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1.
Emerg Med Clin North Am ; 40(1): 119-133, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34782083

RESUMO

Scombroid poisoning, systemic mastocytosis, and hereditary alpha tryptasemia all present with episodes that resemble allergic reactions. Knowledge regarding systemic mastocytosis and hereditary alpha tryptasemia is quickly evolving. Epidemiology, pathophysiology, and strategies to identify and diagnose are discussed. Evidence-based management in the emergency setting and beyond is also explored and summarized. Key differences are described between these events and allergic reactions.


Assuntos
Angioedema/diagnóstico , Hipersensibilidade/diagnóstico , Toxinas Marinhas/biossíntese , Angioedema/fisiopatologia , Mimetismo Biológico , Humanos , Hipersensibilidade/fisiopatologia , Toxinas Marinhas/metabolismo , Triptases/análise , Triptases/deficiência
2.
Resuscitation ; 81(7): 826-30, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20403656

RESUMO

BACKGROUND: Out of hospital cardiac arrest (OHCA) is common and lethal. It has been suggested that OHCA witnessed by EMS providers is a predictor of survival because advanced help is immediately available. We examined EMS witnessed OHCA from the Resuscitation Outcomes Consortium (ROC) to determine the effect of EMS witnessed vs. bystander witnessed and unwitnessed OHCA. METHODS: Data were analyzed from a prospective, population-based cohort study in 10 U.S. and Canadian ROC sites. Individuals with non-traumatic OHCA treated 04/01/06-03/31/07 by EMS providers with defibrillation or chest compressions were included. Cases were grouped into EMS-witnessed, bystander witnessed, and unwitnessed and further stratified for bystander CPR. Multiple logistic regressions evaluated the odds ratio (OR) for survival to discharge relative to the EMS-witnessed group after adjusting for age, sex, public/private location of collapse, ROC site, and initial ECG rhythm. Of 9991 OHCA, 1022 (10.2%) of EMS-witnessed, 3369 (33.7%) bystander witnessed, and 5600 (56.1%) unwitnessed. RESULTS: The most common initial rhythm in the EMS-witnessed group was PEA which was higher than in the bystander- and unwitnessed groups (p<0.001). The adjusted OR (95% CI) of survival compared to the EMS-witnessed group was 0.41, (0.36, 0.46) in bystander witnessed with bystander CPR, 0.37 (0.33, 0.43) in bystander witnessed without bystander CPR, 0.17 (0.14, 0.20) in unwitnessed with bystander CPR and 0.21 (0.18, 0.24) in unwitnessed cases without bystander CPR. CONCLUSIONS: Immediate application of prehospital care for OHCA may improve survival. Efforts should be made to educate patients to access 9-1-1 for prodromal symptoms.


Assuntos
Reanimação Cardiopulmonar/mortalidade , Reanimação Cardiopulmonar/métodos , Serviços Médicos de Emergência/organização & administração , Parada Cardíaca/mortalidade , Parada Cardíaca/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Canadá , Estudos de Coortes , Emergências , Feminino , Seguimentos , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Estudos Prospectivos , Medição de Risco , Análise de Sobrevida , Fatores de Tempo , Resultado do Tratamento , Estados Unidos , Adulto Jovem
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