European Journal of Internal Medicine最新文献_第10页

Predictive performance of HAS-BLED, ORBIT, ABC, and DOAC scores for major bleeding in atrial fibrillation patients on DOACs HAS-BLED、ORBIT、ABC 和 DOAC 评分对服用 DOAC 的心房颤动患者大出血的预测性能。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.ejim.2024.06.027

引用次数: 0

Long-term inhaled corticosteroid treatment in patients with chronic obstructive pulmonary disease, cardiovascular disease, and a recent hospitalised exacerbation: The ICSLIFE pragmatic, randomised controlled study 慢性阻塞性肺病、心血管疾病和近期住院加重期患者的长期吸入皮质类固醇治疗：ICSLIFE 实用随机对照研究。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.ejim.2024.07.001

{"title":"Long-term inhaled corticosteroid treatment in patients with chronic obstructive pulmonary disease, cardiovascular disease, and a recent hospitalised exacerbation: The ICSLIFE pragmatic, randomised controlled study","authors":"","doi":"10.1016/j.ejim.2024.07.001","DOIUrl":"10.1016/j.ejim.2024.07.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with chronic obstructive pulmonary disease (COPD) frequently have cardiovascular comorbidities, increasing the risk of hospitalised COPD exacerbations (H-ECOPDs) or death. This pragmatic study examined the effects of adding an inhaled corticosteroid (ICS) to long-acting bronchodilator(s) (LABDs) in patients with COPD and cardiac comorbidities who had a recent H-ECOPD.</div></div><div><h3>Methods</h3><div>Patients >60 years of age with COPD and ≥1 cardiac comorbidity, within 6 months after discharge following an H-ECOPD, were randomised to receive LABD(s) with or without ICS, and were followed for 1 year. The primary outcome was the time to first rehospitalisation and/or all-cause death.</div></div><div><h3>Results</h3><div>The planned number of patients was not recruited (803/1032), limiting the strength of the conclusions. In the intention-to-treat population, 89/403 patients (22.1 %) were rehospitalised or died in the LABD group (probability 0.257 [95 % confidence interval 0.206, 0.318]), vs 85/400 (21.3 %) in the LABD+ICS group (0.249 [0.198, 0.310]), with no difference between groups in time-to-event (hazard ratio 1.116 [0.827, 1.504]; <em>p</em><span> = 0.473). All-cause and cardiovascular mortality were lower in patients receiving LABD(s)+ICS, with relative reductions of 19.7 % and 27.4 %, respectively (9.8 % vs 12.2 % and 4.5 % vs 6.2 %), although the groups were not formally statistically compared for these endpoints. Fewer patients had adverse events in the LABD+ICS group (43.0 % vs 50.4 %; </span><em>p</em> = 0.013), with 4.9 % vs 5.4 % reporting pneumonia adverse events.</div></div><div><h3>Conclusions</h3><div>Results suggest addition of ICS to LABDs did not reduce the time-to-combined rehospitalisation/death, although it decreased all-cause and cardiovascular mortality. ICS use was not associated with an increased risk of adverse events, particularly pneumonia.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"128 ","pages":"Pages 104-111"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141565023","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

Man with progressed cognitive impairment 患有认知障碍的男子。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.ejim.2024.07.021

Jia-Qi Chen, Wei-Nv Fan

引用次数: 0

Oropouche virus infection: What internal medicine physicians should know 奥罗普切病毒感染：内科医生须知。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.ejim.2024.08.004

Lorenzo Bertolino, Fabian Patauner, Emanuele Durante-Mangoni

引用次数: 0

Antimicrobial therapy and patient management for severe Legionnaires’ pneumonia 重症军团菌肺炎的抗菌治疗和患者管理。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.ejim.2024.08.002

Jordi Rello , Joan Sabater-Riera

引用次数: 0

It is time to get all the job done: For patients’ sake 是时候完成所有工作了：为了病人。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.ejim.2024.07.033

Angelo Avogaro

引用次数: 0

Survival analysis of diabetes cardiovascular outcome trials using reconstructed Kaplan-Meier curves 利用重构的 Kaplan-Meier 曲线对糖尿病心血管结果试验进行生存分析。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.ejim.2024.05.026

引用次数: 0

Relationship between degree of risk factor control and all-cause mortality in individuals with type 2 diabetes: A prospective cohort study 2 型糖尿病患者风险因素控制程度与全因死亡率之间的关系：前瞻性队列研究。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.ejim.2024.05.034

{"title":"Relationship between degree of risk factor control and all-cause mortality in individuals with type 2 diabetes: A prospective cohort study","authors":"","doi":"10.1016/j.ejim.2024.05.034","DOIUrl":"10.1016/j.ejim.2024.05.034","url":null,"abstract":"<div><h3>Aims</h3><div>To assess whether and to what extent excess risk of all-cause death is reduced in individuals with type 2 diabetes by achieving optimal control of traditional cardiovascular risk factors.</div></div><div><h3>Methods</h3><div>This observational, prospective, cohort study enrolled 15,773 Caucasian patients in 19 Italian centres in 2006–2008. Participants were stratified according to the number of the following risk factors outside target: haemoglobin A<sub>1c</sub>, blood pressure, micro/macroalbuminuria, current smoking, LDL cholesterol, and triglycerides. All-cause mortality was retrieved for 15,656 patients (99.3 %) on 31 October 2015.</div></div><div><h3>Results</h3><div>Age-adjusted mortality rates and hazard ratios were significantly higher in the whole RIACE cohort (by ∼20 %) and in patients with (by ∼100 %) but not in those without prior cardiovascular disease (CVD), as compared with the coeval Italian general population. In all patients and in those without prior CVD, the relationship with mortality according to the number of risk factors outside target was J-shaped, an effect that was attenuated after either excluding “overtreated “ patients, i.e., those with haemoglobin A<sub>1c</sub> ≤6.0 % on anti-hyperglycaemic agents causing hypoglycaemia and/or systolic blood pressure ≤120 mmHg on anti-hypertensive agents, or adjusting for “overtreatment”. Conversely, in patients with prior CVD, mortality remained higher than in the general population in all categories and increased progressively from +70 % to +314 %, without J-effect.</div></div><div><h3>Conclusions</h3><div>In patients with type 2 diabetes, optimal treatment of traditional cardiovascular risk factors completely eliminated the excess mortality risk versus the general population, provided that they were not “overtreated”. However, this effect was observed only in participants without history of CVD.</div></div><div><h3>Trial registration</h3><div>ClinicalTrials.gov, NCT00715481, retrospectively registered 15 July 2008.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"128 ","pages":"Pages 53-62"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285239","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}

引用次数: 0

Performance of HAS-BLED and DOAC scores to predict major bleeding events in atrial fibrillation patients treated with direct oral anticoagulants: A report from a prospective European observational registry 用 HAS-BLED 和 DOAC 评分预测接受直接口服抗凝剂治疗的心房颤动患者的大出血事件：欧洲前瞻性观察登记报告。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.ejim.2024.06.022

{"title":"Performance of HAS-BLED and DOAC scores to predict major bleeding events in atrial fibrillation patients treated with direct oral anticoagulants: A report from a prospective European observational registry","authors":"","doi":"10.1016/j.ejim.2024.06.022","DOIUrl":"10.1016/j.ejim.2024.06.022","url":null,"abstract":"<div><h3>Background</h3><div>The DOAC score has been recently proposed for bleeding risk stratification of patients with atrial fibrillation treated with direct oral anticoagulants (DOAC).</div></div><div><h3>Objective</h3><div>To compare the performance of HAS-BLED and DOAC score in predicting major bleeding events in a contemporary cohort of European AF patients treated with DOAC.</div></div><div><h3>Methods</h3><div>We included patients derived from a prospective observational registry of European AF patients. HAS-BLED and DOAC scores were calculated as per the original schemes. Our primary endpoint was major bleeding events. Receiver operating characteristic (ROC) curves were used to compare the predictive ability of the scores.</div></div><div><h3>Results</h3><div>A total of 2834 AF patients (median age [IQR] 69 [62–77] years; 39.6 % female) treated with DOAC were included in the analysis. According to the HAS-BLED score, 577 patients (20.4 %) were categorized as very low risk of bleeding, as compared to 1276 (45.0 %) according to DOAC score. A total of 55 major bleeding events occurred with an overall incidence of 1.04 per 100 patient-years. Both scores showed only a modest ability for the prediction of bleeding events (HAS-BLED area under the curve [AUC], 0.65, 95 % confidence interval [CI] 0.55–0.70; DOAC score AUC 0.62, 95 % CI 0.59–0.71, p for difference = 0.332]. At calibration analysis, the DOAC score showed modest calibration, especially for patients at high risk, when compared to HAS-BLED.</div></div><div><h3>Conclusion</h3><div>In a contemporary cohort of DOAC-treated AF patients, both HAS-BLED and DOAC scores only modestly predicted the occurrence of major bleeding events. Our results do not support the preferential use of DOAC score over HAS-BLED.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"128 ","pages":"Pages 63-70"},"PeriodicalIF":5.9,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141538859","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}

引用次数: 0

Quinolones or macrolides for adults with Legionnaires’ disease and respiratory failure? 喹诺酮类药物还是大环内酯类药物治疗患有军团菌病和呼吸衰竭的成人？

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-01 DOI: 10.1016/j.ejim.2024.07.026

Lorna Pairman , Stephen T. Chambers

引用次数: 0