The American journal of emergency medicine
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Meta Analysis
Neutrophil-to-lymphocyte ratio on admission to predict the severity and mortality of COVID-19 patients: A meta-analysis.
The neutrophil-to-lymphocyte ratio (NLR), an inflammatory marker, was suggested to be predictive of severity and mortality in COVID-19 patients. Here, we investigated whether NLR levels on admission could predict the severity and mortality of COVID-19 patients. ⋯ High NLR levels on admission were associated with severe COVID-19 and mortality. Further studies need to focus on determining the optimal cut-off value for NLR before clinical use.
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Case Reports
Ocular timolol as the causative agent for symptomatic bradycardia in an 89-year-old female.
Bradycardia can present with variations of severity from asymptomatic to life threatening. In this paper we present the case of an 89-year-old female presenting with symptomatic bradycardia for whom the cause was found to be ophthalmic timolol which she had been taking for four years. Prompt recognition of potential causes of bradycardia is essential for correct selection of treatment and disposition.
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Randomized Controlled Trial
Plasma syndecan-1 is associated with fluid requirements and clinical outcomes in emergency department patients with sepsis.
Degradation of the endothelial glycocalyx is recognized as a major part of the pathophysiology of sepsis. Previous clinical studies, mostly conducted in intensive care settings, showed associations between glycocalyx shedding and clinical outcomes. We aimed to explore the association of plasma syndecan-1, a marker of glycocalyx degradation, with the subsequent fluid requirements and clinical outcomes of emergency department patients with sepsis. ⋯ In the emergency department, syndecan-1 levels were associated with fluid requirements, sepsis severity, organ dysfunction, and mortality.
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Meta Analysis
Outcomes of new-onset atrial fibrillation in patients with sepsis: A systematic review and meta-analysis of 225,841 patients.
The outcomes of new-onset atrial fibrillation (AF) during sepsis are inconsistent and inconclusive. This meta-analysis aims to provide a comprehensive description of the impact of new-onset AF on the prognosis of sepsis. ⋯ New-onset AF is frequently associated with adverse outcomes in patients with sepsis. This is a clinical issue that warrants more attention and should be managed appropriately to prevent poor prognosis.
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Multicenter Study
The burden of the pandemic on the non-SARS-CoV-2 emergencies: A multicenter study.
Governments have implemented social distancing interventions to curb the speed of SARS-CoV-2 spread and avoid hospital overload. SARS-CoV-2 social distancing interventions have modified several aspects of society, leading to a change in the emergency medical visit profile. ⋯ The COVID-19 pandemic has changed the non-SARS-CoV-2 emergency profile. The overall number of emergency medical visits has reduced. The mortality of non-SARS-CoV-2 emergencies has not increased in São Paulo.