Background: Point-of-Care Ultrasound (POCUS) is a quick, useful, noninvasive, and inexpensive diagnostic tool used for the diagnosis of trauma, abdominal pain, dyspnea, and chest pain in the emergency department (ED). However, the diagnostic accuracy of ultrasound in the ED may be different from those reported in previous studies owing to the setting and time constraints in ED. Methods: We conducted our study in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. A literature search was conducted using databases on US National Library of Medicine’s database of biomedical literature, Ovid MEDLINE, online database of biomedical articles, and the collection of databases of systematic reviews and other evidence. The inclusion criteria were the use of bedside ultrasound as a diagnostic tool for acute appendicitis in the ED and the available data on diagnostic parameters such as sensitivity, specificity, and positive and negative predictive values (NPV). We constructed forest plots and summary receiver operating characteristic curves to evaluate the diagnostic accuracy of bedside ultrasound for acute appendicitis in the ED. Results: A total of 21 studies that met the inclusion criteria of this study were included for analysis. The overall pooled sensitivity was 0.81 (95% CI, 0.78–0.83), whereas the pooled specificity was 0.87 (95% CI, 0.85–0.88). However, the I ² test showed 91.7% and 90.9% heterogeneity in the sensitivity and specificity values, respectively. The summary receiver operating characteristic curves showed high levels of accuracy, as evidenced by an area under the curve of 0.9249 (standard error: 0.0180). Conclusions: The use of ultrasound for the diagnosis of acute appendicitis in the ED showed that ultrasound has high overall sensitivity and specificity for the diagnosis of acute appendicitis. however, high heterogeneity among the included studies was observed.

We examined whether combining biomarkers measurements and brain images early after the return of spontaneous circulation improves prognostic performance compared with the use of either biomarkers or brain images for patients with cardiac arrest following target temperature management (TTM). This retrospective observational study involved comatose out-of-hospital cardiac arrest survivors. We analyzed neuron-specific enolase levels in serum (NSE) or cerebrospinal fluid (CSF), grey-to-white matter ratio by brain computed tomography, presence of high signal intensity (HSI) in diffusion-weighted imaging (DWI), and voxel-based apparent diffusion coefficient (ADC). Of the 58 patients, 33 (56.9%) had poor neurologic outcomes. CSF NSE levels showed better prognostic performance (area under the curve (AUC) 0.873, 95% confidence interval (CI) 0.749–0.950) than serum NSE levels (AUC 0.792, 95% CI 0.644–0.888). HSI in DWI showed the best prognostic performance (AUC 0.833, 95% CI 0.711–0.919). Combining CSF NSE levels and HSI in DWI had better prognostic performance (AUC 0.925, 95% CI 0.813–0.981) than each individual method, followed by the combination of serum NSE levels and HSI on DWI and that of CSF NSE levels and the percentage of voxels of ADC (AUC 0.901, 95% CI 0.792–0.965; AUC 0.849, 95% CI 0.717–0.935, respectively). Combining CSF/serum NSE levels and HSI in DWI before TTM improved the prognostic performance compared to either each individual method or other combinations.

Background and Objectives: Acute appendicitis is a common cause of abdominal pain requiring surgery in pediatric patients. Given concerns regarding radiation exposure from computed tomography (CT), ultrasound (US) has become the first-line diagnostic modality. In many emergency and resource-limited settings, non-radiologist physicians often perform these examinations. This study aimed to evaluate the diagnostic accuracy of a non-radiologist-performed ultrasound in detecting acute appendicitis in children. Materials and Methods: We conducted a systematic review and meta-analysis according to the PRISMA guidelines. The literature was searched across PubMed, Ovid MEDLINE, EMBASE, the Cochrane Library, and Google Scholar through June 2024. Studies reporting on the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of non-radiologist-performed ultrasounds in pediatric appendicitis were included. Study quality was assessed using the QUADAS-2 tool, and a bivariate random-effects model was used for statistical analysis. Results: Eight studies, with a total of 1006 pediatric patients, were included. The pooled sensitivity and specificity were 0.87 (95% CI, 0.83–0.90) and 0.93 (95% CI, 0.91–0.95), respectively. The area under the SROC curve was 0.783 (95% CI, 0.708–0.853), suggesting moderate-to-good diagnostic accuracy. Substantial heterogeneity was observed across studies, possibly due to differences in operator training and ultrasound techniques. Conclusions: Non-radiologist-performed ultrasound demonstrates moderate-to-good diagnostic accuracy in identifying pediatric appendicitis. These findings support its implementation in emergency or resource-constrained settings and suggest that incorporating structured ultrasound training for non-radiologists may improve timely diagnosis and optimize clinical decision-making in pediatric emergency care.