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Publisher: Hindawi   (Total: 338 journals)

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Showing 1 - 200 of 338 Journals sorted alphabetically
Abstract and Applied Analysis     Open Access   (Followers: 3, SJR: 0.343, CiteScore: 1)
Active and Passive Electronic Components     Open Access   (Followers: 7, SJR: 0.136, CiteScore: 0)
Advances in Acoustics and Vibration     Open Access   (Followers: 37, SJR: 0.147, CiteScore: 0)
Advances in Aerospace Engineering     Open Access   (Followers: 55)
Advances in Agriculture     Open Access   (Followers: 9)
Advances in Artificial Intelligence     Open Access   (Followers: 15)
Advances in Astronomy     Open Access   (Followers: 41, SJR: 0.257, CiteScore: 1)
Advances in Bioinformatics     Open Access   (Followers: 17, SJR: 0.565, CiteScore: 2)
Advances in Biology     Open Access   (Followers: 10)
Advances in Chemistry     Open Access   (Followers: 27)
Advances in Civil Engineering     Open Access   (Followers: 43, SJR: 0.539, CiteScore: 1)
Advances in Computer Engineering     Open Access   (Followers: 4)
Advances in Condensed Matter Physics     Open Access   (Followers: 11, SJR: 0.315, CiteScore: 1)
Advances in Decision Sciences     Open Access   (Followers: 3, SJR: 0.303, CiteScore: 1)
Advances in Electrical Engineering     Open Access   (Followers: 37)
Advances in Electronics     Open Access   (Followers: 79)
Advances in Emergency Medicine     Open Access   (Followers: 12)
Advances in Endocrinology     Open Access   (Followers: 6)
Advances in Environmental Chemistry     Open Access   (Followers: 7)
Advances in Epidemiology     Open Access   (Followers: 8)
Advances in Fuzzy Systems     Open Access   (Followers: 5, SJR: 0.161, CiteScore: 1)
Advances in Geology     Open Access   (Followers: 19)
Advances in Geriatrics     Open Access   (Followers: 6)
Advances in Hematology     Open Access   (Followers: 11, SJR: 0.661, CiteScore: 2)
Advances in Hepatology     Open Access   (Followers: 2)
Advances in High Energy Physics     Open Access   (Followers: 22, SJR: 0.866, CiteScore: 2)
Advances in Human-Computer Interaction     Open Access   (Followers: 21, SJR: 0.186, CiteScore: 1)
Advances in Materials Science and Engineering     Open Access   (Followers: 30, SJR: 0.315, CiteScore: 1)
Advances in Mathematical Physics     Open Access   (Followers: 7, SJR: 0.218, CiteScore: 1)
Advances in Medicine     Open Access   (Followers: 3)
Advances in Meteorology     Open Access   (Followers: 24, SJR: 0.48, CiteScore: 1)
Advances in Multimedia     Open Access   (Followers: 2, SJR: 0.173, CiteScore: 1)
Advances in Nonlinear Optics     Open Access   (Followers: 6)
Advances in Numerical Analysis     Open Access   (Followers: 7)
Advances in Nursing     Open Access   (Followers: 33)
Advances in Operations Research     Open Access   (Followers: 12, SJR: 0.205, CiteScore: 1)
Advances in Optical Technologies     Open Access   (Followers: 4, SJR: 0.214, CiteScore: 1)
Advances in Optics     Open Access   (Followers: 5)
Advances in OptoElectronics     Open Access   (Followers: 6, SJR: 0.141, CiteScore: 0)
Advances in Orthopedics     Open Access   (Followers: 8, SJR: 0.922, CiteScore: 2)
Advances in Pharmacological Sciences     Open Access   (Followers: 8, SJR: 0.591, CiteScore: 2)
Advances in Physical Chemistry     Open Access   (Followers: 11, SJR: 0.179, CiteScore: 1)
Advances in Polymer Technology     Open Access   (Followers: 14, SJR: 0.299, CiteScore: 1)
Advances in Power Electronics     Open Access   (Followers: 33, SJR: 0.184, CiteScore: 0)
Advances in Preventive Medicine     Open Access   (Followers: 6)
Advances in Public Health     Open Access   (Followers: 24)
Advances in Regenerative Medicine     Open Access   (Followers: 3)
Advances in Software Engineering     Open Access   (Followers: 10)
Advances in Statistics     Open Access   (Followers: 4)
Advances in Toxicology     Open Access   (Followers: 2)
Advances in Tribology     Open Access   (Followers: 14, SJR: 0.265, CiteScore: 1)
Advances in Urology     Open Access   (Followers: 9, SJR: 0.51, CiteScore: 1)
Advances in Virology     Open Access   (Followers: 7, SJR: 0.838, CiteScore: 2)
AIDS Research and Treatment     Open Access   (Followers: 3, SJR: 0.758, CiteScore: 2)
Analytical Cellular Pathology     Open Access   (Followers: 3, SJR: 0.886, CiteScore: 2)
Anatomy Research Intl.     Open Access   (Followers: 3)
Anemia     Open Access   (Followers: 5, SJR: 0.669, CiteScore: 2)
Anesthesiology Research and Practice     Open Access   (Followers: 15, SJR: 0.501, CiteScore: 1)
Applied and Environmental Soil Science     Open Access   (Followers: 17, SJR: 0.451, CiteScore: 1)
Applied Bionics and Biomechanics     Open Access   (Followers: 7, SJR: 0.288, CiteScore: 1)
Applied Computational Intelligence and Soft Computing     Open Access   (Followers: 14)
Archaea     Open Access   (Followers: 3, SJR: 0.852, CiteScore: 2)
Autism Research and Treatment     Open Access   (Followers: 29)
Autoimmune Diseases     Open Access   (Followers: 3, SJR: 0.805, CiteScore: 2)
Behavioural Neurology     Open Access   (Followers: 10, SJR: 0.786, CiteScore: 2)
Biochemistry Research Intl.     Open Access   (Followers: 7, SJR: 0.437, CiteScore: 2)
Bioinorganic Chemistry and Applications     Open Access   (Followers: 11, SJR: 0.419, CiteScore: 2)
BioMed Research Intl.     Open Access   (Followers: 4, SJR: 0.935, CiteScore: 3)
Biotechnology Research Intl.     Open Access   (Followers: 1)
Bone Marrow Research     Open Access   (Followers: 2, SJR: 0.531, CiteScore: 1)
Canadian J. of Gastroenterology & Hepatology     Open Access   (Followers: 5, SJR: 0.867, CiteScore: 1)
Canadian J. of Infectious Diseases and Medical Microbiology     Open Access   (Followers: 6, SJR: 0.548, CiteScore: 1)
Canadian Respiratory J.     Open Access   (Followers: 1, SJR: 0.474, CiteScore: 1)
Cardiology Research and Practice     Open Access   (Followers: 10, SJR: 1.237, CiteScore: 4)
Cardiovascular Therapeutics     Open Access   (Followers: 1, SJR: 1.075, CiteScore: 2)
Case Reports in Anesthesiology     Open Access   (Followers: 10)
Case Reports in Cardiology     Open Access   (Followers: 7, SJR: 0.219, CiteScore: 0)
Case Reports in Critical Care     Open Access   (Followers: 10)
Case Reports in Dentistry     Open Access   (Followers: 5, SJR: 0.229, CiteScore: 0)
Case Reports in Dermatological Medicine     Open Access   (Followers: 2)
Case Reports in Emergency Medicine     Open Access   (Followers: 14)
Case Reports in Endocrinology     Open Access   (Followers: 2, SJR: 0.209, CiteScore: 1)
Case Reports in Gastrointestinal Medicine     Open Access   (Followers: 2)
Case Reports in Genetics     Open Access   (Followers: 1)
Case Reports in Hematology     Open Access   (Followers: 6)
Case Reports in Hepatology     Open Access   (Followers: 1)
Case Reports in Immunology     Open Access   (Followers: 4)
Case Reports in Infectious Diseases     Open Access   (Followers: 5)
Case Reports in Medicine     Open Access   (Followers: 2)
Case Reports in Nephrology     Open Access   (Followers: 5)
Case Reports in Neurological Medicine     Open Access   (Followers: 1)
Case Reports in Obstetrics and Gynecology     Open Access   (Followers: 10)
Case Reports in Oncological Medicine     Open Access   (Followers: 2, SJR: 0.204, CiteScore: 1)
Case Reports in Ophthalmological Medicine     Open Access   (Followers: 3)
Case Reports in Orthopedics     Open Access   (Followers: 6)
Case Reports in Otolaryngology     Open Access   (Followers: 6)
Case Reports in Pathology     Open Access   (Followers: 5)
Case Reports in Pediatrics     Open Access   (Followers: 7)
Case Reports in Psychiatry     Open Access   (Followers: 14)
Case Reports in Pulmonology     Open Access   (Followers: 3)
Case Reports in Radiology     Open Access   (Followers: 10)
Case Reports in Rheumatology     Open Access   (Followers: 8)
Case Reports in Surgery     Open Access   (Followers: 12)
Case Reports in Transplantation     Open Access  
Case Reports in Urology     Open Access   (Followers: 10)
Case Reports in Vascular Medicine     Open Access  
Case Reports in Veterinary Medicine     Open Access   (Followers: 5)
Child Development Research     Open Access   (Followers: 18, SJR: 0.144, CiteScore: 0)
Chinese J. of Engineering     Open Access   (Followers: 2, SJR: 0.114, CiteScore: 0)
Chinese J. of Mathematics     Open Access  
Chromatography Research Intl.     Open Access   (Followers: 5)
Complexity     Hybrid Journal   (Followers: 6, SJR: 0.531, CiteScore: 2)
Computational and Mathematical Methods in Medicine     Open Access   (Followers: 2, SJR: 0.403, CiteScore: 1)
Computational Intelligence and Neuroscience     Open Access   (Followers: 12, SJR: 0.326, CiteScore: 1)
Contrast Media & Molecular Imaging     Open Access   (Followers: 3, SJR: 0.842, CiteScore: 3)
Critical Care Research and Practice     Open Access   (Followers: 12, SJR: 0.499, CiteScore: 1)
Current Gerontology and Geriatrics Research     Open Access   (Followers: 9, SJR: 0.512, CiteScore: 2)
Depression Research and Treatment     Open Access   (Followers: 15, SJR: 0.816, CiteScore: 2)
Dermatology Research and Practice     Open Access   (Followers: 3, SJR: 0.806, CiteScore: 2)
Diagnostic and Therapeutic Endoscopy     Open Access   (SJR: 0.201, CiteScore: 1)
Discrete Dynamics in Nature and Society     Open Access   (Followers: 5, SJR: 0.279, CiteScore: 1)
Disease Markers     Open Access   (Followers: 1, SJR: 0.9, CiteScore: 2)
Economics Research Intl.     Open Access   (Followers: 1)
Education Research Intl.     Open Access   (Followers: 19)
Emergency Medicine Intl.     Open Access   (Followers: 9, SJR: 0.298, CiteScore: 1)
Enzyme Research     Open Access   (Followers: 5, SJR: 0.653, CiteScore: 3)
Evidence-based Complementary and Alternative Medicine     Open Access   (Followers: 23, SJR: 0.683, CiteScore: 2)
Game Theory     Open Access   (Followers: 1)
Gastroenterology Research and Practice     Open Access   (Followers: 2, SJR: 0.768, CiteScore: 2)
Genetics Research Intl.     Open Access   (Followers: 1, SJR: 0.61, CiteScore: 2)
Geofluids     Open Access   (Followers: 5, SJR: 0.952, CiteScore: 2)
Hepatitis Research and Treatment     Open Access   (Followers: 6, SJR: 0.389, CiteScore: 2)
Heteroatom Chemistry     Open Access   (Followers: 3, SJR: 0.333, CiteScore: 1)
HPB Surgery     Open Access   (Followers: 7, SJR: 0.824, CiteScore: 2)
Infectious Diseases in Obstetrics and Gynecology     Open Access   (Followers: 5, SJR: 1.27, CiteScore: 2)
Interdisciplinary Perspectives on Infectious Diseases     Open Access   (Followers: 1, SJR: 0.627, CiteScore: 2)
Intl. J. of Aerospace Engineering     Open Access   (Followers: 74, SJR: 0.232, CiteScore: 1)
Intl. J. of Agronomy     Open Access   (Followers: 6, SJR: 0.311, CiteScore: 1)
Intl. J. of Alzheimer's Disease     Open Access   (Followers: 11, SJR: 0.787, CiteScore: 3)
Intl. J. of Analytical Chemistry     Open Access   (Followers: 22, SJR: 0.285, CiteScore: 1)
Intl. J. of Antennas and Propagation     Open Access   (Followers: 11, SJR: 0.233, CiteScore: 1)
Intl. J. of Atmospheric Sciences     Open Access   (Followers: 21)
Intl. J. of Biodiversity     Open Access   (Followers: 4)
Intl. J. of Biomaterials     Open Access   (Followers: 4, SJR: 0.511, CiteScore: 2)
Intl. J. of Biomedical Imaging     Open Access   (Followers: 3, SJR: 0.501, CiteScore: 2)
Intl. J. of Breast Cancer     Open Access   (Followers: 14, SJR: 1.025, CiteScore: 2)
Intl. J. of Cell Biology     Open Access   (Followers: 4, SJR: 1.887, CiteScore: 4)
Intl. J. of Chemical Engineering     Open Access   (Followers: 8, SJR: 0.327, CiteScore: 1)
Intl. J. of Chronic Diseases     Open Access   (Followers: 1)
Intl. J. of Combinatorics     Open Access   (Followers: 1)
Intl. J. of Computer Games Technology     Open Access   (Followers: 10, SJR: 0.287, CiteScore: 2)
Intl. J. of Corrosion     Open Access   (Followers: 10, SJR: 0.194, CiteScore: 1)
Intl. J. of Dentistry     Open Access   (Followers: 6, SJR: 0.649, CiteScore: 2)
Intl. J. of Differential Equations     Open Access   (Followers: 8, SJR: 0.191, CiteScore: 0)
Intl. J. of Digital Multimedia Broadcasting     Open Access   (Followers: 5, SJR: 0.296, CiteScore: 2)
Intl. J. of Electrochemistry     Open Access   (Followers: 8)
Intl. J. of Endocrinology     Open Access   (Followers: 4, SJR: 1.012, CiteScore: 3)
Intl. J. of Engineering Mathematics     Open Access   (Followers: 6)
Intl. J. of Food Science     Open Access   (Followers: 5, SJR: 0.44, CiteScore: 2)
Intl. J. of Forestry Research     Open Access   (Followers: 3, SJR: 0.373, CiteScore: 1)
Intl. J. of Genomics     Open Access   (Followers: 2, SJR: 0.868, CiteScore: 3)
Intl. J. of Geophysics     Open Access   (Followers: 5, SJR: 0.182, CiteScore: 1)
Intl. J. of Hepatology     Open Access   (Followers: 5, SJR: 0.874, CiteScore: 2)
Intl. J. of Hypertension     Open Access   (Followers: 7, SJR: 0.578, CiteScore: 1)
Intl. J. of Inflammation     Open Access   (SJR: 1.264, CiteScore: 3)
Intl. J. of Inorganic Chemistry     Open Access   (Followers: 3)
Intl. J. of Manufacturing Engineering     Open Access   (Followers: 2)
Intl. J. of Mathematics and Mathematical Sciences     Open Access   (Followers: 3, SJR: 0.177, CiteScore: 0)
Intl. J. of Medicinal Chemistry     Open Access   (Followers: 6, SJR: 0.31, CiteScore: 1)
Intl. J. of Metals     Open Access   (Followers: 5)
Intl. J. of Microbiology     Open Access   (Followers: 6, SJR: 0.662, CiteScore: 2)
Intl. J. of Microwave Science and Technology     Open Access   (Followers: 3, SJR: 0.136, CiteScore: 1)
Intl. J. of Navigation and Observation     Open Access   (Followers: 20, SJR: 0.267, CiteScore: 2)
Intl. J. of Nephrology     Open Access   (Followers: 1, SJR: 0.697, CiteScore: 1)
Intl. J. of Oceanography     Open Access   (Followers: 7)
Intl. J. of Optics     Open Access   (Followers: 7, SJR: 0.231, CiteScore: 1)
Intl. J. of Otolaryngology     Open Access   (Followers: 3)
Intl. J. of Partial Differential Equations     Open Access   (Followers: 2)
Intl. J. of Pediatrics     Open Access   (Followers: 6)
Intl. J. of Peptides     Open Access   (Followers: 4, SJR: 0.46, CiteScore: 1)
Intl. J. of Photoenergy     Open Access   (Followers: 3, SJR: 0.341, CiteScore: 1)
Intl. J. of Plant Genomics     Open Access   (Followers: 4, SJR: 0.583, CiteScore: 1)
Intl. J. of Polymer Science     Open Access   (Followers: 24, SJR: 0.298, CiteScore: 1)
Intl. J. of Population Research     Open Access   (Followers: 3)
Intl. J. of Quality, Statistics, and Reliability     Open Access   (Followers: 16)
Intl. J. of Reconfigurable Computing     Open Access   (SJR: 0.123, CiteScore: 1)
Intl. J. of Reproductive Medicine     Open Access   (Followers: 4)
Intl. J. of Rheumatology     Open Access   (Followers: 4, SJR: 0.645, CiteScore: 2)
Intl. J. of Rotating Machinery     Open Access   (Followers: 2, SJR: 0.193, CiteScore: 1)
Intl. J. of Spectroscopy     Open Access   (Followers: 8)
Intl. J. of Stochastic Analysis     Open Access   (Followers: 3, SJR: 0.279, CiteScore: 1)
Intl. J. of Surgical Oncology     Open Access   (Followers: 1, SJR: 0.573, CiteScore: 2)
Intl. J. of Telemedicine and Applications     Open Access   (Followers: 5, SJR: 0.403, CiteScore: 2)
Intl. J. of Vascular Medicine     Open Access   (SJR: 0.782, CiteScore: 2)
Intl. J. of Zoology     Open Access   (Followers: 2, SJR: 0.209, CiteScore: 1)
Intl. Scholarly Research Notices     Open Access   (Followers: 207)
ISRN Astronomy and Astrophysics     Open Access   (Followers: 7)
J. of Addiction     Open Access   (Followers: 14)
J. of Advanced Transportation     Hybrid Journal   (Followers: 13, SJR: 0.581, CiteScore: 1)
J. of Aerodynamics     Open Access   (Followers: 12)

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Similar Journals
Journal Cover
Emergency Medicine International
Journal Prestige (SJR): 0.298
Citation Impact (citeScore): 1
Number of Followers: 9  

  This is an Open Access Journal Open Access journal
ISSN (Print) 2090-2840 - ISSN (Online) 2090-2859
Published by Hindawi Homepage  [338 journals]
  • Colorectal Perforation in Patients with Connective Tissue Disease

    • Abstract: Purpose. The goal of this retrospective study was to identify prognostic factors associated with mortality after surgery for colorectal perforation among patients with connective tissue disease (CTD) and to review postoperative outcomes based on these prognostic factors. Methods. The subjects were 105 patients (CTD group: n=26, 24.8%; non-CTD group: n=79, 75.2%) who underwent surgery for colorectal perforation at our department. Cases with iatrogenic perforation due to colonoscopic examination were excluded from the study. We retrospectively investigated perioperative clinicopathological factors in patients undergoing surgery for colorectal perforation. Results. There were 7 patients (6.7%) who died within 28 days after surgery in all patients. In multivariate analysis, CTD and fecal peritonitis emerged as significant independent prognostic factors (p=0.005, odds ratio=12.39; p=0.04, odds ratio=7.10, respectively). There were 5 patients (19.2%) who died within 28 days after surgery in the CTD group. In multivariate analysis, fecal peritonitis emerged as a significant independent prognostic factor in the CTD group (p=0.03, odds ratio=31.96). The cumulative survival curve in the CTD group was significantly worse than that in the non-CTD group (p=0.006). An analysis based on the presence of fecal peritonitis indicated no significant difference in cumulative survival curves for patients without fecal peritonitis in the CTD and non-CTD groups (p=0.55) but a significant difference in these curves for patients with fecal peritonitis in the two groups (p
      PubDate: Wed, 19 Jun 2019 10:05:14 +000
  • Current Guideline of Chest Compression Depth for Children of All Ages May
           Be Too Deep for Younger Children

    • Abstract: Aim. To determine whether the chest compression depth of at least 1/3 of the Anteroposterior (AP) diameter of the chest and about 5 cm is appropriate for children of all age groups via chest computed tomography. Methods. The AP diameter of the chest, anterior chest wall diameter, and compressible diameter (Cd) were measured at the lower half of the sternum for patients aged 1-18 years using chest computed tomography. The mean ratio of 5 cm compression to the Cd of adult patients was used as the lower limit, and the mean ratio of 6 cm compression to the Cd of adult patients was used as the upper limit. Also, the depth of chest compression resulting in a residual depth
      PubDate: Wed, 19 Jun 2019 09:05:15 +000
  • Characteristics of Elderly Long-Term Care Residents Who Were Injured and
           Transferred to Hospital Emergency Departments in Korea: A Retrospective
           Multicenter Study

    • Abstract: The objective of this retrospective multicenter study was to investigate the mechanism and characteristics of trauma experienced by patients aged ≥65 years who were transferred from a long-term care hospital to one of five university hospital emergency departments. Of 255,543 patients seen in one of the five emergency departments, 79 were transferred from a long-term care hospital because of trauma. The most common trauma mechanism was slipping down, with 33 (58.9%) patients, followed by falling from a bed (17.9%), striking an object such as a wall or corner (10.7%), overextending a joint (8.9%), and unknown mechanisms (3.6%). Many cases of slip (39.4%) occurred in relation to the bathroom. Comparing slip and fall from a bed, we found more hip fractures (95.2%) because of slipping down than falling from a bed (57.1%); traumatic brain injury only occurred in slip cases. These traumas cause significant morbidity in elderly patients; therefore, we sought to identify strategies that prevent slip in long-term care hospitals.
      PubDate: Sun, 02 Jun 2019 11:05:39 +000
  • Association of Plasma Levels of Nitric Oxide Oxidative Metabolites with
           Acute Stroke in Patients Presenting to the Emergency Department of a
           Low-Middle Income Country

    • Abstract: Introduction. Acute stroke incites an inflammatory reaction in the brain’s microvasculature, activating formation of nitric oxide oxidative metabolites, nitrate and nitrite (NOx, collectively), measurable in plasma. Our objectives were to investigate plasma NOx in patients with acute stroke presenting to the Emergency Department (ED) and to determine if it could (i) differentiate between ischemic and hemorrhagic stroke; (ii) predict clinical outcomes. Methods. A cross-sectional study was conducted in the ED of Aga Khan University Hospital, from January 1 to December 31, 2016. Participants were enrolled if they had clinical acute stroke with confirmatory brain imaging to differentiate between ischemia and hemorrhage. Clinical demographic information, ancillary blood, and diagnostic specimens were collected as per standard of care since the center follows stroke algorithmic guidelines. Plasma NOx analysis was performed using high performance liquid chromatography. Clinical outcomes were assessed using Barthel Index and Modified Rankin Score. Data was analyzed using SPSS 19 and expressed in medians with interquartile ranges. Nonparametric tests were applied for comparing among groups. Pearson’s correlation was used to determine associations with aforementioned stroke severity and disability scales. Results. Seventy-five patients were enrolled, with median age of 57 years (IQR 47-66 years), 53 (71%) were males, and 46 (61%) had ischemic stroke. Overall, median NOx was 20.8 μM (IQR 13.4-35.3); there was no statistically significant difference between NOx in ischemic versus hemorrhagic stroke (21.2 μM vs. 17.9 μM; p=0.2). However, there was a significant positive correlation between NOx levels and aforementioned acute stroke scales [r(73)=0.417, p=0.0001], for both. Conclusion. Although plasma NOx could not differentiate between ischemia and hemorrhage, higher levels of the biomarker did show associations with poststroke disability scales. Further study with more patients in a multicenter trial is warranted to establish the real biomarker potential of plasma NOx in acute stroke.
      PubDate: Sun, 02 Jun 2019 00:06:24 +000
  • Characteristics of Bed Bug Infested Patients in the Emergency Department

    • Abstract: Cimex lectularius L., the common bed bug, is a hematophagous human ectoparasite that has undergone a global resurgence in the past two decades. We surveyed 706 active emergency department (ED) patients about their experiences with bed bugs. We found that 2% of ED patients reported having a current bed bug infestation, significantly more than the historical number of ED patients upon which we find bed bug; 37% of ED patients report previously having been fed on by a bed bug; 15% currently know someone with an active infestation; and 59% know someone that has had an infestation within ≤ 5 years. Only 18% of bed bug infested patients reported their infestation to emergency medicine providers and only 21% were put in isolation precautions. We found that 25% of patients with bed bugs worried about receiving worse healthcare because of their infestation. Persons with bed bugs were more likely compared to those without bed bugs to be older (52 vs. 41 years) and arrive by ambulance (57% vs. 14%) (p < 0.05), but not reporting insomnia (50% vs. 49%) (p = 1.0). Bed bug infested patients can be common in the ED. Most bed bug infested patients are older, arrive to the ED by ambulance, do not report their infestation to healthcare providers, and are not adequately placed into isolation precautions, potentially putting other patients and providers at risk for acquiring the infestation.
      PubDate: Thu, 09 May 2019 08:05:18 +000
  • Comparison of Fatal Injuries Resulting from Tractor and High Speed
           Motorcycle Accidents in Turkey: A Multicenter Study

    • Abstract: Aim. Injuries are among the main causes of mortality and morbidity all over the world, and effective initial triage of these patients can determine the thin line between death and life. Tractor accidents and related injuries are significant problems particularly in rural areas. However, major trauma classification systems do not include tractor accidents as a criterion for trauma team activation or transportation of the patients to a trauma center. This study evaluated the general characteristics and outcomes of tractor accidents in comparison to motorcycle accidents, which are considered as a comparison criterion for major trauma. Materials and Methods. This is a multicenter study conducted in 6 emergency departments in 4 cities over a six month period. All cases over 18 years of age who were admitted to emergency service due to tractor or motorcycle accidents and meet the criteria were included in the study. The general characteristics and outcomes of both trauma types were compared to determine whether tractor accident should be considered as major traumas. Results. Eighty-eight patients had a tractor accident, and 339 patients had a motorcycle accident. The tractor accident victims were significantly younger (p
      PubDate: Thu, 02 May 2019 00:10:31 +000
  • Assessment of the Accuracy of Cardiopulmonary Resuscitation Videos in
           English on YouTube according to the 2015 AHA Resuscitation Guidelines

    • Abstract: Over the last decade, YouTube has become one of the largest online resources for medical information. However, uploaded videos are published without any peer review or quality control, so incorrect and incomplete information can be easily disseminated via the virtual platform and can be perceived as correct. The YouTube website was searched for videos in English uploaded between 15 October 2015 and 21 October 2016 using the following keywords: “CPR,” “cardiopulmonary resuscitation,” and “basic life support.” This study had a cross-sectional analytical design. In the first evaluation, the accuracy of the videos was checked according to the information contained in the basic cardiac life support algorithm. In the second evaluation, we assessed whether advanced-level, innovative medical information was included in these videos; when included, the accuracy of such information was checked. Of 774 videos evaluated, 92 videos were included in the study after application of the exclusion criteria. The videos were scored on a scale ranging from 0 to 20 points. The mean total score, based on all criteria, was 4.79 ± 2.88. The highest mean total score was achieved by videos uploaded by official medical organizations (6.43 ± 3.57), followed by those uploaded by health professionals and organizations (4.25 ± 2.49), and those uploaded by unidentified sources. YouTube videos are insufficient in providing information about the basic life support algorithm and advanced-level information according to the 2015 AHA resuscitation guidelines for health professionals. The educational material published by health institutions that are constantly working in the area is a more reliable source of information on subjects that directly affect human life, such as cardiopulmonary resuscitation.
      PubDate: Thu, 02 May 2019 00:00:00 +000
  • Risk Factors for Prolonged Length of Stay of Older Patients in an Academic
           Emergency Department: A Retrospective Cohort Study

    • Abstract: Emergency departments (EDs) are challenged with a growing population of older patients. These patients are at risk for a prolonged length of stay (LOS) at the ED and face more complications and poorer clinical outcomes. We aimed to identify risk factors for a prolonged LOS of older patients at the ED. For this retrospective clinical database study, we analyzed medical records of 2000 patients ≥70 years old presenting at the ED of a large level I trauma center in the Netherlands. LOS above the percentile of LOS at our ED, 293 minutes, was considered prolonged. After bivariate analysis, we identified associations between LOS and patient, organizational, and clinical factors. Associations with a p < 0.05 were inserted in multivariable logistic regression models. We analyzed 1048 men (52%) and 952 women (48%) with a mean age of 78 ± 6.2 years. Risk factors for prolonged LOS of older patients at the ED were follows: higher number (more than one) of consultations (OR [odds ratio] 2.4, CI [confidence interval] 2.0-2.91), or diagnostic interventions (OR 1.5, CI 1.4-1.7); presenting complaints of a neurological (OR 2.2, CI 1.0-4.5) or internal medicine focus (OR 2.6, CI 1.4-4.6); patients with an altered consciousness (OR 3.3, CI 1.6-6.6); treatment by physicians of the departments of surgery (OR 3.4, CI 2.2-5.2), internal medicine (OR 2.6, CI 1.9-3.7), or pulmonology (OR 2.2, CI 1.4-3.6); and urgency category of ≥ U1. Awareness of factors associated with prolonged LOS of older patients presenting at the ED is essential. Physicians should recognize and take these factors into account, in order to improve clinical outcomes of the (strongly increasing) population of older patients at the ED.
      PubDate: Thu, 02 May 2019 00:00:00 +000
  • Diagnostic Agreement between Prehospital Emergency and In-Hospital

    • Abstract: Background. The aim of the study was to determine the diagnostic agreement between the discharge diagnosis and the suspected diagnosis by the prehospital emergency physician and to run a sensitivity analysis of the most common diagnoses by the prehospital emergency physician. Methods. The diagnostic agreement was determined by a systematic comparison of the discharge diagnosis with suspected diagnosis by the prehospital emergency physician in a period of 24 months at the emergency medical services in Bad Belzig. The diagnostic agreement of the 13 most common discharge diagnoses was compared to the remaining diagnostic agreement. The results were tested for statistical significance using the chi-squared test. Results. In 64.1% of cases included, a diagnostic agreement occurred. There was a high proportion of diagnostic agreement for hypoglycemia (97%), atrial fibrillation (87%), cramping seizure (86%), hypertensive crisis (85.5%), and syncope (81%). There was a low proportion of diagnostic agreement for chest wall pain (27%), pneumonia (32%), and cardiac decompensation (53%). Conclusions. Our attention in practice and emergency medical courses should be directed to chest pain patients and the main symptom of dyspnea, because of the high proportion of incorrect diagnoses by the prehospital emergency physician. It should be noted that 92% of incorrectly diagnosed chest wall pain cases were overestimated with an acute coronary syndrome.
      PubDate: Wed, 24 Apr 2019 09:05:27 +000
  • Assessment of Knowledge and Practices of Standard Precaution against Blood
           Borne Pathogens among Doctors and Nurses at Adult Emergency Room in Addis
           Ababa, Ethiopia

    • Abstract: Background. Standard precautions are infection control techniques against pathogenic microorganisms that are present in human blood and can cause disease in humans. Objective. This study aims to assess knowledge and practice of standard precautions against blood borne pathogens among doctors and nurses in adult emergency room, Addis Ababa, Ethiopia. Methods. Institutional based cross sectional study was conducted from February to March 2018. A total of 128 study participants selected from four public hospitals were enrolled in this study. Data were collected using standardized pretested questionnaire and thencoded, entered, checked for completeness, and analyzed using SPSS version-23 statisticalsoftware. Chi-square test was used to measure the association between variables. P values
      PubDate: Tue, 23 Apr 2019 12:05:19 +000
  • A Rare Cause of Abdominal Pain: Scar Endometriosis

    • Abstract: Introduction. Scar endometriosis (SE) is a rare pathology that develops in the scar tissue formed on the anterior abdominal wall usually after a cesarean section. There have been instances of women presenting to emergency or general surgery clinics with abdominal pain due to SE. Materials and Methods. This study retrospectively reviews 19 patients who were operated on in our clinic between January 2010 and January 2017 with a prediagnosis of SE and were reported to have SE based on their pathology results. Results. The mean age of the patients was 30.8 years (range: 20-49 years). The body mass indexes of 12 (63.2%) patients were ≥ 25. All patients had a history of cesarean section and 9 (47.4%) patients had undergone cesarean section once. With the exception of one patient who had her SE localized in her inguinal region, all patients had a mass localized on their anterior abdominal wall neighboring the incision and complained about cyclic pain starting in their premenstrual periods. The complaints began 2 years after their cesarean section in 10 (52.6%) patients. Mostly abdominal ultrasonography was used for diagnostic purposes. The lesions were totally excised and the SE diagnosis was made through a histopathological examination in all patients. No postoperative complications or recurrences were seen in any of the patients. Conclusion. Suspicion of SE is essential in women of reproductive age who have a history of cesarean section and complaints of an anterior abdominal wall mass and a pain at the scar site that is associated with their menstrual cycle. An accurate and early diagnosis can be established in such patients through a careful history and a good physical examination and possible morbidities can be prevented with an appropriate surgical intervention.
      PubDate: Wed, 17 Apr 2019 13:05:21 +000
  • Influence of Time of Mission on Correct Diagnosis by the Prehospital
           Emergency Physician: A Retrospective Study

    • Abstract: Objectives. The objective of this retrospective study was to examine the diagnostic matching (DM) between the prehospital diagnosis by the prehospital emergency physicians and the hospital discharge diagnosis, adjusted for time of mission. Methods. Over a period of 12 months, all patient care reports of the emergency medical services in Bad Belzig were examined. By systematically comparing the prehospital suspected diagnosis to the discharge diagnosis, the DM was determined after careful examination of the entire course of each patient’s case, blinded to time of mission. The results were tested for statistically significant results using the Chi-square test for nominal data and the Mann-Whitney U test for nonnormally distributed independent samples. Results. The DM occurred in 52%, it occurred partially in 24%, and it did not occur in 24% of 580 included cases. The DM showed clear fluctuation over 24 hours, with the worst results at 4 and 5 a.m. and the best results at 6 a.m. and 3 p.m. Conclusions. The DM appears to depend directly on the time of mission. Decreased performance and concentration at night might be a cause for incorrect diagnoses by prehospital emergency physician in the early morning hours. Future studies need to investigate the effect of different shift planning on performance.
      PubDate: Tue, 02 Apr 2019 13:30:05 +000
  • The Effect of Leucocytosis, Gender Difference, and Ultrasound in the
           Diagnosis of Acute Cholecystitis in the Elderly Population

    • Abstract: Introduction. Acute cholecystitis is one of the most common reasons of acute abdominal pain for older patients to present to the emergency department (ED). Presentation may differ from that of the younger patient and is often complicated by coexistent disease due to elderliness. In this study, we aimed to evaluate the clinical presentation of acute cholecystitis, with special focus on comparision between elderly and young patients. Materials and Methods. This study included 318 patients who were admitted to the emergency department with right upper quadrant pain during a period of determined 8 months. After retrospective data collection, patients were groupped in accordance with their age,
      PubDate: Tue, 02 Apr 2019 10:05:14 +000
  • Contribution of Experimental Animal Research Studies to the Emergency
           Medicine Literature

    • Abstract: The aim of this study is to provide a detailed analysis of emergency medicine (EM) research literature to unveil the trends while underlining the importance of experimental research for all territories of science. To this end, the experimental animal research articles published in EM journals indexed to the Science Citation Index Expanded database with a date of publication between January 1, 2008, and December 31, 2017, were reviewed retrospectively. All data regarding the journal name, publication year, country, department and institution of the first author, subject species, type of the experimental model, target organ/system/functions, evaluation method, outcome measures, and citation counts were noted. Resultantly, a total of 736 articles were found to be published in 18 journals. Resuscitation (n=285, 38.7%) had the highest number of articles followed by Injury (n=143, 19.4%), Turkish Journal of Trauma and Emergency Surgery (n=128, 17.4%), and American Journal of Emergency Medicine (n=63, 8.6%). The USA was the largest contributor with 199 studies (27%). The department of the first author was EM in 190 (28.8%) of the reports. Various versions of cardiac arrest models were applied in 257 (34.9%) studies while brain (n=101, 13.7%) was the most commonly explored area. The main outcome measures were clinical outcomes/survival rates (n=408, 55.43%). The molecular mechanisms of the injury were evaluated in 37 (5%) of the studies. In conclusion, experimental animal studies are essential in the progress of contemporary scientific knowledge. EM journals should encourage and consider giving more place to experimental research given their undisputed worth and potential future contributions to science, including the field of EM.
      PubDate: Mon, 01 Apr 2019 11:05:28 +000
  • Prospective Trial to Compare Direct and Indirect Laryngoscopy Using C-MAC
           PMĀ® with Macintosh Blade and D-BladeĀ® in a Simulated Difficult Airway

    • Abstract: Objective. Evaluation of C-MAC PM® in combination with a standard Macintosh blade size 3 in direct and indirect laryngoscopy and D-Blade® in indirect laryngoscopy in a simulated difficult airway. Primary outcome was defined as the best view of the glottic structures. Secondary endpoints were subjective evaluation and assessment of the intubation process. Methods. Prospective monocentric, observational study on 48 adult patients without predictors for difficult laryngoscopy/tracheal intubation undergoing orthopedic surgery. Every participant preoperatively received a cervical collar to simulate a difficult airway. Direct and indirect laryngoscopy w/o the BURP maneuver with a standard Macintosh blade and indirect laryngoscopy w/o the BURP maneuver using D-Blade® were performed to evaluate if blade geometry and the BURP maneuver improve the glottic view as measured by the Cormack-Lehane score. Results. Using a C-MAC PM® laryngoscope, D-Blade® yielded improved glottic views compared with the Macintosh blade used with either the direct or indirect technique. Changing from direct laryngoscopy using a Macintosh blade to indirect videolaryngoscopy using C-MAC PM® with D-Blade® improved the Cormack-Lehane score from IIb, III, or IV to I or II in 31 cases. Conclusion. The combination of C-MAC PM® and D-Blade® significantly enhances the view of the glottis compared to direct laryngoscopy with a Macintosh blade in patients with a simulated difficult airway. Trial Registration Number. This trial is registered under number NCT03403946.
      PubDate: Mon, 01 Apr 2019 10:05:29 +000
  • Does Interhospital Transfer Influence the Outcomes of Patients Receiving
           Surgery for Acute Type A Aortic Dissection' Type A Aortic Dissection:
           Is Transfer Hazardous or Beneficial'

    • Abstract: Introduction. The progression of acute type A aortic dissection may cause immediate death, such that, in the event of its diagnosis, emergency surgery is indicated. Relatedly, an interhospital transfer may prolong the time from diagnosis to surgery. This study therefore investigated how interhospital transfers impact surgical outcomes for acute type A aortic dissection. Materials and Methods. After excluding those patients who received deferred surgery for acute type A aortic dissection, 112 patients who received emergency surgery for the condition at our hospital from January 2011 to January 2018 were enrolled. These patients were divided into two groups, one consisting of the patients who were sent directly to our emergency department (group 1) and the other consisting of the patients who were transferred from another hospital after first being diagnosed with type A aortic dissection (group 2). The collected data included the patient demographics, clinical characteristics, operative findings and methods, postoperative outcomes, latest follow-up time, and most recent status. Results. There were 59 patients in group 1 and 53 patients in group 2. Univariate analysis revealed that group 1 had significantly more patients with a previous stroke (p = 0.007). Moreover, the average length of time from receiving a computed tomography (CT) scan to entering the operating room (OR) was shorter for the group 1 patients (p < 0.001). However, except for the incidence of postoperative acute kidney injury (14.5% versus 33.3%, p = 0.024), there was no statistical difference between the groups in terms of the operative findings and outcomes, such as hypotension before cardiopulmonary bypass, hemopericardium, other complications, and survival rate. Multivariate analysis showed that the independent predictors of hospital mortality included age > 61.5 years (p = 0.017), respiratory rate upon admission > 18.5 breaths/minute (p = 0.046), and total bypass time > 265.6 minutes (p = 0.015). For the patients who survived to discharge, log-rank analysis demonstrated similar cumulative survival rates for the two groups (p = 0.62). Further multivariate analysis showed that the risk of death after discharge was associated with the interval between the CT scan and OR entry (hazard ratio = 0.97 per minute; 95% confidence interval, 0.950–0.998; p = 0.037). Conclusion. In this study, it was found that interhospital transfer did not influence the surgical outcomes of patients with acute type A aortic dissection. As such, it can be concluded that the transfer of the patients with type A aortic dissection to tertiary hospitals with experienced cardiac surgical teams may not increase the surgical risk.
      PubDate: Mon, 18 Mar 2019 13:05:18 +000
  • Role of Parathyroid Hormone Assay and Bedside Ultrasound in the Emergency
           Department in Differentiating Acute Kidney Injury from Chronic Kidney
           Disease: A Systematic Review

    • Abstract: Introduction. It is not uncommon for patients without preceding history of kidney disease to present to the Emergency department with renal failure. The absence of prior medical records or renal imaging presents a diagnostic challenge. Elevated parathyroid hormone levels or echogenic contracted kidneys on ultrasound are known to point to a diagnosis of chronic kidney disease. The literature in this regard is surprisingly limited. The objective of this study is to assess the role of intact parathyroid (iPTH) blood level and bedside ultrasound in differentiating acute kidney injury from chronic kidney disease. Methods. A systematic review which included a literature search of 3 databases, PubMed, Embase, and Cinahl (R) as also secondary sources, was done. The inclusion criteria evaluated studies which evaluated iPTH or bedside ultrasound in differentiating acute kidney injury from chronic kidney disease. We excluded studies which used other laboratory biomarkers like neutrophil gelatin associated lipocalin (NGAL) or carbamylated haemoglobin. A total of 2256 articles were identified. After screening, the relevant articles were reviewed, and an assessment of their methodological quality was made based on the CASP: Critical Appraisals Skill Programme. Results. Of the 2256 articles identified, after screening, only 5 were identified as relevant. Conclusions. An elevated parathyroid hormone level and echogenic contracted kidneys on bedside ultrasound in the Emergency department can help differentiate acute kidney injury from chronic kidney disease. This differentiation helps decide need for admission as well as further management. Although iPTH level may also rise in acute kidney injury, the value (2.5 times normal) can discriminate it from chronic kidney disease.
      PubDate: Tue, 12 Mar 2019 14:05:02 +000
  • A Reversed Trend: Care for Limited English Proficiency Patients in the
           Pediatric Emergency Department

    • Abstract: Objectives. Previous studies in pediatric emergency departments (EDs) showed patients with limited English proficiency (LEP) had gaps in care compared with English-speaking patients. In 2010, the Joint Commission released patient-centered communication standards addressing these gaps. We evaluate the current care of LEP patients in the Children’s Healthcare of Atlanta (CHOA) EDs. Methods. This was a retrospective cohort study of patients
      PubDate: Mon, 11 Mar 2019 07:05:22 +000
  • Knowledge and Attitude about Basic Life Support and Emergency Medical
           Services amongst Healthcare Interns in University Hospitals: A
           Cross-Sectional Study

    • Abstract: Background. Road traffic accident and sudden cardiac arrest are one of the most leading causes of death in KSA. Basic life support (BLS) is lifesaving intervention as a premedical facility. Adequate knowledge and awareness about BLS and CPR are mandatory for healthcare students. Objective. The objective of the present study is to assess the knowledge, awareness and attitude towards BLS among healthcare interns in different university hospitals across Saudi Arabia. Materials and Methods. A total of 865 health interns attending the health colleges (Medicine, Dentistry, Nursing, Pharmacy) in the University Hospitals across KSA participated in the study. A self-explanatory questionnaire, comprising of 15 questions, was designed for the study. All the hypotheses were formulated using two-tailed alternatives against each null hypothesis. Result. Out of 865 subjects, 698 completed the survey with a response rate of (80.69%). The male to female sex ratio in the entire group of respondents was 1.44:1.00. Mean score about the awareness and knowledge of BLS and other emergency services among the participants was 2.74±1.02 and 4.02±1.56 respectively. Female participants revealed significantly higher awareness score than male (P-value
      PubDate: Sun, 03 Mar 2019 07:05:40 +000
  • Conservative Treatment of Spontaneous Rectus Sheath Hematomas: Single
           Center Experience and Literature Review

    • Abstract: Introduction. Spontaneous rectus sheath hematoma (SRSH) is characterized by bleeding within the rectus abdominis muscle sheath, one of the rare causes of acute abdominal pain. Early diagnosis is imperative in SRSH to prevent complications and the treatment is usually conservative. We intended to present in this study our experience with SRSH patients with respect to diagnostic evaluation and management of their disease. Materials and Methods. In this retrospective study, 14 patients who had received treatment for SRSH in our clinic between January 2012 and December 2017 were assessed in terms of demographic and clinical characteristics, comorbidities, laboratory parameters, diagnostic approach methods, treatment practices, length of hospital stay, and patient outcomes. Results. The patients consisted of 10 (71.4%) females and 4 males (28.6%). The age of the patients ranged between 47 and 93 with a mean age of 66.5 ± 12.1. Anticoagulant treatments were being administered to 5 (35.7%) patients, antiplatelet treatments to 4 (28.5%) patients, and both anticoagulant and antiplatelet treatments to 4 (28.5%) patients. The most common triggering factor was severe cough and the most common initial symptom acute abdominal pain (71.4%). In physical examinations, the entire patients had generalized abdominal tenderness, 10 (71.4%) voluntary guarding and 7 (50%) a right lower quadrant mass. The diagnosis was confirmed by abdominal ultrasonography and computed tomography. Based on the computed tomography findings, the disease was classified as Type 2 found in 9 (64.3%) patients, Type 1 in 3 (21.4%) patients, and Type 3 in 2 (14.2%) patients. All the patients were treated conservatively. They were hospitalized for 1 to 23 days. There was no mortality. All the patients were followed up between 3 months and 2 years and no recurrence was recorded. Conclusion. Considering the presence of SRSH particularly in older female patients who use anticoagulant drugs and have newly developed an abdominal pain and a palpable mass after coughing spells is the key to make an early and correct diagnosis and to prevent possible morbidity and mortality with an appropriate treatment method.
      PubDate: Thu, 21 Feb 2019 00:05:29 +000
  • Review of the Problems of Diagnosis of Endopelvic Haemorrhage, Its
           Intensity, Volume, and Duration, and Treatment Methods of Circulatory
           Injuries and Surgical Hemostasis after Pelvic Fractures

    • Abstract: Objective. The development of pelvic surgeries is now making new evolutionary jump for us to witness; this would be unimaginable without significant achievements in anesthesiology and new technologies of blood replacement. Methods. This overview presents analysis of 41 domestic and 20 foreign references sources that are devoted to the problematics of treating patients with fluid injuries of pelvis accompanied by retroperitoneal haemorrhage. Results. The following considers details on determination of endopelvic haemorrhage nature, its intensity, volume, and duration, as well as the treatment methods for circulatory injuries and surgical haemostasis. Conclusions. Energy of mechanical influence of traumatizing agent determines the damage levels (system disintegration) for pelvic ring, the bone core, and soft tissue mass. Diagnosis tactics and treatment of patients with disintegrating pelvic damage in the end are determined with volumes and intensity of haemorrhage as well as the character of related damage.
      PubDate: Tue, 19 Feb 2019 15:05:14 +000
  • Intestinal Obstruction due to Bezoar in Elderly Patients: Risk Factors and
           Treatment Results

    • Abstract: Purpose. Bezoars are foreign particles from the accumulation of indigestible materials in the gastrointestinal system and a rare cause of mechanical intestinal obstruction. We aimed at investigating differences in risk factors for the development of intestinal obstruction associated with bezoar in elderly patients. Methods. Hospital records of patients who underwent surgery associated with phytobezoar between January 2004 and May 2016 were retrospectively evaluated. Patients were divided into two groups [
      PubDate: Sun, 17 Feb 2019 13:05:45 +000
  • A Critical Appraisal of Emergency Medicine Specialty Training and
           Resignation among Residents in Emergency Medicine in Turkey

    • Abstract: Background and Aim. The nonsatisfaction among emergency medicine specialty trainees is an underrated issue in Turkey. Several previous studies have evaluated the burn-out and its consequences among physicians, but there is no study conducted with specialty trainees. The aim of this study is to evaluate the reasons for resignation among emergency medicine specialty residents in Turkey. Method. A total of 41 participants, who resigned from emergency medicine residency, were contacted by phone and invited to complete an online survey that included 25 questions about personal characteristics and departmental information. Results. Most frequent reasons of resignation were violence/security concerns (63.4%), busy work environment (53.7%), and mobbing (26.8%). Participants who reported that they have resigned due to inadequate training were mostly over 30 years old (p=0.02), continued more than 6 months to EMST (p
      PubDate: Sun, 17 Feb 2019 10:05:12 +000
  • Ocular Ultrasonography: A Useful Instrument in Patients with Trauma Brain
           Injury in Emergency Service

    • Abstract: The measurement of the optic nerve sheath by ocular ultrasonography might be an indirect method to assess the quickly increase of the intracranial pressure in patients with moderate trauma brain injury, taking into account that an important proportion of these could develop the increase of the intracranial pressure in a hospital-acquired way. Therefore noninvasive, reliable, and convenient techniques are needed making the ocular ultrasonography a useful tool, due to the invasive monitoring elements’ problems and the poor access to measure the intracranial pressure in emergency services. In spite of the limitations and few studies that exist to consider it as a possible early detection, this technique could work as a noninvasive one in the case that could not be possible to do invasive monitoring or when it is not recommended.
      PubDate: Mon, 21 Jan 2019 13:05:10 +000
  • Knowledge of Nonmedical Individuals about Cardiopulmonary Resuscitation in
           Case of Cardiac Arrest: A Cross-Sectional Study in the Population of
           Jeddah, Saudi Arabia

    • Abstract: Introduction. In cardiac arrest victims, providing a high-quality cardiopulmonary resuscitation (CPR) is a fundamental component of initial care, especially in the out-of-hospital settings. In this study, we sought to assess the knowledge of nonmedical people regarding cardiopulmonary resuscitation in the case of out-of-hospital cardiac arrest. Methods. A cross-sectional survey containing 22 questions was administered to individuals aged ≥ 18 years, who were not health care providers. Sample included residents of Jeddah, Saudi Arabia. The survey included knowledge about cardiac arrest findings, previous experience with CPR, knowledge of basic life support (BLS), and concerns related to CPR. Results. The fully completed survey forms of 600 respondents were analysed. Out of these, 28.7% stated that they had previously received training in CPR. Regarding manifestations of cardiac arrest, 40.7% suggested loss of consciousness, 36.8% suggested cessation of breathing, and 24.7% suggested cessation of circulation. Only 11.7% among respondents were found to be able to perform chest compressions. Also, only 9.2% could perform mouth-to-mouth ventilation, and 29.5% were able to perform both. While 55.5% knew the location for performing chest compressions, 44.7% knew the correct depth, and only 18.5% knew the correct compression–ventilation rate. Bystander CPR had been performed by only 10.7%. Conclusion. In our sample, we found lack of knowledge regarding CPR. We advise for a coordinated national effort to improve the public awareness about CPR performance. This may include mass education, specialized training, and setting legislations.
      PubDate: Wed, 16 Jan 2019 07:05:12 +000
  • The Impact of EGDT on Sepsis Mortality in a Single Tertiary Care Center in

    • Abstract: Background. EGDT (Early Goal Directed Therapy) or some portion of EGDT has been shown to decrease mortality secondary to sepsis and septic shock. Objective. Our study aims to assess the effect of adopting this approach in the emergency department on in-hospital mortality secondary to sepsis/septic shock in Lebanon. Hypothesis. Implementation of the EGDT protocol of sepsis in ED will decrease in-hospital mortality. Methods. Our retrospective study included 290 adult patients presenting to the ED of a tertiary center in Lebanon with severe sepsis and/or septic shock. 145 patients between years 2013 and 2014 who received protocol care were compared to 145 patients treated by standard care between 2010 and 2012. Data from the EHR were retrieved about patients’ demographics, medical comorbidities, and periresuscitation parameters. A multivariate analysis using logistic regression for the outcome in-hospital mortality after adjusting for protocol use and other confounders was done and AOR was obtained for the protocol use. 28-day mortality, ED, and hospital length of stay were compared between the two groups. Results. The most common infection site in the protocol arm was the lower respiratory tract (42.1%), and controls suffered more from UTIs (33.8%). Patients on protocol care had lower in-hospital mortality than that receiving usual care, 31.7% versus 47.6% (p=0.006) with an AOR of 0.429 (p =0.018). Protocol patients received more fluids at 6 and 24 hours (3.8 ± 1.7 L and 6.1 ± 2.1 L) compared to the control group (2.7 ± 2.0 L and 4.9 ± 2.8 L p=
      PubDate: Tue, 15 Jan 2019 13:05:15 +000
  • Increased Serum Concentrations of TNF-Like Weak Inducer of Apoptosis
           Predict Higher 28-Day Mortality in Patients with Sepsis

    • Abstract: We performed the current study to explore potential predictive value of serum Tumor Necrosis Factor- (TNF-) like weak inducer of apoptosis (TWEAK) concentrations for 28-day mortality in patients with sepsis. Adult septic patients (age≥18 years) admitted to a general ICU between November 2016 and October 2017 were consecutively included in our prospective observational study. TWEAK concentrations were detected in septic patients and healthy controls. Dynamic changes of TWEAK concentrations between 1st day and 3rd day of admission to ICU (ΔTWEAK concentrations) were also measured. A total of 79 septic patients were included and 19 of them (24.1%) died after a follow-up period of 28 days. We identified arterial lactate, NT-proBNP, and male gender as independent factors for 28-day mortality of patients with sepsis. The serum levels of TWEAK were significantly lower in septic patients compared to controls (417.4 ± 196.7 pg/ml versus 1243.8 ± 174.3 pg/ml, p
      PubDate: Thu, 10 Jan 2019 13:05:12 +000
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