February 2024

30 Articles

Clinical Insights

Global burden of new-onset hypertension associated with severe acute respiratory syndrome coronavirus 2 infection

16 October 2023
Author(s): Fabio Angeli, Martina Zappa, Paolo Verdecchia

To date, over 770 million confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and approximately 6.9 million deaths related to coronavirus disease 2019 (COVID-19... more


Non-adherence to chronic treatments: A commitment for Internal Medicine specialists

19 December 2023
Author(s): Bianca Clerici, Simone Birocchi, Gian Marco Podda

Adherence to treatment poses two challenges. First, identifying patients who are non-compliant to treatments. Secondly, improving adherence. The issue of adherence has been addressed in this issue of... more

Will the manipulation of the gut microbiota be effective for the treatment of metabolic diseases?

28 November 2023
Author(s): Victoria Catalán, Javier Gómez-Ambrosi

The gut microbiota is a complex ecosystem of microorganisms, including bacteria, viruses, fungi and other microbes, that colonize our gastrointestinal tract. These microorganisms play a fundamental... more

Confused at a higher level, once more? Implications of asymptomatic vs. symptomatic, and clinical vs. subclinial atrial fibrillation

6 November 2023
Author(s): Jan Steffel

About 20 years ago, the definition of atrial fibrillation (AF) seemed to be a very straight forward one: An irregularly irregular heart rhythm, with no discernible P-waves and, ideally, detectable... more

Oral anticoagulants in patients with atrial fibrillation and end-stage renal disease: Walking the tightrope between thromboembolic and bleeding risk

2 November 2023
Author(s): Marco Vitolo, Luigi Gerra, Giuseppe Boriani

Atrial fibrillation (AF) and chronic kidney disease (CKD) have a complex relationship, with each condition reciprocally influencing the other [1–3]. The strong, independent, and graded relationship... more

Internal Medicine Flashcard

Persistent rash associated with multiple pulmonary nodules

18 October 2023
Author(s): Takamitsu Sakamoto, Hiroyuki Mizuta, Teruyoshi Amagai

A male individual aged 39 hailing from a remote island in Japan was directed to the general hospital due to a chest skin rash that persisted for 6 months. The patient denied experiencing any fever or... more

Severe hand deformities in an undertreated condition

7 October 2023
Author(s): Elisa Gremese, Dario Bruno, Gianfranco Ferraccioli

A 79-year-old man presented to the clinic with pain, severe deformities and functional impotence in his hands and feet (Fig. 1A and B). At the age of 59 he had a first episode of knee arthritis,... more

Letter to the Editor

Serological biomarkers at hospital admission and hospitalization treatments are not related to the development of post-COVID dyspnea

7 November 2023
Author(s): César Fernández-de-las-Peñas, Carlos Guijarro, María Velasco-Arribas, Oscar Pellicer-Valero, Juan Torres-Macho

Dear Editor

Congenital anomalies of inferior vena cava

1 November 2023
Author(s): Diego Martínez García, María Teresa Belmonte Alcaraz, Elena Hellín Valiente, Paula Roig Egea, Mari Luz Paredes Martínez

We present a descriptive, single-centre study of congenital anomalies of the inferior vena cava (IVC) detected over 46 months, from September 2019 to July 2023 (double IVC, left-sided IVC,... more

Extra respiratory comorbidities in adult patients with cystic fibrosis

1 November 2023
Author(s): M. Antoine, M. Perceval, R. Nove-Josserand, I. Durieu, Q. Reynaud

Dear Editor,

No evidence of a “July Effect” on mortality

21 October 2023
Author(s): Richard Conway, Declan Byrne, Deirdre O'Riordan, Bernard Silke

There exists an apocryphal adage to avoid going to hospital in July (or August in the UK), attributing a temporal increase in risk due to inexperienced house staff [1]. This phenomenon has been... more

Clinical characteristics of left ventricular thrombus and the use of anticoagulants in patients with dilated cardiomyopathy and sinus rhythm

17 October 2023
Author(s): Hongxia Yao, Qin-Fen Chen, Christos S. Katsouras, Yingdan Lu, Xiao-Dong Zhou

Dear Editor,

Late administration of glucarpidase in methotrexate intoxication: Do we have more time than we thought?

7 October 2023
Author(s): G. Miceli, M. Daidone, F. Corpora, F. Di Gaudio, A. Tuttolomondo, MSc on behalf of the METHOTRETOXY GROUP

Methotrexate (MTX) is a drug interfering with the metabolism of folic acid suitable, at different dosages, for treating neoplastic and rheumatic diseases. It is characterized by a narrow therapeutic... more

Medical specialties in Europe: The less the better?

28 September 2023
Author(s): Livio Garattini, Marco Badinella Martini, Florian Schumacher, Alessandro Nobili

Dear Editor,

Effects of moderate caffeine intake in athletes

27 September 2023
Author(s): Pasquale Mone, Germano Guerra, Sofia Verderosa, Gaetano Santulli, Klara Komici

Caffeine intake increases the risk of premature atrial contractions (PACs) and premature ventricular contractions (PVCs) because of its sympathomimetic effects via dopamine and norepinephrine [1–3].... more

CHEDDAR score versus YEARS algorithm for suspected pulmonary embolism in SARS-CoV-2-infected patients: A comparison of two strategies

16 September 2023
Author(s): Anabel Franco-Moreno, Aida Izquierdo-Martínez, Idoia Pagai-Valcárcel, Juan Torres-Macho, Cristina Lucía de Ancos-Aracil, CHEDDAR Research Group

Patients with clinically suspected pulmonary embolism (PE) should be managed according to standardized flowcharts. These flowcharts include validated algorithms to determine pretest probability, d-... more

Original Article

Asymptomatic vs. symptomatic atrial fibrillation: Clinical outcomes in heart failure patients

25 September 2023
Author(s): Giuseppe Boriani, Niccolo’ Bonini, Marco Vitolo, Davide A Mei, Jacopo F Imberti, Luigi Gerra, Giulio Francesco Romiti, Bernadette Corica, Marco Proietti, Igor Diemberger, Gheorghe-Andrei Dan, Tatjana Potpara, Gregory YH Lip

Atrial fibrillation (AF) is the most common arrhythmia worldwide, afflicting patients’ prognosis and symptoms. The European Heart Rhythm Association (EHRA) proposed the EHRA score for grading the... more

New genetic drivers in hemorrhagic hereditary telangiectasia

7 September 2023
Author(s): Pau Cerdà, Sandra D. Castillo, Cinthia Aguilera, Adriana Iriarte, José Luis Rocamora, Ane M. Larrinaga, Francesc Viñals, Mariona Graupera, Antoni Riera-Mestre

Hereditary hemorrhagic telangiectasia (HHT) or Rendu–Osler–Weber syndrome (ORPHA:774) is a rare autosomal dominant vascular disease characterized by the presence of telangiectases and larger vascular... more

Abatacept in usual and in non-specific interstitial pneumonia associated with rheumatoid arthritis

4 September 2023
Author(s): Belén Atienza-Mateo, Carlos Fernández-Díaz, Esther F. Vicente-Rabaneda, Rafael B. Melero-González, Francisco Ortiz-Sanjuán, Ivette Casafont-Solé, Sebastián C. Rodríguez-García, Iván Ferraz-Amaro, Santos Castañeda, Ricardo Blanco, Spanish Collaborative Group of Abatacept in Interstitial Lung Disease Associated with Rheumatoid Arthritis

Interstitial lung disease (ILD) is a severe and frequent extraarticular manifestation of rheumatoid arthritis (RA). A higher mortality rate in patients with RA-ILD in comparison with those without... more

Novel potassium binders to optimize RAASi therapy in heart failure: A systematic review and meta-analysis

28 August 2023
Author(s): Stefania Paolillo, Christian Basile, Simona Dell'Aversana, Immacolata Esposito, Alfonsina Chirico, Angela Colella, Gennaro Esposito, Mariafrancesca Di Santo, Maria Francesca Fierro, Francesca Carbone, Federica Marzano, Chiara Amato, Paola Gargiulo, Pasquale Perrone Filardi

Heart failure (HF) is a major cause of cardiovascular (CV) mortality and morbidity, resulting in more than one million hospitalizations per year. In patients affected by HF with reduced ejection... more

Efficacy and safety of direct oral anticoagulants vs vitamin K antagonists in patients with atrial fibrillation and end-stage renal disease on hemodialysis: A systematic review and meta-analysis

28 August 2023
Author(s): Ioannis Kyriakoulis, Anastasia Adamou, Iliana Stamatiou, David Dimitris Chlorogiannis, Ioannis Kardoutsos, Despoina Koukousaki, George Ntaios

The prevalence of atrial fibrillation (AF) in individuals with end stage renal disease (ESRD) who are on chronic hemodialysis is increasing, exceeding that of the general population and resulting in... more

Renin‐angiotensin-aldosterone system inhibitors and mortality risk in elderly patients with atrial fibrillation. Insights from the nationwide START registry

28 August 2023
Author(s): Danilo Menichelli, Daniela Poli, Emilia Antonucci, Gualtiero Palareti, Pasquale Pignatelli, Daniele Pastori, the START2 Register Investigators

The estimated prevalence of atrial fibrillation (AF) in the general population is about 1–4% and rises according to aging [1]. Cardiovascular comorbidities are utmost prevalent in patients with AF,... more

Infarct severity and outcomes in ST-elevation myocardial infarction patients without standard modifiable risk factors – A multicenter cardiac magnetic resonance study

25 August 2023
Author(s): Martin Reindl, Thomas Stiermaier, Ivan Lechner, Christina Tiller, Magdalena Holzknecht, Priscilla Fink, Agnes Mayr, Gert Klug, Hans-Josef Feistritzer, Ronak Delewi, Alexander Hirsch, Jaclyn Carberry, David Carrick, Axel Bauer, Bernhard Metzler, Robin Nijveldt, Holger Thiele, Colin Berry, Ingo Eitel, Sebastian J. Reinstadler

Ischemic heart disease remains a leading contributor to the burden of cardiovascular disease with 1.8 million annual deaths in Europe [1]. The annual incidence of hospital admissions for acute... more

Value of inflammatory response and oxidative damage in the diagnosis of infections in severe alcoholic hepatitis

14 August 2023
Author(s): Onán Pérez-Hernández, Emilio González-Reimers, Alen García-Rodríguez, Camino Fernández-Rodríguez, Pedro Abreu-González, José María González-Pérez, María José Sánchez-Pérez, Iván Ferraz-Amaro, Candelaria Martín-González

Alcohol is one of the most consumed substances in the world. Among the organic lesions produced by alcohol consumption, liver disease has been the most studied and documented. Alcohol use disorder is... more

Impact of antimicrobial stewardship in organisms causing nosocomial infection among COVID-19 critically ill adults

12 August 2023
Author(s): Loreto Vidaur, Itziar Eguibar, Ander Olazabal, Maialen Aseguinolaza, Oihana Leizaola, Amalur Guridi, Maria Teresa Iglesias, Jordi Rello

Since the firsts reports of a novel viral respiratory illness emerged in December 2019 in Hubei province, China [1], the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has infected... more

Immunosuppressive therapy and oral anticoagulation in kidney transplant recipients: Direct oral anticoagulants versus vitamin-k antagonists

10 August 2023
Author(s): Francesco Santoro, Annalisa Casanova, Simona Simone, Carlo Alfieri, Adele Falcone, Andrea Dello Strologo, Valeria Grandinetti, Marco Busutti, Giorgia Comai, Tommaso Maria Marvulli, Maria Grazia Zippo, Giuseppe Castellano, Gaetano La Manna, Loreto Gesualdo, Grandaliano Giuseppe, Francesco Pesce

Kidney transplant recipients (KRTs), have an increased risk of atrial fibrillation that has an incidence of about 7% in the first 3 years after transplantation 1. Moreover, the risk of thromboembolic... more

Review Article

From non-adherence to adherence: Can innovative solutions resolve a longstanding problem?

15 October 2023
Author(s): Przemyslaw Kardas

“Non-adherence is a rare deviation of poorly educated patients who do not take their diseases seriously enough”. “Non-adherence is entirely a patient's fault”. “Non-adherence is not a responsibility... more

Gut microbes in metabolic disturbances. Promising role for therapeutic manipulations?

4 October 2023
Author(s): Piero Portincasa, Mohamad Khalil, Annarita Graziani, Gema Frühbeck, Gyorgy Baffy, Gabriella Garruti, Agostino Di Ciaula, Leonilde Bonfrate

A complex polymicrobial ecology exists in the human gut at the interface of internal and external environment [1]. These microbes grow within the mucin layer, as an essential component of the gut... more

The role of adherence in patients with chronic diseases

20 July 2023
Author(s): Michel Burnier

In the long-term management of chronic diseases, adherence and persistence to prescribed medications are continuous challenges in order to obtain all the potential benefits of drug therapies.... more


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