The American journal of emergency medicine
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To explore the impact of mild hypercapnia or normocapnia on the prognosis of patients after the return of spontaneous circulation (ROSC) following cardiac arrest (CA). ⋯ This is the first meta-analysis specifically to compare the clinical outcome of CA with mild hypercapnia or normocapnia and find that mild hypercapnia may not be detrimental to the prognosis of patients after CA. It is unnecessary to control the mild hypercapnia intensively to normal range of PaCO2 in clinics.
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Intravenous (IV) diltiazem and metoprolol are commonly used to achieve rate control for atrial fibrillation with RVR (Afib with RVR), and are both recommended as first-line by current guidelines. While prior studies investigated the efficacy of these medications, there is little evidence available regarding the risk of adverse events (AEs) with their use. ⋯ Afib with RVR treated with metoprolol had lower rates of AE (bradycardia and/or hypotension) compared to those treated with diltiazem. We found no difference in rates of hypotension or bradycardia when individually assessed. Existing data are limited by small sample sizes, variability in dosing, and limited representation of important patient subgroups.
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Neutropenia is defined as an absolute neutrophil count (ANC) < 1500 cells/microL and may be discovered incidentally in an asymptomatic, afebrile patient. ⋯ Understanding the approach to incidental neutropenia can improve patient care. Critically ill or febrile patients should be admitted, but select patients may be discharged.
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Review
Evaluating data sharing statements in leading emergency medicine journals: A mixed methods review.
Emergency medicine remains as the front line of healthcare, providing acute care to a diverse population during urgent and critical moments. Our objective was to systematically quantify the prevalence of data sharing statements (DSS) in high-impact emergency medicine journals and assess their implementation by contacting corresponding authors who indicated data available upon request. ⋯ Our study revealed a lack of adherence to DSS, with a slight improvement recently. Listed funding sources and publishers influence DSS presence, highlighting their policy impacts on open science. Our recommendations include increased funding for data sharing, implementation of FAIR (Findability, Accessibility, Interoperability, and Reuse of digital assets) principles, and encouraging DSS inclusion as a publication requirement to enhance transparency and reproducibility, improving patient care. Further research needs to address barriers to data sharing and develop sustainable solutions in a dynamic research environment.
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Various regional anesthesia techniques have been studied for blunt chest wall trauma over the past decades, but their impact on patient outcomes remains unclear. This systematic review and Bayesian network meta-analysis aimed to identify the most effective regional anesthesia techniques for different outcomes in blunt thoracic trauma patients. ⋯ Various locoregional techniques are being investigated for managing pain in blunt thoracic trauma, with thoracic epidural showing consistent positive effects on pain and other key outcomes. Fascial blocks are emerging as potential alternatives with similar pain relief, though evidence on other outcomes is limited. Future studies should compare the efficacy of these techniques on more definitive endpoints.