Internal and Emergency Medicine最新文献

{"title":"Hospital admission from the emergency department of adult patients affected by immune-mediated inflammatory diseases: a multidimensional retrospective analysis of an hospital-based cohort.","authors":"Elisa Chapuis, Fetta Moussi, Antoine Dossier, Julien Rio, Arthur Mageau, Karim Sacre","doi":"10.1007/s11739-025-03899-2","DOIUrl":"https://doi.org/10.1007/s11739-025-03899-2","url":null,"abstract":"","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":"143541969","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":"Minimally invasive trans-sulcal parafascicular surgery for the early evacuation of spontaneous intracerebral hemorrhage: the ENRICH trial.","authors":"Felice Cinque, Davide Nilo, Alessandro Gezzi, Fabrizio De Gregorio, Bianca Clerici","doi":"10.1007/s11739-025-03907-5","DOIUrl":"https://doi.org/10.1007/s11739-025-03907-5","url":null,"abstract":"","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":"143541970","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":"SGLT-2 inhibitors and diabetic ketoacidosis.","authors":"Francesco Agozzino, Teresa De Falco, Antonio Villa","doi":"10.1007/s11739-025-03862-1","DOIUrl":"10.1007/s11739-025-03862-1","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"337-340"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143046505","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":"Effect of traditional Chinese medicine on cardiovascular death and all-cause death among patients with heart failure and/or atrial fibrillation.","authors":"Wei-Syun Hu, Cheng-Li Lin","doi":"10.1007/s11739-024-03821-2","DOIUrl":"10.1007/s11739-024-03821-2","url":null,"abstract":"<p><p>We tried to define the association of adverse cardiovascular (CV) events, such as CV death and all-cause death among patients with heart failure (HF) and/or atrial fibrillation (AF) receiving traditional Chinese medicine (TCM) or not. We used data from the Taiwan National Health Insurance Research Database in a retrospective cohort study using propensity scoring (PS) matching. We matched 54,859 and 18,307 patients each to the treatment vs. non-treatment group and found a significantly decreased risk of adverse CV events after PS score matching, suggesting that TCM reduces the risk of these adverse outcomes. Compared to HF patients without AF in non-TCM user, HF patients without AF in TCM user and HF patients with AF in TCM user had decreased risk of CV death by 0.50 times (95% CI 0.49, 0.52) and 0.84 times (95% CI 0.49,0.52), respectively. HF patients without AF in TCM user and HF patients with AF in TCM user had decreased risk of all-cause death relative to HF patients without AF in non-TCM user by 0.53 times (95% CI 0.52, 0.54) and 0.74 times (95% CI 0.72,0.76), respectively. The results said that there is significant reduction of decrease in risk of CV death and all death among the patients receiving TCM, especially those without AF.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"463-469"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768579","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":"COmplexity of CARE and Discharge barriers: the 'modern internal medicine patient'. Results from the CO-CARED Study.","authors":"Elisa Ceriani, Olivia Milani, Mattia Donadoni, Alberto Benetti, Sergio Antonio Berra, Ciro Canetta, Fabrizio Colombo, Francesco Dentali, Luigi Magnani, Antonino Mazzone, Nicola Montano, Maria Lorenza Muiesan, Gian Marco Podda, Patrizia Rovere Querini, Alessandro Squizzato, Giovanni Casazza, Chiara Cogliati","doi":"10.1007/s11739-024-03823-0","DOIUrl":"10.1007/s11739-024-03823-0","url":null,"abstract":"<p><p>The ongoing demographic, epidemiological and social changes are dramatically raising the clinical and care complexity of patients admitted to internal medicine (IM) departments. Collecting evidence for a better characterization of patients is crucial to tailor future interventions based on patient's real needs. The aim of this prospective multicenter study was to describe the complexity of care of patients hospitalized in IM by calculating the complexity of care (ICC) score, through the combination of clinical instability (NEWS score) and care dependency scales (mICD). Furthermore, social frailty was assessed according to potential difficulty in discharge planning. 3912 patients were enrolled (median age 78 years); 71% had a Charlson Comorbidity Index ≥ 5. The ICC score was high in 14.7% of patients, while 15% exhibited a NEWS score at least moderate. One in four patients presented moderate to critical social frailty. The length of stay was correlated with social frailty, mICD and ICC scores, but not with NEWS. In-hospital mortality was correlated with the severity of all the considered scores. A relevant proportion of IM patients exhibited a high complexity of care. Our data support a model in which approximately 15% of IM beds are designated for clinically unstable patients managed in intermediate care sub-units. The substantial burden of social frailty highlights the urgency of national plans allowing at the same time to cover the needs of not self-sufficient and socially disadvantaged patients, and to efficiently address the issue of emergency department boarding.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"471-479"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142800621","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":"Less is not always more: complex interactions in blood clot mysteries.","authors":"Giacomo Leo Paolazzi, Marco Montagna, Alberto Davalli, Armando D'Angelo, Patrizia Rovere Querini","doi":"10.1007/s11739-024-03749-7","DOIUrl":"10.1007/s11739-024-03749-7","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"515-518"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142107038","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":"Bloodstream infections due to multi-drug resistant bacteria in the emergency department: prevalence, risk factors and outcomes-a retrospective observational study.","authors":"Nicolò Capsoni, Giulia Maria Azin, Marida Scarnera, Marco Bettina, Riccardo Breviario, Laura Ferrari, Camilla Ferrari, Daniele Privitera, Chiara Vismara, Alessandra Bielli, Filippo Galbiati, Davide Paolo Bernasconi, Marco Merli, Michele Bombelli","doi":"10.1007/s11739-024-03692-7","DOIUrl":"10.1007/s11739-024-03692-7","url":null,"abstract":"<p><p>Multidrug-resistant organisms (MDROs) are prevalent in patients admitted to the Emergency Department (ED) and increase the risk of inappropriate empirical antibiotic therapy. Risk stratification for MDRO infection is essential to early identify patients requiring empirical broad-spectrum antibiotic therapy, but it remains challenging for emergency physicians. This study aimed to evaluate prevalence, risk factors, and outcomes of patients admitted to the ED with a bloodstream infection (BSI) caused by MDROs. A retrospective observational study enrolling all consecutive adult patients admitted with a BSI to the ED of Niguarda Hospital, Italy, from January 2019 to December 2021 was performed. 757 patients were enrolled, 14.1% with septic shock. 156 (20%) patients had a BSI caused by MDRO: extended-spectrum beta-lactamase (ESBL) producing Enterobacterales were the most prevalent followed by methicillin-resistant Staphylococcus aureus (MRSA). Risk factors for BSI due to MDRO and specifically for ESBL were chronic renal failure (OR 2.2; 95%CI 1.4-3.6), nursing home residency (OR 4.4; 95%CI 1.9-10.2) and antibiotic therapy in the last 90-days (OR 2.6; 95%CI 1.7-4), whereas for MRSA were dialysis (OR 12.3; 95%CI 1.8-83), antibiotic therapy and/or hospital admission in the past 90-days (OR 3.6; 95%CI 1.2-10.6) and ureteral stent or nephrostomy (OR 7.8; 95%CI 1.5-40.9). Patients with BSI due to MDRO had a higher rate of inappropriate empirical antibiotic therapy (50%) and longer length of stay, but no higher in-hospital mortality. Among patients admitted to the ED with a BSI, MDROs are frequent and often associated with inappropriate empirical antibiotic therapy. Specific updated risk factors for MDRO may help clinicians to better identify patients requiring a broader antibiotic therapy in the ED, while awaiting microbiological results.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"573-583"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603573","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":"Nonspecific stress biomarkers for mortality prediction in older emergency department patients presenting with falls: a prospective multicenter observational study.","authors":"Lukas Terhalle, Laura Arntz, Felix Hoffmann, Isabelle Arnold, Livia Hafner, Laurentia Picking-Pitasch, Joanna Zuppinger, Karen Delport Lehnen, Jörg Leuppi, Rajan Somasundaram, Christian H Nickel, Roland Bingisser","doi":"10.1007/s11739-024-03693-6","DOIUrl":"10.1007/s11739-024-03693-6","url":null,"abstract":"<p><strong>Background: </strong>Older patients presenting to the emergency department (ED) after falling are increasingly prevalent. Falls are associated with functional decline and death. Biomarkers predicting short-term mortality might facilitate decisions regarding resource allocation and disposition. D-dimer levels are used to rule out thromboembolic disease, while copeptin and adrenomedullin (MR-proADM) may be used as measures of the patient`s stress level. These nonspecific biomarkers were selected as potential predictors for mortality.</p><p><strong>Methods: </strong>Prospective, international, multicenter, cross-sectional observation was performed in two tertiary and two regional hospitals in Germany and Switzerland. Patients aged 65 years or older presenting to the ED after a fall were enrolled. Demographic data, Activities of Daily Living (ADL), and D-dimers were collected upon presentation. Copeptin and MR-proADM levels were determined from frozen samples. Primary outcome was 30-day mortality; and secondary outcomes were mortality at 90, 180, and 365 days.</p><p><strong>Results: </strong>Five hundred and seventy-two patients were included. Median age was 83 [IQR 78, 89] years, 236 (67.7%) were female. Mortality overall was 3.1% (30 d), 5.4% (90 d), 7.5% (180 d), and 13.8% (365 d), respectively. Non-survivors were older, had a lower ADL index and higher levels of all three biomarkers. Elevated levels of MR-proADM and D-dimer were associated with higher risk of mortality. MR-proADM and D-dimer showed high sensitivity and low negative likelihood ratio regarding short-term mortality, whereas copeptin did not.</p><p><strong>Conclusion: </strong>D-dimer and MR-proADM levels might be useful as prognostic markers in older patients presenting to the ED after a fall, by identifying patients at low risk of short-term mortality.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT02244983.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"585-595"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11950067/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141497948","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":"Hirschsprung's disease and Chilaiditi syndrome in young adults.","authors":"Grigoriy Gurvits","doi":"10.1007/s11739-024-03671-y","DOIUrl":"10.1007/s11739-024-03671-y","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"629-630"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141440454","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":"Simultaneous pachymeningeal and cerebral parenchymal involvement by alveolar echinococcosis.","authors":"Hayri Ogul, Yener Aydin, Zakir Sakci","doi":"10.1007/s11739-024-03784-4","DOIUrl":"10.1007/s11739-024-03784-4","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"619-620"},"PeriodicalIF":3.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365148","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}