European Journal of Internal Medicine最新文献

{"title":"PEPPER – Prehospital prediction in pulmonary embolism: The association of the national early warning score with mortality, thrombolysis, and clinical outcomes","authors":"Alexandra J. Lipa ,&nbsp;Karin Janata-Schwatczek ,&nbsp;Anne E. Merrelaar ,&nbsp;Marieke Merrelaar ,&nbsp;Max Sterz ,&nbsp;Ursula Azizi-Semrad ,&nbsp;Christian Schoergenhofer ,&nbsp;Harald Herkner ,&nbsp;Michael Schwameis ,&nbsp;Juergen Grafeneder","doi":"10.1016/j.ejim.2025.04.035","DOIUrl":"10.1016/j.ejim.2025.04.035","url":null,"abstract":"<div><h3>Background</h3><div>Pulmonary embolism (PE) requires careful risk assessment for informed care decisions. We evaluated the value of the National Early Warning Score (NEWS) in patients with PE when used by emergency medical services at the first patient contact in the prehospital phase.</div></div><div><h3>Methods</h3><div>In this retrospective observational study, we included adult patients diagnosed with PE in the ED of the General Hospital of Vienna, Medical University of Vienna, between January 2017 and December 2021, that were hospitalized by emergency medical services. We used a regression model to assess the association between prehospital NEWS and a composite primary outcome (30-day all-cause mortality, systemic thrombolysis, or catheter-directed thrombolysis), IMC/ICU admission, and clinical course during the first 24 h. Age, sex, body mass index, and days of symptoms served as covariables.</div></div><div><h3>Main results</h3><div>Two hundred sixty-one patients (53 % female; mean age 65 years, SD 14.6) with confirmed PE were included. A primary outcome event occurred in 65 (25 %) patients. The prehospital NEWS was associated with the primary outcome (OR 1.23, 95 % CI 1.13–1.33; <em>p</em> &lt; 0.001; adjusted OR 1.21, 95 % CI 1.11–1.32, <em>p</em> &lt; 0.001), the need for admission to the ICU or IMC (OR 1.36, 95 % CI 1.25–1.49; <em>p</em> &lt; 0.001) and mortality (HR: 1.23, 95 % CI 1.11 – 1.38, <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>Prehospital NEWS was significantly associated with key clinical outcomes in patients subsequently diagnosed with PE. It may support prehospital decision-making and help guide referral to higher levels of care when appropriate.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"137 ","pages":"Pages 90-95"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013689","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":"Drug-induced hyponatremia in clinical care","authors":"Buster Mannheimer ,&nbsp;Jonatan D. Lindh ,&nbsp;Cecilia Bergh Fahlén ,&nbsp;Issa Issa ,&nbsp;Henrik Falhammar ,&nbsp;Jakob Skov","doi":"10.1016/j.ejim.2025.04.034","DOIUrl":"10.1016/j.ejim.2025.04.034","url":null,"abstract":"<div><h3>Purpose</h3><div>Over the last decades, advances in understanding of previously described associations have important implications for diagnosis and workup of hyponatremia. In addition, new drug groups potentially affecting sodium balance and water homeostasis have evolved. The aim of this review is to summarize current evidence on drug-induced hyponatremia in clinical care.</div></div><div><h3>Methods</h3><div>We searched PubMed using the string \"Inappropriate ADH Syndrome/chemically induced\"[Mesh] OR \"Inappropriate ADH Syndrome/diagnosis\"[Mesh]) OR (\"Hyponatremia/chemically induced\"[Mesh] OR \"Hyponatremia/diagnosis\"[Mesh]), January 1^st, 2008, to September 2^nd 2024. In total 2003 articles were found and reviewed. Relevant articles referenced herein were subsequently traced backwards and also reviewed.</div></div><div><h3>Results</h3><div>Drugs associated with hyponatremia, including selective serotonin reuptake inhibitors, antipsychotics, antiepileptic drugs and proton pump inhibitors, typically cause hyponatremia shortly after initiation of treatment. For thiazide diuretics, the number one culprit in drug-induced hyponatremia, the risk for hyponatremia is highest the first weeks after initiation and then gradually decreases to a stable but still increased level after around 3 months. Several drugs that promote a negative water balance such as loop diuretics, lithium and of sodium-glucose cotransporter-2 inhibitors appear to decrease the risk for hyponatremia. Treatment with immune checkpoint inhibitors is associated with an increased risk of hypophysitis and adrenalitis resulting in hyponatremia due to secondary and primary cortisol deficiency.</div></div><div><h3>Conclusion</h3><div>For most drugs associated with hyponatremia, including thiazides, the cause-effect relationship is tightly linked to newly initiated treatment. Further research is warranted to characterize the association between hyponatremia and newly developed drugs such as sodium-glucose cotransporter-2 inhibitors and immune checkpoint inhibitors.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"137 ","pages":"Pages 11-20"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037523","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":"A man with chronic progressive mucositis and extensive skin detachment","authors":"Shohei Kitayama,&nbsp;Teruhiko Makino,&nbsp;Tadamichi Shimizu","doi":"10.1016/j.ejim.2025.04.022","DOIUrl":"10.1016/j.ejim.2025.04.022","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"137 ","pages":"Pages 123-124"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144037550","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":"Intermediate care units in internal medicine – From concept to consolidation","authors":"Fredrik von Wowern ,&nbsp;George N Dalekos ,&nbsp;Ricardo Gómez-Huelgas","doi":"10.1016/j.ejim.2025.05.012","DOIUrl":"10.1016/j.ejim.2025.05.012","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"137 ","pages":"Pages 35-36"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129448","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":"Utilizing D-dimer levels for predicting survival probability in unplanned hospital admissions: Insights from a 5-year nationwide population-based register study","authors":"Mikkel Brabrand ,&nbsp;Marianne Fløjstrup ,&nbsp;Søren Bie Bogh ,&nbsp;Tim Cooksley ,&nbsp;Christian Hans Nickel","doi":"10.1016/j.ejim.2025.02.026","DOIUrl":"10.1016/j.ejim.2025.02.026","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"137 ","pages":"Pages 149-151"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568757","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":"Refining the predictive value of nasal pressure swing in acute hypoxemic respiratory failure management","authors":"Danyang Liu","doi":"10.1016/j.ejim.2025.03.020","DOIUrl":"10.1016/j.ejim.2025.03.020","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"137 ","pages":"Pages 125-126"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743998","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":"Fast versus slow fibrosers: Risk factors for fibrosis progression in eosinophilic oesophagitis","authors":"Giovanni Santacroce ,&nbsp;Antonio Di Sabatino","doi":"10.1016/j.ejim.2025.04.042","DOIUrl":"10.1016/j.ejim.2025.04.042","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"137 ","pages":"Pages 1-3"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043936","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 oldest old and critical care: a potentially successful binomial","authors":"Raffaele Antonelli Incalzi ,&nbsp;Claudio Pedone","doi":"10.1016/j.ejim.2025.05.009","DOIUrl":"10.1016/j.ejim.2025.05.009","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"137 ","pages":"Pages 33-34"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121341","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":"Sex-related differences in the management and outcome of intubated adults with community-acquired pneumonia in Europe: A multicentre study.","authors":"Nicolas Garin, Despoina Koulenti, Virginie Prendki, Jordi Rello","doi":"10.1016/j.ejim.2025.06.024","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.06.024","url":null,"abstract":"<p><strong>Aims: </strong>To explore differences between sexes in the prognosis of severe community-acquired pneumonia.</p><p><strong>Methods: </strong>We analysed consecutive patients admitted to 27 intensive care units (ICU) from nine European countries and included in the EU-VAP/CAP cohort. All were mechanically ventilated for severe CAP. Sex was obtained from the medical records. Sexes were compared according to age, severity of illness, chronic health condition, co-morbidities, use of diagnostic procedures, length of mechanical ventilation, stay in the ICU, initial antibiotic treatment, and pathogens. The primary outcome was ICU mortality. We tested in a multivariate logistic regression the association of sex with mortality.</p><p><strong>Results: </strong>We included 257 patients (32 % women; mean age 60.5 years). Mean SAPS II score was 48.6 and 125 patients (50.6 %) were in septic shock, without difference between sexes. Women had more frequently a McCabe score of 0 (61 % vs. 51 % of men, p = 0.13). Bronchoscopy was performed in 39 % of men and 26 % of women (p = 0.04). Antibiotic treatment did not differ between sexes. A pathogen was identified in 47 % of patients. 101 patients (39.3 %) died: 35 % of men and 48 % of women (OR 0.59, 95 % CI 0.34-1.00). Male sex was associated with lower mortality (OR 0.42, 95 % CI 0.21-0.84) after adjusting for age, SAPS II score, McCabe score, and use of bronchoscopy.</p><p><strong>Conclusion: </strong>Women mechanically ventilated at the ICU for severe CAP had higher mortality despite similar severity of disease and better chronic health. Bronchoscopy was performed more frequently in men suggesting differences in management between sexes.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144555499","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":"Hemoglobin levels for the diagnosis of polycythemia vera: How high is high enough?","authors":"Ugur Koca ,&nbsp;Enes Seyda Sahiner ,&nbsp;Ozge Soyer Kosemehmetoglu ,&nbsp;Tekin Guney ,&nbsp;Betul Erismis","doi":"10.1016/j.ejim.2025.02.018","DOIUrl":"10.1016/j.ejim.2025.02.018","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"137 ","pages":"Pages 144-145"},"PeriodicalIF":5.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450899","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}