European Journal of Internal Medicine最新文献

{"title":"Risk of injurious falls in older people with atrial fibrillation","authors":"Anna Litwińska-Kmiecik , Agnieszka Zalewska","doi":"10.1016/j.ejim.2024.12.009","DOIUrl":"10.1016/j.ejim.2024.12.009","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"134 ","pages":"Page 162"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142814690","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 population-based screening for atrial fibrillation on quality of life","authors":"Emilie Katrine Kongebro ,&nbsp;Christian Kronborg ,&nbsp;Lucas Yixi Xing ,&nbsp;Ketil Jørgen Haugan ,&nbsp;Claus Graff ,&nbsp;Søren Højberg ,&nbsp;Morten S Olesen ,&nbsp;Derk Krieger ,&nbsp;Axel Brandes ,&nbsp;Lars Køber ,&nbsp;Jesper Hastrup Svendsen ,&nbsp;Søren Zöga Diederichsen","doi":"10.1016/j.ejim.2024.12.035","DOIUrl":"10.1016/j.ejim.2024.12.035","url":null,"abstract":"<div><h3>Background</h3><div>Screening for atrial fibrillation is rising and may worsen or improve quality of life.</div></div><div><h3>Methods</h3><div>We assessed quality of life (EQ-5D-5L) data in 6,004 participants with stroke risk factors randomised to usual care (n=4,503) or implantable loop recorder with anticoagulation upon detection of atrial fibrillation (n=1,501). Five domains (mobility, selfcare, usual activities, pain/discomfort, anxiety/depression) each scored from one to five were calculated into individual index scores (worst=-0.76, best=1.00). Changes in the index score and the visual analogue scale score (EQ VAS (0=worst, 100=best)) from baseline to year three were the primary outcomes, which were analysed using linear mixed models. Major problem was defined as a domain score ≥3 and analysed with logistic regression in year three.</div></div><div><h3>Results</h3><div>Of 6,004 participants, 5,733 (95 %) were alive after three years, and 5,162 (86 %) had complete EQ-5D-5L data. The baseline index score of 5,733 participants was 0.88 ±0.16, which decreased by -0.05 (-0.05; -0.04) in the control vs -0.04 (-0.05; -0.03) in the screening group after three years, and a baseline EQ VAS score of 78.4±16.2, which decreased by -6.06 (-6.54; -5.57) in control vs -5.18 (-5.95; -4.40) in the screening group after three years, with no significant difference between the groups (p=0.063 and p=0.056, respectively). The most frequent problem was major pain/discomfort (1,202 of 5,162 (23.3 %)), and any major problem occurred equally in the groups after three years (OR 0.91 (0.79;1.05)).</div></div><div><h3>Conclusion</h3><div>A population-based, long-term, and continuous screening for atrial fibrillation in high-risk individuals did not translate into increased quality of life.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"134 ","pages":"Pages 41-50"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973124","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":"Refining risk assessment for intra-abdominal infections in immunocompromised intensive care unit patients. Author's reply","authors":"Stijn Blot ,&nbsp;Mieke Deschepper ,&nbsp;José Artur Paiva","doi":"10.1016/j.ejim.2025.02.005","DOIUrl":"10.1016/j.ejim.2025.02.005","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"134 ","pages":"Pages 140-141"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143371134","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":"Redefining thiamine requirements in alcohol use disorder: Aligning treatment with neurocognitive needs","authors":"Di Sario Giovanna ,&nbsp;Dionisi Tommaso ,&nbsp;Addolorato Giovanni","doi":"10.1016/j.ejim.2025.02.033","DOIUrl":"10.1016/j.ejim.2025.02.033","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"134 ","pages":"Pages 33-34"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143538011","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":"Risk of hepatic decompensation or HCC is similar in patients with ALD- and MASLD-cirrhosis: A population-based cohort study","authors":"Joost Boeckmans ,&nbsp;Linnea Widman ,&nbsp;Ying Shang ,&nbsp;Rickard Strandberg ,&nbsp;Axel Wester ,&nbsp;Jörn M Schattenberg ,&nbsp;Hannes Hagström","doi":"10.1016/j.ejim.2025.02.014","DOIUrl":"10.1016/j.ejim.2025.02.014","url":null,"abstract":"<div><h3>Background</h3><div>It is unclear if the risk of hepatic decompensation or hepatocellular carcinoma (HCC) differs between patients with compensated alcohol-related liver disease (ALD)- and metabolic dysfunction-associated steatotic liver disease (MASLD)-cirrhosis. We investigated the risk to develop hepatic decompensation or HCC based on ALD or MASLD as the underlying etiology of cirrhosis.</div></div><div><h3>Methods</h3><div>All patients with a new diagnosis in hospital-based outpatient care of ALD- or MASLD-cirrhosis in Sweden between 2002 and 2020 were identified using national registers. Hepatic decompensation was analyzed as a composite outcome with HCC. Cox regression was employed to compare rates of hepatic decompensation or HCC, and subsequent death.</div></div><div><h3>Results</h3><div>1660 patients with ALD-cirrhosis and 943 patients with MASLD-cirrhosis were identified. The median ages were 64 years (IQR 57–70) and 69 years (IQR 62–75) in patients with ALD- and MASLD-cirrhosis, respectively. Patients with ALD-cirrhosis consisted of 69.4 % males, compared to 47.6 % males in the MASLD-cirrhosis group. 581 (35 %) patients with ALD-cirrhosis and 284 (30 %) patients with MASLD-cirrhosis developed hepatic decompensation or HCC (median follow-up time: 25 months), resulting in an adjusted hazard ratio of 1.12 (ALD- vs. MASLD-cirrhosis, 95 %-confidence interval=0.88–1.41). The adjusted risk of mortality afterwards was lower in patients with ALD-cirrhosis compared to patients with MASLD-cirrhosis (adjusted hazard ratio 0.62, 95 %-confidence interval=0.39–0.97).</div></div><div><h3>Conclusions</h3><div>The risk of hepatic decompensation or HCC is comparable in patients with ALD- and MASLD-cirrhosis, but the risk of mortality after a decompensation event or HCC tends to be higher in patients with MASLD-cirrhosis.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"134 ","pages":"Pages 104-113"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426438","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 role of an intermediate care unit in reducing intensive care unit admissions and improving patient outcomes in internal medicine: A quasi-experimental study.","authors":"Gianni Turcato, Arian Zaboli, Paolo Ferretto, Lucia Filippi, Daniela Milazzo, Marta Parodi, Michael Maggi, Alessandro Cipriano, Massimo Marchetti, Christian Josef Wiedermann, Lorenzo Ghiadoni","doi":"10.1016/j.ejim.2025.03.028","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.028","url":null,"abstract":"<p><strong>Background: </strong>Effective management of non-intensive critical patients is crucial, especially in hospitals with limited Intensive Care Unit (ICU) capacity. This study explores the impact of introducing a medical Intermediate Care Unit (IMCU) within an Internal Medicine ward on patient management outcomes.</p><p><strong>Methods: </strong>A quasi-experimental study was conducted at Alto Vicentino Hospital in Italy, spanning January 2018 to July 2024. The Interrupted Time Series Analysis (ITSA) assessed the IMCU's effects on ICU admissions, transfers from the Internal Medicine ward to the ICU, hospital length of stay, and outpatient service volume. Monthly data were analyzed, comparing pre- and post-IMCU implementation periods.</p><p><strong>Results: </strong>Post-IMCU implementation, ITSA revealed a significant decrease in ICU transfers, with a reduction of 2.02 per 100 admissions per month (p = 0.001). Hospital length of stay also declined by an average of 2.29 days (p < 0.001). ICU admissions from the Emergency Department dropped significantly from 3.3 to 2.6 per 1000 visits (p = 0.006). Outpatient services per physician markedly increased from 25.5 to 63.9 per month (p < 0.001). There was no significant change in 30-day mortality.</p><p><strong>Conclusions: </strong>The integration of the IMCU into the Internal Medicine ward appears to have contributed to a reduction in ICU demand and facilitated quicker patient stabilization. These changes may have supported an increase in outpatient services, highlighting the IMCU's potential to aid in the management of non-intensive critical patients. However, further studies are needed to confirm these findings and evaluate their applicability in other contexts.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744100","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":"Demographic features in patients with acute mountain sickness.","authors":"Haitong Zhao, Hao Wang, Chao Wang, Lei Chen, Fengming Luo","doi":"10.1016/j.ejim.2025.03.030","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.030","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743990","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 brown macules on the limbs.","authors":"Xie He, Shunhong Chen, Ruiting Huang","doi":"10.1016/j.ejim.2025.03.027","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.027","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743860","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":"Lymphangioplasty 4.0 as a therapeutic and educational opportunity for (Lymph)edema.","authors":"Anna Poretto, Jean Paul Belgrado, Giacomo Rossitto","doi":"10.1016/j.ejim.2025.03.031","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.031","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743915","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":"Association of miR-126-3p, miR-1260b and miR-374a-5p with the incidence of heart failure in a population-based cohort: the Hortega Follow-Up Study.","authors":"Maria Grau-Perez, Olga Martinez-Arroyo, Marta Rubia-Martinez, Ana Flores-Chova, Zulema Rodriguez-Hernandez, Pablo Fernández-Navarro, Anna Gonzalez-Neira, Maria Rosario Alonso, Guillermo Pita, Silvia Pineda, Juan Carlos Martin-Escudero, Ana Ortega, Josep Redon, Maria Tellez-Plaza, Raquel Cortes","doi":"10.1016/j.ejim.2025.03.022","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.022","url":null,"abstract":"<p><strong>Background: </strong>Circulating microRNAs (miRNAs) are emerging markers for cardiovascular prevention and control. miRNAs associated to vascular damage are candidates to play a causal role in the microvascular dysfunction of heart failure (HF). The aim was to evaluate the observational and causal (Mendelian randomization) association of miRNAs related with vascular alterations (miR-126-3p, miR-1260b and miR-374a-5p) with HF incidence in a sample from the general population.</p><p><strong>Methods: </strong>Plasma miRNAs levels were measured in 985 Hortega Study participants using real time quantitative polymerase chain reaction (RT-qPCR). Single nucleotide polymorphisms (SNPs) were genotyped with the TOPMED imputable Illumina GSA array. We identified genetic instrumental variables for miR-126-3p (33 SNPs), miR-1260b (22 SNPs) and miR-374a-5p (35 SNPs) and run several Mendelian randomization approaches.</p><p><strong>Results: </strong>The hazard ratio (95 % confidence interval) of HF by a 10-fold increase in miR-126-3p, miR-1260b and miR-374a-5p was 1.53 (1.09, 2.14), 1.38 (1.03, 1.86), and1.30 (1.09, 1.57), respectively. The corresponding rate differences were 9.7 (-0.1, 19.5), 12.0 (0.4, 23.6) and 9.1 (1.2, 17.1) per 10000 person-years. In flexible dose-response analysis, increased miRNAs levels were associated with higher HF risk, both in the relative and additive scale. In Mendelian randomization analysis, consistently suggestive positive causal associations were found with HF for increased miR-126-3p and miR-1260b levels, but not for miR-374a-5p.</p><p><strong>Conclusions: </strong>In observational analysis, miR-126-3p, miR-1260b and miR-374a-5p levels were positively associated with HF incidence. Mendelian randomization analysis supported a causal role for miR-126-3p and miR-1260b, thus suggesting a potential use as prognostic and therapeutic targets for HF prevention and control.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743904","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}