Internal and Emergency Medicine最新文献_第4页

A normal heart doesn't fail: rethinking HFpEF in acute settings. 一个正常的心脏不会衰竭：重新考虑HFpEF在急性环境。

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-18 DOI: 10.1007/s11739-025-03989-1

Maria Giulia Bellicini

引用次数: 0

When meta-analysis misleads: the need for methodological integrity in e-cigarette research. 当荟萃分析产生误导时：电子烟研究中方法论完整性的必要性。

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-17 DOI: 10.1007/s11739-025-04019-w

Riccardo Polosa, Giulio Geraci, Yusuff Adebayo Adebisi

引用次数: 0

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: comment. MRI-PDFF检测SGLT2抑制剂对2型糖尿病和代谢性脂肪变性肝病患者肝脂肪变性的影响：评论

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-17 DOI: 10.1007/s11739-025-04024-z

Angelo Di Vincenzo, Federico Capone, Marco Rossato

引用次数: 0

Comparison of the prognostic value of complete blood count-derived inflammatory markers for long-term outcomes in ST-segment elevation myocardial infarction. 全血细胞计数衍生炎症标志物对st段抬高型心肌梗死长期预后价值的比较

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-16 DOI: 10.1007/s11739-025-04018-x

Kuan-Chung Ting, Yu-Ting Hsiao, Ya-Ni Yeh, Jih-Chun Lin, Ming-Jen Tsai

{"title":"Comparison of the prognostic value of complete blood count-derived inflammatory markers for long-term outcomes in ST-segment elevation myocardial infarction.","authors":"Kuan-Chung Ting, Yu-Ting Hsiao, Ya-Ni Yeh, Jih-Chun Lin, Ming-Jen Tsai","doi":"10.1007/s11739-025-04018-x","DOIUrl":"https://doi.org/10.1007/s11739-025-04018-x","url":null,"abstract":"Inflammation plays a key role in the pathophysiology of ST-segment elevation myocardial infarction (STEMI). Several complete blood count (CBC)-derived inflammatory markers have been proposed as prognostic tools, but comparative data on their long-term predictive value remain limited. This study aimed to evaluate and compare the prognostic value of six CBC-derived markers-neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammatory response index (SIRI), and pan-immune-inflammation value (PIV)-for 1 year mortality and reinfarction after STEMI. We conducted a retrospective cohort study involving 689 STEMI patients treated with primary percutaneous coronary intervention between 2013 and 2022. Inflammatory markers were calculated from initial CBC values. Optimal cut-off points were identified using receiver operating characteristic analysis. Associations with 1 year mortality were assessed using Kaplan-Meier survival curves and multivariable Cox regression. After adjustment for clinical variables, elevated NLR (HR: 2.18, 95% CI 1.26-3.75), SII (HR: 3.83, 95% CI 1.63-9.01), SIRI (HR: 2.70, 95% CI 1.50-4.88), and PIV (HR: 3.17, 95% CI 1.66-6.07) were independently associated with 1 year mortality. A dose-response relationship was observed across tertiles of these markers. Subgroup analyses showed stronger prognostic value in older adults, males, and patients with diabetes. For 1 year reinfarction, multivariable logistic regression showed that only elevated PLR (OR: 1.59, 95% CI 1.05-2.41) was independently associated and showed a dose-response relationship. Selected CBC-derived inflammatory markers may serve as accessible, cost-effective biomarkers for long-term risk stratification in STEMI patients.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302000","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

Effect of noninvasive ventilation on 6-month mortality in patients with acute cardiogenic pulmonary oedema: a retrospective study dedicated to older persons. 无创通气对急性心源性肺水肿患者6个月死亡率的影响：一项针对老年人的回顾性研究

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-15 DOI: 10.1007/s11739-025-04012-3

Linda Haddi, Laure Valerio, Pascal Bilbault, Georges Kaltenbach, Elise Schmitt

{"title":"Effect of noninvasive ventilation on 6-month mortality in patients with acute cardiogenic pulmonary oedema: a retrospective study dedicated to older persons.","authors":"Linda Haddi, Laure Valerio, Pascal Bilbault, Georges Kaltenbach, Elise Schmitt","doi":"10.1007/s11739-025-04012-3","DOIUrl":"https://doi.org/10.1007/s11739-025-04012-3","url":null,"abstract":"Noninvasive ventilation (NIV) effectively treats acute cardiogenic pulmonary oedema (ACPE), leading to quicker clinical improvement and reduced intubation needs than medical treatment alone. However, the impact of NIV on mortality in patients with ACPE is unclear. The primary objective was to evaluate the impact of NIV on 6-month mortality in older patients with ACPE compared with medical treatment. Secondary objectives included assessing the effects of NIV on length of hospital stay and rehospitalisation. This retrospective study included patients aged ≥ 75 years with ACPE (acute respiratory distress and/or RR ≥ 25 cycles/min and/or paCO2 ≥ 45 mmHg and/or pH < 7.35 and/or uncorrected hypoxemia). Exclusion criteria: positive for SARS-CoV-2 and contraindication to NIV. Of the 186 patients admitted to emergency care with ACPE and eligible for NIV, 104 received NIV and 82 received medical treatment. Survival analyses were performed using a multivariate Cox model and adjusting for confounding factors. NIV was not significantly linked to reduced mortality risk (HR = 0.82, p = 0.51), except for in the acidosis subgroup (HR = 0.24, p = 0.01). No difference was observed in the length of hospital stay or in terms of rehospitalisation. NIV in older patients with ACPE did not significantly decrease 6-month mortality, except in the subgroup with respiratory acidosis, when the risk of death was reduced by 75%. The use of NIV in older patients with ACPE should be limited to patients with acidosis, to see their risk of death significantly reduced. Trial registration: The study protocol has been retrospectively registered on ClinicalTrials.gov (NCT06107257, 2023-10-30).","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302001","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

Reassessing proton pump inhibitor safety: a comment. 重新评估质子泵抑制剂的安全性：评论。

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-13 DOI: 10.1007/s11739-025-04015-0

Hajir Mehrbani, Amirhossein Keshavarz

引用次数: 0

The 2024 ESC guidelines on atrial fibrillation: essential updates for everyday clinical practice. 2024 ESC房颤指南：日常临床实践的必要更新

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-13 DOI: 10.1007/s11739-025-04006-1

Giuseppe Boriani, Davide Antonio Mei, Marco Vitolo, Jacopo Francesco Imberti

{"title":"The 2024 ESC guidelines on atrial fibrillation: essential updates for everyday clinical practice.","authors":"Giuseppe Boriani, Davide Antonio Mei, Marco Vitolo, Jacopo Francesco Imberti","doi":"10.1007/s11739-025-04006-1","DOIUrl":"https://doi.org/10.1007/s11739-025-04006-1","url":null,"abstract":"Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia, and it is associated with substantial morbidity, mortality, and economic burden. Effective management of AF remains a critical focus in contemporary medicine, given its complex and multifaceted nature. In the present paper, we provide the essential updates for everyday clinical practice from the 2024 European Society of Cardiology (ESC) guidelines for AF management. We highlight seven key areas encompassing the adoption of the CHA₂DS₂-VA score for thromboembolic risk stratification, changes in bleeding risk assessment, expanded indications for catheter ablation, promotion of the multidisciplinary AF-CARE pathway for patient management, new recommendations for left atrial appendage closure, updates on clinical decision-making for atrial high-rate episodes, and considerations on the future role of artificial intelligence in advancing predictive analytics. We also compare the new recommendations proposed by the ESC 2024 AF guidelines with the ESC 2021 edition and the 2023 guidelines published by the American College of Cardiology/American Heart Association (ACC/AHA), reflecting regional perspectives and advancements in the field. By presenting these practical updates and their implications for routine practice, this paper aims to guide clinicians in adopting the latest evidence-based approaches to optimize AF patients' care.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293697","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

Exploring the significance of vitamin D insufficiency in the periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome: a single-center retrospective assessment during the decade 2014-2024. 探讨维生素D不足在周期性发热、口疮性口炎、咽炎和宫颈腺炎（PFAPA）综合征中的意义：2014-2024年间的单中心回顾性评估。

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-13 DOI: 10.1007/s11739-025-03999-z

Donato Rigante, Raffaele Manna, Marcello Candelli

{"title":"Exploring the significance of vitamin D insufficiency in the periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome: a single-center retrospective assessment during the decade 2014-2024.","authors":"Donato Rigante, Raffaele Manna, Marcello Candelli","doi":"10.1007/s11739-025-03999-z","DOIUrl":"https://doi.org/10.1007/s11739-025-03999-z","url":null,"abstract":"The underlying mechanisms responsible for the periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome are unknown. The main purpose of this study was to retrospectively assess different characteristics and lab-work investigations including serum 25(OH)-vitamin D levels in patients with PFAPA syndrome evaluated at our University hospital during the decade 2014-2024. The medical charts of 151 children with diagnosis of PFAPA syndrome were retrospectively evaluated: for each patient demographic data, clinical manifestations during acute episodes, and laboratory analyses during a well-being phase within the trimester following PFAPA diagnosis were examined. A focus was given to serum 25-hydroxyvitamin D [25(OH)-vitamin D] concentration, recognized as the functional status indicator for vitamin D. Based on the reference values for normal serum 25(OH)-vitamin D, patients were divided into two groups (inadequate versus normal vitamin D levels); the groups were compared to identify if hypovitaminosis D could have any relationship with the evolution of PFAPA syndrome over time. Forty-five PFAPA patients (30% of the whole cohort) had serum 25(OH)-vitamin D below the normal reference (< 30 ng/mL), and inadequate vitamin D serum levels were associated with a persistent pattern of PFAPA syndrome, also showing an inverse correlation with age at disease onset. This study offers a static snapshot of vitamin D status in children with PFAPA syndrome, without accounting for specific time points, and suggests that serum 25(OH)-vitamin D levels might contribute to a longer duration of the recurring PFAPA symptoms.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293695","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

The impact of cardiogenic shock and out-of-hospital cardiac arrest on the outcome of acute myocardial infarction: a national-level analysis. 心源性休克和院外心脏骤停对急性心肌梗死结局的影响：一项国家级分析。

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-13 DOI: 10.1007/s11739-025-03984-6

Pavol Tomasov, Zuzana Motovska, Ota Hlinomaz, Petr Kala, Marek Sramko, Jan Mrozek, Milan Hromadka, Jan Precek, Josef Bis, Jan Matejka, Tamilla Muzafarova, Pavel Cervinka, Ales Kovarik, Libor Sknouril, Zdenek Coufal, Jiri Jarkovsky

{"title":"The impact of cardiogenic shock and out-of-hospital cardiac arrest on the outcome of acute myocardial infarction: a national-level analysis.","authors":"Pavol Tomasov, Zuzana Motovska, Ota Hlinomaz, Petr Kala, Marek Sramko, Jan Mrozek, Milan Hromadka, Jan Precek, Josef Bis, Jan Matejka, Tamilla Muzafarova, Pavel Cervinka, Ales Kovarik, Libor Sknouril, Zdenek Coufal, Jiri Jarkovsky","doi":"10.1007/s11739-025-03984-6","DOIUrl":"https://doi.org/10.1007/s11739-025-03984-6","url":null,"abstract":"Cardiogenic shock (CS) and out-of-hospital cardiac arrest (OHCA) are events with profound implications for patient outcomes. We aim to analyze the predictors of CS and OHCA in patients with acute myocardial infarction and their effects on mortality. The analysis is based on data from a national registry between 2016 and 2020. A total of 23,703 patients with ST-elevation myocardial infarction (STEMI) were analyzed: (A) patients without CS and OHCA (19,590), (B) after OHCA (2,262), (C) with CS (713), and (D) after OHCA with CS (1,138). Patients after OHCA without CS had the lowest mean age [62.0 (± 12.6) years], while patients with CS without OHCA were the oldest [68.8 (± 11.8) years] and had the highest proportions of comorbidities. CS was a predictor of 30-day and 1-year mortality, with odds ratios [OR; 95% confidence intervals (CI)] of 5.52 (4.51; 6.75) and 4.66 (3.87; 5.61) for patients after OHCA, and OR (95% CI) 9.28 (7.56; 11.38) and 7.33 (6.04; 8.89) for those without OHCA. For overall survival up to 30 days and in comparison to patients without CS and OHCA, the hazard ratios (95% CI) was 2.77 (2.40; 3.20) for patients with OHCA only, 14.36 (12.57; 16.40) for patients with CS only, and 16.96 (15.19; 18.92) for patients with both CS and OHCA. OHCA altered the 30-day mortality risk after STEMI for both patients with and without CS. CS is a predictor of both 30-day and 1-year mortality in patients with STEMI, irrespective of OHCA status.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293698","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

Development of the Mugla Score: an association-based tool for risk stratification in emergency department patients with rhabdomyolysis. Mugla评分的发展：一种基于关联的工具，用于急诊科横纹肌溶解患者的风险分层。

IF 3.2 3区医学

Internal and Emergency Medicine Pub Date : 2025-06-11 DOI: 10.1007/s11739-025-04009-y

Ömer Faruk Karakoyun, Fulden Cantaş Türkiş, Yalcin Golcuk, Mehmet Reha Yılmaz, Burcu Kaymak Golcuk

{"title":"Development of the Mugla Score: an association-based tool for risk stratification in emergency department patients with rhabdomyolysis.","authors":"Ömer Faruk Karakoyun, Fulden Cantaş Türkiş, Yalcin Golcuk, Mehmet Reha Yılmaz, Burcu Kaymak Golcuk","doi":"10.1007/s11739-025-04009-y","DOIUrl":"https://doi.org/10.1007/s11739-025-04009-y","url":null,"abstract":"Rhabdomyolysis is a potentially life-threatening syndrome characterized by skeletal muscle breakdown and systemic release of intracellular components, often resulting in acute kidney injury or death. Early risk stratification remains challenging in the emergency department (ED) setting due to heterogeneous presentations and unpredictable outcomes. To develop and internally validate the Mugla Score-a pragmatic, association-based tool for predicting adverse outcomes in ED patients with rhabdomyolysis. In this retrospective, single-center cohort study, adult ED patients with serum creatine kinase ≥ 1000 U/L between July 1, 2019, and July 1, 2024, were included. The primary outcome was a composite of renal replacement therapy or 90-day mortality. Multivariable logistic regression identified independent predictors, which were assigned weighted point values. Internal validity was assessed using five-fold cross-validation and 1,000-iteration bootstrap resampling. Among 1031 patients (mean age: 49.0 ± 21.8 years; 75.9% male), 109 (10.6%) experienced the composite outcome. Seven variables were independently associated with adverse events: age ≥ 50 years, platelet count ≤ 170 × 103/μL, MCHC ≤ 32.8 g/dL, calcium ≤ 8.5 mg/dL, ALP ≥ 115 U/L, BEecf ≤ - 6 mmol/L, and etiological classification. The Mugla Score (range: 0-12.5) showed strong discrimination (AUC: 0.861, 95% CI: 0.824-0.898). A threshold of ≥ 4 points yielded a 97% negative predictive value. The Mugla Score provides a clinically interpretable, ED-focused tool for early risk stratification in rhabdomyolysis. While internally validated, external prospective studies are needed to assess generalizability prior to routine clinical adoption.","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274750","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