Emergency medicine journal : EMJ
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Review Meta Analysis
Heart-type fatty acid binding protein as an early marker for myocardial infarction: systematic review and meta-analysis.
Heart-type fatty acid binding protein (H-FABP) has been proposed as an early biomarker of myocardial infarction (MI). The authors aimed to undertake a systematic review and meta-analysis to estimate the early sensitivity and specificity of quantitative and qualitative H-FABP assays. ⋯ H-FABP has modest sensitivity and specificity for MI at presentation but estimates are subject to substantial uncertainty and primary data are subject to substantial heterogeneity. H-FABP may have a role alongside troponin in improving early sensitivity but comparison with high sensitivity troponin assays is required.
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Review Meta Analysis
Heart-type fatty acid binding protein as an early marker for myocardial infarction: systematic review and meta-analysis.
Heart-type fatty acid binding protein (H-FABP) has been proposed as an early biomarker of myocardial infarction (MI). The authors aimed to undertake a systematic review and meta-analysis to estimate the early sensitivity and specificity of quantitative and qualitative H-FABP assays. ⋯ H-FABP has modest sensitivity and specificity for MI at presentation but estimates are subject to substantial uncertainty and primary data are subject to substantial heterogeneity. H-FABP may have a role alongside troponin in improving early sensitivity but comparison with high sensitivity troponin assays is required.
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Recent recommendations from the Society for Academic Emergency Medicine and the American College of Emergency Physicians identified the detection of delirium in the emergency department (ED) as a 'high yield' research objective. This review aimed to determine the occurrence rate, and physician detection rates, of delirium within the ED. A systematic literature review was conducted and identified using online databases. ⋯ Given the scale, addressing delirium should be a priority for clinicians and researchers. To improve delirium outcomes and hospital management, measures must include mechanisms to improve detection. Finding a single validated assessment method and facilitating research in this difficult patient population would be an important progress.
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A short-cut review was carried out to determine the clinical features associated with acute intoxication with Salvia divinorum. Sixty-six papers were found using the reported searches, of which three presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these best papers are tabulated. It is concluded that the most common features of intoxication are tachycardia, hallucinations and acute alteration in mental status.
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A short-cut review was carried out to establish which clinical parameters are useful in predicting outcome in patients who present having body packed metamphetamine. Eleven papers were found using the reported searches, of which one presented the best evidence to answer the clinical question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of that best paper are tabulated. It is concluded that there is a greater likelihood of severe outcomes if the presenting pulse is greater than 120 or the presenting temperature is greater than 38°C.