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  • 1
    Online Resource
    Online Resource
    Twelve-Lead Electrocardiogram Acquisition With a Patchy-Type Wireless Device in Ambulance Transport: Simulation-Based Randomized Controlled Trial
    JMIR Publications Inc. ; 2021
    In:  JMIR mHealth and uHealth Vol. 9, No. 4 ( 2021-4-1), p. e24142-
    Details
    In: JMIR mHealth and uHealth, JMIR Publications Inc., Vol. 9, No. 4 ( 2021-4-1), p. e24142-
    Abstract: Cardiovascular disease is the leading cause of death worldwide. Early recognition, diagnosis, and reperfusion are the key elements of treatment for ST-segment elevation myocardial infarction. The absence of a prehospital 12-lead electrocardiogram (P12ECG) can cause definitive treatment delay and repeated transfer. Although guidelines highly recommend the measurement and transmission of P12ECG data, P12ECG use has not been widely established. Objective The aim of this study was to verify the time-efficiency and feasibility of the use of a patchy-type 12-lead ECG measuring and transmitting device (P-ECG) by an emergency medical technician (EMT) in an ambulance during patient transport. Methods This was a simulation-based prospective randomized crossover-controlled study that included EMTs. The participants were randomly assigned to one of two groups. Group A began the experiment with a conventional 12-lead ECG (C-ECG) device and then switched to the intervention device (P-ECG), whereas group B began the experiment with the P-ECG and then switched to the C-ECG. All simulations were performed inside an ambulance driving at 30 km/h. The time interval was measured from the beginning of ECG application to completion of sending the results. After the simulation, participants were administered the System Usability Scale questionnaire about usability of the P-ECG. Results A total of 18 EMTs were recruited for this study with a median age of 35 years. The overall interval time for the C-ECG was 254 seconds (IQR 247-270), whereas the overall interval time for the P-ECG was 130 seconds (IQR 112-150), with a significant difference (P 〈 .001). Significant differences between the C-ECG and P-ECG were identified at all time intervals, in which the P-ECG device was significantly faster in all intervals, except for the preparation interval in which the C-ECG was faster (P=.03). Conclusions Performance of 12-lead ECG examination and transmission of the results using P-ECG are faster than those of C-ECG during ambulance transport. With the additional time afforded, EMTs can provide more care to patients and transport patients more rapidly, which may help reduce the symptoms-to-balloon time for patients with acute coronary syndrome. Trial Registration ClinicalTrials.gov NCT04114760; https://www.clinicaltrials.gov/ct2/show/NCT04114760
    Type of Medium: Online Resource
    ISSN: 2291-5222
    URL: Article
    DOI: 10.2196/24142
    Language: English
    Publisher: JMIR Publications Inc.
    Publication Date: 2021
    detail.hit.zdb_id: 2719220-9
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  • 2
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    Impact of COVID-19 Pandemic on the Overall Diagnostic and Therapeutic Process for Patients of Emergency Department and Those with Acute Cerebrovascular Disease
    MDPI AG ; 2020
    In:  Journal of Clinical Medicine Vol. 9, No. 12 ( 2020-11-26), p. 3842-
    Details
    In: Journal of Clinical Medicine, MDPI AG, Vol. 9, No. 12 ( 2020-11-26), p. 3842-
    Abstract: (1) Background: During a pandemic, patients and processes in the emergency department (ED) change. These circumstances affect the length of stay (LOS) or degree of crowding in the ED. The processes for patients with acute critical illness, such as cerebrovascular disease (CVD), can be also delayed. Using the process mining (PM) method, this study aimed to evaluate LOS, ED processes for CVD, and delayed processes during the coronavirus disease 2019 (COVID-19) pandemic. (2) Methods: Data were collected from the Clinical Data Warehouse of a medical center. Phase 1 included patients who visited the ED before the COVID-19 outbreak. In Phase 2, post-COVID-19 ED patients were divided into the COVID-19 tested group (CTG) and COVID-19 not tested group (CNTG) according to whether polymerase chain reaction test was performed. We analyzed patients’ ED processes before and after COVID-19 using the PM method. We analyzed patients with acute CVD separately to determine whether the process and LOS of patients with acute critical illness were changed or delayed. (3) Results: After the COVID-19 outbreak, the overall LOS was delayed and all processes in CTG patients were delayed. Registration to triage and triage were delayed in both CTG and CNTG patients. The brain imaging process for CTG patients with acute CVD was also delayed. (4) Conclusion: After a pandemic, some processes were changed, new processes were developed, and processes for patients with acute CVD who needed proper time management were not exempted.
    Type of Medium: Online Resource
    ISSN: 2077-0383
    URL: Article
    DOI: 10.3390/jcm9123842
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2662592-1
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  • 3
    Online Resource
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    Availability of drug at convenient stores is not associated with an increased incidence of their poisoning
    Wiley ; 2019
    In:  Pharmacoepidemiology and Drug Safety Vol. 28, No. 4 ( 2019-04), p. 536-543
    Details
    In: Pharmacoepidemiology and Drug Safety, Wiley, Vol. 28, No. 4 ( 2019-04), p. 536-543
    Abstract: In late 2012, South Korea revised the Pharmaceutical Affairs Act to make selected medications including acetaminophen, ibuprofen, and cold medications available in nonpharmacy outlets, including the 24‐hour convenient stores (CVS). The objective of this study was to identify whether the characteristics and trend of self‐poisonings associated with these medications were altered after the legislative change. Methods A retrospective study was performed using national data from the Emergency Department (ED)‐based Injury In‐depth Surveillance database. The patients diagnosed with poisoning were sorted from 2011 to 2016 and included in the study. As the Act was implemented from 2013, the demographic characteristics and clinical outcomes were compared before and after January 2013. A piecewise regression analysis was performed to determine the association between the monthly use of acetaminophen, medication for cold, and nonsteroidal anti‐inflammatory drugs (NSAIDs) and the incidence of total poisonings before and after the January 2013. Results Among 1 536 277 patients included in the database, 17 523 patients diagnosed with poisoning were enrolled. After the legislative change, the etiology of poisoning did not change, although the frequency of hospitalization from ED was significantly increased. The monthly trend for poisoning due to acetaminophen, cold medications, and NSAIDs showed no significant slope change between before and after the legislative change. The proportional use of acetaminophen and cold medications was significantly decreased, while that of NSAIDs was unchanged before and after the legislative change. Conclusions The change in the Pharmaceutical Affairs Act was not associated with any change in the monthly frequency of medication‐related poisoning.
    Type of Medium: Online Resource
    ISSN: 1053-8569 , 1099-1557
    URL: Issue
    URL: Article
    DOI: 10.1002/pds.v28.4
    DOI: 10.1002/pds.4760
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 1491218-1
    SSG: 15,3
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  • 4
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    Point-of-care ultrasound compression of the carotid artery for pulse determination in cardiopulmonary resuscitation
    Elsevier BV ; 2022
    In:  Resuscitation Vol. 179 ( 2022-10), p. 206-213
    Details
    In: Resuscitation, Elsevier BV, Vol. 179 ( 2022-10), p. 206-213
    Type of Medium: Online Resource
    ISSN: 0300-9572
    URL: Article
    DOI: 10.1016/j.resuscitation.2022.06.025
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2010733-X
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  • 5
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    The effect of norepinephrine on common carotid artery blood flow in septic shock patients
    Springer Science and Business Media LLC ; 2021
    In:  Scientific Reports Vol. 11, No. 1 ( 2021-08-18)
    Details
    In: Scientific Reports, Springer Science and Business Media LLC, Vol. 11, No. 1 ( 2021-08-18)
    Abstract: This study was designed to evaluate the hemodynamic effect of norepinephrine (NE) on the peak systolic velocity (PSV), diameter, and blood flow of the common carotid artery (CCA) using the point-of-care ultrasound (POCUS) in patients with septic shock. The study involved patients above 18 years old with septic shock. Arterial monitoring, carotid ultrasonography, and transthoracic echocardiography were performed before NE administration (T 0 ). When the mean arterial pressure exceeded 65 mmHg after NE administration (T 1 ), the measurement was repeated. Twenty-four patients (median age 67 [interquartile range: 54–77] years; 42% female) with septic shock were examined in this study. Before (T 0 ) and after (T 1 ) NE administration, the PSV (mean, standard deviation [SD]) changed from 85.3 (21.1) cm/s to 83.5 (23.5) cm/s (p = 0.417); this change was not significant. However, the diameter and blood flow of the CCA increased significantly from 0.6 (0.09) cm and 0.75 (0.27) L/min to 0.66 (0.09) cm and 0.85 (0.27) L/min, respectively (p  〈  0.001). The diameter of the left ventricular outflow tract (LVOT) remained unchanged, but the velocity time integral of the LVOT increased significantly from 21.7 (4.39) cm to 23.6 (5.14) cm. There was no significant correlation between changes in blood flow of the CCA and changes in cardiac output (coefficient −0.365, p = 0.079). In conclusion, NE increased the diameter and blood flow of the CCA significantly, without changing the PSV in patients with septic shock.
    Type of Medium: Online Resource
    ISSN: 2045-2322
    URL: Article
    DOI: 10.1038/s41598-021-96082-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2021
    detail.hit.zdb_id: 2615211-3
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  • 6
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    Prognostic implication of elevated cardiac troponin I in patients visiting emergency department without diagnosis of coronary artery disease
    Walter de Gruyter GmbH ; 2021
    In:  Clinical Chemistry and Laboratory Medicine (CCLM) Vol. 59, No. 6 ( 2021-05-26), p. 1107-1113
    Details
    In: Clinical Chemistry and Laboratory Medicine (CCLM), Walter de Gruyter GmbH, Vol. 59, No. 6 ( 2021-05-26), p. 1107-1113
    Abstract: Elevated cardiac troponin is not uncommon in patients visiting emergency department (ED) even without coronary artery disease, but its prognostic implication is not well understood in such patients. Methods In this retrospective single-center registry, we investigated clinical outcome of patients visiting ED without documented coronary artery disease. Patients were categorized according to the maximal value of Siemens ADVIA Centaur TnI-Ultra assay (TnI) within 24 h after visit. Primary endpoint was 180-day all-cause death that included cardiac and non-cardiac death. Results A total of 35,205 patients with median age 61 years and male gender 54.7% were included. Below the lowest level of detection (LOD) (≤0.006 ng/mL), between LOD and assay-specific 〈 99th percentile (0.007–0.039 ng/mL), below median of ≥99th percentile (0.040–0.149 ng/mL), and above median of ≥99th percentile (≥0.150 ng/mL) TnI were found in 18,502 (52.6%), 11,338 (32.2%), 3,029 (8.6%), and 2,336 (6.6%) patients. In the 180-day follow-up period, 4,341 (12.3%) all-cause death including 694 (2.0%) cardiovascular death and 3,647 (10.4%) non-cardiovascular death developed. The risks of all-cause, cardiovascular, and non-cardiovascular death increased across higher TnI strata (hazard ratio [HR]=1.3 to 2.4; 2.0 to 9.3; 1.3 to 1.7; p 〈 0.001, all). Analyses of multivariate models showed consistent results. Conclusions In patients visiting ED, elevated TnI was associated with higher risk of 180-day cardiovascular and non-cardiovascular death. Patients with elevated TnI may need additional evaluation or careful follow-up even without primary diagnosis of coronary artery disease.
    Type of Medium: Online Resource
    ISSN: 1434-6621 , 1437-4331
    URL: Article
    DOI: 10.1515/cclm-2020-1392
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2021
    detail.hit.zdb_id: 1492732-9
    SSG: 15,3
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  • 7
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    Cardiac troponin I predicts clinical outcome of patients with cancer at emergency department
    Wiley ; 2020
    In:  Clinical Cardiology Vol. 43, No. 12 ( 2020-12), p. 1585-1591
    Details
    In: Clinical Cardiology, Wiley, Vol. 43, No. 12 ( 2020-12), p. 1585-1591
    Abstract: The prognostic ability of cardiac troponin I (TnI) has been demonstrated in general populations and among cardiovascular disease patients, but it has not been evaluated in cancer patients. Hypothesis This study assumes to have the prognostic ability of cardiac troponin in cancer patients visiting the emergency department. Methods Cancer patients visiting the emergency department were enrolled in this retrospective cohort study. Patients with previously known coronary artery disease or clinically indicated coronary angiography were not included. The maximal value from Siemens ADVIA Centaur troponin I Ultra assay within 24 hours was assessed. The primary endpoint was 180‐day all‐cause death, including cardiovascular and noncardiovascular death. Results A total of 9135 cancer patients (mean age: 63 years, male gender: 60%) were enrolled. Lowest (0.006 ng/mL), assay‐specific 〈 99th % (0.007‐0.039 ng/mL), below median ≥ 99th % (0.040‐0.129 ng/mL), and above median ≥ 99th % (≥0.130 ng/mL) TnI were found in 4487 (49.1%), 3158 (34.6%), 852 (9.3%), and 638 (7.0%) patients, respectively. There was 3192 (34.9%) all‐cause deaths including 137 (1.5%) cardiovascular and 3047 (33.4%) noncardiovascular deaths in the 180‐day follow‐up period. The risks of all‐cause, cardiovascular, and noncardiovascular death increased across higher TnI strata (hazard ratio [HR] = 1.3‐2.9; 2.1‐9.3; 1.3‐1.8; P 〈  .001, all). These findings were consistent within clinical subgroups including solid and hematologic cancers. Conclusions Cancer patients visiting the emergency department with elevated troponin I were at increased risk of 180‐day death. Cancer patients with elevated TnI may need additional evaluation or careful follow‐up even without cardiovascular disease diagnosis.
    Type of Medium: Online Resource
    ISSN: 0160-9289 , 1932-8737
    URL: Issue
    URL: Article
    DOI: 10.1002/clc.v43.12
    DOI: 10.1002/clc.23486
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2048223-1
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  • 8
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    Epidemiology and Outcome of Powered Mobility Device-Related Injuries in Korea
    XMLink ; 2020
    In:  Journal of Korean Medical Science Vol. 35, No. 9 ( 2020)
    Details
    In: Journal of Korean Medical Science, XMLink, Vol. 35, No. 9 ( 2020)
    Type of Medium: Online Resource
    ISSN: 1011-8934 , 1598-6357
    URL: Article
    DOI: 10.3346/jkms.2020.35.e60
    Language: English
    Publisher: XMLink
    Publication Date: 2020
    detail.hit.zdb_id: 2056822-8
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  • 9
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    A Pilot Study Evaluating LV Diastolic Function with M-Mode Measurement of Mitral Valve Movement in the Parasternal Long Axis View
    MDPI AG ; 2023
    In:  Diagnostics Vol. 13, No. 14 ( 2023-07-19), p. 2412-
    Details
    In: Diagnostics, MDPI AG, Vol. 13, No. 14 ( 2023-07-19), p. 2412-
    Abstract: This pilot study aimed to develop a new, reliable, and easy-to-use method for the evaluation of diastolic function through the M-mode measurement of mitral valve (MV) movement in the parasternal long axis (PSLA), similar to E-point septal separation (EPSS) used for systolic function estimation. Thirty healthy volunteers from a tertiary emergency department (ED) underwent M-mode measurements of the MV anterior leaflet in the PSLA view. EPSS, A-point septal separation (APSS), A-point opening length (APOL), and E-point opening length (EPOL) were measured in the PSLA view, along with the E and A velocities and e’ velocity in the apical four-chamber view. Correlation analyses were performed to assess the relationship between M-mode and Doppler measurements, and the measurement time was evaluated. No significant correlations were found between M-mode and Doppler measurements in the study. However, M-mode measurements exhibited high reproducibility and faster acquisition, and the EPOL value consistently exceeded the APOL value, resembling the E and A pattern. These findings suggest that visually assessing the M-mode pattern on the MV anterior leaflet in the PSLA view may be a practical approach to estimating diastolic function in the ED. Further investigations with a larger and more diverse patient population are needed to validate these findings.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics13142412
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662336-5
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  • 10
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    National Surveillance of Injury in the Republic of Korea: Increased Injury Vulnerability in the Late Middle Age
    MDPI AG ; 2021
    In:  International Journal of Environmental Research and Public Health Vol. 18, No. 3 ( 2021-01-29), p. 1210-
    Details
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 18, No. 3 ( 2021-01-29), p. 1210-
    Abstract: Surveillance of injury patterns and comparisons among different age groups help develop a better understanding of recent injury trends and early prevention. This study conducted a national surveillance of injury by age group. Data were collected retrospectively from Emergency Department-Based Injury In-Depth Surveillance (EDIIS) in South Korea, between January 2011 and December 2017. Patients were divided into the following four groups by age: Group 1–18 to 34 years, Group 2–35 to 49 years, Group 3–50 to 64 years, and Group 4—≥65 years. A total of 1,221,746 patients were included in the study. Findings revealed that, each year, the injury rate increased in the population aged ≥65 years. The place and mechanism of injury in Group 3 were similar to those in younger age groups, while injury outcomes and injured body parts were similar to those in Group 4. Further, hospital admission rate, ICU admission rate, hospital death, traumatic brain injury, and injury severity increased with an increase in age. In our study, each age group showed diverse characteristics pertaining to the mechanism, place, time, and outcomes of injuries. Interestingly, Group 3, which represented the late middle age, exhibited increased vulnerability to injury, and emerged as a gray zone between the young and old age groups. Therefore, different injury prevention methods are needed for each age group. Specifically, early prevention methods need to be implemented from the late middle age to improve the old age group’s injury outcomes.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    URL: Article
    DOI: 10.3390/ijerph18031210
    Language: English
    Publisher: MDPI AG
    Publication Date: 2021
    detail.hit.zdb_id: 2175195-X
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