Publications by authors named "Joseph H Walline"

Article Synopsis
  • The study aimed to determine how the timing of initial antibiotic treatment affects mortality rates in hospital patients with sepsis.
  • It analyzed data from 42 studies involving nearly 191,000 patients, focusing on the correlation between antibiotic administration timing and patient outcomes.
  • Results indicated that administering antibiotics within 3-6 hours of sepsis recognition significantly reduced the risk of death compared to later administration, highlighting the urgency of early treatment.
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Article Synopsis
  • This study aimed to compare high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) as initial treatments for patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD) and acute-moderate hypercapnic respiratory failure.
  • A total of 225 patients were analyzed, with HFNC showing a treatment failure rate of 25.7%, significantly higher than the 14.3% for NIV, indicating that NIV may be a more effective initial treatment choice.
  • The study also found that the intubation rate for patients on HFNC was higher than those on NIV and highlighted that other parameters like treatment switch rates and mortality were similar across both groups.
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Background And Aims: Liver injury is one of the common complications of paraquat (PQ) poisoning, but whether the degree of liver injury is related to patient prognosis is still controversial. This study aimed to investigate whether liver injury was a risk factor for death in PQ-poisoned patients.

Methods: We conducted a retrospective cohort study of PQ-poisoned patients from the past 10 years (2011-2020) from a large tertiary academic medical centre in China.

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Background: Unsustained return of spontaneous circulation (ROSC) is a critical barrier to survival in cardiac arrest patients. This study examined whether end-tidal carbon dioxide (ETCO) and pulse oximetry photoplethysmogram (POP) parameters can be used to identify unsustained ROSC.

Methods: We conducted a multicenter observational prospective cohort study of consecutive patients with cardiac arrest from 2013 to 2014.

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Background: Levosimendan is increasingly being used in patients with sepsis or septic shock because of its potential to improve organ function and reduce mortality. We aimed to determine if levosimendan can reduce mortality in patients with sepsis or septic shock via meta-analysis.

Evidence Sources And Study Selection: We comprehensively searched the PubMed, Embase, Web of Science, and Cochrane Library databases from inception through 1 October 2022.

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Article Synopsis
  • The study explores the incidence of difficult airways in emergency departments in mainland China, highlighting the importance of predicting these incidents for patient safety.
  • It involved over 900 patients and found low rates of difficult intubation, but a higher rate of difficult face mask ventilation.
  • Despite some predictive value from assessment methods, the study calls for better strategies to improve airway evaluation overall.
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Background: Sepsis-associated encephalopathy (SAE) is a dysfunction of the central nervous system experienced during sepsis with variable clinical and pathophysiologic features. We sought to identify distinct SAE phenotypes in relation to clinical outcomes. Methods: The Medical Information Mart for Intensive Care IV (MIMIC-IV) database and the eICU database were used to conduct a retrospective cohort study.

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Background: Noninvasive ventilation (NIV) is the recommended mode of ventilation used in acute respiratory failure secondary to an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Recent data has shown that high-flow nasal cannula (HFNC) treatment can be an alternative for patients with hypercapnic respiratory failure. The purpose of this study is to evaluate HFNC with sequential NIV versus NIV alone as the initial ventilatory strategy in AECOPD.

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Background: There is growing evidence that patients recovering after a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may have a variety of acute sequelae including newly diagnosed diabetes. However, the risk of diabetes in the post-acute phase is unclear. To solve this question, we aimed to determine if there was any association between status post-coronavirus disease (COVID-19) infection and a new diagnosis of diabetes.

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Article Synopsis
  • Health workforce development is crucial for effective health systems and managing health emergencies, particularly in low- and middle-income countries (LMIC) and high-income countries (HIC).
  • A Delphi consensus study with 31 international experts assessed 46 recommendations for strengthening Health Emergency and Disaster Risk Management (Health EDRM), resulting in 44 statements from the LMIC group and 34 from the HIC group reaching consensus.
  • Key areas needing attention included Human Resources, Planning and Coordination, and Community Capacities in LMIC, while Policies, Strategies, and Human Resources were focal points in HIC, leading to actionable recommendations for workforce improvement in Health EDRM.
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Article Synopsis
  • Sepsis is a major health issue in emergency departments, with sepsis-associated encephalopathy (SAE) being a serious complication, and rosuvastatin may help protect against this condition.
  • In a study involving sepsis patients, those treated with rosuvastatin showed a significantly lower incidence of SAE compared to a placebo group (32.1% vs. 57.1%).
  • However, the rosuvastatin group experienced higher creatine kinase levels, indicating a potential for adverse effects despite the neuroprotective benefits.
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Background: Blood products are commonly transfused in patients with acute upper gastrointestinal bleeding (UGIB). There exists considerable practice variation and less evidence to guide fresh frozen plasma transfusion in patients with UGIB. The aim of this study was to explore any association between fresh frozen plasma transfusion following acute UGIB and clinical outcomes.

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Background: Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis is a common type of autoimmune encephalitis. Patients with this condition are frequently very ill but are often misdiagnosed in the Emergency Department (ED). The objective of this study was to analyze the clinical characteristics of anti-NMDAR patients in the ED and to identify any associations with a diagnosis of anti-NMDAR encephalitis.

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Immunosuppression and host vulnerability play a key role in non-tuberculous mycobacteria (NTM) pathogenesis. The objective of this study was to compare the clinical characteristics and mortality of NTM infections in immunocompromised and immunocompetent patients. We used a retrospective dataset obtained from our large, tertiary, urban, teaching hospital which is the medical records of hospitalized patients with NTM infections between January 1, 2013 to December 31, 2020.

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Aims: Norepinephrine is recommended as a first-line vasopressor agent in the haemodynamic stabilization of cardiogenic shock. The survival benefit of norepinephrine therapy has not been demonstrated in clinical practice, however. This study aimed to explore the relationship between norepinephrine use and outcomes in cardiogenic shock patients in real-world conditions.

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Background: Tracheal intubation is a necessary but risky procedure performed in emergency departments (EDs) around the world. Relatively high morbidity has been encountered in Chinese EDs, which has raised concerns about peri-intubation ED management. This study aimed to investigate intubation procedures and identify any areas for improvement in Chinese EDs.

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Identifying critically ill patients is a key challenge in emergency department (ED) triage. Mis-triage errors are still widespread in triage systems around the world. Here, we present a machine learning system (MLS) to assist ED triage officers better recognize critically ill patients and provide a text-based explanation of the MLS recommendation.

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Objective: This study aimed to investigate the predictive value of pulse oximetry plethysmography (POP) for the return of spontaneous circulation (ROSC) in cardiac arrest (CA) patients.

Methods: This was a multicenter, observational, prospective cohort study of patients hospitalized with cardiac arrest at 14 teaching hospitals cross China from December 2013 through November 2014. The study endpoint was ROSC, defined as the restoration of a palpable pulse and an autonomous cardiac rhythm lasting for at least 20 minutes after the completion or cessation of CPR.

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Background And Objectives: Acute upper gastrointestinal bleeding (UGIB) is a common problem that can cause significant morbidity and mortality. We aimed to compare the performance of the ABC score (ABC), the AIMS65 score (AIMS65), the Glasgow-Blatchford score (GBS), and the pre-endoscopic Rockall score (pRS) in predicting 90-day mortality or rebleeding among patients with acute UGIB.

Methods: This was a prospective multicenter study conducted at 20 tertiary hospitals in China.

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Background: Hypoxia is one of the life-threatening complications of endotracheal intubation. Supplemental oxygen and ventilation play a vital role in preventing hypoxia. Bag-valve mask (BVM) ventilation is frequently used before intubation, and its ability to improve oxygenation was recently confirmed.

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Chinese emergency department (ED) staff encountered significant mental stress while fighting the coronavirus disease 2019 (COVID-19) pandemic. We sought to investigate the prevalence and associated factors for depressive symptoms among ED staff (including physicians, nurses, allied health, and auxiliary ED staff). A cross-sectional national survey of ED staff who were on duty and participated in combating the COVID-19 pandemic was conducted March 1-15, 2020.

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Article Synopsis
  • Disasters hit poor and marginalized populations harder due to their increased vulnerability from factors like poor living conditions and language barriers.
  • The Health Emergency and Disaster Risk Management (Health EDRM) approach focuses on engaging communities since they play a vital role as first responders during health emergencies and emphasizes community-based education for disaster preparedness.
  • The Ethnic Minority Health Project (EHMP) in China has successfully implemented Health EDRM education in 16 villages, aiming to improve health-risk literacy and self-help capabilities, and provides key insights and recommendations for similar projects in rural communities.
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  • * The 2019 Health EDRM Framework outlines essential functions for managing disasters through stages like prevention and recovery to enhance community health resilience.
  • * A project launched in June 2020 is conducting literature reviews and expert studies to identify competencies for Health EDRM training and create strategies for workforce development across different countries.
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