August 2020

41 Articles

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Screening for pulmonary arterial hypertension in systemic sclerosis: A systematic literature review.

12 June 2020
Author(s): Cosimo Bruni, Giacomo De Luca, Maria-Grazia Lazzaroni, Elisabetta Zanatta, Gemma Lepri, Paolo Airò, Lorenzo Dagna, Andrea Doria, Marco Matucci-Cerinic

Pulmonary arterial hypertension (PAH) is a rare and severe disease characterized by proliferative remodeling of the small pulmonary arteries, leading to increased pulmonary vascular resistance (PVR... more

Commentary

We should no longer play lip service to lifestyle interventions in the prevention of CVD

20 June 2020
Author(s): FD Richard Hobbs

For as long as cardiovascular disease (CVD) prevention has been advocated, and guidance recommendations for clinicians based on the synthesis of existing evidence provided by international guidelines... more

First view of the TESEO registry: From snapshots come photo albums

16 June 2020
Author(s): Jean M. Connors

The increased risk of thrombosis associated with cancer has been known since Trousseau's observations in the 19th century. Roughly 15 to 20 years ago, studies found that patients with cancer and... more

The value of bleeding scores in the assessment of patients presenting with bleeding of unknown cause: Bleeding assessment tools have still a place

15 June 2020
Author(s): Alberto Tosetto

In this issue of the Journal, Genhart and coworkers present data about the discriminatory power of bleeding assessment tools (BATs) in adults with a mild to moderate bleeding tendency [1]. They... more

The value of bleeding scores in the assessment of patients presenting with bleeding of unknown cause: Complex algorithms with little predictive value

7 June 2020
Author(s): Lynn Malec, Mark Crowther

The evaluation of patients with mild to moderate bleeding disorder can be frustratingly unproductive. Patients frequently present with bothersome symptoms, such as recurrent epistaxis, easy bruising... more

Changes in ongoing clinical trial protocol designs behind the scenes

18 May 2020
Author(s): Rafael Dal-Ré

The implications and relevance of a study showing that 54% of clinical trials recently published in the three most influential general medicine journals New England Journal of Medicine, Lancet and... more

Editorial

Chloroquine and COVID-19: A western medical and scientific drift?

23 June 2020
Author(s): Matthieu Million, Yanis Roussel, Didier Raoult

We read with interest the letter entitled “COVID-19 and hydroxychloroquine: is the wonder drug failing ?” by U. Paliani and A. Cordona [1]. This work illustrates the need to be very careful in... more

COVID-19 and hydroxychloroquine: Is the wonder drug failing?

3 June 2020
Author(s): Ugo Paliani, Andrea Cardona

The absence of an effective treatment against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has led clinicians to redirect drugs that are known to be effective for other... more

Internal Medicine Flashcard

Bone pain, splenomegaly and microcytic anemia in a young woman

1 July 2020
Author(s): El Mehdi Mahtat, Naoual Hasnaoui, Hafid Zahid

A 23 years old female patient presented to clinical hematology consultation with asthenia and mild bilateral femoral pain. She has a history of anemia without clear etiology during her childhood.... more

Goosebumps and angioid streaks in a patient with cerebrovascular disease.

30 June 2020
Author(s): Laia Bou-Boluda, Javier Sabater-Abad, Fernando Millán-Parrilla

A 55-year-old man was referred to the dermatology department for a long history of asymptomatic lesions on the skin of his neck and axillae. He had a remarkable history of recurrent ischemic strokes... more

A great masquerader disease…

29 June 2020
Author(s): Thibault Maillet, Mathilde Funes de la Vega, Céline Duperron, Sylvain Audia

A 64-year-old-man, with history of hypertension, dyslipidemia, serous chorioretinopathy and past-smoking history (15 pack-years) presented with asthenia and weight loss (6 kg in 6 months). His-... more

Amlodipine-induced gingival hypertrophy

29 June 2020
Author(s): Alkim Yolcu, Ismet Aydogdu

A 57-year-old male patient who was guided by a dentist, presented with gingival swelling to the department of hematology (Fig. 1A). He had been suffering from increasing gingival enlargement for two... more

Letter to the Editor

Hyponatremia at discharge: A solid risk or accidental findings in community acquired pneumonia – Authors’ reply

15 July 2020
Author(s): Laura Potasso, Clara Odilia Sailer, Claudine Angela Blum, Mirjam Christ-Crain

With great interest have we read the comment of Obradović and Esquinas to our article on hyponatremia in patients with pneumonia published in the European Journal of internal Medicine [1,2].

Some concerns about poor outcome predictors for influenza virus infections: Authors' reply

23 June 2020
Author(s): Matthaios Papadimitriou-Olivgeris, Hervé Duplain

Sir,

Some concerns about poor outcome predictors for influenza virus infections

11 June 2020
Author(s): Hatice Bolek, Ertugrul Cagri Bolek

According to World Health Organization (WHO), influenza virus infections cause 3-5 million clinically severe cases and 290-650 thousand deaths per year due to solely respiratory disease [1]. Besides... more

Management and outcomes of post-acute COVID-19 patients in Northern Italy

10 June 2020
Author(s): Michele Vitacca, Giovanni Battista Migliori, Antonio Spanevello, Mario Giovanni Melazzini, Nicolino Ambrosino, COVID-19 ICS Maugeri IRCCS network

Dear Editor

SARS-CoV-2 infection among asymptomatic homebound subjects in Milan, Italy

8 June 2020
Author(s): Gregorio Paolo Milani, Emanuele Montomoli, Valentina Bollati, On behalf of the UNICORN Consortium investigators, Benedetta Albetti, Claudio Bandi, Tommaso Bellini, Matteo Bonzini, Marco Buscaglia, Carlo Cantarella, Laura Cantone, Michele Carugno, Sergio Casartelli, Guido Cavaletti, Sarah D'Alessandro, Francesca De Chiara, Serena Delbue, Laura Dioni, Ivano Eberini, Chiara Favero, Luca Ferrari, Monica Ferraroni, Laura Galastri, Cristina Galli, Mirjam Hoxha, Simona Iodice, Carlo La Vecchia, Chiara Macchi, Ilaria Manini, Serena Marchi, Jacopo Mariani, Elena Pariani, Angela Cecilia Pesatori, Federica Rota, Massimiliano Ruscica, Tommaso Schioppo, Letizia Tarantini, Claudia Maria Trombetta, Maria Grazia Valsecchi, Marco Vicenzi, Giuliano Zanchetta

At the end of December 2019, the first cases of SARS-CoV-2 infection were identified in Wuhan, China. [1] In the following months, the outbreak of SARS-COV-2 infections spreads worldwide [1] As of... more

Comment to: Cluster analysis for clinical sarcoidosis' phenotyping

29 May 2020
Author(s): Manuel Rubio-Rivas, Xavier Corbella

We have read and appreciated the commentary by M. d'Alessandro to our manuscript entitled “Cluster analysis for clinical sarcoidosis’ phenotyping” published in European Journal of Internal Medicine [... more

Comparison of stroke recurrence between antiplatelet and closure therapy in cryptogenic stroke patients with patent foramen ovale and its influencing factors

16 April 2020
Author(s): Chuanjing Zhang, Liangrong Zheng, Yanxing Zhang, Hangyuan Guo, Jufang Chi

Stroke is the second highest disease causing burden on the global economy and one of the leading causes of non-traumatic disability [1]. As many as 30–40% of ischemic stroke cases have no identified... more

The Impact Of Diabetes Mellitus And Microvascular Complications On Heart Failure Biomarkers

15 April 2020
Author(s): Florina Frîngu, Dumitru Zdrenghea, Raluca Tomoaia, Alexandra Dădârlat-Pop, Dana Pop

The presence of diabetes mellitus (DM) in patients with cardiovascular disease is associated with a greater number of major adverse events [1]. One of the most severe consequences is represented by... more

Comparative prediction of long-term mortality by the CHA2DS2-VASc score and cardiac troponin I levels in patients with atrial fibrillation at the emergency department

14 April 2020
Author(s): Maribel González-del-Hoyo, Anna Carrasquer, Gil Bonet, Isabel Fort-Gallifa, Alfredo Bardají

Atrial fibrillation (AF) is the most common arrhythmia in clinical practice, and is associated with an increased risk of stroke, heart failure (HF) and mortality [1]. In this regard, the CHA2DS2-VASc... more

“Haven't I always been a sickly person?” Controversies about L. van Beethoven's illnesses

10 April 2020
Author(s): Renato Fellin, Jürgen Richert

The life of this exceptional genius (1770–1827), was embittered by progressive hearing loss which he experienced at an early age and undoubtedly caused him very severe suffering and had a hard effect... more

Exploring the characteristics, global distribution and reasons for retraction of published articles involving human research participants: A literature survey

23 March 2020
Author(s): Bin Wang, Junkai Lai, Xiaoyan Yan, Feifei Jin, Chen Yao

Over the past few years, the issue of retractions has attracted the attention of researchers and many studies have reported the current state of retractions [1]. Many previous studies have analyzed... more

Iron deficiency in pregnancy and gastrointestinal cancer: addressing a common gap

23 March 2020
Author(s): O.A. Tiulienieva, C. Tsagkaris, A. Hoian

The article of Alexandre, Leo et al. [1] about the correlation of Iron Deficiency without Anemia (IDWA) with intestinal cancer was an interesting read. Essentially Iron Deficiency (ID) appears as a... more

Original Article

Electrocardiographic features of patients with COVID-19 pneumonia

20 June 2020
Author(s): Fabio Angeli, Antonio Spanevello, Roberto De Ponti, Dina Visca, Jacopo Marazzato, Giulia Palmiotto, Davide Feci, Gianpaolo Reboldi, Leonardo M. Fabbri, Paolo Verdecchia

Coronavirus Disease 2019 (COVID-19) is the clinical manifestation of infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) [1,2]. The clinical course of the infection is... more

Anticholinergic drug exposure at intensive care unit admission affects the occurrence of delirium. A prospective cohort study

30 May 2020
Author(s): Ariël M. Vondeling, Wilma Knol, Toine C.G. Egberts, Arjen J.C. Slooter

Delirium frequently complicates Intensive Care Unit (ICU) stay [1,2]. The costs accompanying delirium are high [3], mainly due to an increased length of stay both in the ICU and in the hospital [1,4,... more

A snapshot of cancer-associated thromboembolic disease in 2018–2019: First data from the TESEO prospective registry

29 May 2020
Author(s): Alberto Carmona-Bayonas, David Gómez, Eva Martínez de Castro, Pedro Pérez Segura, José Muñoz Langa, Paula Jimenez-Fonseca, Manuel Sánchez Cánovas, Laura Ortega Moran, Ignacio García Escobar, Ana Belén Rupérez Blanco, Isaura Fernández Pérez, Purificación Martínez de Prado, Rut Porta i Balanyà, Teresa Quintanar Verduguez, Álvaro Rodríguez-Lescure, Andrés Muñoz

Venous thromboembolism (VTE) is a common cause of morbidity and mortality among patients with cancer [1]. Both pathologies interrelate at a deep biological level with numerous interactions between... more

Early osteopontin levels predict mortality in patients with septic shock

11 May 2020
Author(s): Federico Carbone, Aldo Bonaventura, Alessandra Vecchiè, Jennifer Meessen, Silvia Minetti, Edoardo Elia, Daniele Ferrara, Anna Maria Ansaldo, Giorgio Tulli, Diletta Guarducci, Nicola Rossi, Francesco Bona, Marta Ferrari, Pietro Caironi, Roberto Latini, Fabrizio Montecucco

Despite substantial advances in clinical understanding and disease definition, sepsis remains the leading cause of death in intensive care units (ICUs) [1]. Furthermore, progress in medical care have... more

Longitudinal changes of left and right cardiac structure and function in patients with end-stage renal disease on replacement therapy

10 May 2020
Author(s): Luca Arcari, Giuseppino Massimo Ciavarella, Silvia Altieri, Luca Rosario Limite, Domitilla Russo, Michelangelo Luciani, Luciano De Biase, Paolo Mené, Massimo Volpe

As renal function declines, patients with chronic kidney disease (CKD) are subjected to a graded increase in rates of cardiovascular events [1]. Heart failure and sudden cardiac death account for a... more

Non-adherence to antimicrobial guidelines in patients with bloodstream infection visiting the emergency department

24 April 2020
Author(s): Romy Schuttevaer, Anniek Brink, Jelmer Alsma, Willian van Dijk, Damian C. Melles, Jurriaan E.M. de Steenwinkel, Hester F. Lingsma, Annelies Verbon, Stephanie C.E. Schuit

Bacterial infections can result in considerable mortality and have a profound global burden [1–3]. Patients with a severe infection (e.g. sepsis) often present in an acute care setting, such as the... more

National trends in mechanical ventilation among patients hospitalized with heart failure: a population-based study in Spain (2001-2017)

20 April 2020
Author(s): Javier de Miguel-Díez, Rodrigo Jiménez-García, Manuel Méndez-Bailón, Nuria Muñoz-Rivas, Valentin Hernández-Barrera, Luis Puente-Maestu, José M. de Miguel-Yanes, Napoleón Perez-Farinos, Ana López-de-Andrés

Heart failure (HF) affects around 10% of population over 70 years in developed countries [1]. Despite advances in therapy, it remains a leading cause of hospitalization, morbidity and mortality [2].

The discriminatory power of bleeding assessment tools in adult patients with a mild to moderate bleeding tendency

18 April 2020
Author(s): Johanna Gebhart, Stefanie Hofer, Alexandra Kaider, Judit Rejtö, Cihan Ay, Ingrid Pabinger

Receiver operating characteristic curves for the prediction of any diagnosis of a bleeding disorder by 2 different bleeding assessment tools (Vicenza BAT and ISTH BAT).

Heart rate as an independent predictor of long term mortality of acute heart failure patients in sinus rhythm according to their ejection fraction: data from the AHEAD registry

18 April 2020
Author(s): Jiri Jarkovsky, Jindrich Spinar, Benoit Tyl, Françoise Fougerousse, Jiri Vitovec, Ales Linhart, Petr Widimsky, Roman Miklik, Lenka Spinarova, Jan Belohlavek, Filip Malek, Marian Felsoci, Jiri Kettner, Petr Ostadal, Jan Vaclavik, Ladislav Dusek, Petr Lokaj, Alexandre Mebazaa, Alain Cohen Solal, Jiri Parenica, AHEAD group-authors

Heart failure (HF) is a leading cause of recurrent hospitalization [1,2]. Current European Society of Cardiology (ESC) Guidelines define HF with reduced EF (HFrEF) as HF with EF 

Embolic risk stratification and prognostic impact of early surgery in left-sided infective endocarditis

18 April 2020
Author(s): Valentina Scheggi, Bruno Alterini, Iacopo Olivotto, Stefano Del Pace, Nicola Zoppetti, Benedetta Tomberli, Filippo Bartalesi, Lorenzo Brandi, Nicole Ceschia, Valentina Andrei, Lorenzo Roberto Suardi, Niccolò Marchionni, Pier Luigi Stefàno

Infective endocarditis (IE) is a severe condition, with elevated in-hospital mortality and morbidity due to complications such as acute heart failure and embolic events, the latter largely involving... more

Serial investigation of Angiotensin-Converting Enzyme in sarcoidosis patients treated with Angiotensin-Converting Enzyme Inhibitor

16 April 2020
Author(s): Miriana d'Alessandro, Laura Bergantini, Anna Perrone, Paolo Cameli, Matteo Cameli, Antje Prasse, Dario Plataroti, Piersante Sestini, Elena Bargagli

Sarcoidosis is a systemic granulomatous disease associated with T lymphocyte and macrophage activation and migration into affected organs. The interaction between antigens and antigen-presenting... more

Influence of sex on long-term prognosis in patients with atrial fibrillation treated with oral anticoagulants. Results from the prospective, nationwide FANTASIIA study

14 April 2020
Author(s): Inmaculada Roldán Rabadán, María Asunción Esteve-Pastor, Manuel Anguita Sánchez, Javier Muñiz, Martín Ruiz Ortiz, Francisco Marín, Vanessa Roldán, María Angustias Quesada, José Camacho Siles, Angel Cequier Fillat, Vicente Bertomeu Martinez, Manuel Martínez Sellés, Lina Badimón, FANTASIIA Study Investigators

Atrial fibrillation (AF) is the most frequently cardiac arrhythmia in developed countries [1] and several studies have been described that in both developed and developing countries, the age-adjusted... more

Inappropriate use of carbapenems in an internal medicine ward: Impact of a carbapenem-focused antimicrobial stewardship program

14 April 2020
Author(s): Antonio Faraone, Alice Poggi, Chiara Cappugi, Lorenzo Tofani, Eleonora Riccobono, Tommaso Giani, Alberto Fortini

Carbapenems are last-line beta-lactamic antibiotics used for the treatment of critically ill patients with confirmed or suspected infections involving multidrug-resistant (MDR) bacteria [1]. These... more

Percutaneous mitral valve repair for secondary mitral valve regurgitation: A systematic review and meta-analysis

21 February 2020
Author(s): Ashish Kumar, Jaafar Al-khafaji, Mariam Shariff, Igor Pedreira Vaz, Devina Adalja, Rajkumar Doshi

Mitral Regurgitation (MR) is one of the most prevalent valvular disorders in the United States, with a prevalence of ~1.7% [1] and its etiology may be primary or secondary. Secondary MR, also known... more

Review Article

Chronic cough in adults

17 May 2020
Author(s): Antonio Spanevello, Bianca Beghé, Dina Visca, Leonardo M. Fabbri, Alberto Papi

Cough is a physiologic defense mechanism for clearing the airways of secretions, exudate, or foreign bodies. Its mechanisms are well known, with afferent, central, and efferent nervous pathways that... more

Relevant EFIM Publications

Clinical practice guidelines adaptation for internists - An EFIM methodology

Author(s): Wiktoria Leśniak, Laura Morbidoni, Dror Dicker, Ignacio Marín-León
Date:25 June 2020

The challenge of implementing Less is More medicine: A European perspective

Author(s): Omar Kherad, Nathan Peiffer-Smadja, Lina Karlafti, Margus Lember, Nathalie Van Aerde, Orvar Gunnarsson, Cristian Baicus, Miguel Bigotte Vieira, António Vaz-Carneiro, Antonio Brucato, Ivica Lazurova, Wiktoria Leśniak, Thomas Hanslik, Stephen Hewitt, Eleni Papanicolaou, Olga Boeva, Dror Dicker, Biljana Ivanovska, Pinar Yldiz, Patrick Lacor, Mark Cranston, Frauke Weidanz, Giorgio Costantino, Nicola Montano
Date:16 April 2020

Medical and surgical co-management – A strategy of improving the quality and outcomes of perioperative care

Author(s): Carmen Fierbinţeanu-Braticevicia, Matthias Raspeb, Alin Liviu Predac, Evija Livčāned, Leonid Lazebnike, Soňa Kiňováf, Evert- Jan de Kruijfg, Radovan Hojsh, Thomas Hansliki, Mine Durusu-Tanrioverj, Francesco Dentalik, Xavier Corbellal, Pietro Castellinom, Monica Bivoln, Stefano Bassettio, Vasco Barretop, Eduardo Montero Ruizq, Luis Camposr, The Working Group on Professional Issues and Quality of Care of the European Federation of Internal Medicine (EFIM)
Date:15 November 2018


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What is EFIM?

The principal objectives of EFIM is to promote internal medicine on a scientific educational, ethical and professional level and to support internists in providing better care for patients throughout Europe.

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What is internal medicine?

The specialty of internal medicine covers a wide range of conditions affecting the internal organs of the body. Although some diseases specifically affect individual organs, the majority of common diseases. The internist must then be trained to recognise and manage a broad range of diseases and, with the aging population, many patients with chronic and multiple disorders.

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