 120th minute as well as the 24th and 72nd hour values. Differences between the VAS scores, clinical effectiveness of the treatment and side effects were evaluated.

In the capsaicin group, the mean difference in the delta VAS scores was significantly higher at each measurement time. The mean of the percentage of reduction in the VAS scores of the topical capsaicin group was significantly higher than that in the topical piroxicam group. The highest difference in terms of both outcomes was determined at the 72nd hour VAS change. Mean differences were 1.53 (95% CI 0.85-2.221) and 19.7 (95% CI 12.4-27.2) respectively (p < 0.001). In the capsaicin group, the clinical effect of the treatment was found significantly higher (p < 0.01). The difference between the clinical effectiveness of the groups regarding the treatment outcomes was also statistically significant (p < 0.001). There was no significant difference between the patient groups regarding the presence of side effects.

Topical capsaicin can be used as an alternative to topical piroxicam initially and at follow-up in patients presenting to the emergency department with acute pain as there were no observable differences in side-effects between the two groups.

Topical capsaicin can be used as an alternative to topical piroxicam initially and at follow-up in patients presenting to the emergency department with acute pain as there were no observable differences in side-effects between the two groups.

This study intended to find out how association between response time interval (RTI) and good neurological outcome is affected by bystander CPR. We hypothesized that bystander CPR will ensure positive effect in relationship between RTI and clinical outcome.

A retrospective, observational study was made with Pan-Asian Resuscitation Outcome Study data from January 2009 to December 2016. Six cities from four Asian countries were selected. EMS-treated, non-traumatic witnessed out-of-hospital cardiac arrest (OHCA) cases were included. General demographic data, prehospital cardiac arrest details and clinical outcome were collected and analyzed according to whether bystander CPR was performed. Good neurological outcome and survival discharge were primary and secondary outcomes.

A total of 13,245 OHCA cases were analyzed. Median EMS response time intervals were 6 min, regardless of bystander CPR. Dividing into RTI time range by 3 min, good neurological outcome and survival discharge were only significant in 3 to 6 minutes group (adjusted odds ratio [AOR] 1.42, 1.17-1.73 95% confidence interval [CI] and AOR 1.31, 1.15-1.51 95% CI) in non-bystander CPR group but in bystander CPR group significant RTI time range was 3 to 9 min (AOR 2.02, 1.82, 1.62-2.52, 1.48-2.25 95% CI for primary, AOR 1.66, 1.43, 1.41-1.96, 1.22-1.67 95% CI for secondary).

As response time interval increased, slower deterioration of good neurological outcome and survival discharge was shown in cardiac arrest patients with bystander CPR performed. If bystander CPR is provided, RTI time range showing significant neurological outcome and survival improvement seems to be relatively lengthened.

As response time interval increased, slower deterioration of good neurological outcome and survival discharge was shown in cardiac arrest patients with bystander CPR performed. If bystander CPR is provided, RTI time range showing significant neurological outcome and survival improvement seems to be relatively lengthened.

Over the past few decades, the incidence of Rhabdomyolysis (RM) has significantly increased. The prognosis is substantially worse if renal failure develops. Many problems remain to be addressed regarding the pathogenesis, prevention, and treatment of RM. The purpose of this study was to identify and characterize the top 100 most cited publications regarding rhabdomyolysis (RM) by performing a bibliometric analysis.

Publications focusing on RM were identified from the Science Citation Index-Expanded (SCI-E) of the Web of Science Core Collection (WoSCC). Bibliographic information was collected, including year of publication, authorship, publishing journals, institution, country of origin and keywords. CiteSpace V5.6.R2 and the Online Analysis Platform of Literature Metrology were used for descriptive analysis.

The 100 most cited articles were published between 1995 and 2016, with citation numbers ranging from 116 to 904. L-Mimosine molecular weight The United States (60) has been the largest contributor to RM research. Hartford Hospital and University of Texas were found to be the most productive institutions, with five articles each.