Abstract:
:Acute aortic syndromes (AASs) are deadly cardiovascular emergencies involving the thoracic aorta. AASs are relatively rare conditions, have unspecific signs and symptoms (including truncal pain, syncope, neurologic deficit and limb ischemia) and require contrast-enhanced tomography angiography (CTA) of the chest and abdomen for conclusive diagnosis and subsequent therapeutic planning. In the Emergency Department (ED), most patients with potential signs/symptoms of AASs are finally found affected by other alternative diagnoses. Hence, misdiagnosis and delayed diagnosis of AASs are major concerns. In critically ill patients, decision to perform CTA is usually straightforward, as exam benefits largely outweigh risks. In patients with ST-tract elevation on ECG, suspected primary ischemic stroke and in stable patients (representing the most prevalent ED scenarios), proper selection of patients necessitating CTA is cumbersome, due to concurrent risks of misdiagnosis and over-testing. Available studies support an algorithm integrating clinical probability assessment, bedside echocardiography and D-dimer (if the clinical probability is not high). Therapeutic management includes medical therapy for all patients including an opioid and anti-impulse drugs (a beta-blocker and a vasodilator), targeting a heart rate of 60 bpm and systolic blood pressure of 100-120 mmHg. Patients with AASs involving the ascending aorta are likely candidate for urgent surgery, and complicated type B AASs (severe aortic dilatation, impending or frank rupture, organ malperfusion, refractory pain, severe hypertension) necessitate evaluation for urgent endovascular treatment. For uncomplicated type B AASs, optimal medical therapy is the current standard of care.
journal_name
Intern Emerg Medjournal_title
Internal and emergency medicineauthors
Morello F,Santoro M,Fargion AT,Grifoni S,Nazerian Pdoi
10.1007/s11739-020-02354-8subject
Has Abstractpub_date
2021-01-01 00:00:00pages
171-181issue
1eissn
1828-0447issn
1970-9366pii
10.1007/s11739-020-02354-8journal_volume
16pub_type
杂志文章,评审abstract::Upper extremities deep venous thrombosis (UEDVT) is a rare condition. According to the literature, approximately 4-10% of all cases of venous thrombosis may involve the subclavian, axillary or brachial veins. In the last few decades, the incidence of UEDVT has increased because of more frequent use of central venous c...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,评审
doi:10.1007/s11739-009-0320-x
更新日期:2010-04-01 00:00:00
abstract::Cirrhosis is characterized by a complex coagulation defect leading to the prolongation of the prothrombin and activated partial thromboplastin times (PT and APTT). Arbitrary PT cut-off values are still used as a yardstick to guide treatment with fresh-frozen plasma (FFP) or other pro-coagulant agents in patients under...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-011-0528-4
更新日期:2012-04-01 00:00:00
abstract::Medical therapy in patients with more than one pathology means using more pharmaceuticals, which results in a higher risk of drug interactions which are modifications in the action of one drug when it is administered in the presence of another. The consequences can be diminished therapeutic effect or increased adverse...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-011-0680-x
更新日期:2011-10-01 00:00:00
abstract::Chronic thromboembolic pulmonary hypertension (CTPH) is a potential complication of pulmonary embolism (PE). Only few studies have assessed the role of brain natriuretic peptide (BNP) in patients with chronic pulmonary hypertension, and there are no data on the potential utility of BNP as a preclinical biomarker of CT...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-009-0231-x
更新日期:2009-04-01 00:00:00
abstract::Inconsistent findings in the studies have been observed concerning the higher dose of statins use in the acute phase of ischemic stroke and transient ischemic attack (TIA). Therefore, we performed a systematic review to assess this issue. A computerized literature search in PubMed, Cochrane Library databases, and EMBA...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,评审
doi:10.1007/s11739-017-1650-8
更新日期:2017-08-01 00:00:00
abstract::Auto-titrating noninvasive ventilation (NIV) has been developed as a new mode applying variable expiratory-positive airway pressure (EPAP) in addition to variable inspiratory pressures (IPAP), both to deliver targeted tidal volume (VT) and to eliminate upper airway resistance. The purpose of this study is to evaluate ...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-018-1821-2
更新日期:2018-04-01 00:00:00
abstract::Hypertension and diabetes are known risk factors for obesity-related thrombosis, but several studies have shown that obesity is characterised by a potentially prothrombotic inflammatory state because of activated coagulation and impaired fibrinolysis. In order to verify if obese patients-unaffected by hypertension, di...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-011-0522-x
更新日期:2012-06-01 00:00:00
abstract::The article Reversal agents for oral anticoagulant-associated major or life-threatening bleeding, written by Marco Moia, Alessandro Squizzato was originally published electronically on the publisher's internet portal (currently SpringerLink) on 24 August 2019 without open access. ...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,已发布勘误
doi:10.1007/s11739-019-02232-y
更新日期:2020-06-01 00:00:00
abstract::Extreme hypomagnesemia (hypoMg) can be encountered in many situations, but little data currently exist. Our aim is to describe the epidemiological, clinical, etiological characteristics, and the biological abnormalities of consecutive inpatients with extreme hypomagnesemia. In our observational monocentric study, betw...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-018-1898-7
更新日期:2018-12-01 00:00:00
abstract::The term splanchnic vein thrombosis encompasses Budd-Chiari syndrome (BCS), extrahepatic portal vein obstruction (EHPVO), and mesenteric vein thrombosis; the simultaneous involvement of additional regions is frequent, and clinical presentations and risk factors may be shared. The annual incidence of BCS and isolated m...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,评审
doi:10.1007/s11739-010-0413-6
更新日期:2010-12-01 00:00:00
abstract::Predictors of short-term readmission after ischemic stroke have been previously identified, but few studies analyzed predictors of long-term readmission, namely early imaging findings and treatment with intravenous thrombolysis (IVT). To characterize predictors of hospital readmission during the first year after hospi...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-016-1519-2
更新日期:2017-02-01 00:00:00
abstract::In addition to cardiac output, oxygen delivery is determined by the amount of oxygen carried by hemoglobin, which is estimated by the product of hemoglobin level and peripheral hemoglobin oxygen saturation (SpO2). Optimal hemoglobin concentration for post-cardiac arrest syndrome (PCAS) has not yet been investigated th...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-015-1386-2
更新日期:2016-08-01 00:00:00
abstract::The purpose of this investigation was to investigate the association between first attempt success and intubation-related complications in the Intensive Care Unit after the widespread adoption of video laryngoscopy. We further sought to characterize and identify the predictors of complications that occur despite first...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-016-1549-9
更新日期:2017-12-01 00:00:00
abstract::Diuretic resistance (DR) is common in patients with decompensated heart failure (HF), and is associated with adverse outcomes. To determine the prevalence of DR and its impact on survival among patients with decompensated HF, we prospectively evaluated the prevalence and influence on prognosis of DR (defined as persis...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-018-02019-7
更新日期:2019-06-01 00:00:00
abstract::This study was designed to evaluate the prevalence of cardiometabolic comorbidities and the changes in left ventricular geometry and function in 135 subjects subgrouped according to low or normal total adiponectin plasma (ADPN) levels. Left ventricular (LV) internal diameter/height, total LV mass (LVM) and LVM index (...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-014-1104-5
更新日期:2015-02-01 00:00:00
abstract::Septic arthritis (SA) is commonly associated with Staphylococcal or Streptococcal infections. Overtime, there has been a global increase in the distribution of antimicrobial resistance within both Gram-positive bacteria such as methicillin-resistant Staphylococcus aureus (MRSA) and Gram-negative bacteria such as exten...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-019-02244-8
更新日期:2020-06-01 00:00:00
abstract::Dihydropyridine calcium channel blockers may possess antioxidant properties, and might improve micro and macrovascular structure and function. Combination treatment with an ACE inhibitor may have additional advantages, compared with a thiazide diuretic. The aim of the present study is to investigate the effects of a s...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-017-1696-7
更新日期:2017-10-01 00:00:00
abstract::Iron deficiency anemia (IDA) is one of the most common complications of inflammatory bowel disease (IBD). We planned a prospective study to address tolerability and efficacy of sucrosomial iron, a new oral formulation of ferric pyrophosphate, in IBD patients. Thirty patients with a confirmed diagnosis of Crohn's Disea...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-018-1993-9
更新日期:2019-04-01 00:00:00
abstract::Serum potassium homeostasis play an important role in myocardial function, but the impact of serum potassium levels on long-term mortality has not been well evaluated. In the current study, we investigated patients with acute coronary syndrome (ACS) and analyzed the relationship between admission serum potassium level...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-015-1253-1
更新日期:2015-12-01 00:00:00
abstract::Non-alcoholic fatty liver disease is recognized as the most common and emerging chronic liver disease in western countries. The disease has been traditionally interpreted as a possibly progressing condition to liver fibrosis and cirrhosis. However, recently, a large number of publications have demonstrated that people...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,评审
doi:10.1007/s11739-012-0819-4
更新日期:2012-10-01 00:00:00
abstract::Anthracyclines are extensively used in oncologic patients, in particular for breast cancer and hematological malignancies. Cardiac injury is a potentially dangerous side effect of these drugs. In this systematic review, we analyzed published randomized controlled trials (RCTs) to assess if potential cardioprotective d...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,评审
doi:10.1007/s11739-020-02508-8
更新日期:2020-10-03 00:00:00
abstract::Antimicrobial therapy has been the main stay of therapy of community-acquired aspiration pneumonia (CAAP), but the duration of treatment has not been established. The objective of this study was to describe the time to reach clinical stability in patients with aspiration pneumonia compared to community-acquired pneumo...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-012-0764-2
更新日期:2014-03-01 00:00:00
abstract::Direct thrombin inhibitors (DTIs) are a class of anticoagulants that bind selectively to thrombin and block its interaction with its substrates. Dabigatran etexilate and AZD0837, the new generation of DTIs, are now under intense development, and are potentially of great interest for internists. Dabigatran etexilate is...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-009-0314-8
更新日期:2009-12-01 00:00:00
abstract::Prescription of non-vitamin K antagonist oral anticoagulants (NOACs) requires an assessment of renal function (RF) and the Cockcroft-Gault (CG) equation is traditionally recommended. The objective of the study was to evaluate the potential changes in NOACs management using different equations for estimating RF. In a p...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-018-1857-3
更新日期:2018-10-01 00:00:00
abstract::Increasing evidence shows an association between high lipoprotein(a) [Lp(a)] levels and atherothrombotic diseases. Lp(a) trait is largely controlled by kringle-IV type 2 (KIV-2) size polymorphism in LPA gene, encoding for apo(a). Environmental factors are considered to determinate minor phenotypic variability in Lp(a)...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-020-02276-5
更新日期:2020-10-01 00:00:00
abstract::During the influenza season, most patients suspected of having influenza undergo rapid influenza diagnostic tests (RIDTs) in Japan despite their low sensitivity. However, the physician's actual rationale for prescribing antivirals, besides the results of RIDTs, remains poorly understood. Our study sought to identify t...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-020-02570-2
更新日期:2021-01-02 00:00:00
abstract::A high incidence of isolated left ventricular non-compaction (LVNC) has been reported in previous studies on smaller cohorts of patients with thalassemia by cardiac MRI but the clinical impact of the finding is unknown. This prospective cohort study evaluates the prevalence and clinical implication of the finding. Pro...
journal_title:Internal and emergency medicine
pub_type: 杂志文章
doi:10.1007/s11739-019-02114-3
更新日期:2019-11-01 00:00:00
abstract::According to the Global Burden of Disease Study 2017, between 1990 and 2017, Italy experienced a more attenuate reduction in cardiovascular deaths than Western Europe. When considering risk factors, our Country experienced a reduction in the prevalence of hypertension in the last few decades, especially in women. On t...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,评审
doi:10.1007/s11739-019-02263-5
更新日期:2020-06-01 00:00:00
abstract::Microorganisms and plants produce bioactive metabolites that are potentially useful in the treatment of disease. We have designed and synthesized DHMEQ as a specific inhibitor of NF-κB based on the structure of epoxyquinomicin. It directly binds to NF-κB components to inhibit DNA-binding and was shown to be endowed wi...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,评审
doi:10.1007/s11739-013-0922-1
更新日期:2013-04-01 00:00:00
abstract::Polycystic ovary syndrome, the most common endocrine disorder of reproductive age women, is often associated with insulin resistance and associated disorders. The frequency of type 2 diabetes, hyperlipidemia, cardiac risk markers, structural vascular disease, and clinical disease events are increased in this populatio...
journal_title:Internal and emergency medicine
pub_type: 杂志文章,评审
doi:10.1007/s11739-013-0924-z
更新日期:2013-04-01 00:00:00