European Journal of Internal Medicine最新文献_第6页

How do we diagnose Miyoshi Muscular Dystrophy in the absence of symptoms? 在没有症状的情况下，如何诊断宫吉肌萎缩症？

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.06.010

Özge Sönmez, Uğur Kimyon, Mehmet Çopur, İbrahim Ataş, Işıl Bavunoğlu

引用次数: 0

Comparison of different frailty instruments for prediction of functional decline in older hypertensive outpatients (HYPER-FRAIL pilot study 2) 比较用于预测老年高血压门诊患者功能衰退的不同虚弱工具（HYPER-FRAIL 试验研究 2）。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.05.013

{"title":"Comparison of different frailty instruments for prediction of functional decline in older hypertensive outpatients (HYPER-FRAIL pilot study 2)","authors":"","doi":"10.1016/j.ejim.2024.05.013","DOIUrl":"10.1016/j.ejim.2024.05.013","url":null,"abstract":"<div><h3>Background and aims</h3><div>Few studies have evaluated frailty in older hypertensive individuals and the most appropriate tools to identify frailty in this population have yet to be identified. This study compared the performance of six frailty instruments in the prediction of 1-year functional decline in older hypertensive outpatients.</div></div><div><h3>Methods</h3><div>The HYPERtension and FRAILty in Older Adults (HYPER-FRAIL) longitudinal pilot study involved hypertensive participants ≥75 years from two geriatric outpatient clinics at Careggi Hospital, Florence, Italy, undergoing identification of frailty with four frailty scales (Fried Frailty Phenotype, Frailty Index [FI], Clinical Frailty Scale [CFS], Frailty Postal Score) and two physical performance tests (Short Physical Performance Battery [SPPB] and gait speed). Prediction of 1-year functional decline (i.e. <em>a</em> ≥ 10-point Barthel Index decrease between baseline and follow-up) was examined based on ROC curve analysis and multivariable logistic regression.</div></div><div><h3>Results</h3><div>Among 116 participants, 24 % reported functional decline. In the ROC curve analyses, FI (AUC=0.76), CFS (AUC=0.77), gait speed (AUC=0.73) and the SPPB (AUC=0.77) achieved the best predictive performance, with FI ≥0.21 and CFS ≥4 showing the highest sensitivity (82 %) and negative predictive value (91 %). Frailty identified with FI, CFS or physical performance tests was associated with an increased risk of 1-year functional decline, independently of baseline functional status and comorbidity burden.</div></div><div><h3>Conclusions</h3><div>FI, CFS and physical performance tests showed similar predictive ability for functional decline in hypertensive outpatients. The CFS and gait speed might be more suitable for clinical use and may be useful to identify non-frail individuals at lower risk of functional decline.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"129 ","pages":"Pages 35-40"},"PeriodicalIF":5.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065688","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A man with large periumbilical masses 一名脐周肿块较大的男子。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.08.022

Dimitrios Patoulias, Konstantinos Stavropoulos, Theocharis Koufakis

引用次数: 0

Divergent views on prescription adherence: A qualitative comparison of perspectives from the patient, pharmacist, and physician triad 关于处方依从性的不同观点：病人、药剂师和医生三方观点的定性比较。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.06.016

引用次数: 0

Effectiveness Of Tocilizumab In Aortitis And Aneurysms Associated With Giant Cell Arteritis 托西珠单抗对巨细胞动脉炎相关大动脉炎和动脉瘤的疗效

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.06.013

{"title":"Effectiveness Of Tocilizumab In Aortitis And Aneurysms Associated With Giant Cell Arteritis","authors":"","doi":"10.1016/j.ejim.2024.06.013","DOIUrl":"10.1016/j.ejim.2024.06.013","url":null,"abstract":"<div><h3>Objective</h3><div><span>Aortitis in Giant Cell Arteritis (GCA-aortitis) is a frequent complication that may lead to aneurysms. Tocilizumab (TCZ) was approved in </span>GCA, but the efficacy in GCA-aortitis and aneurysms has not been analyzed to date. Our aim was to assess the effectiveness and safety of TCZ in a wide series of GCA-aortitis and aneurysms.</div></div><div><h3>Methods</h3><div>Multicentre observational study with GCA-aortitis treated with TCZ. GCA was diagnosed by: a) ACR criteria, b) temporal artery biopsy, and/or c) imaging techniques. Aortitis was diagnosed mainly by PET/CT. Main outcomes were EULAR and imaging remission. Others were clinical remission, analytical normalization, corticosteroid-sparing effect, and the prevention and improvement of aneurysms.</div></div><div><h3>Results</h3><div>196 patients with GCA-aortitis treated with TCZ. After 6 months, 72.2% reached EULAR remission but only 12% an imaging remission; increasing up-to 81.4% and 31.8%, respectively, at 24 months. A rapid clinical remission, ESR and CRP normalization was observed in 47.4%, 84.3% and 55.6%, at 1 month, increasing to 89.6%, 85.3% and 80.3% at 24 months, respectively.</div><div>Aneurysms were present in 10 (5%) patients. Five of them required early surgery, while 3 others enlarged. No patient on TCZ therapy developed aneurysms during follow-up.</div></div><div><h3>Conclusion</h3><div>In patients with GCA-aortitis treated with TCZ, a rapid and maintained clinical and analytical improvement was observed. However, there was an uncoupling between clinical and EULAR remission with imaging remission.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"129 ","pages":"Pages 78-86"},"PeriodicalIF":5.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141441058","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}

引用次数: 0

Optimal timing of antibiotic administration in septic patients: The need to reformulate this question 脓毒症患者使用抗生素的最佳时机：重新提出这一问题的必要性。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.08.016

Ángel Estella , Jordi Rello

引用次数: 0

Association of non-cardiac comorbidities and sex with long-term Re-hospitalization for heart failure. 非心脏病合并症和性别与心力衰竭长期再住院的关系

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-31 DOI: 10.1016/j.ejim.2024.10.018

Antonio E Pontiroli, Elena Tagliabue, Fabiana Madotto, Olivia Leoni, Barbara Antonelli, Erberto Carluccio, Francesco Bandera, Giuseppe Galati, Pierpaolo Pellicori, Lars H Lund, Giuseppe Ambrosio

{"title":"Association of non-cardiac comorbidities and sex with long-term Re-hospitalization for heart failure.","authors":"Antonio E Pontiroli, Elena Tagliabue, Fabiana Madotto, Olivia Leoni, Barbara Antonelli, Erberto Carluccio, Francesco Bandera, Giuseppe Galati, Pierpaolo Pellicori, Lars H Lund, Giuseppe Ambrosio","doi":"10.1016/j.ejim.2024.10.018","DOIUrl":"https://doi.org/10.1016/j.ejim.2024.10.018","url":null,"abstract":"<p><p>Heart failure (HF) often coexists with non-cardiac comorbidities (NCC), but their association with long-term HF re-hospitalizations is not defined. Using the Lombardy Regional Health Database, that includes >10 million residents, we assessed the risk of re-hospitalization for HF after first HF discharge as a function of NCC, employing age- and sex-adjusted Cox proportional-hazard models. Kaplan Meier curves for HF re-hospitalizations were stratified for number of NCC. End of follow-up was June 30th 2021. Between January 1st 2015 to December 31st 2019, 88,528 consecutive patients were discharged from hospital with a primary diagnosis of HF; over 42.8 ± 18.3 months follow-up, 79,533 HF re-hospitalizations occurred (32.94/100 patient/year). Number of NCC, age, and male sex were significantly associated with re-hospitalization risk. Compared to those without NCC, females and males with >4 NCC had a 3.08 (CI 2.73-3.47) and a 2.62 (CI 2.39-2.87) fold higher risk, respectively. Risk of all-cause death increased with number of NCC (hazard ratio (HR): 1.42 (1.38-1.46) for HF patients with 1-2 NCC, HR: 1.90 (1.82-1.98) for patients with 3-4 NCC, HR: 2.20 (2.01-2.40) for those with HF and >4 NCC), as it did the number of days spent in hospital because of HF (from 19.91±19.25 for patients without NCC to 45.35±33.00 days for those with >4 NCC, p < 0.0001). In conclusion, this study shows that in patients hospitalized with HF, HF re-hospitalizations, all-cause mortality, and time spent in hospital increased with number of NCC. NCC associates with a worse clinical trajectory in patients with HF.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559293","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}

引用次数: 0

Hyperhomocysteinemia is linked to MASLD. 高同型半胱氨酸血症与 MASLD 有关。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-30 DOI: 10.1016/j.ejim.2024.10.014

Carlo De Matteis, Lucilla Crudele, Ersilia Di Buduo, Salvatore Cantatore, Raffaella Maria Gadaleta, Marica Cariello, Patrizia Suppressa, Gianfranco Antonica, Elsa Berardi, Giusi Graziano, Antonio Moschetta

{"title":"Hyperhomocysteinemia is linked to MASLD.","authors":"Carlo De Matteis, Lucilla Crudele, Ersilia Di Buduo, Salvatore Cantatore, Raffaella Maria Gadaleta, Marica Cariello, Patrizia Suppressa, Gianfranco Antonica, Elsa Berardi, Giusi Graziano, Antonio Moschetta","doi":"10.1016/j.ejim.2024.10.014","DOIUrl":"https://doi.org/10.1016/j.ejim.2024.10.014","url":null,"abstract":"<p><strong>Background and aims: </strong>Homocysteine (Hcy) levels are elevated in different conditions, including cardiovascular diseases (CVD), diabetes, and metabolic-associated steatotic liver disease (MASLD). In this observational retrospective study, we analyzed Hcy levels in a population of 901 outpatients, considering its putative etiological role in MASLD.</p><p><strong>Methods: </strong>A total of 901 outpatients underwent physical and biochemical evaluations. Abdominal and carotid ultrasound were performed to assess liver steatosis, carotid intima-media thickness (IMT) and presence of atherosclerotic plaque.</p><p><strong>Results: </strong>Hyperhomocysteinemia (HHcy) was identified in 140 subjects (16 %). Patients with HHcy showed glucose metabolism impairment (p < 0.001), altered lipid profile (p < 0.001), low Vitamin D levels (p < 0.0001), increased cardiovascular risk (p < 0.001). We then investigated the relationship between Hcy and MASLD (OR=3.6, p < 0.0001), finding that the relationship remained significant also when accounting for confounding variables (age, sex) (OR=3.2, p < 0.0001). Hcy values were significantly higher (p < 0.0001) in patients with MASLD (n = 78, 29.4 ± 10.1μmol/l) compared to those without MASLD (20.4 ± 4.8 1μmol/l). Furthermore, in MASLD patients we found a direct correlation between Hcy level and waist circumference (r = 0.3, p < 0.001) and an inverse correlation with both HDL-c (r=-0.4, p < 0.001) and Vitamin D levels (r=-0.24, p < 0.05).</p><p><strong>Conclusions: </strong>Our data suggest an intriguing scenario whereby HHcy is present in patients with MASLD and is associated to lower vitamin D and altered glucose and lipid profile. Thus, considering Hcy levels may help clinicians with the management of patients with increased MASLD risk.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559294","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}

引用次数: 0

Triglyceride glucose (TyG) index: A promising biomarker for diagnosis and treatment of different diseases. 甘油三酯葡萄糖（TyG）指数：用于诊断和治疗不同疾病的有前途的生物标志物。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-29 DOI: 10.1016/j.ejim.2024.08.026

Yuting Sun, Hangyu Ji, Wenjie Sun, Xuedong An, Fengmei Lian

{"title":"Triglyceride glucose (TyG) index: A promising biomarker for diagnosis and treatment of different diseases.","authors":"Yuting Sun, Hangyu Ji, Wenjie Sun, Xuedong An, Fengmei Lian","doi":"10.1016/j.ejim.2024.08.026","DOIUrl":"https://doi.org/10.1016/j.ejim.2024.08.026","url":null,"abstract":"<p><p>The Triglyceride-glucose index (TyG index) is a comprehensive statistical measure that incorporates fasting triglyceride and fasting glucose levels. Research has demonstrated that it can serve as an effective alternative biomarker for insulin resistance (IR) due to its high sensitivity and specificity. The TyG index is straightforward to compute and imposes fewer time and cost constraints, rendering it suitable for large populations and advantageous for use in various applications, clinical settings, and epidemiological investigations. Numerous high-quality clinical studies have underscored the significance of the TyG index in diverse medical conditions. This review provides a synthesis of the association between the TyG index and diseases such as diabetes, cardiovascular diseases, cerebrovascular diseases, fatty liver, kidney diseases, and reproductive system diseases. Furthermore, the TyG index has exhibited predictive capabilities for identifying IR in children and adolescents. Through a systematic review of pertinent clinical trials, this paper elucidates the correlation between the TyG index and various diseases. The findings presented herein suggest that the TyG index holds promise as a valuable and practical indicator for different medical conditions, prompting a reevaluation of conventional disease risk assessment paradigms and highlighting the intricate interplay of metabolic parameters with diverse diseases. By leveraging insights from the TyG index, tailored disease risk management strategies can be developed to offer a fresh perspective and guidance for clinical interventions.</p>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607428","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}

引用次数: 0

Characteristics of familial Mediterranean fever after 65 years of age. 65 岁以后家族性地中海热的特征。

IF 5.9 2区医学

European Journal of Internal Medicine Pub Date : 2024-10-29 DOI: 10.1016/j.ejim.2024.10.010

François Rodrigues, Léa Savey, Marion Delplanque, Laurence Cuisset, Sophie Georgin-Lavialle

引用次数: 0