European Journal of Internal Medicine最新文献

{"title":"When skin and lung meet","authors":"Sara Piciucchi , Stefano Oldani , Venerino Poletti","doi":"10.1016/j.ejim.2025.01.024","DOIUrl":"10.1016/j.ejim.2025.01.024","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 132-133"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076287","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":"How to promote healthy aging across the life cycle","authors":"Camilla Cocchi ,&nbsp;Maria Beatrice Zazzara ,&nbsp;Elena Levati ,&nbsp;Riccardo Calvani ,&nbsp;Graziano Onder","doi":"10.1016/j.ejim.2025.03.003","DOIUrl":"10.1016/j.ejim.2025.03.003","url":null,"abstract":"<div><div>The global rise in aging populations is challenging healthcare systems, especially in developed countries. Despite advancements in healthcare and living standards, the extension of lifespan has not been matched by an equivalent improvement in healthspan, leading to a higher prevalence of chronic diseases and disabilities in older adults. This review examines strategies to promote healthy aging throughout the life cycle, emphasizing the importance of a comprehensive strategy that integrates individual, healthcare, and environmental approaches.</div><div>Individual strategies include lifestyle factors like diet, physical activity, and social connections. Healthcare approaches focus on improving health literacy, vaccinations, and screenings. Environmental approaches aim to mitigate climate change, reduce pollution, and design longevity-ready cities. A comprehensive strategy combining individual approaches, public health measures, innovative policies, and community support is essential for helping populations live longer, healthier, and more independent lives. Looking forward, this will be complemented by personalized approaches, focusing on individual traits and biological backgrounds. The key to this lies in geroscience, which studies the biological and molecular mechanisms of aging and how they contribute to age-related diseases and functional decline, aiming to design targeted interventions to slow aging and improve quality of life. Artificial intelligence will play a key role in analyzing these complex factors and creating innovative solutions.</div><div>In conclusion, aging is shaped by various factors, requiring more than one solution. A combination of comprehensive and personalized strategies can bridge the gap between public health measures and personalized care, offering the scientific insights needed to slow aging and enhance quality of life.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 5-13"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665114","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 for hospital-treated infections in dermatitis herpetiformis and coeliac disease","authors":"Camilla Pasternack ,&nbsp;Matti Karppelin ,&nbsp;Kaisa Hervonen ,&nbsp;Katri Kaukinen ,&nbsp;Teea Salmi","doi":"10.1016/j.ejim.2024.12.004","DOIUrl":"10.1016/j.ejim.2024.12.004","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 153-155"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822912","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-statistical significance and clinical relevance: Are we chasing shadows in the air pollution-peripheral artery disease debate?","authors":"Stephan Peronard Mayntz ,&nbsp;Kasper Emil Rosenbech","doi":"10.1016/j.ejim.2025.02.024","DOIUrl":"10.1016/j.ejim.2025.02.024","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 145-146"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477188","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. Author's reply","authors":"Lorenzo Onorato,&nbsp;Margherita Macera,&nbsp;Caterina Monari,&nbsp;Nicola Coppola","doi":"10.1016/j.ejim.2025.02.038","DOIUrl":"10.1016/j.ejim.2025.02.038","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 138-140"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588013","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":"Gendered social determinants of health and risk of major adverse outcomes in atrial fibrillation","authors":"Jonathan Houle ,&nbsp;Marco Proietti ,&nbsp;Valeria Raparelli ,&nbsp;Clare L Atzema ,&nbsp;Colleen M Norris ,&nbsp;Michal Abrahamowicz ,&nbsp;Gregory YH Lip ,&nbsp;Giuseppe Boriani ,&nbsp;Louise Pilote","doi":"10.1016/j.ejim.2025.02.009","DOIUrl":"10.1016/j.ejim.2025.02.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Atrial fibrillation (AF) is associated with an increased risk of adverse outcomes. Clinical risk factors have been identified as predictors of such outcomes, but social determinants of health (SDOH) may also play a role. We evaluated the associations between gendered SDOH (unevenly distributed between sexes) and adverse outcomes in AF.</div></div><div><h3>Methods</h3><div>This is a retrospective cohort study using data from a European registry of AF patients from 250 centers and twenty-seven countries. Gendered SDOH included education, living status, subscales of the EQ-5D-5L questionnaire, behavioral factors, and country-level gender inequality index (GII). The primary outcome was a composite of major adverse cardiovascular events and all-cause mortality. We used multivariate logistic regression models to identify associations between SDOH and the primary outcome.</div></div><div><h3>Results</h3><div>The study population comprised of 11,096 patients (mean age 69.2 years; 40.7 % females), with 75.6 % of patients having a high-risk CHA₂DS₂-VASc score. Most participants had secondary education, were physically inactive, lived in countries with gender equity and reported at least moderately elevated quality of life measures; they were less likely to live alone, smoke or drink alcohol. After adjustment for clinical factors, not having any post-secondary education (OR:1.17 95 %CI:1.05–1.28), reporting poorer health status (OR:1.08 95 %CI:1.05–1.11), living in a country with a higher GII (higher gender inequity) (OR:1.12 95 %CI:1.03–1.22 each 0.100), reporting reduced mobility (OR:1.18 95 %CI:1.02–1.38) and reduced self-care (OR:1.35;95 %CI:1.14–1.61) were independently associated with worse outcomes.</div></div><div><h3>Conclusions</h3><div>Gendered SDOH are independently associated with adverse events in patients with AF. These factors should be considered for assessment of risk and as potential targets for interventions to improve outcomes.</div></div><div><h3>Condensed Abstract</h3><div>Atrial fibrillation (AF) is associated with adverse outcomes and social determinants of health (SDOH), which are gendered, may predict adverse outcomes in AF. We used a registry of AF patients from 27 European countries. Multivariate logistic regressions were used to investigate the associations between gendered SDOH and the primary outcome, a composite of major adverse cardiovascular events and all-cause mortality. Several SDOH were independent predictors: no higher education (OR:1.17;95 %CI:1.05–1.28), lower health (OR:1.08;95 %CI:1.05–1.11), higher GII (OR:1.12;95 %CI:1.03–1.22 each 0.100), reduced mobility (OR:1.18;95 %CI:1.02–1.38) and reduced self-care (OR:1.35;95 %CI:1.14–1.61). Gendered SDOH are independently associated with adverse events in AF.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 83-90"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598273","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":"10.1016/j.ejim.2025.03.026","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 151-152"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","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":"NT-proBNP to guide risk stratification after cardiac rehabilitation in patients with ST-segment elevation myocardial infarction.","authors":"Nerea Pérez-Solé, Elena de Dios, José Gavara, César Ríos-Navarro, Víctor Marcos-Garces, Héctor Merenciano, Carlos Bertolín, Josefina I Climent, Laura López-Bueno, Alfonso Payá, Clara Bonanad, Joaquim Cánoves, José V Monmeneu, María P López-Lereu, Gema Miñana, Rafael de la Espriella, Andrea Ventura, Antoni Bayés-Genís, Jorge Rodríguez-Capitán, Manuel Jiménez-Navarro, Luis Martínez-Dolz, Francisco Marín, Francisco J Chorro, Julio Núnez, Juan Sanchis, Vicente Bodí","doi":"10.1016/j.ejim.2025.04.027","DOIUrl":"https://doi.org/10.1016/j.ejim.2025.04.027","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The use of N-terminal pro-brain natriuretic peptide (NT-proBNP) after ST-segment elevation acute myocardial infarction (STEMI) is unclear. We evaluated its prognostic significance after post-STEMI cardiac rehabilitation.</p><p><strong>Methods: </strong>The prognostic significance of NT-proBNP was tested upon completion of cardiac rehabilitation (median, 45 days post-STEMI) in an exploratory group (n = 105 patients with the researchers blinded to NT-proBNP values) and validated in the following 276 patients. Baseline and cardiac imaging variables including cardiovascular magnetic resonance (CMR) parameters were recorded. The primary endpoint was the occurrence of a first major adverse cardiac event (MACE: cardiac death, myocardial infarction, or re-admission for heart failure).</p><p><strong>Results: </strong>In the exploratory group, a cut-off value of NT-proBNP >400 pg/mL emerged as a potent MACE predictor (37 % vs.17 %; hazard ratio [HR]: 6.8 [1.5-30.3], p = 0.01). In the study group, during a 203-week median follow-up, 88 (32 %) first MACEs were detected. NT-proBNP >400 pg/mL (n = 168, 61 %) associated with a higher MACE rate (46 % vs. 10 %, HR: 4.6 [2.3-8.9], p < 0.001) and, separately, with more cardiac deaths, myocardial infarctions, and re-admissions for heart failure (p < 0.05 for all comparisons). NT-proBNP improved the multivariate model for MACE prediction (area under the curve 0.81 vs. 0.72, p < 0.001). Analyzing all measurements performed during follow-up (n = 1018), the risk of transition to MACE was higher in case of NT-proBNP >400 pg/mL (14 % vs.3 %, p < 0.001).</p><p><strong>Conclusions: </strong>Even after comprehensive adjustment, NT-proBNP emerges as a potent, accessible and inexpensive tool for risk stratification of STEMI patients after completion of rehabilitation programs.</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":"144025203","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":"Linear lesions on the chest","authors":"Pei-Chun Weng ,&nbsp;Pei-Rong Gao","doi":"10.1016/j.ejim.2025.01.023","DOIUrl":"10.1016/j.ejim.2025.01.023","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 130-131"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191206","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":"Advancing women's health with a pioneering implant to treat breast cancer related lymphedema","authors":"L. Mazzolai ,&nbsp;V. Triacca ,&nbsp;M.J. Brochu-Vez ,&nbsp;V. Boucard ,&nbsp;M. Aberle ,&nbsp;V. Chaplet ,&nbsp;V. Ferrari ,&nbsp;S. Déglise ,&nbsp;M. Pisano ,&nbsp;S. Staubli","doi":"10.1016/j.ejim.2025.01.027","DOIUrl":"10.1016/j.ejim.2025.01.027","url":null,"abstract":"<div><div>Lymphedema (LE) is a globally recognized chronic and disabling condition with a high prevalence. At present, there is no curative treatment for LE, and management options are primarily limited to conservative approaches. To address this unmet need, we developed an innovative implantable device – the first-of-its-kind designed to replicate the function of lymphatic vessels in the affected limb. This novel device utilizes subcutaneous catheters and a micropump system to actively manage lymphatic fluid, representing a significant departure from traditional treatments. To evaluate feasibility, preliminary safety, and efficacy of this novel device, we conducted the first-in-human pilot study LymphoPilot. Nine patients with unilateral breast cancer-related LE (BCRL) underwent implantation of the device and discontinued conventional LE treatment. The device remained implanted for 8 weeks, during which its safety and efficacy were assessed. Results demonstrated no safety concerns and showed significant reductions in limb volume without the need for manual lymphatic drainage or compression treatment. These promising findings highlight the potential of this innovative approach and emphasize the need for further research into its long-term use as an alternative to current LE management strategies. This pioneering development offers hope for a transformative shift in LE treatment.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"135 ","pages":"Pages 64-73"},"PeriodicalIF":5.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411065","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}