Internal and Emergency Medicine最新文献

{"title":"Nodular fasciitis. A rare, rapidly growing lesion of the parotid gland.","authors":"Nicola Flor, Jacopo Di Napoli, Luca Carsana, Laura Moneghini, Federico Biglioli","doi":"10.1007/s11739-025-03868-9","DOIUrl":"https://doi.org/10.1007/s11739-025-03868-9","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074224","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 program to improve sepsis management in the Emergency Department: a multicenter prospective study in France.","authors":"Anaëlle Nardot, Coralie Lacorre, Antoine Lanneluc, Domitille Paulet, Morgan Gauriat, Cyril Moesch, Pauline Feydeau, Emilie Valantin, Philippe Dupuy, Marine Blondel, Henri Hani Karam, Arthur Baïsse, Isabelle Herafa, Aloïse Blanchet, Manon Dumolard, Thomas Daix, Thomas Lafon","doi":"10.1007/s11739-025-03877-8","DOIUrl":"https://doi.org/10.1007/s11739-025-03877-8","url":null,"abstract":"<p><p>Implementation of a regional sepsis program to improve compliance with sepsis care bundles and optimize septic patient management and outcomes in the Emergency Department (ED). The program included a multifaceted intervention in 8 EDs: creation of a regional sepsis team, meetings, education (yearly 6-h course and site visits) and sepsis alert. Clinical practice was evaluated in each ED during 1 month every year over 3 years. The primary outcome was the initiation of all criteria of the Surviving Sepsis Campaign (SSC) bundle within 3 h after triage. Secondary outcomes were the initiation of the 3-h bundle in patients with hypotension (SBP ≤ 100 mmHg), admission related to infection or not, proportion of organ supports, subsequent intensive care unit (ICU) admission, and early mortality (day 7). During the 3-month study period, 739 patients were identified with a sepsis including 8% with septic shock. Compliance with the SSC bundle improved during the three periods (P1: 28/176 (16%), P2: 42/272 (15%), P3:69/291 (24%), p = 0.023). In patients with hypotension (n = 142, 19%), no improvement was observed (P1:12/38 (32%), P2:18/46 (39%), P3: 28/58 (48%), p = 0.255). Mortality on day 7 was also similar (10% vs 11% vs 9%, p = 0.621). In multivariate analysis, age (OR = 1.03; 95% CI 1.01-1.05, p = 0.003) and confusion (OR = 2.37; 95% CI 1.37-4.14, p = 0.002) were independently associated with D7 mortality. Patients referred to ED for infection had a better prognosis compared to those with a non-specific reason (OR = 0.56; 95% CI 0.32-0.97, p = 0.038). A regional sepsis educational program appears to improve compliance with the SSC bundle. Pre-hospital identification of sepsis appears to improve further management.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065400","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":"Self-rated health differences between exclusive e-cigarette users and exclusive cigarette smokers: evidence from the 2017-2019 Scottish Health Survey.","authors":"Yusuff Adebayo Adebisi, Don Eliseo Lucero-Prisno, Isaac Olushola Ogunkola","doi":"10.1007/s11739-025-03873-y","DOIUrl":"https://doi.org/10.1007/s11739-025-03873-y","url":null,"abstract":"<p><p>The comparative health implications of e-cigarette use versus traditional cigarette smoking remain a critical focus in public health research. This cross-sectional study examined differences in self-rated general health between exclusive e-cigarette users and exclusive cigarette smokers, using data from the 2017-2019 Scottish Health Survey. A total of 2484 adults (aged 16 and above) were included and categorized as exclusive e-cigarette users (n = 565) or exclusive cigarette smokers (n = 1919). Self-rated health was assessed using a single-item measure with five response categories: \"very bad,\" \"bad,\" \"fair,\" \"good,\" and \"very good\". Generalized ordinal logistic regression models were used to estimate the association between nicotine product use and self-rated health, adjusting for age, sex, Scottish Index of Multiple Deprivation, marital status, ethnicity, alcohol consumption frequency, physical activity, presence of longstanding physical or mental health conditions, and age of smoking initiation. In the fully adjusted model, exclusive e-cigarette users had higher odds of reporting better self-rated health compared to exclusive cigarette smokers overall (OR = 1.26, 95% CI 1.05-1.51, p = 0.012). A graded relationship was also observed in the fully adjusted model, with progressively lower odds of reporting better self-rated health as smoking intensity increased, using exclusive e-cigarette users as the reference group. Heavy smokers (≥ 20 cigarettes/day) had the lowest odds of reporting better self-rated health (OR = 0.63, 95% CI 0.49-0.80, p < 0.001), followed by moderate smokers (10 to < 20 cigarettes/day) (OR = 0.81, 95% CI 0.66-0.99, p = 0.047). In contrast, light smokers (< 10 cigarettes/day) showed no significant difference in self-rated health compared to exclusive e-cigarette users (OR = 0.94, 95% CI 0.75-1.18, p = 0.614). These findings indicate that exclusive e-cigarette use is associated with better self-rated health compared to exclusive cigarette smoking, particularly among moderate and heavy smokers. Additional analyses revealed no significant differences in self-rated health among exclusive e-cigarette users based on prior smoking history (OR = 0.94, 95% CI 0.43-2.08, p = 0.882) or among exclusive cigarette smokers based on prior e-cigarette use (OR = 0.87, 95% CI 0.69-1.09, p = 0.219). These findings suggest that prior use is unlikely to explain the observed association between exclusive e-cigarette use and better self-rated health compared to exclusive cigarette smoking. Given the subjective nature of self-rated health, these findings should be interpreted with caution. Future longitudinal studies incorporating objective health measures are essential to assess the long-term impacts of e-cigarette use and inform evidence-based harm reduction policies.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065433","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":"Strengthening team cohesion in the emergency department through a color-coded well-being check-in: are you 'ready to roll?'","authors":"Saskia Anne Carolien van Run, Bart Gerard Jan Candel, Arnoldus George Buenen","doi":"10.1007/s11739-025-03883-w","DOIUrl":"https://doi.org/10.1007/s11739-025-03883-w","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052229","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":"Genomic profiling at a single center cracks the code in inborn errors of immunity.","authors":"Alessandro Andriano, Vanessa Desantis, Carolina Marasco, Antonio Marzollo, Silvia Bresolin, Nicoletta Resta, Lucia Di Marzo, Fabrizio Pappagallo, Antonella Mascolo, Ingrid Catalina Caradonna, Simona D'Amore, Angelo Vacca, Antonio Giovanni Solimando","doi":"10.1007/s11739-025-03871-0","DOIUrl":"https://doi.org/10.1007/s11739-025-03871-0","url":null,"abstract":"<p><p>Inborn errors of immunity (IEI) entail a diverse group of disorders resulting from hereditary or de novo mutations in single genes, leading to immune dysregulation. This study explores the clinical utility of next-generation sequencing (NGS) techniques in diagnosing monogenic immune defects. Eight patients attending the immunodeficiency clinic and with unclassified antibody deficiency were included in the analysis. Clinical records, immune characteristics, and family histories were reviewed, and a target gene panel (TGP) sequencing was performed to identify pathogenic variants. TGPs identified seven variants in TNFRSF13B (TACI), CARMIL2, STAT1, STAT3, and ORAI1 genes. These findings provided definitive diagnoses and proper prognostic assessment. Patients exhibited a wide range of clinical manifestations, including recurrent infections, autoimmune cytopenias, and organ-specific complications. The genetic diversity observed highlights the importance of genetic testing in diagnosing IEIs and tailoring treatments. This study underscores the role of TGPs in diagnosing IEIs, revealing significant genetic heterogeneity and phenotypic variability. They offer a precise tool for identifying underlying genetic defects, facilitating personalized medicine approaches, and eventually improving patient outcomes. The findings emphasize the need for comprehensive genetic testing to uncover novel pathogenic variants, enhancing our understanding of immune system dysfunction. NGS is a critical tool for the management of IEI, enabling precise diagnosis and personalized treatment strategies. Despite resource limitations, the progressive affordability is likely to expand its clinical utility, ultimately improving patient care and advancing the field of immunology. In the meantime, accurate phenotypic assessment is essential for resource optimization and case prioritization.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052223","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 nomogram based on trauma-induced coagulopathy for predicting hospital mortality in multi-trauma patients: a retrospective study.","authors":"Shaochuan Chen, Jiale Yang, Xuezhi Shi, Anwei Liu, Guodong Lin, Huasheng Tong","doi":"10.1007/s11739-025-03867-w","DOIUrl":"https://doi.org/10.1007/s11739-025-03867-w","url":null,"abstract":"<p><p>Multi-trauma presents significant challenges due to the complexity of injuries and high mortality rates. Early identification and intervention are crucial for improving outcomes in these critically injured patients. This retrospective study analyzed clinical data from multi-trauma patients admitted to the emergency department of Huiyang Sanhe Hospital between January 10, 2020, and September 30, 2022. Univariate and multivariate logistic regression analyses were conducted to identify independent predictors of hospital mortality. A prediction model was developed based on these prognostic markers, visualized using a nomogram, and its discriminative ability and clinical benefit were evaluated. A total of 124 multi-trauma patients were included in the study, with a hospital mortality rate of 26.7%. Univariate and multivariate logistic regression analyses identified trauma-induced coagulopathy (TIC) (OR 4.238, 95% CI 1.46-12.28), blood urea nitrogen (BUN) (OR 1.397, 95% CI 1.09-1.78), and Glasgow Coma Scale (GCS) score (OR 0.720, 95% CI 0.61-0.85) as independent factors of hospital mortality. Therefore, a nomogram incorporating TIC, BUN, and GCS score was constructed and demonstrated excellent predictive performance and clinical impact (AUC 0.898, 95% CI 0.834-0.962). The nomogram developed in this study provided a practical tool for early prediction of hospital mortality in multi-trauma patients. By focusing on TIC, BUN, and GCS score, this model may facilitate rapid bedside assessment and timely intervention. However, further multicenter, prospective studies are required to validate its performance and applicability.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052214","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":"The escape room: will we be able to build a team?","authors":"Maria Antonella Pinelli, Puccio Mariani, Donatella Lippi, Linda Vignozzi, Francesca Innocenti","doi":"10.1007/s11739-025-03872-z","DOIUrl":"https://doi.org/10.1007/s11739-025-03872-z","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052378","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":"Targeting Janus kinase 1 in refractory Behçet's disease: a case report on the clinical efficacy of upadacitinib.","authors":"Claudia Ammoscato, Federica Gatti, Florenzo Iannone, Giuseppe Lopalco","doi":"10.1007/s11739-025-03874-x","DOIUrl":"https://doi.org/10.1007/s11739-025-03874-x","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052230","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":"Serum lactate is associated with an ICU admission in patients presenting with seizure at the emergency department: comment.","authors":"Emmeline Leggett, Claudia Wong, Eric Yang, Daniel Najafali, Quincy K Tran","doi":"10.1007/s11739-025-03876-9","DOIUrl":"https://doi.org/10.1007/s11739-025-03876-9","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033096","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 57-year-old woman with unexplained refractory shock.","authors":"David Serantes Gómez, Amaia López de Lacalle, Beatriz Nieto Martino, David Bernal Bello","doi":"10.1007/s11739-025-03865-y","DOIUrl":"https://doi.org/10.1007/s11739-025-03865-y","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004859","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}