European Journal of Internal Medicine最新文献

{"title":"Generalized bullous fixed drug eruption","authors":"Li Chen , Junfeng Zhou , Lei Yao","doi":"10.1016/j.ejim.2024.11.028","DOIUrl":"10.1016/j.ejim.2024.11.028","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"133 ","pages":"Pages 115-116"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774510","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":"An uncommon and unexpected cause of chest pain: When stockings become trauma","authors":"Janneke JC Bastings, Renée Brüggemann, Bart Spaetgens","doi":"10.1016/j.ejim.2025.01.005","DOIUrl":"10.1016/j.ejim.2025.01.005","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"133 ","pages":"Pages 117-118"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967264","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":"Prognostic impact of different triggers in patients with Takotsubo syndrome and chronic obstructive pulmonary disease. Author's reply","authors":"Luca Arcari , Giacomo Tini , Beatrice Musumeci , Emanuele Barbato , Luca Cacciotti","doi":"10.1016/j.ejim.2024.12.003","DOIUrl":"10.1016/j.ejim.2024.12.003","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"133 ","pages":"Pages 129-130"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142808403","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":"Effects of valsartan vs amlodipine and achieved lower blood pressure on the incidence of end-stage kidney disease: The VALUE Trial","authors":"Eirik Olsen ,&nbsp;Kenneth Jamerson ,&nbsp;Roland E. Schmieder ,&nbsp;Camilla L. Søraas ,&nbsp;Julian E. Mariampillai ,&nbsp;Giuseppe Mancia ,&nbsp;Sverre E. Kjeldsen ,&nbsp;Sondre Heimark ,&nbsp;Maria H. Mehlum ,&nbsp;Knut Liestøl ,&nbsp;Anne C.K. Larstorp ,&nbsp;Lene V. Halvorsen ,&nbsp;Aud Høieggen ,&nbsp;Michel Burnier ,&nbsp;Morten Rostrup ,&nbsp;Stevo Julius ,&nbsp;Michael A. Weber","doi":"10.1016/j.ejim.2024.12.021","DOIUrl":"10.1016/j.ejim.2024.12.021","url":null,"abstract":"<div><h3>Background</h3><div>There is a paucity of data investigating the impact of antihypertensive drug classes and blood pressure (BP) treatment targets on the incidence of end-stage kidney disease (ESKD). In patients with high-risk hypertension aged 50–80 years or above, we aimed to, 1) compare effects of valsartan, an angiotensin receptor blocker, with amlodipine, a calcium channel blocker and, 2) assess the effect of achieving systolic BP &lt;135 vs ≥135 mmHg on the ESKD incidence.</div></div><div><h3>Methods</h3><div>The VALUE Trial was a multicenter prospective double-blinded randomized clinical trial in patients with essential hypertension and high cardiovascular risk including known coronary disease, left ventricular hypertrophy and previous stroke, in which ESKD was a secondary endpoint defined as progression to kidney transplant and/or dialysis. Patients were randomized to either valsartan or amlodipine, with other anti-hypertensive medications as add-on if needed to reach the systolic BP target of &lt;140 mmHg. Cox proportional hazards ratio (HR) was used to compare different treatment groups and achieved systolic BP &lt;135 with ≥135 mmHg, during 3–6 years of follow-up.</div></div><div><h3>Results</h3><div>15,245 patients were randomized and followed until 63,631 patient-years with only 90 patients lost to follow-up. The primary outcome, a composite of cardiac morbidity and mortality, was neutral between valsartan and amlodipine. On valsartan 47 patients (0.61 %) and on amlodipine 50 patients (0.66 %) developed ESKD (HR=1.02, 95 % CI 0.68–1.52, <em>p</em> =0.94). Achieved SBP &lt;135 mmHg was strongly related to less ESKD (<em>n</em> =9/5036 patients, 0.2 %) compared with achieved SBP ≥135 mmHg (<em>n</em> =73/8766 patients, 0.8 %) (HR=0.28, CI 0.14–0.58, <em>p</em> &lt;0.001).</div></div><div><h3>Conclusions</h3><div>In hypertensive patients with a high cardiovascular risk, valsartan and amlodipine have a similar impact on the incidence of end-stage kidney disease. Achieving SBP &lt;135 mmHg, averaging 128.8/77.3 mmHg, is highly efficacious in kidney protection.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"133 ","pages":"Pages 55-63"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142856432","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":"Prevalence and impact of multidrug resistance in a cohort of patients admitted to emergency department for urinary tract-infections: The UTILY study, a prospective multicentre study","authors":"Lorenzo Onorato ,&nbsp;Enrico Allegorico ,&nbsp;Margherita Macera ,&nbsp;Caterina Monari ,&nbsp;Biagio Migliaccio ,&nbsp;Carmine Nasta ,&nbsp;Maria Teresa Florio ,&nbsp;Roberta Sciorio ,&nbsp;Fabio Giuliano Numis ,&nbsp;Giovanna Guiotto ,&nbsp;Mauro Giordano ,&nbsp;Rosa Raucci ,&nbsp;Ferdinando Dello Vicario ,&nbsp;Rodolfo Nasti ,&nbsp;Antonio Voza ,&nbsp;Nicola Coppola","doi":"10.1016/j.ejim.2024.12.028","DOIUrl":"10.1016/j.ejim.2024.12.028","url":null,"abstract":"<div><h3>Background and aim</h3><div>The aim of the present study was to evaluate the prevalence and to identify the independent predictors of multi-drug resistance among a cohort of patients admitted to emergency department for urinary tract infections (UTI), and to assess the impact of antimicrobial resistance on the clinical outcomes.</div></div><div><h3>Methods</h3><div>We conducted a prospective multicentre study enrolling all adult patients admitted to one of the eight emergency departments participating in the study with a microbiologically confirmed diagnosis of UTI from February 2023 to July 2024. The primary outcome evaluated was 30-day mortality; secondary outcomes included 7-day mortality and clinical response.</div></div><div><h3>Results</h3><div>During the study period, 681 patients were admitted to one of the 8 participating facilities with signs and symptoms consistent with UTI, 327 of which presented a positive urine culture and were included in the study. A total of 128 out of 327 patients (39.1 %) had an isolation of an MDR organism. At multivariate analysis, male gender (OR 1.79, 95 % CI 1.08–2.97, <em>p</em> = 0.024) and hospital admission during the previous 90 days (OR 4.28, 95 % CI 1.86–9.83, <em>p</em> = 0,001) resulted independently associated with the isolation of an MDR pathogen. Regarding clinical outcomes, the presence of sepsis or septic shock (OR 6.25, 95 % CI 1.36–28.73, <em>p</em> = 0.019), and being infected with an MDR pathogen (OR 2.65, 95 % CI 1.01–6.97, <em>p</em> = 0.048) resulted the only variables independently associated with 30-day mortality.</div></div><div><h3>Conclusions</h3><div>Our study has reported a 39.1 % prevalence of MDR pathogens in patients admitted to emergency departments for UTI, with a 21 % prevalence among patients without any known risk factor.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"133 ","pages":"Pages 93-99"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142911251","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":"The evolving role of head up tilt test: New protocol and indications for optimizing the care of syncope patients","authors":"Vincenzo Russo ,&nbsp;Erika Parente ,&nbsp;Angelo Comune ,&nbsp;Gerardo Nigro ,&nbsp;Michele Brignole","doi":"10.1016/j.ejim.2024.12.032","DOIUrl":"10.1016/j.ejim.2024.12.032","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"133 ","pages":"Pages 126-127"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928566","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":"Optimal BMI cutoff for lean MASLD/MetALD and adverse hepatic outcomes in East-Asian populations","authors":"Byungyoon Yun ,&nbsp;Juyeon Oh ,&nbsp;Heejoo Park ,&nbsp;Beom Kyung Kim ,&nbsp;Jin-Ha Yoon","doi":"10.1016/j.ejim.2024.12.036","DOIUrl":"10.1016/j.ejim.2024.12.036","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"133 ","pages":"Pages 141-144"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985455","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":"Comparative effectiveness of bictegravir versus dolutegravir, raltegravir, and efavirenz-based antiretroviral therapy among treatment-naïve individuals with HIV","authors":"Isaac Núñez ,&nbsp;Yanink Caro-Vega ,&nbsp;Conor MacDonald ,&nbsp;Juan Luis Mosqueda ,&nbsp;Alicia Piñeirúa-Menéndez ,&nbsp;Anthony A. Matthews","doi":"10.1016/j.ejim.2025.01.013","DOIUrl":"10.1016/j.ejim.2025.01.013","url":null,"abstract":"<div><h3>Objective</h3><div>Bictegravir or dolutegravir based antiretroviral therapy are first-line HIV treatments. However, no trial has recruited enough participants to estimate the most effective treatment, and there is little evidence on the comparative effectiveness of bictegravir and other available antiretrovirals, like efavirenz and raltegravir.</div></div><div><h3>Methods</h3><div>We emulated a four-arm target trial using country-wide data from Mexico. The eligibility criteria of the target trial were people with HIV, treatment naïve with viral load &gt;500 copies/mL, without tuberculosis, not pregnant, and started either bictegravir, dolutegravir, efavirenz or raltegravir-based treatment between July 2019 and September 2021. The main outcome was the probability of viral suppression (HIV-RNA &lt;50 copies/mL) at three months estimated using an adjusted logistic regression model, with assignment assumed to be random within levels of adjusted covariates. Probabilities were compared via differences and non-parametric bootstrapping was used to calculate 95 % confidence intervals.</div></div><div><h3>Results</h3><div>20,285 individuals were included, of whom 84.3 % started bictegravir, 7.2 % dolutegravir, 6.6 % efavirenz, and 1.8 % raltegravir. The adjusted probability of viral suppression at 3 months was 79.4 % (79.4 %, 80.2 %) with bictegravir, 78.5 % (76.2 %, 81.1 %) with dolutegravir, 63.9 % (60.6 %, 67.7 %) with efavirenz, and 69.8 % (63.8 %, 76.1 %) with raltegravir. When compared with bictegravir, this resulted in differences of −0.8 % (−3.5 %, 1.9 %) for dolutegravir, −15.5 % (−19 %, −11.7 %) for efavirenz, and −9.6 % (−15.9 %, −3.3 %) for raltegravir. Differences shrank at twelve months and with a higher viral threshold (200 copies/mL).</div></div><div><h3>Conclusions</h3><div>Bictegravir was similar to dolutegravir and slightly more effective than efavirenz or raltegravir at three months, but differences became negligible at twelve months.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"133 ","pages":"Pages 86-92"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025443","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":"Transforming organ donation and transplantation: Strategies for increasing donor participation and system efficiency","authors":"David B. Olawade ,&nbsp;Sheila Marinze ,&nbsp;Nabeel Qureshi ,&nbsp;Kusal Weerasinghe ,&nbsp;Jennifer Teke","doi":"10.1016/j.ejim.2024.11.010","DOIUrl":"10.1016/j.ejim.2024.11.010","url":null,"abstract":"<div><div>Organ transplantation is a critical medical procedure that saves and improves lives, yet the system faces significant challenges that result in many missed opportunities. This comprehensive review examines the factors contributing to these missed opportunities and the concerns of potential donors. The shortage of donors remains a major issue, exacerbated by low registration rates, family consent refusals, and strict medical and health criteria. Inefficiencies within the organ procurement and transplantation process, including logistical delays and suboptimal matching systems, further hinder the availability of organs. Public misconceptions and cultural and religious beliefs also negatively impact donor willingness. Moreover, potential donors and their families face ethical, psychological, and procedural concerns. Ethical dilemmas revolve around issues of autonomy and informed consent, while psychological concerns include fear and anxiety about the donation process and its impact on families. Procedural issues, such as transparency, legal hurdles, and post-donation follow-up, add to the complexities of organ donation. This review explores potential solutions to address these challenges, such as enhancing public education campaigns to dispel myths, and providing incentives for proactive registration. It also recommends improving the performance of organ procurement organizations, optimizing logistics for organ transport, and developing advanced matching algorithms to ensure equitable organ allocation. Addressing donor concerns through robust ethical standards, comprehensive psychological support, and clear communication strategies is essential. By adopting these multifaceted strategies, the organ transplantation system can be made more efficient and supportive, increasing the availability of organs and ultimately saving more lives. This review underscores the need for integrated and targeted approaches to overcome the existing barriers in organ transplantation.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"133 ","pages":"Pages 14-24"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689434","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":"Enhancing cardiovascular risk management in rheumatoid arthritis: From medication adherence to multidisciplinary interventions","authors":"Shulin Dou,&nbsp;Wei Fang,&nbsp;Wei Wang,&nbsp;Hailiang Wang","doi":"10.1016/j.ejim.2024.11.016","DOIUrl":"10.1016/j.ejim.2024.11.016","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"133 ","pages":"Pages 134-135"},"PeriodicalIF":5.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142734368","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}