The American journal of emergency medicine
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Misdiagnosis of cerebrovascular disease among Emergency Department (ED) patients with headache has been reported. We hypothesized that markers of substandard diagnostic processes would be associated with subsequent ischemic cerebrovascular events among patients discharged from the ED with a headache diagnosis even after adjusting for demographic variables and medical history. ⋯ Factors associated with diagnostic process failures did not increase the odds of subsequent ischemic stroke/TIA hospitalization following ED headache visit in our study.
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Observational Study
Diagnostic accuracy of lactate levels after initial fluid resuscitation as a predictor for 28 day mortality in septic shock.
The aim of the study was to investigate the diagnostic accuracy of initial and post-fluid resuscitation lactate levels in predicting 28 day mortality. ⋯ The post-fluid resuscitation lactate level was more accurate than the initial lactate level in predicting 28 day mortality in patients with suspected septic shock.
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Comparative Study
Comparison of performances of top emergency medicine journals in terms of COVID-19 publications in 2020.
The aim of this study is to evaluate the qualitative and quantitative contribution of Emergency Medicine (EM) journals to scientific literature on COVID-19 and compare the journals in terms of publications. ⋯ The contribution of EM journals to COVID-19 literature is controversial. "Effects of COVID-19 on the Health System" is the most studied field. "Clinical Properties, Ethical Issues and Treatment Methods" are neglected fields in EM journals.
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Hollow adrenal gland sign on dual-phase contrast-enhanced CT in critically ill patients with sepsis.
We aimed to describe the clinical manifestations of patients with sepsis who had the hollow adrenal gland sign (HAGS) during the acute phase of resuscitation and evaluated its value in predicting in-hospital mortality. ⋯ Patients with sepsis who showed the HAGS had more severe illness than those who did not, and had an increased need for organ-supportive interventions. Presence of the HAGS was independently associated with in-hospital mortality.
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Observational Study
A pilot study examining the use of ultrasound to measure sarcopenia, frailty and fall in older patients.
The importance of this study is to devise an efficient tool for assessing frailty in the ED. The goals of this study are 1) to correlate ultrasonographic (US) measurements of muscle thickness in older ED patients with frailty and 2) to correlate US-measured sarcopenia with falls, subsequent hospitalizations and ED revisits. ⋯ US measurements of sarcopenia in older patients had mild to moderate associations with frailty, falls and subsequent hospitalizations. Further investigation is needed to confirm these findings.