首页 > 最新文献

Journal of Internal Medicine最新文献

英文 中文
Regarding: Time to initiation of extracorporeal membrane oxygenation in conventional cardiopulmonary resuscitation affects the patient survival prognosis. 关于:在常规心肺复苏术中启动体外膜肺氧合的时间会影响患者的生存预后。
IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-24 DOI: 10.1111/joim.20022
Xiao Liu, Bo Liu, Minli Yang, Liu Yang, Jun Wang
{"title":"Regarding: Time to initiation of extracorporeal membrane oxygenation in conventional cardiopulmonary resuscitation affects the patient survival prognosis.","authors":"Xiao Liu, Bo Liu, Minli Yang, Liu Yang, Jun Wang","doi":"10.1111/joim.20022","DOIUrl":"https://doi.org/10.1111/joim.20022","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142491711","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
Regarding: Time to initiation of extracorporeal membrane oxygenation in conventional cardiopulmonary resuscitation affects the patient survival prognosis. 关于:在常规心肺复苏术中启动体外膜肺氧合的时间会影响患者的生存预后。
IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-24 DOI: 10.1111/joim.20021
Wei-Zhen Tang, Zhe-Ming Kang, Tai-Hang Liu
{"title":"Regarding: Time to initiation of extracorporeal membrane oxygenation in conventional cardiopulmonary resuscitation affects the patient survival prognosis.","authors":"Wei-Zhen Tang, Zhe-Ming Kang, Tai-Hang Liu","doi":"10.1111/joim.20021","DOIUrl":"https://doi.org/10.1111/joim.20021","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142491710","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
Authors reply: Time to initiation of extracorporeal membrane oxygenation in conventional cardiopulmonary resuscitation affects the patient survival prognosis. 作者回复:在常规心肺复苏中启动体外膜肺氧合的时间会影响患者的生存预后。
IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-24 DOI: 10.1111/joim.20023
Sang-Wook Lee, Ji-Hoon Sim
{"title":"Authors reply: Time to initiation of extracorporeal membrane oxygenation in conventional cardiopulmonary resuscitation affects the patient survival prognosis.","authors":"Sang-Wook Lee, Ji-Hoon Sim","doi":"10.1111/joim.20023","DOIUrl":"https://doi.org/10.1111/joim.20023","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142491707","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
Increased risk of hypereosinophilia following initiation of glucagon-like peptide 1 receptor agonist: A symmetry analysis using the Danish health registries. 开始服用胰高血糖素样肽 1 受体激动剂后嗜酸性粒细胞增多症的风险增加:利用丹麦健康登记进行的对称性分析。
IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-23 DOI: 10.1111/joim.20025
Martin Torp Rahbek, Søren Andreas Just, Kasper Bruun Kristensen, Hussam Mahmoud Sheta, Jesper Hallas, Anton Pottegård, Lars Christian Lund
{"title":"Increased risk of hypereosinophilia following initiation of glucagon-like peptide 1 receptor agonist: A symmetry analysis using the Danish health registries.","authors":"Martin Torp Rahbek, Søren Andreas Just, Kasper Bruun Kristensen, Hussam Mahmoud Sheta, Jesper Hallas, Anton Pottegård, Lars Christian Lund","doi":"10.1111/joim.20025","DOIUrl":"https://doi.org/10.1111/joim.20025","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142491708","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
Regarding: Time to initiation of extracorporeal membrane oxygenation in conventional cardiopulmonary resuscitation affects the patient survival prognosis. 关于:在常规心肺复苏术中启动体外膜肺氧合的时间会影响患者的生存预后。
IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-23 DOI: 10.1111/joim.20020
Zegang Ruan, Yuhao Gan, Chenyang Xu
{"title":"Regarding: Time to initiation of extracorporeal membrane oxygenation in conventional cardiopulmonary resuscitation affects the patient survival prognosis.","authors":"Zegang Ruan, Yuhao Gan, Chenyang Xu","doi":"10.1111/joim.20020","DOIUrl":"https://doi.org/10.1111/joim.20020","url":null,"abstract":"","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142491709","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
Neck triangle nerve enlargement in hereditary transthyretin amyloidosis correlates with changes in the autonomic, cardiac, and gastrointestinal systems. 遗传性转甲状腺素淀粉样变性病的颈三角神经扩张与自主神经、心脏和胃肠道系统的变化相关。
IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-22 DOI: 10.1111/joim.20019
Hsueh-Wen Hsueh, Chi-Chao Chao, Yen-Hung Lin, Ping-Huei Tseng, Mao-Yuan Su, Sung-Tsang Hsieh

Background: Hereditary transthyretin amyloidosis (ATTRv) is a hereditary disease that affects multiple bodily systems. Although sonography generally reveals enlargement of nerves in the limbs, the brachial plexus, and vagus nerve, the clinical significance of these findings remains unclear.

Methods: We performed sonographic measurements of the median nerve, cervical spinal nerves at the C5-C7 level, and the vagus nerve in patients with ATTRv and healthy controls. Clinical profiles and cardiac and gastrointestinal examination results were also collected for linear regression analysis.

Results: We recruited 47 patients with ATTRv (males/females: 34/13, age: 65.6 ± 5.3 years). The sampled segments were all significantly larger than those of the controls. In the clinical profiles, the sum of the Z scores of the neck triangle nerves (cervical spinal nerves and vagus nerve) and of all nerves (cervical spinal nerves, vagus nerve, and median nerve at the wrist) significantly correlated with the familial amyloid polyneuropathy stage, onset of autonomic nervous system (ANS) symptoms, and autonomic symptom scores. On cardiac examinations, several ultrasonography and magnetic resonance imaging parameters (primarily those that reflect heart volume) were found to be significantly correlated with the sum of the Z scores of the cervical spinal nerves but not with the Z score of the vagus nerve. In gastrointestinal evaluation, the cross-sectional area of the vagus nerve was correlated with gastric emptying time parameters on scintigraphy.

Conclusions: Neck triangle nerve enlargement on sonography correlated with parameters related to ANS dysfunction, indicating that nerve enlargement observed on ultrasonography may serve as a potential surrogate biomarker of ATTRv.

背景:遗传性转甲状腺素淀粉样变性(ATTRv)是一种影响多个身体系统的遗传性疾病。虽然声像图通常显示四肢神经、臂丛神经和迷走神经增大,但这些发现的临床意义仍不明确:我们对 ATTRv 患者和健康对照组的正中神经、C5-C7 颈椎神经和迷走神经进行了声像图测量。我们还收集了临床概况、心脏和胃肠道检查结果,用于线性回归分析:我们招募了 47 名 ATTRv 患者(男性/女性:34/13,年龄:65.6 ± 5.3 岁)。取样的节段均明显大于对照组。在临床资料中,颈部三角神经(颈脊神经和迷走神经)和所有神经(颈脊神经、迷走神经和腕部正中神经)的 Z 评分总和与家族性淀粉样变性多神经病分期、自律神经系统(ANS)症状发作和自律神经症状评分有明显相关性。在心脏检查中,发现一些超声波和磁共振成像参数(主要是那些反映心脏容积的参数)与颈脊神经的 Z 评分总和有明显相关性,但与迷走神经的 Z 评分无明显相关性。在胃肠道评估中,迷走神经的横截面积与闪烁扫描的胃排空时间参数相关:结论:超声检查中颈部三角神经的增大与自律神经系统功能障碍的相关参数有关,表明超声检查中观察到的神经增大可作为ATTRv的潜在替代生物标志物。
{"title":"Neck triangle nerve enlargement in hereditary transthyretin amyloidosis correlates with changes in the autonomic, cardiac, and gastrointestinal systems.","authors":"Hsueh-Wen Hsueh, Chi-Chao Chao, Yen-Hung Lin, Ping-Huei Tseng, Mao-Yuan Su, Sung-Tsang Hsieh","doi":"10.1111/joim.20019","DOIUrl":"https://doi.org/10.1111/joim.20019","url":null,"abstract":"<p><strong>Background: </strong>Hereditary transthyretin amyloidosis (ATTRv) is a hereditary disease that affects multiple bodily systems. Although sonography generally reveals enlargement of nerves in the limbs, the brachial plexus, and vagus nerve, the clinical significance of these findings remains unclear.</p><p><strong>Methods: </strong>We performed sonographic measurements of the median nerve, cervical spinal nerves at the C5-C7 level, and the vagus nerve in patients with ATTRv and healthy controls. Clinical profiles and cardiac and gastrointestinal examination results were also collected for linear regression analysis.</p><p><strong>Results: </strong>We recruited 47 patients with ATTRv (males/females: 34/13, age: 65.6 ± 5.3 years). The sampled segments were all significantly larger than those of the controls. In the clinical profiles, the sum of the Z scores of the neck triangle nerves (cervical spinal nerves and vagus nerve) and of all nerves (cervical spinal nerves, vagus nerve, and median nerve at the wrist) significantly correlated with the familial amyloid polyneuropathy stage, onset of autonomic nervous system (ANS) symptoms, and autonomic symptom scores. On cardiac examinations, several ultrasonography and magnetic resonance imaging parameters (primarily those that reflect heart volume) were found to be significantly correlated with the sum of the Z scores of the cervical spinal nerves but not with the Z score of the vagus nerve. In gastrointestinal evaluation, the cross-sectional area of the vagus nerve was correlated with gastric emptying time parameters on scintigraphy.</p><p><strong>Conclusions: </strong>Neck triangle nerve enlargement on sonography correlated with parameters related to ANS dysfunction, indicating that nerve enlargement observed on ultrasonography may serve as a potential surrogate biomarker of ATTRv.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142454306","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
Romosozumab versus denosumab in long-term users of glucocorticoids: A pilot randomized controlled trial. 在长期使用糖皮质激素的患者中,Romosozumab 与 Denosumab 孰优孰劣?随机对照试验
IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-10 DOI: 10.1111/joim.20017
Chi Chiu Mok, Kar Li Chan, Sau Mei Tse, Sammy Pak Lam Chen, Kathryn Choon Beng Tan, Wai Han Ma

Objective: To compare the efficacy of romosozumab (ROMO) and denosumab (DEN) in prevalent long-term glucocorticoid (GC) users.

Methods: Adult patients receiving oral prednisolone (≥5 mg/day) with high risk of fracture were randomized to receive subcutaneous ROMO (210 mg monthly) or DEN (60 mg 6-monthly) for 12 months, followed by DEN for two more doses. The primary end point was the change in spine bone mineral density (BMD) from Months 0 to 12. Secondary end points included changes in BMD of the spine/hip/femoral neck and bone turnover markers at various time points and adverse events.

Results: Seventy patients (age 62.6 ± 9.1 years; 96% women; median prednisolone dose 5.0 mg/day; duration of therapy 10.7 ± 7.4 years) were enrolled, and 63 completed the study. At Month 12, the spine BMD increased significantly in both ROMO (+7.3% ± 4.5%; p < 0.001) and DEN (+2.3% ± 3.1%; p < 0.001) groups. The absolute spine BMD gain from Months 0 to 12 was significantly greater in ROMO-treated patients (p < 0.001). Although the total hip BMD at Month 12 also increased significantly in the ROMO (+1.6% ± 3.3%; p = 0.01) and DEN groups (+1.6% ± 2.6%; p = 0.003), the absolute BMD gain was not significantly different between the groups. At Month 24, the spine BMD continued to increase in both the ROMO (+9.7% ± 4.8%; p < 0.001) and DEN group (+3.0% ± 3.0%; p < 0.001) compared to baseline, and the absolute BMD gain remained significantly greater in ROMO-treated patients. The total hip BMD continued to increase in both groups (ROMO +2.9% ± 3.7%; p < 0.001; DEN +2.2% ± 3.4%; p = 0.001), but the changes from baseline were similar. Injection site reaction was more frequently reported in ROMO-treated patients.

Conclusion: ROMO was superior to DEN in raising the spine BMD at Month 12 in chronic GC users. After switching to DEN, ROMO-treated patients continued to gain spine BMD to a greater extent than DEN until Month 24.

目的比较romosozumab(ROMO)和denosumab(DEN)对糖皮质激素(GC)长期使用者的疗效:方法:对口服泼尼松龙(≥5毫克/天)且有骨折高风险的成年患者进行随机分组,接受皮下注射ROMO(210毫克/月)或DEN(60毫克/6个月)治疗12个月,然后再接受两次DEN治疗。主要终点是脊柱骨质密度 (BMD) 从第 0 个月到第 12 个月的变化。次要终点包括不同时间点脊柱/髋部/股骨颈骨密度和骨转换标志物的变化以及不良事件:70名患者(年龄为62.6 ± 9.1岁;96%为女性;中位泼尼松龙剂量为5.0毫克/天;疗程为10.7 ± 7.4年)参加了研究,其中63人完成了研究。在第 12 个月,ROMO 和 DEN 的脊柱 BMD 均显著增加(+7.3% ± 4.5%;P 结论:ROMO 和 DEN 在提高脊柱 BMD 方面更优:在第 12 个月,ROMO 在提高慢性 GC 使用者的脊柱 BMD 方面优于 DEN。在改用 DEN 后,ROMO 治疗的患者直到第 24 个月的脊柱 BMD 增幅仍高于 DEN。
{"title":"Romosozumab versus denosumab in long-term users of glucocorticoids: A pilot randomized controlled trial.","authors":"Chi Chiu Mok, Kar Li Chan, Sau Mei Tse, Sammy Pak Lam Chen, Kathryn Choon Beng Tan, Wai Han Ma","doi":"10.1111/joim.20017","DOIUrl":"https://doi.org/10.1111/joim.20017","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of romosozumab (ROMO) and denosumab (DEN) in prevalent long-term glucocorticoid (GC) users.</p><p><strong>Methods: </strong>Adult patients receiving oral prednisolone (≥5 mg/day) with high risk of fracture were randomized to receive subcutaneous ROMO (210 mg monthly) or DEN (60 mg 6-monthly) for 12 months, followed by DEN for two more doses. The primary end point was the change in spine bone mineral density (BMD) from Months 0 to 12. Secondary end points included changes in BMD of the spine/hip/femoral neck and bone turnover markers at various time points and adverse events.</p><p><strong>Results: </strong>Seventy patients (age 62.6 ± 9.1 years; 96% women; median prednisolone dose 5.0 mg/day; duration of therapy 10.7 ± 7.4 years) were enrolled, and 63 completed the study. At Month 12, the spine BMD increased significantly in both ROMO (+7.3% ± 4.5%; p < 0.001) and DEN (+2.3% ± 3.1%; p < 0.001) groups. The absolute spine BMD gain from Months 0 to 12 was significantly greater in ROMO-treated patients (p < 0.001). Although the total hip BMD at Month 12 also increased significantly in the ROMO (+1.6% ± 3.3%; p = 0.01) and DEN groups (+1.6% ± 2.6%; p = 0.003), the absolute BMD gain was not significantly different between the groups. At Month 24, the spine BMD continued to increase in both the ROMO (+9.7% ± 4.8%; p < 0.001) and DEN group (+3.0% ± 3.0%; p < 0.001) compared to baseline, and the absolute BMD gain remained significantly greater in ROMO-treated patients. The total hip BMD continued to increase in both groups (ROMO +2.9% ± 3.7%; p < 0.001; DEN +2.2% ± 3.4%; p = 0.001), but the changes from baseline were similar. Injection site reaction was more frequently reported in ROMO-treated patients.</p><p><strong>Conclusion: </strong>ROMO was superior to DEN in raising the spine BMD at Month 12 in chronic GC users. After switching to DEN, ROMO-treated patients continued to gain spine BMD to a greater extent than DEN until Month 24.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142454307","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
Pyridoxal-5′-phosphate: A cost-effective treatment candidate for hypertensive patients? 5'-磷酸吡哆醛:高血压患者的经济有效治疗方法?
IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-10 DOI: 10.1111/joim.20015
Michaela Lellig, Mariano Rodríguez, Rodrigo López-Baltanás, Juliane Hermann, Julia Wollenhaupt, Heidi Noels, Walter Zidek, Martin Tepel, Felix Mahfoud, Joachim Jankowski, Juan R. Muñoz-Castañeda, Vera Jankowski

Objectives

Because angiotensin (Ang) II is an essential vasoconstrictive peptide, we analyzed the impact of its post-translational modification to pyruvamide–Ang II (Ang P) by pyridoxal-5′-phosphate (PLP) on blood pressure. PLP is a less expensive vitamin B6 derivative and, therefore, could be a cost-effective drug against hypertension.

Methods

Effect of Ang P on calcium ion entry into vascular smooth muscle cells (VSMCs) was analyzed. Binding affinity of Ang P to angiotensin II type 1 receptor (AT1R) was measured. Vasoconstrictive effect of Ang P was investigated using the bioassay of isolated perfused rat kidneys. Spontaneously hypertensive rats (SHR) were administered PLP. Additionally, Wistar Kyoto rats (WKY) received Ang II and PLP. Blood pressure was measured time-dependently.

Results

Ang II, incubated with PLP, was post-translationally modified to Ang P. Calcium ion entry in VSMCs was significantly lower with Ang P compared to Ang II. Binding affinity of Ang P to AT1R was lower compared to Ang II. Perfusion pressure of isolated perfused rat kidneys increased less by Ang P than by Ang II. Blood pressure of SHR treated with PLP decreased significantly. Blood pressure of WKY rats treated with Ang II was increased to hypertensive values, whereas blood pressure of WKY rats cotreated with Ang II and PLP was not.

Conclusion

PLP induces a post-translational modification of Ang II decreasing blood pressure in rats. Assuming that increased PLP intake in the form of vitamin B6 might reduce blood pressure in hypertensive patients, PLP might be a cost-effective drug against hypertension.

研究目的由于血管紧张素(Ang)II是一种重要的血管收缩肽,我们分析了5'-磷酸吡哆醛(PLP)将其翻译后修饰为丙酮酰胺-Ang II(Ang P)对血压的影响。PLP是一种价格较低的维生素B6衍生物,因此可以成为一种经济有效的高血压药物:方法:分析 Ang P 对钙离子进入血管平滑肌细胞(VSMCs)的影响。测量了 Ang P 与血管紧张素 II 1 型受体(AT1R)的结合亲和力。使用离体灌注大鼠肾脏的生物测定法研究了 Ang P 的血管收缩效应。给自发性高血压大鼠(SHR)注射 PLP。此外,Wistar Kyoto 大鼠(WKY)接受 Ang II 和 PLP。血压测量与时间有关:与 Ang II 相比,Ang P 在血管内皮细胞中的钙离子进入量明显降低。Ang P 与 AT1R 的结合亲和力低于 Ang II。Ang P 对离体灌注大鼠肾脏灌注压的增加低于 Ang II。用 PLP 治疗 SHR 的血压明显下降。用 Ang II 治疗的 WKY 大鼠的血压升高至高血压值,而 Ang II 和 PLP 联合治疗的 WKY 大鼠的血压则没有升高:结论:PLP 可诱导 Ang II 翻译后修饰,降低大鼠血压。假设增加维生素 B6 形式的 PLP 摄入量可降低高血压患者的血压,那么 PLP 可能是一种经济有效的高血压防治药物。
{"title":"Pyridoxal-5′-phosphate: A cost-effective treatment candidate for hypertensive patients?","authors":"Michaela Lellig,&nbsp;Mariano Rodríguez,&nbsp;Rodrigo López-Baltanás,&nbsp;Juliane Hermann,&nbsp;Julia Wollenhaupt,&nbsp;Heidi Noels,&nbsp;Walter Zidek,&nbsp;Martin Tepel,&nbsp;Felix Mahfoud,&nbsp;Joachim Jankowski,&nbsp;Juan R. Muñoz-Castañeda,&nbsp;Vera Jankowski","doi":"10.1111/joim.20015","DOIUrl":"10.1111/joim.20015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Because angiotensin (Ang) II is an essential vasoconstrictive peptide, we analyzed the impact of its post-translational modification to pyruvamide–Ang II (Ang P) by pyridoxal-5′-phosphate (PLP) on blood pressure. PLP is a less expensive vitamin B<sub>6</sub> derivative and, therefore, could be a cost-effective drug against hypertension.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Effect of Ang P on calcium ion entry into vascular smooth muscle cells (VSMCs) was analyzed. Binding affinity of Ang P to angiotensin II type 1 receptor (AT<sub>1</sub>R) was measured. Vasoconstrictive effect of Ang P was investigated using the bioassay of isolated perfused rat kidneys. Spontaneously hypertensive rats (SHR) were administered PLP. Additionally, Wistar Kyoto rats (WKY) received Ang II and PLP. Blood pressure was measured time-dependently.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ang II, incubated with PLP, was post-translationally modified to Ang P. Calcium ion entry in VSMCs was significantly lower with Ang P compared to Ang II. Binding affinity of Ang P to AT<sub>1</sub>R was lower compared to Ang II. Perfusion pressure of isolated perfused rat kidneys increased less by Ang P than by Ang II. Blood pressure of SHR treated with PLP decreased significantly. Blood pressure of WKY rats treated with Ang II was increased to hypertensive values, whereas blood pressure of WKY rats cotreated with Ang II and PLP was not.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>PLP induces a post-translational modification of Ang II decreasing blood pressure in rats. Assuming that increased PLP intake in the form of vitamin B<sub>6</sub> might reduce blood pressure in hypertensive patients, PLP might be a cost-effective drug against hypertension.</p>\u0000 </section>\u0000 </div>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142386777","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
Depression and risk of stroke and mortality after percutaneous coronary intervention: A nationwide population study. 抑郁与经皮冠状动脉介入治疗后的中风和死亡风险:一项全国性人口研究。
IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-06 DOI: 10.1111/joim.20018
Dae Young Cheon, Yong-Moon Park, Myung Soo Park, Jae Hyuk Choi, Mi-Sun Oh, Seongwoo Han, Kyung-Ho Yu, Byung-Chul Lee, Kyungdo Han, Minwoo Lee

Background: Limited evidence exists on the role of depression in the risk of developing stroke and other cardiovascular outcomes in patients who have undergone percutaneous coronary interventions (PCI). We investigated this relationship with data from the Korean National Health Insurance Service database.

Methods: Our nationwide retrospective cohort study included 164,198 patients who had undergone PCI between 2010 and 2017. Depression was defined with the ICD-10 codes recorded prior to the PCI. The primary outcome was a new-onset stroke following the PCI. Secondary outcomes included PCI with myocardial infarction (MI), revascularization (PCI or coronary artery bypass grafting), and all-cause mortality. A multivariable Cox proportional hazards regression analysis was used to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (CI), adjusting for potential confounders, including sociodemographic and lifestyle factors, comorbidities, and MI at the index PCI.

Results: Over a median follow-up of 5.0 years, acute stroke occurred in 5.7% of patients with pre-existing depression (17.4% of the study population), compared to 3.5% of those without depression. Depression was associated with a 27% increased risk of acute stroke (aHR 1.27, 95% CI 1.20-1.35). Additionally, depression was linked with a 25% elevated risk of all-cause death (aHR 1.25, 95% CI, 1.21-1.29) and an 8% increased risk of revascularization (aHR 1.08, 95% CI 1.04-1.11). The associations with the risk of stroke and all-cause mortality were stronger in patients under 65 years.

Conclusions: Our findings suggest that pre-existing depression may increase the risk of stroke and all-cause mortality following PCI, particularly in patients under 65 years. Additionally, depression was significantly associated with an increased need for revascularization. This underscores the potential benefits of managing depression to reduce stroke risk and overall cardiovascular outcomes following PCI.

背景:关于抑郁症在经皮冠状动脉介入治疗(PCI)患者发生中风和其他心血管疾病风险中的作用,目前证据有限。我们利用韩国国民健康保险服务数据库的数据研究了这种关系:我们的全国性回顾性队列研究纳入了 164198 名在 2010 年至 2017 年间接受过 PCI 的患者。抑郁症是根据 PCI 之前记录的 ICD-10 代码定义的。主要结果是PCI术后新发中风。次要结局包括 PCI 并发心肌梗死(MI)、血管再通术(PCI 或冠状动脉旁路移植术)和全因死亡率。采用多变量考克斯比例危险回归分析计算调整后的危险比(aHR)和95%置信区间(CI),并调整潜在的混杂因素,包括社会人口学和生活方式因素、合并症和指数PCI时的心肌梗死:在中位随访 5.0 年期间,5.7% 的原有抑郁症患者(占研究人群的 17.4%)发生了急性脑卒中,而无抑郁症患者仅为 3.5%。抑郁症导致急性中风风险增加 27%(aHR 1.27,95% CI 1.20-1.35)。此外,抑郁症还导致全因死亡风险增加 25%(aHR 1.25,95% CI,1.21-1.29),血管再通风险增加 8%(aHR 1.08,95% CI 1.04-1.11)。65岁以下患者的中风风险和全因死亡率的相关性更强:我们的研究结果表明,原有抑郁可能会增加PCI术后中风和全因死亡的风险,尤其是65岁以下的患者。此外,抑郁症还与血管重建需求的增加密切相关。这强调了管理抑郁症对降低PCI术后中风风险和整体心血管预后的潜在益处。
{"title":"Depression and risk of stroke and mortality after percutaneous coronary intervention: A nationwide population study.","authors":"Dae Young Cheon, Yong-Moon Park, Myung Soo Park, Jae Hyuk Choi, Mi-Sun Oh, Seongwoo Han, Kyung-Ho Yu, Byung-Chul Lee, Kyungdo Han, Minwoo Lee","doi":"10.1111/joim.20018","DOIUrl":"https://doi.org/10.1111/joim.20018","url":null,"abstract":"<p><strong>Background: </strong>Limited evidence exists on the role of depression in the risk of developing stroke and other cardiovascular outcomes in patients who have undergone percutaneous coronary interventions (PCI). We investigated this relationship with data from the Korean National Health Insurance Service database.</p><p><strong>Methods: </strong>Our nationwide retrospective cohort study included 164,198 patients who had undergone PCI between 2010 and 2017. Depression was defined with the ICD-10 codes recorded prior to the PCI. The primary outcome was a new-onset stroke following the PCI. Secondary outcomes included PCI with myocardial infarction (MI), revascularization (PCI or coronary artery bypass grafting), and all-cause mortality. A multivariable Cox proportional hazards regression analysis was used to calculate adjusted hazard ratios (aHR) and 95% confidence intervals (CI), adjusting for potential confounders, including sociodemographic and lifestyle factors, comorbidities, and MI at the index PCI.</p><p><strong>Results: </strong>Over a median follow-up of 5.0 years, acute stroke occurred in 5.7% of patients with pre-existing depression (17.4% of the study population), compared to 3.5% of those without depression. Depression was associated with a 27% increased risk of acute stroke (aHR 1.27, 95% CI 1.20-1.35). Additionally, depression was linked with a 25% elevated risk of all-cause death (aHR 1.25, 95% CI, 1.21-1.29) and an 8% increased risk of revascularization (aHR 1.08, 95% CI 1.04-1.11). The associations with the risk of stroke and all-cause mortality were stronger in patients under 65 years.</p><p><strong>Conclusions: </strong>Our findings suggest that pre-existing depression may increase the risk of stroke and all-cause mortality following PCI, particularly in patients under 65 years. Additionally, depression was significantly associated with an increased need for revascularization. This underscores the potential benefits of managing depression to reduce stroke risk and overall cardiovascular outcomes following PCI.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379585","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
Delirium and frailty in older adults: Clinical overlap and biological underpinnings 老年人的谵妄和虚弱:临床重叠与生物学基础。
IF 9 2区 医学 Q1 MEDICINE, GENERAL & INTERNAL Pub Date : 2024-10-01 DOI: 10.1111/joim.20014
Giuseppe Bellelli, Federico Triolo, Maria Cristina Ferrara, Stacie G. Deiner, Alessandro Morandi, Matteo Cesari, Daniel Davis, Alessandra Marengoni, Marco Inzitari, Leiv Otto Watne, Kenneth Rockwood, Davide Liborio Vetrano

Frailty and delirium are two common geriatric syndromes sharing several clinical characteristics, risk factors, and negative outcomes. Understanding their interdependency is crucial to identify shared mechanisms and implement initiatives to reduce the associated burden. This literature review summarizes scientific evidence on the complex interplay between frailty and delirium; clinical, epidemiological, and pathophysiological commonalities; and current knowledge gaps. We conducted a PubMed systematic search in June 2023, which yielded 118 eligible articles out of 991. The synthesis of the results—carried out by content experts—highlights overlapping risk factors, clinical phenotypes, and outcomes and explores the influence of one syndrome on the onset of the other. Common pathophysiological mechanisms identified include inflammation, neurodegeneration, metabolic insufficiency, and vascular burden. The review suggests that frailty is a risk factor for delirium, with some support for delirium associated with accelerated frailty. The proposed unifying framework supports the integration and measurement of both constructs in research and clinical practice, identifying the geroscience approach as a potential avenue to develop strategies for both conditions. In conclusion, we suggest that frailty and delirium might be alternative—sometimes coexisting—manifestations of accelerated biological aging. Clinically, the concepts addressed in this review can help approach older adults with either frailty or delirium from a different perspective. From a research standpoint, longitudinal studies are needed to explore the hypothesis that specific pathways within the biology of aging may underlie the clinical manifestations of frailty and delirium. Such research will pave the way for future understanding of other geriatric syndromes as well.

虚弱和谵妄是两种常见的老年综合征,它们具有一些共同的临床特征、风险因素和不良后果。了解它们之间的相互依存关系对于确定共同机制和实施减轻相关负担的措施至关重要。本文献综述总结了有关虚弱与谵妄之间复杂相互作用的科学证据、临床、流行病学和病理生理学共性以及当前的知识空白。我们于 2023 年 6 月在 PubMed 上进行了系统检索,从 991 篇文章中筛选出 118 篇符合条件的文章。由内容专家对结果进行了综合,突出了重叠的风险因素、临床表型和结果,并探讨了一种综合征对另一种综合征发病的影响。发现的共同病理生理机制包括炎症、神经变性、代谢不足和血管负担。综述表明,虚弱是导致谵妄的一个风险因素,并在一定程度上支持谵妄与加速虚弱有关。所提出的统一框架支持在研究和临床实践中整合和测量这两个概念,并将全球科学方法确定为针对这两种情况制定策略的潜在途径。总之,我们认为虚弱和谵妄可能是生物衰老加速的另一种表现形式,有时甚至是并存的表现形式。在临床上,本综述所涉及的概念有助于从不同的角度来看待患有虚弱或谵妄的老年人。从研究的角度来看,需要进行纵向研究,以探讨衰老生物学中的特定途径可能是虚弱和谵妄临床表现的基础这一假设。此类研究将为今后了解其他老年综合症铺平道路。
{"title":"Delirium and frailty in older adults: Clinical overlap and biological underpinnings","authors":"Giuseppe Bellelli,&nbsp;Federico Triolo,&nbsp;Maria Cristina Ferrara,&nbsp;Stacie G. Deiner,&nbsp;Alessandro Morandi,&nbsp;Matteo Cesari,&nbsp;Daniel Davis,&nbsp;Alessandra Marengoni,&nbsp;Marco Inzitari,&nbsp;Leiv Otto Watne,&nbsp;Kenneth Rockwood,&nbsp;Davide Liborio Vetrano","doi":"10.1111/joim.20014","DOIUrl":"10.1111/joim.20014","url":null,"abstract":"<p>Frailty and delirium are two common geriatric syndromes sharing several clinical characteristics, risk factors, and negative outcomes. Understanding their interdependency is crucial to identify shared mechanisms and implement initiatives to reduce the associated burden. This literature review summarizes scientific evidence on the complex interplay between frailty and delirium; clinical, epidemiological, and pathophysiological commonalities; and current knowledge gaps. We conducted a PubMed systematic search in June 2023, which yielded 118 eligible articles out of 991. The synthesis of the results—carried out by content experts—highlights overlapping risk factors, clinical phenotypes, and outcomes and explores the influence of one syndrome on the onset of the other. Common pathophysiological mechanisms identified include inflammation, neurodegeneration, metabolic insufficiency, and vascular burden. The review suggests that frailty is a risk factor for delirium, with some support for delirium associated with accelerated frailty. The proposed unifying framework supports the integration and measurement of both constructs in research and clinical practice, identifying the geroscience approach as a potential avenue to develop strategies for both conditions. In conclusion, we suggest that frailty and delirium might be alternative—sometimes coexisting—manifestations of accelerated biological aging. Clinically, the concepts addressed in this review can help approach older adults with either frailty or delirium from a different perspective. From a research standpoint, longitudinal studies are needed to explore the hypothesis that specific pathways within the biology of aging may underlie the clinical manifestations of frailty and delirium. Such research will pave the way for future understanding of other geriatric syndromes as well.</p>","PeriodicalId":196,"journal":{"name":"Journal of Internal Medicine","volume":null,"pages":null},"PeriodicalIF":9.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/joim.20014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337986","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
期刊
Journal of Internal Medicine
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1