Internal and Emergency Medicine最新文献

{"title":"Preoxygenation via noninvasive ventilation compared to oxygen masks for critically ill patients prior to endotracheal intubation.","authors":"Cassandra Chisholm, Conné Lategan, Eddy Lang","doi":"10.1007/s11739-025-03957-9","DOIUrl":"10.1007/s11739-025-03957-9","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1265-1267"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144003904","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":"Development of an Emergency Department Safety Checklist through a global consensus process.","authors":"Lucrezia Rovati, Daniele Privitera, Alexander S Finch, John M Litell, Autumn M Brogan, Aysun Tekin, Claudia Castillo Zambrano, Yue Dong, Ognjen Gajic, Bo E Madsen","doi":"10.1007/s11739-024-03760-y","DOIUrl":"10.1007/s11739-024-03760-y","url":null,"abstract":"<p><p>Emergency departments (EDs) are at high risk for medical errors. Checklist implementation programs have been associated with improved patient outcomes in other high-risk clinical settings and when used to address specific aspects of ED care. The aim of this study was to develop an ED Safety Checklist with broad applicability across different international ED settings. A three-round modified Delphi consensus process was conducted with a multidisciplinary and multinational panel of experts in emergency medicine and patient safety. Initial checklist items were identified through a systematic review of the literature. Each item was evaluated for inclusion in the final checklist during two rounds of web-based surveys and an online consensus meeting. Agreement for inclusion was defined a priori with a threshold of 80% combined agreement. Eighty panel members from 34 countries across all seven world regions participated in the study, with comparable representation from low- and middle-income and high-income countries. The final checklist contains 86 items divided into: (1) a general ED Safety Checklist focused on diagnostic evaluation, patient reassessment, and disposition and (2) five domain-specific ED Safety Checklists focused on handoff, invasive procedures, triage, treatment prescription, and treatment administration. The checklist includes key clinical tasks to prevent medical errors, as well as items to improve communication among ED team members and with patients and their families. This novel ED Safety Checklist defines the essential elements of high-quality ED care and has the potential to ensure their consistent implementation worldwide.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1203-1213"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142345995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global burden and risk factors of MASLD: trends from 1990 to 2021 and predictions to 2030.","authors":"Minshan Huang, Hang Chen, Hui Wang, Yudi Zhang, Liya Li, Yang Lan, Lanqing Ma","doi":"10.1007/s11739-025-03895-6","DOIUrl":"10.1007/s11739-025-03895-6","url":null,"abstract":"<p><p>The prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing globally, posing a major public health issue. This study analyzes the global, regional, and national burden of MASLD and its risk factors from 1990 to 2021, with projections to 2030. We obtained data on MASLD prevalence, deaths, and disability-adjusted life years (DALYs) from the Global Burden of Disease 2021 for 204 countries. Counts and rates per 100,000 population were calculated, and trends to 2030 were predicted using the Bayesian Age-Period-Cohort model. In 2021, there were 1,267.9 million MASLD cases globally, with 138.3 thousand deaths and 3667.3 thousand DALYs. The global age-standardized prevalence, death, and DALY rates were 15,018.1, 1.6, and 42.4 per 100,000 population, increasing by 24.3%, 5.5%, and 5.5% since 1990. North Africa and the Middle East had the highest prevalence, while Andean and Central Latin America had the highest death and DALY rates. Men aged 15-69 and 90-94 had higher DALY rates, while women aged 70-89 and 95+ had higher rates. A reversed V-shaped association was found between the sociodemographic index and DALY rate. High fasting plasma glucose (5.9%) and smoking (2.4%) were major risk factors. Public health efforts should prioritize early detection and management of MASLD in younger populations and develop targeted strategies for older adults, especially women, to reduce the disease burden. Effective policies to address high fasting plasma glucose and smoking can mitigate MASLD's impact.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1013-1024"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interventions to reduce burnout in emergency medicine: a national inventory of the Canadian experience to support global implementation of wellness initiatives.","authors":"Kathy Liu, Christopher Patey, Paul Norman, Anders Broens Moellekaer, Rodrick Lim, Al'ai Alvarez, Eric Pieter Heymann","doi":"10.1007/s11739-024-03811-4","DOIUrl":"10.1007/s11739-024-03811-4","url":null,"abstract":"<p><p>Burnout in healthcare workers is a global issue, with Emergency Medicine (EM) particularly impacted. Many countries have tried implementing wellness initiatives to reduce burnout and improve wellness. This paper summarizes interventions implemented in Canada to-date with the aim of supporting the design of wellness interventions in EDs globally. A systematic review and a grey literature search were completed in November 2023. Original studies in both English and French that included the implementation and evaluation of a wellness intervention in EDs in Canada were included. The study design, content of the intervention, target population, and outcomes were extracted and narratively analyzed. 13 studies were included. Each implemented a unique wellness intervention for EDs. All three studies (3/3, 100%) that included a structured wellness curriculum demonstrated significant improvement in burnout as measured by the Maslach Burnout Inventory, physical health (PCS-8), and Brief Resident Wellness Profile (BRWP). Other interventions included Ice Cream Rounds, therapy dogs, changing the duration of night shifts, and sessions on resilience and self-care. Our Canada-wide analysis of wellness interventions identified initiatives geared towards trainees, staff, or entire ED workface groups. Examples include educational programs, dedicated sessions for compassion literacy and resilience, critical events debriefing, and optimizing shift schedules. Structured wellness curriculums seem to be effective, and this area warrants further study. Moreover, we identify a need for global collaboration to build wellness programs and for more easily translatable standardized outcome measures for assessing the efficacy of wellness programs in EM.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1245-1264"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800655","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":"Long-term left ventricular thrombosis resolution in patients receiving vitamin k antagonists: a multicenter observational study.","authors":"Emanuele Valeriani, Giulia Astorri, Arianna Pannunzio, Daniele Pastori, Ilaria Maria Palumbo, Danilo Menichelli, Marco Paolo Donadini, Davide Santagata, Katarzyna Satula, Erica De Candia, Luca D'Innocenzo, Antonella Tufano, Rossella Marcucci, Martina Berteotti, Antonio Chistolini, Francesco Dragoni, Tommaso Bucci, Walter Ageno, Cecilia Becattini, Pasquale Pignatelli","doi":"10.1007/s11739-025-03922-6","DOIUrl":"10.1007/s11739-025-03922-6","url":null,"abstract":"<p><p>Optimal duration of anticoagulant therapy for left ventricular thrombous (LVT) is unclear. The aim of this study is to evaluate effectiveness and safety of vitamin K antagonists (VKAs) up to 12 months in patients with LVT. Patients diagnosed with LVT between 2011 and 2023 and treated with VKAs until LVT resolution or up to 12 months were enrolled in a retrospective cohort study. Primary outcome included on-treatment LVT resolution, secondary outcomes acute ischemic stroke, myocardial infarction, peripheral embolism, and major and clinically relevant non-major bleedings during the 12-month follow-up. Ninety patients were included. Median age was 66 years and 78.9% were male. Mean time in therapeutic range was 61% and 32.9% of patients received VKA monotherapy, with the remaining concomitant antiplatelet treatment. The 3, 6, 12 months cumulative incidences of LVT resolution were 27% (95% confidence intervals -95%CI-, 18%-36%), 47% (95%CI 36%-57%), and 70% (95% CI 60%-79%), respectively. At Cox regression model, reduced left ventricular ejection fraction (Hazard Ratio 0.48; 95%CI 0.24-0.95) and left-ventricular aneurysms (Hazard Ratio 0.44; 95%CI 0.22-0.88) were associated with reduced LVT resolution. One patient developed an acute ischemic stroke and one an acute myocardial infarction. Two patients developed a major and four a clinically relevant non-major bleeding. Incidence of LVT resolution appeared to be higher at 12 than at 3 and 6 months of follow-up, and the rates of on-treatment acute arterial and bleeding events were low. Reduced left ventricular ejection fraction and left-ventricular aneurysm appeared to be associated with a lower rates of LVT resolution.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1069-1076"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12130138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing triage efficiency in Italy: a comparative study using simulated cases among nurses, a comment.","authors":"Nicola Ramacciati, Gian Domenico Giusti","doi":"10.1007/s11739-024-03824-z","DOIUrl":"10.1007/s11739-024-03824-z","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1291-1292"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142739437","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":"10.1007/s11739-025-03876-9","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1297-1298"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","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":"New-generation nicotine delivery products require new approaches to research.","authors":"Derek Yach","doi":"10.1007/s11739-025-03925-3","DOIUrl":"10.1007/s11739-025-03925-3","url":null,"abstract":"<p><p>Toxicological and epidemiological studies suggest that new-generation nicotine delivery products will reduce the harmful exposures associated with combustible cigarettes and toxic forms of smokeless tobacco products. However, enhanced study designs are needed to support epidemiological research that was more appropriate when the ways of consuming nicotine were limited and methods to assess causality in less than decades were unavailable. Given their different perspectives and scientific capabilities, progress in THR requires deeper and transparent engagement between industry scientists and those in academia that rigorously applies conflicts of interest norms.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"959-964"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735815","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":"Clinical and echocardiographic predictors of postoperative atrial fibrillation in lung surgery: the role of left atrial remodelling.","authors":"Valentina Scheggi, Alberto Salvicchi, Silvia Menale, Jacopo Giovacchini, Stefano Fumagalli, Emanuele Santamaria, Giulia Spanalatte, Rossella Marcucci, Luca Voltolini, Niccolò Marchionni","doi":"10.1007/s11739-025-03930-6","DOIUrl":"10.1007/s11739-025-03930-6","url":null,"abstract":"<p><p>Postoperative atrial fibrillation (PoAF) complicates 10-15% of pulmonary lobectomy and 20-30% of pneumonectomy, contributing to increased morbidity, extended hospital stays, and healthcare costs. Identifying predictors of PoAF may aid in risk stratification and preventive care. We prospectively studied 100 consecutive patients who underwent lung surgery for a malignant tumour, including video-assisted thoracic surgery (VATS) and open thoracotomy. Patients with prior atrial fibrillation, cardiac surgery, or thyroid abnormalities were excluded. All patients received pre-operative echocardiography, including speckle-tracking for left atrial (LA) and ventricular function. PoAF incidence was monitored through continuous electrocardiographic follow-up. Univariable and multivariable analyses identified clinical and echocardiographic predictors of PoAF. At univariable analysis, PoAF patients (8%) were more likely to have hypertension (100% vs. 58%, p = 0.018), higher fibrinogen (432 ± 118 mg/dl vs. 346 ± 87 mg/dl, p = 0.03), and lower magnesium levels (1.8 ± 0.2 mEq/l vs. 2.1 ± 0.2 mEq/l, p = 0.003). Echocardiographic differences included larger LA diameter (42 ± 5 mm vs. 35 ± 5 mm, p = 0.002), area (23.8 ± 3.3 cm² vs. 17.7 ± 4.5 cm², p < 0.001), and volume (36.9 ± 7.2 ml vs. 28.6 ± 9.4 ml, p = 0.003). Multivariable analysis identified fibrinogen (HR 1.01, p = 0.036), interventricular septal thickness (HR 3.05, p = 0.029), LA area (HR 1.33, p = 0.016) and LA peak contraction strain (PACS, HR 2.3, p = 0.023) as independent PoAF predictors. Hypertension, inflammation, electrolyte imbalance, and LA remodelling were associated with PoAF. Pre-operative identification of these factors may help target high-risk patients for preventive interventions.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1097-1106"},"PeriodicalIF":3.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12129850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic associated steatotic liver disease in renal transplant recipients: a retrospective cohort study.","authors":"Carmine Secondulfo, Pietro Torre, Candida Iacuzzo, Renata Angela Di Pietro, Luca Apicella, Nicoletta Vecchione, Mario Masarone, Marcello Persico, Giancarlo Bilancio","doi":"10.1007/s11739-025-03967-7","DOIUrl":"https://doi.org/10.1007/s11739-025-03967-7","url":null,"abstract":"<p><p>Metabolic associated steatotic liver disease (MASLD) is a major contributor to chronic liver disease, with rising prevalence. Chronic kidney disease (CKD) shares risk factors with MASLD, including obesity, diabetes, hypertension, and metabolic syndrome. CKD prevalence in MASLD patients ranges from 4 to 40%. The interplay between MASLD and CKD may influence disease progression through intestinal barrier changes, uremic toxins, and glucocorticoid metabolism. Limited data exist on steatosis in renal transplant recipients and its impact on cardiovascular disease (CVD). This study investigates the prevalence and factors associated with steatosis and liver stiffness in kidney transplant patients, and secondarily its relationship with CVD history. Two hundred kidney transplant patients at Salerno University Hospital were studied. The data included demographics, clinical and laboratory findings, abdominal ultrasonography (US), liver stiffness, and controlled attenuation parameter (CAP). Cardiovascular disease (CVD) history was also recorded. Statistical significance was set at p < 0.05. Of the cohort, 69% were male, with a mean age of 56.8 years. Steatosis was found in 45.5%, with 11.1% at risk of fibrosis. Steatosis was associated with higher BMI (28.5 vs. 25.5, p = 0.0001) and metabolic syndrome (30.8% vs. 11.0%, p = 0.001). CAP was linked to self-reported male gender and eGFR (p < 0.05), while fibrosis correlated with age, self-reported male gender, and HDL < 40 mg/dL. CVD prevalence was 14.5%, with no significant association with steatosis. MASLD and metabolic syndrome were highly prevalent in kidney transplant recipients, though no significant link was found between steatosis and CVD history.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191755","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}