European Journal of Internal Medicine最新文献

{"title":"Fever and eye swelling in a teenager","authors":"Haruhiko Fukuchi , Kazuya Nagasaki","doi":"10.1016/j.ejim.2025.07.026","DOIUrl":"10.1016/j.ejim.2025.07.026","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"140 ","pages":"Article 106430"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745791","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":"Uric acid and heart failure with mildly reduced ejection fraction (HFmrEF): one more step","authors":"Claudio Borghi, Giulia Fiorini","doi":"10.1016/j.ejim.2025.106453","DOIUrl":"10.1016/j.ejim.2025.106453","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"140 ","pages":"Article 106453"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800846","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":"Annual chest computed tomography in multimorbid COPD: is universal screening clinically feasible?","authors":"Shilun Yu, Jinliang Han, Luyu Yue, Yunlong Song","doi":"10.1016/j.ejim.2025.106504","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.106504","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":"106504"},"PeriodicalIF":6.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208355","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 between sPESI score and 90-day hospital readmissions in patients with acute pulmonary embolism.","authors":"Kwadwo O Bonsu, Rufaro S Chitsike, Tiffany A Lee, Hai V Nguyen, Stephanie W Young","doi":"10.1016/j.ejim.2025.106532","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.106532","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":"106532"},"PeriodicalIF":6.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202051","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":"Not all immunosuppression is equal: Implications for post-discharge outcomes in community-acquired pneumonia - Authors' reply.","authors":"Fabian Reichel, Martin Kolditz","doi":"10.1016/j.ejim.2025.106534","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.106534","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":"106534"},"PeriodicalIF":6.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208411","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":"Cardiovascular-kidney-metabolic domains and impact on antithrombotic treatment, integrated care and clinical outcomes in patients with atrial fibrillation: results from a prospective European registry.","authors":"Davide Antonio Mei, Jacopo Francesco Imberti, Marco Vitolo, Giulio Francesco Romiti, Bernadette Corica, Marta Mantovani, Niccolò Bonini, Benedetta Cherubini, Francisco Marin, Igor Diemberger, Gheorghe Andrei Dan, Tatjana Potpara, Marco Proietti, Gregory Y H Lip, Giuseppe Boriani","doi":"10.1016/j.ejim.2025.106512","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.106512","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular, kidney, and metabolic (CKM) conditions frequently coexist with atrial fibrillation (AF), but their impact in AF population remains poorly characterized.</p><p><strong>Objective: </strong>To evaluate the prevalence, clinical impact of CKM domains and the effect of integrated care on outcomes in a European cohort of patients with AF.</p><p><strong>Methods: </strong>In the EORP-AF General Long-Term Registry, we define CKM domains according to cardiovascular, kidney and metabolic conditions. Patients were stratified by the number and combinations of CKM domains. The primary outcome was a composite of all-cause death, acute coronary syndrome, and thromboembolic events. The impact of adherence to the Atrial fibrillation Better Care (ABC) integrated care pathway was assessed.</p><p><strong>Results: </strong>Among 7,736 individuals included in the analysis (39.8 % women; mean age 68.1 [SD 11.6] years), CKM domains were highly prevalent (93.7 % had ≥1 domain; 21.4 % had all three), with regional variation. A higher burden of CKM domains was associated with increased risk of primary outcome events (hazard ratio [HR] [95 % confidence interval] 1 vs 0 domains: HR 1.45 [0.93-2.26]; 2 vs 0: HR 2.05 [1.32-3.19]; 3 vs 0: HR 2.69 [1.71-4.23]). Groups including the cardiovascular domain, especially cardio-kidney, had the highest hazard of events (HR 4.00 [2.41-6.65]). ABC pathway adherence was associated with lower risk of events consistently across number (Pint = 0. 585) and group (Pint = 0.063) of CKM domains.</p><p><strong>Conclusions: </strong>In this large cohort of European AF patients, CKM domains were highly prevalent and associated with progressively worse outcomes. ABC-integrated care was associated with favourable outcomes across CKM profiles.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":"106512"},"PeriodicalIF":6.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208330","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":"Short and long term effects of a two-week transcutaneous vagus nerve stimulation in hyperadrenergic postural orthostatic tachycardia syndrome: a proof-of-concept trial.","authors":"Dana Shiffer, Stefano Rigo, Maura Minonzio, Deniz Timothy Yarsuvat, Eleonora Tobaldini, Ludovico Furlan, Nicola Montano, Beatrice Cairo, Alberto Porta, Antonio Roberto Zamunér, Stefanos Bonovas, Vasile Urechie, Italo Biaggioni, André Diedrich, Raffaello Furlan","doi":"10.1016/j.ejim.2025.106529","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.106529","url":null,"abstract":"<p><strong>Background and aims: </strong>Hyperadrenergic POTS (Hyper-POTS) is characterized by excessive central sympathetic activity and impaired cardiovagal modulation. A single transcutaneous vagus nerve stimulation (tVNS) rebalanced cardiovascular autonomic control in previous studies. Repetitive tVNS may similarly restore autonomic balance and improve symptoms in Hyper-POTS.</p><p><strong>Methods: </strong>Twenty-two Hyper-POTS were studied at baseline (Pre-tVNS), after 14 days of tVNS (tVNS), and within 24 months post-discontinuation (Post-tVNS). The modified Vanderbilt Orthostatic Symptoms Score (mVOSS) quantified symptoms. ECG, arterial pressure, respiratory activity, and muscle sympathetic nerve activity (MSNA) were continuously recorded while supine and during 75° head-up tilt (HUT). Cardiac vagal modulation (high frequency power,HF_RR), sinoatrial node sympatho-vagal interaction (low-to high-frequency ratio,LF/HF), sympathetic vasomotor control (LF_SAP) and arterial baroreflex sensitivity (α_LF) were assessed by spectral analysis. Baroreflex sensitivity was also evaluated by spontaneous sequences (BRS) technique.</p><p><strong>Results: </strong>At tVNS, MSNA decreased in both positions. tVNS increased HF_RR and decreased LF/HF in supine. During HUT, αLF increased, HF_RR increased_, and HR decreased compared to Pre-tVNS. Total symptom score declined in both positions, with improvements in multiple mVOSS domains during tilt. At Post-tVNS, HF_RR and BRS increased in both positions. During HUT, αLF increased, HR and LF_SAP decreased. MSNA returned to Pre-tVNS in both positions. Total symptom score showed sustained improvement.</p><p><strong>Conclusions: </strong>Fourteen-day tVNS enhanced cardiovagal modulation, reduced sympathetic activity, and improved orthostatic symptoms in Hyper-POTS patients. Additionally, some benefits persisted beyond the stimulation period. Thus, tVNS could potentially be used as an additional therapeutic tool in Hyper-POTS.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":"106529"},"PeriodicalIF":6.1,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187353","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":"Effectiveness of tezepelumab in severe asthma: A multicenter real-world study.","authors":"Remo Poto, Gianluca Manganello, Antonio di Salvatore, Ludovica Capitelli, Gianluca Lagnese, Carla Messuri, Tommaso Muto, Fausto De Michele, Gilda Varricchi","doi":"10.1016/j.ejim.2025.106528","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.106528","url":null,"abstract":"<p><p>Severe asthma is a complex, heterogeneous disease that remains a major therapeutic challenge. Despite several biologics targeting type 2 (T2) inflammation, some patients remain uncontrolled, highlighting the need for upstream interventions. Tezepelumab, a monoclonal antibody against thymic stromal lymphopoietin (TSLP), has shown broad efficacy in randomized trials regardless of eosinophilic status or biomarker levels. We conducted a prospective, multicenter, observational study to assess real-world effectiveness and safety of tezepelumab in severe asthma. Thirty patients were enrolled at two tertiary centers in Italy between September 2023 and December 2024. Inclusion criteria were a severe asthma diagnosis per ERS and GINA 2024 guidelines and inadequate control despite maximal inhaled therapy. Tezepelumab was given at 210 mg every 4 weeks. Clinical, functional, and biomarker data were collected at baseline, 1 month, and 6 months. After six months, patients showed significant improvement in Asthma Control Test (ACT) score, with marked reductions in oral glucocorticoid use and exacerbation rate. Sinonasal symptoms improved over time. Blood eosinophils and FeNO decreased significantly, while total IgE remained unchanged. Lung function improved in both FEV₁/FVC ratio and FEF_25-75, suggesting benefit on airflow limitation and small airway function. No serious adverse events occurred. Improvements were consistent in both T2-high and T2-low subgroups. This real-world study confirms tezepelumab's clinical effectiveness and safety in severe asthma. Benefits across inflammatory phenotypes support TSLP blockade as a broad-spectrum therapeutic approach. Larger, longer-term studies are warranted to confirm results and identify response predictors.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":"106528"},"PeriodicalIF":6.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182341","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":"Non-cardiac surgeries in adults with congenital heart disease -influence of complexity of disease and estimated risk of surgery on adverse events.","authors":"Alicia Jeanette Friedrich, Robert Radke, Stefan Orwat, Gerrit Kaleschke, Philipp Darius Garthe, Fernando de Torres-Alba, Kevin Willy, Joachim Gerß, Helmut Baumgartner, Gerhard-Paul Diller, Jeanette Köppe","doi":"10.1016/j.ejim.2025.106514","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.106514","url":null,"abstract":"<p><strong>Background: </strong>To provide information on adults with congenital heart disease (ACHD) undergoing non-cardiac surgeries (NCS), specific risk compared non-ACHD, independent risk factors for adverse outcome and mortality.</p><p><strong>Methods: </strong>Based on non-selective data including all in-hospital admissions in Germany from 2009 to 2021, all ACHD cases that underwent NCS were selected. NCS was categorized in low, medium and high-risk procedures. As primary endpoints, major adverse cardiovascular events (MACE), major infection (MIE), major bleeding (MBE), major thromboembolism (MTE), and in-hospital death were defined. Outcomes of ACHD were compared to a propensity score matched cohort of non-ACHD.</p><p><strong>Results: </strong>Overall, 15,349 inpatient ACHD cases were selected for analysis. Of those 72.3 % (n=11,094) were simple, 20.1 % (n=3,086) were moderate and 7.6 % (n=1,169) were complex ACHD. Patients with more than moderate ACHD faced a substantially higher risk for adverse outcome regarding all predefined endpoints compared to non-ACHD. Specifically, risk for MACE was increased with an Odds ratio (OR) of 1.29 (95 % CI 1.11-1.51) for moderate ACHD and OR 1.58 (95 % CI 1.23-2.02) for complex ACHD. In-hospital mortality was OR 1.39 (95 % CI 1.13-1.71) for moderate and OR 2.22 (95 % CI 1.62-3.03) for complex ACHD compared to non-ACHD.</p><p><strong>Conclusions: </strong>Patients with more than moderate complexity ACHD are at specific risk for adverse outcomes when undergoing non-cardiac surgery. Further analyses are needed to give precise recommendations on the choice of appropriate surgical site as well as how to improve care and outcome of ACHD undergoing NCS.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":"106514"},"PeriodicalIF":6.1,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182342","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":"Serum transthyretin in ATTR-CM: A pragmatic biomarker edging toward prime time.","authors":"Alberto Aimo, Vincenzo Castiglione, Giuseppe Vergaro","doi":"10.1016/j.ejim.2025.106531","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.106531","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":"106531"},"PeriodicalIF":6.1,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180072","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}