The American journal of emergency medicine
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Multicenter Study Observational Study
Risk factors associated with intracranial bleeding and neurosurgery in patients with mild traumatic brain injury who are receiving direct oral anticoagulants.
The established clinical risk factors for post-traumatic intracranial bleeding have not been evaluated in patients receiving DOACs yet. ⋯ Clinical risk factors can be used in DOACs patients to better define the risk of post-traumatic ICH.
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Observational Study
Initial creatine kinase level as predictor for delayed neuropsychiatric sequelae associated with acute carbon monoxide poisoning.
The primary goal of treating patients with carbon monoxide (CO) poisoning is preventing delayed neuropsychiatric sequelae (DNS). It is difficult to predict DNS because there is no precise diagnostic method in the early phase of CO poisoning. In this study, we aimed to investigate the optimal cut-off value for creatine kinase level to predict DNS. ⋯ In patients with CO poisoning, initial creatine kinase concentrations of >1603 U/L can be used as an independent predictor of DNS.
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Meta Analysis
Effect of antiplatelet treatments on patients with COVID-19 infection: A systematic review and meta-analysis.
Despite the rationale that early anti-platelet would lower the risk of major organ dysfunction, the effectiveness of this approach remains controversial. Therefore, we perform a systematic review and meta-analysis to investigate the effect of antiplatelet treatments on patients with COVID-19 infection. An electronic search was carried out in Pubmed, Embase, Cochrane library, Web of Science, MEDLINE, Wanfang and China National Knowledge Infrastructure (CNKI). ⋯ The meta-analysis showed antiplatelet agents were not associated with higher risk of severe COVID-19 disease (OR = 0.98, 95%CI: 0.64 to 1.50, P = 0.94; I 2 = 65%), while an adjusted analysis indicated that antiplatelet agents was not associated with an increased risk of mortality (OR = 0.65, 95%CI: 0.40 to 1.06, P = 0.498; I 2 = 0%). The results of this study reveal that while there is no significant benefit on mortality demonstrated with the use of antiplatelet agents, the upper bound of the confidence interval suggests that there is unlikely to be a compelling risk of harm associated with this practice. The benefit and risk of the use of antiplatelet agents should be fully considered especially in the presence of thrombocytopenia status in patients with COVID-19.
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The purpose of this study was to compare the effect of two types of cervical collars (Philadelphia and Miami-J) on pulmonary function and ventilation in healthy volunteers through spirometry, peak flow meter, and capnograph. ⋯ In summary, we noted a statistically significant expiratory flow obstruction after both the Philadelphia and Miami-J cervical collar. These changes were not clinically significant in healthy volunteers, albeit may have ramifications in patients with pre-existing respiratory compromise.