Journal of Internal Medicine最新文献

{"title":"Differential long-term impact of primary glomerular diseases on major outcomes: All are not equal!","authors":"Austin G Stack","doi":"10.1111/joim.20057","DOIUrl":"https://doi.org/10.1111/joim.20057","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142913398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regarding: Alpha-1 antitrypsin deficiency associated with increased risks of skin cancer, leukemia, and hepatic cancer: A nationwide cohort study.","authors":"Malin Fromme, Katharina Remih, Carolin Victoria Schneider, Pavel Strnad","doi":"10.1111/joim.20055","DOIUrl":"https://doi.org/10.1111/joim.20055","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors reply: Alpha-1 antitrypsin deficiency associated with increased risks of skin cancer, leukemia, and hepatic cancer: A nationwide cohort study.","authors":"Eskild M Landt, Sarah C W Marott, Morten Dahl","doi":"10.1111/joim.20056","DOIUrl":"https://doi.org/10.1111/joim.20056","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment strategies to reduce cardiovascular risk in persons with chronic kidney disease and Type 2 diabetes.","authors":"Faiez Zannad, Darren K McGuire, Alberto Ortiz","doi":"10.1111/joim.20050","DOIUrl":"https://doi.org/10.1111/joim.20050","url":null,"abstract":"<p><p>Chronic kidney disease (CKD) is a prevalent and progressive condition associated with significant mortality and morbidity. Diabetes is a common cause of CKD, and both diabetes and CKD increase the risk of cardiovascular disease (CVD), the leading cause of death in individuals with CKD. This review will discuss the importance of early detection of CKD and prompt pharmacological intervention to slow CKD progression and delay the development of CVD for improving outcomes. Early CKD is often asymptomatic, and diagnosis usually requires laboratory testing. The combination of estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR) measurements is used to diagnose and determine CKD severity. Guidelines recommend at least annual screening for CKD in at-risk individuals. While eGFR testing rates are consistently high, rates of UACR testing remain low. This results in underdiagnosis and undertreatment of CKD, leaving many individuals at risk of CKD progression and CVD. UACR testing is an actionable component of the CKD definition. A four-pillar treatment approach for slowing the progression of diabetic kidney disease is suggested, comprising a renin-angiotensin-system (RAS) inhibitor, a sodium-glucose cotransporter 2 inhibitor, a glucagon-like peptide 1 receptor agonist, and the nonsteroidal mineralocorticoid receptor antagonist finerenone. The combination of these agents provides a greater cardiorenal risk reduction compared with RAS inhibitors alone. Early detection of CKD and prompt intervention with guideline-directed medical therapy are crucial for reducing CVD risk in individuals with CKD and diabetes. Evidence from ongoing studies will advance our understanding of optimal therapy in this population.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142908730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fluid overload trajectories and mortality in hemodialysis patients.","authors":"Carmine Zoccali, Giovanni Tripepi, Paola Carioni, Francesca Mallamaci, Matteo Savoia, Len S Usvyat, Franklin W Maddux, Stefano Stuard","doi":"10.1111/joim.20049","DOIUrl":"https://doi.org/10.1111/joim.20049","url":null,"abstract":"<p><strong>Background: </strong>Fluid overload remains critical in managing patients with end-stage kidney disease. However, there is limited empirical understanding of fluid overload's impact on mortality. This study analyzes fluid overload trajectories and their association with mortality in hemodialysis patients.</p><p><strong>Methods and patients: </strong>This longitudinal study included 9332 incident hemodialysis patients from the EuCliD database, treated in Fresenius Medical Care NephroCare dialysis centers across seven countries between January 2016 and December 2019, with follow-up until May 2023. Fluid overload was assessed using bioimpedance spectroscopy, and patients were grouped based on fluid overload trajectories using group-based trajectory modeling. Cox regression models, adjusted for potential confounders, were used to investigate the relationship between trajectory groups and mortality.</p><p><strong>Results: </strong>Four distinct fluid overload trajectories were identified. Patients in the highest trajectory group (8.5% of the cohort) had more frequent background cardiovascular complications, lower BMI and serum albumin, and their adjusted mortality risk was 2.20 times higher than the lowest trajectory. There was a dose-response relationship between trajectories and mortality. The incidence rate of death increased with the degree of fluid overload, from 8.6 deaths per 100 person-years in the lowest trajectory to 18.6 in the highest.</p><p><strong>Conclusions: </strong>This longitudinal study highlights the significant risk of chronic fluid overload in hemodialysis patients. Latent trajectory analysis provides novel information into the dynamic nature of fluid overload and its impact on mortality in the hemodialysis population.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of an intensive lifestyle intervention on cystatin C-based kidney function in adults with overweight and obesity: From the PREDIMED-Plus trial.","authors":"José Ignacio Martínez-Montoro, Isabel Cornejo-Pareja, Andrés Díaz-López, Antoni Sureda, Estefania Toledo, Itziar Abete, Nancy Babio, Josep A Tur, Miguel A Martinez-Gonzalez, J Alfredo Martínez, Montse Fitó, Jordi Salas-Salvadó, Francisco J Tinahones","doi":"10.1111/joim.20038","DOIUrl":"https://doi.org/10.1111/joim.20038","url":null,"abstract":"<p><strong>Background: </strong>Large-scale trials evaluating a multicomponent lifestyle intervention aimed at weight loss on kidney function are lacking.</p><p><strong>Methods: </strong>This was a post hoc analysis of the \"PREvención con DIeta MEDiterránea-Plus\" (PREDIMED-Plus) randomized controlled trial, including patients with overweight/obesity and metabolic syndrome, measured cystatin C and creatinine. Participants were randomly assigned (1:1) to an intensive weight loss lifestyle intervention (intervention group [IG]) consisting of an energy-restricted Mediterranean diet (MedDiet), physical activity promotion and behavioral support, or a control group (CG) receiving ad libitum MedDiet recommendations. The primary outcome was between-group differences in cystatin C-based kidney function (cystatin C-based estimated glomerular filtration rate-eGFRcys-and combined cystatin C-creatinine-based eGFR-eGFRcr-cys) change from baseline to 12 and 36 months. Secondary outcomes included between-group differences in creatinine-based eGFR (eGFRcr) and urinary albumin-to-creatinine ratio (UACR) change and the predictive capacity of these formulas at baseline for new-onset chronic kidney disease (CKD).</p><p><strong>Results: </strong>A total of 1909 participants (65 ± 5 years, 54% men) were included. Twelve-month decline in eGFRcys, eGFRcr-cys, and eGFRcr was greater in the CG compared to the IG, with between-group differences of -1.77 mL/min/1.73 m² [95% confidence interval -2.92 to -0.63], -1.37 [-2.22 to -0.53], and -0.91 [-1.74 to -0.71], respectively. At 36 months, the decline in eGFRcr-cys and eGFRcr was greater in the CG. No between-group differences in UACR were found. Significant adjusted areas under the curve for baseline eGFRcys and eGFRcr-cys were observed for incident CKD at 36 months, which were similar to those for eGFRcr and UACR.</p><p><strong>Conclusions: </strong>In older adults with overweight/obesity and metabolic syndrome, the PREDIMED-Plus intervention may be an optimal approach to preserve kidney function.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142891074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authors reply: Delirium and frailty in older adults: Clinical overlap and biological underpinnings.","authors":"Giuseppe Bellelli, Maria Cristina Ferrara, Federico Triolo, Davide Liborio Vetrano","doi":"10.1111/joim.20047","DOIUrl":"https://doi.org/10.1111/joim.20047","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870657","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of moderate-intensity statin with ezetimibe in elderly patients with atherosclerotic cardiovascular disease.","authors":"Jung-Joon Cha, Ju Hyeon Kim, Soon Jun Hong, Subin Lim, Hyung Joon Joo, Jae Hyoung Park, Cheol Woong Yu, Pil Hyung Lee, Seung Whan Lee, Cheol Whan Lee, Jae Youn Moon, Jong-Young Lee, Jung-Sun Kim, Jae Suk Park, Do-Sun Lim","doi":"10.1111/joim.20029","DOIUrl":"https://doi.org/10.1111/joim.20029","url":null,"abstract":"<p><strong>Background: </strong>High-intensity statin therapy significantly reduces mortality and cardiovascular events in patients with atherosclerotic cardiovascular disease (ASCVD). However, moderate-intensity statins are often preferred for elderly patients due to their higher risk of intolerance to high-intensity statins.</p><p><strong>Objective: </strong>To compare the incidence of statin-associated muscle symptoms (SAMS) and the effect on low-density lipoprotein cholesterol (LDL-C) levels between elderly ASCVD patients receiving high-intensity statin monotherapy and those receiving moderate-intensity statin with ezetimibe in a combination therapy.</p><p><strong>Method: </strong>In a prospective, multicenter, open-label trial conducted in South Korea, 561 patients aged 70 years or above with ASCVD were randomly assigned to receive either moderate-intensity statin with ezetimibe combination therapy (rosuvastatin 5 mg with ezetimibe 10 mg) or high-intensity statin monotherapy (rosuvastatin 20 mg) over 6 months. The primary endpoint was the incidence of SAMS, and the key secondary endpoint was the achievement of target LDL-C levels (<70 mg/dL) within 6 months.</p><p><strong>Results: </strong>The primary endpoint showed a lower incidence of SAMS in the combination therapy group (0.7%) compared to the high-intensity statin monotherapy group (5.7%, p = 0.005). Both groups achieved similar LDL-C levels, with 75.4% in the combination therapy group and 68.7% in the monotherapy group reaching target levels.</p><p><strong>Conclusion: </strong>Moderate-intensity statin with ezetimibe combination therapy offers a lower risk of SAMS and similar LDL-C reduction in elderly patients with ASCVD, compared to high-intensity statin monotherapy.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142870658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay of delirium and frailty in hospitalized older adults: Implications for healthcare utilization.","authors":"Zhiying Lim, Natalie Ling, Reshma Aziz Merchant","doi":"10.1111/joim.20046","DOIUrl":"https://doi.org/10.1111/joim.20046","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol-induced pancreatitis and alcohol-related liver disease: Two different phenotypes of alcohol-related harm or related conditions?","authors":"Einar Stefan Björnsson","doi":"10.1111/joim.20043","DOIUrl":"https://doi.org/10.1111/joim.20043","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.0,"publicationDate":"2024-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}