European journal of internal medicine
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Eur. J. Intern. Med. · Feb 2025
Characterization of ischemic etiology in heart failure with reduced ejection fraction randomized clinical trials: A systematic review and meta-analysis.
We investigated how ischemic etiology has been assigned in heart failure with a reduced ejection fraction (HFrEF) randomized controlled trials (RCTs). ⋯ An accurate definition of ischemic etiology is mostly lacking in HFrEF RCTs, and primarily assigned based on investigators clinical judgment, sometimes in the presence of a prior MI, although the rate of this component showed a decline over time.
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Eur. J. Intern. Med. · Feb 2025
Comparative analysis of obesity indices in discrimination and reclassification of cardiovascular disease risk: The ATTICA study (2002-2022).
Despite the established link between obesity and cardiovascular disease (CVD), the optimal anthropometric index for risk prediction remains uncertain. ⋯ Obesity indices are strongly associated with long-term risk of ASCVD, underscoring the major role of excessive body fat in the pathogenesis of this condition. The inclusion of an obesity index in a CVD risk model significantly enhances its predictive accuracy and reclassification of risk, emphasizing the importance of these indices in refining CVD risk assessment among the general population.
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Eur. J. Intern. Med. · Feb 2025
Advancing women's health with a pioneering implant to treat breast cancer related lymphedema.
Lymphedema (LE) is a globally recognized chronic and disabling condition with a high prevalence. At present, there is no curative treatment for LE, and management options are primarily limited to conservative approaches. To address this unmet need, we developed an innovative implantable device - the first-of-its-kind designed to replicate the function of lymphatic vessels in the affected limb. ⋯ Results demonstrated no safety concerns and showed significant reductions in limb volume without the need for manual lymphatic drainage or compression treatment. These promising findings highlight the potential of this innovative approach and emphasize the need for further research into its long-term use as an alternative to current LE management strategies. This pioneering development offers hope for a transformative shift in LE treatment.
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Eur. J. Intern. Med. · Feb 2025
High-flow nasal oxygen therapy in patients with hypercapnic respiratory failure: A systematic review and meta-analysis.
Noninvasive ventilation (NIV) is recommended as the first-line respiratory support method for patients with hypercapnic respiratory failure (HRF). However, the need for well-trained operators and the occurrence of treatment discomfort may limit its efficacy. High-flow nasal oxygen therapy (HFNO) is a convenient respiratory support with user-friendly operation, high comfort, and good compliance. This systematic review and meta-analysis was performed to compare the therapeutic effects of HFNO and other noninvasive respiratory support methods [NIV or conventional oxygen therapy (COT)] in patients with acute HRF (AHRF) or chronic HRF (CHRF). ⋯ The evidence of its clinical efficacy in hypercapnic patients remains inconclusive. Further studies are needed to generate more evidence for the application of HFNO in patients with HRF and to determine the subset of patients for whom may be preferable.