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Out-of-hospital cardiac arrest (OHCA) is heterogeneous in terms of etiology and severity. Owing to this heterogeneity, differences in outcome and treatment efficacy have been reported from case to case; however, few reviews have focused on the heterogeneity of OHCA. We conducted a literature review to identify differences in the prognosis and treatment efficacy in terms of CA-related waveforms (shockable or non-shockable), age (adult or pediatric), and post-CA syndrome severity and to determine the preferred treatment for patients with OHCA to improve outcomes. [ABSTRACT FROM AUTHOR]

Objective: Pain in pediatric musculoskeletal (MSK) injuries can lead to increased anxiety, fear, and avoidance of medical care, making analgesic management critical. Therefore, we evaluated analgesic efficacy and adverse effects to select the optimal analgesic agent in pediatric patients with MSK injuries. Methods: Four databases were searched from inception to March 2023 for peer‐reviewed, open randomized controlled trials (RCTs). Inclusion criteria were: (1) trials with RCT design, (2) children aged 1 month–18 years with MSK injury, (3) outpatient setting, (4) interventions and control, (5) primary outcome of pain score at 60 and 120 min and secondary outcome of adverse effects, and (6) full‐text and peer‐reviewed articles. Two reviewers screened, extracted data, and assessed the risk of bias. A frequentist random‐effects network meta‐analysis (NMA) was performed. Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation working group approach. Results: We included eight trials comprising 1645 children. Ibuprofen was significantly associated with pain reduction at 120 min, compared with acetaminophen (SMD 0.31 [95% CI 0.11–0.51]; moderate certainty) and opioids (SMD 0.34 [95% CI 0.20–0.48]; moderate certainty). Compared with opioids alone, ibuprofen–opioid combination was significantly associated with pain reduction at 120 min (SMD 0.19 [95% CI 0.03–0.35]). No significant differences were found in pain interventions at 60 min. Ibuprofen had statistically fewer adverse events than opioids (RR, 0.54 [95% CI 0.33–0.90]; moderate certainty) and ibuprofen with opioids (RR 0.47 [95% CI 0.25–0.89]; moderate certainty). In terms of limitations, the eight RCTs included had relatively small sample sizes; only two were high‐quality RCTs. Conclusions: Our NMA found ibuprofen to be the most effective and least adverse analgesic in pediatric patients with MSK injuries. [ABSTRACT FROM AUTHOR]

This document is a reply to a comment made by Sethuraman et al. regarding a study on the differences in pathophysiology and treatment efficacy for out-of-hospital cardiac arrest. Sethuraman et al. raised concerns about the cutoff values of a specific test for neurological outcomes. The authors of the original study defended their interpretation of the cutoff values and acknowledged an error in citing a reference. They thanked Sethuraman et al. for their suggestions and stated that it helped them refine their report. The document includes a graph illustrating the possibility of reversed median and cutoff values in a small sample of patients. The authors declare no conflicts of interest. [Extracted from the article]

Background and Objectives: Victims of natural disasters are exposed to air pollution, changes in living conditions, and physical/emotional stress, which leads to exacerbation of asthma. The study aimed to examine the association between being victims of a natural disaster and asthma medication prescriptions among children and adolescents by comparing those affected and unaffected by the 2018 Japan floods., Methods: Within the most severely impacted regions, a 1-year postdisaster retrospective cohort study was conducted on the basis of the National Health Insurance Claims Database. Participants aged 0 to 19 years with no record of asthma treatment in the year preceding the disaster were included in the analysis. The cumulative incidence of newly prescribed asthma inhalers in the 12 months after the disasters was compared between victims and nonvictims using survival analysis. To test the robustness, a difference-in-differences analysis was performed, including participants with a history of asthma prescriptions., Results: Of the 1 073 170 participants included in the study, 4425 (0.40%) were assigned to the victim group. Of these, 287 individuals (6.5%) from the victim group and 59 469 individuals (5.6%) from the nonvictim group were newly prescribed asthma inhalers within the year after the floods. Survival analysis revealed that victims were more prone to receiving inhaler prescriptions compared with nonvictims (adjusted hazard ratio 1.30; 95% confidence interval 1.16-1.46). Consistent results were obtained from the difference-in-differences analysis., Conclusions: The 2018 Japan floods increased the demand for asthma inhalers among flood victims, underscoring the general implication that natural disasters can increase the incidence of asthma., (Copyright © 2024 by the American Academy of Pediatrics.)