Journal of Internal Medicine最新文献

{"title":"Authors' reply: Poor long-term cardiovascular risk factor management after acute coronary syndrome: An observational cohort study.","authors":"Jessica Schubert, Maria Svensson K, Margret Leosdottir, Bertil Lindahl, Håkan Melhus, Elin Täufer, Nina Johnston, Thomas Cars, Emil Hagström","doi":"10.1111/joim.70106","DOIUrl":"10.1111/joim.70106","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2026-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147808993","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: Poor long-term cardiovascular risk factor management after acute coronary syndrome: An observational cohort study.","authors":"Laurent Fauchier, Thibaud Genet, Mickael Guglieri","doi":"10.1111/joim.70105","DOIUrl":"https://doi.org/10.1111/joim.70105","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758448","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":"Association of baseline screening results and management with subsequent adherence in the Korean national lung cancer screening program.","authors":"Hyungjin Kim, Eunseo Jo, Jinseob Kim, Soonho Yoon, Florian J Fintelmann, Gerard A Silvestri, Jin Mo Goo","doi":"10.1111/joim.70103","DOIUrl":"https://doi.org/10.1111/joim.70103","url":null,"abstract":"<p><strong>Background: </strong>Adherence to subsequent lung cancer screening (LCS) is essential but not well characterized in biennial national programs.</p><p><strong>Objectives: </strong>To assess whether baseline LCS results and their management are associated with subsequent screening adherence and clinical outcomes.</p><p><strong>Methods: </strong>We analyzed participants in the Korean national LCS program who underwent baseline low-dose computed tomography (CT) between 2019 and 2021 and remained lung cancer-free for 2 years. Baseline results were classified as true negative or false positive (FP); FPs were grouped by management (invasive diagnostic procedures, chest CT surveillance, or no further evaluation). Adherence to the next biennial screening was modeled using multivariable logistic regression. Lung cancer incidence and all-cause mortality were assessed using Cox models with a 2-year landmark design.</p><p><strong>Results: </strong>Among 235,753 participants, 54.4% returned for subsequent screening. Compared with true-negative results, adherence was lower among those with FP results who underwent invasive procedures (adjusted odds ratio [aOR], 0.64; 95% confidence interval [CI], 0.56-0.72) or CT surveillance (aOR, 0.77; 95% CI, 0.74-0.80) but was similar among those with FP results without further evaluation (aOR, 1.00; 95% CI, 0.95-1.04). In the landmark analysis, FPs were associated with higher risks of lung cancer incidence (adjusted hazard ratios [aHRs], 2.95-2.49 across management groups) and higher all-cause mortality among those who underwent invasive procedures (aHR, 1.57; 95% CI, 1.10-2.24) or CT surveillance (aHR, 1.23; 95% CI, 1.07-1.41).</p><p><strong>Conclusion: </strong>Downstream management after baseline FP findings, rather than FP status alone, was associated with subsequent LCS adherence, highlighting the need to support return screening in higher risk FP groups.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758441","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":"Acute clinical events and trajectories of frailty after age 60: A population-based cohort study.","authors":"Clare Tazzeo, Caterina Gregorio, Debora Rizzuto, Laura Fratiglioni, Francesco Innocenti, Jonas Bjurgert, Stefania Maggi, Anna-Karin Welmer, Alberto Zucchelli, Amaia Calderón-Larrañaga, Davide L Vetrano","doi":"10.1111/joim.70102","DOIUrl":"https://doi.org/10.1111/joim.70102","url":null,"abstract":"<p><strong>Background: </strong>We aimed to examine the relationship between acute events and frailty trajectories of community-dwelling adults aged 60 and older.</p><p><strong>Methods: </strong>We included 3146 participants, aged 60+, from the Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). We considered all myocardial infarctions (MIs), lower respiratory tract infections (LRTIs) and falls that resulted in a hospitalization 5 years before to 12 years after SNAC-K baseline (2001-2004). Frailty was operationalized using a data-driven frailty index (FI), scored from 0 to 1. Linear quantile mixed models were used to examine the relationship between number and type of acute events and FI trajectories over a median follow-up of 11 years.</p><p><strong>Results: </strong>Falls (n = 690) were most common, followed by LRTIs (n = 353) and MIs (n = 205). Those with more acute events showed significantly higher frailty levels over time from age 75 to 95. The greatest differences in frailty trajectories by event count were observed at age 80, with increases between zero to one, one to two and two to three or more events of 0.04 (95% confidence interval [CI] = 0.03-0.05), 0.08 (95% CI = 0.05-0.11) and 0.09 (95% CI = 0.05-0.13) FI units, respectively. Falls emerged as most deleterious, but there were also clear differences by MI and LRTI count after imputing frailty at death.</p><p><strong>Conclusion: </strong>Older adults who experience falls, LRTIs and MIs are more likely to sustain unfavourable frailty trajectories, with increasingly higher frailty levels with each additional acute event. Prevention, before age 75, should be optimized to avoid a vicious cycle of acute events and frailty progression as well as reduced lifespan.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758361","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":"Trends in celiac disease autoimmunity before and after the COVID-19 pandemic.","authors":"James A King, Stephanie Coward, Jenny Godley, Amy Metcalfe, Paul E Ronksley, Tyler Williamson, Gilaad G Kaplan","doi":"10.1111/joim.70101","DOIUrl":"https://doi.org/10.1111/joim.70101","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147758438","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":"Contrast-enhanced CT-Nephrotoxic or not? A critical review of propensity-score-adjusted studies.","authors":"Ulf Nyman, Jonas Björk, Mikael Hellström, Peter Leander, Per Liss, Gunnar Sterner, Torkel B Brismar","doi":"10.1111/joim.70095","DOIUrl":"https://doi.org/10.1111/joim.70095","url":null,"abstract":"<p><p>Retrospective, propensity-score-adjusted (PSA) studies have indicated to practitioners in the field that contrast-induced acute kidney injury (AKI) after contrast-enhanced CT (CECT) is of minor importance or even non-existent. This has led to controversies between clinicians demanding CECT not to miss any diagnoses and radiologists reluctant or even refusing CECT in risky patients. A critical review of AKI/dialysis risk post-CECT in PSA studies was performed based on a Cochrane Library/Embase/PubMed search up to December 2024 with stratification for various populations. Among unselected emergency-/inpatients with chronic kidney disease, CECT was associated with significantly higher AKI incidence than in controls in 8/10 cohorts (weighted absolute risk increase 4.0 percentage points (pp), cohort range -4 to 16.9 pp at glomerular filtration rate (GFR) <30 mL/min/1.73 m²) and dialysis in 5/6 cohorts (weighted absolute risk increase 1.8 pp, cohort range 1.0-5.9 pp at GFR <30 mL/min/1.73 m²). Corresponding figures regarding cohorts with presumed/potentially unstable renal function were 1/10 and 3/8 cohorts, respectively. No increased risk was found in the five miscellaneous cohorts, but with a few patients with low GFR. Associations between individual contrast medium (CM) doses and AKI/dialysis were generally lacking. Marked selection bias was evident in one cohort. Thus, the analyses support an association between CECT and AKI in emergency-/inpatients, including a non-negligible dialysis risk, especially at GFR <30 mL/min/1.73 m². PSA studies reporting no increased risk of CECT must be interpreted with caution due to risk for selection bias and the potential masking effects of acute kidney functional recovery. Studies on CM dose or gram-iodine/GFR ratio correlation with AKI/dialysis are warranted.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":9.2,"publicationDate":"2026-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721195","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":"Epigenetic analyses suggest different pathways during pregnancy for development of type 1 diabetes in children with high versus low-neutral human leukocyte antigen-risk","authors":"Shamila D. Alipoor,&nbsp;Angelica Ahrens,&nbsp;Julia Åkesson,&nbsp;Thomas Hillerton,&nbsp;Mika Gustafsson,&nbsp;Maria Lerm,&nbsp;Johnny Ludvigsson","doi":"10.1111/joim.70077","DOIUrl":"10.1111/joim.70077","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and objective</h3>\u0000 \u0000 <p>The development of Type 1 diabetes (T1D) is shaped by genetic predisposition and epigenetic regulation. Human leukocyte antigen (HLA) risk alleles are major genetic determinants, but the epigenetic landscape in relation to disease onset remains unclear. Early-life epigenetic modifications may reveal how environmental and epigenetic factors interact in T1D pathogenesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We investigated epigenetic differences in cord blood DNA from individuals with different HLA risk alleles who later developed T1D using epigenome-wide association studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>High-risk HLA carriers showed differentially methylated genes (DMGs) mainly involved in immune and autoimmune processes, resembling patterns in other autoimmune diseases. In contrast, low-to-neutral risk carriers exhibited DMGs linked to signaling cascades, metabolic pathways, and Type 2 diabetes–related mechanisms such as beta cell function and insulin signaling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings indicate that heterogeneity in T1D pathogenetic mechanisms based on HLA background may influence disease development.</p>\u0000 </section>\u0000 </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"299 5","pages":"570-586"},"PeriodicalIF":9.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061103/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147281553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Colorectal cancer screening and incidence and mortality of colorectal and other cancers in the United Kingdom","authors":"Marko Mandic,&nbsp;Fatemeh Safizadeh,&nbsp;Michael Hoffmeister,&nbsp;Hermann Brenner","doi":"10.1111/joim.70075","DOIUrl":"10.1111/joim.70075","url":null,"abstract":"&lt;p&gt;Dear Editor,&lt;/p&gt;&lt;p&gt;Randomized controlled trials (RCTs) have demonstrated that colorectal cancer (CRC) screening, including screening by fecal occult blood tests (FOBTs), reduces CRC incidence and mortality under trial conditions. A 2019 meta-analysis of RCTs found that screening by annual guaiac-based FOBTs (gFOBTs) was associated with a 31% decrease in CRC mortality (95% CI: −44% to −20%), and a nonsignificant 14% reduction in CRC incidence (95% CI: −28% to +3%) [&lt;span&gt;1&lt;/span&gt;]. Although RCTs are crucial for establishing the efficacy of screening offers under trial conditions, additional evidence is needed to evaluate the effectiveness of screening under real-life conditions. Large-scale observational epidemiological studies comparing cancer incidence and mortality between screening users and nonusers under real-life conditions may serve that purpose. However, such studies may be subject to residual confounding factors associated with screening behavior, even if every effort is made to adjust for potential confounders. One way of addressing these concerns is to examine whether the associations with CRC screening are specific to CRC incidence and mortality [&lt;span&gt;2&lt;/span&gt;]. If similar associations appear for other cancers that share similar confounding factors but would not plausibly benefit from CRC screening, this would suggest residual confounding.&lt;/p&gt;&lt;p&gt;Therefore, we aimed to assess the associations between CRC screening and CRC incidence and mortality and to compare these associations with the associations with incidence and mortality of other cancers in a very large cohort from the United Kingdom, where organized gFOBT screening began in 2006, initially limited to individuals aged 60–69 years [&lt;span&gt;3&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;We analyzed data from 342,164 individuals aged 50–69 years recruited to the UK Biobank [&lt;span&gt;4&lt;/span&gt;] between 2006 and 2010. Details of the study population selection, baseline characteristics, and statistical analysis are provided in the Supplement. CRC screening was defined as (self-reported) ever use of CRC screening, which at the time of recruitment primarily consisted of gFOBTs in the United Kingdom. Associations with CRC incidence and mortality and with anatomic subsites were ascertained using multivariable Cox models and compared with those for other cancers. During a median follow-up of 11.7 years, 5391 participants were diagnosed with CRC, 39,503 with other cancers, and 1465 died from CRC and 13,465 from other cancers (Supporting Information).&lt;/p&gt;&lt;p&gt;CRC screening was associated with a 14% (95% CI: 10%–18%) lower CRC incidence and a 26% (95% CI: 18%–34%) lower CRC mortality (Fig. 1). No associations were observed for other cancers. Particularly strong associations were seen with distal colon cancer incidence and mortality, with 30% (95% CI: 22%–37%) and 44% (95% CI: 27%–58%) lower risk among screening users, respectively. However, no significant associations were found for proximal colon cancer. These subsite-speci","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"299 5","pages":"639-642"},"PeriodicalIF":9.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146224674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Who can safely discontinue lifelong follow-up among patients with sporadic pheochromocytoma and paraganglioma?","authors":"Min Jeong Park,&nbsp;Seung Shin Park,&nbsp;Won Woong Kim,&nbsp;Su-Jin Kim,&nbsp;Yu-Mi Lee,&nbsp;Kyu Eun Lee,&nbsp;Tae-Yon Sung,&nbsp;Jae-Kyung Won,&nbsp;Dong Eun Song,&nbsp;Jung-Min Koh,&nbsp;Sara Talvacchio,&nbsp;Tamara Prodanov,&nbsp;Hussam Alkaissi,&nbsp;Karel Pacak,&nbsp;Seung Hun Lee,&nbsp;Jung Hee Kim","doi":"10.1111/joim.70080","DOIUrl":"10.1111/joim.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Current guidelines recommend at least 10 years of follow-up for all pheochromocytoma and paraganglioma (PPGL) patients and lifelong monitoring for high-risk individuals. Nonetheless, data identifying patients who may not require routine lifelong follow-up are scarce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Among 999 patients with PPGL, 703 who were non-metastatic, non-hereditary, and had undergone complete resection were included. Variables that significantly differed between the recurrence (<i>n</i> = 50) and non-recurrence groups over 10 years (<i>n</i> = 83) were identified, and cutoff values were determined using receiver-operating characteristic curve analysis. These very low-risk criteria were validated in an internal cohort and an external dataset from the National Institutes of Health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The non-recurrence group was older and had smaller pheochromocytomas (PCCs) than the recurrence group, with cutoffs of 37 years and 5.7 cm, respectively. The non-recurrence group had a higher percentage of patients with pheochromocytoma of the adrenal gland scaled score (PASS) &lt;4 or grading system for adrenal pheochromocytoma and paraganglioma (GAPP) score &lt;3 (<i>p </i>= 0.027). Age &gt;40 years (hazard ratio [HR] [95% confidence intervals] of 0.36 [0.17–0.76]), PCC size &lt;6 cm (HR = 0.43 [0.19–0.98]), and PASS &lt;4 or GAPP score &lt;3 (HR = 0.37 [0.16–0.89]) were associated with lower recurrence risk. None of the patients meeting all these criteria in the internal (<i>n</i> = 114) and external (<i>n</i> = 13) validation sets experienced recurrence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study suggests that routine lifelong follow-up may be unnecessary for patients with sporadic PCC aged &gt;40 years, size &lt;6 cm, and PASS &lt;4 or GAPP score &lt;3.</p>\u0000 </section>\u0000 </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"299 5","pages":"615-627"},"PeriodicalIF":9.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13061095/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147353118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative immune checkpoint inhibitor therapy across tumors: Insights and shared lessons from a rapidly evolving field","authors":"Karl Björkström,&nbsp;Alexios Matikas,&nbsp;Fernanda Costa Svedman,&nbsp;Einar Björgvinsson,&nbsp;Mark Zupancic,&nbsp;Lisa Villabona,&nbsp;Hanna Eriksson,&nbsp;Marcus Skribek,&nbsp;Josefin Fernebro,&nbsp;Magnus Lindskog,&nbsp;Jan-Erik Frödin,&nbsp;Anders Ullén,&nbsp;Simon Ekman,&nbsp;Hildur Helgadottir","doi":"10.1111/joim.70073","DOIUrl":"10.1111/joim.70073","url":null,"abstract":"<p>The integration of immune checkpoint inhibitors into perioperative management marks a major evolution in curative-intent oncology. This review examines the current evidence for perioperative immunotherapy encompassing neoadjuvant, adjuvant, and combined strategies in melanoma and non-melanoma skin cancers, non-small cell lung cancer (NSCLC), triple-negative breast cancer (TNBC), esophageal and gastroesophageal junction cancer, renal cell carcinoma, urothelial carcinoma, head and neck squamous cell carcinoma, colorectal cancer, gynecological malignancies, and hepatocellular carcinoma. Neoadjuvant immunotherapy demonstrates biological advantages by exposing the immune system to intact tumor antigens, consistently improving event-free survival and pathological response rates across tumor types. Notable successes include CheckMate 816 in NSCLC, KEYNOTE-522 in TNBC, and emerging trials in melanoma that show superior outcomes compared to adjuvant-only approaches. Pathological complete response and major pathological response have emerged as robust surrogate endpoints correlating with long-term survival. In contrast, adjuvant immunotherapy shows more variable results, with demonstrated recurrence-free survival benefits but inconsistent overall survival (OS) advantages—particularly concerning given the risk of overtreatment in patients potentially cured by surgery alone. Critical challenges include the absence of predictive biomarkers in most cancer types, immune-related adverse events occurring in up to 30% of patients, substantial healthcare costs, and insufficient OS follow-up duration in many approved indications. Future priorities include biomarker development, adaptive trial designs incorporating response-guided therapy, and long-term toxicity assessment. Although perioperative immunotherapy is reshaping curative-intent cancer treatment, optimal patient selection, treatment sequencing, and safety optimization remain essential for widespread implementation.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":"299 5","pages":"538-569"},"PeriodicalIF":9.2,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.70073","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}