Paul Lips, Renate T de Jongh, Natasja M van Schoor
{"title":"Vitamin D supplements for prevention of diseases.","authors":"Paul Lips, Renate T de Jongh, Natasja M van Schoor","doi":"10.1016/j.ejim.2025.06.028","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.06.028","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530891","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}
Henrik Falhammar, Mikael Andersson Franko, Jonatan D Lindh, Jakob Skov, Buster Mannheimer
{"title":"Neurologic and psychiatric disorders following correction of profound hyponatremia - A cohort study.","authors":"Henrik Falhammar, Mikael Andersson Franko, Jonatan D Lindh, Jakob Skov, Buster Mannheimer","doi":"10.1016/j.ejim.2025.06.023","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.06.023","url":null,"abstract":"<p><strong>Background: </strong>Rapid correction of profound hyponatremia (serum sodium <125 mmol/L) has been associated with osmotic demyelination syndrome (ODS) but this has been challenged. Potential associations with other neurological and psychiatric diseases have not been studied.</p><p><strong>Methods: </strong>The basis of this study was the Stockholm Sodium Cohort, a laboratory data repository covering inhabitants of the Stockholm Region who had a sodium concentration analyzed (2005-2018, n = 1632,249). Patients admitted with profound hyponatremia for the first time during the study period where sodium correction rates during the first 24 h could be calculated were included. Sodium correction ≤8 and >8 mmol/L/24 h was compared.</p><p><strong>Results: </strong>Hospitalization with profound hyponatremia occurred in 7623 individuals, 3199 (42.0 %) were males, and the median age was 70 years (IQR 59-80 years). Alcohol misuse was present in 18.3 %, a neurological and/or psychiatric disease in 52.4 % and hypokalemia in 27.9 %. The recommended correction rate ≤8 mmol/L/24 h was adhered to in 3985 (52.3 %) patients. Seven patients (0.09 %) were diagnosed with ODS, six had a correction rate >8 mmol/L/24 h (compared to 1 patient with a correction rate ≤8 mmol/L, P = 0.0441). The risk of new neurological or psychiatric diseases did not differ significantly between those with a correction rate ≤8 mmol/L/24 h and those above in the fully adjusted model (adjusted hazard ratio 1.02 95 %CI 0.89-1.17)) nor in the subgroups.</p><p><strong>Conclusions: </strong>ODS was rare, however, mainly associated with rapid correction. Consequently, slow correction may be preferable.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509256","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":"Survival effect of early high-flow nasal oxygen after the extubation of patients in the intensive care unit.","authors":"Atsushi Ishihara, Hideshi Okada, Teruki Mori, Takashi Yoshizane, Kentaro Morishita, Takuji Yamamoto, Izumi Toyoda, Toshiyuki Noda","doi":"10.1016/j.ejim.2025.06.021","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.06.021","url":null,"abstract":"<p><strong>Background: </strong>Reintubation of patients admitted to the intensive care unit (ICU) is associated with mortality risk during the clinical course. We aimed to investigate the survival effect of early high-flow nasal oxygen (HFNO) using the respiratory rate oxygenation (ROX) index cutoff point of 12.8 for early HFNO introduction following the extubation of patients in the ICU.</p><p><strong>Methods: </strong>This study comprised 315 patients, divided into two groups: 159 patients admitted to the ICU from January 2021 to June 2022, before the establishment of the extubation criteria, and 156 patients admitted from July 2022 onwards, after the criteria were established. The exclusion criteria were death in the ICU, absence of extubation, and tracheotomy. We compared the HFNO reintubation rate and ROX index 2 h after extubation, before and after the establishment of early HFNO introduction criteria.</p><p><strong>Results: </strong>The HFNO use rates before and after the application of the early HFNO criteria were not significantly different. However, the mortality rate significantly decreased following early HFNO use. Additionally, the period until the HFNO introduction was significantly different. The HFNO use rate within 2 h of extubation was significantly higher after the application of the early HFNO use criteria compared to before. Furthermore, significant differences were noted in the reintubation rate and length of ICU stay.</p><p><strong>Conclusions: </strong>Early HFNO use after extubation in patients admitted to the ICU may reduce mortality and reintubation rate in the ICU. The ROX index is effective, can sensitively detect breathing changes, and is easy to implement.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486816","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":"Community-acquired pneumonia: The burden echoes well beyond discharge.","authors":"Andrei M Darie, Daiana Stolz","doi":"10.1016/j.ejim.2025.06.020","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.06.020","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486815","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":"Prognostic value of N-terminal prohormone B-type natriuretic peptide modified by renal function in patients with acute heart failure.","authors":"Rui Zhu, Yaoyao Wang, Lili Liu, Xuejiao Liu, Zhanyuan Chen, Yu Wei, Weifeng Lin, Lihua Zhang, Guangda He, Jianfang Cai","doi":"10.1016/j.ejim.2025.06.017","DOIUrl":"10.1016/j.ejim.2025.06.017","url":null,"abstract":"<p><strong>Introduction: </strong>It remains unclear whether renal function and follow-up duration impact the prognostic value of N-terminal prohormone B-type natriuretic peptide (NT-proBNP) in patients with heart failure (HF).</p><p><strong>Methods: </strong>A nationwide prospective cohort study was conducted in 4907 adults hospitalized for acute HF, of whom 4766 were eligible for analysis. We used Cox regression to estimate the relative risks and Poisson regression to assess the absolute risks of adverse outcomes associated with NT-proBNP levels at admission. Effect modification by renal function was tested in both Cox and Poisson models.</p><p><strong>Results: </strong>Over a median follow-up period of 4.6 years, patients with the middle and highest NT-proBNP tertiles had hazard ratios (HRs) (95 % CI) of 1.41 (1.24-1.59) and 2.15 (1.89-2.44) for all-cause mortality, 1.59 (1.37-1.85) and 2.35 (2.01-2.74) for cardiovascular mortality, respectively, compared to those with the lowest tertile. These associations diminished over time. The associations between NT-proBNP levels and the risks of mortality (P-for-interaction < 0.01) were modified by estimated glomerular filtration rate (eGFR) levels, remaining significant yet weaker in HF patients with eGFR <30 ml/min/1.73m<sup>2</sup>. The incidence rates of mortality at the same NT-proBNP level were higher in HF patients with lower eGFR (P-for-interaction < 0.05).</p><p><strong>Conclusion: </strong>NT-proBNP levels demonstrated graded associations with the risks of adverse outcomes. As eGFR reduced, its excessive relative risks attenuated, while its absolute risks increased. The associations waned over an extended follow-up period. These findings highlight the prognostic significance of NT-proBNP in patients with reduced renal function and the necessity of its dynamic monitoring.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369496","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":"Efficacy and safety of beta-blockers in patients with comorbid chronic obstructive pulmonary disease and cardiovascular disease.","authors":"Tejuss Kakarla, Yash Vardhan Trivedi, Parth Munjal, Avi Kumar, Rohit Jain","doi":"10.1016/j.ejim.2025.06.018","DOIUrl":"10.1016/j.ejim.2025.06.018","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340583","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":"Substantial variety in point of care ultrasound training across EFIM.","authors":"N Smallwood, J Neves","doi":"10.1016/j.ejim.2025.06.015","DOIUrl":"10.1016/j.ejim.2025.06.015","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340584","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}
Lurbe E, Regueiro-Ons C, Mancia G, Düzova A, Erdine S, Herceg-Cavrak V, Kulaga Z, Litwin M, Pall D, Petricevic N, Seeman T, Simão C, Stabouli S, Redon J, González López-Valcarcel B
{"title":"Blood pressure values in healthy normal weight children and adolescents in eight European countries: auscultatory and oscillometric measurements.","authors":"Lurbe E, Regueiro-Ons C, Mancia G, Düzova A, Erdine S, Herceg-Cavrak V, Kulaga Z, Litwin M, Pall D, Petricevic N, Seeman T, Simão C, Stabouli S, Redon J, González López-Valcarcel B","doi":"10.1016/j.ejim.2025.06.011","DOIUrl":"10.1016/j.ejim.2025.06.011","url":null,"abstract":"<p><strong>Aim: </strong>The aim of the study is to provide BP values adjusted for sex, age and height in a large sample of healthy and normal weight children and adolescents 3-17 years in eight European countries, using standardized BP measurement by oscillometric and auscultatory methods.</p><p><strong>Subjects and methods: </strong>In 38.374 children (20.189 girls) BP values were measured following the European Society of Hypertension guidelines. To derive BP percentiles the estimated influences of age and height simultaneously on BP levels were estimated.</p><p><strong>Results: </strong>The estimated BP values corresponding to 90th, 95th, and 99th systolic and diastolic percentiles according to height percentiles, age and sex were calculated. In both methods, the 90th and 95th percentiles of systolic blood pressure, tended to increase with both age and height, higher in boys than in girls without differences in diastolic blood pressure. The study illustrates the differences in 95th Blood Pressure percentile obtained by oscillometric and auscultatory methods in both sexes at the 50th height percentile. The threshold corresponding to 95th percentile at age 13 is close to 130/80 mmHg in both sexes and measurement methods at median height and at age 17 it is around 140/90 mmHg for boys.</p><p><strong>Conclusions: </strong>The progressive increment of blood pressure in children across age is largely influenced by height. In boys blood pressure values still increase after 13 years old, while in girls the BP increment after this age was lower. Differences in systolic blood pressure and diastolic blood pressure among the two used methods are minimal except in the oldest age group.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337188","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}
Christopher Paschen, Franziska Ecker, Patrick Haider, Claudia Wenzel, Eva Katharina Masel
{"title":"Determinants of time to first palliative care consultation in hospitalized patients with advanced or terminal illness - A retrospective analysis.","authors":"Christopher Paschen, Franziska Ecker, Patrick Haider, Claudia Wenzel, Eva Katharina Masel","doi":"10.1016/j.ejim.2025.06.013","DOIUrl":"10.1016/j.ejim.2025.06.013","url":null,"abstract":"<p><strong>Background: </strong>Diagnosis and sex-related biases can affect clinical decision-making in serious illness, including the recognition of palliative needs. Such biases may influence when and how patients receive palliative care (PC). This study aimed to investigate differences in timing and frequency of PC consultations by diagnosis, comorbidities, age, and sex among hospitalized patients.</p><p><strong>Methods: </strong>This study retrospectively analyzed 918 patients (50.5 % female) who received a PC consultation during hospitalization between 2016 and 2022. Time from admission to first PC consultation was analyzed using a Cox proportional hazards model adjusted for primary diagnosis, comorbidities, age, and sex. Further analysis included number of follow-up consultations, time from primary disease onset to first PC consultation, and from consultation to discharge or death.</p><p><strong>Results: </strong>Inpatients with organ failure (HR: 0.7 [95 %-CI: 0.5-0.9]; p = 0.02) or neurological diseases (HR: 0.7 [95 %-CI: 0.5-1.0]; p = 0.03) received later PC consultations than those with solid organ tumors or hematologic malignancies. Higher comorbidity burden was associated with earlier PC consultation (HR: 1.04 [CI: 1.01-1.07]; p = 0.02), while age was not linked to consultation timing (HR: 0.997 [CI: 0.992-1.002]; p = 0.20). Women received earlier PC consultations than men (HR: 1.3 [95 %-CI: 1.1-1.4]; p < 0.001). Only 9.4 % of individuals received a follow-up consultation, with the lowest proportion in subjects with organ failure (4.7 %).</p><p><strong>Conclusions: </strong>This study highlights earlier PC consultation requests during hospitalization for individuals with malignant diseases and for women. The low rate of follow-up PC consultations indicates that the importance of regular PC involvement to improve patient's outcomes still did not permeate into clinical practice.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337189","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}
Shiqing Zhao, Shengpu Zhou, Junmei Wang, Yanyan Shi
{"title":"When inflammatory bowel disease meets pregnancy.","authors":"Shiqing Zhao, Shengpu Zhou, Junmei Wang, Yanyan Shi","doi":"10.1016/j.ejim.2025.06.014","DOIUrl":"10.1016/j.ejim.2025.06.014","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a group of chronic and relapsing inflammatory conditions that affect the gastrointestinal tract. Women of reproductive age comprise a significant proportion of patients with IBD. The management of IBD during pregnancy presents unique and complex challenges that have garnered increasing attention recently. Moreover, considerable attention has been directly toward the safety of novel treatments for IBD during pregnancy. This review summarises the complex interaction between pregnancy and IBD, the special management of IBD during pregnancy, and the effects of early life events on IBD of offspring.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337190","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}