We investigated the relationship between thoracic diameters and chest compression-related thoracoabdominal injury in patients with non-traumatic out-of-hospital cardiac arrest who had a return of spontaneous circulation after cardiopulmonary resuscitation. A total of 63 consecutive adult non-traumatic out-of-hospital cardiac arrest patients were enrolled in this prospective study. Computed tomography was performed on each patient and the anteroposterior diameter, skin-to-skin anteroposterior diameter, and transverse diameter of the chest were measured. Patients were divided into two groups based on the presence or absence of cardiopulmonary resuscitation-related thoracoabdominal injury. Age, sex, and duration of cardiopulmonary resuscitation, anteroposterior diameter, skin-to-skin anteroposterior diameter, and transverse diameter were compared between the groups. The primary outcome was the relationship between thoracic diameters and cardiopulmonary resuscitation-induced thoracoabdominal injuries. Thoracoabdominal injuries were detected in 46% (n=29) of the patients and consisted of rib fractures in 22 (34.9%) patients, pulmonary contusion in 7 (11.1%), and sternal fracture in 3 (4.8%) patients. There were no significant differences in cardiopulmonary resuscitation duration between patients with and without thoracoabdominal injuries (p=0.539). Similarly, there were no significant differences in anteroposterior diameter, skin-to-skin anteroposterior diameter, or transverse diameter between patient groups (p=0.978, p=0.730, and p=0.146, respectively) or between patients who died within the first 28 days and those who survived for longer than 28 days (p=0.488, p=0.878, and p=0.853, respectively). The iatrogenic thoracoabdominal injuries caused by cardiopulmonary resuscitation performed according to the cardiopulmonary resuscitation guidelines were independent of thoracic diameters. Therefore, the cardiac compression depth of 5–6 cm recommended by the current cardiopulmonary resuscitation guidelines is reliable for patients with different thoracic diameters.

Impulsiveness in primary headaches is not well understood.To analyze impulsiveness in patients with medication-overuse headache (MOH) and either chronic migraines or chronic tension-type headaches (TTHs).This cross-sectional study included 119 participants (96 female) divided into 3 groups: the migraine with MOH (M-O, n = 44, age = 36.6 ± 11.1), the tension-type headache with MOH group (TTH-O, n = 38, age = 42.6 ± 11.8), and the healthy control group (HC, n = 37, age = 36.9 ± 13.1). The Barratt Impulsiveness Scale-11 Short Form (BIS-11 SF), Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), and Pittsburgh Sleep Quality Index (PSQI) were used to assess impulsiveness, depression, anxiety, and sleep quality, respectively.Impulsiveness levels were significantly higher in the M-O (p < 0.01) and TTH-O (p < 0.01) groups compared with the HC. However, no significant difference in impulsiveness was found between the M-O and TTH-O (p > 0.05). The PSQI scores were significantly higher in the M-O and TTH-O compared with the HC (p < 0.01). Additionally, anxiety scores were notably higher in the M-O compared with both the TTH-O and HC (p < 0.01).The present study, which compared the M-O and TTH-O groups with HC in terms of impulsiveness, with no significant differences in parameters such as age, gender, schooling, frequency of headache attacks, and disease onset duration, concluded that both patient groups exhibited higher impulsiveness compared with the controls. Furthermore, the lack of difference in impulsiveness between MO and chronic TTH-O patients with a common denominator of MOH suggests that it may be associated with MOH, which is a shared subset of two distinct headache disorders.

Objectives: The primary aim of this study was to determine the value of the inferior vena cava (IVC) ultrasound in the decision to hospitalise acute decompensated heart failure (ADHF) patients. Our secondary aim was to find the most successful IVC measurement method in monitoring volume status. Methods: ADHF patients were accepted over a 1-year period in this study. Patients’ vital signs, laboratory tests and IVC measurements measured by six methods (in B- and M-mode; maximum, minimum diameter and caval index) performed on an hourly basis were recorded. The presence of any statistically significant difference between the IVC measurement methods, laboratory tests and vital parameters between the hospitalised and discharged patients was calculated. ROC curves were produced in order to determine the ability of parameters to differentiate two groups. Spearman’s correlation test was used to investigate correlation between the IVC measurement methods and patients’ urine outputs. Results: A total of 71 patients were included in the study; 42 of these were hospitalised and 29 were discharged. Potassium, brain natriuretic peptide, respiration rate, urine output, maximum and minimum IVC diameters differed significantly between the two groups. Minimum IVC diameter measured in M-mode was identified as a weak marker with 65% sensitivity and 64% specificity (+PPV: 73%; −NPV:54%) for hospitalisation. Change in maximum IVC diameter measured in B-mode exhibited a high degree of correlation with change in body fluid (cc: 0.802). Conclusion: IVC ultrasound may have a limited value in the decision to hospitalise ADHF patients. But Maximum IVC diameter may be an ideal method for monitoring hypervolemic patients’ volume status. Clinical Trials Identifier: NCT02725151

We investigated bleeding complications in patients admitted to the emergency department (ED) who were taking oral anticoagulants and compared the rates of major and minor bleeding events between the direct oral anticoagulant (DOAC) and warfarin groups. We conducted a prospective, multicenter observational study of warfarinand DOAC-treated patients who presented to the EDs of tertiary-care hospitals between July 2020 and July 2021 with a bleeding event. Among 518 patients on anticoagulation therapy, 121 (23.4%) presented to EDs with bleeding events. A chart review revealed 73 (60.24%) patients with bleeding events who were taking a DOAC (i.e., apixaban, edoxaban, rivaroxaban, or dabigatran) and 48 who were taking warfarin. The rate of bleeding events was significantly higher among patients treated with warfarin than among those treated with DOACs (48/129 [37.2%] vs. 73/389 [18.8%], p<0,001). Subgroup analysis of the DOAC-treated patients revealed a significant difference in the frequency of bleeding events among the DOAC groups (p=0.016), with a significantly lower frequency in patients treated with rivaroxaban versus edoxaban (14.9% vs. 34.7%, p=0.002) and in those treated with apixaban versus edoxaban (18.8% vs. 34.7%, p=0.021). Our findings indicate that although the rates of overall bleeding events differed among DOAC-treated patients, the rates of bleeding events were lower than those in warfarin-treated patients. Additionally, major bleeding events occurred less frequently in patients treated with rivaroxaban or apixaban compared with edoxaban