Journal of Internal Medicine
0954-6820
1365-2796
Anh Quốc
Cơ quản chủ quản: Wiley-Blackwell Publishing Ltd , WILEY
Lĩnh vực:
Internal Medicine
Phân tích ảnh hưởng
Thông tin về tạp chí
Journal of Internal Medicine (JIM), with its International Advisory Board, has developed into a highly successful journal since it was launched in its revised form in 1989. With an Impact Factor of 6.051, Journal of Internal Medicine now ranks 14th among the 160 journals in the General & Internal Medicine category. -Established in 1863. -Features original clinical articles within the broad field of general and internal medicine and its sub-specialties. -A fully international journal publishing articles in English from all over the world. -Peer-reviewed and published in both print and online versions. JIM also supports and organizes scientific meetings in the form of symposia within the scope of the journal.
Các bài báo tiêu biểu
Fever of unknown origin in adults: 40 years on Abstract. Knockaert DC, Vanderschueren S, Blockmans D. (Gasthuisberg University Hospital, Leuven, Belgium). Fever of unknown origin in adults: 40 years on (Review). J Intern Med 2003; 253: 263–275.A revision of the criteria of fever of unknown origin (FUO), established in 1961, is desirable because of important evolutions in medical practice and the emergence of new patient populations. The development of rapid laboratory tests and powerful diagnostic tools, such as ultrasonography, computed tomography and magnetic resonance imaging often makes hospitalization unnecessary and new categories of patients such as those with HIV infection, neutropenia, immunosuppression and nosocomial illness require an approach different from classical FUO. The more then 200 reported causes of FUO can be classified into four diagnostic categories; infections, tumours, noninfectious inflammatory diseases (NIID) and miscellaneous. A uniform classification system is highly wanted to allow comparison between different series. The reports of the 1990s show slight changes in the distribution of causes, namely less infections, less tumours, more NIID and more undiagnosed cases. A uniform diagnostic strategy cannot be determined. The initial investigation should be directed by potentially diagnostic clues revealed by extensive history, meticulous physical examination and a standard set of laboratory tests. 18 Fluoro‐deoxy‐glucose‐positron‐emitted‐tomgraphy is a new valuable total body scintigraphy in the search for the site of origin of the fever. In view of the rather good long‐term prognosis, a wait‐and‐see strategy may be more appropriate than a systematic staged approach. Elderly patients and patients with episodic fever represent two specific groups of classical FUO that require a distinct approach. HIV‐associated, nosocomial and neutropenic FUO should be considered as separate clinical entities.
Tập 253 Số 3 - Trang 263-275 - 2003
Unique patient with cerebrotendinous xanthomatosis. Evidence for presence of a defect in a gene that is not identical to sterol 27‐hydroxylase Abstract. Cerebrotendinous xanthomatosis (CTX) is a rare autosomal recessive disorder believed to be exclusively caused by mutations in the CYP27A1 gene coding for the enzyme sterol 27‐hydroxylase. Common findings in CTX are tendon xanthomas, cataracts and progressive neurological dysfunction. Here, we characterize an adult female patient with tendon xanthomas and classic biochemical findings of CTX (i.e. high levels of bile alcohols and cholestanol and extremely low levels of 27‐hydroxycholesterol in plasma). Additionally, sterol 27‐hydroxylase activity in cultured monocyte‐derived macrophages from this patient was <5% of normal. Sequencing the CYP27A1 gene uncovered that the patient is heterozygous for two previously undescribed base substitutions in exon 8, C478A and C479A, which are expected to affect the haeme‐binding domain of the enzyme. When expressed in HEK293 cells, the corresponding protein had only 8% of normal enzymatic activity. No other mutation was found in the open reading frame of the CYP27A1 gene, intron–exon boundaries or in the 5′‐untranslated region up to 5000 bp distal to the translational start site. Sequencing mRNA isolated from leucocytes from the patient revealed a 1 : 1 ratio of mutated and nonmutated species, with total mRNA levels that were not significantly different from the controls. It is concluded that the patient is heterozygous for two mutations affecting one allele of the CYP27A1 gene and with at least one additional yet undefined gene that is of critical importance for the activity of sterol 27‐hydroxylase.
Tập 261 Số 5 - Trang 504-510 - 2007
A UK Consensus Group on management of glucocorticoid‐induced osteoporosis: an update Abstract. Eastell R, Reid DM, Compston J, Cooper C, Fogelman I, Francis RM, Hosking DJ, Purdie DW, Ralston SH, Reeve J, Russell RGG, Stevenson JC, Torgerson DJ (University of Sheffield Medical School, Sheffield; University of Aberdeen, Aberdeen; University of Cambridge School of Clinical Medicine, Addenbrooke's Hospital, Cambridge; Southampton General Hospital, Southampton; Guy's Hospital, London; Freeman Hospital, Newcastle upon Tyne; Nottingham City Hospital, Nottingham; Hull Royal Infirmary, Hull; Wynn Institute for Metabolic Research, London; and the University of York, York, UK). A UK Consensus Group on management of glucocorticoid‐induced osteoporosis: an update (Review). J Intern Med 1998; 244: 271–292. In the UK, over 250 000 patients take continuous oral glucocorticoids (GCs), yet no more than 14% receive any therapy to prevent bone loss, a major complication of GC treatment. Bone loss is rapid, particularly in the first year, and fracture risk may double. This review, based wherever possible on clinical evidence, aims to provide easy‐to‐use guidance with wide applicability. A treatment algorithm is presented for adults receiving GC doses of 7.5 mg day−1 or more for 6 months or more. General measures, e.g. alternative GCs and routes of administration, and therapeutic interventions, e.g. cyclical etidronate and hormone replacement, are recommended.
Tập 244 Số 4 - Trang 271-292 - 1998
Platelet endothelial cell adhesion molecule‐1 and mechanotransduction in vascular endothelial cells Abstract. Endothelial cells are known to respond to mechanical forces such as fluid shear stress and cyclic stretch, but elucidating the mechanism for mechanosensing has been difficult. Experimental data indicate that there are probably several sensing mechanisms. We have recently proposed a novel mechanoresponse mechanism that involves platelet endothelial cell adhesion molecule‐1 (PECAM‐1). When endothelial cells are stimulated by fluid shear stress, PECAM‐1 is tyrosine phosphorylated and activates the extracellular signal‐regulated kinase 1 and 2 (ERK1/2) signalling cascade. The same signalling events occurred when we applied pulling force directly on PECAM‐1 on the endothelial cell surface using magnetic beads coated with antibodies against the external domain of PECAM‐1. These results appear to indicate that PECAM‐1 is a mechanotransduction molecule. To our knowledge, this is the first mammalian molecule that is shown to respond to mechanical force directly exerted to it.
Tập 259 Số 4 - Trang 373-380 - 2006
Perceived stress as a risk factor for changes in health behaviour and cardiac risk profile: a longitudinal study Abstract. Objective. The aim of this study was to evaluate the long‐term effects of stress on changes in health behaviour and cardiac risk profile in men and women.Design. A prospective cohort study.Setting. The Copenhagen City Heart Study, Denmark.Subjects. The analyses were based on 7066 women and men from the second (1981–1983) and third (1991–1993) wave of the Copenhagen City Heart Study. All participants were asked questions on stress and health behaviour and they had their weight, height, blood pressure and level of blood lipids measured by trained personnel.Main outcome measures. Changes in health behaviour (smoking, physical activity, alcohol consumption, overweight) and cardiac risk profile (cholesterol, HDL cholesterol, blood pressure, diabetes).Results. Individuals with high levels of stress compared to those with low levels of stress were less likely to quit smoking (OR = 0.58; 95% CI: 0.41–0.83), more likely to become physically inactive (1.90; 1.41–2.55), less likely to stop drinking above the sensible drinking limits (0.43; 0.24–0.79), and stressed women were more likely to become overweight (1.55; 1.12–2.15) during follow‐up. Men and women with high stress were more likely to use antihypertensive medication (1.94; 1.63–2.30), and stressed men were more than two times as likely to develop diabetes during follow‐up (2.36; 1.22–4.59).Conclusion. This longitudinal study supports a causal relation between stress and cardiovascular diseases mediated through unfavourable changes in health behaviour and cardiac risk profile.
Tập 266 Số 5 - Trang 467-475 - 2009
Hyaluronan: its nature, distribution, functions and turnover Fraser JRE, Laurent TC, Laurent UBG (Monash University, Clayton, Victoria, Australia; and University of Uppsala, Uppsala, Sweden). Hyaluronan: its nature, distribution, functions and turnover (Minisymposium: Hyaluronan). J Intern Med 1997; 242 : 27–33. Hyaluronan is a polysaccharide found in all tissues and body fluids of vertebrates as well as in some bacteria. It is a linear polymer of exceptional molecular weight, especially abundant in loose connective tissue. Hyaluronan is synthesized in the cellular plasma membrane. It exists as a pool associated with the cell surface, another bound to other matrix components, and a largely mobile pool. A number of proteins, the hyaladherins, specifically recognize the hyaluronan structure. Interactions of this kind bind hyaluronan with proteoglycans to stabilize the structure of the matrix, and with cell surfaces to modify cell behaviour. Because of the striking physicochemical properties of hyaluronan solutions, various physiological functions have been assigned to it, including lubrication, water homeostasis, filtering effects and regulation of plasma protein distribution. In animals and man, the half‐life of hyaluronan in tissues ranges from less than 1 to several days. It is catabolized by receptor‐mediated endocytosis and lysosomal degradation either locally or after transport by lymph to lymph nodes which degrade much of it. The remainder enters the general circulation and is removed from blood, with a half‐life of 2–5 min, mainly by the endothelial cells of the liver sinuoids.
Tập 242 Số 1 - Trang 27-33 - 1997
Nonalcoholic fatty liver disease increases risk of incident advanced chronic kidney disease: a propensity‐matched cohort study Abstract Background As the prevalence of nonalcoholic fatty liver disease (NAFLD) escalates, understanding its potential impact on the development of chronic kidney disease (CKD) is needed. Objective To determine the longitudinal association of NAFLD with the development of advanced CKD in the United States. Methods A retrospective cohort analysis of the Truven Health MarketScan Database (2006–2015) was conducted. We used Cox proportional hazards models to compare the risk of developing CKD stages 3–5 in patients with NAFLD versus non‐NAFLD, identified by ICD‐9 codes, after 1:3 propensity score (PS) matching. Results In a cohort of 262 619 newly diagnosed patients with NAFLD and 769 878 PS (1:3)‐matched non‐NAFLD patients, we identified 5766 and 8655 new advanced (stage 3–5) CKD cases, respectively. The crude CKD incidence rate was 8.2 and 5.5 per 1000 person‐years in NAFLD and non‐NAFLD groups, respectively. In multivariable Cox model, patients with NAFLD had a 41% increased risk of developing advanced CKD compared with non‐NAFLD patients [adjusted hazard ratio (aHR), 1.41; 95% confidence interval (CI), 1.36–1.46]. In the sensitivity analysis adjusting for time‐varying covariates after NAFLD diagnosis, NAFLD persisted as a significant CKD risk factor (aHR, 1.58; 95% CI, 1.52–1.66) and the association remained significant when stratified by age, gender and pre‐existing comorbidities. The risk of CKD increased in NAFLD with compensated cirrhosis (aHR, 1.47; 95% CI, 1.36–1.59) and decompensated cirrhosis (aHR, 2.28; 95% CI, 2.12–2.46). Conclusion Nonalcoholic fatty liver disease was independently associated with an increased risk of advanced CKD development suggesting renal function screening and regular monitoring are needed in this population.
Tập 286 Số 6 - Trang 711-722 - 2019
Prevalence and significance of cardiovascular risk factors in a large cohort of patients with familial hypercholesterolaemia Abstract. de Sauvage Nolting PRW, Defesche JC, Buirma RJA, Hutten BA, Lansberg PJ, Kastelein JJP (Academic Medical Center, Amsterdam; Clinical Research, Haarlem; Slotervaart Hospital, Amsterdam; the Netherlands). Prevalence and significance of cardiovascular risk factors in a large cohort of patients with familial hypercholesterolaemia. J Intern Med 2003; 253: 161–168. Objective. Patients with familial hypercholesterolaemia (FH) vary widely in terms of onset of cardiovascular disease (CVD).Design. The association between cardiovascular risk factors and prevalent CVD was examined in a cross‐sectional study in order to elucidate their contribution to atherogenesis.Setting and subjects. Patients were recruited from 37 Dutch Lipid Clinics. The diagnosis of FH was based on a uniform diagnostic protocol, confirmed by DNA analysis in 62% of the cases. All patients were investigated free from any lipid‐lowering drug for at least 6 weeks.Main outcome measures. Differences in lipids, lipoproteins and other risk factors for CVD were analysed in FH patients with and without CVD.Results. A total of 526 patients were assessed and more than 37% had a history of CVD with a mean age of onset of 46.8 years. Mean LDL cholesterol (LDL‐C) levels were severely elevated (8.38 ± 2.13 mmol L−1 ). In univariate analysis, age, presence of hypertension or diabetes, body mass index, triglycerides (TG) and low HDL cholesterol (HDL‐C) were all significantly associated with CVD. Also in multivariate analysis, all these risk factors, except TG and diabetes, were significantly linked to CVD.Conclusion. A high CVD risk in this large well‐documented characterized sample of FH patients is not only conferred by elevated LDL‐C but also by low HDL‐C.
Tập 253 Số 2 - Trang 161-168 - 2003
Cholesterol efflux pathways and other potential mechanisms involved in the athero‐protective effect of high density lipoproteins Abstract. Plasma high density lipoprotein (HDL) levels bear a strong independent inverse relationship with atherosclerotic cardiovascular disease. Although HDL has anti‐oxidant, anti‐inflammatory, vasodilating and anti‐thrombotic properties, the central anti‐atherogenic activity of HDL is likely to be its ability to remove cholesterol and oxysterols from macrophage foam cells, smooth muscle cells and endothelial cells in the arterial wall. To some extent, the pleotropic athero‐protective properties of HDL may be related to its ability to promote sterol and oxysterol efflux from arterial wall cells, as well as to detoxify oxidized phospholipids. In cholesterol‐loaded macrophages, activation of liver X receptors (LXRs) leads to increased expression of adenosine triphosphate (ATP) binding cassetter transporter (ABCA1), ATP binding cassetter transporter gene (ABCG1) and apoE and promotes cholesterol efflux. ABCA1 stimulates cholesterol efflux to lipid‐poor apolipoproteins, whilst ABCG1 promotes efflux of cholesterol and oxysterols to HDL. Despite some recent setbacks in the clinical arena, there is still intense interest in therapeutically targeting HDL and macrophage cholesterol efflux pathways, via treatments with niacin, cholesterol ester transfer protein inhibitors, LXR activators and infusions of apoA‐1, phospholipids and peptides.
Tập 263 Số 3 - Trang 256-273 - 2008
Cost of illness of adult diabetes mellitus underestimated if comorbidity is not considered Norlund A, Apelqvist J, Bitzén P.‐O, Nyberg P, Scherstén (Swedish Council on Technology Assessment in Health Care, Stockholm; and University Hospital; and Dalby/Lund, University of Lund, Lund, Sweden) Cost of illness of adult diabetes mellitus underestimated if comorbidity is not considered.J Intern Med 2001;250: 57–65. Objective. To determine costs of illness for adult diabetes mellitus (DM), including complications caused by DM.Design. A population‐based multicentre cross‐ sectional study including an interview and a physical examination of patients identified as having DM. The patients’ medical records were analysed regarding diagnoses and complications attributable to DM.Setting. Eight health care centres of six primary care districts in Southern Sweden.Subjects. 1677 adults aged 25+, cared for at the health care centres, entered the study.Main outcome measures. Utilization of health care and care from relatives and the municipality, absence of short‐ and long‐term sickness, cost of illness.Results. The average annual direct and indirect costs for an adult with DM were calculated to be 61 700 Swedish Kronor (SEK) or 2.5 times higher than earlier estimates. The incremental cost of DM was 34 100 SEK. The cost distribution was 28% for health care, 31% for the municipality and relatives and 41% lost productivity.Conclusions. Calculations for the cost of illness of DM are underestimated if comorbidity caused by DM is not considered. When DM‐related complications are included to identify the actual burden of disease to society, the cost of illness as a result of DM in Sweden is substantially higher than previously estimated.
Tập 250 Số 1 - Trang 57-65 - 2001