European Journal of Internal Medicine最新文献_第2页

The medical ward round: evidence, pitfalls, and tips. 医学查房：证据、陷阱和提示。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2025-05-16 DOI: 10.1016/j.ejim.2025.05.004

Stefano Bassetti, Armon Arpagaus, Flavio Gössi, Christoph Becker, Sabina Hunziker

{"title":"The medical ward round: evidence, pitfalls, and tips.","authors":"Stefano Bassetti, Armon Arpagaus, Flavio Gössi, Christoph Becker, Sabina Hunziker","doi":"10.1016/j.ejim.2025.05.004","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.05.004","url":null,"abstract":"Ward rounds are pivotal for patient-centered care and bedside teaching. In today's hospitals, care is provided by multidisciplinary and multiprofessional teams. To conduct an effective and efficient ward round, active patient involvement is essential, and the input from all team members must be shared and integrated into the diagnostic and therapeutic plan. The organization and structure of ward rounds, the roles and responsibilities of participants, the preparation before the round, and the communication rules must be clearly defined. Successful ward rounds require a focused, explicitly structured, patient-centered communication, and a balanced interprofessional information exchange. Bedside interprofessional ward rounds preceded by a discussion of the patient's condition and clinical course outside the room appear to optimally support comprehensive, collaborative patient-centered care, while fostering alignment within the interprofessional healthcare team. However, stringent round structure and strong leadership are needed to ensure active involvement of all interprofessional team members, and time efficiency.","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095240","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 contribution of minor salivary glands biopsy in clinical practice. 小唾液腺活检在临床中的诊断价值。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2025-05-16 DOI: 10.1016/j.ejim.2025.05.005

Marion Mauclin, Anh-Tuan Nguyen, Hubert Nielly, Hélène Vanquaethem, Weniko Caré

引用次数: 0

Insights from the VALUE Trial: Achieving blood pressure targets for renal protection. 来自VALUE试验的见解：实现肾脏保护的血压目标。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2025-05-15 DOI: 10.1016/j.ejim.2025.05.010

Eirik Olsen, Camilla L Søraas, Julian E Mariampillai, Sverre E Kjeldsen, Anne C K Larstorp, Morten Rostrup

引用次数: 0

Abrupt fluoroquinolone-associated suicides: a SONAR report from North America, Europe, Australia, and Asia. 突然氟喹诺酮相关自杀：来自北美、欧洲、澳大利亚和亚洲的声纳报告。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2025-05-13 DOI: 10.1016/j.ejim.2025.04.041

Charles L Bennett, Mia Lynch, Gretchen LeFever Watson, Linda Martin, June M McKoy

引用次数: 0

Genotype-phenotype correlations and resistance to colchicine in a familial Mediterranean fever cohort in southwestern Spain. 西班牙西南部一个家族性地中海热队列基因型-表型相关性和秋水仙碱耐药性

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2025-05-13 DOI: 10.1016/j.ejim.2025.05.002

Carlos Hernández Quiles, Ana Casado Díaz, Aurora González Estrada, Marco Antonio Montes Cano, José Salvador García Morillo

引用次数: 0

Hyponatremia and mortality: Marker of disease or modifiable risk? Rethinking causality in large-scale observational research. Authors' reply. 低钠血症与死亡率：疾病的标志还是可改变的危险？重新思考大规模观察研究中的因果关系。作者的回答。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2025-05-13 DOI: 10.1016/j.ejim.2025.05.008

Buster Mannheimer, Jonatan D Lindh, Issa Issa, Henrik Falhammar, Jakob Skov

引用次数: 0

PEPPER - Prehospital prediction in pulmonary embolism: The association of the national early warning score with mortality, thrombolysis, and clinical outcomes. PEPPER——肺栓塞的院前预测：国家预警评分与死亡率、溶栓和临床结果的关系。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2025-05-12 DOI: 10.1016/j.ejim.2025.04.035

Alexandra J Lipa, Karin Janata-Schwatczek, Anne E Merrelaar, Marieke Merrelaar, Max Sterz, Ursula Azizi-Semrad, Christian Schoergenhofer, Harald Herkner, Michael Schwameis, Juergen Grafeneder

{"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, Karin Janata-Schwatczek, Anne E Merrelaar, Marieke Merrelaar, Max Sterz, Ursula Azizi-Semrad, Christian Schoergenhofer, Harald Herkner, Michael Schwameis, Juergen Grafeneder","doi":"10.1016/j.ejim.2025.04.035","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.04.035","url":null,"abstract":"Background: 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.Methods: 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.Main results: 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; p < 0.001; adjusted OR 1.21, 95 % CI 1.11-1.32, p < 0.001), the need for admission to the ICU or IMC (OR 1.36, 95 % CI 1.25-1.49; p < 0.001) and mortality (HR: 1.23, 95 % CI 1.11 - 1.38, p < 0.001).Conclusion: 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.","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-05-12","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}

引用次数: 0

New onset left atrial dilatation in the general population: A quarter-century follow-up. 普通人群新发左心房扩张：四分之一世纪的随访。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2025-05-11 DOI: 10.1016/j.ejim.2025.05.001

Cesare Cuspidi, Rita Facchetti, Fosca Quarti-Trevano, Raffaella Dell'Oro, Andrea Faggiano, Giuseppe Mancia, Guido Grassi

{"title":"New onset left atrial dilatation in the general population: A quarter-century follow-up.","authors":"Cesare Cuspidi, Rita Facchetti, Fosca Quarti-Trevano, Raffaella Dell'Oro, Andrea Faggiano, Giuseppe Mancia, Guido Grassi","doi":"10.1016/j.ejim.2025.05.001","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.05.001","url":null,"abstract":"Background: Information on the incidence of left atrial enlargement (LAE) and the factors underlying progressive LA remodelling in long-term longitudinal population-based studies is scanty. We investigated the incidence of new onset LAE and its determinants among middle aged adults over a 25-year time period.Methods: A total of 423 participants with measurable echocardiographic parameters at baseline (mean age 41+10 years, 52 % men) and after a 25-year follow-up were included in the analysis. LA diameter (LAD) was measured with 2D-guided M-mode technique. LAE was detected according to sex-specific non-indexed criteria and a sex-independent indexed to body surface area (BSA) criterion recommended by contemporary echocardiographic guidelines.Results: New LAE occurred in 27.4 % (absolute LA diameter, LAD) and 16.5 % (LAD/BSA), respectively. Initial LAD and body mass index (BMI), as well as the 25-year change in BMI and left ventricular mass index (LVMI) were independently correlated to incident non-indexed LAE. Besides age, the independent modifiable predictors of new-onset LAE/BSA were initial LAD/BSA, the 25-year change in BMI and 24-h pulse pressure (PP).Conclusions: The incidence of LAE from mid to late adulthood occurs in a large clinically relevant fraction of participants and is affected by initial LAD, BMI and 25-year change in BMI, LVMI and 24-h PP. The findings provided by the present study support the view that avoid obesity and maintain normal levels of BMI, blood pressure and LVMI during life can contribute to strengthen cardiovascular prevention in the general population through prevention of LA remodelling and its harmful consequences.","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144030870","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

The effects of sleep improving interventions in medical hospital wards: the WEsleep study - A randomized clinical trial. 睡眠改善医疗病房干预的效果：wessleep研究-一项随机临床试验。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2025-05-09 DOI: 10.1016/j.ejim.2025.04.015

C J de Gans, A J G Meewisse, E S van den Ende, M L van Zuylen, P W B Nanayakkara, J Hermanides, D J Stenvers

{"title":"The effects of sleep improving interventions in medical hospital wards: the WEsleep study - A randomized clinical trial.","authors":"C J de Gans, A J G Meewisse, E S van den Ende, M L van Zuylen, P W B Nanayakkara, J Hermanides, D J Stenvers","doi":"10.1016/j.ejim.2025.04.015","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.04.015","url":null,"abstract":"Objective: Hospitalized patients often experience disturbed sleep, affecting general health. While some randomized studies have assessed individual non-pharmacological interventions, none have evaluated approaches that combine multiple strategies to improve sleep. This study aimed to assess the effects of a multicomponent sleep-enhancing protocol in hospitalized medical patients.Methods: The WEsleep cluster randomized controlled trial was conducted between July 2023 and March 2024 across six medical departments in a large Dutch academic hospital. Adult medical patients who were able to provide informed consent and were expected to stay at least two nights were eligible for inclusion. The multicomponent intervention included delaying early morning nursing rounds, training healthcare professionals, optimizing sleep-disturbing medication timing, offering earplugs and eye masks, and conducting evening sleep rounds. The primary outcome was sleep quality on the second night, assessed with the Richards-Campbell Sleep Questionnaire (RCSQ). Secondary outcomes included sleep quantity, 30-day mortality, delirium incidence, and use of sleep-enhancing tools.Results: Data from 291 patients were analyzed. The intervention group reported better sleep quality, with a median RCSQ score of 66.6 (IQR 44.3-78.9), compared to 55.7 (IQR 38.2-74.3) in the control group (p = 0.033). No significant differences were observed in sleep quantity, 30-day mortality or delirium incidence. Protocol adherence ranged from 42 % to 73 %.Conclusions: This study provides a valuable roadmap for hospitals aiming to enhance patient care through improved sleep management. A multicomponent intervention can lead to significantly better sleep quality in medical wards, highlighting the potential of structured, non-pharmacological strategies in routine hospital care.","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993077","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

Fast versus slow fibrosers: Risk factors for fibrosis progression in eosinophilic oesophagitis. 快速与缓慢纤维化：嗜酸性食管炎纤维化进展的危险因素。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2025-05-08 DOI: 10.1016/j.ejim.2025.04.042

Giovanni Santacroce, Antonio Di Sabatino

引用次数: 0