Internal and Emergency Medicine最新文献

{"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":"10.1007/s11739-025-04018-x","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1775-1786"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","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}

{"title":"Seven versus fourteen days of antibiotic therapy in bloodstream infections: the BALANCE trial.","authors":"Paolo Sciarrone, Bianca Sciacca, Filippo Manicardi, Ersilia Di Buduo, Elisa Tarasconi","doi":"10.1007/s11739-025-04086-z","DOIUrl":"10.1007/s11739-025-04086-z","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1959-1960"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873045","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":"Prognostic impact of right ventricular dysfunction in patients with severe aortic stenosis treated with trans-catheter aortic valve implantation.","authors":"Valentina Scheggi, Yohann Bohbot, Jasim Hasan, Pierre Vanhaecke, Carlo Fumagalli, Francesco Meucci, Manuel Garofalo, Ruggero Mazzotta, Samuele Salvi, Giorgia Panichella, Lucrezia Biagiotti, Matteo Orlandi, Angela Ilaria Fanizzi, Nicola Zoppetti, Renato Valenti, Alfredo Cerillo, Pier Luigi Stefàno, Carlo Di Mario, Dan Rusinaru, Anfani Mirode, Christophe Tribouilloy, Niccolò Marchionni","doi":"10.1007/s11739-025-03985-5","DOIUrl":"10.1007/s11739-025-03985-5","url":null,"abstract":"<p><p>Transcatheter aortic valve implantation (TAVI) is a standard treatment for severe aortic stenosis (AS), especially in high-risk surgical patients. However, the impact of right ventricular (RV) dysfunction on TAVI outcomes remains unclear. This study aimed to evaluate RV function, measured by tricuspid annular plane systolic excursion (TAPSE), as a predictor of mortality post-TAVI. In a multicenter retrospective cohort study, 637 patients with severe AS who underwent TAVI were assessed for RV function using TAPSE measurements. Data were analyzed to explore the relationship between TAPSE and mortality at 30 days and 1 year, adjusting for demographic factors, comorbidities, and echocardiographic parameters. The prognostic value of the RV-pulmonary artery coupling parameter (TAPSE/PASP) was also investigated. A reduced TAPSE was identified as an independent predictor of 30-day mortality, with each 1-mm increase in TAPSE linked to a 14% reduction in mortality risk (HR 0.86 [95% CI 0.76-0.99]; p = 0.033). The association between TAPSE and 1-year mortality was weaker, with long-term outcomes more strongly influenced by the Charlson Comorbidity Index (CCI) (HR 1.2 [95% CI 1.0-1.3]; p = 0.007). In addition, TAPSE/PASP showed no significant correlation with mortality outcomes. Reduced TAPSE is a valuable predictor of early mortality following TAVI, suggesting that preoperative TAPSE assessments may enhance risk stratification and early post-procedural management. In contrast, long-term mortality in TAVI patients appears to depend more on overall comorbidity burden. Future research should consider integrating TAPSE into risk models to improve individualized TAVI patient care.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1705-1712"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215734","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":"Predictors of e-cigarette use among individuals with asthma: findings from a cross-sectional population-based study.","authors":"Yusuff Adebayo Adebisi, Najim Z Alshahrani","doi":"10.1007/s11739-025-04045-8","DOIUrl":"10.1007/s11739-025-04045-8","url":null,"abstract":"<p><p>The use of electronic cigarettes (e-cigarettes) among individuals with asthma is rising, yet limited evidence exists on predictors of use in this clinical population. Understanding factors associated with e-cigarette use may help inform public health interventions. In this study, we analysed data from 2671 individuals aged 16 years and older with doctor-diagnosed asthma, drawn from the 2017, 2018, 2019, and 2021 waves of the Scottish Health Survey. Current e-cigarette use was defined as self-reported use at the time of the survey. We used multivariable logistic regression to examine factors associated with current e-cigarette use among individuals with asthma, estimating adjusted odds ratios (aORs), 95% confidence intervals (CIs), and p values for age, sex, education, socio-economic deprivation, smoking status, alcohol consumption, and self-rated health. Overall, 193 participants (7.2%) reported current e-cigarette use. Current smokers had significantly higher odds of using e-cigarettes compared to never smokers (aOR: 38.9; 95% CI: 18.5-82.0; p < 0.001). Former smokers also had increased odds of e-cigarette use relative to never smokers (aOR: 32.0; 95% CI: 15.2-67.2; p < 0.001). Each one-category increase in age group (spanning approximately 10 years) was associated with a 23% reduction in the odds of current e-cigarette use (aOR: 0.77; 95% CI: 0.69-0.86; p < 0.001). Participants living in less deprived areas had 15% lower odds of current e-cigarette use for each one-quintile increase in the Scottish Index of Multiple Deprivation (aOR: 0.85; 95% CI: 0.74-0.97; p = 0.016). E-cigarette use was not significantly associated with sex, educational level, alcohol consumption, or self-rated health. These findings indicate that e-cigarette use among individuals with asthma is more prevalent among younger participants, those living in socioeconomically deprived areas, and those with a current or former smoking history. Further longitudinal research is needed to explore usage trajectories and respiratory health impacts in this clinical population.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1847-1855"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617413","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":"Tango between obesogenic environment and metabolic dysfunction-associated steatotic liver disease (MASLD): shifting towards earlier detection.","authors":"Harshitha Shanmugam, Agostino Di Ciaula, Mohamad Khalil, Piero Portincasa","doi":"10.1007/s11739-025-04090-3","DOIUrl":"10.1007/s11739-025-04090-3","url":null,"abstract":"<p><p>Obesity prevalence is increasing worldwide, and drives the rising prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), currently the most prevalent chronic liver disease in all age groups. MASLD, like obesity, is linked to premature motality and increased risk of comorbidities. As in a Tango, the obesogenic environment and MASLD interact closely through complex interplays involving the gut-liver-brain axis. Once established, MASLD alters several metabolic responses to environmental mstimuli, promoting a feedback loop. It is therefore urgent to improve the awareness of the pathways leading to metabolic disease, focusing on pathophysiology, early diagnosis using non-invasive tools, environmental determinants, and multidisciplinary models of care. Efforts to combat obesity and MASLD must extend beyond simple clinical care and pills. Rather, we need multisectoral responses to protect public and environmental health, since many health systems remain passive, and therefore facilitate the onset consequences due to unnecessary and harmful body fat over storage. Care models must pivot to risk-based screening, early detection, tailored intervention, with mitigation of environmental hazards driving involuntary exposure. This includes early liver dysfunction assessment, access to lifestyle programmes, and digital tools for remote monitoring. Building on such needs, we joined important EU-funded initiatives FOIE GRAS, PAS GRAS, and PRIMA to advance knowledge on hepatic bioenergetics, gut-liver axis dysfunction, and gene-environment interactions, while testing lifestyle-based preventive strategies. We also implemented the 13Cmethacetin breath test, a novel non-invasive functional tool that detects subclinical hepatocyte dysfunction in individuals with obesity, even before structural changes or biochemical abnormalities appear in the liver. The detrimental Tango can be interrupted at the individual level by non-invasive diagnostics, personalised prevention, adequate phenotyping, and at the community level through cross-sectoral policies oriented toward equity, sustainability, and primary prevention. Strategic, integrated actions can transform global health by advancing not only longevity but also healthspan and resilience. The Tango between the obesogenic environment and MASLD urgently requires active partners, not passive spectators. Internal medicine is pivotal in coordinating this transition across settings and disciplines.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1655-1661"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145113074","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":"Life on a table: the stories that the bedside table of a patient can tell us.","authors":"Christian Bracco, Roberto Galliano, Luigi Maria Fenoglio","doi":"10.1007/s11739-025-04059-2","DOIUrl":"10.1007/s11739-025-04059-2","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1963-1964"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659139","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":"Empowering the vulnerable in internal medicine: a narrative review on physical exercise as a tool to tackle frailty.","authors":"Marco Vincenzo Lenti, Alice Silvia Brera, Antonio Di Sabatino, Gino Roberto Corazza","doi":"10.1007/s11739-025-03988-2","DOIUrl":"10.1007/s11739-025-03988-2","url":null,"abstract":"<p><p>Frailty is an increasingly recognized issue in internal medicine, which develops as a consequence of age-related decline in multiple physiological systems, underlying a vulnerable state of health due to poor homeostatic resources. Rapid muscle exhaustion, muscle weakness, dynapaenia, and sarcopenia are common features of frail patients. Indeed, frailty is associated with an increased risk of hospitalization and mortality, and it may be reversed through physical activity and other lifestyle interventions, so to prevent the decline of physical and mental functioning. We herein sought to describe in a narrative fashion the current knowledge about frailty and physical exercise, focusing only on original articles in which frailty was detected and quantified according to international, validated scales or other methods. We will finally discuss future perspectives with regard to the applications of physical exercise in the prevention or treatment of frailty.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1679-1694"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198993","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":"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":"10.1007/s11739-025-03999-z","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1721-1729"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","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}

{"title":"The application of pleural ultrasound features in different lung diseases characterized by B-lines of lung ultrasound in hemodialysis patients.","authors":"Haotian Zhao, Yaru Yan, Yi Liu, Xiaona Wang, Li Li","doi":"10.1007/s11739-025-04004-3","DOIUrl":"10.1007/s11739-025-04004-3","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1969-1971"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266099","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":"Self-similarity logic: a common pattern in the vascular and nervous systems.","authors":"Diego Guidolin, Domenico Ribatti","doi":"10.1007/s11739-025-03948-w","DOIUrl":"10.1007/s11739-025-03948-w","url":null,"abstract":"<p><p>Vascular and neuronal networks are examples of body structures created by processes of branching morphogenesis, showing a similar architecture. Like vascular network morphogenesis, where morphology adapts to the amount of flow, neuronal branching dynamics also can be modulated by neural activity. Axon branching, indeed, often occurs as a dynamic process that involves branch addition and branch retraction. Self-similarity logic characterizes both the nervous and the vascular system. From a morphologic point of view, the self-similarity of the vascular system is straightforward, being the result of a hierarchical sequence of bifurcations, leading to a structure which can be considered strictly self-similar.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1979-1981"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810970","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}