Internal and Emergency Medicine最新文献

{"title":"Patterns of heated tobacco product use and biochemically verified smoking status among customers of dedicated heated tobacco product stores.","authors":"Konstantinos Farsalinos, Eleni Diamantopoulou, Theoni Agapitou, Giannis Trikilis, Anastasia Barbouni","doi":"10.1007/s11739-025-04029-8","DOIUrl":"10.1007/s11739-025-04029-8","url":null,"abstract":"<p><p>To understand the population impact of heated tobacco products (HTPs), examining the profile of their users is crucial. This study aimed to assess characteristics, patterns of HTP use, and biochemically verified smoking status of customers visiting specialized HTP stores in Greece. Two specialized stores selling IQOS HTPs were randomly selected in Athens. Researchers recruited consecutive adult customers purchasing products for personal use during store visits. Current smoking status was determined by measuring exhaled carbon monoxide (eCO), with ≥ 7 ppm classifying participants as current smokers. A questionnaire explored demographics, past and current smoking history, HTP use patterns, and dependence indicators. A total of 373 HTP users participated. The vast majority (98.1%) had a smoking history prior to HTP initiation. Former smokers represented 67.8% of the study sample, defined based on self-report and having eCO < 7 ppm, with 90.1% of them reporting they had quit with the use of HTPs. Current smokers represented 30.3% of the sample and reported a 50% median reduction in daily cigarette consumption post-HTP use initiation. Never-smokers represented 1.9% of the sample, all of whom had eCO ≤ 3 ppm. Daily HTP use was the predominant pattern of use in both groups, but was more prevalent among former smokers. Most participants perceived HTPs as less harmful than cigarettes. From logistic regression analysis, factors associated with being a former smoker were HTP use duration (OR: 1.06, 95% CI 1.02-1.09) and daily HTP use (OR: 6.93, 95% CI 1.93-24.92). Customers of specialized HTP stores in Greece were predominantly individuals with a history of smoking. A substantial proportion was biochemically verified former smokers and reported they had quit with the help of HTPs. Use by never-smokers was rare in this retail setting, and did not lead to subsequent smoking.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1803-1813"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505608","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":"Differences between xanthogranulomatous cholecystitis and gallbladder adenocarcinoma: an 11-year retrospective study.","authors":"Mehmet Berksun Tutan, Ramazan Topcu, İbrahim Tayfun Şahiner","doi":"10.1007/s11739-025-04007-0","DOIUrl":"10.1007/s11739-025-04007-0","url":null,"abstract":"<p><p>Xanthogranulomatous cholecystitis (XGC) is a benign yet locally aggressive inflammatory condition that often mimics gallbladder adenocarcinoma (GBC) in clinical, radiological, and intraoperative presentation, leading to diagnostic uncertainty and potential overtreatment. This retrospective study aimed to identify distinguishing features between XGC and GBC by analyzing demographic, clinical, biochemical, radiological, and histopathological data from 133 patients who underwent cholecystectomy between 2013 and 2024. Among them, 115 were diagnosed with XGC and 18 with GBC. Gallbladder wall thickness ≥ 7.5 mm was identified as the most powerful predictor of malignancy, demonstrating 94.4% sensitivity, 84.3% specificity, and a 99% negative predictive value. Additional parameters associated with GBC included advanced age (≥ 65.5 years), anemia (hemoglobin ≤ 11.45 g/dL), thrombocytopenia (platelet count ≤ 215 × 10⁹/L), and mild hyponatremia (sodium ≤ 137.5 mmol/L), though their individual diagnostic performance was limited. Gallbladder polyps were significantly more prevalent in GBC cases. While conversion to open surgery was frequent in both groups due to technical complexity, it was not significantly different. These findings highlight the critical role of gallbladder wall thickness as a non-invasive, reliable diagnostic marker, particularly when combined with patient age and laboratory indicators. Incorporating these parameters into the preoperative assessment may improve diagnostic accuracy, reduce unnecessary radical procedures in benign conditions such as XGC, and facilitate timely intervention in malignancy.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1741-1751"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144234003","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":"Eosinophilic esophagitis in adults: expanding therapeutic options while still seeking precision medicine.","authors":"Michele Di Stefano, Giovanni Sarnelli","doi":"10.1007/s11739-025-04043-w","DOIUrl":"10.1007/s11739-025-04043-w","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1663-1665"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608258","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":"Correction: Dynamic cytokine monitoring enhances CAP severity scores in elderly patients: a prospective pilot study.","authors":"Cheng-Han Chen, Yi-Tzu Lee, Ching-Fen Shen, Chao-Min Cheng","doi":"10.1007/s11739-025-04053-8","DOIUrl":"10.1007/s11739-025-04053-8","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1985"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682592","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":"Experiences, challenges, and best practices of dispatcher-assisted cardiopulmonary resuscitation: a scoping review.","authors":"Guglielmo Imbriaco, Alessandro Galazzi, Federico Semeraro, Nicola Ramacciati","doi":"10.1007/s11739-025-03991-7","DOIUrl":"10.1007/s11739-025-03991-7","url":null,"abstract":"<p><strong>Background: </strong>Out-of-hospital cardiac arrest is a leading cause of mortality, with survival rates from 8 to 13%. Dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) may increase bystander-initiated CPR, improving survival outcomes. Despite these benefits, DA-CPR is often hindered by barriers and organizational issues.</p><p><strong>Objective: </strong>To map and summarize the existing literature on DA-CPR, to identify strategies to improve provision rates, overcoming potential barriers.</p><p><strong>Eligibility criteria: </strong>Primary studies with an English abstract, published between 2018 and 2024, focusing on experiences, challenges, and best practices related to DA-CPR. Studies were included if they reported on emergency callers and dispatchers (population), focusing on DA-CPR provision methods (concept), in any setting (context). Simulation studies were excluded.</p><p><strong>Sources of evidence: </strong>The following databases were searched: Medline (PubMed), EMBASE, CINAHL, and the Cochrane Library. Grey literature from repositories, conference proceedings, and social media were also reviewed.</p><p><strong>Charting methods: </strong>Characteristics of the included studies were reported in a specific extraction table and synthesized narratively.</p><p><strong>Results: </strong>Fifty-eight studies were included. Results were categorized into themes (dispatcher, caller, system, and community/context). Dispatcher training, simplified protocols, effective communication, and video calls emerged as elements potentially improving DA-CPR provision. Caller-related barriers like emotional distress and language problems were prevalent. System-level interventions, including centralized call-handling and performance evaluations, improved DA-CPR rates. Community initiatives for CPR education enhanced bystander compliance.</p><p><strong>Conclusions: </strong>This scoping review identifies strategies to enhance DA-CPR provision, emphasizing tailored dispatcher protocols, communication strategies, system-level improvements, and community-based interventions. Future research should evaluate the effectiveness of these strategies to optimize out-of-hospital cardiac arrest response.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1869-1900"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144821312","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":"Correction: Cytisine for smoking cessation in hospitalised smokers with cardiovascular diseases: an observational study.","authors":"Erika Tedesco, Sofia Ceccato, Alessandro Torazzi, Laura Santin, Lorenzo Losso, Andrea Bottardi, Rebecca Casari, Silvia Melchiori, Erica Secchettin, Valeria Ferrero, Elena Arzenton, Paola Marini, Fabio Lugoboni, Cristiano Chiamulera","doi":"10.1007/s11739-025-04067-2","DOIUrl":"10.1007/s11739-025-04067-2","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":"1987"},"PeriodicalIF":3.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873022","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":"Why internists should care about Helicobacter pylori: recapitulating gastric cancer prevention.","authors":"Agostino Di Ciaula, Mohamad Khalil, Giulia Fiorini, Dino Vaira, Piero Portincasa","doi":"10.1007/s11739-025-04104-0","DOIUrl":"https://doi.org/10.1007/s11739-025-04104-0","url":null,"abstract":"<p><p>Infection with Helicobacter pylori (H. pylori) is a leading but also modifiable cause of gastric cancer. However, evidence indicates that the goal of a primary prevention of gastric cancer is still far from being achieved. Main obstacles derive from inadequate screening and management of H. pylori infection but also from other external risk factors, responsible for about a quarter of future cases of gastric cancer. The need for population-based H. pylori screen-and-treat programs remains not fully addressed, mainly due to concerns about cost, to underpowered screening efficacy of policies only targeting symptomatic people, to the lack of screen-and-treat approach performed early. Further concerns derive from persisting gaps between guideline-recommended H. pylori management and real-world patterns, leading to inappropriate therapies and increased antimicrobial resistance. A critical role is also played by unhealthy lifestyle and by environmental factors other than H. pylori. In fact, critical external factors increasing the risk of gastric cancer originate from the contamination of environmental matrices and of the food chain with toxic chemicals of anthropogenic origin. An effective strategy for the primary prevention of gastric cancer should therefore consider a full implementation of population-based screen-and-treat programs, but also educational strategies oriented to correct unhealthy habits, and rules and policies oriented to decrease the involuntary exposure to toxic chemicals. In the absence of this comprehensive approach and urgent and efficient prevention policies, local health systems should be prepared to manage the high cost deriving from the growing burden of a preventable (but not prevented) disease, as is gastric cancer. Maximal efforts should also be oriented to ensure a correct application of the available guidelines for the management of H. pylori infection. This goal should lead to an accurate selection of the best treatment regimen, but also to antibiotic stewardship, and to constant monitoring of outcomes and epidemiologic data, to improve quality and equity of care. Internist as well urge to master such topics which involve present and future key public health issues.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953005","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":"Hypertensive retinopathy in Dutch emergency departments: a multicenter retrospective cohort analysis.","authors":"Arrien Blokland, Vivienne de Smet, Riemke Mars, Margot Verhofstad, David Baden, Steef van den Broek, Joris Holkenborg, Djoke Douma, Evelien Oostdijk, Gert-Jan Mauritz","doi":"10.1007/s11739-025-04105-z","DOIUrl":"https://doi.org/10.1007/s11739-025-04105-z","url":null,"abstract":"<p><p>Suspected hypertensive emergencies account for approximately one in every 200 emergency department (ED) visits in the Netherlands. One manifestation of hypertensive-mediated organ damage (HMOD) is hypertensive retinopathy. A rapid and aggressive reduction in blood pressure in these patients can result in severe cerebral complications, however a clear clinical definition is lacking, resulting in a heterogeneous patient population and ongoing debate regarding the necessity of intravenous therapy in these cases. This descriptive study aims to assess adherence to the ESC guidelines regarding fundoscopy and to determine the incidence of hypertensive retinopathy. Furthermore this study seeks to provide insights into the current clinical practice and the therapeutic strategies for patients with suspected hypertensive emergencies. A retrospective, multicenter cohort study was performed across four large nonacademic teaching hospitals in the Netherlands. All nonpregnant patients between 2019 and 2020 with a suspected hypertensive emergency referred to the ED were included. Primary outcome measures included the proportion of fundoscopy performed and incidence of grade III/IV retinopathy. Secondary aim encompassed the impact of oral antihypertensive treatment on blood pressure and on the incidence of neurological complications during the ED visit or within 30 days postdischarge. 1057 patients were enrolled in the study. 396 patients (40.2%) with indication for fundoscopy underwent fundoscopy. Of these patients 41 (10.4%) had grade III/IV retinopathy. 642 patients (60.7%) received oral antihypertensive drugs. Blood pressure reduction was less than 25% in all blood pressure derivatives. One complication was observed in the ED and 7 within 30 days. Our findings highlight the gap between current guidelines and show partial guideline adherence and low incidence of retinopathy. Furthermore oral antihypertensive drugs appeared to induce a gradual decrease in blood pressure in the ED with a relatively low rate of complications. Further prospective studies are needed to refine clinical definitions, improve the identification of patients at risk for neurological deterioration, and critically evaluate the role of fundoscopy in emergency settings.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953031","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":"Plasma SIRT7 as a novel biomarker for coronary artery disease and rehospitalization risk in hypertensive patients: a cross-sectional and longitudinal study.","authors":"Xinyu Zhou, Ying Liu, Ying Guo, Ning Wang, Siyuan Wang, Jiawei Song, Zhaojie Dong, Xiaoyan Yang, Yufei Chen, Jing Li, Lin Zhao, Ying Dong, Jiuchang Zhong","doi":"10.1007/s11739-025-04092-1","DOIUrl":"https://doi.org/10.1007/s11739-025-04092-1","url":null,"abstract":"<p><p>The exact role of SIRT7 in hypertensive patients with coronary artery disease (CAD) remains elusive. This study aimed to explore plasma SIRT7 levels and their clinical significance in this population. From July 2022 to June 2024, 222 hypertensive patients (106 with isolated hypertension and 116 with hypertension plus CAD) were enrolled. Plasma SIRT7 was measured by ELISA, and participants were followed for rehospitalization (median 804 days). ROC curves, LASSO regression, and Cox proportional hazards models were used for statistical analysis. Hypertensive CAD patients had significantly higher SIRT7 levels than those without CAD (P < 0.001). Plasma SIRT7 levels were positively correlated with CK (R = 0.36, P < 0.001) and CK-MB (R = 0.50, P < 0.001), and negatively with HDL-C (R = -0.23, P < 0.001). The optimal cutoff of SIRT7 for diagnosing CAD demonstrated 94.0% sensitivity and 75.5% specificity, exhibiting an AUC of 0.917, superior to CK, CK-MB, and HDL-C. Multivariate analysis identified SIRT7 as an independent CAD risk factor (adjusted OR = 1.97, 95% CI 1.48-2.63). Restricted cubic spline (RCS) analysis revealed a linear correlation between SIRT7 and rehospitalization (P for overall = 0.038), but no non-linear relationship (P for non-linear = 0.164). Elevated SIRT7 predicted rehospitalization risk (HR = 1.15, 95% CI 1.02-1.29) and improved risk prediction, with an integrated discrimination index (IDI) of 21.8% and net reclassification improvement (NRI) of 51.0%. Plasma SIRT7 acts as both a diagnostic marker for CAD and a predictor of rehospitalization in hypertensive patients, indicating its dual role in pathogenesis and clinical monitoring. Targeting SIRT7 signaling may offer a new therapeutic strategy for hypertension-associated CAD.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953018","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":"Why internists should be concerned about glyphosate.","authors":"Agostino Di Ciaula, Harshitha Shanmugam, Mohamad Khalil, Piero Portincasa","doi":"10.1007/s11739-025-04103-1","DOIUrl":"https://doi.org/10.1007/s11739-025-04103-1","url":null,"abstract":"<p><p>Environmental health should be an ethical obligation for experts in internal medicine. Besides the harmful health effects of air pollution, endocrine-disrupting chemicals and climate change, growing evidence points to glyphosate, a widely used herbicide, which generates risks to public health in terms of noncommunicable diseases and cancer. Detection of glyphosate in humans has been associated with all-cause mortality, increased frailty, insulin resistance, impaired glucose homeostasis and diabetes, increased risk of atherosclerotic cardiovascular diseases, fatty liver, and chronic obstructive pulmonary disease. In addition, recent animal studies demonstrated that long-term intake of glyphosate with drinking water, even at very low levels, dose-dependently increases cancer incidence. Experts in internal medicine are called to increase awareness on the pathogenetic role of glyphosate, to amplify their function as privileged healthcare providers. The discussion about environmental hazards, as for glyphosate, could be efficiently driven by an ethical involvement of experts in internal medicine to generate significant beneficial effects. Although primary prevention is mainly a political issue, internists should act as health advocates for the community, sharing scientific evidence and expert knowledge in complexity, and encouraging them to take actions oriented at decreasing the health risk deriving from glyphosate through a one-health approach.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952989","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}