Abstract:
:It is now well recognized that cardiovascular events (CVE) occur quite commonly, both in the acute phase and in the long-term, in patients with community-acquired pneumonia (CAP). CVE have been noted in up to 30% of patients hospitalized with all-cause CAP. One systematic review and meta-analysis of hospitalized patients with all-cause CAP noted that the incidence rates for overall cardiac events were 17.7%, for incident heart failure were 14.1%, for acute coronary syndromes were 5.3% and for incident cardiac arrhythmias were 4.7%. In the case of pneumococcal CAP, almost 20% of patients studied had one or more of these cardiac events. Recent research has provided insights into the pathogenesis of the acute cardiac events occurring in pneumococcal infections. With respect to the former, key involvements of the major pneumococcal protein virulence factor, pneumolysin, are now well documented, whilst systemic platelet-driven neutrophil activation may also contribute. However, events involved in the pathogenesis of the long-term cardiovascular sequelae remain largely unexplored. Emerging evidence suggests that persistent antigenaemia may predispose to the development of a systemic pro-inflammatory/prothrombotic phenotype underpinning the risk of future cardiovascular events. The current manuscript briefly reviews the occurrence of cardiovascular events in patients with all-cause CAP, as well as in pneumococcal and influenza infections. It highlights the close interaction between influenza and pneumococcal pneumonia. It also includes a brief discussion of mechanisms of the acute cardiac events in CAP. However, the primary focus is on the prevalence, pathogenesis and prevention of the longer-term cardiac sequelae of severe pneumococcal disease, particularly in the context of persistent antigenaemia and associated inflammation.
journal_name
J Intern Medjournal_title
Journal of internal medicineauthors
Feldman C,Normark S,Henriques-Normark B,Anderson Rdoi
10.1111/joim.12875subject
Has Abstractpub_date
2019-06-01 00:00:00pages
635-652issue
6eissn
0954-6820issn
1365-2796journal_volume
285pub_type
杂志文章,评审abstract:OBJECTIVES:To study antibodies against five infectious agents for their prediction of major coronary events in men with and without evidence of coronary heart disease at baseline. DESIGN:A case-control study nested within a prospective population study. SUBJECTS:The study cases included 441 men 45-64 years old with n...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1046/j.1365-2796.2002.01052.x
更新日期:2002-11-01 00:00:00
abstract:OBJECTIVES:To analyse and evaluate current practice of asthma therapy by use of computerized prescription data. DESIGN:Descriptive, non-interventive. SETTING:A pharmacoepidemiological database on computerized refund claims from pharmacies in the Odense region in Denmark. SUBJECTS:Persons aged 20-44, presenting presc...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1993.tb00706.x
更新日期:1993-07-01 00:00:00
abstract::The therapeutic effect of an elemental diet (Pepti 2000) and blended normal diet (placebo) was investigated in 43 out-patients with chronic inflammatory bowel disease (IBD); 24 with ulcerative colitis (UC) and 19 with Crohn's disease (CD), in a mild to moderate state of disease activity. A pilot study on healthy volun...
journal_title:Journal of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2796.1989.tb00089.x
更新日期:1989-05-01 00:00:00
abstract::We studied the effect of sleeping in the head-up tilt (HUT) position, alone and in combination with fludrocortisone, on orthostatic tolerance and blood pressure (BP) in six patients with hypoadrenergic orthostatic hypotension. A high salt diet of 150-200 mmol Na+ d-1 was also administered. Combined treatment reduced o...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1992.tb00563.x
更新日期:1992-08-01 00:00:00
abstract:OBJECTIVE:To explore the relation between 25-hydroxyvitamin D deficiency and frailty. Frailty is a multidimensional phenotype that describes declining physical function and a vulnerability to adverse outcomes in the setting of physical stress such as illness or hospitalization. Low serum concentrations of 25-hydroxyvit...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.2010.02248.x
更新日期:2010-08-01 00:00:00
abstract::Cardiovascular disorders including hypertension and associated renal disease are major health problems affecting more than 1.5 billion people worldwide. Apart from nonmodifiable factors such as ageing, family history and gender, both sedentary lifestyle and unhealthy dietary habits are considered as major risk factors...
journal_title:Journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1111/joim.12818
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVES:Cardiac sarcoidosis (CS) without clinically apparent extracardiac disease may escape detection because of the poor sensitivity of endomyocardial biopsy (EMB). We set out to analyse our experience of repeated and imaging-guided biopsies in clinically isolated CS. METHODS:We retrospectively reviewed the medic...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.2011.02396.x
更新日期:2011-11-01 00:00:00
abstract::We observed two patients with hypercholesterolaemia and tendon xanthomas associated with apolipoprotein (apoE-7) E-7, a rare variant of the apoE isoforms. Both suffered from coronary artery disease and had undergone a coronary bypass operation. Their cholesterol levels were 268 and 310 mg dl-1, respectively. Both pati...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1994.tb01051.x
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVES:To evaluate the prognostic value of exercise testing performed soon after acute myocardial infarction (AMI) in patients treated with thrombolytic therapy. DESIGN:A 1-year prospective follow-up of 185 subjects treated with thrombolytic therapy who survived AMI, and who performed exercise testing 3 weeks afte...
journal_title:Journal of internal medicine
pub_type: 临床试验,杂志文章
doi:10.1111/j.1365-2796.1994.tb00841.x
更新日期:1994-11-01 00:00:00
abstract::Primary hyperparathyroidism (HPT) has been associated with hypertension, hyperinsulinaemia, hypertriglyceridaemia and hyperuricaemia. In the present study, plasma ionized calcium (Ca2+) was studied in relation to cardiovascular risk factors in 20 subjects with mild hypertension. Plasma Ca2+ was found to be negatively ...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1992.tb00955.x
更新日期:1992-04-01 00:00:00
abstract:OBJECTIVES:Mild hyperhomocysteinaemia (HHC), fasting or after methionine loading, is associated with an increased risk and severity of atherosclerotic vascular disease. Post-methionine and fasting HHC are responsive to treatment with vitamin B, and folic acid. We performed a prospective cohort study amongst normohomocy...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1046/j.1365-2796.1999.00541.x
更新日期:1999-07-01 00:00:00
abstract:OBJECTIVE:Plasma fibrinogen predicts cardiovascular events in patients with stable peripheral arterial occlusive disease, but its predictive value in patients with chronic critical limb ischaemia, a condition associated with a high risk of death, is unknown. DESIGN:A prospective cohort study. SETTING:Determination of...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1046/j.1365-2796.1999.00410.x
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:To investigate the risk of ipsilateral versus contralateral recurrent deep vein thrombosis in the leg. DESIGN:An open prospective long term follow-up multicentre trial. Patients were followed by frequent outpatient visits at each centre during the first 12 months after inclusion and thereafter annually. SE...
journal_title:Journal of internal medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1046/j.1365-2796.2000.00662.x
更新日期:2000-05-01 00:00:00
abstract::A 40-year-old woman with previous parathyroidectomy for adenoma was found to have a serum calcium level of 5.35 mmol l-1 (21.4 mg dl-1). Inadvertent calcium overdose had occurred because of her mistaken belief that if some prescribed calcium was good, then more was better. Her misconception is in contrast with that of...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1990.tb00215.x
更新日期:1990-08-01 00:00:00
abstract::This study was performed to evaluate thyroid and adrenal function in patients with familial amyloidotic polyneuropathy. Twenty-four patients without any clinical overt endocrinological dysfunction were studied. None of the patients showed laboratory evidences of hypo- or hyperthyroidism. A short ACTH-stimulation test ...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1989.tb00091.x
更新日期:1989-05-01 00:00:00
abstract::A major challenge in the growing field of bioelectronic medicine is the development of tissue interface technologies promoting device integration with biological tissues. Materials based on organic bioelectronics show great promise due to a unique combination of electronic and ionic conductivity properties. In this re...
journal_title:Journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1111/joim.12595
更新日期:2017-07-01 00:00:00
abstract::The Swedish Twin Registry (STR), which today has developed into a unique resource, was first established in the late 1950s to study the importance of smoking and alcohol consumption on cancer and cardiovascular diseases whilst controlling for genetic propensity to disease. Since that time, the Registry has been expand...
journal_title:Journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1046/j.1365-2796.2002.01032.x
更新日期:2002-09-01 00:00:00
abstract::Although a variety of factors, inherited or environmental, can influence expression of ion channel proteins to impact on repolarization, that environment can affect genetic determinants of repolarization for intervals of varying duration is a concept that is not as generally appreciated as it should be. In the followi...
journal_title:Journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1111/j.1365-2796.2005.01592.x
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES:To determine whether mutations in APOA1 affect levels of high-density lipoprotein (HDL) cholesterol and to predict risk of ischaemic heart disease (IHD) and total mortality in the general population. BACKGROUND:Epidemiologically, risk of IHD is inversely related to HDL cholesterol levels. Mutations in apoli...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.2011.02381.x
更新日期:2011-08-01 00:00:00
abstract:OBJECTIVES:Mixed cryoglobulinaemia (MC) and autoimmune chronic hepatitis (AI-CH) are frequently associated with hepatitis C virus (HCV) chronic infection. Because HCV represents a possible common aetiological factor, the aim of the present study is to investigate the clinico-serological alterations of both MC and AI-CH...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1994.tb01116.x
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVES:Atherosclerosis is an inflammatory disease of the arterial wall that leads to myocardial infarction and stroke. Regulatory T cells (Tregs) and IL-10 exert significant anti-atherogenic effects in experimental models of atherosclerosis by modulating vascular inflammation. We have previously shown that Mycobact...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/joim.12127
更新日期:2014-01-01 00:00:00
abstract:OBJECTIVE:To assess the prophylactic efficacy of aspirin and a high-dose antioxidant vitamin combination in patients with peripheral arterial disease (PAD) in terms of reduction of the risk of a first vascular event (myocardial infarction, stroke, vascular death) and critical limb ischaemia. DESIGN:Randomized, placebo...
journal_title:Journal of internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1365-2796.2006.01763.x
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVE:To study the impact of the cost of pharmaceuticals on physicians' decisions about drug prescription. DESIGN:A simulation protocol for the treatment of two patients, one with mild and the other with a severe form of urinary tract infection (UTI), was designed. Thirty family physicians in outpatient clinics an...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1046/j.1365-2796.1997.137143000.x
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND:The impact of season when determining a serum 25-hydroxyvitamin D (S-25OHD) cut-off level for optimal bone health is unknown. OBJECTIVE:To investigate the relative importance of S-25OHD for bone mineral density (BMD) by season. METHODS:A subcohort of 5002 Swedish women (mean age 68 years), randomly selecte...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/joim.12563
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:To study the short-term efficacy, tolerability and safety of the treatment with gemfibrozil 600 mg twice daily or placebo in male patients with established atherosclerosis, with a lipid profile matching the 'high triglyceride-low high-density lipoprotein (HDL) cholesterol trait'. DESIGN:Double-blind randomiz...
journal_title:Journal of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2796.1994.tb00813.x
更新日期:1994-10-01 00:00:00
abstract:OBJECTIVES:The objective was to analyse whether a favourable change in risk factors, caused by a comprehensive risk factor modification programme, affected intima-media thickness (IMT) in the common carotid artery, and whether any such change was associated with a change in cardiovascular events during a 6-year follow-...
journal_title:Journal of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2796.2001.00818.x
更新日期:2001-04-01 00:00:00
abstract::In Sweden, prophylactic treatment of boys with severe haemophilia has been practised since 1958 in an attempt to convert the disease from a severe to a milder form. The present study population consisted of 60 severe haemophiliacs (52 A, 8 B), aged 3-32 years. Treatment is started when the boys are 1-2 years of age, t...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1992.tb00546.x
更新日期:1992-07-01 00:00:00
abstract:OBJECTIVES:Angiotensin II may play an important role in the progression of renal disease. Currently, angiotensin converting enzyme (ACE) inhibitors and angiotensin II receptor antagonists are commonly used for renoprotection. To our knowledge, there is no study investigating this effect of angiotensin II receptor antag...
journal_title:Journal of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1046/j.1365-2796.2003.01071.x
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to examine the effects of treatment with atorvastatin, alpha-tocopherol and the combination of both, on lipoproteins and oxidative stress in dialysis patients. DESIGN AND SETTING:This double-blind randomised placebo-controlled trial was performed at the dialysis department of...
journal_title:Journal of internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1111/j.1365-2796.2005.01484.x
更新日期:2005-05-01 00:00:00
abstract::Six patients with acute renal failure, in five cases due to acute crescentic glomerulonephritis and in one case due to total bilateral renal cortical necrosis, were studied. All had serum erythropoietin (EPO) concentrations in the normal range, despite a relatively severe anaemia. Half-life and plasma clearance of int...
journal_title:Journal of internal medicine
pub_type: 杂志文章
doi:10.1111/j.1365-2796.1991.tb00360.x
更新日期:1991-04-01 00:00:00