Internal and Emergency Medicine最新文献

{"title":"Maximum heart rate and mortality in sepsis patients: a retrospective cohort study: comment.","authors":"Zhihan Liu, Ziyang Zhou, Chunlei Ding, Yunjiang Zheng","doi":"10.1007/s11739-025-04023-0","DOIUrl":"10.1007/s11739-025-04023-0","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations between serum levels of ferroptosis-related molecules and outcomes in stable COPD: an exploratory prospective observational study.","authors":"Cristina Ghadban, Mayte García-Unzueta, Juan Agüero, Paula Martín-Audera, Bernardo Alio Lavín, Armando Raúl Guerra, Ana Berja, Nieves Aranda, Anastasia Guzun, Ana Isabel Insua, Carlos Antonio Amado","doi":"10.1007/s11739-025-04016-z","DOIUrl":"https://doi.org/10.1007/s11739-025-04016-z","url":null,"abstract":"<p><p>Ferroptosis is an iron-dependent form of cell death that contributes to the pathophysiology of chronic obstructive pulmonary disease (COPD). Ferroptosis-associated factors, including acyl-CoA synthetase long-chain family 4 (ACSL4), soluble transferrin receptor 1 (sTfR1), glutathione peroxidase 4 (GPX4), and apoptosis-inducing factor 2, (AIFM2) mediate intracellular iron metabolism, oxidative stress, and lipid peroxidation. Despite their potential clinical relevance, no studies have measured serum levels of these factors with respect to the manifestations of COPD. The study enrolled 179 stable, non-anemic outpatients diagnosed with COPD and 57 age- and sex-matched smokers who did not carry this diagnosis. Clinical characteristics were assessed together with baseline serum levels of the four ferroptosis-associated factors. Moderate and severe exacerbations of COPD were monitored over the following 12 months. Soluble TfR1 levels were higher and GPX4 levels were lower among those in the COPD group compared to smokers without COPD (p = 0.004 and p = 0.002, respectively). The sTfR1/GPX4 ratio was also higher among those in the COPD group (p = 0.001). Multivariate analysis identified low serum GPX4 (OR 5.475; p = 0.001), and high sTfR1/GPX4 (OR 4.293; p < 0.001) as independent predictors of poor performance on the six-minute walk distance test. Additionally, high sTfR1 (HR 1.850; p = 0.004), low GPX4 (HR 2.301; p = 0.001), and high sTfR1/GPX4 (HR 2.223; p < 0.001) were associated with increased risk of moderate exacerbation. High sTfR1 (HR 2.970; p = 0.014), low GPX4 (HR 3.753; p = 0.012), and high sTfR1/GPX4 (HR 3.668; p = 0.009) were also independent predictors of severe exacerbation. Serum levels of ferroptosis-associated factors were significantly different in patients diagnosed with COPD compared to smokers who had not been diagnosed with this disorder. Elevated sTfR1, low levels of GPX4, and higher sTfR1/GPX4 were associated with poor clinical outcomes, including reduced exercise capacity and an increased risk of moderate and severe exacerbations. These findings highlight the potential of ferroptosis-associated factors, particularly the calculated sTfR1/GPX4, in predicting COPD progression and the risk of exacerbation in stable, non-anemic outpatients.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is a cell-free DNA blood-based test for colorectal cancer screening useful?","authors":"Ramona Santangeli, Sabrina Scilletta, Angela Dupuis, Paolo Sipari, Ilaria Fucile","doi":"10.1007/s11739-025-04017-y","DOIUrl":"https://doi.org/10.1007/s11739-025-04017-y","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diaphragmatic dysfunction assessed by ultrasound: a key predictor of prolonged ventilation in emergency department.","authors":"Gennaro Sansone, Francesco Barbato, Giovanni Porta, Enrico Allegorico, Claudia Serra, Valentina Minerva, Valeria Caterino, Paola Arbo, Valentina Latini, Roberto Allocca, Alessandro Giaquinto, Antonio Pagano, Giorgio Bosso, Fabio Giuliano Numis","doi":"10.1007/s11739-025-04020-3","DOIUrl":"https://doi.org/10.1007/s11739-025-04020-3","url":null,"abstract":"<p><p>This study aimed to evaluate the feasibility and diagnostic value of diaphragmatic ultrasound in the management of respiratory failure in the emergency department (ED), with a focus on its potential to guide treatment decisions and improve patient outcomes.We conducted an observational study at the ED of Santa Maria delle Grazie Hospital in Pozzuoli, Italy, from November 2023 to April 2024. Patients with type 1 or type 2 respiratory failure requiring non-invasive ventilation (NIV) or continuous positive airway pressure (CPAP) were included. The Diaphragmatic ultrasound was performed at baseline to assess diaphragmatic excursion and thickening fraction, alongside arterial blood gas (ABG) measurements. The follow-up ABGs were taken at 1, 3, 6, and 12 h.A total of 44 patients were included in the study. Patients with diaphragmatic dysfunction (defined as excursion < 10 mm or thickening fraction < 30%) had significantly longer in-ED and in-hospital ventilation times (p = 0.002 and p < 0.001, respectively). Power-type regression analysis showed a significant correlation between diaphragmatic excursion and ventilation time (p = 0.003 for in-ED and p = 0.003 for in-hospital ventilation time).Diaphragmatic ultrasound is a feasible and valuable tool for assessing diaphragmatic function in the ED. Its use provides important prognostic information, potentially guiding ventilatory strategies and improving patient outcomes by identifying those at risk for prolonged ventilation.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144336498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor: addressing sample size and methodological considerations in burnout research among Italian internists.","authors":"Shoaib Majeed","doi":"10.1007/s11739-025-04025-y","DOIUrl":"10.1007/s11739-025-04025-y","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Particulate matter concentration is associated with increased utilization of the emergency department: a single-centre time-series analysis.","authors":"Alessio Gnerucci, Andrea Rossetto, Paola Faraoni, Francesco Ranaldi, Gabriele Cavallaro, Barbara Tonietti, Ugo Santosuosso, Lorella Bonaccorsi, Peiman Nazerian","doi":"10.1007/s11739-025-04013-2","DOIUrl":"10.1007/s11739-025-04013-2","url":null,"abstract":"<p><p>Fluctuations in emergency department (ED) utilization may be related to pollutant concentration variations that can heighten acute pathologies, exacerbate chronic conditions or indicate increased human activity. This study investigates the association between particulate matter (PM2.5-PM10) concentrations in patients' residential areas and ED visits. Retrospective, single-centre, time-series cohort study on a 100km² urban area around a level 1 hospital in Florence, Italy, with 307,279 ED visits of patients of age > 14 years between 01/01/2019 and 31/12/2022. PM2.5 and PM10 daily concentrations, recorded by 14 air-quality stations, were interpolated at patients' residences, in a 250m² grid, with inverse distance weighting and averaged on various time windows (lag) up to 30 days before ED visit. The association between ED visits and pollutant concentrations as percent excess of incidence rate (%Er) with 95% confidence intervals were investigated with generalized additive models. Significant association was found with short-term PM2.5 and PM10 fluctuations (PM2.5_Lag1: 1.24%Er, 0.59-1.99 95%CI; PM10_Lag2: 1.79%Er, 1.08-2.72). Such association was stronger for the subgroups of deceased patients (PM2.5_Lag1 5.71%Er, 1.44-8.99; PM10_Lag2 6.38%Er, 2.02-10.83), elderly patients presenting with dyspnoea (PM2.5_Lag1 4.18%Er, 2.36-6.33; PM10_Lag2 4.99%Er, 2.77-7.32) and younger patients suffering traumatic events (PM2.5_Lag1 1.29%Er, 0.32-2.51; PM10_Lag2 2.14%Er, 0.88-3.50). Exposure-response curves showed that particulate matter is associated with ED visits even at concentrations below the WHO guard levels. A short-term rise in PM2.5 and PM10, even below guard levels, was associated with increased ED utilization, particularly related to elderly patients with dyspnoea and the concomitant lurking occurrence of vehicle accidents in the younger population. Trial registration: NCT06491290; 09/07/2024; retrospectively registered.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144333070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cancer, the new and hackneyed unknowns.","authors":"Zhaohui Su","doi":"10.1007/s11739-025-04001-6","DOIUrl":"https://doi.org/10.1007/s11739-025-04001-6","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'E-cigarette smoking' is a misleading term: a critical review of its use in academic literature.","authors":"Yusuff Adebayo Adebisi, Nafisat Dasola Jimoh, Chimwemwe Ngoma","doi":"10.1007/s11739-025-04014-1","DOIUrl":"https://doi.org/10.1007/s11739-025-04014-1","url":null,"abstract":"<p><p>The terminology used to describe e-cigarette-related behaviours in academic literature is critical for accurate communication and interpretation. Despite fundamental differences between e-cigarette use (vaping) and tobacco smoking, terms such as \"e-cigarette smoking\" have been used to refer to vaping, potentially conflating the two behaviours. This study aims to assess the use of the term \"e-cigarette smoking\" and its variants in peer-reviewed literature and discuss the implications of their usage. A review of academic literature published between 2015 and 2024 was conducted using Embase, Scopus, Web of Science, ScienceDirect, and ProQuest databases. Searches included terms such as \"e-cigarette smoking\" and related variants, with database-specific filters applied to exclude irrelevant document types. A supplementary search in Google Scholar was performed to capture broader usage, including grey literature. The search identified 613 articles in Embase, 462 in Web of Science, 407 in ScienceDirect, 282 in Scopus and 121 in ProQuest, highlighting the widespread use of \"e-cigarette smoking\" and related terms. The Google Scholar search returned approximately 4680 results, reflecting the widespread and informal use of \"e-cigarette smoking\" across diverse publication types, including grey literature. The term has also appeared in highly cited and recent studies in ways that conflate e-cigarette use with smoking, obscuring the fundamental differences between these distinct behaviours. The use of \"e-cigarette smoking\" and its variants in academic literature has notable implications for research integrity, addiction science, public health, and policy. Misleading terminology can contribute to distorted understandings of nicotine dependence, complicate harm reduction strategies, and risk shaping restrictive policies that fail to differentiate e-cigarette use from smoking. Standardising terminology in academic literature is essential to ensure accurate communication, support evidence-based policymaking, and enhance public health initiatives.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A normal heart doesn't fail: rethinking HFpEF in acute settings.","authors":"Maria Giulia Bellicini","doi":"10.1007/s11739-025-03989-1","DOIUrl":"https://doi.org/10.1007/s11739-025-03989-1","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325599","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When meta-analysis misleads: the need for methodological integrity in e-cigarette research.","authors":"Riccardo Polosa, Giulio Geraci, Yusuff Adebayo Adebisi","doi":"10.1007/s11739-025-04019-w","DOIUrl":"https://doi.org/10.1007/s11739-025-04019-w","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}