February 2018
42 ArticlesNo Section
Prospective analysis of safety and efficacy of medical cannabis in large unselected population of patients with cancer
Cancer is a major public health problem as the leading cause of death. Palliative treatment aimed to alleviate pain and nausea in patients with advanced disease is a cornerstone of oncology. In 2007... more
Ethical issues in medical cannabis use
The increasing use of medical cannabis (MC) in the past decade raises several ethical considerations for the clinician. Regulatory issues stem from a gap between MC registration and certification in... more
Vasodilators in acute heart failure - evidence based on new studies
Acute heart failure (AHF) contributes largely to the worldwide burden of heart failure (HF) and is associated with high mortality, poor prognosis and high rehospitalization rate. The pharmacologic... more
Predicting resistant etiology in hospitalized patients with blood cultures positive for Gram-negative bacilli
To develop a risk-scoring tool to predict multidrug-resistant (MDR) etiology in patients with bloodstream infections (BSI) caused by Gram-negative bacilli (GNB).
Factors reducing omalizumab response in severe asthma
Despite adding Omalizumab to conventional therapy, several severe asthmatics still show poor disease control. We investigated the factors that may affect a reduced Omalizumab response in a large... more
Are there ways to improve the citations of a scientific paper?
The expansion of scientific publications makes more difficult the mining of relevant information necessary for a productive appraisal of authors' work, scientific interaction and exchange. Papers... more
Recurrent and persistent pneumonia
A 60-year-old man presented to our department for investigation of pulmonary opacity detected by Chest Computed Tomography (CT) at medical checkup. He had no clinical symptoms. Chest CT revealed a... more
Editorial
Medical cannabis: What physicians need to know?
The current issue of European Journal of Internal Medicine is dedicated to the topic of cannabis derived products use in contemporary pharmacopeia. Despite hundreds of years of experience with... more
Comprehensive geriatric assessment: Benefits and limitations
The traditional disease-oriented model of medicine focuses on the theory that organ- or system-based pathologies cause disease and, thus, treatment is focused on eliminating the underlying pathology... more
How to win space in medical journals: Bits and tips
I chose to convey to the readership a few words not only on the achievements of the European Journal of Internal Medicine and the strategies implemented by me and the other editors for the disposal... more
Internal Medicine Flashcard
A young female with cyanosis and clubbing
A 21 year old female, deaf-mute since birth, presented with a history of exertional dyspnea since 8 years. On auscultation, she had a single, loud second heart sound and no murmurs. Fig. 1 is a... more
Purple urine bag syndrome
An 86-year-old woman, with history of metastatic pancreatic cancer, presented with asthenia, abdominal pain and weight loss. Few days after hospitalization, purple urine were observed in the... more
Letter to the Editor
The role of echocardiography as a risk-stratification tool in infective endocarditis
We would like to thank the interest in our paper “Prognostic implications of a negative echocardiography in patients with infective endocarditis” [1]. Our aim was to address the impact of... more
Evolution of bendopnea during admission in patients with decompensated heart failure
The presence of bendopnea (lack of air that occurs during the first 30 s while bending forward) in the population with heart failure (HF), both stable (ambulatory) and decompensated (hospitalized)... more
Unexpected trends in hospital standardized mortality indicate a novel cause
Physicians will be aware of alternating periods of management jubilation and witch-hunting relating to changes in hospital mortality, which may then result in needless clinical audit [1].
Lyme borreliosis and depressive symptoms in patients aged 65 years and older referred to a tertiary Lyme centre
Little is known on Lyme borreliosis (LB) in patients aged ≥65 years. To optimize management of older patients referred to a tertiary Lyme centre, characteristics of older patients need to be assessed... more
Molecular imaging should have played a role
In their account of the prognostic implications of negative echocardiography in infective endocarditis (IE) the authors made the observation that “molecular imaging may have provided additional... more
Significance of macro creatine kinase in admitted patients
High molecular mass forms have been reported for many serum enzymes measured in clinical laboratories. They are described as either type-1 (a normal enzyme complexed with an immunoglobulin by an... more
Shortening antibiotic duration for community acquired pneumonia
For the last 20 years multi-resistant strains have changed the paradigm of in-hospital antibiotic prescription, forcing physicians to prescribe more broad-spectrum antibiotics. This selective... more
Hospital mortality scores are unduly influenced by changes in the number of admissions
Any hospital doctor will point out that length of stay (LOS) is a far better indicator of patient acuity than diagnosis. So why do hospital doctors continue to be harassed over supposed changes in... more
Artificial intelligence in internal medicine: Between science and pseudoscience
When faced with new, complex phenomena, humans frantically seek to predict their impact on the individual and society. The more complex the phenomenon, the more difficult it is to understand rapidly... more
The Internal Medicine and Assessment of Gender Differences in Europe (IMAGINE): The new European Federation of Internal Medicine initiative on sex and gender medicine
The evidence that women and men are different is arguably as old as human life, yet basic research studies are performed exclusively in male animals and women are largely excluded from clinical... more
Impact of revascularization procedures on Doppler parameters in patients with atherosclerotic renal artery stenosis
Atherosclerotic renal artery stenosis (ARAS) represents 1% to 2% of all cases of secondary hypertension in the general population, rising up to 5.8%in patients ≥65 years old [1].
Violence against doctors: A pandemic in the making
“No physician, however conscientious or careful can tell what day or hour he may not be the object of some undeserved attack, malicious accusation, black mail or suit for damages…”‘Assaults upon... more
Comment on “Mild water restriction with or without urea for the longterm treatment of SIADH: Can urine osmolality help the choice?” by Decaux et al.
Dear Editor,
Narrative Review
Cannabinoids and cancer pain: A new hope or a false dawn?
The endocannabinoid system is involved in many areas of physiological function and homeostasis. Cannabinoid receptors are expressed in the peripheral and central nervous system and on immune cells,... more
Original Article
Risk factors for the development of incident atrial fibrillation in patients with cardiac implantable electronic devices
Cardiac implantable electronic devices (CIEDs) can detect atrial fibrillation (AF) early and accurately. Risk factors for the development of new-onset AF in patients with CIEDs remains uncertain.
A new standardized data collection system for interdisciplinary thyroid cancer management: Thyroid COBRA
The big data approach offers a powerful alternative to Evidence-based medicine. This approach could guide cancer management thanks to machine learning application to large-scale data. Aim of the... more
Declining prevalence and increasing awareness of HCV infection in Italy: A population-based survey in five metropolitan areas
In metropolitan areas in Italy, HCV is prevalent in elderly, reflecting a cohort effect determined by modalities of viral transmission no longer operative. The impact of the infection will further... more
External validation of a decision tree early warning score using only laboratory data: A retrospective review of prospectively collected data
Early warning scores (EWS) have been developed to identify the degree of illness severity among acutely ill patients. One system, The Laboratory Decision Tree Early Warning Score (LDT-EWS) is wholly... more
Postoperative pneumonia among patients with and without COPD in Spain from 2001 to 2015
To describe and compare incidence, characteristics and outcomes of postoperative pneumonia among patients with or without COPD.
Newer glomerular filtration rate estimating equations for the full age spectrum based on serum creatinine and cystatin C in predicting mortality in patients with ischemic stroke
Renal dysfunction is associated with increased risk of mortality. The novel Full Age Spectrum (FAS) equations estimating the glomerular filtration rate (GFR) based on serum creatinine (FAScrea) and... more
Pleural effusions in acute decompensated heart failure: Prevalence and prognostic implications
The incidence of pleural effusions (PEs) in acute decompensated heart failure (ADHF) is not well established. We aimed to determine their prevalence, clinical characteristics and prognostic... more
The use of cerebral imaging for investigating delirium aetiology
This study aims to investigate the frequency and patterns of use of cerebral imaging in delirium and to describe pathological changes associated with delirium using computed tomography (CT) and... more
Impaired renal function is associated with adverse outcomes in patients with chest pain discharged from internal medicine wards
Assessment of chest pain is one of the most common reasons for hospital admissions in internal medicine wards. However, little is known regarding predictors for poor prognosis in patients discharged... more
Prognostic implications of a negative echocardiography in patients with infective endocarditis
Echocardiography plays an important role in infective endocarditis (IE) diagnosis according with the modified Duke criteria. We evaluated the implications of a positive echocardiography in the... more
Association of non-immediate drug hypersensitivity with drug exposure: A case control analysis of spontaneous reports from a Tunisian pharmacovigilance database
To assess delayed-type cutaneous reactions (DTCRs) related to drugs, using a case-control approach to qualify drug risks.
A proposed Oxford classification-based clinicopathological nomogram for predicting short-term renal outcomes in IgA nephropathy after acute kidney injury
This study aimed to investigate the effect of acute kidney injury (AKI) on the progression of renal disease and to develop a clinico-pathological nomogram to predict the renal outcome of IgA... more
Geriatrician-performed comprehensive geriatric care in older adults referred to an outpatient community rehabilitation unit: A randomized controlled trial
Older adults make increasing demands on all sectors of the healthcare system. We investigated the effect of geriatrician-performed comprehensive geriatric care (CGC) in older adults referred to an... more
Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly
There is a substantial growth in the use of medical cannabis in recent years and with the aging of the population, medical cannabis is increasingly used by the elderly. We aimed to assess the... more
Differential diagnosis of unexplained falls in dementia: Results of “Syncope & Dementia” registry
Dementia patients have an increased risk of fall, and some of them might suffer from undiagnosed syncope. The present analysis aimed at identifying predictors of differential diagnosis between... more
Review Article
The role of gut microbiota in Clostridium difficile infection
Clostridium difficile infection has emerged as a major health problem. Because it is a spore-forming microorganism, C. difficile is difficult to eradicate and recurrences of the infection are... more