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Diagnostics
Special Issues
Diagnosis and Management in Emergency Medicine
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Diagnosis and Management in Emergency Medicine

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: 30 April 2024 | Viewed by 3252

Special Issue Editors

Dr. Shih-Chang Hsu

E-Mail Website
Guest Editor
Emergency Department, Department of Emergency and Critical Medicine, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
Interests: emergency medicine; biomarkers; respiratory diseases; bioinformatics; sepsis; systemic inflammation
Dr. Wen-Cheng Huang

E-Mail Website
Guest Editor
Emergency Department, Department of Emergency and Critical Medicine, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
Interests: emergency medicine; critical care; medical education; ultrasound
Dr. Chin-Wung Hsu

E-Mail Website
Guest Editor
Emergency Department, Department of Emergency and Critical Medicine, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
Interests: emergency medicine; critical care; geriatrics; sepsis

Special Issue Information

Dear Colleagues,

The field of diagnosis in emergency medicine has been rapidly evolving in recent years. Medical diagnostics are crucial for patient management in an emergency department. Inaccurate diagnostics could lead to delayed or inappropriate treatments. Thus, diagnosis plays an essential role in emergency medicine. This Special Issue aims to introduce advanced diagnostic tools for emergency medicine, including, but not limited to, sonography, computed tomography, magnetic resonance imaging, biomarkers, risk stratification algorithms, and new screening algorithms. We are pleased to invite contributions to this Special Issue of Diagnostics, entitled “Diagnosis and Management in Emergency Medicine”, in the form of original research articles, review articles, and meta-analyses focusing on current knowledge in the field.

Dr. Shih-Chang Hsu
Dr. Wen-Cheng Huang
Dr. Chin-Wung Hsu
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • emergency medicine
  • biomarkers
  • ultrasound
  • basic research
  • big data
  • risk factors
  • diagnostic Tools
  • morbidity
  • mortality

Published Papers (4 papers)

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Research

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11 pages, 2389 KiB  
Article
Photon-Counting Detector CT Virtual Monoenergetic Images in Cervical Trauma Imaging—Optimization of Dental Metal Artifacts and Image Quality
by Daniel Dillinger, Daniel Overhoff, Matthias F. Froelich, Hanns L. Kaatsch, Christian Booz, Achim Hagen, Thomas J. Vogl, Stefan O. Schönberg and Stephan Waldeck
Diagnostics 2024, 14(6), 626; https://doi.org/10.3390/diagnostics14060626 - 15 Mar 2024
Viewed by 461
Abstract
Objectives: The aim of this study was to analyze the extent of dental metal artifacts in virtual monoenergetic (VME) images, as they often compromise image quality by obscuring soft tissue affecting vascular attenuation reducing sensitivity in the detection of dissections. Methods: Neck photon-counting [...] Read more.
Objectives: The aim of this study was to analyze the extent of dental metal artifacts in virtual monoenergetic (VME) images, as they often compromise image quality by obscuring soft tissue affecting vascular attenuation reducing sensitivity in the detection of dissections. Methods: Neck photon-counting CT datasets of 50 patients undergoing contrast-enhanced trauma CT were analyzed. Hyperattenuation and hypoattenuation artifacts, muscle with and without artifacts and vessels with and without artifacts were measured at energy levels from 40 keV to 190 keV. The corrected artifact burden, corrected image noise and artifact index were calculated. We also assessed subjective image quality on a Likert-scale. Results: Our study showed a lower artifact burden and less noise in artifact-affected areas above the energy levels of 70 keV for hyperattenuation artifacts (conventional polychromatic CT images 1123 ± 625 HU vs. 70 keV VME 1089 ± 733 HU, p = 0.125) and above of 80 keV for hypoattenuation artifacts (conventional CT images −1166 ± 779 HU vs. 80 keV VME −1170 ± 851 HU, p = 0.927). Vascular structures were less hampered by metal artifacts than muscles (e.g., corrected artifact burden at 40 keV muscle 158 ± 125 HU vs. vessels −63 ± 158 HU p < 0.001), which was also reflected in the subjective image assessment, which showed better ratings at higher keV values and overall better ratings for vascular structures than for the overall artifact burden. Conclusions: Our research suggests 70 keV might be the best compromise for reducing metal artifacts affecting vascular structures and preventing vascular contrast if solely using VME reconstructions. VME imaging shows only significant effects on the general artifact burden. Vascular structures generally experience fewer metal artifacts than soft tissue due to their greater distance from the teeth, which are a common source of such artifacts. Full article
(This article belongs to the Special Issue Diagnosis and Management in Emergency Medicine)
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13 pages, 2628 KiB  
Article
A Comprehensive Look at Maxillofacial Traumas: On the Basis of Orbital Involvement
by Fatma Dilek Gokharman, Ozlem Kadirhan, Ozlem Celik Aydin, Arzu Gulsah Yalcin, Pınar Kosar and Sonay Aydin
Diagnostics 2023, 13(22), 3429; https://doi.org/10.3390/diagnostics13223429 - 11 Nov 2023
Viewed by 790
Abstract
Introduction: Orbital wall fractures that may develop in maxillofacial traumas (MFTs) may cause ophthalmic complications (OCs). The aim of this study is to determine the frequency of orbital fractures (OFs) accompanying MFTs and findings suspicious for orbital traumatic involvement. Materials and Methods: Computed [...] Read more.
Introduction: Orbital wall fractures that may develop in maxillofacial traumas (MFTs) may cause ophthalmic complications (OCs). The aim of this study is to determine the frequency of orbital fractures (OFs) accompanying MFTs and findings suspicious for orbital traumatic involvement. Materials and Methods: Computed tomography (CT) images of 887 patients who presented to the emergency department within a 1-year period with a history of MFT were retrospectively scanned. During the examination, patients with orbital wall fractures, craniofacial bone fractures, and posttraumatic soft tissue changes were recorded. Results: OF was observed in 47 (5.3%) of the patients admitted for MFT. In cases with OFs, accompanying nasal (25.5%), ethmoid (2.1%), frontal (19.1%), maxillary (38%), and zygomatic bone fracture (10.6%), sphenoid (4.3%), and soft tissue damage (55.3%) were observed. It was observed that the pathologies mentioned at these levels were significantly higher than in patients without orbital involvement (p < 0.05). In our study, mild (48.9%) and moderate-severe (2.12–4.25%) OCs accompanying OFs were observed after MFT. Conclusions: The frequency of MFT varies depending on various factors, and such studies are needed to take preventive measures. Knowing the risk and frequency of orbital damage accompanying MFTs may help reduce complications by allowing rapid and accurate diagnosis. Full article
(This article belongs to the Special Issue Diagnosis and Management in Emergency Medicine)
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Review

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14 pages, 315 KiB  
Review
Pediatric Chest Pain: A Review of Diagnostic Tools in the Pediatric Emergency Department
by Szu-Wei Huang and Ying-Kuo Liu
Diagnostics 2024, 14(5), 526; https://doi.org/10.3390/diagnostics14050526 - 01 Mar 2024
Viewed by 964
Abstract
Pediatric chest pain is a common chief complaint in the emergency department. Not surprisingly, children with chest pain are usually brought to the emergency department by their parents out of fear of heart disease. However, chest pain in the pediatric population is generally [...] Read more.
Pediatric chest pain is a common chief complaint in the emergency department. Not surprisingly, children with chest pain are usually brought to the emergency department by their parents out of fear of heart disease. However, chest pain in the pediatric population is generally a benign disease. In this review, we have identified musculoskeletal pain as the most prevalent etiology of chest pain in the pediatric population, accounting for 38.7–86.3% of cases, followed by pulmonary (1.8–12.8%), gastrointestinal (0.3–9.3%), psychogenic (5.1–83.6%), and cardiac chest pain (0.3–8.0%). Various diagnostic procedures are commonly used in the emergency department for cardiac chest pain, including electrocardiogram (ECG), chest radiography, cardiac troponin examination, and echocardiography. However, these examinations demonstrate limited sensitivity in identifying cardiac etiologies, with sensitivities ranging from 0 to 17.8% for ECG and 11.0 to 17.2% for chest radiography. To avoid the overuse of these diagnostic tools, a well-designed standardized algorithm for pediatric chest pain could decrease unnecessary examination without missing severe diseases. Full article
(This article belongs to the Special Issue Diagnosis and Management in Emergency Medicine)

Other

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3 pages, 427 KiB  
Interesting Images
Periportal Edema as an Extrarenal Manifestation of Acute Pyelonephritis
by Yu-Yun Chang and Kuei-Hong Kuo
Diagnostics 2024, 14(6), 638; https://doi.org/10.3390/diagnostics14060638 - 18 Mar 2024
Viewed by 601
Abstract
Acute pyelonephritis is a common infection of the upper urinary tract that affects approximately 250,000 adults in the United States. Individuals with acute pyelonephritis require hospitalization and intravenous antimicrobial therapy. Diagnoses of acute pyelonephritis are made on the basis of clinical and laboratory [...] Read more.
Acute pyelonephritis is a common infection of the upper urinary tract that affects approximately 250,000 adults in the United States. Individuals with acute pyelonephritis require hospitalization and intravenous antimicrobial therapy. Diagnoses of acute pyelonephritis are made on the basis of clinical and laboratory findings. Individuals with complex or severe acute pyelonephritis undergo contrast-enhanced computed tomography (CT) for the diagnosis and assessment of perirenal abnormalities. However, extrarenal manifestations, such as periportal edema and gallbladder wall thickening, may complicate the diagnostic process. We report the case of a 42-year-old woman who presented with fever, dysuria, and flank pain—the hallmarks of urosepsis. CT results confirmed acute pyelonephritis accompanied by periportal edema and elevated levels of hepatic enzymes and C-reactive protein. Despite antibiotic intervention, febrile episodes persisted for 4 days and abated over a fortnight. The patient’s blood and urine cultures yielded negative results, which may be attributed to her prior antimicrobial treatment. Recognition of extrarenal signs in acute pyelonephritis is crucial for obtaining accurate diagnoses and understanding their clinical implications. Full article
(This article belongs to the Special Issue Diagnosis and Management in Emergency Medicine)
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