European journal of internal medicine
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Accurate assessment of kidney function is essential for diagnosing and managing chronic kidney disease (CKD) and acute kidney injury (AKI), adjusting drug dosages, and predicting clinical outcomes. Despite its ubiquitous use, serum creatinine has significant limitations, necessitating the exploration of alternative and complementary biomarkers and technologies. ⋯ Furthermore, it highlights innovations in real-time glomerular filtration rate (GFR) measurement, such as transdermal monitoring using MB-102 and dual fluorescent tracers. We conclude with a discussion on the development, validation, and clinical integration of these advancements, which may redefine renal function assessment in the years to come.
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Eur. J. Intern. Med. · Jan 2025
ReviewChronic obstructive pulmonary disease: A narrative synthesis of its hallmarks for palliative care clinicians.
Chronic obstructive pulmonary disease (COPD) is a life-limiting condition and the third leading cause of death worldwide. People with COPD experience physical and psychological symptoms and functional limitations that impair their quality of life. ⋯ In this narrative synthesis of key aspects of COPD care, we propose practical, evidence-based strategies to integrate palliative care principles with conventional disease-directed treatments throughout the illness trajectory. We emphasize the importance of equipping clinicians caring for people with COPD with a thorough understanding of both the inherent disease complexities and the cornerstones of its multimodal management, including palliative care, to address the unique psychosocial and physical needs of this patient population.
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Eur. J. Intern. Med. · Jan 2025
ReviewTranslating evidence into practice: Managing electrolyte imbalances and iron deficiency in heart failure.
Mineral abnormalities are a common complication of heart failure (HF). In particular, dyskalaemia, hyponatraemia, and hypomagnesaemia are prevalent, with hypo- and hyperkalaemia observed in over 40 % of HF patients, hyponatraemia in 18-27 %, hypomagnesaemia in 7-52 %, and phosphate imbalance in 13 %. These abnormalities serve as indicators of the severity of HF and are strongly associated with an increased risk of morbidity and mortality. ⋯ Various pathways contribute to the development of ID in HF, including reduced iron intake due to anorexia, increased hepcidin levels associated with chronic inflammation and hepatic congestion, and occult gastrointestinal bleeding due to the concomitant use of antithrombotic agents. The efficacy of iron replacement therapy has been demonstrated in clinical trials, particularly in heart failure with reduced ejection fraction (HFrEF), whilst more recently, it has also been shown to improve exercise capacity in patients with heart failure with preserved ejection fraction (HFpEF). This review focuses on potassium and phosphate abnormalities, hyponatraemia, hypomagnesaemia, and ID in HF, providing a comprehensive overview of the mechanisms, clinical significance, and intervention strategies with the latest findings.
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Eur. J. Intern. Med. · Jan 2025
ReviewTriglyceride glucose (TyG) index: A promising biomarker for diagnosis and treatment of different diseases.
The Triglyceride-glucose index (TyG index) is a comprehensive statistical measure that incorporates fasting triglyceride and fasting glucose levels. Research has demonstrated that it can serve as an effective alternative biomarker for insulin resistance (IR) due to its high sensitivity and specificity. The TyG index is straightforward to compute and imposes fewer time and cost constraints, rendering it suitable for large populations and advantageous for use in various applications, clinical settings, and epidemiological investigations. ⋯ Through a systematic review of pertinent clinical trials, this paper elucidates the correlation between the TyG index and various diseases. The findings presented herein suggest that the TyG index holds promise as a valuable and practical indicator for different medical conditions, prompting a reevaluation of conventional disease risk assessment paradigms and highlighting the intricate interplay of metabolic parameters with diverse diseases. By leveraging insights from the TyG index, tailored disease risk management strategies can be developed to offer a fresh perspective and guidance for clinical interventions.
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Eur. J. Intern. Med. · Jan 2025
ReviewTriglyceride glucose (TyG) index: A promising biomarker for diagnosis and treatment of different diseases.
The Triglyceride-glucose index (TyG index) is a comprehensive statistical measure that incorporates fasting triglyceride and fasting glucose levels. Research has demonstrated that it can serve as an effective alternative biomarker for insulin resistance (IR) due to its high sensitivity and specificity. The TyG index is straightforward to compute and imposes fewer time and cost constraints, rendering it suitable for large populations and advantageous for use in various applications, clinical settings, and epidemiological investigations. ⋯ Through a systematic review of pertinent clinical trials, this paper elucidates the correlation between the TyG index and various diseases. The findings presented herein suggest that the TyG index holds promise as a valuable and practical indicator for different medical conditions, prompting a reevaluation of conventional disease risk assessment paradigms and highlighting the intricate interplay of metabolic parameters with diverse diseases. By leveraging insights from the TyG index, tailored disease risk management strategies can be developed to offer a fresh perspective and guidance for clinical interventions.