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Diagnostics
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Emergency Medicine: Diagnosis and Management
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Emergency Medicine: Diagnosis and Management

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Pathology and Molecular Diagnostics".

Deadline for manuscript submissions: closed (30 April 2024) | Viewed by 8097

Special Issue Editor

Dr. Sung-Yuan Hu

E-Mail
Guest Editor
1. Department of Emergency Medicine, Taichung General Veterans General Hospital, Taichung 407219, Taiwan
2. Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
3. School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan
4. Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung 402, Taiwan
5. School of Medicine, National Yang Ming Chiao Tung University, Taipei 11217, Taiwan
Interests: diagnostics; prehospital care; disaster; trauma; neurovascular disease; respiratory failure; sepsis; cardiovascular disease; community-acquired infections; paediatrics emergency; clinical toxicology; emergency nursing care; occupational medicine

Special Issue Information

Dear Colleagues,

This Special Issue aims to improve the care of patients with diagnosis and treatment of emergency medicine by acquiring, discussing, distributing, and promoting evidence-based information relevant to emergency physicians. In particular, we welcome articles related to the diagnostics of emergency patients, including but not limited to the risk stratification of emergencies and critical illnesses, and the diagnosis of a certain disease/complication/syndrome.

The issue will publish original articles, reviews, technical notes, and case reports covering all aspects of emergency medicine, including but not limited to pre-hospital care, disasters, trauma, neurovascular disease, respiratory failure, sepsis, cardiovascular disease, community-acquired infections, paediatric emergencies, clinical toxicology, emergency nursing care, and occupational medicine.

Dr. Sung-Yuan Hu
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • diagnostics
  • prehospital care
  • disaster
  • trauma
  • neurovascular disease
  • respiratory failure
  • sepsis
  • cardiovascular disease
  • community-acquired infections
  • paediatrics emergency
  • clinical toxicology
  • emergency nursing care
  • occupational medicine

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  • Greater discoverability: Special Issues support the reach and impact of scientific research. Articles in Special Issues are more discoverable and cited more frequently.
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Further information on MDPI's Special Issue policies can be found here.

Published Papers (4 papers)

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Research

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8 pages, 521 KiB  
Article
The Role of Vascular Cell Adhesion Molecule-1 (VCAM-1) in Predicting Complicated Appendicitis in Children
by Wen-Ya Lin, En-Pei Lee, Chun-Yu Chen, Bei-Cyuan Guo, Mao-Jen Lin and Han-Ping Wu
Diagnostics 2024, 14(12), 1256; https://doi.org/10.3390/diagnostics14121256 - 14 Jun 2024
Cited by 1 | Viewed by 992
Abstract
Background: Acute appendicitis is a common abdominal emergency observed in emergency departments (ED). Distinguishing between uncomplicated and complicated appendicitis is important in determining a treatment strategy. Serum soluble vascular cell adhesion molecule-1 (VCAM-1) is an inflammatory biomarker. We aimed to determine the role [...] Read more.
Background: Acute appendicitis is a common abdominal emergency observed in emergency departments (ED). Distinguishing between uncomplicated and complicated appendicitis is important in determining a treatment strategy. Serum soluble vascular cell adhesion molecule-1 (VCAM-1) is an inflammatory biomarker. We aimed to determine the role of VCAM-1 in predicting complicated appendicitis in children. Methods: Pediatric patients with suspected appendicitis admitted to the ED were enrolled in this prospective study. Pre-surgical serum VCAM-1 was tested in children with acute appendicitis within 72 h of symptoms (from day 1 to day 3). Serum VCAM-1 levels were further analyzed and compared between patients with and without complicated appendicitis. Results: Among the 226 pediatric appendicitis patients, 70 had uncomplicated appendicitis, 138 had complicated appendicitis, and 18 had normal appendices. The mean serum VCAM-1 levels in patients with perforated appendicitis were higher than in those with simple appendicitis (p < 0.001). On day 1 to day 3, the mean VCAM-1 levels in patients with complicated appendicitis were all significantly higher than in those with uncomplicated appendicitis (all p < 0.001). Conclusion: Serum VCAM-1 levels may be helpful in differentiating uncomplicated and complicated appendicitis in children and could predict appendiceal perforation. Full article
(This article belongs to the Special Issue Emergency Medicine: Diagnosis and Management)
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14 pages, 1848 KiB  
Article
Implementation of a Smart Teaching and Assessment System for High-Quality Cardiopulmonary Resuscitation
by Li-Wen Huang, Yu-Wei Chan, Yu-Tse Tsan, Qi-Xiang Zhang, Wei-Chang Chan and Han-Hsuan Yang
Diagnostics 2024, 14(10), 995; https://doi.org/10.3390/diagnostics14100995 - 10 May 2024
Cited by 1 | Viewed by 1662
Abstract
The purpose of this study is to develop a smart training and assessment system called SmartCPR, for teaching and training cardiopulmonary resuscitation (CPR), based on human posture estimation techniques. In this system, trainees can automatically recognize and evaluate whether chest compressions during [...] Read more.
The purpose of this study is to develop a smart training and assessment system called SmartCPR, for teaching and training cardiopulmonary resuscitation (CPR), based on human posture estimation techniques. In this system, trainees can automatically recognize and evaluate whether chest compressions during CPR meet the standard of high-quality CPR by simply using a device such as a smart phone. Through the system, trainees are able to obtain real-time feedback on the quality of compressions so that they can adjust the cycle, depth, frequency, and posture of compressions to meet the standard of high-quality CPR. In addition, the SmartCPR system is convenient for CPR trainers. Trainers can instantly and accurately assess whether the trainee’s compressions meet the standard of high-quality CPR, which reduces the risk of manual assessment errors and also reduces the trainer’s teaching pressures. Therefore, the SmartCPR system developed in this study can be an important tool for CPR teaching and training for physicians, which can provide training and guidance for high-quality CPR maneuvers and enable trainees to become more proficient in CPR and self-training. Full article
(This article belongs to the Special Issue Emergency Medicine: Diagnosis and Management)
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16 pages, 3354 KiB  
Article
Good Performance of Revised Scoring Systems in Predicting Clinical Outcomes of Aeromonas Bacteremia in the Emergency Department: A Retrospective Observational Study
by Cheng-Yang Wen, Sung-Yuan Hu, Ming-Shun Hsieh, Shih-Che Huang, Chia-Hui Shen and Yi-Chun Tsai
Diagnostics 2024, 14(2), 124; https://doi.org/10.3390/diagnostics14020124 - 5 Jan 2024
Viewed by 1311
Abstract
Background: Aeromonas species, Gram-negative, non-sporulating, facultative, and anaerobic bacilli, widely distributed in aquatic environments, derive various infections, including bacteremia. Most of these infections were opportunistic and found in patients with predisposing conditions. Among the infections, bacteremia remains with notable mortality, reported from 15% [...] Read more.
Background: Aeromonas species, Gram-negative, non-sporulating, facultative, and anaerobic bacilli, widely distributed in aquatic environments, derive various infections, including bacteremia. Most of these infections were opportunistic and found in patients with predisposing conditions. Among the infections, bacteremia remains with notable mortality, reported from 15% to 45%. However, predicting systems for assessing the mortality risk of this disease have yet to be investigated. We aimed to validate the performance of specific predictive scoring systems to assess the clinical outcomes of Aeromonas bacteremia and applied the revised systems to predict mortality risk. Methods: A retrospective observational study reviewed patients with bacteremia caused by Aeromonas spp. based on at least one positive blood culture sample collected in the emergency department from January 2012 to December 2020. The outcome was in-hospital mortality. We used seven predictive scoring systems to predict the clinical outcome. According to the effectiveness in predicting mortality, we revised three of the seven predictive scoring systems by specific characteristics to refine their risk-predicting performances. Results: We enrolled 165 patients with bacteremia caused by Aeromonas spp., including 121 males (73.3%) and 44 females (26.7%), with a mean age of 66.1 ± 14.9 years and an average length of hospital stay of 12.4 ± 10.9 days. The overall mortality rate was 32.7% (54/165). The non-survivors had significantly higher scores in MEDS (6.7 ± 4.2 vs. 12.2 ± 3.3, p < 0.001), NEWS (4.0 ± 2.8 vs. 5.3 ± 3.0, p = 0.008), and qSOFA (0.3 ± 0.6 vs. 0.6 ± 0.7, p = 0.007). Regarding mortality risk prediction, the MEDS demonstrated the best predictive power with AUC of ROC measured up to 0.834, followed by NEWS (0.626) and qSOFA (0.608). We revised the MEDS, NEWS, and qSOFA by hemoglobin and lactate. We found that the revised scores had better powerful performance, including 0.859, 0.767, and 0.691 of the AUC of ROC, if the revised MEDS ≥10, revised NEWS ≥8, and revised qSOFA ≥2, respectively. Conclusions: MEDS, NEWS, and qSOFA were good tools for predicting outcomes in patients with Aeromonas spp. bacteremia. The revised MEDS, NEWS, and qSOFA demonstrated more powerful predicting performance than the original scoring systems. We suggested that patients with higher scores in revised MEDS (≥10), revised NEWS (≥8), and revised qSOFA (≥2) received early goal-directed therapy and appropriate broad-spectrum antibiotic treatment as early as possible to reduce mortality. Full article
(This article belongs to the Special Issue Emergency Medicine: Diagnosis and Management)
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Other

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20 pages, 420 KiB  
Systematic Review
Myocarditis, Myositis, and Myasthenia Gravis Overlap Syndrome Associated with Immune Checkpoint Inhibitors: A Systematic Review
by Demis N. Lipe, Aiham Qdaisat, Pavitra P. Krishnamani, Trung D. Nguyen, Patrick Chaftari, Nour El Messiri, Aswin Srinivasan, Elkin Galvis-Carvajal, Cielito C. Reyes-Gibby and Monica K. Wattana
Diagnostics 2024, 14(16), 1794; https://doi.org/10.3390/diagnostics14161794 - 16 Aug 2024
Cited by 2 | Viewed by 3645
Abstract
Immune checkpoint inhibitors (ICIs) have significantly transformed cancer treatment, but their use is linked to immune-related adverse events (irAEs), including the rare ICI-associated myocarditis, myositis, and myasthenia gravis (MMM) overlap syndrome. This systematic review aims to highlight MMM’s clinical implications in emergency departments. [...] Read more.
Immune checkpoint inhibitors (ICIs) have significantly transformed cancer treatment, but their use is linked to immune-related adverse events (irAEs), including the rare ICI-associated myocarditis, myositis, and myasthenia gravis (MMM) overlap syndrome. This systematic review aims to highlight MMM’s clinical implications in emergency departments. PubMed and Embase were searched using a specific search strategy. Reports were eligible for inclusion if all three conditions were present and associated with the use of an ICI. Data were extracted by independent reviewers using the Rayyan web application for systematic reviews. Descriptive statistics and qualitative synthesis were used to summarize demographic, clinical, and treatment data for the reported cases. Among 50 cases, predominantly associated with melanoma, lung cancer, and renal cancer, the in-hospital mortality rate was 38.0%. The most commonly presenting symptoms were ptosis (58%), dyspnea (48%), diplopia (42%), or myalgia (36%). The median time from ICI initiation to MMM presentation was 21 days (interquartile range: 15–28 days). Corticosteroids were the primary treatment for the irAEs. MMM, a rare but potentially fatal complication of ICI therapy, requires prompt recognition in emergency settings. Corticosteroids should be initiated if suspected, without waiting for confirmation. Multidisciplinary collaboration is vital for diagnosis and treatment planning. Research on MMM’s link to specific cancers and ICIs is imperative for better risk assessment and interventions. Full article
(This article belongs to the Special Issue Emergency Medicine: Diagnosis and Management)
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