European Journal of Internal Medicine最新文献

Early vasopressin administration in septic shock: A systematic review, meta-analysis, and multicenter retrospective observational study. 脓毒性休克的早期抗利尿激素治疗：一项系统回顾、荟萃分析和多中心回顾性观察研究。

IF 6.1 2区医学

European Journal of Internal Medicine Pub Date : 2026-05-08 DOI: 10.1016/j.ejim.2026.106933

Chiwon Ahn, Gun Tak Lee, Jae Hwan Kim, Sejoong Ahn, Sung Yeon Hwang, Sang-Min Kim, Won Young Kim, Sung-Joon Park, Sung-Hyuk Choi, Woon Yong Kwon, Taeyoung Kong, Sung Phil Chung, Byuk Sung Ko, Kyung Hun Yoo, Tae Ho Lim, Tae Gun Shin, Kyuseok Kim

{"title":"Early vasopressin administration in septic shock: A systematic review, meta-analysis, and multicenter retrospective observational study.","authors":"Chiwon Ahn, Gun Tak Lee, Jae Hwan Kim, Sejoong Ahn, Sung Yeon Hwang, Sang-Min Kim, Won Young Kim, Sung-Joon Park, Sung-Hyuk Choi, Woon Yong Kwon, Taeyoung Kong, Sung Phil Chung, Byuk Sung Ko, Kyung Hun Yoo, Tae Ho Lim, Tae Gun Shin, Kyuseok Kim","doi":"10.1016/j.ejim.2026.106933","DOIUrl":"https://doi.org/10.1016/j.ejim.2026.106933","url":null,"abstract":"Objective: To determine the optimal timing for initiating vasopressin in septic shock.Methods: First, we performed a retrospective analysis of a multicenter registry of adults with septic shock to evaluate associations between vasopressin initiation timing-defined by norepinephrine (NE) dose at initiation or time from first vasopressor use-and clinical outcomes. Second, we conducted a systematic review and meta-analysis integrating these registry data with randomized controlled trials (RCTs) and observational studies comparing early versus non-early vasopressin initiation. The primary outcome was mortality.Results: The registry analysis included 2001 patients. Initiation of vasopressin at an NE dose ≥0.5 μg/kg/min (adjusted odds ratio [aOR] 2.15, 95% CI 1.59-2.92) and delays of 6-24 hours after initial vasopressor use (aOR 1.59, 95% CI 1.21-2.11) were associated with higher 28-day mortality compared with initiation at NE doses <0.25 μg/kg/min and within 2 hours, respectively. The meta-analysis included 15 studies (5 RCTs and 10 observational studies). In RCTs, early vasopressin initiation was not associated with reduced mortality (OR 0.84, 95% CI 0.66-1.07) but was associated with a lower requirement for renal replacement therapy (OR 0.46, 95% CI 0.26-0.81). In observational studies, early initiation was associated with lower mortality (OR 0.71, 95% CI 0.60-0.84) and shorter ICU LOS (mean difference -1.06 days, 95% CI -1.94 to -0.18).Conclusion: Earlier vasopressin initiation may offer clinical benefits in septic shock. However, as evidence is primarily observational and findings vary by study design, further high-quality randomized studies are warranted.","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":"106933"},"PeriodicalIF":6.1,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857689","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}

引用次数: 0

Social determinants of health in the era of precision medicine. 精准医疗时代健康的社会决定因素。

IF 6.1 2区医学

European Journal of Internal Medicine Pub Date : 2026-05-06 DOI: 10.1016/j.ejim.2026.106926

Ludovico Furlan, Giorgio Costantino

引用次数: 0

Corrigendum to "Role of 12-lead Electrocardiogram for identifying very low mortality risk patients with non-hypotensive acute pulmonary embolism" [European Journal of Internal Medicine 140 (2025) 106373]. “12导联心电图在鉴别死亡率极低的非低血压急性肺栓塞患者中的作用”的勘误表[欧洲内科学杂志140(2025)106373]。

IF 6.1 2区医学

European Journal of Internal Medicine Pub Date : 2026-05-05 DOI: 10.1016/j.ejim.2026.106895

Crhistian-Mario Oblitas, Francisco Galeano-Valle, Luis-Antonio Alvarez-Sala Walther, Pablo Demelo-Rodríguez

引用次数: 0

Scurvy in a hemodialysis patient after prolonged hospitalization. 血液透析患者长期住院后的坏血病。

IF 6.1 2区医学

European Journal of Internal Medicine Pub Date : 2026-05-05 DOI: 10.1016/j.ejim.2026.106928

Naohiro Muraki, Naoto Hamano, Michiya Shinozaki

引用次数: 0

Relationship between T90 and systemic hypertension in patients with obstructive sleep apnea: Data from the European sleep apnea database. 阻塞性睡眠呼吸暂停患者T90与全身性高血压的关系：来自欧洲睡眠呼吸暂停数据库的数据

IF 6.1 2区医学

European Journal of Internal Medicine Pub Date : 2026-05-04 DOI: 10.1016/j.ejim.2026.106906

M S Tasbakan, S Svedmyr, J Bergqvist, H Hein, S Mihaicuta, Z Dogas, G Trakada, F Fanfulla, P Joppa, D Testelmans, O Ludka, M Drummond, S Matthes, H Gouveris, R Staats, O K Basoglu

{"title":"Relationship between T90 and systemic hypertension in patients with obstructive sleep apnea: Data from the European sleep apnea database.","authors":"M S Tasbakan, S Svedmyr, J Bergqvist, H Hein, S Mihaicuta, Z Dogas, G Trakada, F Fanfulla, P Joppa, D Testelmans, O Ludka, M Drummond, S Matthes, H Gouveris, R Staats, O K Basoglu","doi":"10.1016/j.ejim.2026.106906","DOIUrl":"https://doi.org/10.1016/j.ejim.2026.106906","url":null,"abstract":"Background: Hypertension (HTN) is one of the most prevalent cardiovascular comorbidities in patients with obstructive sleep apnoea (OSA). Although OSA severity measured by the apnoea-hypopnoea index (AHI) is a known risk factor, the role of hypoxic load in HTN remains less well established.Methods: We analysed data from 12,141 patients with OSA enrolled in the European Sleep Apnea Database (ESADA). Clinical and sleep study parameters were assessed to identify factors associated with HTN.Results: The cohort included 2650 patients with mild OSA, 3339 with moderate OSA, and 6152 with severe OSA. The mean age was 53.1 ± 12.5 years, the mean body mass index (BMI) 31.7 ± 6.2 kg/m², and 73.1% were male. HTN was present in 41.8% of the patients. In univariate analyses, older age, female sex, obesity, larger neck circumference, greater OSA severity as measured by AHI or oxygen desaturation index (ODI), minimum oxygen saturation (SpO₂), and increased hypoxic load (T90% ≥ 5%) were significantly associated with HTN. After adjustment for age, sex and BMI, increased neck circumference, higher AHI and T90% ≥ 5% remained independently associated with HTN. Notably, HTN prevalence was higher in mild-to-moderate OSA patients with T90% ≥ 5 than in severe OSA patients with T90% < 5 (51.5% vs. 42.8%, p < 0.001). Following propensity score matching, only minimum SpO₂ (p = 0.022) and T90% ≥ 5% (p = 0.044) remained significantly associated with HTN.Conclusions: Hypoxic load as reflected by T90% and minimum SpO2, rather than AHI alone, is independently associated with hypertension in patients with OSA, underscoring the importance of oxygenation metrics in cardiovascular risk assessment.","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":"106906"},"PeriodicalIF":6.1,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845673","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}

引用次数: 0

Should Ticagrelor in association with aspirin be still considered the standard dual antiplatelet treament for acute coronary syndromes ? 替格瑞洛联合阿司匹林是否仍应被视为急性冠状动脉综合征的标准双重抗血小板治疗？

IF 6.1 2区医学

European Journal of Internal Medicine Pub Date : 2026-05-04 DOI: 10.1016/j.ejim.2026.106918

Stefano De Servi, Claudio Montalto, Stefano Savonitto

引用次数: 0

Cardiac amyloidosis trends: Methodological limitations in estimating incidence and mortality from inpatient data alone. 心脏淀粉样变趋势：仅从住院患者数据估计发病率和死亡率的方法学局限性。

IF 6.1 2区医学

European Journal of Internal Medicine Pub Date : 2026-05-04 DOI: 10.1016/j.ejim.2026.106887

Gang Zhang, Tong Ye, Yan Cai

引用次数: 0

The central dot sign in liver. 肝脏中心点征。

IF 6.1 2区医学

European Journal of Internal Medicine Pub Date : 2026-05-04 DOI: 10.1016/j.ejim.2026.106930

Qingren Cao, Qing Xie, Zhujun Cao

引用次数: 0

Timing of brain biopsy in cryptogenic neurological diseases: beyond diagnostic yield. 隐源性神经系统疾病的脑活检时机：超出诊断结果。

IF 6.1 2区医学

European Journal of Internal Medicine Pub Date : 2026-05-04 DOI: 10.1016/j.ejim.2026.106934

Xin Wang, Sulong Zheng, Chao Sun

引用次数: 0

Dialysis, but not severe renal dysfunction, is associated with excess bleeding in venous thromboembolism: Insights from a nationwide registry. 透析，而不是严重的肾功能不全，与静脉血栓栓塞的过量出血有关：来自全国登记的见解。

IF 6.1 2区医学

European Journal of Internal Medicine Pub Date : 2026-05-02 DOI: 10.1016/j.ejim.2026.106927

Takahiro Kuno, Norimichi Koitabashi, Yugo Yamashita, Takeshi Morimoto, Hideki Ishii

引用次数: 0