European Journal of Internal Medicine最新文献

{"title":"Long-term secondary prevention with colchicine in patients with CAD: an updated systematic review and meta-analysis.","authors":"Patrizia Boracchi, Giuseppe Marano, Ester Luconi, Claudio Cimminiello","doi":"10.1016/j.ejim.2025.04.024","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.04.024","url":null,"abstract":"<p><p>The CLEAR SYNERGY trial failed to demonstrate any benefit of colchicine in patients with acute myocardial infarction (MI). In this meta-analysis of the randomized clinical trials (RCTs) of colchicine in coronary artery disease (CAD), we updated the estimates of effect on cardiovascular events in patients with CAD. We searched for the largest RCTs of colchicine in CAD patients. The effect was assessed in a pooled analysis of individual events such as MI, urgent coronary revascularization (UR), stroke, cardiovascular mortality, and total mortality, for each of these endpoints using hazard ratios (HR) and their 95 % confidence intervals (CI), estimated by the Cox model. Fixed-effects or random-effects models were used. A similar approach was used for the composite of MI, UR, and cardiovascular mortality (MACE 1) and stroke, MI, total mortality (MACE 2). Safety was also assessed. Five studies were selected with a total of 18,656 patients. Colchicine reduced the risk of MI by 21 %, HR 0.79 (95 % CI: 0.68 - 0.92).Its effect was neutral on total and cardiovascular mortality. The composite endpoints MACE 1 and MACE 2 were reduced by colchicine, HR 0.81 (95 % CI: 0.68 - 0.98), and HR 0.88 (95 % CI: 0.79 - 0.98), respectively. There were no differences in non-cardiovascular mortality, cancer, and serious gastrointestinal and infectious events. The benefit of colchicine appears attenuated compared to past analyses, but is still valuable in reducing the risk of MI and the composite of MI, UR, and cardiovascular death. The safety appears reassuring in relation to all serious adverse reactions.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144250639","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":"Gastroenteritis caused by Shiga-toxigenic Escherichia coli. Are antibiotics always prohibited in this disease?","authors":"Juan Gabriel Sánchez-Cano, Ana Belén Mecina-Gutiérrez, Carolina Campelo-Gutiérrez, María Velasco-Arribas, Leonor Moreno-Núñez","doi":"10.1016/j.ejim.2025.05.035","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.05.035","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227455","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":"Real-world glucose-lowering strategies for managing glucocorticoid-induced diabetes in non-intensive hospital settings.","authors":"Michela Vergani, Matteo Conti, Alessia Lari, Federico Bertuzzi, Basilio Pintaudi","doi":"10.1016/j.ejim.2025.05.033","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.05.033","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235825","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":"Phenomena and noumena in nephrology: Beyond the illusion of precision in kidney function assessment.","authors":"Diego Moriconi","doi":"10.1016/j.ejim.2025.05.027","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.05.027","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227457","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":"Atypical and fatal presentation of acute liver failure.","authors":"Ana Pérez González, Javier Martín López, Jesus Rivera-Esteban","doi":"10.1016/j.ejim.2025.05.036","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.05.036","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217441","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":"Different loop diuretic dosing and administration in acute heart failure (DIUR-AHF): a multicenter prospective observational open-label study.","authors":"Alberto Palazzuoli, Filippo Pirrotta, Andrea Stefanini, Antonio Pagliaro, Paolo Severino, Andrea D'Amato, Dario Vizza, Andrea Salzano, Giulia Crisci, Marco Guazzi, Simone Frea, Guido Pastorini, Mauro Feola, Francesco Fedele","doi":"10.1016/j.ejim.2025.05.026","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.05.026","url":null,"abstract":"<p><p>Background Although Loop diuretics (LD) represent the milestone treatment in acute heart failure (AHF), relevant concerns exist about the best administration modality. We aim to investigate the effects of different LD regimen and dosage in patients with AHF. Methods In this multicenter prospective observational open-label study, patients were assigned to receive twice-daily intravenous injections (Bolus infusion, BiV) or continuous intravenous infusion (CiV) of furosemide for a period of 72-120 hours. High dose (HD) was defined as furosemide dose >120 mg/day. Patients were eligible if they showed clinical signs of congestion associated with N-terminal pro-B-type natriuretic peptide (NT-proBNP) >500 pg/ml. Combined of rehospitalisation or death for cardiovascular causes were evaluated as primary endpoint during a 6-months follow-up. Results 402 AHF patients were included, 197 treated with CiV and 205 with BiV. CiV showed higher rate of NTproBNP decrease >30 % (63 % vs 45 %, p < 0.001), associated with significantly weight loss (-4.3 ± 2.6 vs -3.2 ± 2.4 Kg, <0.001) and daily mean urine output (2181 ± 845 ml vs 2019 ± 696 ml, p = 0.036) compared to BiV. Conversely, BiV patients experienced a shorter hospital stay (11.5 ± 4.5 vs 12.7 ± 4.5 days, p = 0.006) and lower adverse events rate (29 % vs 45 %, p = 0.001). HD administration was associated with prolonged hospital stay and poor outcome (55 % vs 18 %). Multivariable analysis confirmed CiV (HR 1.51, 1.02-2.23) and HD infusion (HR 2.50,1.64-3.83) were both associated with the primary endpoints. Conclusions CiV was associated with higher NTproBNP decrease and weight loss but it demonstrates a poorer outcome. Similarly, HD was associated with an increased risk.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217442","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":"Prevalence of malnutrition and its impact on clinical outcomes in internal medicine wards: The SIMI-NUTRO study.","authors":"Maurizio Muscaritoli, Maria Ida Amabile, Carmen Gallicchio, Giovanni Imbimbo, Caterina Conte, Elisa Ceriani, Antonello Pietrangelo, Elena Corradini, Giuseppe Mandraffino, Gaetano Serviddio, Silvio Buscemi, Ferdinando Carlo Sasso, Clara Balsano, Alberto Moggi Pignone, Alessio Molfino","doi":"10.1016/j.ejim.2025.05.025","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.05.025","url":null,"abstract":"<p><strong>Introduction: </strong>Screening for malnutrition is recommended for all hospitalized patients and can be performed using tools such NRS-2002, MUST, and MNA-SF. Patients at risk should undergo further evaluation for the diagnosis of malnutrition using a validated tool, including the GLIM criteria. This study aimed to evaluate the prevalence of malnutrition and its risk at hospital admission in Internal Medicine Wards, and to assess the impact of malnutrition on the length of stay and on the development of infectious complications.</p><p><strong>Methods: </strong>The SIMI-NUTRO study is a multicenter, observational cohort study conducted in 16 Internal Medicine Wards located in North, Center and South of Italy. Malnutrition risk and diagnosis were assessed by MUST, MNA-SF, and GLIM, respectively.</p><p><strong>Results: </strong>A total of 650 patients were enrolled; 258/610 (42.3 %) were identified as at risk of malnutrition by MUST, while 169/643 (26.3 %) were classified as malnourished by MNA-SF. According to GLIM (n = 625), which requires the presence of at least one etiological and one phenotypic criterion, 233 patients (37.3 %) were considered malnourished. The agreement between MUST and GLIM was moderate (k = 0.55, p < 0.001), as well as between MNA-SF and GLIM (k = 0.49, p < 0.001). Malnourished patients were older and had lower levels of hemoglobin, total cholesterol, and cholinesterase (p < 0.05). Finally, malnutrition was associated with longer hospital stay (p = 0.001) and a higher rate of infectious complications (p = 0.001).</p><p><strong>Conclusions: </strong>The prevalence of malnutrition was high among patients admitted to Internal Medicine Wards distributed in a large national area. Malnutrition was associated with increased number of infections and prolonged hospital stay, underscoring the need for an early identification of nutritional problems.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217443","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":"Trends in industry-sponsored research payments to internist principal investigators","authors":"Aurora J. Grutman ,&nbsp;Zeyad Hammadeh ,&nbsp;Joseph G. Cheaib ,&nbsp;Evans K.H. Brown ,&nbsp;Misop Han","doi":"10.1016/j.ejim.2025.01.009","DOIUrl":"10.1016/j.ejim.2025.01.009","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"136 ","pages":"Pages 131-133"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015578","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 impact of sensitization patterns on COPD severity and exacerbations: Insights from a case-control and longitudinal study","authors":"Meropi Karakioulaki ,&nbsp;Caroline Maria Berkemeier ,&nbsp;Leticia Grize ,&nbsp;Ingmar Heijnen ,&nbsp;Stergios A. Polyzos ,&nbsp;Antonis Goulas ,&nbsp;Michael Tamm ,&nbsp;Daiana Stolz","doi":"10.1016/j.ejim.2025.04.001","DOIUrl":"10.1016/j.ejim.2025.04.001","url":null,"abstract":"<div><h3>Background</h3><div>Total Immunoglobulin E (tIgE) and allergen-specific IgE (sIgE) have been linked to asthma in numerous studies, with emerging evidence suggesting IgE sensitization influences chronic obstructive pulmonary disease (COPD) onset and severity. This study explores whether (a) serum tIgE and sIgE profiles differ among COPD, asthma, and controls (case-control substudy) and (b) tIgE and 300 individual sIgE levels correlate with disease severity and outcomes in 343 COPD patients (longitudinal substudy).</div></div><div><h3>Methods</h3><div>The case-control substudy measured tIgE and sIgE in 122 participants (76 COPD, 19 asthma, 27 controls). The longitudinal substudy analyzed tIgE and 300 sIgE in 343 COPD patients, examining links to disease severity and outcomes. Atopy was defined as tIgE&gt;20 kUA/L, while skin-sensitization was determined by skin prick test positivity.</div></div><div><h3>Results</h3><div>No significant tIgE differences were observed among asthma, COPD, and controls, however asthma and COPD patients showed distinct sIgE patterns for various allergens. Atopic men reported fewer urgent visits for acute exacerbations of COPD (ECOPD) than non-atopic men (79.07 % vs.91.33 %, p = 0.007), while skin-sensitized women experienced more severe ECOPD than non-skin-sensitized women (46.43 % vs. 24.36 %, p = 0.028). Exacerbation etiology was not associated with atopic or skin-sensitization profiles. Fungal sensitization correlated with older age (p = 0.032), worse 6-minute walking test outcomes (p = 0.007), and reduced diffusion capacity (DLCO/VA %, p = 0.006).</div></div><div><h3>Conclusion</h3><div>While atopic profiles are similar across groups, asthma features higher aeroallergen sIgE. Skin-sensitization and atopy may influence lung function and symptom severity in COPD but are differently associated with ECOPD between sexes and are not linked to the etiology of ECOPD.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"136 ","pages":"Pages 71-81"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054703","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":"Disability and caregivers in Italy: Results from an online survey","authors":"Sergio Harari ,&nbsp;Antonella Caminati ,&nbsp;Luigi Ripamonti ,&nbsp;Paolo Marveggio ,&nbsp;Pier Mannuccio Mannucci","doi":"10.1016/j.ejim.2025.01.029","DOIUrl":"10.1016/j.ejim.2025.01.029","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"136 ","pages":"Pages 142-143"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191203","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}