November 2019

38 Articles

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Predictive value of the Canada Acute Coronary Syndrome risk score for post-acute myocardial infarction infection

12 November 2019
Author(s): YuanHui Liu, YiNing Dai, JiaYing Chen, Cheng Huang, ChongYang Duan, Shuai Shao, HongHuan Chen, Ling Xue, DanQing Yu, JiYan Chen, Ning Tan, PengCheng He

Infection in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) significantly increases mortality, prolongs the length of hospital stay, and... more

The relationship among frailty, delirium and attentional tests to detect delirium: a cohort study

21 November 2019
Author(s): Prof Giuseppe Bellelli, Martina Biotto, Alessandro Morandi, David Meagher, Matteo Cesari, Paolo Mazzola, Giorgio Annoni, Antonella Zambon

Frailty and delirium are two medical conditions of older people that have been described as geriatric giants (1). Frailty is characterized by a decrease of functional reserves due to a multisystemic... more

Depression is independently associated with increased length of stay and readmissions in multimorbid inpatients

29 November 2019
Author(s): P.E. Beeler, M. Cheetham, U. Held, E. Battegay

Little is known about the impact of depression across a broad range of multimorbid patients hospitalized for reasons other than depression. The objective of the study was to investigate in a large... more

A rare cause of dysphagia

Author(s): Michiel Bronswijk, Jan Tack

An 80-year-old male patient, with a history of Alzheimer's disease and recurrent idiopathic angioedema, was evaluated at the emergency room for another episode of angioedema. He also mentioned slowly... more

Proton pump inhibitors and cardiovascular adverse effects: Real or surreal worries?

30 November 2019
Author(s): Antonis A. Manolis, Theodora A. Manolis, Helen Melita, Niki Katsiki, Antonis S. Manolis

Proton pump inhibitors (PPIs) are among the most widely prescribed agents [1]. For over 30 years, guidelines promote PPIs as the best treatment of gastroesophageal reflux disease (GERD), esophagitis... more

Apixaban-induced fatal liver injury with a cholestatic pattern

Author(s): Federico Pasin, Maria del Pilar Esteban, Sophie Testa

The hepatobiliary effects of direct oral anticoagulants (DOACs) have been under close surveillance since hepatotoxicity was demonstrated with ximelagatran during the post marketing phase,... more

Preemptive plasma therapy prevents atypical hemolytic uremic syndrome relapse in kidney transplant recipients

30 November 2019
Author(s): Christof Aigner, Georg A. Böhmig, Farsad Eskandary, Harald Herkner, Zoltán Prohászka, Dorottya Csuka, Renate Kain, Martina Gaggl, Raute Sunder-Plassmann, Thomas Müller-Sacherer, André Oszwald, Gottfried Fischer, Alice Schmidt, Gere Sunder-Plassmann

Atypical hemolytic syndrome (aHUS) is a rare cause of thrombotic microangiopathy (TMA) that can lead to end-stage renal disease (ESRD) (1). Without preemptive therapy early recurrence after kidney... more

Renal function and delirium in older fracture patients: different information from different formulas?

8 November 2019
Author(s): Enrico Mossello, Giulia Rivasi, Virginia Tortù, Antonella Giordano, Iacopo Iacomelli, Maria Chiara Cavallini, Martina Rafanelli, Alice Ceccofiglio, Alessandro Cartei, Carlo Rostagno, Mauro Di Bari, Andrea Ungar

the association between renal function and delirium has not been investigated in older fracture patients. Creatinine is frequently low in these subjects, which may influence the association between... more

Hepatitis C virus (HCV) infection and cardiovascular disease: Hepatologists and cardiologists need to talk!

8 November 2019
Author(s): Bernhard Wernly, Sarah Wernly, David Niederseer, Christian Datz

Several studies reported adverse cardiovascular outcomes in patients with hepatitis C virus (HCV) infection [1]. In our opinion, this should prompt consequences in the work-up of both patients with... more

The prognostic effect of left ventricular thrombus formation after acute myocardial infarction in the contemporary era of primary percutaneous coronary intervention: A meta-analysis

7 November 2019
Author(s): Peng-fei Chen, Liang Tang, Jun-lin Yi, Jun-yu Pei, Xin-qun Hu

: The prognosis and management of left ventricular thrombus (LVT) following acute myocardial infarction (AMI) have not been well evaluated since the advent of primary percutaneous coronary... more

Heart failure etiologies and clinical factors precipitating for worsening heart failure: Findings from BIOSTAT-CHF

7 November 2019
Author(s): Masatake Kobayashi, Adriaan A. Voors, Nicolas Girerd, Maxime Billotte, Stefan D. Anker, John G. Cleland, Chim C. Lang, Leong L. Ng, Dirk J. van Veldhuisen, Kenneth Dickstein, Macro Metra, Kevin Duarte, Patrick Rossignol, Faiez Zannad, João Pedro Ferreira

Heart failure (HF) therapies have improved patient outcome over the last decades, however those with worsening symptoms and/or signs of HF still have a poor prognosis [1,2]. Both the etiology of HF... more

Commentary

Management of venous thromboembolism in cancer patients: Considerations about the clinical practice guideline update of the American society of clinical oncology

12 November 2019
Author(s): Melina Verso, Marcello Di Nisio

Venous thromboembolism (VTE) is a common complication in patients with cancer. About 15% of patients with cancer experience one or more episodes of acute VTE during the course of their disease, while... more

Precision medicine in heart failure no longer a visual theory but a realistic opportunity?

11 November 2019
Author(s): G. Sinagra, A. Porcari, M. Merlo

Over the last decades, major advances in the understanding of pathophysiology in a wide spectrum of cardiovascular diseases provided several effective pharmacological and non-pharmacological... more

Hypertensive urgencies and emergencies: Misconceptions and pitfalls

6 November 2019
Author(s): Fabio Angeli, Gianpaolo Reboldi, Paolo Verdecchia

Hypertension remains the dominant risk factor for premature cardiovascular disease worldwide [1,2]. It increases the short- and long-term risk of a variety of cardiovascular complications, including... more

Post myocardial infarction infection: Can we predict it or not?

7 November 2019
Author(s): Athanasios Manolis, Dimitrios Varvarousis

We read with interest the study of Liu et al. [1], investigating the predictive value of the Canada Acute Coronary Syndrome (C-ACS) risk score for post-infarction infection among patients... more

Editorial

A new approach for anemia in kidney disease

26 November 2019
Author(s): Piergiorgio Messa, Maria Domenica Cappellini

Anemia represents an almost obligatory complication in patients with chronic kidney disease (CKD) and, if ineffectively treated, is associated with increased cardiovascular (CV) mortality, a reduced... more

Prognostication by concomitant organ failure in mechanically ventilated patients in ICU: Important issue to face with

5 November 2019
Author(s): Bianca Beghè, E. Clini

Acute Physiology And Chronic Health Evaluation-2 (APACHE II) and Simplified Acute Physiology Score II (SAPS2) have been developed to assess the risk stratification of patients admitted to the... more

Internal Medicine Flashcard

Lung fibrosis and painful fingers

Author(s): Chen Fei Ng, Boon Hau Ng

A 38-year-old man with no previous medical illness presented with 2-month history of dry cough and dyspnoea. There was no hemoptysis or fever. He was a non-smoker. Of note, he started to have burning... more

A schizophrenic man with severe disorders of consciousness

Author(s): Keizo Tanitame

A 48-year-old man with severe disorders of consciousness and fever up to 38 °C was transferred from a psychiatric hospital to the author's hospital. He had suffered from schizophrenia for 15 years... more

Strange cutaneous abnormalities and polyposis in an Asiatic man

5 November 2019
Author(s): F Maurier, T Moulinet, J Galland

A 56-year-old-man, born in Laos, was hospitalized for weight loss to 9 kg in 3 months, asthenia, pruritus and a skin and nails changed color. He had no significant past medical history. He described... more

A woman with an alarming electrocardiogram

7 November 2019
Author(s): Shing Ching, Chiu Sun Yue

An 86-year-old woman is evaluated for an abnormal electrocardiogram (ECG) during admission for hemoptysis (Figure 1-A). She denied any chest pain. Other medical problems include bronchiectasis,... more

Letter to the Editor

Do we have enough evidence to support the use of SGLT2 inhibitors for MACE reduction in patients with advance kidney disease?

1 November 2019
Author(s): Rajkumar Doshi, Zahara Meghji, Ashish Kumar, Mariam Shariff, Devina Adalja

Sodium-Glucose co-transporter 2 inhibitors (SGLT2i) are novel therapeutic agents used for the treatment of type 2 diabetes mellitus (T2DM) and have reno-protective effects in patients with T2DM with... more

H63/H63D genotype and the H63D allele are associated in patients with hyperferritinemia to the development of metabolic syndrome

30 November 2019
Author(s): Agustin Castiella, Iratxe Urreta, Eva Zapata, M Dolores de Juan, Jose I. Emparanza, Burnia Group

The metabolic syndrome (MtS) is present in the 25% of the population of Western countries [1]. MtS is frequently associated with hyperferritinemia (HF) and this can be produced by mutations in the... more

SAPHO syndrome and subclavian thrombosis: Simple fortuitous association?

30 November 2019
Author(s): Amélie Godot, Olivier Fakih, Clément Prati, Daniel Wendling, Frank Verhoeven

The SAPHO syndrome (Synovitis, Acne, Pustulose, Hyperostosis, Osteitis) described in 1987 associates joint, skin and especially bone damage. It is a rare disease, included in the group of... more

Magnesium disorders: Myth or facts?

Author(s): A. Catalano, F. Bellone, D. Chilà, S. Loddo, F. Corica

Dear Editor,

Protective activity of Ticagrelor against bacterial infection in acute myocardial infarction patients

Author(s): Gianluca Rigatelli, Marco Zuin, Alberto Rigatelli, Luca Conte, Loris Roncon

Dear Editor,

Contributors to survival benefit of dual versus single antithrombotic therapy in chronic coronary syndrome

6 November 2019
Author(s): Giuseppe Patti, Alessandro Sticchi, Vincenzo Pasceri

In randomized trials the use of dual antithrombotic therapy (DAT) versus single antithrombotic therapy (SAT) in patients with chronic coronary syndrome (CCS) reduced the risk of major adverse... more

Identification of EML4-ALK fusion in a sporadic case of cholangiocarcinoma

8 November 2019
Author(s): Domenico Trombetta, Paola Parente, Tiziana Pia Latiano, Federico Pio Fabrizio, Lucia Anna Muscarella

Cholangiocarcinoma (CCA) are a heterogeneous group of malignant epithelial neoplasia arising from the epithelial cell lining the intra and extra-hepatic biliary tree, which represent the second most... more

Equity, diversity, and inclusion in academic internal medicine at US medical schools

7 November 2019
Author(s): Shu Nan Jessica Li, Javed Siddiqi, Ashraf Mahmood, Faisal Khosa

As minority populations continue to increase in the United States (US), diversification of medical faculty and professionals remains critical to effectively serving minority groups and improving... more

Thyroid dysfunction in adult patients with biopsy-proved myocarditis: Screening and characterization

13 November 2019
Author(s): Giovanni Perettoa, Cristina Basso, Paolo Della Bella, Simone Sala

Myocarditis is a complex inflammatory disease, usually secondary to viral infections or autoimmune processes selectively involving the myocardium [1]. Thyroid dysregulation, often triggered by... more

Narrative Review

Comorbidities in chronic heart failure: An update from Italian Society of Cardiology (SIC) Working Group on Heart Failure

7 November 2019
Author(s): Michele Correale, Stefania Paolillo, Valentina Mercurio, Giuseppe Limongelli, Francesco Barillà, Gaetano Ruocco, Alberto Palazzuoli, Domenico Scutinio, Rocco Lagioia, Carolina Lombardi, Laura Lupi, Damiano Magrì, Daniele Masarone, Giuseppe Pacileo, Pietro Scicchitano, Marco Matteo Ciccone, Gianfranco Parati, Carlo G Tocchetti, Savina Nodari

The Prevalence of Heart Failure (HF) in the western world is around 1-2% and more than 10% over 70 years of age and the incidence is about 5–10 per 1000 persons per year, representing the leading... more

Original Article

Comparative influence of Acute Illness Severity and comorbidity on mortality

22 November 2019
Author(s): Richard Conway, Declan Byrne, Deirdre O'Riordan, Bernard Silke

Acute Medicine is concerned with the immediate specialist management of urgent medical presentations [1]. Acute Medicine practitioners have an intuitive or experiential feel of major outcome... more

Increased serum uric acid level predicts poor prognosis in mildly severe chronic heart failure with reduced ejection fraction. An analysis from the MECKI score research group

28 November 2019
Author(s): Massimo Francesco Piepoli, Elisabetta Salvioni, Ugo Corrà, Francesco Doni, Alice Bonomi, Rocco La Gioia, Giuseppe Limongelli, Stefania Paolillo, Gianfranco Sinagra, Angela B. Scardovi, Rosa Raimondo, Michele Emdin, Federica Re, Mariantonietta Cicoira, Michele Correale, Roberto Badagliacca, Francesco Clemenza, Carlo Lombardi, Piergiuseppe Agostoni

The association between elevated serum uric acid (SUA) levels and risk of cardiovascular (CV) disease has gained a lot of attention over the last years, considering that using the cut-off levels... more

Diagnosis and treatment of hypertensive emergencies and urgencies among Italian emergency and intensive care departments. Results from an Italian survey: Progetto GEAR (Gestione dell'Emergenza e urgenza in ARea critica)

Author(s): F. Saladini, C. Mancusi, F. Bertacchini, F. Spannella, A. Maloberti, A. Giavarini, M. Rosticci, R.M. Bruno, G. Pucci, D. Grassi, M. Pengo, M.L. Muiesan

Hypertensive emergencies (HE) and urgencies (HU) are defined as a blood pressure (BP) elevation usually above 180 mmHg for systolic (SBP) and/or above 120 mmHg for diastolic (DBP) and differ by the... more

Impact of stable angina on health status and quality of life perception of currently treated patients. The BRIDGE 2 survey

5 November 2019
Author(s): Athanasios J. Manolis, Giuseppe Ambrosio, Peter Collins, Ralf Dechend, Jose Lopez-Sendon, Valeria Pegoraro, A. John Camm

Stable Angina (SA) is a common condition in patients with coronary heart disease, with a prevalence of around 2–4% of the general population in western European countries. In patients with... more

Effects of benzodiazepines on orthostatic blood pressure in older people

6 November 2019
Author(s): Giulia Rivasi, Rose Anne Kenny, Andrea Ungar, Roman Romero-Ortuno

Psychoactive medications are widely used in older people [1–3], despite increasing concerns about their safety profile in this population. In particular, benzodiazepines (BDZs) are commonly... more

Short and long-term mortality in elderly patients with suspected not confirmed pulmonary embolism

8 November 2019
Author(s): Hernan Polo Friz, Annalisa Orenti, Mattia Brambilla, Alessandro Caleffi, Valentina Pezzetti, Luca Cavalieri d'Oro, Cristina Giannattasio, Giuseppe Vighi, Claudio Cimminiello, Patrizia Boracchi

Pulmonary embolism (PE) is a leading cause of mortality [1] and both its incidence and mortality increase with age [2–4]. After pursuing Emergency Department (ED) diagnostic work-up, the prevalence... more

Review Article

Creatinine: From physiology to clinical application

7 November 2019
Author(s): Kianoush Kashani, Mitchell H. Rosner, Marlies Ostermann

Estimating static kidney function accurately and detecting changes in kidney function in a timely fashion are challenging and critically important.

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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