European Journal of Internal Medicine最新文献

{"title":"Considerations on the impact of apixaban on patient-reported outcomes in frail older adults","authors":"Kuo-Chin Hung , Chia-Ter Chao","doi":"10.1016/j.ejim.2025.02.020","DOIUrl":"10.1016/j.ejim.2025.02.020","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 141-142"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460489","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":"Critical considerations for sodium bicarbonate therapy in metabolic acidosis: Addressing confounding factors and methodological limitations","authors":"Danyang Liu","doi":"10.1016/j.ejim.2025.02.034","DOIUrl":"10.1016/j.ejim.2025.02.034","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 149-150"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568755","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":"More on peripheral artery disease and air pollution. Author's reply","authors":"Chiara Di Blasi , Alberto Maria Settembrini , Massimo Stafoggia , Matteo Renzi , Pier Mannuccio Mannucci","doi":"10.1016/j.ejim.2025.03.004","DOIUrl":"10.1016/j.ejim.2025.03.004","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 147-148"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588014","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":"Tularemia for clinicians: An up-to-date review on epidemiology, diagnosis, prevention and treatment","authors":"Roberta Maria Antonello ,&nbsp;Andrea Giacomelli ,&nbsp;Niccolò Riccardi","doi":"10.1016/j.ejim.2025.03.013","DOIUrl":"10.1016/j.ejim.2025.03.013","url":null,"abstract":"<div><div>Tularemia, also known as rabbit fever, caused by <em>Francisella tularensis</em>, is re-emerging in the Northern Hemisphere and in particular in Europe in recent years. It is a bacterial zoonotic, arthropod-borne, air-borne, food- and water-borne disease and the multiple routes of infection result in six typical clinical pictures (ulceroglandular, glandular, oculoglandular, oropharyngeal, typhoidal, and pneumonic) along with several other uncommon presentations, potentially affecting any body site. In addition, due to the ease of airborne transmission, <em>F. tularensis</em> is a category A agent for bioterrorism. If not promptly diagnosed and treated, the fatality rate can be as high as 60 %, with the poorest outcomes reported in the pneumonic and typhoidal forms. Gentamicin is the first-line treatment for severe tularemia, while fluoroquinolones and tetracyclines are commonly the drugs of choice in less severe forms. Prevention is based on environmental and animal control strategies, proper signaling of the clinical suspicion to the laboratory staff and postexposure prophylaxis. In consideration of the re-emergence of the disease and the diagnostic and therapeutic challenges it poses, we performed a comprehensive up-to-date review of tularemia epidemiology, clinical presentation, diagnostic tools, treatment and prevention strategies.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 25-32"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665115","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":"Impact of L-arginine and liposomal vitamin C supplementation on quality of life and daily life activities in patients with COPD: a randomized, multicenter, single blind, placebo-controlled trial (ILDA study).","authors":"Dejan Radovanovic, Juan Camilo Signorello, Giuseppe Fuccia, Giada Lazzaroni, Fiammetta Danzo, Gualtiero Maria Guandalini, Federica Massaro, Francesco Tursi, Pierachille Santus","doi":"10.1016/j.ejim.2025.04.039","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.04.039","url":null,"abstract":"<p><strong>Objective: </strong>Chronic Obstructive Pulmonary Disease (COPD) patients experience limitations in activities of daily living (ADL) despite optimal inhaled treatment. L-arginine depletion is associated with poor exercise performance. Our aim was to assess whether oral L-arginine supplementation improves dyspnea and ADL in COPD patients.</p><p><strong>Design and methods: </strong>Randomized, multicenter, single blind, placebo-controlled study (NCT05412160). Stable COPD patients received L-arginine (1.66 g) plus liposomal vitamin C (500 mg) twice daily or placebo for 4 weeks. At baseline (T0) and after treatment (T1) lung function, six minutes walking test (6MWT), dyspnea and ADL perfomance, evaluated through: COPD assessment test (CAT), self-administered chronic respiratory questionnaire (CRQ-SA), Clinical COPD Questionnaire 24 h and 7 days (CCQ) and London Chest Activity of Daily Living Scale (LCADL) -were assessed. The primary endpoint was CRQ score change compared with placebo.</p><p><strong>Results: </strong>150 patients were enrolled (67 % males, median FEV1 57 %predicted), with 76 receiving L-arginine. Baseline characteristics and questionnaire scores were balanced between arms. At T1, L-arginine patients demonstrated significant improvements compared to placebo in CRQ total score (median (IQR) 3.5 (0.0;6.75); P = 0.006), CRQ dyspnea domain (3.0 (0.0;6.0); P < 0.001); LCADL total score (-1.0 (-3.0;0.0); P = 0.005); LCADL housework (-1.0 (-3.0;0.0); P < 0.001) and LCADL free time (0.0 (-1.0;0.0); P = 0.003). More L-arginine patients reached the minimal clinically important difference (MCID) in CRQ dyspnea and total LCADL. Baseline CRQ dyspnea<20 (OR (95 %CI): 4.296 (2.051-8.999); P < 0.001) and a LCADL score<27 (7.126 (2.729-18.609); P < 0.001) predicted MCID response.</p><p><strong>Conclusion: </strong>Oral supplementation with L-arginine added to inhaled therapy appears to improve dyspnea and ADL in COPD.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052229","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":"Doppler ultrasound unveils splanchnic arteries ischemia allowing early successful revascularization in symptomatic systemic sclerosis patients","authors":"Giulia Bandini ,&nbsp;Corrado Campochiaro ,&nbsp;Gabriele Ciuti ,&nbsp;Domenico Baccellieri ,&nbsp;Vincenzo Ardita ,&nbsp;Silvia Bellando Randone ,&nbsp;Khadija El Aoufy ,&nbsp;Dilia Giuggioli ,&nbsp;Martina Orlandi ,&nbsp;Lorenzo Dagna ,&nbsp;Roberto Chiesa ,&nbsp;Marco Matucci Cerinic ,&nbsp;Alberto Moggi Pignone","doi":"10.1016/j.ejim.2025.03.019","DOIUrl":"10.1016/j.ejim.2025.03.019","url":null,"abstract":"<div><h3>Background</h3><div>Systemic sclerosis (SSc) is characterized by macro and microvasculopathy, including splanchnic circulation. Chronic mesenteric ischemia (CMI) is a potentially severe condition which can complicate SSc gastrointestinal vasculopathy. Doppler ultrasound (DUS) may be a non-invasive procedure for identifying CMI in symptomatic SSc patients.</div></div><div><h3>Objectives</h3><div>To investigate the capacity of DUS to detect early CMI and the effect of the endovascular approach on CMI-related symptoms.</div></div><div><h3>Methods</h3><div>DUS of splanchnic arteries was performed in symptomatic SSc patients, during routinary outpatient visits.</div></div><div><h3>Results</h3><div>In 6 out of 72 SSc symptomatic patients, DUS suggested a splanchnic vessels stenosis which was confirmed by computed tomography angiography (CTA). After multidisciplinary evaluation in 3 patients a revascularization was performed. Three-monthly clinical and DUS follow-up was negative in all patients.</div></div><div><h3>Conclusion</h3><div>CDU is a useful screening tool for CMI in SSc patients. Revascularization of stenotic mesenteric arteries seems to be a safe and effective procedure.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 126-129"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722474","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 ,&nbsp;Olga Martinez-Arroyo ,&nbsp;Marta Rubia-Martinez ,&nbsp;Ana Flores-Chova ,&nbsp;Zulema Rodriguez-Hernandez ,&nbsp;Pablo Fernández-Navarro ,&nbsp;Anna Gonzalez-Neira ,&nbsp;Maria Rosario Alonso ,&nbsp;Guillermo Pita ,&nbsp;Silvia Pineda ,&nbsp;Juan Carlos Martin-Escudero ,&nbsp;Ana Ortega ,&nbsp;Josep Redon ,&nbsp;Maria Tellez-Plaza ,&nbsp;Raquel Cortes","doi":"10.1016/j.ejim.2025.03.022","DOIUrl":"10.1016/j.ejim.2025.03.022","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 118-125"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","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}

{"title":"Building on the UTILY Study: Exploring uncharted aspects of multidrug-resistant pathogens in urinary tract infections","authors":"Heng Xiao ,&nbsp;Wen Xiao ,&nbsp;Xinmin Deng","doi":"10.1016/j.ejim.2025.01.026","DOIUrl":"10.1016/j.ejim.2025.01.026","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 136-137"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076180","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":"Lipoprotein(a) and prothrombotic effects: Evidence from a genetic association study","authors":"Elena Olmastroni ,&nbsp;Julius L. Katzmann ,&nbsp;Federica Galimberti ,&nbsp;Ulrich Laufs ,&nbsp;Alberico L. Catapano","doi":"10.1016/j.ejim.2025.01.021","DOIUrl":"10.1016/j.ejim.2025.01.021","url":null,"abstract":"<div><h3>Background</h3><div>It is unknown whether lipoprotein(a) [Lp(a)] has prothrombotic effects contributing to its association with the risk of myocardial infarction (MI).</div></div><div><h3>Methods</h3><div>In 410,177 participants of UK Biobank, associations of <em>LPA</em> genetic variants and observed Lp(a) concentrations with the risk of venous thromboembolism (VTE) and MI were investigated, stratified by scores of genetic variants influencing coagulation through the thrombin and platelet pathways (denoted as <em>F2</em>/<em>F5</em> and <em>GUCY1A3</em> scores, respectively). Risk estimates are expressed as hazard ratio (HR) and 95% confidence interval (95% CI).</div></div><div><h3>Results</h3><div>Neither <em>LPA</em> genetic variants nor observed Lp(a) concentration were associated with the risk of incident VTE (HR per 100 nmol/L higher Lp(a) 1.02, 95% CI 1.00–1.04, <em>p</em>=0.13). In contrast, there was a strong association with the risk of incident MI (HR per 100 nmol/L higher Lp(a) 1.31, 95% CI 1.29–1.33, <em>p</em>&lt;0.001). The <em>F2</em>/<em>F5</em> score was associated with a stepwise decrease in the risk of VTE, and the <em>GUCY1A3</em> score with a stepwise decrease in the risk of MI. However, the associations of <em>LPA</em> genetic variants and observed Lp(a) concentrations with the risk of MI were not modified by stratification for either of the coagulation scores.</div></div><div><h3>Conclusion</h3><div>The association between Lp(a) and MI was not modified by genetically determined levels of coagulation activity through the thrombin or platelet pathway. Our findings do not support the notion that the increased risk of MI caused by elevated Lp(a) is due to prothrombotic effects.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 47-54"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076284","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":"Chest pain, inflammatory syndrome and headache","authors":"Romain Batton ,&nbsp;Ludivine Lebourg ,&nbsp;Gaëtan Sauvêtre","doi":"10.1016/j.ejim.2025.02.039","DOIUrl":"10.1016/j.ejim.2025.02.039","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 134-135"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598272","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}