European Journal of Internal Medicine最新文献

Comparative safety and efficacy analysis of GLP-1 receptor agonists and SGLT-2 inhibitors among frail individuals with type 2 diabetes in the era of continuous population ageing. 在人口持续老龄化的时代，GLP-1 受体激动剂和 SGLT-2 抑制剂在体弱的 2 型糖尿病患者中的安全性和疗效比较分析。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-02 DOI: 10.1016/j.ejim.2024.09.020

Paschalis Karakasis, Dimitrios Patoulias, Ieva Ruža, Alberto Maria Marra, Ricardo Gómez-Huelgas

引用次数: 0

Targets for deprescribing in patients with hypertension and reflex syncope. 高血压和反射性晕厥患者取消处方的目标。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 Epub Date: 2024-05-24 DOI: 10.1016/j.ejim.2024.05.014

Antonella Groppelli, Giulia Rivasi, Artur Fedorowski, Frederik de Lange, Vincenzo Russo, Roberto Maggi, Marco Capacci, Sara Nawaz, Angelo Comune, Andrea Ungar, Gianfranco Parati, Michele Brignole

{"title":"Targets for deprescribing in patients with hypertension and reflex syncope.","authors":"Antonella Groppelli, Giulia Rivasi, Artur Fedorowski, Frederik de Lange, Vincenzo Russo, Roberto Maggi, Marco Capacci, Sara Nawaz, Angelo Comune, Andrea Ungar, Gianfranco Parati, Michele Brignole","doi":"10.1016/j.ejim.2024.05.014","DOIUrl":"10.1016/j.ejim.2024.05.014","url":null,"abstract":"Background: We aimed to identify the target of deprescribing, i.e. the 24-hour SBP increase needed to achieve the greatest reduction of SBP drops.Method: Forty hypertensive patients (mean age 73.6 ± 9.3 years, 26 females) with reflex syncope and SBP drops on a screening ABPM were advised to withdraw or to reduce their therapy. The study objective was the reduction of SBP drops <90 mmHg and <100 mmHg on a second ABPM performed within 3 months.Results: Out of a total of 98 drugs taken during ABPM 1, 44 were withdrawn, 16 had a dose reduction and 38 remained unchanged at the time of ABPM 2. 24-hour SBP increased from 119.7 ± 10.1 mmHg to 129.4 ± 13.2 mmHg during ABPM2. Total disappearance of daytime SBP drops <100 mmHg was achieved in 20 (50 %) patients who had 24-hour SBP of 134±13 mmHg and an increase from ABPM 1 of 12 (IQR 5-20) mmHg. Compared with the 20 patients who had persistence of drops, these patients had a greater reduction of the number of hypotensive drugs (67 % versus 19 %, p = 0.002) and a greater rate of withdrawals (62 % versus 29 %, p = 0.003).Conclusion: In hypertensive patients with reflex syncope, an increase of 12 mmHg and an absolute value of 24-hour SBP of 134 mmHg appear to represent the optimal goals aimed to prevent SBP drops. Drugs withdrawal, rather than simply dose reduction, is mostly required to achieve the above target.","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141094329","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

Metabolic health and genetic predisposition in inflammatory bowel disease: Insights from a prospective cohort study. 炎症性肠病的代谢健康和遗传易感性：前瞻性队列研究的启示。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 Epub Date: 2024-07-02 DOI: 10.1016/j.ejim.2024.06.020

Ningning Mi, Qiangsheng He, Yuyao Liu, Yingmei Li, Ying Li, Yingjie Wu, Man Yang, Yingya Zhao, Peng Xie, Wenjing Li, Siqin Wu, Zijun Li, Danni Wang, Xiwen Qin, Jinqiu Yuan, Pingguang Lei, Jian Qi, Bin Xia

{"title":"Metabolic health and genetic predisposition in inflammatory bowel disease: Insights from a prospective cohort study.","authors":"Ningning Mi, Qiangsheng He, Yuyao Liu, Yingmei Li, Ying Li, Yingjie Wu, Man Yang, Yingya Zhao, Peng Xie, Wenjing Li, Siqin Wu, Zijun Li, Danni Wang, Xiwen Qin, Jinqiu Yuan, Pingguang Lei, Jian Qi, Bin Xia","doi":"10.1016/j.ejim.2024.06.020","DOIUrl":"10.1016/j.ejim.2024.06.020","url":null,"abstract":"Background: Metabolic disorders exhibit strong inflammatory underpinnings and vice versa. This study aimed to investigate the association between metabolic health status, genetic predisposition, and the risk of inflammatory bowel disease (IBD), and to explore the potential benefits of maintaining ideal metabolic status for individuals with a predetermined genetic risk of IBD.Method: This population-based prospective study included 385,820 unrelated European descent participants from the UK Biobank. Using multivariable Cox regression, we assessed the relationship of metabolic phenotypes with risk of IBD and its subtypes. We also developed a polygenic risk score to examine how metabolic health status interacted with genetic risk in relation to IBD risk.Results: During the follow-up period of 4,328,895 person-years, 2,044 newly-diagnosed IBD cases were identified. Higher genetic risk and an increasing number of abnormal metabolic phenotypes were associated with elevated IBD risk (p-trend <0.001). Individuals with high genetic risk and poor metabolic health had a significantly higher risk of IBD (HR=4.56, 95 % CI=3.27-6.36) compared to those with low genetic risk and ideal metabolic health. These results remained consistent for IBD subtypes. Maintaining ideal metabolic status reduced IBD risk within each genetic risk category and jointly decreased subsequent risk by 40 % in high genetic risk individuals.Conclusion: Our study reveals a combined impact of poor metabolic health and genetic risk on IBD incidence. Those with low genetic risk and optimal metabolic health exhibit the lowest IBD risk, offering insights into potential management strategies for individuals at predefined genetic risk.","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494113","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

Challenges in using the clock drawing test for prognosis prediction in patients with non-specific complaints. 使用时钟画图测试预测非特异性主诉患者预后的挑战。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 Epub Date: 2024-08-09 DOI: 10.1016/j.ejim.2024.08.006

Hiroshi Ito

引用次数: 0

Navigating the challenges: Would onboarding bootcamps enhance comfort and wellbeing of residents in medicine? 迎接挑战：入职训练营能否提高住院医师的舒适度和幸福感？

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 Epub Date: 2024-05-28 DOI: 10.1016/j.ejim.2024.05.008

Jonathan Assouly, Margaret Hayes, Blaise Debien, Camille Roubille, Boris Jung

引用次数: 0

Unmasking eosinophilic granulomatosis with polyangiitis (EGPA). 揭开嗜酸性粒细胞肉芽肿伴多血管炎（EGPA）的神秘面纱。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 Epub Date: 2024-08-10 DOI: 10.1016/j.ejim.2024.08.009

Luca Moroni, Gabriele Gallina, Lorenzo Dagna

引用次数: 0

Managing and discharging COPD patients hospitalized because of an exacerbation of respiratory symptoms: An opportunity to improve outcomes. 因呼吸道症状加重而住院的慢性阻塞性肺病患者的管理和出院：改善疗效的机会。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 Epub Date: 2024-09-05 DOI: 10.1016/j.ejim.2024.08.024

Alvar Agusti, Bartolome R Celli, Leonardo Fabbri, Claus Vogelmeier

引用次数: 0

Beta-cell function and glucose metabolism in patients with chronic pancreatitis. 慢性胰腺炎患者的β细胞功能和葡萄糖代谢。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 Epub Date: 2024-06-12 DOI: 10.1016/j.ejim.2024.06.007

Gea Ciccarelli, Gianfranco Di Giuseppe, Laura Soldovieri, Giuseppe Quero, Enrico Celestino Nista, Michela Brunetti, Francesca Cinti, Simona Moffa, Umberto Capece, Vincenzo Tondolo, Andrea Mari, Antonio Gasbarrini, Alfredo Pontecorvi, Sergio Alfieri, Andrea Giaccari, Teresa Mezza

{"title":"Beta-cell function and glucose metabolism in patients with chronic pancreatitis.","authors":"Gea Ciccarelli, Gianfranco Di Giuseppe, Laura Soldovieri, Giuseppe Quero, Enrico Celestino Nista, Michela Brunetti, Francesca Cinti, Simona Moffa, Umberto Capece, Vincenzo Tondolo, Andrea Mari, Antonio Gasbarrini, Alfredo Pontecorvi, Sergio Alfieri, Andrea Giaccari, Teresa Mezza","doi":"10.1016/j.ejim.2024.06.007","DOIUrl":"10.1016/j.ejim.2024.06.007","url":null,"abstract":"Aims: Chronic pancreatitis (CP) is - along with acute pancreatitis - the most frequent cause of diabetes of the exocrine pancreas (DEP). Although insulin deficiency is widely accepted as the major feature of DEP, it is still unclear whether diabetes associated with CP is characterized by additional or different functional defects of the insulin secretory machinery. To identify possible functional defects specifically induced by CP, we performed a cross-sectional study in individuals with normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and diabetes mellitus (DM) comparing patients with and without CP (CP vs. NCP).Methods: We administered an oral glucose tolerance test (OGTT) to all participants and, according to their glucose tolerance, classified them as NGT, IGT and DM. Insulin sensitivity and beta-cell functional parameters were derived from OGTT, hyperglycemic clamp and hyperinsulinemic euglycemic clamp.Results: Studying 146 subjects, we found that beta-cell function and insulin secretion were significantly lower in CP compared to NCP patients. However, when we classified the subjects according to OGTT-derived glucose tolerance, we found no differences in beta-cell function or in insulin sensitivity between CP and NCP with the same glucose tolerance status. Of note, we found that arginine-stimulated insulin secretion is reduced only in subjects with CP and DM compared to NCP subjects with DM.Conclusions: Patients with CP had no specific alterations in insulin secretion and beta-cell function. However, in patients diagnosed with diabetes, we found a lower arginine-stimulated insulin secretion, a marker of reduced functional mass.","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318889","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

Exploring Cardiovascular Risk Factors and Atherosclerosis in Rheumatoid Arthritis. 探索类风湿关节炎的心血管风险因素和动脉粥样硬化。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 Epub Date: 2024-07-23 DOI: 10.1016/j.ejim.2024.07.016

Alexandros A Drosos, Aliki A Venetsanopoulou, Eleftherios Pelechas, Paraskevi V Voulgari

{"title":"Exploring Cardiovascular Risk Factors and Atherosclerosis in Rheumatoid Arthritis.","authors":"Alexandros A Drosos, Aliki A Venetsanopoulou, Eleftherios Pelechas, Paraskevi V Voulgari","doi":"10.1016/j.ejim.2024.07.016","DOIUrl":"10.1016/j.ejim.2024.07.016","url":null,"abstract":"Rheumatoid arthritis (RA) is a chronic inflammatory disease mainly affecting the peripheral diarthrodial joints symmetrically and also presenting many extra-articular manifestations. Morbidity and mortality in RA patients are higher compared to the general population. Cardiovascular (CV) disease is one of the most common causes of death in these patients. Classical or traditional risk factors for atherosclerosis development occur more frequently in RA patients compared to those without this condition. Studies have showed that RA patients often present comorbidities such as hypertension, dyslipidemia, diabetes mellitus and obesity. However, the high incidence of CV events occurring in RA patients is not explained by the presence of traditional risk factors. Systemic inflammation, as it is expressed with the presence of proinflammatory cytokines and increased acute phase reactants, may contribute to the development of premature atherosclerosis in these patients. In this review, we explore the risk factors for CV disease, the generation of dyslipidemia, the lipid paradox and the role of systemic inflammation in the atherosclerotic process in RA. We discuss also the role of early therapeutic intervention that suppresses inflammation which may have beneficial effects on CV disease in RA patients.","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141762337","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

Diagnostic challenge of hemoptysis in a hemodialysis patient. 血液透析患者咯血的诊断难题。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 Epub Date: 2024-07-23 DOI: 10.1016/j.ejim.2024.07.022

Fullana Martin, Aliaga Leandro, Verni Giuliana

引用次数: 0