The American journal of emergency medicine
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Chest X-ray, the established standard of confirming endotracheal tube (ETT) position, has important drawbacks including radiation exposure. Point-of-care airway ultrasound, which has been insufficiently studied in children, can overcome these problems. ⋯ Bedside ultrasound is a good method to confirm ETT depth in children. The tracheal ring method had the best diagnostic accuracy and is easy to perform. The new method using cricoid cuff distance needs further validation in different ICU settings.
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The aim of this study is to evaluate gender perception among patients in the emergency department (ED) and to examine the effect of gender perception on patients' preference of physician's gender. ⋯ In the context of emergency settings and general examinations, approximately three-quarters of the participants indicated no preference regarding the gender of the physician. However, in the case of sensitive medical issues, the proportion of participants with no gender preference was less than half. For patients with a gender preference for their physician, perception of gender is a significant predictor.
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Case Reports
High homocysteine levels as potential indicators of subacute combined degeneration of the spinal cord.
Homocysteine (Hcy) is widely recognized as a significant risk factor for cardiovascular and cerebrovascular diseases. However, our research has uncovered a novel perspective, suggesting that elevated levels of Hcy could serve as an indicator for neurological diseases. This article presents a unique case of Subacute Combined Degeneration of the spinal cord(SCD), characterized by high homocysteine levels, yet normal vitamin B12 and imaging results. This discovery could facilitate early detection and ensure timely referral of patients to specialized departments for further treatment.
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Airway management is a key intervention during the resuscitation of critically ill trauma patients. Emergency surgical airway (ESA) placement is taught as a backup option when endotracheal intubation (ETI) fails. We sought to (1) describe the incidence of the emergency department (ED) ESA, (2) compare ESA versus ETI-only recipients, and (3) determine which factors were associated with receipt of an ESA. ⋯ ESA placement is a rarely performed procedure but frequently used as a primary airway intervention in this dataset. Penetrating mechanisms, and injuries to face were most associated with ESA placement. Our findings reinforce the need to maintain this critical airway skill for trauma management.
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To analyze the clinical characteristics, surgical management decisions, and outcomes of Neonatal testicular torsion (NTT) in order to offer guidance for future clinical practice. ⋯ NTT primarily occurs prenatally with insidious manifestations, often leading to omission or misdiagnosis. The testicular salvage rate is extremely low. Physicians need to attach importance to neonatal testicular examination, improve the vigilance of NTT. Early bilateral exploration does not necessarily save the affected testes, but it is more important to prevent damage to the contralateral one.