European Journal of Internal Medicine最新文献

{"title":"Cardiovascular safety and efficacy of intensive blood pressure control: how low should we go?","authors":"Paschalis Karakasis , Dimitrios Patoulias , Antonios P Antoniadis , Nikolaos Fragakis , Ricardo Gómez-Huelgas","doi":"10.1016/j.ejim.2025.04.006","DOIUrl":"10.1016/j.ejim.2025.04.006","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106299"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042295","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":"Prevalence, awareness, and control of cardiovascular risk factors among specialists in cardiovascular field: A survey","authors":"Claudia Agabiti Rosei , Rita Del Pinto , Maria Lorenza Muiesan , Claudio Ferri , Guido Grassi , PROTECTO study group","doi":"10.1016/j.ejim.2025.04.011","DOIUrl":"10.1016/j.ejim.2025.04.011","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106304"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006575","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 impact of bone scintigraphy in elderly patients with hypertrophic cardiomyopathy","authors":"Younes Kamal, Lisa Lochon, Anne Bernard, Arnaud Bisson, Laurent Fauchier","doi":"10.1016/j.ejim.2025.04.023","DOIUrl":"10.1016/j.ejim.2025.04.023","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106316"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020155","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":"Latent class analysis identifies novel coeliac disease subgroups with distinctive clinical features: a multicentric study","authors":"Marco Vincenzo Lenti ,&nbsp;Daniele Pala ,&nbsp;Nicola Aronico ,&nbsp;Arianna Dagliati ,&nbsp;Paola Ilaria Bianchi ,&nbsp;Giovanni Santacroce ,&nbsp;Silvana Quaglini ,&nbsp;Giordano Lanzola ,&nbsp;Gino Roberto Corazza ,&nbsp;Antonio Di Sabatino","doi":"10.1016/j.ejim.2025.05.020","DOIUrl":"10.1016/j.ejim.2025.05.020","url":null,"abstract":"<div><h3>Background</h3><div>Coeliac disease (CD) is a lifelong, immune-mediated disorder characterised by a wide clinical spectrum, which often challenges traditional classifications like the Oslo definitions. We aimed to recognise novel CD subtypes based on clinical features using latent class analysis (LCA) and validate these phenotypes with a predictive supervised model.</div></div><div><h3>Methods</h3><div>In this multicentric retrospective study, 2478 adult CD patients from 19 Italian centres (2011–2021) were analysed. Clinical, laboratory, endoscopic, and histological data were collected. LCA was applied to categorical symptom variables, including gastrointestinal, haematological, neuropsychiatric manifestations, and fatigue, to identify latent clusters, with the optimal number of classes determined by the Bayesian Information Criterion. The newly derived classes were compared with the traditional Oslo classification using Chi-squared tests, while multinomial logistic regression (MLR) was employed to validate the associations between latent classes and additional features.</div></div><div><h3>Results</h3><div>LCA identified four classes, namely Class 1 (predominant lower gastrointestinal symptoms); Class 2 (upper gastrointestinal manifestations); Class 3 (mainly asymptomatic or nonspecific cases); and Class 4 (microcytic anaemia with asthenia). Comparison with the Oslo classification revealed partial overlap, indicating potential misclassification under current criteria. MLR confirmed significant associations, with female sex strongly linked to Class 2 (OR 2.7, 95 % CI 1.52–4.78). Autoimmune comorbidities (OR 1.96, 95 % CI 1.18–3.25) and severe histological damage (B2 Corazza-Villanacci classification, OR 9.12, 95 % CI 1.86–44.63) were also more frequent in Class 2.</div></div><div><h3>Conclusions</h3><div>LCA may offer a novel, data-driven approach to refine CD phenotyping that should be validated in future studies.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106355"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227456","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":"Current epidemiology, risk factors and influence on prognosis of multidrug resistance in Klebsiella spp. bloodstream infection. Insights from a prospective cohort","authors":"Jorge Calderón-Parra ,&nbsp;María Teresa Carretero-Henriquez ,&nbsp;Gabriela Escudero ,&nbsp;Elena Suances-Martin ,&nbsp;Marta Murga de la Fuente ,&nbsp;Patricia González-Merino ,&nbsp;Ane Andrés-Eisenhofer ,&nbsp;Ana Visedo-Colino ,&nbsp;Ana Rodríguez ,&nbsp;Ana Rojo-Reyes ,&nbsp;Itziar Diego-Yagüe ,&nbsp;Andrea Gutiérrez-Villanueva ,&nbsp;Isabel Sánchez-Romero ,&nbsp;Antonio Ramos-Martinez","doi":"10.1016/j.ejim.2025.05.034","DOIUrl":"10.1016/j.ejim.2025.05.034","url":null,"abstract":"<div><h3>Introduction</h3><div>We aimed to describe clinical characteristics, risk factors and prognosis in patients with Klebsiella spp. bacteremia according to their beta-lactam resistance profile.</div></div><div><h3>Material and methods</h3><div>Single-centre prospective cohort, including all adults patients with a first episode of <em>Klebsiella spp</em>. bacteriemia from January 2021 to December 2023. Patients were divided into 2 groups: Klebsiella spp. susceptible to carbapenems (CS-K)); and carbapenem-resistant <em>Klebsiella spp.</em> (CR-K). The primary endpoint for prognosis was 30-day mortality.</div></div><div><h3>Results</h3><div>Of the 186 patients included, 156 (83.9 %) were CS-K, and 30 (16.1 %) CR-K. The only factor independently associated with CR-K was previous known colonization (aOR 353.7, 95 %CI 39.8–3142.5). Thirty-day mortality was higher for CR-K than CS-K (40.0 % vs 10.9 %, <em>p</em> &lt; 0.001). An adequate initial antibiotic was used more frequently in CS-K vs CR-K (75.6 % vs 36.7 %, <em>p</em> &lt; 0.001). After adjusting for possible cofounding factors, CR-K was associated with higher mortality (aOR 3.97, 95 % CI 1.40–9.12). Among CR-K, receiving new beta-lactams/betalactamase inhibitors was independently associated with lower 30-day mortality (aOR 0.10, 95 % CI 0.01–0.91). Those patients had similar mortality than those with carbapenem-susceptible <em>Klebsiella spp</em>. bacteremia (10.9 % vs 16.7 %, <em>p</em> = 0.680)</div></div><div><h3>Conclusions</h3><div>CR-K bacteremia was associated with worse outcomes. Prior colonization was the most important factor associated with this infection. The use of active new betalactam/betalactamase inhibitor antibiotic in patients with CR-K bacteremia was associated with a better prognosis, matching the 30-day mortality observed in carbapenem-susceptible <em>Klebsiella spp</em>. strains.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106369"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287012","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":"The approach to triglyceride levels in patients with coronary heart disease","authors":"Ilay Shani ,&nbsp;Avishay Elis","doi":"10.1016/j.ejim.2025.06.004","DOIUrl":"10.1016/j.ejim.2025.06.004","url":null,"abstract":"<div><h3>Background</h3><div>Clinical trials demonstrate residual risk despite aggressive LDL-C lowering, partialy realated to high TG levels. CHD patients in Israel do not reach the recommended LDL-C target levels, even after hospitalization. Our impression is that it is the same regarding TG levels.</div></div><div><h3>Objectives</h3><div>Exploring the TG levels among CHD patients and adressing specific therapeutic regimens needed.</div></div><div><h3>Design and methods</h3><div>A sub-analysis of a retrospective cohort study of CHD patients who were admitted to internal medicine wards because of anginal syndrome during 2020–2022. The data was evaluated for demographic and clinical characteristics, TG levels and lipid lowering treatment at admission, 6 months previously, 3 months and 6–9 months after discharge. The factors that affect TG levels, with attention given to very high levels, were also evaluated.</div></div><div><h3>Results</h3><div>The cohort included 10,540 patients. Two-thirds had TG levels &lt; 150 mg/dL. Among the subjects with levels ≥ 150 mg/dL, 4–6 % had severe hypertriglyceridemia (≥ 500 mg/dl). In two-thirds of the patients with TG levels ≥ 150 mg/dL, the HbA1c levels were &gt; 6.4 %. Patient with severe hypertriglyceridemia had higher rates of uncontrolled diabetes mellitus. The majority of subjects received statin treatment, regardless of their TG levels. The use of fibrates was very low, but was significantly higher among patients with severe hypertriglyceridemia. Hospitalization did not have a clinically-significant effect on short-term treatment nor on TG levels.</div></div><div><h3>Conclusions</h3><div>Most CHD patients have controlled TG levels. However, additional attention should be given to the diabetic ones. Further education and strict policy are needed.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106375"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276507","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":"Redrawing the map for corticosteroids in severe community-acquired pneumonia","authors":"Grant Waterer ,&nbsp;Jordi Rello","doi":"10.1016/j.ejim.2025.07.001","DOIUrl":"10.1016/j.ejim.2025.07.001","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106405"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651111","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":"In the line of fire: Sleep well as the first step of care","authors":"Maria Teresa La Rovere ,&nbsp;Francesco Fanfulla","doi":"10.1016/j.ejim.2025.07.030","DOIUrl":"10.1016/j.ejim.2025.07.030","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106434"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144776779","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 term variability of peripheral blood eosinophil count in individuals with stable COPD","authors":"Claudio Candia ,&nbsp;Claudia Merola ,&nbsp;Salvatore Fuschillo ,&nbsp;Pasquale Ambrosino ,&nbsp;Nicolino Ambrosino ,&nbsp;Mauro Maniscalco","doi":"10.1016/j.ejim.2025.04.008","DOIUrl":"10.1016/j.ejim.2025.04.008","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106301"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055411","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 risk or misestimated baseline? Reconsidering relative survival in the oldest ICU patients","authors":"Juan Ye ,&nbsp;Kun Huang","doi":"10.1016/j.ejim.2025.04.005","DOIUrl":"10.1016/j.ejim.2025.04.005","url":null,"abstract":"","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"139 ","pages":"Article 106298"},"PeriodicalIF":6.1,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144006625","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}