European journal of internal medicine
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Eur. J. Intern. Med. · Oct 2024
Multicenter Study Observational StudyPerformance of HAS-BLED and DOAC scores to predict major bleeding events in atrial fibrillation patients treated with direct oral anticoagulants: A report from a prospective European observational registry.
The DOAC score has been recently proposed for bleeding risk stratification of patients with atrial fibrillation treated with direct oral anticoagulants (DOAC). ⋯ In a contemporary cohort of DOAC-treated AF patients, both HAS-BLED and DOAC scores only modestly predicted the occurrence of major bleeding events. Our results do not support the preferential use of DOAC score over HAS-BLED.
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Eur. J. Intern. Med. · Oct 2024
ReviewAdvances in the pathophysiology, diagnosis and management of chronic diarrhoea from bile acid malabsorption: a systematic review.
Bile acid malabsorption (BAM) is an important disorder of digestive pathophysiology as it generates chronic diarrhoea. This condition originates from intricate pathways involving bile acid synthesis and metabolism in the liver and gut, the composition of gut microbiota, enterohepatic circulation and key receptors as farnesoid X receptor (FXR), fibroblast growth factor receptor 4 (FGFR4), and the G-protein bile acid receptor-1 (GPBAR-1). Although symptoms can resemble those related to disorders of gut brain interaction, accurate diagnosis of BAM may greatly benefit the patient. ⋯ These novel agents can best make their foray into the therapeutic armamentarium if BAM does not remain a diagnosis of exclusion. Ignoring BAM as a specific condition may continue to contribute to increased healthcare costs and reduced quality of life. Here, we aim to provide a comprehensive review of the pathophysiology, diagnosis, and management of BAM.
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Eur. J. Intern. Med. · Oct 2024
Metabolic health and genetic predisposition in inflammatory bowel disease: Insights from a prospective cohort study.
Metabolic disorders exhibit strong inflammatory underpinnings and vice versa. This study aimed to investigate the association between metabolic health status, genetic predisposition, and the risk of inflammatory bowel disease (IBD), and to explore the potential benefits of maintaining ideal metabolic status for individuals with a predetermined genetic risk of IBD. ⋯ Our study reveals a combined impact of poor metabolic health and genetic risk on IBD incidence. Those with low genetic risk and optimal metabolic health exhibit the lowest IBD risk, offering insights into potential management strategies for individuals at predefined genetic risk.
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Eur. J. Intern. Med. · Oct 2024
Letter Observational StudyMulti-organ abnormalities assessed by a single MRI scan in individuals with blood cancer.
During the COVID-19 pandemic individuals with all blood cancers were classified as clinically vulnerable and at high risk of complications and death. Our study sought to determine if individuals with specific blood cancers were at a heightened risk of longer term organ impairment, secondary to SARS-CoV-2 infection. ⋯ A multi-organ MRI platform offers the capacity to accurately evaluate organ health dynamically in blood cancers and detect asymptomatic organ impairment. The application of multi-organ MRI could aid early detection and longitudinal monitoring of organ impairment, potentially guiding more personalised treatment strategies and improving clinical outcomes in many rare diseases.