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Journal of Internal Medicine | Page 2

Johannes Mofors, Elizabeth V Arkema, Albin Björk, Linnea Westermark, Marika Kvarnström, Helena Forsblad-d'Elia, Sara Magnusson Bucher, Per Eriksson, Thomas Mandl, Gunnel Nordmark, Marie Wahren-Herlenius
OBJECTIVE: Environmental factors have been suggested in the pathogenesis of rheumatic diseases. We here investigated whether infections increase the risk of developing primary Sjögren's syndrome (pSS). METHODS: Patients with pSS in Sweden (n=945) and matched controls from the general population (n=9,048) were included, and data extracted from the National Patient Register to identify infections occurring before pSS diagnosis during a mean observational time of 16...
March 20, 2019: Journal of Internal Medicine
A Bonaventura, S Carbone, D L Dixon, A Abbate, F Montecucco
Patients with type 2 diabetes mellitus (T2D) present an increased risk for cardiovascular (CV) complications. In addition to improvement in glycaemic control, glucose-lowering therapies, such as glucagon-like peptide-1 receptor agonists (GLP-1RAs) and sodium-dependent glucose cotransporter (SGLT)-2 inhibitors, have been shown to significantly reduce CV events. In 2008, the US Food and Drug Administration mandated that all new glucose-lowering drugs undergo CV outcomes trials (CVOTs) to determine their CV safety...
March 19, 2019: Journal of Internal Medicine
Ian R Reid, Anne M Horne, Borislav Mihov, Angela Stewart, Elizabeth Garratt, Katy R Wiessing, Mark J Bolland, Sonja Bastin, Gregory D Gamble
BACKGROUND: We recently reported that the administration of zoledronate every 18 months to osteopenic older women reduces the incidence of fractures. OBJECTIVE: Here we present a more detailed analysis of that trial to determine whether baseline clinical characteristics impact on the anti-fracture efficacy of this intervention. METHODS: This is a prospective, randomized, placebo-controlled, double-blind trial in osteopenic postmenopausal women aged ≥65 years, to determine the anti-fracture efficacy of zoledronate...
March 18, 2019: Journal of Internal Medicine
Jonathan Kay
No abstract text is available yet for this article.
March 14, 2019: Journal of Internal Medicine
A Mantovani, A Ponzetta, A Inforzato, S Jaillon
Components of the cellular and the humoral arm of the immune system are essential elements of the tumour microenvironment (TME). The TME includes tumour-associated macrophages which have served as a paradigm for the cancer-promoting inflammation. Cytokines, IL-1 in particular, and complement have emerged as important players in tumour promotion. On the other hand, myeloid cells, innate lymphoid cells and complement have the potential, if unleashed, to mediate anticancer resistance. Targeting checkpoints restraining innate immunity, macrophages and natural killer (NK) cells in particular holds promise as a therapeutic strategy...
March 14, 2019: Journal of Internal Medicine
S A Urwyler, C A Blum, M Coslovsky, B Mueller, P Schuetz, M Christ-Crain
BACKGROUND: A previous study found community-acquired pneumonia (CAP) patients with imbalance of high inflammation and discordantly low cortisol levels to benefit most from adjunctive corticosteroid treatment. Our aim was to validate this hypothesis in a preplanned secondary analysis of the randomized controlled STEP trial. METHODS: Patients included in the STEP trial receiving 50 mg prednisone or placebo for 5 days were categorized based on pro-inflammatory cytokines (Interleukin-6/8/MCP-1), CRP and cortisol levels on admission into four groups (high/low inflammation and high/low cortisol)...
March 14, 2019: Journal of Internal Medicine
T Hendrikx, B Schnabl
Alterations in the bacteria that reside in our gastrointestinal tract play a role in the pathogenesis and progression of many disorders including liver and gastrointestinal diseases. Both qualitative (composition) and quantitative (amount) changes in gut microbes are associated with increased susceptibility to liver disease. Importantly, the intestinal microbiota is involved in the regulation of many host signalling pathways via the generation of different metabolites. Hence, dysbiosis influences disease development and progression by directly affecting the host-bacteria metabolic interaction...
March 14, 2019: Journal of Internal Medicine
Magnus Tobiasson, Astrid Olsnes Kittang
Next-generation sequencing (NGS) is rapidly changing the clinical care of patients with myelodysplastic syndrome (MDS). NGS can be used for various applications: (i) in the diagnostic process to discriminate between MDS and other diseases such as aplastic anaemia, myeloproliferative disorders and idiopathic cytopenias; (ii) for classification, for example where the presence of SF3B1 mutation is one criterion for the ring sideroblast anaemia subgroups in the World Health Organization 2016 classification; (iii) for identification of patients suitable for targeted therapy (e...
March 14, 2019: Journal of Internal Medicine
Qu Tian, Susan M Resnick, Christos Davatzikos, Guray Erus, Eleanor M Simonsick, Stephanie A Studenski, Luigi Ferrucci
BACKGROUND: The parallel decline of mobility and cognition with aging is explained in part by shared brain structural changes that are related to fitness. However, the temporal sequence between fitness, brain structural changes, and mobility loss has not been fully evaluated. METHODS: Participants were from the Baltimore Longitudinal Study of Aging, aged 60 or older, initially free of cognitive and mobility impairments, with repeated measures of fitness(400m time), mobility(6m gait speed), and neuroimaging markers over 4 years(n=332)...
March 12, 2019: Journal of Internal Medicine
B H Shaw, L E Stiles, K Bourne, E A Green, C A Shibao, L E Okamoto, E M Garland, A Gamboa, A Diedrich, V Raj, R S Sheldon, I Biaggioni, D Robertson, S R Raj
BACKGROUND: Patients with postural tachycardia syndrome (POTS) experience chronic symptoms of orthostatic intolerance. There are minimal data detailing the demographics, clinical features and clinical course of this condition. This online, community-based survey highlights patients' experience with POTS. It consists of the largest sample of POTS patients reported to date. OBJECTIVES: To describe the demographics, past medical history, medications, treatments and diagnostic journey for patients living with POTS...
March 12, 2019: Journal of Internal Medicine
Gisela Barbany, Cecilia Arthur, Agne Liedén, Magnus Nordenskjöld, Richard Rosenquist, Bianca Tesi, Karin Wallander, Emma Tham
In recent years, detection of cell free tumour DNA (ctDNA) or liquid biopsy has emerged as an attractive non-invasive methodology to detect cancer-specific genetic aberrations in plasma, and numerous studies have reported on the feasibility of ctDNA in advanced cancer. In particular, ctDNA assays can capture a more 'global' portrait of tumour heterogeneity, monitor therapy response and lead to early detection of resistance mutations. More recently, ctDNA analysis has also been proposed as a promising future tool for detection of early cancer and/or cancer screening...
March 12, 2019: Journal of Internal Medicine
T A Eyre, N Martinez-Calle, C Hildyard, D W Eyre, H Plaschkes, J Griffith, J Wolf, P Fields, A Gunawan, R Oliver, F Djebbari, S Booth, A McMillan, C P Fox, M J Bishton, G P Collins, C S R Hatton
BACKGROUND: The increasing incidence of diffuse large B-cell lymphoma (DLBCL) in ageing populations places a significant burden on healthcare systems. Co-morbidity, frailty, and reduced organ and physiological reserve contribute to treatment-related complications. The optimal dose intensity of R-CHOP to optimize outcome across different ages with variable frailty and comorbidity burden is unclear. OBJECTIVES AND METHODS: We examined the influence of intended (IDI) and relative (RDI) dose intensity of the combination of cyclophosphamide and doxorubicin, age and comorbidity on outcomes for DLBCL patients ≥70 years in a representative, consecutive cohort across eight UK centres (2009-2018)...
February 27, 2019: Journal of Internal Medicine
N Marklund, B-M Bellander, A K Godbolt, H Levin, P McCrory, E P Thelin
Traumatic brain injury (TBI) is a major cause of acquired disability globally, and effective treatment methods are scarce. Lately, there has been increasing recognition of the devastating impact of TBI resulting from sports and other recreational activities, ranging from primarily sport-related concussions (SRC) but also more severe brain injuries requiring hospitalization. There are currently no established treatments for the underlying pathophysiology in TBI and while neuro-rehabilitation efforts are promising, there are currently is a lack of consensus regarding rehabilitation following TBI of any severity...
June 2019: Journal of Internal Medicine
A Egesten, S Gordon, H Herwald
No abstract text is available yet for this article.
May 2019: Journal of Internal Medicine
M Rydén, P Petrus, D P Andersson, G Medina-Gómez, E Escasany, P Corrales Cordón, I Dahlman, A Kulyté, P Arner
OBJECTIVE: Many overweight/obese subjects appear metabolically healthy with normal in vivo insulin sensitivity. Still, they have increased long-term risk of developing type 2 diabetes. We hypothesized that adipose tissue dysfunction involving decreased insulin action in adipocytes is present in apparently healthy overweight/obese subjects. DESIGN/METHODS: Subjects with normal metabolic health according to Adult Treatment Panel-III or Framingham risk score criteria were subdivided into 67 lean, 32 overweight and 37 obese according to body mass index...
May 2019: Journal of Internal Medicine
Eva Rye Rasmussen, Anton Pottegård, Anette Bygum, Christian von Buchwald, Preben Homøe, Jesper Hallas
BACKGROUND: It has long been suggested that angiotensin-converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (AT2s) have some degree of 'cross-reactivity' in causing angioedema. Therefore, caution has been advised when switching patients with ACEi-related angioedema to an AT2. OBJECTIVES: To clarify whether AT2s can be used safely in patients with a history of angioedema during ACEi treatment and to estimate the incidence rate of angioedema in patients subsequently treated with other antihypertensive drugs (beta-adrenergic blockers, calcium channel blockers, thiazides and analogues) or no antihypertensives...
May 2019: Journal of Internal Medicine
M Nahrendorf
Myeloid cells assume a wide range of phenotypes, some of which are protective against injury and infection whilst others promote cardiovascular disease. This heterogeneity is partially caused by switching of cell sources from local tissue-resident macrophage proliferation to recruitment of circulating cells, and partially due to macrophages' phenotypic plasticity. While long-lived tissue-resident macrophages support development, tissue homoeostasis and cardiac conduction, monocyte-derived cells may promote destruction of the arterial wall and the myocardium, leading to organ ischaemia and heart failure...
May 2019: Journal of Internal Medicine
W S Tan, A Ahmad, A Feber, H Mostafid, J Cresswell, C D Fankhauser, S Waisbrod, T Hermanns, P Sasieni, J D Kelly
BACKGROUND: A lack of consensus exists amongst national guidelines regarding who should be investigated for haematuria. Type of haematuria and age-specific thresholds are frequently used to guide referral for the investigation of haematuria. OBJECTIVES: To develop and externally validate the haematuria cancer risk score (HCRS) to improve patient selection for the investigation of haematuria. METHODS: Development cohort comprise of 3539 prospectively recruited patients recruited at 40 UK hospitals (DETECT 1; ClinicalTrials...
April 2019: Journal of Internal Medicine
T Willinger
Cholesterol is an essential molecule for life. It is a component of the cell membrane, and it is a precursor molecule for bile acids, vitamin D and steroid hormones. Cholesterol is actively metabolized, but the impact of endogenous cholesterol metabolites on immune function, especially in the intestine, is poorly understood. In this review, I focus on oxysterols, hydroxylated forms of cholesterol, and their specialized functions in intestinal immunity. Oxysterols act through various intracellular and extracellular receptors and serve as key metabolic signals, coordinating immune activity and inflammation...
April 2019: Journal of Internal Medicine
K M Eggers, M Hjort, T Baron, T Jernberg, A M Nordenskjöld, P Tornvall, B Lindahl
BACKGROUND: Myocardial infarction (MI) with nonobstructive coronary arteries (MINOCA) is receiving increasing interest as a prognostically adverse entity distinct from myocardial infarction with significant coronary artery disease (MI-CAD). However, data are still limited regarding long-term cardiovascular morbidity and cause-specific mortality in MINOCA. METHODS: This is a registry-based cohort study using data from patients admitted to Swedish coronary care units...
April 2019: Journal of Internal Medicine
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