European journal of clinical investigation
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Eur. J. Clin. Invest. · Apr 2023
ReviewGlobal burden of gout in 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019.
Although gout is one of the most common rheumatic diseases, world data are lacking because most studies have focused on industrialized countries. Therefore, we aimed to investigate the global burden of gout and its associations with the year of diagnosis, age, geographical region, sociodemographic status and various further risk factors. ⋯ The global prevalence of gout, as well as incidence, and YLDs increased worldwide from 1990 to 2019 and had a significant association with sex, age, geographic region, SDI and risk factors. Understanding the complex interplay of environmental, sociodemographic and geographic risk factors is essential in mitigating the ever-rising disease burden of gout.
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Eur. J. Clin. Invest. · Apr 2023
ReviewLeveraging the future of diagnosis and management of diabetes: from old indexes to new technologies.
Diabetes is a heterogeneous and multifactorial disease. However, glycemia and glycated hemoglobin have been the focus of diabetes diagnosis and management for the last decades. As diabetes management goes far beyond glucose control, it has become clear that assessment of other biochemical parameters gives a much wider view of the metabolic state of each individual, enabling a precision medicine approach. ⋯ In long-term, the solution for a better diabetes management would be a platform that allows to integrate all sorts of relevant information for the person with diabetes and for the healthcare practitioners, namely glucose, insulin and C-peptide or, in case of need, other parameters/indexes at home, sometimes more than once a day. This solution would allow a better and simpler disease management, more adequate therapeutics thereby improving patients' quality of life and reducing associated costs.
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Eur. J. Clin. Invest. · Apr 2023
Response rate in cardiac resynchronization therapy patients implanted with a left ventricular quadripolar lead and the MultiPointTM Pacing feature activated. QUARTO III.
Although cardiac resynchronization therapy (CRT) is beneficial in most heart failure patients, up to 40% do not respond to CRT. It has been suggested that multipoint left ventricle pacing (MPP) would increase the response rate. ⋯ Early activation of MPP was not associated to an advantage increasing echocardiography responders to CRT at 6 months of follow-up. Nevertheless, patients programmed using widest pacing cathodes had a numerically higher responder rate. Finally, early activation of MPP was associated to a low incidence of clinical endpoints at 6 months of follow-up.
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Eur. J. Clin. Invest. · Apr 2023
Multicenter Study Observational StudyAntihypertensive treatment changes and related clinical outcomes in older hospitalized patients.
Hypertension management in older patients represents a challenge, particularly when hospitalized. ⋯ Guidelines-suggested MT for hypertension at discharge is associated with a lower risk of adverse clinical outcomes. Nevertheless, changes in antihypertensive treatment still occur in a significant proportion of older hospitalized patients.
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Eur. J. Clin. Invest. · Apr 2023
Cancer Patients with Venous Thromboembolism: Diagnostic and Prognostic Value of Elevated D-dimers.
D-dimer testing is known to have a high sensitivity at simultaneously low specificity, resulting in nonspecific elevations in a variety of conditions. ⋯ Although D-dimer testing in cancer patients is discouraged by current guidelines, very high concentrations above the 10-fold upper reference limit contain diagnostic and prognostic information and might be helpful in risk assessment, while low concentrations remain useful for ruling out VTE.