Journal of European Internal Medicine Professionals https://jeimp.com/index.php/pub <p><strong>The Journal of European Internal Medicine Professionals (JEIMP)</strong> has a mission to promote core values within the field of internal medicine. It seeks to empower clinicians and healthcare providers to be well-informed participants in the medical community and society at large. The journal is dedicated to advancing the standards of scientific research in terms of its design, conduct, and reporting, with the ultimate goal of contributing to the improvement of global health.</p> <p>JEIMP takes on the responsibility of publishing a diverse range of original research articles, conducting reviews, providing concise discussions on guidelines, and sharing relevant suggestions for clinical practice. The primary areas of focus for JEIMP include healthcare delivery, public health, healthcare policy, medical education, ethics, and research methodology. Furthermore, the journal encourages authors to express their opinions on addressing issues impacting community health.</p> <p>The editorial board of JEIMP consists of experienced internists and subspecialists who possess extensive knowledge and expertise in internal medicine. Recognizing that internal medicine is an integral component of general medicine, the journal welcomes submissions from various medical branches as long as they are related to the fundamental principles of internal diseases. JEIMP encompasses a wide range of content, including original research articles, comprehensive reviews, case reports, editorial interpretations, letters to editors, and meta-analyses. In certain cases, external authors may be invited by the editors to discuss or summarize current guidelines or notable events relevant to healthcare.</p> <p>JEIMP is a refereed journal that follows an open-access model, ensuring that its content is accessible to a broad readership. It is published four times a year in the English language and strives to be indexed in reputable and widely accessible databases.</p> <p>All research articles published in JEIMP are fully open-access, meaning they are immediately and freely available for reading, downloading, and sharing. This accessibility ensures that the knowledge and insights shared in the journal can reach a wide audience and have a positive impact on the medical community and society as a whole.</p> <p>The content of JEIMP encompasses a wide range of medical branches and their subspecialties. Therefore, topics covered by JEIMP are not limited to Internal Medicine alone; they also include subspecialties within Internal Medicine such as Cardiology, Gastroenterology, Hematology, Infectious Disease, Nephrology, Oncology, Pulmonology (Respiratory Medicine), Rheumatology, Endocrinology, Allergy and Immunology, Geriatrics, and Hospital Medicine. In addition to Internal Medicine, the journal addresses Pediatric diseases, specifically those in adolescents aged 10-17 years, Psychiatry, Dermatology, Radiology, Physical Medicine and Rehabilitation (Physiatry), Pain Medicine, Nuclear Medicine, Geriatrics, Neurology, ENT, obstetrics and gynecology, etc.. All of these areas fall within the scope of the journal.</p> <p>No fee is charged from the authors or institutions.</p> <p>If artificial intelligence applications were used during the preparation of manuscripts submitted to JEIMP, this must be indicated in the manuscript. The type of support received and the specific applications used should be specified.</p> <p><strong>Notes: </strong></p> <p>Upon receipt of a complete manuscript submission, the editorial team conducts an initial assessment within 7 days. Subsequently, the manuscript is promptly assigned to two independent peer reviewers. Reviewers are generally allotted a period of 2 to 3 weeks to complete their evaluations, with extensions granted under exceptional circumstances. Following the peer review process, and upon satisfactory revision where applicable, the reviewers' recommendations are taken into account for the final editorial decision. If the manuscript is accepted for publication, it is scheduled for inclusion in the forthcoming issue of the journal.</p> en-US editor@jeimp.com (MKD Digital Publishing & MIA Technology ) editor@jeimp.com (Technical support) Wed, 06 Aug 2025 00:00:00 +0300 OJS 3.3.0.13 http://blogs.law.harvard.edu/tech/rss 60 Gout: Evaluation and Management https://jeimp.com/index.php/pub/article/view/109 <p>Uric acid is a byproduct of purine nucleotide metabolism, primarily synthesized in the liver and less frequently in other tissues. Hyperuricemia, characterized by elevated uric acid levels, can lead to gout and nephrolithiasis. It is also associated with conditions such as hypertension, metabolic syndrome, cardiovascular disease, and chronic kidney disease. Gout is an inflammatory disease marked by the deposition of monosodium urate (MSU) crystals in joints and tissues. It commonly affects the metatarsophalangeal joint, followed by other lower extremity joints, making it the most prevalent inflammatory arthritis. The pathophysiology of gout involves pro-inflammatory cytokines, lipid mediators, and the complement system, which contribute to the initiation and exacerbation of gout flares. Diagnosis relies on clinical evaluation, the identification of MSU crystals, and radiological imaging. Treatment encompasses acute gout flare management, prophylaxis, dietary modifications, and urate-lowering therapies. Common therapeutic agents include nonsteroidal anti-inflammatory drugs, colchicine, glucocorticoids, adrenocorticotropic hormone, and anti-IL-1β biological agents.</p> Can Hüzmeli Copyright (c) 2025 Can Hüzmeli https://creativecommons.org/licenses/by/4.0 https://jeimp.com/index.php/pub/article/view/109 Wed, 06 Aug 2025 00:00:00 +0300 Assessment of Oxidative Stress in Hashimoto’s Thyroiditis Patients: Effects of Levothyroxine Sodium Treatment https://jeimp.com/index.php/pub/article/view/106 <p class="western"><strong>Background:</strong> Hashimoto’s thyroiditis (HT) is a prevalent autoimmune disease characterized by chronic inflammation of the thyroid gland, leading to hypothyroidism. Oxidative stress has been implicated in the pathogenesis of HT, influencing disease progression and therapeutic outcomes. Understanding the dynamics of thiol/disulfide balance, a marker of oxidative stress, in HT patients receiving levothyroxine treatment is crucial for elucidating its role in disease management. Our study has the largest cohort on this topic. <br /><strong>Methods:</strong> This study enrolled 357 euthyroid HT patients, divided into groups based on levothyroxine treatment status. Thiol/disulfide homeostasis was assessed using the Erel method. Clinical parameters, including thyroid function tests and antibody levels, were measured. Statistical analyses were performed to compare oxidative stress markers between groups. <br /><strong>Results:</strong> Patients on levothyroxine therapy showed lower native and total thiol levels than untreated patients, indicating potential antioxidant depletion. Higher disulfide/native thiol and disulfide/total thiol ratios in the treated group suggest elevated oxidative stress. There were no correlations between thyroid antibodies (TPO-Ab, TG-Ab) and thiol/disulfide levels. <br /><strong>Conclusion:</strong> This study highlights alterations in thiol/disulfide balance among euthyroid HT patients, with implications for oxidative stress management in clinical practice. Levothyroxine treatment appears to be associated with oxidative stress markers, suggesting associations that warrant further investigation.</p> Burçak Cavnar Helvacı, Özant Helvacı, Gamze Dam, Salim Neşelioğlu, Özcan Erel Copyright (c) 2025 Burçak Cavnar Helvacı, Özant Helvacı, Gamze Dam, Salim Neşelioğlu, Özcan Erel https://creativecommons.org/licenses/by/4.0 https://jeimp.com/index.php/pub/article/view/106 Wed, 06 Aug 2025 00:00:00 +0300 Empirical Treatment Approach for Itchy Ear Syndrome: Topical Steroids or Antifungals? https://jeimp.com/index.php/pub/article/view/111 <p><strong>Background:</strong> “Itchy ear syndrome”, defined as ear itching after exclusion of related pathologies with a thorough physical examination, is common in otolaryngology practice. Despite the fact that it is frequent, high quality evidence regarding its etiology and treatment is lacking. We aimed to investigate whether empirical antifungal therapy is effective in this situation in comparison with corticosteroid therapy and the effectiveness of topical mometasone furoate lotion. <br /><strong>Methods:</strong> This retrospective observational study included 57 patients who applied with recurrent ear pruritus, were treated with mometasone or ciclopirox olamine, and who did not have any pathological findings on examination. The patients were retrospectively scanned through the hospital database, called, and asked to fill out a modified form of the 5D itching questionnaire to assess the degree of itching before and after treatment. The results were compared statistically. <br /><strong>Results:</strong> Of the 57 patients included, 25 (43.8%) were male and 32 (56.1%) were female. The mean age of the two groups was similar (p=0.915). Twenty-eight (49.1%) patients were treated with ciclopirox olamine, and 29 (50.9%) patients with mometasone. When the scores before and after treatment were compared, the decrease in scores was significant (p&lt;0.001). There was no significant difference between the two cohorts regarding pre-treatment and post-treatment scores (p=0,26 and p=0.22, respectively). <br /><strong>Conclusion:</strong> Our findings indicate that topical antifungal treatment with ciclopirox olamine and topical steroid treatment with lotion form mometasone furoate are both effective in the treatment of itchy ear syndrome.</p> Başak Yalçıner, Özge Nur Koçak, Gökhan Yalçıner, Onur Büyükkoç, Burak Çelik, Mehmet Ali Babademez Copyright (c) 2025 Başak Yalçıner, Özge Nur Koçak, Gökhan Yalçıner, Onur Büyükkoç, Burak Çelik, Mehmet Ali Babademez https://creativecommons.org/licenses/by/4.0 https://jeimp.com/index.php/pub/article/view/111 Wed, 06 Aug 2025 00:00:00 +0300 Investigation of Factors Affecting the Formation of Secondary Non-Traumatic Fractures Due to Mineral Bone Disorder in Hemodialysis Patients: A Single-Center Experience https://jeimp.com/index.php/pub/article/view/113 <p data-start="0" data-end="259"><strong>Background:</strong> In our study, we aimed to determine whether demographic data and biochemical parameters of patients undergoing hemodialysis influence the prediction of secondary non-traumatic fractures due to mineral bone disorder caused by chronic kidney disease.</p> <p data-start="261" data-end="595"><strong>Methods:</strong> This cross-sectional study was conducted by retrospectively scanning the records of patients aged 18 years and older who had undergone hemodialysis for at least six months at our hospital’s hemodialysis unit between 2017 and 2022. A total of 272 patients meeting the inclusion criteria were examined through hospital records.</p> <p data-start="597" data-end="1555"><strong>Results:</strong> Of the 272 patients included in the study, 57.7% were males, and the median age was 65 years. Non-traumatic fractures were detected in 32 (11.8%) patients. Non-traumatic fractures were significantly more common in female patients compared to males (18.3% vs. 7%; p=0.008). Eight patients had undergone parathyroidectomy, and among them, non-traumatic fractures were significantly more frequent compared to those who had not undergone the procedure (50% vs. 10.6%; p=0.008). Patients using steroids had significantly more non-traumatic fractures compared to non-users (26.9% vs. 10.2%; p=0.021). The duration of dialysis was significantly longer in patients with non-traumatic fractures compared to those without (60.5 months [7 - 324] vs. 39.5 months [7 - 330]; p=0.017). The risk of non-traumatic fractures was found to be 3.66 times higher in women, 4.17 times higher in steroid users, and increased by 0.7% with each additional month of dialysis.</p> <p data-start="597" data-end="1555"><strong>Conclusion:</strong> This study investigated factors influencing non-traumatic fractures associated with mineral bone disorder in hemodialysis patients. Female gender, steroid use, parathyroidectomy, and dialysis duration were found to increase the risk of fractures. No significant association was found between fractures and other laboratory parameters or medications used by patients to regulate bone mineral metabolism.</p> Özdem Kavraz Tomar, Haldun Öner, Tülin Akagün , Muhammed Aydın Copyright (c) 2025 Özdem Kavraz Tomar, Haldun Öner, Tülin Akagün , Muhammed Aydın https://creativecommons.org/licenses/by/4.0 https://jeimp.com/index.php/pub/article/view/113 Wed, 06 Aug 2025 00:00:00 +0300 Renal and Hemodynamic Effects of Sodium-Glucose Cotransporter 2 Inhibitors in Patients with Type 2 Diabetes and Chronic Kidney Disease Receiving Varying Doses of Renin-Angiotensin System Blockade https://jeimp.com/index.php/pub/article/view/116 <p><strong>Background:</strong> Chronic kidney disease (CKD) in the context of type 2 diabetes mellitus (T2DM) remains a significant global health challenge. Sodium-glucose co-transporter-2 inhibitors (SGLT2i) have emerged as a renoprotective therapy, often co-administered with renin–angiotensin system inhibitors (RASi). However, the clinical impact of background RASi intensity on SGLT2i-associated renal and hemodynamic outcomes remains unclear.<br /><strong>Methods:</strong> This retrospective study included 67 patients with T2DM and CKD initiated on SGLT2i therapy and followed for 12 months. Patients were stratified into three groups based on background RASi use: no RASi, moderate-dose RASi, and full-dose RASi. Clinical, biochemical, and hemodynamic parameters—including blood pressure, eGFR, proteinuria, and glycemic/metabolic markers—were evaluated at baseline, 3 months, and 12 months. Adverse events including acute kidney injury (AKI) and urinary tract infections (UTIs) were recorded.<br /><strong>Results:</strong> All groups exhibited significant reductions in systolic blood pressure (SBP), with the greatest decline observed in the full-dose RASi group (–13 mmHg at 12 months). A transient significant dip in eGFR was noted at month 3 in the full-dose group, with partial recovery by month 12. Proteinuria decreased significantly in both the moderate-dose and full-dose RASi groups, with the greatest absolute reduction in the moderate-dose group. Glycemic control improved across all groups, with the non-RASi group showing the most pronounced decline in fasting glucose and HbA1c. No significant differences in AKI or UTI incidence were observed among groups.<br /><strong>Conclusion:</strong> SGLT2i therapy is safe and effective across all RASi backgrounds. However, co-administration with RASi—particularly at full doses—appears to enhance antihypertensive, renal function, and antiproteinuric outcomes. These findings underscore the potential synergistic role of full-dose RAS blockade in optimizing the renoprotective benefits of SGLT2i in diabetic CKD.</p> Bülent Demirelli Copyright (c) 2025 Bülent Demirelli https://creativecommons.org/licenses/by/4.0 https://jeimp.com/index.php/pub/article/view/116 Wed, 06 Aug 2025 00:00:00 +0300 Seasonal, Geographic, and Socioeconomic Patterns of Public Interest in Frailty Syndrome: Insights From Google Trends https://jeimp.com/index.php/pub/article/view/117 <p><strong>Background:</strong> Frailty syndrome is a complex geriatric condition characterized by reduced physiological reserves and increased vulnerability to stressors. While its clinical implications are well established, knowledge on public awareness remains limited. As online search behavior increasingly reflects public interest, tools like Google Trends offer real-time insights into population-level awareness of frailty and its influencing factors.<br /><strong>Methods:</strong> This observational study analyzed global Google Trends data for the search topic “frailty syndrome” from January 2004 to May 2025. Relative search volume (RSV) was examined across temporal, seasonal, geographic, and socioeconomic dimensions. Seasonal trends were evaluated using time-series decomposition and winter-to-summer amplitude ratios. Geographic patterns were assessed by mapping RSV and classifying countries by World Bank income levels. Pearson correlation was used to assess associations between RSV and socioeconomic indicators including GDP per capita and internet penetration.<br /><strong>Results:</strong> Global RSV increased from a baseline mean of 8.2 (±3.1) in 2004–2009 to a peak of 78.5 (±15.2) in 2020, followed by sustained elevated interest through 2025 (mean: 45.3 ±12.1). Seasonal analysis showed consistent winter peaks, with amplitude ratios exceeding 1.3. Japan had the highest RSV (100), followed by the United Kingdom (55), Singapore (52), and Ireland (44). All top countries were high-income. RSV was significantly correlated with GDP per capita (r = 0.62, p &lt; 0.01) and internet penetration (r = 0.58, p &lt; 0.01).<br /><strong>Conclusion:</strong> Search interest varied by season and socioeconomic context. Higher wintertime interest may reflect seasonal vulnerability in older adults, while increased search activity in high-income countries suggests better digital access and health literacy. Low visibility in lower-income regions highlights a digital and educational gap. Google Trends provides meaningful insight into frailty awareness. Understanding seasonal and socioeconomic patterns can guide targeted public health campaigns to promote early detection and prevention in aging populations.</p> Mert Zure Copyright (c) 2025 Mert Zure https://creativecommons.org/licenses/by/4.0 https://jeimp.com/index.php/pub/article/view/117 Wed, 06 Aug 2025 00:00:00 +0300 A Rare Relapse: Recurrence of Nephrotic Syndrome in an NPHS1 Mutation Post-Kidney Transplant https://jeimp.com/index.php/pub/article/view/94 <p>Letter to Editor - No Abstract</p> Mehmet Sezen, Abdülmecit Yıldız Copyright (c) 2025 Mehmet Sezen, Abdülmecit Yıldız https://creativecommons.org/licenses/by/4.0 https://jeimp.com/index.php/pub/article/view/94 Wed, 06 Aug 2025 00:00:00 +0300 Piperacillin-Tazobactam Induced Fanconi Syndrome https://jeimp.com/index.php/pub/article/view/105 <p>Letter to Editor -No Abstract</p> Ferah Taran, Ercan Turkmen Copyright (c) 2025 Ferah Taran, Ercan Turkmen https://creativecommons.org/licenses/by/4.0 https://jeimp.com/index.php/pub/article/view/105 Wed, 06 Aug 2025 00:00:00 +0300