European Journal of Internal Medicine最新文献

{"title":"Hyponatremia and mortality: Marker of disease or modifiable risk? Rethinking causality in large-scale observational research. Authors’ reply","authors":"Buster Mannheimer , Jonatan D. Lindh , Issa Issa , Henrik Falhammar , Jakob Skov","doi":"10.1016/j.ejim.2025.05.008","DOIUrl":"10.1016/j.ejim.2025.05.008","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106343"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081737","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":"Systemic markers of inflammation and immune activation in patients with obstructive sleep apnea and paroxysmal atrial fibrillation","authors":"TE Hunt ,&nbsp;GM Traaen ,&nbsp;L Aakerøy ,&nbsp;B Øverland ,&nbsp;C Bendz ,&nbsp;AE Michelsen ,&nbsp;S Steinshamn ,&nbsp;KH Haugaa ,&nbsp;OG Anfinsen ,&nbsp;P Aukrust ,&nbsp;K Broch ,&nbsp;H Akre ,&nbsp;JP Loennechen ,&nbsp;L Gullestad ,&nbsp;T Ueland","doi":"10.1016/j.ejim.2025.05.028","DOIUrl":"10.1016/j.ejim.2025.05.028","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) and obstructive sleep apnea (OSA) frequently coexist, contributing to cardiovascular risk, possibly through shared inflammatory pathways. The specific role of inflammatory markers in patients with AF and OSA is not well established.</div></div><div><h3>Aim</h3><div>This study aimed to determine whether markers of inflammation and immune activation are elevated in patients with paroxysmal AF and OSA, assess the effects of continuous positive airway pressure (CPAP) and pulmonary vein isolation (PVI) on these markers, and evaluate their association with clinical outcomes, such as AF recurrence and thromboembolic risk.</div></div><div><h3>Methods</h3><div>We studied 143 patients with paroxysmal AF and moderate to severe OSA (apnea-hypopnea index ≥15). Of these, 99 were randomised to receive CPAP plus standard care (<em>n</em> = 51) or standard care alone (<em>n</em> = 48). A comparison group of 19 patients with paroxysmal AF and mild/no OSA (AHI &lt;15) and 22 healthy controls were also included. Inflammatory markers related to leukocyte activation, vascular inflammation, and extracellular matrix remodelling were assessed at baseline, 6 months and 12 months follow-up.</div></div><div><h3>Results</h3><div>Patients with OSA and paroxysmal AF had higher levels of NGAL, PTX-3, GDF-15, MMP-9, VCAM1 and ANGP2 than healthy controls. These markers correlated poorly with AF and OSA severity. There was no modifying effect of CPAP on any marker. PTX3 was associated with AF recurrence and a high-risk score for thromboembolic stroke.</div></div><div><h3>Conclusion</h3><div>Moderate to severe OSA and AF are associated with elevated inflammatory markers. However, CPAP therapy did not significantly affect these levels. PTX-3 may hold prognostic value for AF recurrence and thromboembolic risk.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106363"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295253","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":"Modern data on blood pressure distribution in European children and adolescents","authors":"Paolo Verdecchia ,&nbsp;Prerna Banati","doi":"10.1016/j.ejim.2025.07.010","DOIUrl":"10.1016/j.ejim.2025.07.010","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106414"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627614","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":"Dropped fingers","authors":"De-an Qin ,&nbsp;Rui-feng Ji ,&nbsp;Cong-hui Gao","doi":"10.1016/j.ejim.2025.07.018","DOIUrl":"10.1016/j.ejim.2025.07.018","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106422"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144709665","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":"From vectors to victims: understanding the threat of West Nile virus infection","authors":"Raffaella Gallo ,&nbsp;Rosanna C. De Rosa ,&nbsp;Emanuele Durante-Mangoni","doi":"10.1016/j.ejim.2025.106449","DOIUrl":"10.1016/j.ejim.2025.106449","url":null,"abstract":"<div><div>Growing numbers of West Nile virus infection cases are sparking fears among citizens and health care providers in Europe. In this Clinical Insight, we provide Internal Medicine physicians with a brief overview of the epidemiology, clinical consequences and management of West Nile virus infection.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106449"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800845","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":"Long-term quality of life after sleeve gastrectomy vs Roux-en-Y Gastric Bypass in patients with severe obesity: Results from the SleeveBypass multicentre randomised controlled trial","authors":"J.W.H. ‘t Hart ,&nbsp;B.J. Noordman ,&nbsp;E. Birnie ,&nbsp;J.F. Smulders ,&nbsp;S. Nienhuijs ,&nbsp;M. Dunkelgrün ,&nbsp;J.F. Zengerink ,&nbsp;I.A.M. Friskes ,&nbsp;G.H.H. Mannaerts ,&nbsp;C. Verhoef ,&nbsp;J.A. Apers ,&nbsp;L.U. Biter","doi":"10.1016/j.ejim.2025.06.006","DOIUrl":"10.1016/j.ejim.2025.06.006","url":null,"abstract":"<div><h3>Background</h3><div>Limited information is available on long-term quality of life (QoL) outcomes after sleeve gastrectomy compared to Roux-en-Y gastric bypass.</div></div><div><h3>Methods</h3><div>These techniques were compared in an open-label randomised controlled trial. This paper focuses on generic health-related QoL (HRQoL) using the 36-Item Short Form Health Survey and EuroQol-5 Dimension 3-Level questionnaires and disease-specific QoL (DSQoL), using the Moorehead-Ardelt questionnaire (specifically designed for individuals with obesity to assesses self-esteem, physical activity, work performance, sexual life, eating behaviour, and social interactions)the Gastroesophageal Reflux Disease Questionnaire (GERD-Q); the Gastrointestinal Quality of Life Index (GIQLI); and the Asthma Control Questionnaire. Simple carbohydrate consumption was assessed with the Dutch Sweet Eating Questionnaire. Measurements were taken preoperatively, 2 months post-surgery, and annually up to 5 years. Analyses used a linear mixed model. Cohen's d (CD) effect sizes indicate small (0∙2), medium (0∙5), and large (0∙8) effects. Dutch Trial Register NTR4741.</div></div><div><h3>Findings</h3><div>From 2013 until 2017, 628 patients were randomised between sleeve gastrectomy (<em>n</em> = 312) and Roux-en-Y gastric bypass (<em>n</em> = 316). Minimal follow-up was 5 years (last follow-up July 29th, 2022). Mean age was 43 [SD, 11] years; mean BMI 43∙5 [SD, 4∙7] and 81∙8 % were women. No clinically relevant differences in generic HRQoL were observed. Moorehead-Ardelt scored higher in the bypass group at 2 years (difference 0∙4, [95 % CI -0∙6 to -0∙1], <em>P=</em>.002, CD -0∙3), without statistically differences later on. GERD-Q scores were consistently better in the bypass group at all time points and remained higher after 5 years (difference 1∙5, [95 % CI 0∙7 to 2∙3], <em>P</em>&lt;.001, CD 0∙3). GIQLI showed a statistically significant better outcome in the bypass group after 4 and 5 years (difference -4∙6, [95 % CI -8∙7 to -0∙4], <em>P</em> = 0.032, CD -0∙17). Sweet-eating showed no statistically significant differences over time.</div></div><div><h3>Conclusion</h3><div>For patients living with severe obesity, sleeve gastrectomy and Roux-en-Y gastric bypass overall showed good long-term HRQoL and DSQoL outcomes. Roux-en-Y gastric bypass was associated with less GERD-related symptoms. Factors such as GERD should be considered when choosing the type of surgery.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106377"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334353","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":"“Limits to medicine” still needed after 50 years","authors":"Bjørn Hofmann","doi":"10.1016/j.ejim.2025.06.026","DOIUrl":"10.1016/j.ejim.2025.06.026","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106397"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144592848","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":"Efficacy and safety of once-daily oral semaglutide in patients with heart failure with preserved ejection fraction, type 2 diabetes and obesity: a real-world study","authors":"Alicia Trenas ,&nbsp;Miguel A. Pérez-Velasco ,&nbsp;Maria-Rosa Bernal-López ,&nbsp;María-Dolores López-Carmona ,&nbsp;Juan J. Gómez-Doblas ,&nbsp;María-Dolores Martínez-Esteban ,&nbsp;Oumayma Bouarich ,&nbsp;Natalia García-Casares ,&nbsp;Diego Fernández-García ,&nbsp;María-Dolores García de Lucas ,&nbsp;Ricardo Gómez-Huelgas ,&nbsp;Luis M. Pérez-Belmonte","doi":"10.1016/j.ejim.2025.06.007","DOIUrl":"10.1016/j.ejim.2025.06.007","url":null,"abstract":"<div><h3>Background</h3><div>There is limited evidence on the role of glucagon-like peptide-1 receptor agonists in heart failure. This work analyzes the efficacy of once-daily oral semaglutide in terms of health status and change in body weight in patients with heart failure with preserved ejection fraction, type 2 diabetes, and obesity.</div></div><div><h3>Methods</h3><div>This prospective, real-world study included patients treated with once-daily semaglutide (O-Sema Group) and without glucagon-like peptide-1 receptor agonists (Control Group). The primary outcome was the heart failure status, defined as the ≥5 point difference in the Kansas City Cardiomyopathy Questionnaire total symptom score, and change in body weight at 18 months.</div></div><div><h3>Results</h3><div>After a 1:1 propensity score matching, 202 patients were included in each group (mean age 77.8 years, mean body mass index 33.5, 59.2 % females). Patients in the O-Sema Group were more likely to have an improvement in heart failure health status from baseline to 18 months (OR:2.92; 95 %CI: 1.45–4.90; <em>p</em> &lt; 0.01). The mean change in body weight was -9.5 ± 3.2 kg in patients with oral semaglutide and -2.0 ± 1.1 kg in control patients (<em>p</em> &lt; 0.01). After treatment, there were negative correlations between the Kansas City Cardiomyopathy Questionnaire total symptom score and the body weight (<em>r</em>=-0.577, <em>p</em> &lt; 0.01) and glycated hemoglobin (<em>r</em>=-0.499, <em>p</em> = 0.011). It had good tolerability and safety.</div></div><div><h3>Conclusions</h3><div>Once-daily oral semaglutide was associated with an improvement in heart failure health status, and weight loss in patients with heart failure with preserved ejection fraction, type 2 diabetes, and obesity. Further research on glucagon-like peptide-1 receptor agonists in heart failure with preserved ejection fraction is needed.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106378"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303512","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":"Progressive skin thickening in a young adult","authors":"Thomas Didier ,&nbsp;Sophie Leducq ,&nbsp;Boris Laure","doi":"10.1016/j.ejim.2025.05.032","DOIUrl":"10.1016/j.ejim.2025.05.032","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106367"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144327642","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":"Disabling hearing loss in ischemic stroke: Prevalence, predictors, and prognostic implications","authors":"Angeline Yi Ling Teo ,&nbsp;Hazel Kai Hui Yeo ,&nbsp;Amy May Lin Quek ,&nbsp;Jenny Hooi Yin Loo ,&nbsp;Raymond Chee Seong Seet ,&nbsp;Hearing in Stroke Study Group","doi":"10.1016/j.ejim.2025.04.037","DOIUrl":"10.1016/j.ejim.2025.04.037","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106330"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059735","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}