| 1. |
- Akrawi, Delshad, et al.
(författare)
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End stage renal disease risk and neighbourhood deprivation: A nationwide cohort study in Sweden.
- 2014
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 25:9, s. 853-859
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Tidskriftsartikel (refereegranskat)abstract
- Chronic kidney disease has been associated with socioeconomic disparities and neighbourhood deprivation. We aimed to determine whether there is an association between neighbourhood deprivation and end stage renal disease (ESRD), and whether this association is independent of individual-level sociodemographic factors and comorbidities.
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| 2. |
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| 3. |
- Bengtsson, Mariette, et al.
(författare)
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Anxiety in close relationship is higher and self-esteem lower in patients with irritable bowel syndrome compared to patients with inflammatory bowel disease
- 2013
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Ingår i: European journal of internal medicine. - : Elsevier. - 0953-6205 .- 1879-0828. ; 24:3, s. 266-272
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Tidskriftsartikel (refereegranskat)abstract
- Background Previous research has suggested an interaction between personality factors and inflammatory bowel disease (IBD) as well as irritable bowel syndrome (IBS). We therefore aimed to elucidate differences in psychological and coping functioning between patients with IBD and IBS, and to assess the relationship of disease activity with these functions. Methods Seventy-four patients with IBD (mean age 43 ± 17 years, range 18–82 years) and 81 patients with IBS (mean age 37 ± 12 years, range 21–66 years) completed the questionnaires; Rosenberg Self-Esteem Scale, Toronto Alexithymia, Experiences in Close Relationships, and Sense of Coherence. Disease activity was evaluated either by the Harvey-Bradshaw index, the Simple Clinical Colitis Activity Index, or the Visual Analogue Scale for Irritable Bowel Syndrome. Results The study revealed that patients with IBS had higher degree of anxiety in close relationships than patients with IBD (p = 0.003), and lower self-esteem (p = 0.001). No other statistical differences between the whole groups IBS and IBD or between subgroups were seen. Conclusions The fact that patients with IBS seem to have higher levels of anxiety in relationships and lower self-esteem could influence the way the patient deal with the disease and how the communication with health care professionals works out. A higher awareness of the importance of past negative life events should be taken into consideration. Whether the disease or the personal traits are the primary event should be addressed in future research.
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| 4. |
- Bengtsson, Mariette, et al.
(författare)
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The brief Visual Analogue Scale for Irritable Bowel Syndrome questionnaire can be used to evaluate psychological well-being in patients with irritable bowel syndrome
- 2013
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Ingår i: European journal of internal medicine. - : Elsevier. - 0953-6205 .- 1879-0828. ; 24:7, s. e82-e83
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Objective: The questionnaire Visual Analogue Scale for Irritable Bowel Syndrome (VAS-IBS) has been validated in measuring gastrointestinal symptoms and psychological well-being in patients with IBS. The aim of this study was to additional evaluate the items of VAS-IBS, and to examine correlations in the items measuring psychological well-being and intestinal symptoms´ influence on daily life to attachment in close relationships, self-esteem and coping. Methods: Eighty-one patients with IBS completed VAS-IBS with five VAS items for each gastrointestinal symptom, one item for the psychological well-being, and one item for the intestinal symptoms´ influence on daily life. They also completed the questionnaires Experiences in Close Relationships, the Rosenberg Self-Esteem Scale, and the Sense of Coherence. Correlations between the questionnaires and differences between subgroups were examined. Results: The rating of the item psychological well-being as poor well-being, correlated to a high degree of anxiety in close relationships (rs = -0.293, p = 0.008), low self-esteem (rs = 0.487, p = 0.000), and reduced coping (rs = 0.579, p = 0.000). Psychological well-being correlated to the intestinal symptoms´ influence on the patients´ daily life (rs = 0.515, p = 0.000). Conclusions. By this easy-to-use and brief VAS-IBS questionnaire, the health care professionals get a lot of information not only about physical symptoms, but also about the patient´s psychological well-being.
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| 5. |
- Cranston, Mark, et al.
(författare)
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Postgraduate education in internal medicine in Europe
- 2013
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 24:7, s. 633-638
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Tidskriftsartikel (refereegranskat)abstract
- Background: Limited information exists on the framework and content of postgraduate education in internal medicine in Europe. This report describes the results of a survey of postgraduate training in internal medicine in the European countries. Methods: Two online questionnaire-based surveys were carried out by the European Board of Internal Medicine, one on the practice of internists and the other on postgraduate training in internal medicine. The national internal medicine societies of all 30 member countries of the European Federation of Internal Medicine were invited to participate. The responses were reviewed by internal medicine residents from the respective countries and summaries of the data were sent to the national societies for approval. Descriptive analysis of the data on postgraduate training in internal medicine was performed. Results: Twenty-seven countries (90%) completed the questionnaire and approved their datasets. The length of training ranged from four to six years and was commonly five years. The majority of countries offered training in internal medicine and a subspecialty. A common trunk of internal medicine was frequently a component of subspecialty training programmes. Hospital inpatient service was the predominant setting used for training. A final certifying examination was in place in 14 countries. Conclusion: Although some similarities exists, there appear to be significant differences in the organisation, content and governance of postgraduate training in internal medicine between the European countries. Our findings will prove invaluable for harmonisation of training and qualification in internal medicine in Europe. (C) 2013 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.
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| 6. |
- Cranston, Mark, et al.
(författare)
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The practice of internal medicine in Europe: organisation, clinical conditions and procedures
- 2013
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 24:7, s. 627-632
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Tidskriftsartikel (refereegranskat)abstract
- Background: Current information on the role of internists in the European countries is scarce. This report describes the results of a survey of the practice of internists in Europe. Methods: Two online questionnaire-based surveys were carried out by the European Board of Internal Medicine, one on the practice of internists and the other on postgraduate training in internal medicine. The national internal medicine societies of all 30 member countries of the European Federation of Internal Medicine were invited to participate. The responses were reviewed by internal medicine trainees from the respective countries and summaries of the data were sent to the national societies for approval. Descriptive analysis of the data on the practice of internists was carried out. Results: Twenty-seven countries (90%) completed the questionnaire and approved their datasets. In 8 European countries, most internists practised internal medicine alone and in 7 countries at least half of physicians practised internal medicine together with a subspecialty. Internal medicine was considered a hospital-based specialty in most countries. The majority of selected presenting problems and diagnoses were rated as commonly encountered in all countries. More variability between countries was observed in the performance of diagnostic and therapeutic procedures. Conclusion: Many similarities exist in the practice of internal medicine between the European countries, while some differences are present that likely reflect the variable impact of subspecialisation. The results of the survey should prove valuable for the definition of specific competencies and development of a common curriculum for internal medicine at the European level. (C) 2013 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.
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| 7. |
- Dimberg, Ivar, et al.
(författare)
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Computerised assistance for warfarin dosage - Effects on treatment quality
- 2012
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 23:8, s. 742-744
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Tidskriftsartikel (refereegranskat)abstract
- Background: Well-managed warfarin treatment with a high time in therapeutic range (TTR) corresponds to fewer bleedings or thromboembolic complications. Many small centres manage their warfarin dosing manually, with little or no knowledge of their treatment quality as measured by TTR. AuriculA is a Swedish National web-based anticoagulation dosing system. Our hypothesis was that the web based dosing system, compared to manual dosing, would improve the TTR. Methods: Retrospective cohort study of medical records from patients with atrial fibrillation on warfarin treatment from two centres, with previously manual warfarin dosing regimens. Data for calculation of TTR was extracted manually from medical records from the time when using manual dosing and compared with the computerised regimen. Results: In centre 1, the mean TTR was significantly increased after the introduction of AuriculA, from 64.3% (95% CI 58.8-69.8) to 71.3% (95% CI 67.7-74.8), p=0.03. In centre 2, a high TTR of 73.6% (95% CI 71.3-75.9) was maintained after the implementation, 74.0% (95% CI 71.6-76.3). INR tests were prescribed significantly more frequent after the introduction of AuriculA in both centres; 20% more often at centre 1 and 21% at centre 2. Conclusion: Computerised dosing assistance within the Swedish national quality registry AuriculA improves or maintains a high treatment quality with warfarin as measured by TTR. (C) 2012 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.
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| 8. |
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| 9. |
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| 10. |
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| 11. |
- Olsson, Karin, et al.
(författare)
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Epidemiology and characteristics of hyponatremia in the emergency department.
- 2012
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Hyponatremia is the most common electrolyte abnormality and it is associated with increased morbidity and mortality. The aim of the study was to investigate the underlying causes and management of hyponatremia in an unselected population presenting with hyponatremia to the emergency department. METHODS: A descriptive, retrospective hospital record study was performed. A database search was conducted for all patients presenting to the emergency departments in Lund and Malmo and patients with a P-Na-value<135mmol/L were identified. Patients were divided into four groups based on the severity of hyponatremia (Group 1: P-Na<120mM, Group 2: Na 120-124mM, Group 3: Na 125-129mM, Group 4: Na 130-134mM) and 100 patients from each group were included. Groups 2-4 were matched to Group 1 for age, gender and month for ER visit. RESULTS: The prevalence of hyponatremia (P-Na<135mmol/L) was 3% in the entire emergency population. A single underlying cause was identified in 45% of patients in Group 1. The leading aetiologies were thiazide diuretics (17%), SIADH (17%) and other diuretics (14%). The likelihood of being on thiazide diuretics increased with hyponatremia severity (p<0.0001) and patients in Group 1 were 3.6 times (CI95%:1.9-6.8) more likely to be on thiazide diuretics compared to Group 4. The in-hospital mortality ranged between 2 and 7% between the groups (NS). One patient developed osmotic demyelinisation syndrome but survived. Only 31% of patients in Group 1 were evaluated with a basic laboratory investigation. CONCLUSIONS: Thiazide diuretics and SIADH were dominating underlying causes of hyponatremia, however, the frequency of adequate diagnostic testing was low. The majority of patients were treated with sodium chloride infusion.
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| 12. |
- Pandolfi, Maurizio
(författare)
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Acupuncture cannot be verified
- 2013
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 24:1, s. 6-6
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 13. |
- Pandolfi, Maurizio, et al.
(författare)
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Herbal medicine, Chaplin, and "The Kid"
- 2012
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 23:4, s. 330-332
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Forskningsöversikt (refereegranskat)abstract
- At variance with other largely safe complementary alternative medicines like homeopathy and acupuncture, which only carry the risk of inducing patients to shun effective treatment, herbal remedies are real, albeit impure, drugs and therefore fully capable of producing undesirable consequences if misused. The advantages they offer are uncertain since genuine evidence of efficacy and effectiveness is present in only a few cases. A result of this imbalance is that studies in this field are considerably more meaningful when they deal with untoward effects than with therapeutic uses. This disproportion has suggested to us the curious similarity with the situation portrayed in the film "The Kid" where the essential task of the protagonist (Chaplin) is to repair the windows his stone-throwing child has just broken. (C) 2012 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.
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| 14. |
- Pandolfi, Maurizio, et al.
(författare)
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The faulty statistics of complementary alternative medicine (CAM)
- 2014
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 25:7, s. 607-609
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Tidskriftsartikel (refereegranskat)abstract
- The authors illustrate the difficulties involved in obtaining a valid statistical significance in clinical studies especially when the prior probability of the hypothesis under scrutiny is low. Since the prior probability of a research hypothesis is directly related to its scientific plausibility, the commonly used frequentist statistics, which does not take into account this probability, is particularly unsuitable for studies exploring matters in various degree disconnected from science such as complementary alternative medicine (CAM) interventions. Any statistical significance obtained in this field should be considered with great caution and may be better applied to more plausible hypotheses (like placebo effect) than that examined - which usually is the specific efficacy of the intervention. Since achieving meaningful statistical significance is an essential step in the validation of medical interventions, CAM practices, producing only outcomes inherently resistant to statistical validation, appear not to belong to modern evidence-based medicine. (C) 2014 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.
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| 15. |
- Roth, Bodil, et al.
(författare)
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Diarrhoea is not the only symptom that needs to be treated in patients with microscopic colitis
- 2013
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Ingår i: European journal of internal medicine. - : Elsevier. - 0953-6205 .- 1879-0828. ; 24:6, s. 573-578
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many patients with microscopic colitis (MC) also suffer from symptoms of irritable bowel syndrome (IBS), but the only treatment given is corticosteroids for the diarrhoea. The aim of this study was to examine how social factors, life style factors and drug treatment affect symptoms and well-being in patients suffering from MC. METHODS: Women, over the age of 73years, with biopsy-verified MC, at any Departments of Gastroenterology, Skåne, between 2002 and 2010 were invited. The questionnaires Gastrointestinal Symptom Rating Scale (GSRS) and Psychological General Well-being Index (PGWB) were sent by mail, along with questions about social and life style factors, and medical history. RESULTS: Of 240 invited, 158 patients (66%) were included (median age 63years, range 27-73years). Only 26% had never smoked. Smoking and concomitant IBS were associated with both impaired gastrointestinal symptoms (OR=3.96, 95% CI=1.47-10.66 and OR=4.40, 95% CI=2.09-9.26, respectively) and impaired psychological well-being (OR=2.77, 95% CI=1.04-7.34 and OR=3.82, 95% CI=1.83-7.99, respectively). Treatment with proton pump inhibitors (PPI) was associated with increased gastrointestinal symptoms (OR=3.44, 95% CI=1.45-8.16). Age, social factors, and corticosteroids had no effect on symptoms or well-being. Smoking was the only risk factor associated with IBS (OR=2.68, 95% CI=1.115-6.26). CONCLUSION: Smoking and IBS are associated with impaired gastrointestinal symptoms and psychological well-being in MC patients. PPI is associated with impaired gastrointestinal symptoms.
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| 16. |
- Semple, Colin G., et al.
(författare)
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European examinations in internal medicine
- 2010
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 21:1, s. 1-1
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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| 17. |
- Tornberg, Åsa, et al.
(författare)
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Impact of exercise intensity and duration on insulin sensitivity in women with T2D.
- 2010
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 21:5, s. 404-408
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Clinical guidelines seldom provide in depth information about the most suitable type and intensity of exercise to obtain optimal benefit in different subgroups of T2D individuals. The aim of this study was to examine the effect of group exercise training on exercise capacity, insulin sensitivity and HbA1c in women with diabetes. METHODS: Twenty-two women with T2D participated in a supervised group exercise program for six months. The program combined endurance and resistance exercise. The duration and intensity of exercise for each subject was recorded. The volume of exercise was calculated as the product of exercise duration and intensity. Exercise capacity, insulin sensitivity and HbA1c were measured at baseline and after six months of training. The subjects were dichotomized with respect to training volume in a high training volume group and a low training volume group. RESULTS: Exercise capacity did not change significantly during the training period. Insulin sensitivity increased significantly and HbA1c decreased significantly from baseline in the high volume group but not in the low volume group. The increase in insulin sensitivity was explained with the intensity of exercise by 30%. The reduction in HbA1c was explained with exercise by 25%. CONCLUSION: Improvement in insulin sensitivity after six months combined supervised group training in female diabetic subjects is related to exercise intensity, whereas the reduction in HbA1c is related mainly to training volume. Metabolic effects of training may be seen in the absence of improved exercise capacity.
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| 18. |
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| 19. |
- Zöller, Bengt, et al.
(författare)
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Risk of venous thromboembolism in first- and second-generation immigrants in Sweden.
- 2012
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 1879-0828 .- 0953-6205. ; 23:1, s. 40-47
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Tidskriftsartikel (refereegranskat)abstract
- There are ethnic differences in the incidence of venous thromboembolism. This is the first nationwide study to examine whether there is an association between country of birth in first-generation immigrants and first hospitalisation for venous thrombosis (VT) and pulmonary embolism (PE), and to study whether a similar association exists in second-generation immigrants.
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| 20. |
- Holmström, Alexandra, et al.
(författare)
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Red blood cell distribution width and its relation to cardiac function and biomarkers in a prospective hospital cohort referred for echocardiography
- 2012
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Ingår i: European Journal of Internal Medicine. - : Elsevier BV. - 0953-6205. ; 23:7, s. 604-609
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Tidskriftsartikel (refereegranskat)abstract
- Background: Red blood cell distribution width (RDW), a measure of anisocytosis, is a prognostic biomarker for heart failure (HF). However it is still unclear how RDW is associated with heart function and established cardiac biomarkers. Methods and results: In a prospective hospital cohort of 296 patients referred for echocardiography because of suspected HF, blood sampling and clinical examination were performed within 24 h after echocardiography. The patients were divided into four HF groups, including one group where the HF diagnosis was uncertain (gray zone). In the patients the mean age was 70 +/- 11 years, 44% with systolic HF (SHF), 18% with heart failure with normal ejection fraction (HFNEF), 17% with gray zone and 21% without HF (non-HF). RDW was higher among patients with SHF and HFNEF, compared with gray zone and non-HF patients. The distribution of different variables over the RDW quartiles showed an inverse correlation between RDW levels and LVEF and a positive correlation between RDW and NT-proBNP levels. Further analysis with stepwise multiple linear regression demonstrated that NT-proBNP levels, but not LVEF, were independently correlated with RDW. Conclusion: In patients referred for echocardiography because of suspected HF, RDW levels were higher in patients with SHF and HFNEF. Moreover, NT-proBNP levels were independently linked with elevated RDW. (C) 2012 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
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| 21. |
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