May 2020

35 Articles

No Section

Bleeding in COVID-19 severe pneumonia: the other side of abnormal coagulation pattern?

6 May 2020
Author(s): Clara Benedetta Conti, Sonia Henchi, Giovanni Paolo Coppeta, Sophie Testa, Roberto Grassia

A novel coronavirus (SARS CoV-2) spread in China in December 2019, becoming soon a relevant problem of international public health concern [1]. In Italy the SARS-CoV-2 officially spread around the... more

Influence of BMI and geographical region on prescription of oral anticoagulants in newly diagnosed atrial fibrillation: The GLORIA-AF Registry Program

14 May 2020
Author(s): Giuseppe Boriani, Menno V. Huisman, Christine Teutsch, Sabrina Marler, Lionel Riou França, Shihai Lu, Gregory Y.H. Lip, GLORIA-AF Investigators

Body mass index (BMI) is widely used for estimating adiposity and has been extensively studied across different populations for evaluating the relationships between BMI values and the risks of... more


The 2019 ESC guidelines on pulmonary embolism: some further insights

20 May 2020
Author(s): Helia Robert-Ebadi, Marc Righini

This manuscript represents original work, and it is not under consideration for publication elsewhere. It has never been neither submitted nor published in another scientific journal. All authors... more

From meta-analysis to the individual patient with atrial fibrillation and coronary artery disease: the complexity of antithrombotic treatment in real-world clinical practice and the need for a tailored approach

22 May 2020
Author(s): Giuseppe Boriani, Jacopo Francesco Imberti, Marco Vitolo

The management of antithrombotic therapy in atrial fibrillation (AF) patients presenting with acute coronary syndromes (ACS) and/or undergoing percutaneous coronary interventions (PCI) is highly... more

First episode of acute heart failure: Can we already predict the risk of short-term mortality?

15 May 2020
Author(s): Pedro Moliner, Josep Comin-Colet

This commentary refers to “Short-term mortality risk score for de novo acute heart failure (ESSIC-FEHF)” by S. García-Gutiérrez et al., published in this issue.

Tocilizumab for severe COVID-19: a promising intervention affecting inflammation and coagulation

16 May 2020
Author(s): Marcel Levi

The COVID-19 pandemic is causing significant morbidity and mortality worldwide. Although most patients experience predominantly a respiratory tract infection, a proportion of patients progresses to a... 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

Internal Medicine Flashcard

A 44-year-old man with cough, arthralgia, and fever

14 May 2020
Author(s): Priyanka Bhugra, Abhishek Maiti

A 44-year- old man presented with dry cough, diffuse joint pain, fevers, and night sweats for one month and poor appetite and weight loss for three months. Physical examination showed... more

Sudden onset headache, dizziness, unilateral facial numbness, and speech disturbance

14 May 2020
Author(s): Keizo Tanitame

A 48-year-old woman presented to the emergency department with acute onset of headache, dizziness, right facial numbness, and difficulty of swallowing and speech. She was not a smoker and consumed... more


14 May 2020
Author(s): Manajyoti Yadav, Namrata Singhania, Saurabh K. Bansal

28-year-old woman with no significant past medical history presented with acute onset of sub-sternal chest pain at work. It was “pinching” type and got worse on deep breathing, coughing, leaning... more

Multiple facial prominences of benign origin

14 May 2020
Author(s): Rim Bourguiba, Claude Bachmeyer, Bruno Angelard

An 18-year-old girl sought medical advice for an asymptomatic prominence of the right malar region evolving for two years because of cosmetic concern. Her medical history was relevant for Salmonella... more

Multiple cutaneous lesions and pulmonary cysts

19 May 2020
Author(s): Sudharsan Venkatesan, Henrik Falhammar

A 50-year-old woman presented with multiple cutaneous lesions that had been present for many years (Figure 1a and 1b) similar to other family members. Her past history was significant for... more

Internal Medicine Flashcards

Woman with sore throat, fever and abdominal pain

11 May 2020
Author(s): Pierrick Le Borgne, Claudia Brunhuber, Pascal Bilbault

A 32-year-old woman, presented to the Emergency Department (ED) with a 15-day fever, and a sore throat recently associated with a growing abdominal pain. At admission in the ED, the patient had... more

Letter to the Editor

A surveillance study of the prevalence of Hepatitis B, C, and D markers among hospitalized patients at an Internal Medicine Department of a Greek Hospital

21 May 2020
Author(s): Vassilios A. Sevastianos, Charalampia V. Geladari, Theodoros A. Voulgaris, Anna I. Georgantoni, Emmanuel A. Andreadis

Viral hepatitis is a leading cause of morbidity and mortality worldwide [1]. Vaccination programs, demographic and socioeconomic changes, safer medical and nursing practices, screening of blood... more

Active smoking and COVID-19: a double-edged sword

1 May 2020
Author(s): Giuseppe Lippi, Fabian Sanchis-Gomar, Brandon Michael Henry

We are thankful to Garufi et al [1] for the comments on our recent article published in this journal [2], and we wish to add some further pieces to the intricate puzzle linking active cigarette... more

Do we know when to end isolation of persons affected with COVID-19?

3 May 2020
Author(s): Dror Dicker, Tatiana Kournos, Dana Marcoviciu, Rachel Golan

The pathogen responsible for coronavirus disease 2019 (COVID-19) is severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This novel coronavirus was first detected in Wuhan, China in late... more

Left ventricular ejection fraction and global longitudinal strain in patients with acute myocardial infarction after percutaneous revascularization: standard 2D vs triplane and 3D imaging

23 May 2020
Author(s): Raluca Tomoaia, Ruxandra-Ștefana Beyer, Dumitru Zdrenghea, Alexandra Dădârlat-Pop, Dana Pop

Left ventricular ejection fraction (LVEF) is one of the main determinants in the prognostic of patients with myocardial infarction (MI) [1]. Three-dimensional (3D) measurement of the LV volumes and... more

Protective role of statins during anticoagulation for venous thromboembolism: beyond their lipid lowering effect?

7 May 2020
Author(s): Carmine Siniscalchi

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality [1]. VTE represents a major health problem for high prevalence, incidence, and costs [2]. The number of people affected by... more

Long-term proton-pump inhibitor use in older adults with mild-to-moderate Alzheimer's disease: Are there cognitive consequences?

7 May 2020
Author(s): Adam H Dyer, Claire Murphy, Brian Lawlor, Sean P Kennelly, NILVAD Study Group⋆⋆

Proton-Pump Inhibitors (PPIs) are commonly prescribed medications indicated for the treatment of various acid-related disorders including duodenal/gastric ulcers, erosive oesophagitis and... more

Prevention of infective endocarditis and clinical practice guidelines: From theory to real clinical practice.

10 May 2020
Author(s): Dr. María Sánchez Ledesma, Dr. Borja Arias-Peso, Dr. David González Call, Dr. Ana Elvira Laffond, Dr. Eduardo Villacorta Argüelles

In spite of current diagnostic techniques and therapeutic approaches, infective endocarditis (IE) is still associated with high rates of morbidity and mortality [1].

Good times, bad times: A diary of a physician in the COVID-19 era

15 May 2020
Author(s): Tommaso Lupia, Giacomo Stroffolini, Roberto Angilletta, Stefano Bonora, Giovanni Di Perri

7:30 a.m.

Why should we use convalescent plasma for COVID-19?

16 May 2020
Author(s): Massimo Franchini

Coronavirus, an enveloped virus belonging to the family of Coronaviridae which initially caused enzootic infections, has shown in the last decades to be capable of crossing the species barrier... more

Letter to the Editor (European Journal of Internal Medicine).

Strengthening the continuity of medical care through the hospital discharge multimedia report

21 May 2020
Author(s): Nando Campanella, Roberto Campagnacci, Harold Martin Wright, Pierpaolo Morosini

Dear Sir,

Original Article

Efficacy and safety of tocilizumab in severe COVID-19 patients: a single-centre retrospective cohort study

22 May 2020
Author(s): Corrado Campochiaro, Emanuel Della-Torre, Giulio Cavalli, Giacomo De Luca, Marco Ripa, Nicola Boffini, Alessandro Tomelleri, Elena Baldissera, Patrizia Rovere-Querini, Annalisa Ruggeri, Giacomo Monti, Francesco De Cobelli, Alberto Zangrillo, Moreno Tresoldi, Antonella Castagna, Lorenzo Dagna, TOCI-RAF Study Group

Starting from December 2019, the World has faced a global pandemic of a novel coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. As... more

Off-label use of tocilizumab for the treatment of SARS-CoV-2 pneumonia in Milan, Italy

21 May 2020
Author(s): Valentina Morena, Laura Milazzo, Letizia Oreni, Giovanna Bestetti, Tommaso Fossali, Cinzia Bassoli, Alessandro Torre, Maria Vittoria Cossu, Caterina Minari, Elisabetta Ballone, Andrea Perotti, Davide Mileto, Fosca Niero, Stefania Merli, Antonella Foschi, Stefania Vimercati, Giuliano Rizzardini, Salvatore Sollima, Lucia Bradanini, Laura Galimberti, Riccardo Colombo, Valeria Micheli, Cristina Negri, Anna Lisa Ridolfo, Luca Meroni, Massimo Galli, Spinello Antinori, Mario Corbellino

Figure 4 modified: A curves showing survival of participants with severe COVID-19 pneumonia treated with tocilizumab: B. Kaplan-meier survival curves in patients with severe COVID-19 stratified... 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

Bleeding risk comparison between direct oral anticoagulants at doses approved for atrial fibrillation and aspirin: systematic review, meta-analysis and meta-regression

11 May 2020
Author(s): Dimitrios Sagris, Ioannis Leventis, Georgios Georgiopoulos, Eleni Korompoki, Konstantinos Makaritsis, Konstantinos Vemmos, Haralampos Milionis, Gregory Y.H. Lip, George Ntaios

Aspirin was recommended in the past as an alternative to oral anticoagulation for the prevention of thromboembolism in patients with atrial fibrillation (AF) and a CHA2DS2-VASc score of 1 [1]. The... 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

Early procalcitonin determination in the emergency department and clinical outcome of community-acquired pneumonia in old and oldest old patients

12 May 2020
Author(s): Marcello Covino, Andrea Piccioni, Nicola Bonadia, Graziano Onder, Luca Sabia, Luigi Carbone, Marcello Candelli, Veronica Ojetti, Rita Murri, Francesco Franceschi

Community-acquired pneumonia (CAP) is a frequent cause of morbidity in the adult population, with a mortality rate reaching 20% of hospitalized patients [1]. A diagnosis of CAP is given to 5-12% of... more

Impact of low dose tocilizumab on mortality rate in patients with COVID-19 related pneumonia

14 May 2020
Author(s): Ruggero Capra, Nicola De Rossi, Flavia Mattioli, Giuseppe Romanelli, Cristina Scarpazza, Maria Pia Sormani, Stefania Cossi

The epidemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originating in Wuhan has dramatically spread in Italy, with very high mortality rates (7960 deaths over 46065 positive... more

Higher odds and rising trends in arrhythmia among young cannabis users with comorbid depression

14 May 2020
Author(s): Rupak Desai, Samarthkumar Thakkar, Harsh P Patel, Bryan E-Xin Tan, Nanush Damarlapally, Fariah Asha Haque, Nazia Farheen, Natalie DeWitt, Sejal Savani, Fahria Jessy Parisha, Rajkumar Doshi, Zeeshan Mansuri, Kishorbhai Gangani

The high prevalence of substance abuse especially cannabis among adolescents is one of the major health care challenges of the 21st century. The permissive nature of laws regarding cannabis use has... more

Use of intravenous iron in patients with iron deficiency and chronic heart failure: Real-world evidence

19 May 2020
Author(s): José Gonzalez-Costello, Miguel Cainzos-Achirica, Josep Lupón, Nuria Farré, Pedro Moliner-Borja, Cristina Enjuanes, Marta de Antonio, Lara Fuentes, Carles Díez-López, Antoni Bayés-Genis, Nicolás Manito, Ramón Pujol, Josep Comin-Colet

Iron deficiency (ID) affects up to 50% of patients with chronic heart failure (HF). ID in patients with HF has been shown to be an independent adverse prognostic factor [1,2], it is associated with... more

Review Article

Therapeutic strategies for virus-negative myocarditis: a comprehensive review

10 May 2020
Author(s): Giacomo De Luca, Corrado Campochiaro, Silvia Sartorelli, Giovanni Peretto, Lorenzo Dagna

Myocarditis is defined by World Health Organization as an inflammatory disease affecting the myocardium, diagnosed by endomyocardial biopsy (EMB) using established histological, immunological, and... more

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

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

Hospital ambulatory medicine: A leading strategy for Internal Medicine in Europe

Author(s): Xavier Corbellaa, Vasco Barretob, Stefano Bassettic, Monica Bivold, Pietro Castellinoe, Evert-Jan de Kruijff, Francesco Dentalig, Mine Durusu-Tanriöverh, Carmen Fierbinţeanu-Braticevicii, Thomas Hanslikj, Radovan Hojsk, Soňa Kiňovál, Leonid Lazebnikm, Evija Livčānen, Matthias Raspeo, Luis Camposp, The Working Group on Professional Issues and Quality of Care, European Federation of Internal Medicine (EFIM)
Date:14 April 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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