Internal and Emergency Medicine最新文献_第2页

The effect of SGLT2 inhibitors on hepatic steatosis detected by MRI-PDFF in patients with type 2 Diabetes mellitus and metabolic-associated steatotic liver disease.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-14 DOI: 10.1007/s11739-025-03902-w

Mona Ahmed Amin, Noha Adly Sadik, Hala Ahmed Saad, Mohammed Fawzy, Hend Abdallah Elsheimy

{"title":"The effect of SGLT2 inhibitors on hepatic steatosis detected by MRI-PDFF in patients with type 2 Diabetes mellitus and metabolic-associated steatotic liver disease.","authors":"Mona Ahmed Amin, Noha Adly Sadik, Hala Ahmed Saad, Mohammed Fawzy, Hend Abdallah Elsheimy","doi":"10.1007/s11739-025-03902-w","DOIUrl":"https://doi.org/10.1007/s11739-025-03902-w","url":null,"abstract":"Sodium-glucose co-transporter type-2 (SGLT2) inhibitors have been identified to have a crucial hepatoprotective role in patients with type 2 diabetes (T2DM) and metabolic-associated steatotic liver disease (MASLD). Thus, we aimed to assess the effect of SGLT2 inhibitors on hepatic steatosis in patients with T2DM and MASLD added to the standard of care (SOC) treatment. Our study was a single-arm clinical trial with trial no ISRCTN85961860. Thirty T2DM patients with MASLD were recruited from the outpatient endocrinology and diabetes clinic of the Internal Medicine Department at Kasr Al-Aini Hospital, Cairo University, Egypt. Our Patients received Empagliflozin 10 mg daily which was added to SOC treatment and followed up for 24 weeks. Magnetic resonance imaging proton density fat fraction (MRI-PDFF) was done at baseline and after 24 weeks to assess the percentage change in hepatic fat mass. Also changes in Fib-4 and NAFLD fibrosis scores were calculated. Our study showed a statistically significant decrease in the mean MRI-PDFF measurement of hepatic steatosis after 24 weeks of adding empagliflozin to SOC treatment (13.297 ± 7.15) compared to the mean at baseline (15.288 ± 8.72), P = 0.006 with overall percentage decrease about 13.16% of liver steatosis. There were significant decreases in BMI, fasting blood glucose, and Alanine transaminase, (P < 0.001, 0.03, 0.01) respectively. There were no significant differences in Fib-4 or NAFLD fibrosis scores. Adding empagliflozin 10 mg to the standard treatment in patients with diabetes and MASLD could reduce hepatic fat mass significantly after 24 weeks of treatment. Thus, adding SGLT2 inhibitors to the clinical practice guidelines could be a therapeutic agent for patients with MASLD and T2DM.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630388","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}

引用次数: 0

Iatrogenic fever of unknown origin.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-12 DOI: 10.1007/s11739-025-03915-5

Shinnosuke Fukushima, Hideharu Hagiya, Keiji Yunoki, Gentaro Kato, Shinichi Mukai

引用次数: 0

Does helmet CPAP reduce carotid flow compared to oronasal mask CPAP? A randomized cross-over trial in healthy subjects.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-12 DOI: 10.1007/s11739-025-03914-6

Andrea Duca, Laura Frosio, Luca Molinero, Andrea Finazzi, Ivan Oppedisano, Carlo Bellazzi, Giovanni Nattino, Fabiola Signorini, Guido Bertolini, Eugenia Belotti, Roberto Cosentini

{"title":"Does helmet CPAP reduce carotid flow compared to oronasal mask CPAP? A randomized cross-over trial in healthy subjects.","authors":"Andrea Duca, Laura Frosio, Luca Molinero, Andrea Finazzi, Ivan Oppedisano, Carlo Bellazzi, Giovanni Nattino, Fabiola Signorini, Guido Bertolini, Eugenia Belotti, Roberto Cosentini","doi":"10.1007/s11739-025-03914-6","DOIUrl":"https://doi.org/10.1007/s11739-025-03914-6","url":null,"abstract":"This study aimed to assess whether delivering Continuous Positive Airway Pressure (CPAP) through a Helmet interface (H-CPAP) reduces common carotid artery flow (CCAF), compared to breathing room air (RA) or using an oronasal mask (M-CPAP). This trial is an unblinded, randomized, controlled crossover trial. The primary outcome was CCAF, measured using Doppler ultrasound. The secondary outcome was mean arterial pressure (MAP). A convenient sample of adult healthy volunteers was enrolled. Subjects were enrolled and randomized to receive either H-CPAP or M-CPAP first at + 10 cmH2O, followed by the alternate intervention, each for 5 min. CCAF, mean arterial pressure (MAP), heart rate (HR), respiratory rate (RR), oxygen saturation (SpO₂), and anxiety score (AS) were recorded at baseline (RA) and after 5 min under each CPAP condition. Results showed a significant 14% reduction in CCAF between RA and H-CPAP (p = 0.001) and a 13% reduction between M-CPAP and H-CPAP (p = 0.004), with no significant difference between RA and M-CPAP. MAP remained unchanged across treatments, suggesting that the reduction in cerebral perfusion observed with H-CPAP was independent of systemic blood pressure changes. Helmet CPAP significantly reduces CCAF compared to RA and M-CPAP. While H-CPAP may offer advantages in respiratory support, its effect on cerebral perfusion suggests caution in patients with impaired cerebral autoregulation, such as those with stroke.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143614865","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}

引用次数: 0

Predictors of high‑flow nasal cannula (HFNC) failure in severe community‑acquired pneumonia or COVID‑19: comment.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-12 DOI: 10.1007/s11739-025-03917-3

Aslıhan Gürün Kaya, Akın Kaya

引用次数: 0

Holding breath.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-08 DOI: 10.1007/s11739-025-03912-8

Silvia Tiraboschi

引用次数: 0

Clarkson disease in critically and non-critically ill patients: insights from the Italian IRIS-CLS registry.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-08 DOI: 10.1007/s11739-025-03890-x

Riccardo Colombo, Jonathan Montomoli, Teresa Lanzi, Antonella Tosoni, Claudia Agabiti Rosei, Giuseppe Visani, Franco Verlicchi, Chiara Cogliati, Manuela Nebuloni, Maddalena Alessandra Wu

{"title":"Clarkson disease in critically and non-critically ill patients: insights from the Italian IRIS-CLS registry.","authors":"Riccardo Colombo, Jonathan Montomoli, Teresa Lanzi, Antonella Tosoni, Claudia Agabiti Rosei, Giuseppe Visani, Franco Verlicchi, Chiara Cogliati, Manuela Nebuloni, Maddalena Alessandra Wu","doi":"10.1007/s11739-025-03890-x","DOIUrl":"https://doi.org/10.1007/s11739-025-03890-x","url":null,"abstract":"Idiopathic Systemic Capillary Leak Syndrome (ISCLS) is a poorly understood paroxysmal permeability disorder. This study aimed to characterize the clinical features and severity markers of ISCLS in critically and non-critically ill patients. We analyzed prospectively and retrospectively collected data on ISCLS cases from the Italian IRIS-CLS Registry (January 1995-December 2023). A total of 124 acute episodes were identified in 32 patients; 61 episodes in 26 patients having complete records were included in the analysis. Monoclonal gammopathy was found in 20/23 adults but was absent in all three pediatric patients, who exhibited IgA deficiency instead. At admission, patients presented with hypotension (systolic arterial pressure 87 mmHg [80-105]), tachycardia (110 bpm [96-130]), and hemoconcentration (hematocrit 57% [48-62.7]). ICU admission was required in 70.5%, and cardiac involvement occurred in 49.2% of episodes. Fluid volume infused correlated positively with rhabdomyolysis severity, and the need for renal replacement therapy was more frequent in patients receiving ≥ 3 L. No pharmacologic treatment was effective during the crises. Mortality was 9.8% per episode, and the day-1 Sequential Organ Failure Assessment score was a predictor of death (p = 0.0181). Immunoglobulin prophylaxis reduced attack frequency from 0.67 (0.4-1.07) to 0.4 (0.1-0.52) per year (p = 0.033). Two adults (8.7%) developed multiple myeloma during follow-up. This study provides a comprehensive overview of ISCLS in both critically and non-critically ill patients. We highlight clinical-biochemical-instrumental red-flags and emphasize the need for increased awareness and early recognition since effective treatments for acute shock remain elusive.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585755","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}

引用次数: 0

Summer-type hypersensitivity pneumonitis.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-07 DOI: 10.1007/s11739-025-03913-7

Kosuke Ishizuka, Masaki Yamamoto, Yoshiyuki Ohira, Mitsuyasu Ohta

引用次数: 0

Capillary leakage leading to bilateral visual impairment: a diagnostic journey.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-07 DOI: 10.1007/s11739-025-03910-w

Francesco Urso, Giovanni Tondini, Mattia Donadoni, Alessandro Invernizzi, Maddalena Alessandra Wu

引用次数: 0

Musculoskeletal manifestations in a cohort of Behçet's disease patients and their impact on health-related quality of life.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-07 DOI: 10.1007/s11739-025-03903-9

Samar Tharwat, Nasim Jaber, Hamza Aljubaeh, Omar Abumunshar

{"title":"Musculoskeletal manifestations in a cohort of Behçet's disease patients and their impact on health-related quality of life.","authors":"Samar Tharwat, Nasim Jaber, Hamza Aljubaeh, Omar Abumunshar","doi":"10.1007/s11739-025-03903-9","DOIUrl":"https://doi.org/10.1007/s11739-025-03903-9","url":null,"abstract":"Behçet's disease (BD) is a multifaceted disorder of undetermined etiology. Distinct clinical manifestations exhibit varying prevalences, with mucocutaneous and ocular presentations being the most prevalent in the BD population. The aim of this study was to assess musculoskeletal (MSK) manifestations and their effect on health-related quality of life (HRQoL) of life in individuals with BD. We asked patients with BD to complete an online survey. The survey had many questions focused on demographic, clinical, and therapeutic data, as well as the Nordic musculoskeletal questionnaire and the short form-36 (SF-36). There was a total of 185 BD patients, mostly females (54.6%), with a mean age of 33.81 years. The most prevalent clinical manifestation was recurrent oral aphthosis (95.1%), followed by ocular involvement (72.4%). Most of the study patients (85.4%) reported MSK manifestations in the last 6 months. These manifestations included mainly the lower back (69%) and neck (67%), followed by the left and right knees (62% and 60%, respectively), while the least affected areas of the body were the right elbow (37%), and the right ankle and foot (7%). The age at disease onset (p = 0.007) showed a statistically significant difference between those with MSK manifestations and those without. Patients exhibiting MSK manifestations demonstrated statistically significant lower scores of all SF-36 domains compared to those without such manifestations. MSK manifestations are prevalent and adversely affect HRQoL among BD patients. Therefore, early identification and treatment are strongly recommended.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585759","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}

引用次数: 0

Reviewers 2024.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-05 DOI: 10.1007/s11739-025-03884-9

引用次数: 0