Internal and Emergency Medicine最新文献

{"title":"Thyroid storm presenting with acute respiratory distress syndrome in a postpartum patient: a case report.","authors":"Handan Özen Olcay, İzzettin Ertaş, Seda Dağar, Yunsur Çevik","doi":"10.1007/s11739-025-03858-x","DOIUrl":"https://doi.org/10.1007/s11739-025-03858-x","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964394","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":"Asterixis in the lower extremities.","authors":"Hayato Shimizu, Wataru Kaita, Hiroaki Nishioka","doi":"10.1007/s11739-024-03856-5","DOIUrl":"https://doi.org/10.1007/s11739-024-03856-5","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948152","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 family with gallstone disease: defining inherited risk in the era of clinical genetic testing.","authors":"Susanne N Weber, Irina Lambert, Frank Lammert, Marcin Krawczyk","doi":"10.1007/s11739-024-03854-7","DOIUrl":"https://doi.org/10.1007/s11739-024-03854-7","url":null,"abstract":"<p><p>Gallstones are among the most frequent hepatobiliary conditions. Although in most cases, they remain asymptomatic, they can cause complications and, in such cases, invasive treatments like endoscopic retrograde cholangiography (ERC) or cholecystectomy are required. Here, we present the results of genetic testing of a single family with a high incidence of symptomatic gallstones and cholestatic liver phenotypes. Gallstone disease was detected among seven family members spanning three generations, and DNA samples were available from five of them. Genotyping was performed using TaqMan assays for known, selected genetic risk factors for gallstones and cholestasis, as well as next generation sequencing (NGS) of three genes involved in hepatobiliary transport. In all genotyped patients, we detected at least one copy of the gallstone-predisposing p.D19H variant in the hepatobiliary sterol transporter ABCG5/8, and in three cases, this variant was found in the rare homozygous state. In addition, the patients were all homozygous carriers of two intronic variants (c.2211+16C >T and c.3508-16T>C) and two common polymorphisms (c.504C>T and c.711A>T) in the ABCB4 gene, as well as the ATP8B1 gene variant c.696T>C. All genotyped patients also carried the predisposing variants c.1331C>T and c.3084A>G of the hepatobiliary bile salt export pump ABCB11 in either heterozygous or homozygous form. Hence, we propose that these variants taken together may have contributed to the high frequency of gallstone disease in this family, although functional studies for some variants are still lacking. In this report, we present these findings and discuss the challenges associated with interpreting sequencing data.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142948151","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":"Use of nicotine products, prescription drug products, and other methods to stop smoking by US adults in the 2022 National Health Interview Survey.","authors":"Floe Foxon, Raymond Niaura","doi":"10.1007/s11739-024-03847-6","DOIUrl":"https://doi.org/10.1007/s11739-024-03847-6","url":null,"abstract":"<p><p>Recent data on methods used by adults to stop smoking can inform tobacco control policies. Nationally representative Centers for Disease Control and Prevention survey data from the 2022 National Health Interview Survey (N = 27,651) were used to analyze populations of US adults who self-reported having stopped smoking cigarettes for 6 months or longer in the last year and the methods they used, or who did not stop smoking but tried in the last year (N = 1735). In 2022, an estimated 2.9 million [95% CI 2.5 million-3.2 million] US adults had stopped smoking in the past year. Most were male, non-Hispanic White, aged < 55 years, college-educated, identified as straight, were not depressed, and currently drank alcohol. The most popular methods used to stop smoking were nicotine products (53.9% [47.4-60.3%]; 1.5 [1.3-1.8] million adults), especially e-cigarettes in combination with other methods (40.8% [34.4-47.5%]; 1.2 [0.9-1.4] million) and e-cigarettes alone (26.0% [20.4-32.3%]; 0.7 [0.6-0.9] million). Prescription drug products (8.1% [5.3-11.8%]; 0.2 [0.1-0.3] million) and non-nicotine, non-prescription drug methods (6.3% (3.9-9.7%); 0.2 [0.1-0.3] million) were less popular. A further 13.1 [12.2-14.0] million tried but did not stop smoking. Compared to those who tried but didn't stop smoking, those who successfully stopped were more likely to be younger, degree-educated, and to use e-cigarettes to stop smoking. Many adults still attempt to stop smoking unaided. Interventions to reduce smoking could focus on populations that stopped smoking the least and encourage use of evidence-based methods.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931779","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":"Dream and its interpretation: scientific perspective.","authors":"Chukwuemeka O Eze","doi":"10.1007/s11739-024-03849-4","DOIUrl":"https://doi.org/10.1007/s11739-024-03849-4","url":null,"abstract":"<p><p>Dream is a mental activity that occurs during sleep. Its interpretation is common practice in many African cultures and this role is vested in unqualified persons, such as diviners, priests, and healers. Their unprofessional activities have led to dangerous consequences, such as anxiety, depression, loss of material possessions, bodily harm, family, or community conflicts, or even death. This review manuscript sought to unravel the mystery of dreams from a scientific perspective to educate the scientific community, especially in the developing world. This review manuscript unraveled the enigma of dreams by delving into the mechanisms underlying their occurrence, exploring the brain processes that shape their content, discussing different types of dreams, and examining the potential scientific basis for interpreting their significance. The scientific study of dreams and their interpretation has provided fascinating insights into the neural processes, cognitive functions, and emotional dimensions of this intriguing phenomenon.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931776","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":"Frequency of emergency medical service contacts after hospital admissions.","authors":"Emilie Sigvardt, Markus Harboe Olsen, Fredrik Folke, Eske Kvanner Aasvang, Christian Sylvest Meyhoff","doi":"10.1007/s11739-024-03852-9","DOIUrl":"https://doi.org/10.1007/s11739-024-03852-9","url":null,"abstract":"<p><p>Identifying frequent users of Emergency Medical Services (EMS) in the post-discharge period can potentially direct interventions to prevent deterioration at home. This study aimed to describe the frequency of post-discharge emergency phone calls within 30 days after common medical and surgical categories of hospital admission. A retrospective cohort study retrieved data from the electronic medical record and the EMS Capital Region Denmark database after approval by the Danish Health Data Authority. The study investigated the number of 30-day EMS calls per 1000 days alive outside hospital in patients hospitalized due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD), colorectal surgery, and 18 other disease categories. We included 16,338 patients with a discharge from hospital between August 2021 and August 2022.The overall number of EMS calls was 4,263 with 9.1 (95% confidence interval (95% CI)): 8.8-9.4) calls per 1000 patient days within 30 days. Patients discharged after medical hospitalization due to AECOPD contacted EMS 15 (95% CI: 13-16) times per 1000 patient days only surpassed by sepsis with 19 calls per 1000 patient days (95% CI: 17-21). Patients undergoing colorectal surgery had an EMS call frequency of 7.5 (95% CI: 6.4-8.7) and highest among types of surgery was hip- and knee replacements with 12 (95% CI: 11-13) calls per 1000 patient days. Patients discharged after hospitalization due to AECOPD and sepsis had a higher 30-day EMS call frequency compared with other medical cohorts, whereas major orthopedic surgery was followed by more EMS calls than admissions for colorectal surgery.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931777","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":"Association between a geriatric measure tool and adverse outcomes among older adults treated in an emergency department: a retrospective cohort study.","authors":"Carolina Gómez-Moreno, Alan Alexis Chacón-Corral, Ayari Pérez-Méndez, Ashuin Kammar-García, Corina Ortega-Ortiz, Ana Cristina Torres-Pérez, Luis Asdruval Zepeda-Gutierrez, Enrique Soto-Perez-de-Celis, Thierry Hernández-Gilsoul","doi":"10.1007/s11739-024-03843-w","DOIUrl":"https://doi.org/10.1007/s11739-024-03843-w","url":null,"abstract":"<p><p>The COVID-19 pandemic provided an ideal scenario for studying the care of the elderly population, we implemented a tool named the Geriatric Measure (GM) tool to determine the severity and need for hospitalization. The objective of the study is to evaluate if the results of a brief Geriatric Measure tool are associated with mortality and other outcomes among older adults with COVID-19 treated in the emergency department. Retrospective observational cohort study. Participants were older adults (65 years and over) who required hospitalization for SARS CoV2 pneumonia. Patients were evaluated with the GM tool and were followed-up until death or discharge and associations between GM tool scores and mortality and other outcomes were assessed. A total of 275 patients were included. The proportion of patients who died increased with every category of the GM tool. Patients in category 1 (fit with good functional status) had a mortality of 24.7% versus those in category 4 (frail with poor functional status) who had a mortality of 51%. Our results show an association between our GM tool and mortality among older adults with pneumonia caused by SARS CoV2 and treated in the emergency department, and highlight the need of individualizing care for older patients.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927008","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":"Evaluation of ST-segment and T-wave changes associated with NSTE-ACS in patients with RBBB: a nested case-control study design.","authors":"Murat Duyan, Süleyman Ibze, Nafis Vural, Hasan Can Guven, Elif Ertas, Rauf Avci, Serhat Gunlu, Yıldıray Cete","doi":"10.1007/s11739-024-03855-6","DOIUrl":"https://doi.org/10.1007/s11739-024-03855-6","url":null,"abstract":"<p><p>Patients presenting with suspected acute coronary syndrome (ACS) in the emergency department (ED) require rapid and accurate electrocardiographic (ECG) evaluation. This study aims to assess conventional ECG markers for diagnosing non-ST-elevation ACS (NSTE-ACS) in patients with chest discomfort and right bundle branch block (RBBB). A nested case-control design was employed to compare patients with RBBB admitted to the ED for suspected cardiac ischemia, focusing on those who developed NSTE-ACS versus those who did not. The sample consisted of 352 patients with suspected ACS and RBBB identified on ECG. Among them, 88 were diagnosed with NSTE-ACS. In the presence of RBBB, ST-segment elevation on the isoelectric line and/or positive T-waves on the ECG were significantly associated with the diagnosis of NSTE-ACS (p < 0.05). In patients who developed NSTE-ACS, the likelihood of an isoelectric ST-segment was 3.48 (95% CI 2.07-5.82) times higher, the likelihood of positive T-waves was 4.16 (95% CI 2.51-6.91) times higher, and the combination of an isoelectric ST-segment with positive T-waves was 4.81 (95% CI 2.28-8.25) times higher (p < 0.05). In addition, ST-segment depression and non-negative T-waves were significantly more frequent in patients who developed NSTE-ACS, with odds ratios of 5.78 (95% CI 3-11.3), compared to those who did not (p < 0.05). The odds ratios for ST-segment and T-wave changes were 2.81 and 3.47, respectively, with an 80% correct classification rate for predicting NSTE-ACS. Clinicians should closely monitor the presence of an isoelectric ST-segment and positive T-waves in patients with RBBB to assess for potential cardiac ischemia.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142927009","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 Fenice project to evaluate and improve the quality of healthcare in high-dependency care units: results after the first year.","authors":"Giovanni Porta, Fabiola Signorini, Marcella Converso, Giulia Cavalot, Valeria Caramello, Carlotta Rossi, Franco Aprà, Angela Beltrame, Adriana Boccuzzi, Riccardo Boverio, Mario Calci, Ersilia Castaldo, Michele Covella, Patrizia Cuppini, Giulia Irene Ghilardi, Enrico Mirante, Paola Noto, Lucia Pierpaoli, Paolo Pinna Parpaglia, Alberto Ricchiardi, Michele Zanetti, Daniela Zatelli, Giovanni Nattino, Guido Bertolini","doi":"10.1007/s11739-024-03640-5","DOIUrl":"10.1007/s11739-024-03640-5","url":null,"abstract":"<p><p>High-Dependency care Units (HDUs) have been introduced worldwide as intermediate wards between Intensive Care Units (ICUs) and general wards. Performing a comparative assessment of the quality of care in HDU is challenging because there are no uniform standards and heterogeneity among centers is wide. The Fenice network promoted a prospective cohort study to assess the quality of care provided by HDUs in Italy. This work aims at describing the structural characteristics and admitted patients of Italian HDUs. All Italian HDUs affiliated to emergency departments were eligible to participate in the study. Participating centers reported detailed structural information and prospectively collected data on all admitted adult patients. Patients' data are presented overall and analyzed to evaluate the heterogeneity across the participating centers. A total of 12 HDUs participated in the study and enrolled 3670 patients. Patients were aged 68 years on average, had multiple comorbidities and were on major chronic therapies. Several admitted patients had at least one organ failure (39%). Mortality in HDU was 8.4%, raising to 16.6% in hospital. While most patients were transferred to general wards, a small proportion required ICU transfer (3.9%) and a large group was discharged directly home from the HDU (31%). The expertise of HDUs in managing complex and fragile patients is supported by both the available equipment and the characteristics of admitted patients. The limited proportion of patients transferred to ICUs supports the hypothesis of preventing of ICU admissions. The heterogeneity of HDU admissions requires further research to define meaningful patients' outcomes to be used by quality-of-care assessment programs.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"257-266"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140956475","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":"Itching papules on the axillae.","authors":"Gerardo Cazzato, Francesca Ambrogio, Caterina Foti, Domenico Ribatti","doi":"10.1007/s11739-024-03721-5","DOIUrl":"10.1007/s11739-024-03721-5","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"309-311"},"PeriodicalIF":3.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141787941","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}