European Journal of Internal Medicine最新文献

英文中文

The clinical relevance of the reversal of coronary atherosclerotic plaque 冠状动脉粥样硬化斑块逆转的临床意义。

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.08.010

Arturo Cesaro , Vincenzo Acerbo , Ciro Indolfi , Pasquale Perrone Filardi , Paolo Calabrò

Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of death globally despite advances in preventive therapies. Understanding of the initiation and progression of atherosclerosis, the interplay between lipoproteins, endothelial dysfunction, inflammation, and immune responses is critical to treating this disease. The development of vulnerable coronary plaques prone to thrombosis, can lead to acute coronary syndromes, for these reasons, the potential plaque stabilization and regression through pharmacological interventions, particularly lipid-lowering agents like statins and PCSK9 inhibitors is crucial. The imaging techniques such as intravascular ultrasound (IVUS), near-infrared spectroscopy (NIRS), and optical coherence tomography (OCT) play a key role in assessing plaque composition and guiding interventional therapeutic strategies. Clinical evidence supports the efficacy of intensive lipid-lowering therapy in inducing plaque regression, with studies demonstrating reductions in plaque volume and improvements in plaque morphology assessed by IVUS, OCT and NIRS.

While pharmacological interventions show promise in promoting plaque regression and stabilization, their impact on long-term cardiovascular events requires further investigation. Multimodality imaging and comprehensive outcome trials are proposed as essential tools for elucidating the relationship between plaque modification and clinical benefit in coronary atherosclerosis. The stabilization or regression of atherosclerotic plaque might serve as the phenomenon linking the reduction in LDL-C levels to the decrease in cardiovascular events. Overall, this review emphasizes the ongoing efforts to advance our understanding of ASCVD pathophysiology and optimize therapeutic approaches for improving patient outcomes.

尽管预防性疗法取得了进展，但动脉粥样硬化性心血管疾病（ASCVD）仍然是全球死亡的主要原因。了解动脉粥样硬化的发生和发展过程，以及脂蛋白、内皮功能障碍、炎症和免疫反应之间的相互作用，对于治疗这种疾病至关重要。易形成血栓的脆弱冠状动脉斑块可导致急性冠状动脉综合征，因此，通过药物干预，特别是他汀类药物和 PCSK9 抑制剂等降脂药物，稳定和消退斑块至关重要。血管内超声（IVUS）、近红外光谱（NIRS）和光学相干断层扫描（OCT）等成像技术在评估斑块组成和指导介入治疗策略方面发挥着关键作用。临床证据支持强化降脂疗法在诱导斑块消退方面的疗效，研究表明斑块体积缩小，斑块形态也有所改善，这些都是通过 IVUS、OCT 和 NIRS 评估得出的结果。虽然药物干预有望促进斑块消退和稳定，但其对长期心血管事件的影响还需要进一步研究。多模态成像和综合结果试验被认为是阐明斑块改变与冠状动脉粥样硬化临床获益之间关系的重要工具。动脉粥样硬化斑块的稳定或消退可能是低密度脂蛋白胆固醇水平降低与心血管事件减少之间的关联现象。总之，这篇综述强调了我们正在努力推进对 ASCVD 病理生理学的了解，并优化治疗方法以改善患者预后。

{"title":"The clinical relevance of the reversal of coronary atherosclerotic plaque","authors":"Arturo Cesaro , Vincenzo Acerbo , Ciro Indolfi , Pasquale Perrone Filardi , Paolo Calabrò","doi":"10.1016/j.ejim.2024.08.010","DOIUrl":"10.1016/j.ejim.2024.08.010","url":null,"abstract":"<div><div>Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of death globally despite advances in preventive therapies. Understanding of the initiation and progression of atherosclerosis, the interplay between lipoproteins, endothelial dysfunction, inflammation, and immune responses is critical to treating this disease. The development of vulnerable coronary plaques prone to thrombosis, can lead to acute coronary syndromes, for these reasons, the potential plaque stabilization and regression through pharmacological interventions, particularly lipid-lowering agents like statins and PCSK9 inhibitors is crucial. The imaging techniques such as intravascular ultrasound (IVUS), near-infrared spectroscopy (NIRS), and optical coherence tomography (OCT) play a key role in assessing plaque composition and guiding interventional therapeutic strategies. Clinical evidence supports the efficacy of intensive lipid-lowering therapy in inducing plaque regression, with studies demonstrating reductions in plaque volume and improvements in plaque morphology assessed by IVUS, OCT and NIRS.</div><div>While pharmacological interventions show promise in promoting plaque regression and stabilization, their impact on long-term cardiovascular events requires further investigation. Multimodality imaging and comprehensive outcome trials are proposed as essential tools for elucidating the relationship between plaque modification and clinical benefit in coronary atherosclerosis. The stabilization or regression of atherosclerotic plaque might serve as the phenomenon linking the reduction in LDL-C levels to the decrease in cardiovascular events. Overall, this review emphasizes the ongoing efforts to advance our understanding of ASCVD pathophysiology and optimize therapeutic approaches for improving patient outcomes.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"129 ","pages":"Pages 16-24"},"PeriodicalIF":5.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142009870","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 potential novel stratification model to predict cardiovascular disease in patients with metabolic dysfunction-associated steatotic liver disease 预测代谢功能障碍相关脂肪肝患者心血管疾病的潜在新型分层模型。

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.09.005

Thomas Bülow Pedersen , Martin Bødtker Mortensen , Henning Grønbæk

引用次数: 0

Insights into recurrence of hypertriglyceridemia-associated acute pancreatitis: Methodological challenges 洞察高甘油三酯血症相关急性胰腺炎的复发：方法学挑战。

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.06.028

引用次数: 0

Associations of cannabis use and body mass index–The Coronary Artery Risk Development in Young Adults (CARDIA) study 吸食大麻与体重指数的关系--年轻人冠状动脉风险发展（CARDIA）研究。

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.07.007

Background

With increasing use of cannabis, we need to know if cannabis use and Body Mass Index (BMI) are associated.

Methods

The Coronary Artery Risk Development in Young Adults Study followed Black and White adults over 30 years with assessments every 2 to 5 years in four centers in the USA. We assessed self-reported current and computed cumulative cannabis exposure at every visit, and studied associations with BMI, adjusted for relevant covariables in mixed longitudinal models. We also applied marginal structural models (MSM) accounting for the probability of having stopped cannabis over the last 5 years.

Results

At the Year 30 visit, 1,912 (58 %) identified as women and 1,600 (48 %) as Black, mean age was 56 (SD 2) years. While 2,849 (85 %) had ever used cannabis, 479 (14 %) currently used cannabis. Overall, participants contributed to 35,882 individual visits over 30 years. In multivariable adjusted models, mean BMI was significantly lower in daily cannabis users (26.6 kg/m², 95 %CI 26.3 to 27.0) than in participants without current use (27.7 kg/m², 95 %CI 27.5 to 27.9, p < 0.001). Cumulative cannabis use was not associated with BMI. The MSM showed no change in BMI when stopping cannabis use over a 5-year period (β=0.2 kg/m² total, 95 %CI -0.2 to 0.6).

Conclusions

Current cannabis use was associated with lower BMI, but cumulative cannabis use and cessation were not. This suggests that recreational cannabis use may not lead to clinically relevant changes in BMI and that the association between current cannabis use and lower BMI is likely due to residual confounding.

背景：随着大麻使用量的增加，我们需要知道大麻使用量和体重指数（BMI）是否相关：年轻人冠状动脉风险发展研究对美国四个中心的黑人和白人成年人进行了长达 30 年的跟踪调查，每 2 至 5 年进行一次评估。我们在每次访问时评估自我报告的当前大麻暴露量并计算累计大麻暴露量，研究与体重指数的关系，并在混合纵向模型中对相关协变量进行调整。我们还应用了边际结构模型（MSM），考虑过去 5 年中停止吸食大麻的概率：在第 30 年的访问中，有 1,912 人（58%）被确认为女性，1,600 人（48%）被确认为黑人，平均年龄为 56 岁（标准差为 2）。2,849人（85%）曾经吸食大麻，479人（14%）目前吸食大麻。总体而言，参与者在 30 年间共进行了 35,882 次个人就诊。在多变量调整模型中，每日吸食大麻者的平均体重指数（26.6 kg/m2，95 %CI 26.3 至 27.0）明显低于未吸食者（27.7 kg/m2，95 %CI 27.5 至 27.9，p < 0.001）。累积吸食大麻与体重指数无关。MSM 在 5 年内停止使用大麻后，体重指数没有变化（β=0.2 kg/m2，95 %CI -0.2 至 0.6）：当前使用大麻与较低的体重指数有关，但累积使用大麻和停止使用大麻则无关。这表明，娱乐性吸食大麻可能不会导致体重指数发生临床相关的变化，当前吸食大麻与体重指数降低之间的关联可能是由于残余混杂因素造成的。

{"title":"Associations of cannabis use and body mass index–The Coronary Artery Risk Development in Young Adults (CARDIA) study","authors":"","doi":"10.1016/j.ejim.2024.07.007","DOIUrl":"10.1016/j.ejim.2024.07.007","url":null,"abstract":"<div><h3>Background</h3><div>With increasing use of cannabis, we need to know if cannabis use and Body Mass Index (BMI) are associated.</div></div><div><h3>Methods</h3><div>The Coronary Artery Risk Development in Young Adults Study followed Black and White adults over 30 years with assessments every 2 to 5 years in four centers in the USA. We assessed self-reported current and computed cumulative cannabis exposure at every visit, and studied associations with BMI, adjusted for relevant covariables in mixed longitudinal models. We also applied marginal structural models (MSM) accounting for the probability of having stopped cannabis over the last 5 years.</div></div><div><h3>Results</h3><div>At the Year 30 visit, 1,912 (58 %) identified as women and 1,600 (48 %) as Black, mean age was 56 (SD 2) years. While 2,849 (85 %) had ever used cannabis, 479 (14 %) currently used cannabis. Overall, participants contributed to 35,882 individual visits over 30 years. In multivariable adjusted models, mean BMI was significantly lower in daily cannabis users (26.6 kg/m<sup>2</sup>, 95 %CI 26.3 to 27.0) than in participants without current use (27.7 kg/m<sup>2</sup>, 95 %CI 27.5 to 27.9, <em>p</em> < 0.001). Cumulative cannabis use was not associated with BMI. The MSM showed no change in BMI when stopping cannabis use over a 5-year period (β=0.2 kg/m<sup>2</sup> total, 95 %CI -0.2 to 0.6).</div></div><div><h3>Conclusions</h3><div>Current cannabis use was associated with lower BMI, but cumulative cannabis use and cessation were not. This suggests that recreational cannabis use may not lead to clinically relevant changes in BMI and that the association between current cannabis use and lower BMI is likely due to residual confounding.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"129 ","pages":"Pages 41-47"},"PeriodicalIF":5.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581400","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

Plasma levels of myeloperoxidase and resistin independently predict mortality in dialysis patients 血浆中髓过氧化物酶和抵抗素水平可独立预测透析患者的死亡率。

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.07.013

Luca Liberale , Claudia Torino , Patrizia Pizzini , Sabrina Mezzatesta , Graziella D'Arrigo , Mercedes Gori , Federico Carbone , Elisa Schiavetta , Valeria Cugno , Mara Cabri , Cosimo Sgura , Elia Maioli , Danielle Mbarga , Gianluca Rubini , Amedeo Tirandi , Davide Ramoni , Francesca Mallamaci , Giovanni Tripepi , Carmine Zoccali , Fabrizio Montecucco

Background

In patients with kidney failure (KF) undergoing dialysis, neutrophils are dysfunctionally activated. Such chronic activation does not correspond to increased protection against infections and is thought to cause direct vascular damage accounting for the higher incidence of cardiovascular (CV) events. We hypothesized that circulating levels of neutrophil degranulation products (i.e. myeloperoxidase (MPO) and resistin) can predict overall and CV-specific mortality in dialysis patients.

Methods

MPO and resistin levels were assessed in plasma samples from n = 1182 dialysis patients who were followed-up for median 2.9 years (IQR: 1.7–4.2).

Results

Patients were 65 ± 14 (SD) years old and 36 % women. Median value of MPO and resistin were 78 ng/mL (IQR: 54 - 123) and 72 ng/mL (IQR: 46 - 110), respectively. MPO and resistin levels correlated with biomarkers of organ damage, nutritional status and inflammation. Both MPO and resistin levels predicted all-cause mortality even after adjustment for traditional risk factors and inflammation, nutritional and KF-related indexes (MPO, HR_{for 1 ln unit increase}: 1.26, 95 %CI 1.11 – 1.42, P < 0.001; Resistin, HR_{for 1 ln unit increase}: 1.25, 95 %CI 1.09 – 1.44, P = 0.001). Similarly, their predictive ability held true also for CV death (MPO, HR_{for 1 ln unit increase}: 1.19, 95 %CI 1.01 – 1.41, P = 0.04; Resistin, HR_{for 1 ln unit increase}: 1.29, 95 %CI 1.07 – 1.56, P = 0.007).

Conclusion

Plasma levels of MPO and resistin correlate with prospective overall and CV-specific mortality risk in KF patients undergoing dialysis and might be useful prognostic tools. Mediators of inflammation may be potential target to improve survival of those patients.

背景：在接受透析治疗的肾衰竭（KF）患者中，中性粒细胞处于功能失调的激活状态。这种慢性活化并不能增强对感染的保护，而且被认为会造成直接的血管损伤，从而导致心血管（CV）事件的发生率升高。我们假设中性粒细胞脱颗粒产物（即髓过氧化物酶（MPO）和抵抗素）的循环水平可以预测透析患者的总死亡率和心血管特异性死亡率：方法：对 n = 1182 名透析患者的血浆样本进行 MPO 和抵抗素水平评估，这些患者的随访时间中位数为 2.9 年（IQR：1.7-4.2 年）：结果：患者年龄为 65 ± 14 (SD) 岁，36% 为女性。MPO和抵抗素的中位值分别为78纳克/毫升（IQR：54 - 123）和72纳克/毫升（IQR：46 - 110）。MPO和抵抗素水平与器官损伤、营养状况和炎症的生物标志物相关。即使在调整了传统的风险因素以及炎症、营养和 KF 相关指数后，MPO 和抵抗素水平仍可预测全因死亡率（MPO，1 ln 单位增加的 HR：1.26，95 %CI ：1.26，95 %CI ：1.26，95 %CI ：1.26）：1.26，95 %CI 1.11 - 1.42，P <0.001；抵抗素，增加 1 ln 单位的 HR：1.25，95 %CI 1.11 - 1.42，P <0.001：1.25，95 %CI 1.09 - 1.44，P = 0.001）。同样，它们对 CV 死亡的预测能力也是如此（MPO，增加 1 ln 单位的 HR：1.19，95 %CI 1.09 - 1.44，P = 0.001）：1.19, 95 %CI 1.01 - 1.41, P = 0.04; Resistin, HRfor 1 ln unit increase：1.29, 95 %CI 1.07 - 1.56, P = 0.007）：结论：血浆 MPO 和抗阻素水平与接受透析的 KF 患者的预期总死亡率和心血管特异性死亡率风险相关，可能是有用的预后工具。炎症介质可能是改善这些患者生存状况的潜在目标。

{"title":"Plasma levels of myeloperoxidase and resistin independently predict mortality in dialysis patients","authors":"Luca Liberale , Claudia Torino , Patrizia Pizzini , Sabrina Mezzatesta , Graziella D'Arrigo , Mercedes Gori , Federico Carbone , Elisa Schiavetta , Valeria Cugno , Mara Cabri , Cosimo Sgura , Elia Maioli , Danielle Mbarga , Gianluca Rubini , Amedeo Tirandi , Davide Ramoni , Francesca Mallamaci , Giovanni Tripepi , Carmine Zoccali , Fabrizio Montecucco","doi":"10.1016/j.ejim.2024.07.013","DOIUrl":"10.1016/j.ejim.2024.07.013","url":null,"abstract":"<div><h3>Background</h3><div>In patients with kidney failure (KF) undergoing dialysis, neutrophils are dysfunctionally activated. Such chronic activation does not correspond to increased protection against infections and is thought to cause direct vascular damage accounting for the higher incidence of cardiovascular (CV) events. We hypothesized that circulating levels of neutrophil degranulation products (i.e. myeloperoxidase (MPO) and resistin) can predict overall and CV-specific mortality in dialysis patients.</div></div><div><h3>Methods</h3><div>MPO and resistin levels were assessed in plasma samples from <em>n</em> = 1182 dialysis patients who were followed-up for median 2.9 years (IQR: 1.7–4.2).</div></div><div><h3>Results</h3><div>Patients were 65 ± 14 (SD) years old and 36 % women. Median value of MPO and resistin were 78 ng/mL (IQR: 54 - 123) and 72 ng/mL (IQR: 46 - 110), respectively. MPO and resistin levels correlated with biomarkers of organ damage, nutritional status and inflammation. Both MPO and resistin levels predicted all-cause mortality even after adjustment for traditional risk factors and inflammation, nutritional and KF-related indexes (MPO, HR<sub>for 1 ln unit increase</sub>: 1.26, 95 %CI 1.11 – 1.42, <em>P</em> < 0.001; Resistin, HR<sub>for 1 ln unit increase</sub>: 1.25, 95 %CI 1.09 – 1.44, <em>P</em> = 0.001). Similarly, their predictive ability held true also for CV death (MPO, HR<sub>for 1 ln unit increase</sub>: 1.19, 95 %CI 1.01 – 1.41, <em>P</em> = 0.04; Resistin, HR<sub>for 1 ln unit increase</sub>: 1.29, 95 %CI 1.07 – 1.56, <em>P</em> = 0.007).</div></div><div><h3>Conclusion</h3><div>Plasma levels of MPO and resistin correlate with prospective overall and CV-specific mortality risk in KF patients undergoing dialysis and might be useful prognostic tools. Mediators of inflammation may be potential target to improve survival of those patients.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"129 ","pages":"Pages 87-92"},"PeriodicalIF":5.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141635645","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

Door-to-antibiotic time and mortality in patients with sepsis: Systematic review and meta-analysis 脓毒症患者从进门到获得抗生素的时间和死亡率：系统回顾和荟萃分析。

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.06.015

Ling Yan Leung , Hsi-Lan Huang , Kevin KC Hung , Chi Yan Leung , Cherry CY Lam , Ronson SL Lo , Chun Yu Yeung , Peter Joseph Tsoi , Michael Lai , Mikkel Brabrand , Joseph H Walline , Colin A Graham

Objectives

To evaluate whether the timing of initial antibiotic administration in patients with sepsis in hospital affects mortality.

Methods

This systematic review and meta-analysis included studies from inception up to 19 May 2022. Interventional and observational studies including adult human patients with suspected or confirmed sepsis and reported time of antibiotic administration with mortality were included. Data were extracted by two independent reviewers. Summary estimates were calculated by using random-effects model. The primary outcome was mortality.

Results

We included 42 studies comprising 190,896 patients with sepsis. Pooled data showed that the OR for patient mortality who received antibiotics ≤1 hr was 0.83 (95 %CI: 0.67 to 1.04) when compared with patients who received antibiotics >1hr. Significant reductions in the risk of death in patients with earlier antibiotic administration were observed in patients ≤3 hrs versus >3 hrs (OR: 0.80, 95 %CI: 0.68 to 0.94) and ≤6 hrs vs 6 hrs (OR: 0.57, 95 %CI: 0.39 to 0.82).

Conclusions

Our findings show an improvement in mortality in sepsis patients with early administration of antibiotics at <3 and <6 hrs. Thus, these results suggest that antibiotics should be administered within 3 hrs of sepsis recognition or ED arrival regardless of the presence or absence of shock.

目的评估对住院败血症患者首次使用抗生素的时间是否会影响死亡率：本系统综述和荟萃分析纳入了自开始至 2022 年 5 月 19 日的研究。纳入的干预性和观察性研究包括疑似或确诊败血症的成人患者，并报告了使用抗生素的时间与死亡率的关系。数据由两名独立审稿人提取。采用随机效应模型计算汇总估计值。主要结果为死亡率：我们纳入了 42 项研究，包括 190,896 名败血症患者。汇总数据显示，与接受抗生素治疗时间大于 1 小时的患者相比，接受抗生素治疗时间小于 1 小时的患者死亡率的 OR 值为 0.83（95 %CI：0.67 至 1.04）。在≤3小时与＞3小时（OR：0.80，95 %CI：0.68-0.94）和≤6小时与6小时（OR：0.57，95 %CI：0.39-0.82）的患者中，观察到较早使用抗生素的患者死亡风险显著降低：我们的研究结果表明，脓毒症患者在脓毒症发生时尽早使用抗生素可降低死亡率。

{"title":"Door-to-antibiotic time and mortality in patients with sepsis: Systematic review and meta-analysis","authors":"Ling Yan Leung , Hsi-Lan Huang , Kevin KC Hung , Chi Yan Leung , Cherry CY Lam , Ronson SL Lo , Chun Yu Yeung , Peter Joseph Tsoi , Michael Lai , Mikkel Brabrand , Joseph H Walline , Colin A Graham","doi":"10.1016/j.ejim.2024.06.015","DOIUrl":"10.1016/j.ejim.2024.06.015","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate whether the timing of initial antibiotic administration in patients with sepsis in hospital affects mortality.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis included studies from inception up to 19 May 2022. Interventional and observational studies including adult human patients with suspected or confirmed sepsis and reported time of antibiotic administration with mortality were included. Data were extracted by two independent reviewers. Summary estimates were calculated by using random-effects model. The primary outcome was mortality.</div></div><div><h3>Results</h3><div>We included 42 studies comprising 190,896 patients with sepsis. Pooled data showed that the OR for patient mortality who received antibiotics ≤1 hr was 0.83 (95 %CI: 0.67 to 1.04) when compared with patients who received antibiotics >1hr. Significant reductions in the risk of death in patients with earlier antibiotic administration were observed in patients ≤3 hrs versus >3 hrs (OR: 0.80, 95 %CI: 0.68 to 0.94) and ≤6 hrs vs 6 hrs (OR: 0.57, 95 %CI: 0.39 to 0.82).</div></div><div><h3>Conclusions</h3><div>Our findings show an improvement in mortality in sepsis patients with early administration of antibiotics at <3 and <6 hrs. Thus, these results suggest that antibiotics should be administered within 3 hrs of sepsis recognition or ED arrival regardless of the presence or absence of shock.</div></div>","PeriodicalId":50485,"journal":{"name":"European Journal of Internal Medicine","volume":"129 ","pages":"Pages 48-61"},"PeriodicalIF":5.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141735586","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

A peculiar cause of dysphagia 吞咽困难的特殊原因。

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.07.023

Pinar Kucukdagli, Ozlem Yilmaz , Gulistan Bahat

引用次数: 0

Risk of psoriatic arthritis development with interleukin-17 inhibitors compared to tumour necrosis factor inhibitors 与肿瘤坏死因子抑制剂相比，白细胞介素-17抑制剂引发银屑病关节炎的风险。

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.06.014

引用次数: 0

Putting frailty at the forefront of hypertension management in the elderly 将体弱放在老年人高血压管理的首位。

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.09.006

Giacomo Buso , Claudia Agabiti-Rosei , Maria Lorenza Muiesan

引用次数: 0

Myocardial infarction in foreign-born individuals in the total population of Sweden 瑞典总人口中外国出生者的心肌梗死情况。

IF 5.9 2区医学 Q1 MEDICINE, GENERAL & INTERNAL

European Journal of Internal Medicine

Pub Date : 2024-11-01 DOI: 10.1016/j.ejim.2024.06.011

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

European 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.

﹀