BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effec...BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.展开更多
BACKGROUND:In-flight medical emergencies(IMEs)present significant challenges to healthcare professionals,particularly those with limited training or experience in managing such situations.The objective of this study w...BACKGROUND:In-flight medical emergencies(IMEs)present significant challenges to healthcare professionals,particularly those with limited training or experience in managing such situations.The objective of this study was to evaluate the level of knowledge,attitudes,and behaviors of licensed doctors in Saudi Arabia concerning IMEs,and to identify the demographic factors influencing their preparedness.METHODS:A cross-sectional study was conducted with a sample of 383 licensed physicians across five regions of Saudi Arabia.Participants completed a self-administered questionnaire assessing demographics,knowledge of IMEs,attitudes towards providing assistance,and previous experience with in-flight emergencies.Data were analyzed using SPSS 26,with statistical significance set at P<0.05.RESULTS:The results revealed a predominantly young(75.8% aged 25-34 years)and male(69.6%)participant pool.While 76.6% of respondents recognized the impact of cabin pressure on oxygen,only 45.4% correctly identified air travel risks for asthmatic patients.Although 66.8% felt confident assisting in IMEs,20.9% cited medicolegal concerns.Moreover,area of working within Saudi Arabia(P=0.020),year of experience(P=0.041),prior experience with IMEs(P=0.021),and IMEs training(P<0.001)had a significant association with levels of knowledge.CONCLUSION:The study highlights a critical need for enhanced training programs with a focus on the management of IMEs among healthcare practitioners in Saudi Arabia.展开更多
Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major...Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.展开更多
BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the tr...BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.展开更多
Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern me...Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern medicine.Clinical decisions often must be made within minutes,yet these decisions are traditionally guided by limited information,heuristic reasoning,and past experience.In this context,the rise of medical data mining and real-time analytics offers a transformative opportunity:to extract actionable intelligence from the flood of clinical,imaging,and physiological data already being collected,and to use this intelligence to guide care in real time[1–3](Figure 1).展开更多
The accurate prediction and analysis of emergencies in Urban Rail Transit Systems(URTS)are essential for the development of effective early warning and prevention mechanisms.This study presents an integrated perceptio...The accurate prediction and analysis of emergencies in Urban Rail Transit Systems(URTS)are essential for the development of effective early warning and prevention mechanisms.This study presents an integrated perception model designed to predict emergencies and analyze their causes based on historical unstructured emergency data.To address issues related to data structuredness and missing values,we employed label encoding and an Elastic Net Regularization-based Generative Adversarial Interpolation Network(ER-GAIN)for data structuring and imputation.Additionally,to mitigate the impact of imbalanced data on the predictive performance of emergencies,we introduced an Adaptive Boosting Ensemble Model(AdaBoost)to forecast the key features of emergencies,including event types and levels.We also utilized Information Gain(IG)to analyze and rank the causes of various significant emergencies.Experimental results indicate that,compared to baseline data imputation models,ER-GAIN improved the prediction accuracy of key emergency features by 3.67%and 3.78%,respectively.Furthermore,AdaBoost enhanced the accuracy by over 4.34%and 3.25%compared to baseline predictivemodels.Through causation analysis,we identified the critical causes of train operation and fire incidents.The findings of this research will contribute to the establishment of early warning and prevention mechanisms for emergencies in URTS,potentially leading to safer and more reliable URTS operations.展开更多
Colorectal cancer(CRC)is a leading cause of cancer-related morbidity and mortality globally,and its management in the emergency setting presents distinct challenges.In addition to its advantages in elective CRC surger...Colorectal cancer(CRC)is a leading cause of cancer-related morbidity and mortality globally,and its management in the emergency setting presents distinct challenges.In addition to its advantages in elective CRC surgery,studies have demonstrated that minimally invasive surgery(MIS)can provide benefits in CRC emergencies,such as reduced morbidity and a shorter length of hospitalization.However,the applicability of MIS in the emergency setting is limited by factors such as compromised patient physiology,resource constraints,and the need for technical expertise.As an alternative to emergency MIS,endoscopic interventions have also been increasingly supported by emerging evidence as a bridge to surgery.This article appraises contemporary guidelines and the evidence behind their recommendations for MIS surgery in CRC emergencies,whilst highlighting the challenges to implementation and the strategies to overcome them.展开更多
Obstacle removal in crowd evacuation is critical to safety and the evacuation system efficiency. Recently, manyresearchers proposed game theoreticmodels to avoid and remove obstacles for crowd evacuation. Game theoret...Obstacle removal in crowd evacuation is critical to safety and the evacuation system efficiency. Recently, manyresearchers proposed game theoreticmodels to avoid and remove obstacles for crowd evacuation. Game theoreticalmodels aim to study and analyze the strategic behaviors of individuals within a crowd and their interactionsduring the evacuation. Game theoretical models have some limitations in the context of crowd evacuation. Thesemodels consider a group of individuals as homogeneous objects with the same goals, involve complex mathematicalformulation, and cannot model real-world scenarios such as panic, environmental information, crowds that movedynamically, etc. The proposed work presents a game theoretic model integrating an agent-based model to removethe obstacles from exits. The proposed model considered the parameters named: (1) obstacle size, length, andwidth, (2) removal time, (3) evacuation time, (4) crowd density, (5) obstacle identification, and (6) route selection.The proposed work conducts various experiments considering different conditions, such as obstacle types, obstacleremoval, and several obstacles. Evaluation results show the proposed model’s effectiveness compared with existingliterature in reducing the overall evacuation time, cell selection, and obstacle removal. The study is potentially usefulfor public safety situations such as emergency evacuations during disasters and calamities.展开更多
[Objectives] To explore the influence and effect of psychological intervention on patients with public security emergencies.[Methods] From May 2021 to June 2021, 29 patients with public safety emergencies were selecte...[Objectives] To explore the influence and effect of psychological intervention on patients with public security emergencies.[Methods] From May 2021 to June 2021, 29 patients with public safety emergencies were selected as the main research objects. On the basis of routine nursing, psychiatric and psychological nursing were carried out, and SAS and SDS scores, satisfaction scores and quality of life scores were compared before and after intervention.[Results] After nursing, the scores of SAS and SDS were lower than those before nursing, and the difference was statistically significant ( P <0.05);the scores of satisfaction were higher than those before nursing, and the difference was statistically significant ( P <0.05);the scores of quality of life were better than those before nursing, and the difference was statistically significant ( P <0.05).[Conclusions] The psychiatric and psychological nursing reduced the negative emotions and psychological stress reactions of patients in public safety emergencies, increased the clinical comfort, changed the negative coping styles of patients, and strengthened the coping measures.展开更多
The aim was to evaluate obstetric emergencies at the Gao hospital. Materials and Methods: This was a descriptive, cross-sectional, analytical, prospective study from January 1 to December 31, 2015, i.e. a period of 12...The aim was to evaluate obstetric emergencies at the Gao hospital. Materials and Methods: This was a descriptive, cross-sectional, analytical, prospective study from January 1 to December 31, 2015, i.e. a period of 12 months. Results: During our study period, we registered 1853 patients among whom were 88 cases of obstetric emergencies, i.e. a frequency of 4.75%. The age group between 15 and 19 years old was the most concerned. Obstetric emergencies are dominated by: placenta previa 20.45%, retroplacental hematoma (RPH) 12.5%, fetal distress (FAS) 12.5%, postpartum hemorrhage (PPH) due to uterine atony 13.63%. Caesarean section was the most used mode of delivery with 70.45%. The maternal death rate was 6.82%. The cause of maternal death was haemorrhage. We say that obstetric emergencies are a public health problem in the world. The conditions of evacuations and the unfavorable socio-economic conditions are the main problems in our context. Conclusion: Urgent care and an improvement in the standard of living of the population are necessary to reduce fetal-maternal mortality.展开更多
Introduction: Benin was embarked on phase 3 of the REDISSE Benin project (Regional Disease Surveillance Systems Enhancement) which began in 2018. The objectives were in five key components namely, Surveillance and hea...Introduction: Benin was embarked on phase 3 of the REDISSE Benin project (Regional Disease Surveillance Systems Enhancement) which began in 2018. The objectives were in five key components namely, Surveillance and health information;Laboratory capacity building;Emergency preparedness and response;Human resources management for effective disease surveillance and epidemic preparedness;and Institutional Capacity Building, Project Management, Coordination and Advocacy. After five years of implementation, this study aimed at the documentation of lessons learned and best practices. Methods: A descriptive cross-sectional study. Apart from individual semi-structured interviews, a thematic workshops bringing together the project’s main stakeholders recruited on an exhaustive way by component to identify and validate lessons learned, good practices and propose improvement mechanisms to be taken into account by the sector. Criteria were set up and used to validate best practices and lessons learned. Results: A total 54 (Surveillance workshop), 47 (Preparedness & response workshop), 53 (Human Resources workshop), 26 (Laboratories workshop) participated to the thematic workshops, and five interviews. The good practices (33: 9 for animal health, 7 for human health and 17 crosscutting) and lessons learned (10: 3 for animal health and 7 for human health) have been identified and have been the subject, depending on the case, of proposals for improvement or conditions necessary for their maintenance. Discussion: The richness of a project lies not only in the immediate achievement of its results, but also and above all, in its usefulness for similar interventions, whether in the local, regional, national or international context. It is in this context that the REDISSE project has set out to make public the various lessons learned and best practices from the implementation of its activities over a period of some five consecutive years.展开更多
Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we s...Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we set ourselves the objectives of: 1) Studying digestive surgical emergencies in the general surgery department of the “Mother Child” Le Luxembourg hospital in Bamako, Mali;2) Determine the frequency of digestive surgical emergencies, 3) Describe the clinical and therapeutic aspects, and 4) Analyze the results of treatment. From November 1, 2022 to October 31, 2023, the general surgery department of the “Mother Child” Luxembourg Hospital Center in Bamako, Mali, carried out 139 digestive surgical emergencies whose files were usable;75 men and 64 women, a sex ratio of 1.2. The 20 - 40 years old age group was the most represented, at 40.29%. The average age was 39 years;the extremes 16 years and 93 years with a standard deviation of 21.65 years. The reference concerned 51.08% of our patients. Abdominal pain was the main reason for consultation (100% of cases). In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain clinical cases, we requested ultrasound (109/139), ASP (46/139) and CT (15/139). The main etiology was acute appendicitis with 42.45% of cases. The frequency of digestive surgical emergencies was 10.71% of all activities in the general surgery department of the “Mère Enfant” Le Luxembourg hospital center in Bamako. All our patients were seen in consultation by an anesthesiologist before entering the operating room. The surgical consequences were complicated in 11.51% of cases with 7.91% deaths. Surgical site infections accounted for 12.5% of postoperative complications. Eleven deaths were noted, representing 68.75% of complications and 7.91% of our sample. Acute peritonitis was the cause of death in 100% of cases. The average cost of care was 329,000 FCFA.展开更多
Introduction: Obstetric emergencies are common throughout the world and more particularly in developing countries where they are responsible for high maternal-fetal mortality and morbidity. Objective: Study obstetric ...Introduction: Obstetric emergencies are common throughout the world and more particularly in developing countries where they are responsible for high maternal-fetal mortality and morbidity. Objective: Study obstetric emergencies in the maternity ward of Kara University Hospital. Method: Retrospective and descriptive study from April 1, 2022 to March 30, 2023, carried out in the Obstetrics and Gynecology Department of Kara University Hospital. Results: Eight hundred and thirty-five (835) obstetric emergencies were recorded out of 2215 admissions, i.e. a frequency of 37.7%. The average age of the patients was 26.7 with a range of 14 and 45 years. They were primigravidas (36.7%) and nulliparous (38.7%), referred (84.7%) and came from rural areas (72%). Emergencies occurred in the 3<sup>rd</sup> trimester in 74.1% and in parturients (54.1%). Preeclampsia (27%), cessation of progression of labor due to feto-pelvic disproportion (12.4%), postpartum hemorrhage (7.5%) constituted the main obstetric emergencies. In 44.8%, the delivery was carried out vaginally. Magnesium sulfate was the most used drug, i.e. 30.1%;followed by antihypertensive medications in 28.1%. Blood transfusion was performed in 24.3%. The evolution was simple in 90.9%. The maternal fatality rate was 1.6%. The perinatal case fatality rate was 12.3%. Conclusion: Obstetric emergencies are common, dominated by preeclampsia, stopping progress of labor and postpartum hemorrhages. They are responsible for high morbidity and mortality.展开更多
Introduction: Urological emergencies play a significant role in the medical and surgical activity of a urology department. The objective of this study was to determine the hospital prevalence of urological emergencies...Introduction: Urological emergencies play a significant role in the medical and surgical activity of a urology department. The objective of this study was to determine the hospital prevalence of urological emergencies at the University Hospital of Brazzaville (CHUB), identify the different pathologies requiring urgent care, and list the various therapeutic methods. Patients and methods: A retrospective study of patients admitted to the medical and surgical emergencies department of CHUB over a 5-year period. Patient records admitted and treated for a urological emergency were included. The variables studied were the frequency of urological emergencies, patient age at admission, gender, nature of the emergency, and various therapeutic options. Results: Urological emergencies accounted for 4.3% of all medical and surgical emergencies. The mean age was 57 ± 28 years with a range of 3 to 93 years. The male-to-female ratio was 7.1. The most common conditions were urinary retention (54.67%), hematuria (17.20%), and renal colic (8.13%). Therapeutically, surgical urinary drainage was dominated by cystostomy. Conclusion: Urological emergencies are infrequent at the University Hospital of Brazzaville. Their management is often delayed.展开更多
1.INTRODUCTION.As the authors of this commentary,we would like to clarify that the figures presented originated from ChatGPT 3.5.Unless specified otherwise,in all figures,questions were provided as input through its u...1.INTRODUCTION.As the authors of this commentary,we would like to clarify that the figures presented originated from ChatGPT 3.5.Unless specified otherwise,in all figures,questions were provided as input through its user interface and the responses generated have been illustrated in a distinct font.The human authors subsequently under-took the editing process where we edited the ChatGPT 3.5 generated responses for better clarity(in terms of text organization)[1-3].展开更多
Introduction: ENT infectious emergencies encompass all infectious pathologies affecting the ear, nose, sinuses, throat, and neck. A good understanding of these emergencies is essential for organizing appropriate care....Introduction: ENT infectious emergencies encompass all infectious pathologies affecting the ear, nose, sinuses, throat, and neck. A good understanding of these emergencies is essential for organizing appropriate care. In Guinea, few studies have described ENT infectious pathologies in rural areas. Objective: To study ENT infectious emergencies in the Otorhinolaryngology department of the Mamou Regional Hospital. Materials and Methods: This is a retrospective and prospective descriptive study, conducted from August 1, 2021, to July 31, 2022. All patients admitted to the ENT department of the Mamou Regional Hospital for an infectious emergency were included. Results: Among the 1854 recorded consultations, 261 cases involved ENT infectious emergencies, representing a prevalence of 14.07%. The most represented age group was 0 to 10 years (31.03%), with a majority of female patients (59%) and a predominantly urban origin (81.61%). Students accounted for 32.18% of the cases. The main reasons for consultation were odynophagia/dysphagia (32.42%) and otalgia (22.94%). The primary etiologies were tonsillitis (28.73%) and otitis (27.20%). Treatments administered included probabilistic antibiotic therapy (38.80%), analgesics (32.03%), and corticosteroid therapy (10.47%). The outcome was favorable in 98.85% of cases, with only 0.38% lost to follow-up. Conclusion: The results of our study confirm the frequency of ENT infectious pathologies. Their management requires joint actions for population awareness, staff training, and services equipment, particularly in rural areas.展开更多
文摘BACKGROUND Managing critical care emergencies in children with autism spectrum disorder(ASD)presents unique challenges due to their distinct sensory sensitivities,communication difficulties,and behavioral issues.Effective strategies and protocols are essential for optimal care in these high-stress situations.AIM To systematically evaluate and synthesize current evidence on best practices for managing critical care emergencies in children with ASD.The review focuses on key areas,including sensory-friendly environments,communication strategies,behavioral management,and the role of multidisciplinary approaches.METHODS A comprehensive search was conducted across major medical databases,including PubMed,Embase,and Cochrane Library,for studies published between 2000 and 2023.Studies were selected based on their relevance to critical care management in children with ASD,encompassing randomized controlled trials,observational studies,qualitative research,and case studies.Data were extracted and analyzed to identify common themes,successful strategies,and areas for improvement.RESULTS The review identified 50 studies that met the inclusion criteria.Findings highlighted the importance of creating sensory-friendly environments,utilizing effective communication strategies,and implementing individualized behavioral management plans.These findings,derived from a comprehensive review of current evidence,provide valuable insights into the best practices for managing critical care emergencies in children with ASD.Sensory modifications,such as reduced lighting and noise,visual aids,and augmentative and alternative communication tools,enhanced patient comfort and cooperation.The involvement of multidisciplinary teams was crucial in delivering holistic care.Case studies provided practical insights and underscored the need for continuous refi-nement of protocols.CONCLUSION The review emphasizes the need for a tailored approach to managing critical care emergencies for children with ASD.Sensory-friendly adjustments,effective communication,and behavioral strategies supported by a mul-tidisciplinary team are integral to improving outcomes.Despite progress,ongoing refinement of care practices and protocols is necessary.This ongoing process addresses remaining challenges and engages healthcare professionals in continuous improvement of care for children with ASD in critical settings.
基金approved by the Regional Research Ethics Committee,Qassim Province,Saudi Arabia.Number(607-45-12634).
文摘BACKGROUND:In-flight medical emergencies(IMEs)present significant challenges to healthcare professionals,particularly those with limited training or experience in managing such situations.The objective of this study was to evaluate the level of knowledge,attitudes,and behaviors of licensed doctors in Saudi Arabia concerning IMEs,and to identify the demographic factors influencing their preparedness.METHODS:A cross-sectional study was conducted with a sample of 383 licensed physicians across five regions of Saudi Arabia.Participants completed a self-administered questionnaire assessing demographics,knowledge of IMEs,attitudes towards providing assistance,and previous experience with in-flight emergencies.Data were analyzed using SPSS 26,with statistical significance set at P<0.05.RESULTS:The results revealed a predominantly young(75.8% aged 25-34 years)and male(69.6%)participant pool.While 76.6% of respondents recognized the impact of cabin pressure on oxygen,only 45.4% correctly identified air travel risks for asthmatic patients.Although 66.8% felt confident assisting in IMEs,20.9% cited medicolegal concerns.Moreover,area of working within Saudi Arabia(P=0.020),year of experience(P=0.041),prior experience with IMEs(P=0.021),and IMEs training(P<0.001)had a significant association with levels of knowledge.CONCLUSION:The study highlights a critical need for enhanced training programs with a focus on the management of IMEs among healthcare practitioners in Saudi Arabia.
文摘Introduction: Respiratory distress is a clinical condition accompanied by an increase in work of breathing, with the respiratory accessory muscles brought into play to ensure normal arterial oxygenation. It is a major cause of morbidity and mortality in pediatrics. The aim of our study was to investigate the epidemiological, clinical and therapeutic aspects of respiratory distress in children aged between 1 month and 15 years seen in the emergency department of the Bangui paediatric university hospital. Methodology: This was a 3-month descriptive cross-sectional study, from January 1 to March 31, 2023. All children aged 1 month to less than 15 years presenting with respiratory distress were included. Results: A total of 3021 children were admitted to the emergency medical services of Bangui’s pediatric university hospital. Of these, 164 were included in the study. The predominance was male, with a sex ratio of 1.09. The 0 - 2 age group was the most represented, with 67 patients (42.85%). The majority of patients came from Bangui, accounting for 146 (89.02%) of cases. Respiratory difficulty (59.15%), characterized by dyspnea and cough, associated with fever, vomiting, physical asthenia and diarrhea, were the main reasons for consultation. The main pathologies noted were respiratory 92 (56.10%), followed by cardiac pathologies 21 (12.8%). Antibiotic administration (76.82%) was the most common therapeutic procedure used in the management of respiratory distress. Conclusion: Respiratory distress remains an important cause of infant mortality in our context, with major management problems.
文摘BACKGROUND Emergency medical care is essential in preventing morbidity and mortality,especially when interventions are time-sensitive and require immediate access to supplies and trained personnel.AIM To assess the treatment rates of eye emergencies in Africa.Ocular emergencies are particularly delicate due to the eye’s intricate structure and the necessity for its refractive components to remain transparent.METHODS This review examines the low treatment rates of eye emergencies in Africa,drawing on 96 records extracted from the PubMed database using predetermined search criteria.RESULTS The epidemiology of ocular injuries,as detailed in the studies,reveals significant relationships between the incidence and prevalence of eye injuries and factors such as age,gender,and occupation.The causes of eye emergencies range from accidents to gender-based violence and insect or animal attacks.Management approaches reported in the review include both surgical and non-surgical interventions,from medication to evisceration or enucleation of the eye.Preventive measures emphasize eye health education and the use of protective eyewear and facial protection.However,inadequate healthcare infrastructure and personnel,cultural and geographical barriers,and socioeconomic and behavioral factors hinder the effective prevention,service uptake,and management of eye emergencies.CONCLUSION The authors recommend developing eye health policies,enhancing community engagement,improving healthcare personnel training and retention,and increasing funding for eye care programs as solutions to address the low treatment rate of eye emergencies in Africa.
文摘Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern medicine.Clinical decisions often must be made within minutes,yet these decisions are traditionally guided by limited information,heuristic reasoning,and past experience.In this context,the rise of medical data mining and real-time analytics offers a transformative opportunity:to extract actionable intelligence from the flood of clinical,imaging,and physiological data already being collected,and to use this intelligence to guide care in real time[1–3](Figure 1).
基金supported by the Fundamental Research Funds for the Central Universities(grant number 2024YJS096)National Natural Science Foundation of China(grant numbers 62433005,62272036,62173167).
文摘The accurate prediction and analysis of emergencies in Urban Rail Transit Systems(URTS)are essential for the development of effective early warning and prevention mechanisms.This study presents an integrated perception model designed to predict emergencies and analyze their causes based on historical unstructured emergency data.To address issues related to data structuredness and missing values,we employed label encoding and an Elastic Net Regularization-based Generative Adversarial Interpolation Network(ER-GAIN)for data structuring and imputation.Additionally,to mitigate the impact of imbalanced data on the predictive performance of emergencies,we introduced an Adaptive Boosting Ensemble Model(AdaBoost)to forecast the key features of emergencies,including event types and levels.We also utilized Information Gain(IG)to analyze and rank the causes of various significant emergencies.Experimental results indicate that,compared to baseline data imputation models,ER-GAIN improved the prediction accuracy of key emergency features by 3.67%and 3.78%,respectively.Furthermore,AdaBoost enhanced the accuracy by over 4.34%and 3.25%compared to baseline predictivemodels.Through causation analysis,we identified the critical causes of train operation and fire incidents.The findings of this research will contribute to the establishment of early warning and prevention mechanisms for emergencies in URTS,potentially leading to safer and more reliable URTS operations.
文摘Colorectal cancer(CRC)is a leading cause of cancer-related morbidity and mortality globally,and its management in the emergency setting presents distinct challenges.In addition to its advantages in elective CRC surgery,studies have demonstrated that minimally invasive surgery(MIS)can provide benefits in CRC emergencies,such as reduced morbidity and a shorter length of hospitalization.However,the applicability of MIS in the emergency setting is limited by factors such as compromised patient physiology,resource constraints,and the need for technical expertise.As an alternative to emergency MIS,endoscopic interventions have also been increasingly supported by emerging evidence as a bridge to surgery.This article appraises contemporary guidelines and the evidence behind their recommendations for MIS surgery in CRC emergencies,whilst highlighting the challenges to implementation and the strategies to overcome them.
文摘Obstacle removal in crowd evacuation is critical to safety and the evacuation system efficiency. Recently, manyresearchers proposed game theoreticmodels to avoid and remove obstacles for crowd evacuation. Game theoreticalmodels aim to study and analyze the strategic behaviors of individuals within a crowd and their interactionsduring the evacuation. Game theoretical models have some limitations in the context of crowd evacuation. Thesemodels consider a group of individuals as homogeneous objects with the same goals, involve complex mathematicalformulation, and cannot model real-world scenarios such as panic, environmental information, crowds that movedynamically, etc. The proposed work presents a game theoretic model integrating an agent-based model to removethe obstacles from exits. The proposed model considered the parameters named: (1) obstacle size, length, andwidth, (2) removal time, (3) evacuation time, (4) crowd density, (5) obstacle identification, and (6) route selection.The proposed work conducts various experiments considering different conditions, such as obstacle types, obstacleremoval, and several obstacles. Evaluation results show the proposed model’s effectiveness compared with existingliterature in reducing the overall evacuation time, cell selection, and obstacle removal. The study is potentially usefulfor public safety situations such as emergency evacuations during disasters and calamities.
文摘[Objectives] To explore the influence and effect of psychological intervention on patients with public security emergencies.[Methods] From May 2021 to June 2021, 29 patients with public safety emergencies were selected as the main research objects. On the basis of routine nursing, psychiatric and psychological nursing were carried out, and SAS and SDS scores, satisfaction scores and quality of life scores were compared before and after intervention.[Results] After nursing, the scores of SAS and SDS were lower than those before nursing, and the difference was statistically significant ( P <0.05);the scores of satisfaction were higher than those before nursing, and the difference was statistically significant ( P <0.05);the scores of quality of life were better than those before nursing, and the difference was statistically significant ( P <0.05).[Conclusions] The psychiatric and psychological nursing reduced the negative emotions and psychological stress reactions of patients in public safety emergencies, increased the clinical comfort, changed the negative coping styles of patients, and strengthened the coping measures.
文摘The aim was to evaluate obstetric emergencies at the Gao hospital. Materials and Methods: This was a descriptive, cross-sectional, analytical, prospective study from January 1 to December 31, 2015, i.e. a period of 12 months. Results: During our study period, we registered 1853 patients among whom were 88 cases of obstetric emergencies, i.e. a frequency of 4.75%. The age group between 15 and 19 years old was the most concerned. Obstetric emergencies are dominated by: placenta previa 20.45%, retroplacental hematoma (RPH) 12.5%, fetal distress (FAS) 12.5%, postpartum hemorrhage (PPH) due to uterine atony 13.63%. Caesarean section was the most used mode of delivery with 70.45%. The maternal death rate was 6.82%. The cause of maternal death was haemorrhage. We say that obstetric emergencies are a public health problem in the world. The conditions of evacuations and the unfavorable socio-economic conditions are the main problems in our context. Conclusion: Urgent care and an improvement in the standard of living of the population are necessary to reduce fetal-maternal mortality.
文摘Introduction: Benin was embarked on phase 3 of the REDISSE Benin project (Regional Disease Surveillance Systems Enhancement) which began in 2018. The objectives were in five key components namely, Surveillance and health information;Laboratory capacity building;Emergency preparedness and response;Human resources management for effective disease surveillance and epidemic preparedness;and Institutional Capacity Building, Project Management, Coordination and Advocacy. After five years of implementation, this study aimed at the documentation of lessons learned and best practices. Methods: A descriptive cross-sectional study. Apart from individual semi-structured interviews, a thematic workshops bringing together the project’s main stakeholders recruited on an exhaustive way by component to identify and validate lessons learned, good practices and propose improvement mechanisms to be taken into account by the sector. Criteria were set up and used to validate best practices and lessons learned. Results: A total 54 (Surveillance workshop), 47 (Preparedness & response workshop), 53 (Human Resources workshop), 26 (Laboratories workshop) participated to the thematic workshops, and five interviews. The good practices (33: 9 for animal health, 7 for human health and 17 crosscutting) and lessons learned (10: 3 for animal health and 7 for human health) have been identified and have been the subject, depending on the case, of proposals for improvement or conditions necessary for their maintenance. Discussion: The richness of a project lies not only in the immediate achievement of its results, but also and above all, in its usefulness for similar interventions, whether in the local, regional, national or international context. It is in this context that the REDISSE project has set out to make public the various lessons learned and best practices from the implementation of its activities over a period of some five consecutive years.
文摘Digestive surgical emergencies concern all patients admitted urgently, for whom a decision for surgical intervention may be necessary within 24 hours. They are on guard duty day and night. To carry out this work, we set ourselves the objectives of: 1) Studying digestive surgical emergencies in the general surgery department of the “Mother Child” Le Luxembourg hospital in Bamako, Mali;2) Determine the frequency of digestive surgical emergencies, 3) Describe the clinical and therapeutic aspects, and 4) Analyze the results of treatment. From November 1, 2022 to October 31, 2023, the general surgery department of the “Mother Child” Luxembourg Hospital Center in Bamako, Mali, carried out 139 digestive surgical emergencies whose files were usable;75 men and 64 women, a sex ratio of 1.2. The 20 - 40 years old age group was the most represented, at 40.29%. The average age was 39 years;the extremes 16 years and 93 years with a standard deviation of 21.65 years. The reference concerned 51.08% of our patients. Abdominal pain was the main reason for consultation (100% of cases). In the majority of cases, the physical examination made it possible to make the diagnosis. Faced with certain clinical cases, we requested ultrasound (109/139), ASP (46/139) and CT (15/139). The main etiology was acute appendicitis with 42.45% of cases. The frequency of digestive surgical emergencies was 10.71% of all activities in the general surgery department of the “Mère Enfant” Le Luxembourg hospital center in Bamako. All our patients were seen in consultation by an anesthesiologist before entering the operating room. The surgical consequences were complicated in 11.51% of cases with 7.91% deaths. Surgical site infections accounted for 12.5% of postoperative complications. Eleven deaths were noted, representing 68.75% of complications and 7.91% of our sample. Acute peritonitis was the cause of death in 100% of cases. The average cost of care was 329,000 FCFA.
文摘Introduction: Obstetric emergencies are common throughout the world and more particularly in developing countries where they are responsible for high maternal-fetal mortality and morbidity. Objective: Study obstetric emergencies in the maternity ward of Kara University Hospital. Method: Retrospective and descriptive study from April 1, 2022 to March 30, 2023, carried out in the Obstetrics and Gynecology Department of Kara University Hospital. Results: Eight hundred and thirty-five (835) obstetric emergencies were recorded out of 2215 admissions, i.e. a frequency of 37.7%. The average age of the patients was 26.7 with a range of 14 and 45 years. They were primigravidas (36.7%) and nulliparous (38.7%), referred (84.7%) and came from rural areas (72%). Emergencies occurred in the 3<sup>rd</sup> trimester in 74.1% and in parturients (54.1%). Preeclampsia (27%), cessation of progression of labor due to feto-pelvic disproportion (12.4%), postpartum hemorrhage (7.5%) constituted the main obstetric emergencies. In 44.8%, the delivery was carried out vaginally. Magnesium sulfate was the most used drug, i.e. 30.1%;followed by antihypertensive medications in 28.1%. Blood transfusion was performed in 24.3%. The evolution was simple in 90.9%. The maternal fatality rate was 1.6%. The perinatal case fatality rate was 12.3%. Conclusion: Obstetric emergencies are common, dominated by preeclampsia, stopping progress of labor and postpartum hemorrhages. They are responsible for high morbidity and mortality.
文摘Introduction: Urological emergencies play a significant role in the medical and surgical activity of a urology department. The objective of this study was to determine the hospital prevalence of urological emergencies at the University Hospital of Brazzaville (CHUB), identify the different pathologies requiring urgent care, and list the various therapeutic methods. Patients and methods: A retrospective study of patients admitted to the medical and surgical emergencies department of CHUB over a 5-year period. Patient records admitted and treated for a urological emergency were included. The variables studied were the frequency of urological emergencies, patient age at admission, gender, nature of the emergency, and various therapeutic options. Results: Urological emergencies accounted for 4.3% of all medical and surgical emergencies. The mean age was 57 ± 28 years with a range of 3 to 93 years. The male-to-female ratio was 7.1. The most common conditions were urinary retention (54.67%), hematuria (17.20%), and renal colic (8.13%). Therapeutically, surgical urinary drainage was dominated by cystostomy. Conclusion: Urological emergencies are infrequent at the University Hospital of Brazzaville. Their management is often delayed.
文摘1.INTRODUCTION.As the authors of this commentary,we would like to clarify that the figures presented originated from ChatGPT 3.5.Unless specified otherwise,in all figures,questions were provided as input through its user interface and the responses generated have been illustrated in a distinct font.The human authors subsequently under-took the editing process where we edited the ChatGPT 3.5 generated responses for better clarity(in terms of text organization)[1-3].
文摘Introduction: ENT infectious emergencies encompass all infectious pathologies affecting the ear, nose, sinuses, throat, and neck. A good understanding of these emergencies is essential for organizing appropriate care. In Guinea, few studies have described ENT infectious pathologies in rural areas. Objective: To study ENT infectious emergencies in the Otorhinolaryngology department of the Mamou Regional Hospital. Materials and Methods: This is a retrospective and prospective descriptive study, conducted from August 1, 2021, to July 31, 2022. All patients admitted to the ENT department of the Mamou Regional Hospital for an infectious emergency were included. Results: Among the 1854 recorded consultations, 261 cases involved ENT infectious emergencies, representing a prevalence of 14.07%. The most represented age group was 0 to 10 years (31.03%), with a majority of female patients (59%) and a predominantly urban origin (81.61%). Students accounted for 32.18% of the cases. The main reasons for consultation were odynophagia/dysphagia (32.42%) and otalgia (22.94%). The primary etiologies were tonsillitis (28.73%) and otitis (27.20%). Treatments administered included probabilistic antibiotic therapy (38.80%), analgesics (32.03%), and corticosteroid therapy (10.47%). The outcome was favorable in 98.85% of cases, with only 0.38% lost to follow-up. Conclusion: The results of our study confirm the frequency of ENT infectious pathologies. Their management requires joint actions for population awareness, staff training, and services equipment, particularly in rural areas.
