European Journal of Internal Medicine最新文献

{"title":"Refining the predictive value of nasal pressure swing in acute hypoxemic respiratory failure management.","authors":"Danyang Liu","doi":"10.1016/j.ejim.2025.03.020","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.020","url":null,"abstract":"","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":"143743998","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. Author's reply.","authors":"Huaqing Liu","doi":"10.1016/j.ejim.2025.03.026","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.026","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732778","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":"Excess mortality of critically ill patients aged ≥90 years in intensive care units: A retrospective cohort study.","authors":"Jan Frederic Weller, Kevin Roedl, Rikus Daniels, Pauline Theile, Jakob Müller, Frederik Peters, Claudia Lengerke, Carsten Bokemeyer, Liesbeth de Wreede, Stefan Kluge, Maximilian Christopeit","doi":"10.1016/j.ejim.2025.03.015","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.015","url":null,"abstract":"<p><strong>Introduction: </strong>The number of elderly patients (≥90 years) admitted to intensive care units (ICUs) is continuously increasing. Survival estimations that differentiate into population and excess mortality are lacking but might be warranted given the higher baseline mortality in this group.</p><p><strong>Methods: </strong>We evaluated excess mortality and risk factors in 1076 ICU patients ≥90 treated at the University Medical Center Hamburg-Eppendorf, Germany, from 2008 to 2019 by relative survival analysis. The Human Mortality Database of the German population served as reference.</p><p><strong>Results: </strong>Population mortality - vulgo baseline mortality - accounted for 22.2 % of the observed 1-year mortality rate of 57.8 %. Within the tenth and eleventh decade of life, excess mortality was not significantly influenced by age - neither in ICU patients (HR 0.98 (0.94-1.03), p = 0.46) nor in ICU survivors (HR 0.96 (0.91-1.02), p = 0·15, each per year). Yet, SAPS-II, SOFA scores, dementia, aortic valve stenosis, myocardial infarction and other factors significantly influenced survival. The initial excess mortality rate was high after ICU admission (excess mortality risk λ=0.059 for all patients), but lower after ICU survival (λ=0.022). After around 100 days, the excess mortality risk had disappeared.</p><p><strong>Discussion: </strong>In the largest dataset analyzed to date, we were able show that age did not significantly affect excess mortality of ICU patients aged 90 years or older. With respect to the severity of their illness, excess mortality of patients aged 90 years and older in ICUs is within an adequate range. Briefly after patients have left the ICU alive, mortality equals that of the general population.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711949","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 febrile woman with gas collection in the right upper abdomen.","authors":"Shinji Yoshida, Junpei Komagamine","doi":"10.1016/j.ejim.2025.03.024","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.024","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722471","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, Corrado Campochiaro, Gabriele Ciuti, Domenico Baccellieri, Vincenzo Ardita, Silvia Bellando Randone, Khadija El Aoufy, Dilia Giuggioli, Martina Orlandi, Lorenzo Dagna, Roberto Chiesa, Marco Matucci Cerinic, Alberto Moggi Pignone","doi":"10.1016/j.ejim.2025.03.019","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.019","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Objectives: </strong>To investigate the capacity of DUS to detect early CMI and the effect of the endovascular approach on CMI-related symptoms.</p><p><strong>Methods: </strong>DUS of splanchnic arteries was performed in symptomatic SSc patients, during routinary outpatient visits.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>CDU is a useful screening tool for CMI in SSc patients. Revascularization of stenotic mesenteric arteries seems to be a safe and effective procedure.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-25","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":"Efficacy and safety of crinecerfont for the treatment of congenital adrenal hyperplasia.","authors":"André Saad Cleto, João Matheus Schirlo, Janete Machozeki, Camila Marinelli Martins","doi":"10.1016/j.ejim.2025.03.021","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.021","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711947","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":"Clinical factors associated with limited therapeutic implementation in patients with heart failure and reduced ejection fraction hospitalized in internal medicine wards.","authors":"Arianna Bartoli, Mattia Donadoni, Elisa Ceriani, Chiara Cogliati","doi":"10.1016/j.ejim.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.018","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711945","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":"Ultra-processed foods and cardio-kidney-metabolic syndrome: A review of recent evidence.","authors":"Mehmet Kanbay, Lasin Ozbek, Mustafa Guldan, Sama Mahmoud Abdel-Rahman, Arif E Narin, Alberto Ortiz","doi":"10.1016/j.ejim.2025.03.017","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.017","url":null,"abstract":"<p><p>The rapid increase in the consumption of ultra-processed foods (UPFs) has become a significant global public health concern. UPFs are typically high in unhealthy fats, refined sugars, sodium, and other additives while being low in proteins, fibers, and other essential nutrients. Their high glycemic index and glycemic load lead to blood sugar spikes, contributing to metabolic dysregulation. Emerging evidence links UPF intake to the development of the cardiovascular-kidney-metabolic (CKM) syndrome and a higher risk of adverse health outcomes, such as all-cause and cardiovascular mortality. The pathophysiological mechanisms likely involve chronic inflammation, oxidative stress, dysregulated lipid metabolism, insulin resistance, immune dysfunction, and gut microbiota disruption. The adverse effects are even more concerning in vulnerable populations, including individuals with chronic kidney disease, kidney failure, and the elderly. This review article explores how UPF intake contributes to chronic diseases across the CKM spectrum, including cardiovascular disease, kidney disease, obesity, and type 2 diabetes mellitus, while also exacerbating frailty and reducing quality of life. The focus goes beyond risks of individual metabolic complications to address the broader health implications of UPFs on the increased prevalence of multiple coexistent non-communicable diseases, frailty, reduced quality of life, meta-inflammation, metabolic memory, and syndemics, which are particularly critical for the aging geriatric population.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694322","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":"R202Q homozygosity of Mediterranean fever gene is associated with atypical clinical phenotype of familial Mediterranean fever.","authors":"Dimitrios Sagris, Christina Antoniadou, Nikolaos K Gatselis, Efstratios Gavriilidis, Vasileios Papadopoulos, Sarah Georgiadou, Stella Gabeta, Victoria Tsironidou, Konstantinos P Makaritsis, Panagiotis Skendros, Eirini I Rigopoulou, Konstantinos Ritis, George N Dalekos","doi":"10.1016/j.ejim.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.016","url":null,"abstract":"<p><strong>Objective: </strong>Apart from the classical phenotypes, familial Mediterranean fever (FMF) has several atypical manifestations making its diagnosis quite challenging. Our aim was to address the characteristics of FMF patients and the clinical importance of R202Q variant in a large cohort of patients from Greece.</p><p><strong>Methods: </strong>Prospectively collected data from 321 FMF patients were retrospectively reviewed and analyzed. All patients were tested for Mediterranean fever gene/MEFV alterations in exon-2 and exon-10, by non-isotopic RNase-cleavage assay, and subsequent sequencing analysis. Hardy-Weinberg equilibrium (HWE) was used to assess R202Q allelic and genotypic frequencies in relation to FMF HWE.</p><p><strong>Results: </strong>Among 223 FMF patients with available follow-up data, 54.3 % were females and mean age at diagnosis was 35.4 ± 16.7 years. Regarding genetic analysis, 38.2 % had pathogenic/likely pathogenic variants, 12.1 % had variants of unknown significance, 16.1 % were R202Q homozygotes, while 33.6 % had negative genetic test. As explained by the strong deviation from HWE observed among FMF patients (p < 0.0001), R202Q homozygosity is considered disease-related. R202Q homozygosity was identified mainly among native Greeks (77.8 %) and was associated with a higher age of disease onset (p < 0.001) and a lower occurrence of abdominal pain (p < 0.001) compared to pathogenic/likely pathogenic variants. R202Q homozygosity (10/30, 33.3 %) was associated with atypical disease phenotype (OR: 1.95, 95 %CI: 1.24-3.08, p = 0.004) after adjustment for age, origin and sex.</p><p><strong>Discussion and conclusion: </strong>Excess R202Q homozygosity was observed among Greek FMF patients presenting atypical/non-criteria manifestations. In patients with periodic fevers and atypical clinical phenotype, the identification of R202Q homozygosity is linked with the diagnosis of FMF.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694319","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":"Wheels within wheels: Diagnostic and risk modifiers for familial hypercholesterolemia in the community.","authors":"Seyed Saeed Tamehri Tamehri Zadeh, Jing Pang, Gerald F Watts","doi":"10.1016/j.ejim.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.03.014","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694323","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}