Internal and Emergency Medicine最新文献

{"title":"Linezolid-induced neuropathy in Nocardia pneumonia.","authors":"Yiwei Wang, Miao Dai","doi":"10.1007/s11739-025-03886-7","DOIUrl":"https://doi.org/10.1007/s11739-025-03886-7","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143382498","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":"Detection and management of postoperative atrial fibrillation after coronary artery bypass grafting or non-cardiac surgery: a survey by the AF-SCREEN International Collaboration.","authors":"Giuseppe Boriani, Jacopo F Imberti, William F McIntyre, Davide A Mei, Jeff S Healey, Renate B Schnabel, Emma Svennberg, A John Camm, Ben Freedman","doi":"10.1007/s11739-025-03861-2","DOIUrl":"https://doi.org/10.1007/s11739-025-03861-2","url":null,"abstract":"<p><p>We developed a survey to describe current practice on the detection and management of new-onset postoperative atrial fibrillation (POAF) occurring after coronary artery bypass grafting (CABG) or non-cardiac surgery. We e-mailed an online anonymous questionnaire of 17 multiple choice or rank questions to an international network of healthcare professionals. Between June 2023 and June 2024, 158 participants from 25 countries completed the survey. For CABG patients, 62.7% of respondents reported use of telemetry to detect POAF on the ward until discharge, and 40% reported no dedicated methods for monitoring AF recurrences during follow-up. The largest number (46%) reported prescribing oral anticoagulants (OACs) at discharge if patients were at risk according to CHA₂DS₂-VASc/CHA₂DS₂-VA scores, and the most common duration of OAC therapy was 3 months to 1 year (43%). For non-cardiac surgery patients, POAF detection methods varied, with 29% using periodic 12-lead ECG and 27% using telemetry followed by periodic ECGs. For monitoring AF recurrence, 33% reported planned cardiology visits with ECG. Regarding OAC prescription during follow-up, 51% reported they prescribe OACs only for patients who are at risk of stroke, and 42% prescribe OACs for an interval of 3 months to 1 year. The most commonly reported barrier to OAC prescription was the lack of randomized controlled trial data. For both CABG and non-cardiac surgery, the reported methods for POAF detection and recurrences monitoring were heterogeneous and prescription patterns for OACs varied greatly. The most frequently reported concern about long-term anticoagulation was lack of randomized data, indicating the urgent need for sound studies that inform daily clinical practice.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143373950","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":"Fertility in male patients with familial Mediterranean fever and paternal effect of FMF on pregnancy outcomes and complications.","authors":"Kerem Parlar, Feyza Nur Azman, Sena Ladin Sıcakyüz, Melike Rızaoğlu, Enes Azman, Mebrure Burçak Yüzbaşıoğlu, Dilvin Korkmaz, Serdal Uğurlu","doi":"10.1007/s11739-025-03881-y","DOIUrl":"https://doi.org/10.1007/s11739-025-03881-y","url":null,"abstract":"<p><strong>Objectives: </strong>This study investigates the impact of Familial Mediterranean Fever (FMF) and its treatment on male infertility, and the paternal effect of FMF on pregnancy outcomes or complications.</p><p><strong>Methods: </strong>We enrolled 282 adult male FMF patients and excluded 102 for never attempting pregnancy. Demographic and clinical data, including MEFV mutation status and treatment history, were collected. Fertility status and pregnancy outcomes were assessed through interviews and medical records. Statistical analysis was performed using Fisher's exact test, with significance set at p < 0.05.</p><p><strong>Results: </strong>Among the 180 patients who attempted pregnancy, 177 (98.3%) achieved pregnancy. Only 3 (1.7%) were infertile. A total of 452 pregnancies were conceived, with 85.0% resulting in live births. Miscarriages occurred in 11.9%, stillbirths in 0.9%, and ectopic pregnancies in 0.9%. The most common complication was preterm birth (4.2%), followed by gestational diabetes (2.1%). Eleven patients with amyloidosis achieved 39 pregnancies, with no cases of infertility.</p><p><strong>Conclusion: </strong>FMF does not lead to decreased male fertility or adverse pregnancy outcomes. Colchicine is safe for use during conception. Male FMF patients and their partners do not need additional precautions during pregnancy attempts and follow-up.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189106","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":"Predictive factors for successful weaning from mechanical ventilation in the internal medicine department.","authors":"Gal Cohen, Idan Bergman, Alaa Atamna, Avishay Elis","doi":"10.1007/s11739-025-03860-3","DOIUrl":"https://doi.org/10.1007/s11739-025-03860-3","url":null,"abstract":"<p><p>The aging of the Israeli population along with a shortage of ICU beds have led to hospitalization of invasive mechanical ventilation patients in internal medicine departments, where, as opposed to ICU, the treatment is less than optimal. The aims of the study were to evaluate the predictive factors for successful weaning from mechanical ventilation in ventilated patients admitted to internal medicine departments. A retrospective study that included non-COVID 19 ventilated patients in internal medicine departments in a university affiliated hospital in Israel between the years 2018-2019. We compared datapoints between patients who were weaned from ventilators versus those who remained ventilated during the hospitalization, and defined demographic and clinical predictive factors for successful weaning. Data were collected from electronic medical records and included demographic, clinical, laboratory and ventilator information. The study group included 348 patients. The rate of successful weaning was 19%; patients who were successfully weaned were primarily functionally independent prior to ventilation, ventilated with low PEEP values, had high hemoglobin and albumin levels alongside with low CRP and lactate levels. Those who remained ventilated either required vasopressor treatment, had positive blood cultures or had lower GFR levels. The overall in-hospital mortality rate was 60%, while the 30-day mortality rate was lower in the extubated group [214 (76%) vs. 6 (9%), P < 0.0001]. Our findings highlight the low rate of weaning from ventilation in the department of medicine, with higher mortality rate among the remained ventilated patients. Various favorable clinical parameters might predict successful weaning.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189164","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":"Nodular fasciitis. A rare, rapidly growing lesion of the parotid gland.","authors":"Nicola Flor, Jacopo Di Napoli, Luca Carsana, Laura Moneghini, Federico Biglioli","doi":"10.1007/s11739-025-03868-9","DOIUrl":"https://doi.org/10.1007/s11739-025-03868-9","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074224","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 program to improve sepsis management in the Emergency Department: a multicenter prospective study in France.","authors":"Anaëlle Nardot, Coralie Lacorre, Antoine Lanneluc, Domitille Paulet, Morgan Gauriat, Cyril Moesch, Pauline Feydeau, Emilie Valantin, Philippe Dupuy, Marine Blondel, Henri Hani Karam, Arthur Baïsse, Isabelle Herafa, Aloïse Blanchet, Manon Dumolard, Thomas Daix, Thomas Lafon","doi":"10.1007/s11739-025-03877-8","DOIUrl":"https://doi.org/10.1007/s11739-025-03877-8","url":null,"abstract":"<p><p>Implementation of a regional sepsis program to improve compliance with sepsis care bundles and optimize septic patient management and outcomes in the Emergency Department (ED). The program included a multifaceted intervention in 8 EDs: creation of a regional sepsis team, meetings, education (yearly 6-h course and site visits) and sepsis alert. Clinical practice was evaluated in each ED during 1 month every year over 3 years. The primary outcome was the initiation of all criteria of the Surviving Sepsis Campaign (SSC) bundle within 3 h after triage. Secondary outcomes were the initiation of the 3-h bundle in patients with hypotension (SBP ≤ 100 mmHg), admission related to infection or not, proportion of organ supports, subsequent intensive care unit (ICU) admission, and early mortality (day 7). During the 3-month study period, 739 patients were identified with a sepsis including 8% with septic shock. Compliance with the SSC bundle improved during the three periods (P1: 28/176 (16%), P2: 42/272 (15%), P3:69/291 (24%), p = 0.023). In patients with hypotension (n = 142, 19%), no improvement was observed (P1:12/38 (32%), P2:18/46 (39%), P3: 28/58 (48%), p = 0.255). Mortality on day 7 was also similar (10% vs 11% vs 9%, p = 0.621). In multivariate analysis, age (OR = 1.03; 95% CI 1.01-1.05, p = 0.003) and confusion (OR = 2.37; 95% CI 1.37-4.14, p = 0.002) were independently associated with D7 mortality. Patients referred to ED for infection had a better prognosis compared to those with a non-specific reason (OR = 0.56; 95% CI 0.32-0.97, p = 0.038). A regional sepsis educational program appears to improve compliance with the SSC bundle. Pre-hospital identification of sepsis appears to improve further management.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065400","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-rated health differences between exclusive e-cigarette users and exclusive cigarette smokers: evidence from the 2017-2019 Scottish Health Survey.","authors":"Yusuff Adebayo Adebisi, Don Eliseo Lucero-Prisno, Isaac Olushola Ogunkola","doi":"10.1007/s11739-025-03873-y","DOIUrl":"https://doi.org/10.1007/s11739-025-03873-y","url":null,"abstract":"<p><p>The comparative health implications of e-cigarette use versus traditional cigarette smoking remain a critical focus in public health research. This cross-sectional study examined differences in self-rated general health between exclusive e-cigarette users and exclusive cigarette smokers, using data from the 2017-2019 Scottish Health Survey. A total of 2484 adults (aged 16 and above) were included and categorized as exclusive e-cigarette users (n = 565) or exclusive cigarette smokers (n = 1919). Self-rated health was assessed using a single-item measure with five response categories: \"very bad,\" \"bad,\" \"fair,\" \"good,\" and \"very good\". Generalized ordinal logistic regression models were used to estimate the association between nicotine product use and self-rated health, adjusting for age, sex, Scottish Index of Multiple Deprivation, marital status, ethnicity, alcohol consumption frequency, physical activity, presence of longstanding physical or mental health conditions, and age of smoking initiation. In the fully adjusted model, exclusive e-cigarette users had higher odds of reporting better self-rated health compared to exclusive cigarette smokers overall (OR = 1.26, 95% CI 1.05-1.51, p = 0.012). A graded relationship was also observed in the fully adjusted model, with progressively lower odds of reporting better self-rated health as smoking intensity increased, using exclusive e-cigarette users as the reference group. Heavy smokers (≥ 20 cigarettes/day) had the lowest odds of reporting better self-rated health (OR = 0.63, 95% CI 0.49-0.80, p < 0.001), followed by moderate smokers (10 to < 20 cigarettes/day) (OR = 0.81, 95% CI 0.66-0.99, p = 0.047). In contrast, light smokers (< 10 cigarettes/day) showed no significant difference in self-rated health compared to exclusive e-cigarette users (OR = 0.94, 95% CI 0.75-1.18, p = 0.614). These findings indicate that exclusive e-cigarette use is associated with better self-rated health compared to exclusive cigarette smoking, particularly among moderate and heavy smokers. Additional analyses revealed no significant differences in self-rated health among exclusive e-cigarette users based on prior smoking history (OR = 0.94, 95% CI 0.43-2.08, p = 0.882) or among exclusive cigarette smokers based on prior e-cigarette use (OR = 0.87, 95% CI 0.69-1.09, p = 0.219). These findings suggest that prior use is unlikely to explain the observed association between exclusive e-cigarette use and better self-rated health compared to exclusive cigarette smoking. Given the subjective nature of self-rated health, these findings should be interpreted with caution. Future longitudinal studies incorporating objective health measures are essential to assess the long-term impacts of e-cigarette use and inform evidence-based harm reduction policies.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065433","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":"Strengthening team cohesion in the emergency department through a color-coded well-being check-in: are you 'ready to roll?'","authors":"Saskia Anne Carolien van Run, Bart Gerard Jan Candel, Arnoldus George Buenen","doi":"10.1007/s11739-025-03883-w","DOIUrl":"https://doi.org/10.1007/s11739-025-03883-w","url":null,"abstract":"","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052229","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":"Genomic profiling at a single center cracks the code in inborn errors of immunity.","authors":"Alessandro Andriano, Vanessa Desantis, Carolina Marasco, Antonio Marzollo, Silvia Bresolin, Nicoletta Resta, Lucia Di Marzo, Fabrizio Pappagallo, Antonella Mascolo, Ingrid Catalina Caradonna, Simona D'Amore, Angelo Vacca, Antonio Giovanni Solimando","doi":"10.1007/s11739-025-03871-0","DOIUrl":"https://doi.org/10.1007/s11739-025-03871-0","url":null,"abstract":"<p><p>Inborn errors of immunity (IEI) entail a diverse group of disorders resulting from hereditary or de novo mutations in single genes, leading to immune dysregulation. This study explores the clinical utility of next-generation sequencing (NGS) techniques in diagnosing monogenic immune defects. Eight patients attending the immunodeficiency clinic and with unclassified antibody deficiency were included in the analysis. Clinical records, immune characteristics, and family histories were reviewed, and a target gene panel (TGP) sequencing was performed to identify pathogenic variants. TGPs identified seven variants in TNFRSF13B (TACI), CARMIL2, STAT1, STAT3, and ORAI1 genes. These findings provided definitive diagnoses and proper prognostic assessment. Patients exhibited a wide range of clinical manifestations, including recurrent infections, autoimmune cytopenias, and organ-specific complications. The genetic diversity observed highlights the importance of genetic testing in diagnosing IEIs and tailoring treatments. This study underscores the role of TGPs in diagnosing IEIs, revealing significant genetic heterogeneity and phenotypic variability. They offer a precise tool for identifying underlying genetic defects, facilitating personalized medicine approaches, and eventually improving patient outcomes. The findings emphasize the need for comprehensive genetic testing to uncover novel pathogenic variants, enhancing our understanding of immune system dysfunction. NGS is a critical tool for the management of IEI, enabling precise diagnosis and personalized treatment strategies. Despite resource limitations, the progressive affordability is likely to expand its clinical utility, ultimately improving patient care and advancing the field of immunology. In the meantime, accurate phenotypic assessment is essential for resource optimization and case prioritization.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052223","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 nomogram based on trauma-induced coagulopathy for predicting hospital mortality in multi-trauma patients: a retrospective study.","authors":"Shaochuan Chen, Jiale Yang, Xuezhi Shi, Anwei Liu, Guodong Lin, Huasheng Tong","doi":"10.1007/s11739-025-03867-w","DOIUrl":"https://doi.org/10.1007/s11739-025-03867-w","url":null,"abstract":"<p><p>Multi-trauma presents significant challenges due to the complexity of injuries and high mortality rates. Early identification and intervention are crucial for improving outcomes in these critically injured patients. This retrospective study analyzed clinical data from multi-trauma patients admitted to the emergency department of Huiyang Sanhe Hospital between January 10, 2020, and September 30, 2022. Univariate and multivariate logistic regression analyses were conducted to identify independent predictors of hospital mortality. A prediction model was developed based on these prognostic markers, visualized using a nomogram, and its discriminative ability and clinical benefit were evaluated. A total of 124 multi-trauma patients were included in the study, with a hospital mortality rate of 26.7%. Univariate and multivariate logistic regression analyses identified trauma-induced coagulopathy (TIC) (OR 4.238, 95% CI 1.46-12.28), blood urea nitrogen (BUN) (OR 1.397, 95% CI 1.09-1.78), and Glasgow Coma Scale (GCS) score (OR 0.720, 95% CI 0.61-0.85) as independent factors of hospital mortality. Therefore, a nomogram incorporating TIC, BUN, and GCS score was constructed and demonstrated excellent predictive performance and clinical impact (AUC 0.898, 95% CI 0.834-0.962). The nomogram developed in this study provided a practical tool for early prediction of hospital mortality in multi-trauma patients. By focusing on TIC, BUN, and GCS score, this model may facilitate rapid bedside assessment and timely intervention. However, further multicenter, prospective studies are required to validate its performance and applicability.</p>","PeriodicalId":13662,"journal":{"name":"Internal and Emergency Medicine","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052214","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}