January 2021
120 ArticlesNo Section
Cardiac imaging in heart failure in the personalized medicine era: Pathway to knowledge or Tiresias’ paradox?
Tiresias was the blind prophet of Apollo in Thebes. His figure finds roots in Greek mythology and recurs in literature and art. In Sophocles' Oedipus Rex, Tiresias discloses an appalling truth to... more
Pulmonary congestion and mortality during venoarterial extracorporeal membrane oxygenation (VA-ECMO): does time matter?
In a recent edition of this Journal, an intriguing study was published which examined the association between (development of) pulmonary congestion (PC) and mortality in patients with post-cardiotomy... more
Anticoagulation dosing in atherosclerotic cardiovascular disease: Is less more?
Pivotal randomized clinical trials (RCTs) conducted in the 1970s and 1980s comparing aspirin with placebo in patients with prior myocardial infarction established antithrombotic agents as mainstays... more
Lower dose direct oral anticoagulants and improved survival: A combined analysis in patients with established atherosclerosis
Anti-thrombotic and anti-coagulation effects of direct oral anticoagulants (DOACs) are dose-dependent [1–5]. Conversely, the benefit from higher dose DOACs is counterbalanced by a dose-dependent risk... more
Disease- and gender-related characteristics of coeliac disease influence diagnostic delay
Coeliac disease is a high-prevalent, immune-mediated, chronic enteropathy caused by the ingestion of gluten in genetically susceptible individuals [1,2]. From the clinical viewpoint, coeliac disease... more
The 2020 International Society of Hypertension global hypertension practice guidelines - key messages and clinical considerations
The International Society of Hypertension (ISH) has recently developed practice guidelines for the management of hypertension in adults aged ≥18 years. Conceptually, the 2020 ISH Guidelines are... more
Predicting spontaneous conversion to sinus rhythm in symptomatic atrial fibrillation: The ReSinus score
In patients with symptomatic atrial fibrillation rates of spontaneous conversion are high.1-3 In real-world emergency cohorts optimal management is unclear; however, treatment with early... more
Commentary
Sex, age and venous thrombosis—Are men and women indeed from different planets?
“Mars or Venus” titled Elliot and Rubin their editorial that accompanied the landmark study which described for the first time the strikingly higher risk of recurrent venous thromboembolism (VTE) in... more
COPD is not only one of the several VTE risk factors
Chronic obstructive pulmonary disease (COPD) is a frequent and severe chronic respiratory disease [1]. It is ranked in the 5th main causes of death worldwide [1]. Patients with COPD suffer from... more
Sodium: sign, signifier, or signified, of sepsis?
85% of the known universe is made up of something we cannot directly observe as it does not absorb, emit, or reflect light. We can only infer the existence of dark matter through its effects on... more
Increasing the impact of Post Authorisation Safety Studies: transparency is key
In ETNA VTA Europe: A contemporary snapshot of patients treated with edoxaban in clinical practice across eight European countries, Cohen et al. report the results of a non-interventional drug... more
Hydroxychloroquine for COVID-19: Balancing contrasting claims
The place of hydroxychloroquine in the prevention and treatment of COVID-19 has been controversial, with contrasting claims and high-emotions. It was initially proposed as treatment or prophylaxis... more
Large-scale use of hydroxychloroquine for COVID-19 confirms safety, if not effectiveness
In this issue of the Journal, Di Castelnuovo and colleagues report the findings of the observational multicentre Italian CORIST Study on the use of hydroxychloroquine (HCQ) in hospitalised COVID-19... more
Venous thromboembolism and COVID-19: Mind the gap between clinical epidemiology and patient management
Since the beginning of the coronavirus disease-2019 (COVID-19) pandemic, a compelling evidence of the association between this infection and an increased risk of venous thromboembolism has drawn the... more
Hypertension guidelines: Managing the differences or the patients?
Clinical guidelines summarize and evaluate all evidence available on a topic, with the aim of assisting physicians in selecting the best diagnostic and therapeutic strategies for an individual... more
Does hydroxychloroquine reduce mortality for COVID-19?
A paper published in this issue of the European Journal of Internal Medicine shows results from the COVID-19 RISK and Treatments (CORIST) Collaboration Study [1]. The authors analysed data from a... more
Utilize the full potential of real world evidence
After the pivotal phase 3 trials on venous thromboembolism (VTE) treatment with non-vitamin K antagonist oral anticoagulants (NOACs) had been performed some 10 years ago, these drugs have now become... more
European Journal of Internal Medicine: IM Flashcards
Atypical chest pain with precordial T wave inversions
A 74-year-old woman with a prior history of coronary artery disease presented to the emergency department with intermittent, burning epigastric pain. Five months prior, she had a stress... more
Internal Medicine Flashcard
Family rash
A healty 35-year-old woman suddenly developed a papular rash with linear disposition, involving predominantly her arms. She had no history of allergies and did not take any medication; moreover she... more
Concomitant pulmonary and rib lesions in a 44-year-old male nonsmoker
A 44-year-old male nonsmoker presented to the respiratory department with progressive left chest pain for 20 days. He had previously been healthy with normal immunity. He had no cough, fever,... more
“High absorption area in the pelvis”
A 42-year-old man presented to our emergency room with epigastric pain. He had undergone a barium examination 6 weeks previously for gastric cancer screening. He was apyrexial. Physical examination... more
Bilateral foot drop and cherry skin lesion
A 34-year-old woman with no previous medical history presented with bilateral lower limbs weakness and numbness for three months. It was progressively worsening that she required wheelchair for... more
Spontaneous discoloration of the finger in a 67-year-old woman
A 67-year-old woman presented to our clinic because she had developed spontaneous pain and purple discoloration of the fourth finger of her right hand that had started the previous day. She had... more
Chronic urticaria with inflammation
A 67-year-old man presented with a 15-year history of chronic urticaria. It was distributed symmetrically on the limb trunk (Fig. 1A and B) without pruritus. No fever or joint pain or headache is... more
Bright liver: a surprise discovery
A 69-year-old woman with hypothyroidism, alcoholic liver disease, coronary artery disease, ventricular arrhythmia requiring placement of an implantable cardioverter defibrillator, and end-stage renal... more
A middle-aged woman with acute onset of fever, altered mental status, and movement disorder
A 60-year-old woman was admitted in the emergency room with acute onset of fever, altered mental status, and movement disorder. The patient had well-controlled type 2 diabetes mellitus with... more
Internal Medicine Flashcards
A middle-aged woman with numbness and weakness of the extremities
A 45-year-old woman presented to the neurology department with numbness and weakness of extremities, which had progressed during 3 months. The patient had tingling sensation in the left neck.... more
Disturbance of consciousness after postpartum hemorrhage
A 37-year-old woman with postpartum hemorrhage was transferred by ambulance to our hospital for emergency treatment. On arrival massive hemorrhage continued, and she developed tachycardia (130 beats/... more
Invited Article
PPI co-therapy and gastrointestinal bleeding with antithrombotic drugs: A step forward but not enough
Nonvariceal gastrointestinal (GI) bleeding is common and one of the most frequent medical events which determine hospitalizations worldwide. Death rates (5-12%) in patients with GI bleeding are... more
Letter to the Editor
Do four SGLT2 inhibitors lead to different cardiorenal benefits in type 2 diabetes, in chronic heart failure, and in chronic kidney disease?
Large randomized trials have confirmed the cardiorenal benefits from sodium-glucose transporter 2 (SGLT2) inhibitors for patients with type 2 diabetes (T2D), for patients with chronic heart failure... more
Serum uric acid levels: A surrogate marker of oxidative stress or dehydration?
Dear Editors,
Less is more: Perspectives from the European Code Against Cancer
We have read the article of Kherad et al. with great interest. The authors elaborate on the “less is more” principle, which has become quite relevant in various areas of medicine including cancer [1... more
Mid-day sleep and blood pressure in patients with arterial hypertension. Author's reply
We thank Dr Kawada for his comments on our study [1]. He raised some concerns regarding the effect of mid-day sleep on alertness and performance as well as health outcomes. He based his concerns on... more
Proprotein Convertase Subtilisin-Kexin Type 9 inhibitors and stroke prevention: A meta-analysis
Dear Editor, over the last decades lipid-modifying strategies made a pivotal change in cardiovascular prevention especially in patients with previous coronary artery disease or ischemic stroke. In... more
Flying higher than politics: The goal of preventive medicine at the time of the COVID-19 pandemic
The present SARS-CoV-2-caused COVID-19 pandemic [1] has clearly shown that great health crises can elicit heated political and scientific debates. The history of medicine teaches us how, throughout... more
Associating enterococcal endocarditis and colorectal neoplasia: is colonoscopy mandatory? – Authors’ reply
We are glad to share with Corredoira and colleagues the interest for our recently published work regarding the relationship between Enteroccocus spp infective endocarditis (EIE) and colorectal... more
Heart rate turbulence in obstructive sleep apnea syndrome: The effect of short-term CPAP therapy
Patients affected by obstructive sleep apnea (OSA) present an increased risk of cardiovascular (CV) events [1]. This is likely due to the imbalance in the autonomic nervous system, with cardiac... more
Low influenza vaccination coverage among hospitalized COVID-19 patients in Milan: A gap to be urgently filled
The first wave of the COVID-19 epidemic in Italy during March and April 2020 put extreme pressure on the national healthcare system, particularly on the hospitals in the most affected regions of... more
Mid-day sleep and blood pressure in patients with arterial hypertension
To the Editor
NEWS2 is a valuable tool for appropriate clinical management of COVID-19 patients
Coronavirus disease 2019 (COVID-19) is a severe acute respiratory infection caused by an emergent coronavirus, SARS-CoV-2, recognized in Wuhan (China) in December 2019. The World Health Organization... more
From the CHA2DS2-VASc score to inflammation: a path leading to frailty? An update of the PURE-Rhythm Trial
Atrial fibrillation (AF) is the most frequently sustained arrhythmia diagnosed in elderly patients. AF is associated with an increased thrombo-embolic risk and with the development of heart failure... more
Comparative analysis of adropin concentration changes in response to kidney transplantation
Adropin acts as an energy regulator through lipid and glucose metabolism [1,2]. This 76 amino acid protein encoded by the ENHO (Energy Homeostasis Associated Gene) gene is primarily expressed in the... more
Prevalence and influence of gastroesophageal reflux symptoms on sleep apnea and sleepiness
To the Editor,
Home-based COVID 19 management: A consensus document from Italian general medical practitioners and hospital consultants in the Lombardy region (Italy)
The coronavirus disease 2019 (COVID-19) pandemic has infected more than 56,628,581 people causing 1,406,449 deaths worldwide, as of November 24, 2020. [1] Among the 17,131,853 active cases (November... more
Prognostic Implications of Residual Pleural Effusions at Discharge in Patients with Acute Decompensated Heart Failure
Pleural effusion, which is included as one of the Framingham minor diagnostic criteria for heart failure (HF), is one of the common signs reflecting body fluid retention and can be quickly and... more
Angiotensin-converting enzyme inhibitors versus angiotensin II receptor blockers for renal outcomes and mortality in diabetic kidney disease
Diabetic kidney disease (DKD) is the leading cause of end-stage renal disease (ESRD) worldwide. Inhibition of intrarenal renin-angiotensin system (RAS) with angiotensin-converting enzyme inhibitors (... more
Associating enterococcal endocarditis and colorectal neoplasia: is colonoscopy mandatory?
Dear Editor:
Sodium fluctuation, a novel single parameter to predict hospital mortality
Dysnatremia is the most common electrolyte disorder in hospitalized patients [1]. Dysnatremia is generally classified as hyponatremia (145mmol/L). Many studies showed that hypernatremia and... more
Prescription of interleukin-1 inhibitors in a French adult cohort of familial Mediterranean fever
Dear Editor,
The COVID-19 burden for health care professionals: Results of a global survey
At the end of December 2019, a novel coronavirus (SARS-CoV-2) started to spread in the city of Wuhan, Hubei province in China, first described as novel coronavirus [1,2]. Meanwhile, the current COVID... more
Risk of infectious events in acute myocardial infarction patients treated with ticagrelor or clopidogrel
Ticagrelor is an oral direct-acting antiplatelet agent that inhibits P2Y12 receptor activation. The PLATO study showed that ticagrelor significantly reduced the composite outcome of vascular death,... more
End-Stage renal disease and 30-day mortality for adults with and without COVID-19
Emerging evidence suggests that people with chronic kidney disease have a higher risk of severe infection with coronavirus disease 2019 (COVID-19) [1]. Furthermore, acute kidney injury is common... more
What changed in the Italian internal medicine and geriatric wards during the lockdown
Italy was the most affected European country in the first few weeks of the COVID-19 pandemic, with a dramatic burden on sub-intensive and intensive care units. Among the several arrangements... more
Time to speed up–the rate at which we correct hypernatremia
Hypernatremia is a common electrolyte disorder. It is defined as a serum sodium concentration > 145 mmol/L and is a hyperosmolar state in which there is a deficit in total body volume relative to... more
Temporal changes in co-morbidities and mortality in patients hospitalized for COVID-19 in Italy
In response to the growing pandemic of Coronavirus Disease 2019 (COVID-19) in Italy, the Italian government imposed a strict nationwide quarantine which began on March 9, 2020. The restrictive... more
Autoimmune disorders and venous thromboembolism: An update from the COMMAND VTE registry
There are various well-known predisposing risk factors for development of venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), and several studies reported... more
Determinants of circulating angiotensin-converting enzyme 2 protein levels in the general population
Similar to SARS-CoV, the novel coronavirus (SARS-CoV-2) uses the angiotensin-converting enzyme 2 (ACE2) receptor to infiltrate target cells [1]. Previous experimental study provided the genetic proof... more
Risk of thrombosis, pregnancy morbidity or death in antiphospholipid antibodies positive patients with or without thrombocytopenia
Antiphospholipid syndrome (APS) is an immune-mediated acquired disorder characterized by venous, arterial or small vessels thromboses and/or obstetrical morbidity, and the persistent presence of... more
Disease course in patients with systemic autoimmune diseases: insights on the safety of immunosuppression during the SARS-CoV-2 outbreak in Italy
From December 2019 the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), responsible for the Coronavirus Disease 2019 (COVID-19), has caused a pandemic, with over 28 million cases and... more
COMPASS vs PEGASUS approach in a comparative budget impact analysis.
The treatment of coronary artery disease (CAD), peripheral artery disease (PAD) and ischemic heart disease (IHD), has been radically modified in the recent past by the implementation of the results... more
Significant increase in the incidence of high-risk pulmonary embolism during the COVID-19 shutdown: The pandemic response causes serious collateral consequences
When the novel coronavirus disease (COVID-19) started to spread globally in December 2019 and COVID-19 related deaths continued to increase rapidly [1], the World Health Organization (WHO) declared a... more
Is the 2020 Sampson equation the best formula for LDL-C estimation?
Dear Editor,
Trans-catheter valve implantation and patient outcomes: Focus on the kidney
In 2012 the Kidney Disease Improving Global Outcomes organization published a guideline focused on the definition and management of acute kidney injury (AKI) [1] which became an important reference... more
Healthy and non healthy obese patients. The truth lies in the adipose tissue
Obesity is commonly correlated with metabolic complications such as insulin resistance, type 2 diabetes mellitus, dyslipidemia, arterial hypertension and metabolic syndrome that are significant risk... more
Cause of death and risk factors for mortality in AA amyloidosis: A French retrospective study
AA amyloidosis (AAA) is a major complication of chronic inflammation. It is the consequence of the deposition of fibrils of serum amyloid A protein (SAA) in tissues [1]. Lachman et al. prospectively... more
Renal failure after trans-catheter aortic valve implantation
Trans-catheter aortic valve implantation (TAVI) is by now considered the treatment of choice in patients with severe and symptomatic aortic stenosis deemed at prohibitive or high surgical risk.... more
Patterns of anticoagulation for atrial fibrillation in cancer patients referred to cardio-oncological evaluation
Prophylaxis of atrial fibrillation (AF)-related cardioembolism in oncology is often challenging [1]. The CHA2DS2-VASc score performs differently according to the presence or absence of cancer, with... more
Bowel resection reduces aortic pulse wave velocity in patients with ulcerative colitis. A longitudinal study
Ulcerative colitis (UC) is characterized by an involvement of the large bowel which leads to chronic systemic inflammation, increased aortic stiffness and reflected waves [1–4] and an excess of... more
Original Article
Impact of the number of comorbidities on cardiac sympathetic derangement in patients with reduced ejection fraction heart failure
Heart failure (HF) is a very prevalent condition associated with high morbidity and mortality rates, thus representing a relevant global health burden. It affects more than 26 million people... more
Cannabis is associated with blood pressure reduction in older adults – A 24-hours ambulatory blood pressure monitoring study
Background: Medical cannabis use is increasing rapidly in the past several years, with older adults being the fastest growing group. Nevertheless, the evidence for cardiovascular safety of cannabis... more
Validity of "Sepsis-3" criteria in identifying patients with community-onset sepsis in Internal Medicine wards; a prospective, multicenter study
Few data are available on the validity of “Sepsis-3” criteria in identifying patients with sepsis in internal medicine wards (IMWs). Real-life data about this topic and on the prevalence of sepsis in... more
Alcoholic liver disease and autoimmune hepatitis: Sometimes a closer look under the surface is needed
Differential diagnosis of autoimmune hepatitis (AIH) incorporates various liver diseases, including alcoholic liver disease (ALD). We report on clinical, laboratory and outcome characteristics of AIH... more
Non-retrieved inferior vena cava filters: causes and long-term follow-up
Inferior vena cava (IVC) filters are implantable devices created to trap thrombi from the lower extremities and prevent clinically significant pulmonary embolism (PE). According to guidelines, the... more
Predictors of mortality among adult, old and the oldest old patients with bloodstream infections: An age comparison
In recent years, incidence of bloodstream infections (BSIs) has been increasing worldwide, with over 1.2 million estimated episodes of BSI per year in Europe and around 600 000 in North America [1].... more
Long-term outcomes of postoperative atrial fibrillation following non cardiac surgery: A systematic review and metanalysis
New-onset atrial fibrillation (AF) in non-cardiac postoperative setting is common and is associated with a high risk of in-hospital mortality and morbidity. The long-term risks of stroke, mortality... more
Lung ultrasonography: a prognostic tool in non-ICU hospitalized patients with COVID-19 pneumonia.
From February to March 2020, Italy became the most affected country worldwide by coronavirus disease (COVID-19). Our healthcare system was put under enormous pressure, especially in Lombardia which... more
Efficacy and safety of rituximab biosimilar (CT-P10) in IgG4-related disease: an observational prospective open-label cohort study
IgG4-related disease (IgG4-RD) is an increasingly recognized immune-mediated disorder that can affect almost every organ system and cause severe damage if left untreated [1-5]. Clinical and... more
Prevalence and impact on outcome of sodium and potassium disorders in patients with community-acquired pneumonia: A retrospective analysis
Disorders of serum sodium and potassium are frequently encountered in hospitalized patients and patients presenting to the emergency department (ED) [1, 2].
Cardiac involvement in eosinophilic granulomatosis with polyangiitis (formerly Churg-Strauss syndrome): Prospective evaluation at a tertiary referral centre
Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis. Cardiac specific involvement (CSI) is caused by coronary artery vasculitis, but also by myocardial eosinophilic... more
The Atrial fibrillation Better Care (ABC) pathway and cardiac complications in atrial fibrillation: a potential sex-based difference. The ATHERO-AF study
An integrated care approach is recommended to optimize management of patients with atrial fibrillation (AF). The impact of the Atrial fibrillation Better Care (ABC) pathway on major adverse cardiac... more
Neuraminidase inhibitors are effective and safe in reducing influenza complications: meta-analysis of randomized controlled trials.
Influenza is an infection of variable severity resulting in high accumulated mortality worldwide [1]. Seasonal influenza deaths occur mainly in young children and the elderly, while during influenza... more
Is there excessive troponin testing in clinical practice? Evidence from emergency medical admissions
Troponin assays are a relatively common laboratory diagnostic request in emergency medical admissions. Following cardiac injury these macromolecules diffuse into the cardiac interstitium with... more
Negligible HCC risk during stringently defined untreated immune-tolerant phase of chronic hepatitis B
Among patients with chronic hepatitis B (CHB), a persistently high serum hepatitis B virus (HBV)-DNA level, a surrogate marker of active HBV replication in hepatocytes, is associated with an... more
The effect of COPD on the incidence and mortality of hospitalized patients with pulmonary embolism: A nationwide population-based study (2016-2018)
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world. It affects more than 10% of people over 40 years old and is expected to become the third leading... more
Home FIRsT: interdisciplinary geriatric assessment and disposition outcomes in the Emergency Department
With population ageing worldwide, the numbers of older people attending Emergency Departments (ED) continue to increase, which may lead to adverse operational and patient outcomes. [1] Older people... more
Non-classical clinical presentation at diagnosis by male celiac disease patients of older age
Celiac disease (CeD) is a complex immune-mediated disease that occurs in ̴1–2% of the Caucasian population [1]. In patients with CeD, ingestion of gluten peptides that are present in barley, wheat... more
Long-term recurrence risk after a first venous thromboembolism in men and women under 50 years old: A French prospective cohort
Venous thromboembolism (VTE) is a frequent and potentially life-threatening disease. Beyond the initial three months of anticoagulation, it is essential to evaluate accurately the recurrence risk of... more
Serum levels of C-terminal FGF23 (cFGF23) are associated with 1-year-mortality in patients undergoing transcatheter aortic valve replacement (TAVR)
The family of fibroblast growth factors (FGFs) was discovered in 1975 [1] and has since been investigated in numerous scientific studies. The FGFs comprise a group of 22 small polypeptides (... more
Prevalence, risk factors and proteomic bioprofiles associated with heart failure in rheumatoid arthritis: The RA-HF study
Rheumatoid Arthritis (RA) is a systemic chronic and progressive inflammatory disease, characterized by persistent synovitis and joint erosion [1]. It affects around 1% of the general population and... more
Hypernatremia and moderate-to-severe hyponatremia are independent predictors of mortality in septic patients at emergency department presentation: A sub-group analysis of the need-speed trial
Early risk stratification of septic patients admitted to the Emergency Department (ED) is challenging [1,2] since signs and symptoms may be similar for patients who will have either a favorable or an... more
Interleukin-6 receptor blockade with subcutaneous tocilizumab improves coagulation activity in patients with COVID-19
A considerable proportion of patients with Coronavirus Disease 2019 (COVID-19) presents with a hypercoagulable state which may increase the risk of thromboembolic complications [1]. The most typical... more
Pre-operative physical performance as a predictor of in-hospital outcomes in older patients undergoing elective cardiac surgery
Improved surgical techniques and intensive care management have dramatically reduced perioperative complications and mortality after cardiac surgery over the last two decades [1]. Therefore,... more
Serum uric acid and mortality thresholds among men and women in the Irish health system: A cohort study
It is widely considered that serum uric acid (SUA), the final breakdown product of purine metabolism in humans, may represent a major cardiovascular risk factor and contribute to adverse health... more
Mobile health technology-supported atrial fibrillation screening and integrated care: A report from the mAFA-II trial Long-term Extension Cohort
The priorities of atrial fibrillation management include stroke prevention, decisions on rate or rhythm control and proactive management of comorbidities, as well as lifestyle changes. Given that... more
Sex-specific outcomes and management in critically ill septic patients
Sepsis is a life-threatening condition triggered by an “out-of-proportion” immune response to an infection [1]. Septic patients have low survival rates, and research to refine and individualize... more
Enterococcal infective endocarditis is a marker of current occult or future incident colorectal neoplasia
Streptococcus gallolyticus and Enterococcus species are members of the gut microbiota and a major cause of infective endocarditis (IE), mainly affecting elderly subjects with digestive or urinary... more
Trends and outcomes of device-related 30-day readmissions after left ventricular assist device implantation
Newer generation, continuous-flow left ventricular assist devices (LVAD) have been introduced for use in end-stage heart failure as a bridge to transplant therapy or destination therapy, leading to... more
Consumer-led screening for atrial fibrillation using consumer-facing wearables, devices and apps: A survey of health care professionals by AF-SCREEN international collaboration
Atrial fibrillation (AF) is the most common sustained arrhythmia diagnosed in clinical practice, with an incidence that increases in the elderly [1,2] and a prevalence of diagnosed AF that is... more
Seventeen-year trend (2001–2017) in pacemaker and implantable cardioverter-defibrillator utilization based on hospital discharge database data: An analysis by age groups
National Registries are needed to monitor health care interventions, optimize the resources and utilize them appropriately [1], but are challenging to implement and manage due to the possible lack... more
Long-term effects of non-retrieved inferior vena cava filters on recurrences of venous thromboembolism in cancer and non-cancer patients: From the COMMAND VTE registry
There is a paucity of data comparing the long-term outcomes after inferior vena cava (IVC) filters placement for patients with acute venous thromboembolism (VTE) between those with and without active... more
Baseline and incident hypochloremia in chronic heart failure outpatients: Clinical correlates and prognostic role
Abnormalities in serum electrolyte levels often complicate heart failure (HF) disease in acute (ADHF) and chronic (CHF) settings. Serum sodium has long been considered the most important electrolyte... more
Impact of non-selective ß-blockers on hepatic encephalopathy in patients with liver cirrhosis
Liver cirrhosis accounts for over one million deaths per year worldwide [1]. Hepatic encephalopathy (HE) - one of its most severe complications - is a brain dysfunction mainly caused by liver... more
Use of hydroxychloroquine in hospitalised COVID-19 patients is associated with reduced mortality: Findings from the observational multicentre Italian CORIST study
Hydroxychloroquine (HCQ) was proposed as potential treatment for COVID-19.
Definition of tachycardia for risk stratification of pulmonary embolism
Acute pulmonary embolism (PE) is the most serious manifestation of venous thromboembolism (VTE) and a major cause of mortality, morbidity and hospitalization in Western countries [1]. Acute right... more
Gastric regurgitation predicts neurological outcome in out-of-hospital cardiac arrest survivors
Neurological prognostication after out-of-hospital cardiac arrest (OHCA) is challenging due to the lack of early and reliable predictors for clinically relevant brain damage [1]. The identification... more
Screening for nonalcoholic fatty liver disease in patients with type 2 diabetes mellitus using transient elastography - a prospective, cross sectional study
The number of people suffering from type 2 diabetes (T2DM) and obesity around the world has significantly increased during the past several decades due to changes in eating habits and sedentary... more
Prognostic impact of Vitamin D deficiency in patients with coronary artery disease undergoing percutaneous coronary intervention
Vitamin D (25(OH)D) is a fat-soluble vitamin, representing not only the principal modulator of calcium and bone homeostasis, but also a key-hormone, regulating the transcription of about 2000 to 8000... more
How many urinalysis and urine cultures are necessary?
Low-value care is defined as a test or treatment that is unlikely to benefit the patient given the cost, available alternatives, and preferences of patients, [1] and can even cause harm to patients [... more
ETNA VTE Europe: A contemporary snapshot of patients treated with edoxaban in clinical practice across eight European countries
Venous thromboembolism (VTE) encompasses both deep vein thrombosis (DVT) and pulmonary embolism (PE). It has an incidence of approximately 1–2 per 1,000 person-years in Europe [1]. While both events... more
Pharmacist-driven medication recognition/ reconciliation in older medical patients
Older patients, the largest fraction of those acutely admitted to hospital medical wards, are often affected by multiple chronic diseases, that are in turn associated with the intake of multiple... more
Low Creatinine Potentially Overestimates Glomerular Filtration Rate in Older Fracture Patients: A Plea for an Extensive Use of Cystatin C?
The correct evaluation of renal function is crucial in clinical practice for diagnosis (e.g., imaging with contrast agents), treatment (e.g., drug dosing) and prognostic assessment (e.g., clinical... more
Impact of admission serum acid uric levels on in-hospital outcomes in patients with acute coronary syndrome
High levels of serum uric acid (SUA) have been showed to increase the risk of cardiac adverse events, independently of traditional cardiovascular risk factors [1,2]. Hyperuricemia has been also... more
The CHA2DS2-VASc score and Geriatric Multidimensional Assessment tools in elderly patients with persistent atrial fibrillation undergoing electrical cardioversion. A link with arrhythmia relapse?
The CHA2DS2-VASc is a clinical score used in everyday clinical practice to evaluate thrombo-embolic risk in patients with atrial fibrillation (AF) [1], and the guidelines for the management of AF... more
Review
Multiparametric assessment of “fluid status” in heart failure
The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.ejim.2017.09.016. The duplicate article has therefore... more
Review Article
Mechanisms of weight regain.
Obesity is a chronic progressive disease with a high tendency to recidivism. Weight regain is frequent after any attempts of voluntary weight loss [1]. Weight regain is frequently attributed to the... more
The Brain-Gut-Microbiotal Axis: A framework for understanding functional GI illness and their therapeutic interventions
At the core of the BGA is a bidirectional network of communication between the central nervous system (CNS-brain, spinal cord) and the sensory and effector nerve complexes of the GI tract (Figure 1... more
Gastroprotection in patients on antiplatelet and/or anticoagulant therapy: a position paper of National Association of Hospital Cardiologists (ANMCO) and the Italian Association of Hospital Gastroenterologists and Endoscopists (AIGO)
Aspirin and P2Y12 receptor antagonists are widely used across the spectrum of cardiovascular and cerebrovascular diseases. Gastrointestinal complications, including ulcer and bleeding, are relatively... more
How does SARS-CoV-2 targets the elderly patients? A review on potential mechanisms increasing disease severity
On November 18th 2020, there have been over 55 million confirmed cases of SARS-CoV-2 infection causing COVID-19, with up to 1.3 million deaths worldwide. In the Netherlands alone, there are up to 8,... more
Transthyretin amyloid cardiomyopathy: An uncharted territory awaiting discovery
Amyloidosis represents a largely unexplored field in medicine, with many grey areas remaining. The search for the mechanism triggering protein misfolding has been an important research topic for many... more
Incidence of acute pulmonary embolism in COVID-19 patients: Systematic review and meta-analysis.
The outbreak of coronavirus disease 2019 (COVID-19) remains a severe public health emergency of international concern. Over the past months, several investigations have suggested an association... more