Internal and Emergency Medicine最新文献_第3页

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

Clinical characterization of aortitis and periaortitis: study of 134 patients from a single university hospital.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-04 DOI: 10.1007/s11739-025-03908-4

Carmen Secada-Gómez, Javier Loricera, Adrián Martín-Gutiérrez, Fernando López-Gutiérrez, Lucía García-Alcalde, María Núñez-Sayar, Ander Ucelay-Aristi, Isabel Martínez-Rodríguez, Santos Castañeda, Ricardo Blanco

{"title":"Clinical characterization of aortitis and periaortitis: study of 134 patients from a single university hospital.","authors":"Carmen Secada-Gómez, Javier Loricera, Adrián Martín-Gutiérrez, Fernando López-Gutiérrez, Lucía García-Alcalde, María Núñez-Sayar, Ander Ucelay-Aristi, Isabel Martínez-Rodríguez, Santos Castañeda, Ricardo Blanco","doi":"10.1007/s11739-025-03908-4","DOIUrl":"https://doi.org/10.1007/s11739-025-03908-4","url":null,"abstract":"Aortitis and periaortitis refer to the inflammation of the aortic wall and the surrounding tissues. Both conditions are associated with various diseases and express nonspecific manifestations. Early diagnosis and treatment are crucial to improve the prognosis of the disease. This study aimed to assess the causes and main clinical features of aortitis and periaortitis in patients from a single centre in Spain. Observational, retrospective study of patients diagnosed with aortitis or periaortitis at a Spanish referral center over the last decade. 134 patients (87 female; mean age of 55.1 ± 9.1 years) were recruited, 132 of which had aortitis and two periaortitis. Aortitis was associated with giant cell arteritis (n = 102), Takayasu's arteritis (n = 6), IgG4-related disease (n = 6), infectious diseases (n = 3), malignancy (n = 1), drugs (n = 1), isolated aortitis (n = 1), and other immune-mediated inflammatory diseases (IMIDs) (n = 12). IMIDs included were Sjögren's syndrome (n = 2), sarcoidosis (n = 2), rheumatoid arthritis (n = 2), axial spondyloarthritis (n = 2), inflammatory bowel disease (n = 1), primary biliary cirrhosis (n = 1), idiopathic pulmonary fibrosis (n = 1), and polyarteritis nodosa (n = 1). Periaortitis was due to idiopathic retroperitoneal fibrosis in both cases. Imaging techniques used for diagnosis included 18F-FDG PET/CT scan (n = 133), CT-angiography (n = 44), and/or MRI-angiography (n = 33). Polymyalgia rheumatica (52.2%) and asthenia (53.7%) were the most common manifestations, followed by limb claudication (23.9%) and inflammatory back pain (26.9%). Acute-phase reactants were typically increased. Aortitis is a common condition and may be associated with multiple non-infectious diseases. Its clinical presentation is often unspecific, requiring a high level of suspicion to get an early diagnosis and treatment.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143556670","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

Ultrasound-guided nerve blocks: developing a ultrasound-guided nerve block program.

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-03-03 DOI: 10.1007/s11739-025-03901-x

Frederick Milgrim, Matthew Riscinti, Andrew Goldsmith, Arun Nagdev, Joseph Brown

{"title":"Ultrasound-guided nerve blocks: developing a ultrasound-guided nerve block program.","authors":"Frederick Milgrim, Matthew Riscinti, Andrew Goldsmith, Arun Nagdev, Joseph Brown","doi":"10.1007/s11739-025-03901-x","DOIUrl":"https://doi.org/10.1007/s11739-025-03901-x","url":null,"abstract":"Managing acute pain in the Emergency Department (ED) is one of the primary roles of an Emergency Physician (EP), but the constraints of using opiate sparing medications provide an additional challenge for EPs to circumnavigate. In an effort to avoid opioids, many EPs have turned to ultrasound-guided nerve blocks (UGNBs), which have demonstrated outstanding analgesia, in addition to a strong safety profile, decreased risk of delirium, and shortened ED lengths of stay. Some of the primary obstacles to performing nerve blocks, however, are institutional barriers, including buy-in from ED leadership and other hospital stakeholders, ensuring appropriate equipment as well as a lack of provider familiarity with UGNBs. Here, we lay out a framework for developing a nerve block program from scratch, which includes highlighting the various stakeholders and their respective roles, how to set up quality assurance monitoring, educational guidelines, and safety measures. As more EPs are performing UGNBs globally, it is imperative for EDs to initiate block programs, and we hope that these guidelines help provide a starting point for such departmental initiatives.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541971","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