European journal of internal medicine
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Eur. J. Intern. Med. · Mar 2023
CommentGeneral health check-ups: To check or not to check? A question of choosing wisely.
In high-income countries, regular general health check-ups are part of the fabric of the health care systems. The hidden concept of general health check-ups, promoted for more than a century, is to identify diseases at a stage at which early intervention can be effective. ⋯ Choosing wisely (CW) campaigns may represent a tremendous opportunity to eventually shift patients and physicians away from the non-evidence based yet firmly entrenched practice of the general health check-up. As campaign leaders and members of the CW working group of the European Federation of Internal Medicine, we want to join the discussion by giving our perspective based on the best available evidence.
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Eur. J. Intern. Med. · Mar 2023
Meta AnalysisThe effect of sex inequality on solid organ transplantation: A systematic review and meta-analysis.
Sex disparities are related to biological differences, which may have significant impact on patient and allograft outcomes. The aim was to investigate the impact of sex on clinical and safety outcomes after solid organ transplantation (SOT). ⋯ Females represent one-third of SOT recipients but have higher survival rates than males after liver and kidney transplantation. The impact on graft dysfunction was heterogeneous. While further research is warranted, our findings should encourage clinicians and researchers to consider sex as a factor when taking decisions regarding SOT management.
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Eur. J. Intern. Med. · Mar 2023
Meta AnalysisActive fluid de-resuscitation in critically ill patients with septic shock: A systematic review and meta-analysis.
To evaluate the impact of active fluid de-resuscitation on mortality in critically ill patients with septic shock. ⋯ We found no evidence for superiority of active fluid de-resuscitation compared to usual care regarding mortality, fluid balance or patient-centred outcomes in patients with septic shock. Current evidence is limited by the lack of high-quality RCTs in patients with septic shock, the small sample sizes and the heterogeneity of the applied de-resuscitation techniques. In addition, validity of the majority of RCTs is compromised by their inability to achieve fluid separation.