January 2022

136 Articles

No Section

Efficacy and safety of therapeutic vs. prophylactic bemiparin in noncritically ill patients with COVID-19 pneumonia.

20 January 2022
Author(s): Jose F Varona, Elena Núñez, Borja M. Fernández Félix, Jose María Castellano Vázquez, Antonio Cubillo

Thrombotic and thromboembolic phenomena are one of the leading complications and causes of poor outcomes in COVID-19 patients admitted to hospital (1). In the pathophysiology of pulmonary and... more

Uric acid is associated with acute heart failure and shock at presentation in ACS patients

17 January 2022
Author(s): Paola Rebora, Marco Centola, Nuccia Morici, Alice Sacco, Giuseppe Occhino, Giovanna Viola, Jacopo Oreglia, Diego Castini, Simone Persampieri, Ludovico Sabatelli, Giulia Ferrante, Stefano Lucreziotti, Stefano Carugo, Maria Grazia Valsecchi, Fabrizio Oliva, Cristina Giannattasio, Alessandro Maloberti

Uric Acid (UA) has been related to the development of fatal and non-fatal Cardio-Vascular (CV) events in the general population [1] as well as in patients experiencing an Acute Coronary Syndromes (... more

Derivation and validation of the NAFLD Cirrhosis Score (NCS) to distinguish bridging fibrosis from cirrhosis

17 January 2022
Author(s): Christian Labenz, Gerrit Toenges, Ming-Hua Zheng, Dora Ding, Robert P. Myers, Peter R. Galle, Angelo Armandi, Javier Ampuero, Manuel Romero Gómez, Elisabetta Bugianesi, Quentin M. Anstee, Jörn M. Schattenberg

Non-alcoholic fatty liver disease (NAFLD) has become a major health burden [1]. Among the large group of patients that are affected, the subgroup progressing to end-stage disease exhibits the highest... more

Secondary hyperaldosteronism and liver fibrosis in patients with compensated chronic liver disease or portal hypertension

15 January 2022
Author(s): Giovanni Vitale, Kimberly Coscia, Guido Zavatta, Maria Cristina Morelli, Valentina Vicennati

Among edematous disorders, liver cirrhosis (LC) is considered one of the main models of secondary hyperaldosteronism (SH), as pointed out by several studies in the past [1]. Aldosterone is expected... more

Associations between post-discharge medical consultations and 30-day unplanned hospital readmission: A prospective observational cohort study

13 January 2022
Author(s): Gregor John, Loïc Payrard, Jacques Donzé

Early readmission after hospital discharge is frequent, partly preventable, and puts a heavy burden on healthcare systems [1,2]. Many risk factors—like adverse drug events [3], physician workload [4... more

Heart failure with preserved ejection fraction: Squaring the circle between comorbidities and cardiovascular abnormalities

12 January 2022
Author(s): Alberto Maria Marra, Leonardo Bencivenga, Roberta D'Assante, Giuseppe Rengo, Antonio Cittadini

The original descriptions of Heart Failure (HF) with preserved ejection fraction (HFpEF) dates back to the mid-1980s, and, for approximatively a decade, studies on this HF subtype consisted of... more

COVID-19 Infection Survivors and the Risk of Depression and Anxiety Symptoms: A Nationwide Study of Adults in the United States

11 January 2022
Author(s): Jagdish Khubchandani, James H. Price, Sushil Sharma, Fern J. Webb

Recently, media reports and scientific publications have started highlighting the long-term sequalae of COVID-19 infections. A wide variety of persistent symptoms such as respiratory distress, cough... more

Abdominal aortic aneurysm and gas in the kidney in a diabetes patient

10 January 2022
Author(s): Yueming Liu, Mian Ren, Yicheng Huang

A 65-year-old man was admitted to our emergency department with a 12-day history of nausea and a progressive backache, and an 8-day history of dysuria with low-grade fever. He had been diagnosed with... more

Palpitations in a middle-aged male… Searching a needle in a haystack

10 January 2022
Author(s): Abhishek Thakur, Anish Kapil, Sandeep Singh

A gentleman in his 50s presented with episodes of intermittent palpitations which were self-limiting. His symptoms were not related to exertion and had short duration with sudden onset and offset. He... more

Appropriate dosing of the individual direct oral anticoagulants in atrial fibrillation: Differences in the questions to be answered

7 January 2022
Author(s): Andrea Rubboli, Nuccia Morici, Gregory Y.H. Lip

Direct oral anticoagulants; Apixaban; Dabigatran; Edoxaban; Rivaroxaban

High-sensitivity troponins for outcome prediction in the general population: a systematic review and meta-analysis

7 January 2022
Author(s): Alberto Aimo, Georgios Georgiopoulos, Giorgia Panichella, Giuseppe Vergaro, Claudio Passino, Michele Emdin, Aldo Clerico

High-sensitivity (hs) assays allow to measure cardiac troponin T and I (cTnT/I) even in healthy individuals. The higher hs-cTn values, the higher the ongoing cardiomyocyte damage, and then reasonably... more

Acute abdominal pain following esophagogastroduodenoscopy

7 January 2022
Author(s): Takashi Oshima, Hiroyuki Yano, Mitsuyo Kinjo

A 48-year-old man developed abdominal pain and vomiting twelve hours after esophagogastroduodenoscopy. He had lost 4.4 kg while being treated for a gluteal muscle abscess two months prior, and then... more

Segmental anhidrosis and heat intolerance

7 January 2022
Author(s): Valentin Lacombe, Christian Le Clec'h

A 62 year-old woman with no previous medical history presented to the Dermatology department with sweating disorders for several years. She described segmental hyperhidrosis and hyperemia while... more

Convalescent plasma for COVID-19. TSUNAMI is not the final word

6 January 2022
Author(s): Massimo Franchini, Daniele Focosi, Arturo Casadevall, Michael J. Joyner, Cesare Perotti

We read with interest the paper by Menichetti and colleagues recently published in the European Journal of Internal Medicine, which allows us to make some considerations [1].

Darier's sign

6 January 2022
Author(s): Ivan Krečak, Ivana Karaman, Sanja Jakelić

A 38-year-old Caucasian male presented with a ten-year history of back pains, dyspepsia and allergic rhinitis and conjunctivitis treated with non-steroidal antirheumatic drugs and on-demand... more

One-year mepolizumab for Allergic bronchopulmonary aspergillosis: Focus on steroid sparing effect and markers of response

6 January 2022
Author(s): Marco Caminati, Veronica Batani, Lucia Guidolin, Giuliana Festi, Gianenrico Senna

Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction to Aspergillus fumigatus, mainly characterized by severe asthma symptoms, hyper eosinophilia in blood, lung and... more

Real world comparison of spironolactone and eplerenone in patients with heart failure

6 January 2022
Author(s): Patricia Pardo-Martínez, Eduardo Barge-Caballero, Alberto Bouzas-Mosquera, Gonzalo Barge-Caballero, David Couto-Mallón, María J. Paniagua-Martín, Marta Sagastagoitia-Fornie, Óscar Prada-Delgado, Javier Muñiz, Luis Almenar-Bonet, José M. Vázquez-Rodríguez, María G. Crespo-Leiro

Mineralocorticoid receptor antagonists (MRA) play a central role in the therapeutic scheme recommended for patients with heart failure and reduced left ventricular ejection fraction (HFrEF). Three... more

An unusual cause of colitis

5 January 2022
Author(s): Yusaku Kajihara

An 81-year-old Japanese woman presented to the author's department with acute abdominal pain and nausea. Laboratory evaluation showed a white-cell count of 13,270 cells/mm3 (Reference range, 3500–... more


5 January 2022
Author(s): Shuhei Takeyama, Nobuya Abe, Tatsuya Atsumi

A 30-year-old woman manifested fatigue and high fever. She was diagnosed with antiphospholipid antibodies positive-systemic lupus erythematosus (SLE), but she had never demonstrated any serious organ... more

SARS-CoV-2 antibody response eight months after vaccination with mRNA vaccines. Influence of prior SARS-CoV-2 exposure

4 January 2022
Author(s): Jesús Fernando García-Cruces-Méndez, Luis Corral-Gudino, María Piedad Del-Amo-Merino, José María Eiros-Bouza, Marta Domínguez-Gil González

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appeared in late 2019. Since then, SARS-CoV-2 spread worldwide and led to a health crisis due to coronavirus disease (COVID-19). To... more

“Which one should I choose, a glucagon-like peptide-1 receptor agonist or a sodium−glucose cotransporter 2 inhibitor? Or maybe both?”

27 December 2021
Author(s): Dimitrios Patoulias, Christodoulos Papadopoulos, Asterios Karagiannis, Michael Doumas

In a recently published narrative review article authored by Gomez-Huelgas and colleagues, authors propose an interesting treatment algorithm, based on the cardiovascular and renal protection offered... more

Admissions in a medical ward and factors independently associated with mortality

24 December 2021
Author(s): Petros Ioannou, Stamatis Karakonstantis, Diamantis P Kofteridis

Admission to a medical ward is commonly used for the management of conditions that are not amenable to outpatient management, either due to the need for specialized care or for practical reasons,... more

Glucocorticoid sparing in sarcoidosis using the JAK inhibitor tofacitinib

23 December 2021
Author(s): Collaborative group: MI study group

There is an unmet medical need to provide novel treatments with high efficiency and low side effects in patients with sarcoidosis resistant to glucocorticoids or second-line therapies (methotrexate,... more

Interstitial pneumonia with autoimmune features: Evaluation of connective tissue disease incidence during follow-up

22 December 2021
Author(s): Paul Decker, Vincent Sobanski, Thomas Moulinet, David Launay, Eric Hachulla, Victor Valentin, Benoit Godbert, Sabine Revuz, Anne Guillaumot, Emmanuel Gomez, François Chabot, Lidwine Wémeau, Roland Jaussaud

Interstitial lung diseases (ILD) are a heterogenous group of diseases characterized by diffuse abnormal deposition of collagen matrices in the pulmonary parenchyma [1,2]. Interstitial lung diseases (... more

The age-adjusted D-dimer cutoff level to rule out pulmonary embolism in patients with syncope

21 December 2021
Author(s): Eyal Fuchs, Emilia Hardak, Anat Keren-Politansky, Ron Hoffman, Inna Tzoran

Syncope is one of the most common main complaints, requiring emergency department (ED) evaluations, and among the most insidious and life-threatening conditions that are attributed to pulmonary... more

Prediction of ischemic stroke in different populations: a comparison of absolute stroke risk and CHA2DS2-VASc in real-world and clinical trial patients

21 December 2021
Author(s): José Miguel Rivera-Caravaca, Wern Yew Ding, Francisco Marín, Vanessa Roldán, Gregory Y.H. Lip, Christina J.-Y. Lee MD, PhD; Christian Torp-Pedersen MD, DMSc

The CHA2DS2-VASc score is one of the most validated risk tools in atrial fibrillation (AF) [1], and remains a simple and practical clinical score to aid decision-making. However, it has limitations... more

Real-life data on the impact of successful downstaging in patients with hepatocellular carcinoma: A Dutch Multicenter Study

21 December 2021
Author(s): Annelotte G.C. Broekhoven, Marta Fiocco, Dave Sprengers, R. Bart Takkenberg, Suzanne van Meer, Karel J. van Erpecum, Dewkoemar Ramsoekh, Hein W. Verspaget, Mark C. Burgmans, Susanne Osanto, Andrzej G. Baranski, Bart van Hoek, Minneke J. Coenraad

Hepatocellular Carcinoma

Correlation of non-invasive oxygenation parameters with paO2/FiO2 ratio in patients with COVID-19 associated ARDS

20 December 2021
Author(s): Giacomo Zaccagnini, Andrea Berni, Filippo Pieralli

COVID-19 associated ARDS (CARDS) is defined as a new-onset respiratory failure with bilateral, non-cardiogenic pulmonary infiltrates, and a paO2/FiO2 ratio (P/F) ≤ 300 mmHg is the most severe... more

Venous thromboembolism during pregnancy and postpartum period

20 December 2021
Author(s): Syed Bukhari, Shumail Fatima, Amr F. Barakat, Annemarie E. Fogerty, Ido Weinberg, Islam Y. Elgendy

The maternal mortality rates in the United States (US) remain the highest among developed countries, and continue to rise (1). Cardiovascular diseases are the leading etiology of maternal deaths in... more

Willingness to participate in a lung cancer screening program: Patients’ attitudes towards USPSTF recommendations

20 December 2021
Author(s): Narjes Zarei Jalalabadi, Besharat Rahimi, Morteza Foroumandi, Alexandra Lackey, Soheil Peiman

Like many other cancers, the prognosis of lung cancer largely depends on the stage of cancer at the time of diagnosis and early detection could significantly improve cancer-related morbidity and... more

The relevance of nutritional and metabolic derangements in COVID-19 patients

20 December 2021
Author(s): Alessio Molfino, Giovanni Imbimbo, Maurizio Muscaritoli

Dear Editor,

The impact of nutrition on cancer prevention in Europe: From the bench to the Parliament

12 December 2021
Author(s): Christos Tsagkaris, Dimitrios V. Moysidis, Andreas S. Papazoglou, Anna Loudovikou, Gizem Acar

Dear Editor,

Diagnosis is a probabilistic estimate of disease. A dynamic approach to diminish resource overuse

11 December 2021
Author(s): António Vaz Carneiro

Clinical reasoning (mostly diagnostic reasoning) is made of two sequential steps: firstly, problem-solving - estimating disease probabilities through information from the physical exam and sequential... more

Factors associated with persistence of symptoms 1 year after COVID-19: A longitudinal, prospective phone-based interview follow-up cohort study

5 December 2021
Author(s): Carlo Fumagalli, Chiara Zocchi, Luigi Tassetti, Maria Vittoria Silverii, Carla Amato, Luca Livi, Lorenzo Giovannoni, Federica Verrillo, Alessandro Bartoloni, Rossella Marcucci, Federico Lavorini, Stefano Fumagalli, Andrea Ungar, Iacopo Olivotto, Laura Rasero, Francesco Fattirolli, Niccoló Marchionni, AOU Careggi COVID-19 Follow-up study Group

Since the beginning of the SARS-CoV-2 pandemic and its disease (COVID-19), over 200 million cases of infection and 4.37 million deaths have been reported world-wide [1,2]. While the most common acute... more

Clinical significance of Staphylococcus aureus bacteriuria

3 December 2021
Author(s): Queralt Jordano, Ainhoa Garcia, Clara Gallego, Mariona Xercavins, Helena Monzon

Dear editor

Short term blood pressure alterations in recently COVID-19 vaccinated patients

28 November 2021
Author(s): Elias Sanidas, Theoharis Anastasiou, Dimitrios Papadopoulos, Maria Velliou, Marina Mantzourani

The global medical community supports that vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is crucial for reaching the herd immunity threshold needed to curb the... more

Phenotyping congestion in patients with acutely decompensated heart failure with preserved and reduced ejection fraction: The Decongestion duRing therapY for acute decOmpensated heart failure in HFpEF vs HFrEF- DRY-OFF study

26 November 2021
Author(s): C Cogliati, E Ceriani, G Gambassi, G De Matteis, S Perlini, T Perrone, ML Muiesan, M Salvetti, F Leidi, F Ferrara, C Sabbà, P Suppressa, A Fracanzani, N Montano, E Fiorelli, G Tripepi, M Gori, A Pitino, A Pietrangelo

Acute decompensation of heart failure (ADHF) is the most common reason for hospitalization in patients above the age of 65 years in Western countries [1]. It imposes a significant burden both on... more

Associations of Post-Acute COVID syndrome with physiological and clinical measures 10 months after hospitalization in patients of the first wave

25 November 2021
Author(s): Anna Staudt, Rudolf A. Jörres, Thilo Hinterberger, Nadine Lehnen, Thomas Loew, Stephan Budweiser

Since the beginning of the COVID-19 pandemic in 2020, in Germany almost 3.8 million inhabitants have been positively tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1], and... more

Colchicine for the prevention of COVID-19 “hard” outcomes: All that glitters is not gold

24 November 2021
Author(s): Dimitrios Patoulias, Christodoulos Papadopoulos, Asterios Karagiannis, Michael Doumas

In a paper recently published in the European Journal of Internal Medicine, Schattner provided a thorough and in-depth review regarding the multiple, pleiotropic effects of colchicine, also... more

Procedural myocardial infarction and major myocardial injury after percutaneous coronary interventions in chronic coronary syndrome: Is the fog really waning?

18 November 2021
Author(s): Stefano De Servi, Antonio Landi

Procedural myocardial infarction (MI) is among the components of major endpoints of several trials evaluating the effects of different treatment strategies, intracoronary devices and/or drugs in... more

Glucagon-like peptide-1 receptor agonists and sodium−glucose cotransporter 2 inhibitors for cardiovascular and renal protection: A treatment approach far beyond their glucose-lowering effect

16 November 2021
Author(s): Ricardo Gómez-Huelgas, Jaime Sanz-Cánovas, Lidia Cobos-Palacios, Almudena López-Sampalo, Luis M. Pérez-Belmonte

Type 2 diabetes (T2D) is a major risk factor for cardiovascular disease (CVD) [1]. The presence of CVD has been described as the main cause of death among individuals with T2D and is associated with... more

Trends and outcomes of opioid-related cardiac arrest in a contemporary US population

16 November 2021
Author(s): Senada S. Malik, Wilbert S. Aronow, Alexandros Briasoulis

Opioid abuse is a worldwide public health issue, and deaths related to opioid abuse are increasing. We aimed to investigate trends, predictors, and outcomes of cardiac arrest in patients with opioid... more

Representativity of women and racial/ethnic minorities in randomized clinical trials on bempedoic acid: Positive efforts and lacking data

13 November 2021
Author(s): Federica Fogacci, Davide Gori, Arrigo F.G. Cicero

Even though today there is recognition of the need to proportionally include in clinical trials and prospectively evaluate women and racial minorities through all phases of drug development, in... more

Infective endocarditis, is there a goal beyond antibiotics and surgery?

12 November 2021
Author(s): Benoit Guery, Matthaios Papadimitriou-Olivgeris

In the vast majority of infectious diseases, the primary endpoint to evaluate an intervention relies on short terms variables and, when relevant, in-hospital mortality, or 28 days mortality. In most... more

Learning in times of stress: Lessons from COVID-19 that will last throughout this century

11 November 2021
Author(s): Paula Jiménez-Fonseca, Ramón Salazar, Vicent Valentí, Alberto Carmona-Bayonas, Giancarlo Agnelli

Systems tend toward inertia until an external pressure pushes them toward change; thus, a situation of crisis such as the COVID-19 pandemic represents an opportunity for technological innovation. The... more

Mobile stroke unit is not a stroke unit

11 November 2021
Author(s): Stefano Ricci, Danilo Toni, Mauro Silvestrini

Dear Editor,

Hematuria and subsequent long-term risk of end-stage kidney disease: A Danish population-based cohort study

11 November 2021
Author(s): Kristine Fogh, Søren Viborg Vestergaard, Christian Fynbo Christiansen, Lars Pedersen, Dorothea Nitsch, Mette Nørgaard

Hematuria is a frequent incidental clinical finding and may be a symptom of pre-existing underlying benign or malignant urinary tract or kidney disease. However, in patients with no apparent... more

Anakinra in COVID-19: A step closer to the cure

10 November 2021
Author(s): Fotios Barkas, Eirini Christaki, Evangelos Liberopoulos, Maria Kosmidou, Haralampos Milionis

Acute respiratory distress syndrome and cytokine release syndrome are the major complications of coronavirus disease 2019 (COVID-19) associated with increased mortality risk [1]. Apart from... more

Optimal duration of anticoagulation therapy for venous thromboembolism in autoimmune diseases

9 November 2021
Author(s): Yugo Yamashita, Takeshi Morimoto, Takeshi Kimura

Venous thromboembolism (VTE) is a common issue in patients with autoimmune diseases. One of the clinically relevant issues for VTE in autoimmune disorders is the optimal duration of anticoagulation... more

Hydroxichloroquine for COVID-19 infection: Do we have a final word after one year?

26 October 2021
Author(s): Augusto Di Castelnuovo, Simona Costanzo, Alessandro Gialluisi, Licia Iacoviello, Giovanni de Gaetano

The results presently available from randomised clinical trials and their meta-analysis indicate that Hydroxychloroquine is not associated in COVID-19 patients with either decreased mortality or... more

Serum IgG4 elevation in hyper-inflamed COVID-19 patients. Author's reply

21 October 2021
Author(s): Emanuel Della-Torre, Marco Lanzillotta, Giuseppe Alvise Ramirez, Lorenzo Dagna, Moreno Tresoldi

Dear Editor, we thank Dulak and Trzciński for their insightful and pertinent comments on our observation about serum IgG4 levels predicting mortality in hospitalized patients affected by Coronavirus... more

Outcomes of patients with heart failure with preserved ejection fraction discharged on treatment with neurohormonal antagonists after an episode of decompensation

24 August 2021
Author(s): Josep Tost, Pere Llorens, Gad Cotter, Beth Davison, Javier Jacob, Víctor Gil, Pablo Herrero, Francisco Javier Martín-Sánchez, Ruxandra Donea, Beatriz Rodríguez, Francisco Javier Lucas-Imbernon, Juan Antonio Andueza, Ana Belén Mecina, Raquel Torres-Gárate, Pascual Piñera, Aitor Alquézar-Arbé, Begoña Espinosa, Alexandre Mebazaa, Ovidiu Chioncel, Òscar Miró, ICA-SEMES group

To analyze the frequency with which patients with heart failure with preserved ejection fraction (HFpEF) discharged after an acute heart failure (AHF) episode are treated with antineurohormonal drugs... more

A metabolomic index based on lipoprotein subfractions and branched chain amino acids is associated with incident hypertension

25 July 2021
Author(s): Jose L. Flores-Guerrero, Margery A. Connelly, Irina Shalaurova, Erwin Garcia, Stephan J.L. Bakker, Robin P.F. Dullaart

Hypertension is the leading preventable risk factor for cardiovascular disease (CVD) and all-cause mortality worldwide, with a sustained increment in mortality over the last 40 years [1]. Over the... more

A year later

Anticoagulant therapy for COVID-19: What we have learned and what are the unanswered questions?

10 November 2021
Author(s): Dimitrios Giannis, James D. Douketis, Alex C. Spyropoulos

Venous thromboembolism (VTE), which comprises deep vein thrombosis (DVT) and pulmonary embolism (PE), and arterial thromboembolism (ATE), which includes myocardial infarction, ischemic stroke,... more

Beyond the Guidelines

Pulmonary embolism – An EFIM guideline critical appraisal and adaptation for practicing clinicians

11 December 2021
Author(s): Cecilia Becattini, Valentin A. Kokorin, Wiktoria Lesniak, Ignacio Marin-Leon, Francisco J. Medrano, Laura Morbidoni, Alberto M. Marra, Ewelina Biskup, Antoni Riera-Mestre, Dror Dicker

Pulmonary embolism (PE) is the third most common cardiovascular disease with an incidence of 100–200 cases per 100,000 population per year. Moreover, the incidence rates of PE have been increasing... more

Clinical Insights

Does early systemic sclerosis really exist?

27 December 2021
Author(s): Andrés González-García, José Luis Callejas-Rubio

Systemic sclerosis (SSc) is an autoimmune systemic disease of unknown origin, characterized by sclerosis of the skin and internal organs associated with endothelial dysfunction, immune dysregulation... more

Management of COVID patients with convalescent plasma: Do we have the final word?

30 November 2021
Author(s): Francesco Menichetti, Marco Falcone, Giusy Tiseo

Immunotherapy with convalescent plasma (CP) has been used in the past in several infectious diseases (influenza, SARS, MERS) with the aim to shorten or stop the phase of viral replication and to... more

Predicting adverse outcomes in patients with COVID-19: just an epidemiological debate or a valuable clinical approach?

22 October 2021
Author(s): Xavier Corbella

On February 16, 2020 the executive committee of the European Federation of Internal Medicine (EFIM) met in Malaga, Spain, to prepare for the EFIM annual congress to be held in March 2021. As usual,... more


Gender distribution in boards of internal medicine societies and paper authorship: Networking is the key to success

8 January 2022
Author(s): Francesca Rubulotta, Cristina Santonocito, Giorgia Rubulotta

Networking is about building long-term relationships as well as a good reputation over time. Active professional networking is vital to career growth as it involves meeting people who you can support... more

Surprising outcomes of general internal medicine care versus specialty care in acutely admitted medical patients

6 January 2022
Author(s): Marcel Levi

Biomedical knowledge, resulting in better treatment for patients, is accumulating at a breathtaking pace. As these developments occur, in some situations medicine gets increasingly complex, requiring... more

The effect of telemedicine in heart failure based on frailty phenotypes

16 December 2021
Author(s): A Driscoll, S Cartledge

Heart failure (HF) is a disease of the elderly. In people aged>65years, it is the most common cause of rehospitalisations [1]. Nearly half of the patients diagnosed with HF will be frail (44.5%,... more

Rheumatoid arthritis patients “al nostro cuore”

13 December 2021
Author(s): José A. Gómez-Puerta, Raimon Sanmartí

Rheumatoid arthritis (RA) constitutes one of the main inflammatory chronic diseases which can lead to important disability and an inflammatory burden including a higher risk of cardiovascular (CV)... more

Nephrotoxicity: A growing problem or an exaggerated fear with unpredictable dimensions?

25 November 2021
Author(s): Neriman Sıla Koç, Mustafa Arici

Nephrotoxicity is not only a simple matter of a sudden rise in creatinine followed by a return to normal. In many cases, this scenario may be seen without any permanent damage, but in others an acute... more

Tocilizumab in severe COVID-19: A promise fulfilled

21 November 2021
Author(s): Marcel Levi

A proportion of patients who are infected with SARS-CoV-2 develop severe disease. Apart from a serious bilateral pneumonia organs other than the lungs may become involved as well. The clinical... more

Anticoagulation for stroke prevention after embolic stroke of undetermined source of presumably cardiac source: The sail to Ithaca

26 October 2021
Author(s): Dimitrios Sagris, George Ntaios

During the last decade, the term embolic stroke of undetermined source (ESUS) was introduced in a pursue to standardized diagnostic workup in a more targeted sub-population of cryptogenic stroke... more

Concise report

Off-label use of biologics for the treatment of refractory and/or relapsing granulomatosis with polyangiitis

26 October 2021
Author(s): C. Mettler, CA. Durel, P. Guilpain, B. Bonnotte, F. Cohen-Aubart, M. Hamidou, JC. Lega, V. Le Guern, F. Lifermann, V. Poindron, G. Pugnet, A. Servettaz, X. Puéchal, L. Guillevin, B. Terrier, French Vasculitis Study Group

Granulomatosis with polyangiitis (GPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAVs), characterized by granulomatous necrotizing vasculitis of small vessels [1].... more


The 2021 ESC guidelines on cardiovascular prevention: Whether the ends justify the means

22 November 2021
Author(s): Claudio Cimminiello, Charalambos Vlachopulos, Marco De Carlo

In chapter XVIII of "The Prince", the Florentine political theorist Niccolò Machiavelli wrote “in the actions of all men, and especially of princes, which it is not prudent to challenge, one judges... more

One year later: The case of tocilizumab in COVID-19

22 October 2021
Author(s): Corrado Campochiaro, Alessandro Tomelleri, Marco Matucci-Cerinic, Lorenzo Dagna

In severe coronavirus disease 2019 (COVID-19) patients, SARS-CoV-2 infection induces a systemic immune activation characterized by an afinalistic release of inflammatory cytokines [1,2]. This... more

Ideas and Opinions

Should the European Union have an office of research integrity?

3 August 2021
Author(s): C Candal-Pedreira, A Ruano-Ravina, M Pérez-Ríos

Scientific misconduct is detrimental to both society and researchers, potentially resulting in a mistrust in science. When the results of a scientific publication are based on erroneous content or... more

Internal Medicine Flashcard

A diagnosis at hand

10 January 2022
Author(s): Giorgia Protti, Fabrizio Elia, Franco Aprà

A 45-year-old man was found unconscious on the sidewalk and brought to the Emergency Department. He could not provide anamnestic information, but the hospital electronic archive revealed he was... more

A diagonal earlobe crease

10 January 2022
Author(s): Yusaku Kajihara

A 67-year-old man had a medical history of type 2 diabetes mellitus, dyslipidemia, hypertension, and alcohol-related liver disease. His vital signs were normal, and he had no symptoms. On physical... more

A pretibial skin lesion in a patient with type 1 diabetes mellitus

10 January 2022
Author(s): Bruna Crea, Fabrizio Elia, Giulia Cavalot

A 17-years-old woman with type 1 diabetes mellitus known since the age of 9 was admitted in the high-dependency unit for diabetic ketoacidosis. She had a history of poor glycemic control and many... more

Multiple tumors on the pleura with pleural effusion mimicking malignant mesothelioma

26 October 2021
Author(s): Hisanori Machida, Keishi Naruse, Tsutomu Shinohara

A 68-year-old male presented with left chest pain and was referred to our hospital due to left-sided pleural effusion on a chest X-ray (Fig. 1 A). Initial laboratory data included a white blood cell... more

Multiple organ nodules or polyps

26 October 2021
Author(s): Junnan Hu, Zhen Li

A 48-year old female presented with intermittent epigastric pain for 2 months accompanied with belching, nausea, vomiting and occasionally melena. She had endometrial polypectomy and thyroidectomy in... more

New onset rectal bleeding

24 October 2021
Author(s): Brian M. Fung, Kelly M. Zucker, Joseph David

A 36-year-old male with no significant past medical history presented to the emergency department for new onset hematochezia. Prior to arrival, the patient reported having five episodes of passing... more

Stuck in my head as an old song

22 October 2021
Author(s): Ilaria De Benedetto, Alberto Gaviraghi, Francesco Giuseppe De Rosa

A 61-year-old piano man was admitted to the emergency department for loss of consciousness, aphasia and Glasgow coma scale of 13 points. His past medical history included hypertension, non-insulin-... more

“Comb and Target signs” in abdominal CT in patients with purpura

21 October 2021
Author(s): Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara

A 56-year-old woman complained of nausea, abdominal pain, and bloody diarrhea 10 days prior to the day of consult in our institution. Her abdominal pain worsened and was accompanied by joint pain for... more

COVID-19 vaccination and a severe pain in the neck

17 October 2021
Author(s): Angelos Kyriacou, Stamatina Ioakim, Akheel A. Syed

A 40-year-old woman developed malaise and severe anterior neck pain 12 hours after the second dose of COVID-19 mRNA vaccine (Pfizer/BioNTech). The pain peaked and plateaued at the fourth post-... more

Letter to the Editor

The impact of oral anticoagulant drugs for arterial thromboembolism in patients with cancer

20 January 2022
Author(s): Andreana Foresta, Pierluca Colacioppo, Marta Baviera, Luisa Ojeda-Fernandez, Claudio Cimminiello

cancer is a known independent risk factor for venous thromboembolism (VTE)[1]. However, in recent years, its role also as a risk factor for arterial thrombotic events (ATE) has been elucidated[2].... more

Return to work after hospitalisation for COVID-19 infection

9 January 2022
Author(s): Orlando Hürlimann, Pierre Decavel, Jean-Marie Annoni, Marco Mancinetti

Dear Editor

Colchicine for COVID-19: Hype or hope?

12 November 2021
Author(s): Chia Siang Kow, Dinesh Sangarran Ramachandram, Syed Shahzad Hasan

We appreciate the efforts of Schattner [1] to summarize the evidence from randomized controlled trials regarding the efficacy and safety of colchicine for various emerging indications, which included... more

The prognostic value of malnutrition on duration of admission, financial cost and mortality in elderly, hospitalized patients

8 November 2021
Author(s): Christos E Lampropoulos, Maria Konsta, Afroditi Roumpou, Vicky Dradaki, Ioanna Papaioannou

Dear Editor,

Ankle-brachial index and the risk of hemorrhagic stroke

8 November 2021
Author(s): Lia Alves-Cabratosa, Marc Comas-Cufí, Ruth Martí-Lluch, Anna Ponjoan, Rafel Ramos

Dear editor,

Long COVID: A patient perspective

28 October 2021
Author(s): S. Harari, L. Ripamonti, P. Marveggio, P.M. Mannucci

Even though in this [1,2] and other journals [3–5] a number of articles described the long-term consequences of COVID-19 in patients who recovered from the acute illness, most reports mainly dealt... more

Disguised aspects of IgG4

27 October 2021
Author(s): Natalia Aleksandra Dułak, Rafał Trzciński

Dear Editor,

Humoral SARS-COV-2 IgG decay within 6 months in COVID-19 healthy vaccinees: The need for a booster vaccine dose?

26 October 2021
Author(s): Anat Achiron, Mathilda Mandel, Sapir Dreyer-Alster, Gil Harari, Michael Gurevich

The most effective approach to fight COVID-19 infection is prevention by targeted vaccines that prime the immune system prior to a first encounter with the virus. The BNT162b2 messenger RNA (mRNA)... more

Venous thromboembolism treatment duration in autoimmune diseases. Research trends

26 October 2021
Author(s): Pablo Ruiz-Sada, Lara Palacios-García, Julia Sada-Sainz

Dear editor,

Standardized PaO2/FiO2 ratio in COVID-19: Added value or risky assumption. Author's reply

22 October 2021
Author(s): Irene Prediletto, Stefano Nava, Paolo Palange

Dear Editor,

Cardiopulmonary exercise test with stress echocardiography in COVID-19 survivors at 6 months follow-up

10 October 2021
Author(s): Luca Vannini, Alejandro Quijada-Fumero, M Purificación Ramirez Martín, Nuria Castejón Pina, Julio S. Hernandez Afonso

Although many studies suggest different degrees of myocardial and pulmonary injury during the acute infection and early follow-up [1–3],there is disagreement about cardio-pulmonary injury and... more

Smartphone-based ECG devices: Beyond atrial fibrillation screening

5 October 2021
Author(s): Felix K. Wegner, Lars Eckardt

Dear Professor Agnelli,

Is serum hyperosmolality related with myocardial dysfunction in septic shock patients?

4 October 2021
Author(s): Cristina Murcia-Gubianas, Juan Carlos Yébenes, Maria Buxó, Sara Foradada, Elisabeth Pinart

Etiopathogenesis of cardiac dysfunction in septic shock is multifactorial, arising from autonomic dysregulation, increased capillary permeability, metabolic and mitochondrial dysfunction, oxidative... more

Gender gap in authorship: a study of 44,000 articles published in 100 high-impact general medical journals

28 September 2021
Author(s): Paul Sebo, Carole Clair

Dear Editor, the profile of the medical profession has changed dramatically in recent decades, with an increasing proportion of women physicians [1]. However, the gender gap in academic medicine... more

Association of new-onset atrial fibrillation in patients taking high-dose fish oil

27 September 2021
Author(s): Rajkumar Doshi, Monil Majmundar, Ashish Kumar, Krunalkumar Patel, Saraschandra Vallabhajosyula, Ankur Kalra

Atrial fibrillation (AF) is the most common cardiac arrythmia, with an estimate of 37.6 million cases (0.51% of the world population) in 2017. Its prevalence has increased by 33% in the last 20 years... more

A simple method to validate medical bed number calculations

7 September 2021
Author(s): Rodney P. Jones

Doctors are often called upon to make input into planning for hospital bed numbers. Unknown to doctors the models behind forecasting bed numbers can be deliberately manipulated. It is often the case... more

Do we really know what drives relapse in obesity management?

17 July 2021
Author(s): Catia Martins

I have read with much interest the narrative review by Busetto and colleagues entitled “Mechanisms of weight regain”, recently published in your journal [1]. There is no doubt that relapse in obesity... more

Original Article

Obesity survival paradox in patients hospitalized with community-acquired pneumonia. Assessing sex-differences in a population-based cohort study

20 January 2022
Author(s): Javier de Miguel-Diez, Rodrigo Jimenez-Garcia, Valentin Hernandez-Barrera, Jose M. de Miguel-Yanes, David Carabantes-Alarcon, Jose J Zamorano-Leon, Ana Lopez-de-Andres

Community acquired pneumonia (CAP) is one of the most common infectious diseases and contributes significantly to morbidity, mortality and costs [1]. In fact, it has been ranked as the third leading... more

Prevalence of markers of atrial cardiomyopathy in embolic stroke of undetermined source: A systematic review

19 January 2022
Author(s): Nikolaos Stalikas, Ioannis Doundoulakis, Efstratios Karagiannidis, Anastasios Kartas, Maria Gavriilaki, George Sofidis, Eleftherios Panteris, Andreas S. Papazoglou, Anna-Bettina Haidich, Georgios Sianos, George Giannakoulas

The majority of cryptogenic strokes are likely embolic; these have been termed “embolic strokes of undetermined source’’ (ESUS) [1]. One out of four ischemic strokes occurring in young (≤50 years)... more

Ultrasound evaluation of bowel vasculopathy in systemic sclerosis

17 January 2022
Author(s): Bandini Giulia, Cometi Laura, Accogli Esterita, Domanico Andrea, Tofani Lorenzo, Bruni Cosimo, Bellando-Randone Silvia, Lepri Gemma, Orlandi Martina, Guiducci Serena, El-Aoufy Khadija, Ciuti Gabriele, Fabbri Alessia, Matucci-Cerinic Marco, Moggi-Pignone Alberto, Study Group of Rheumathology and Internal Medicine

Systemic sclerosis (SSc) is a complex disease with a heterogenous clinical spectrum and a complex pathophysiology characterized by immune activation and diffuse microvascular injury resulting in... more

Outcome of SARS CoV-2 inpatients treated with convalescent plasma: One-year of data from the Veneto region (Italy) Registry

27 December 2021
Author(s): Giustina De Silvestro, Piero Marson, Massimo La Raja, Anna Maria Cattelan, Gabriella Guarnieri, Jacopo Monticelli, Ivo Tiberio, Andrea Vianello, Giorgio Gandini, Gianluca Gessoni, Francesco Fiorin, Corrado Sardella, Laura Astolfi, Mario Saia, Veneto Hospitals

Convalescent plasma (CP) has been used worldwide to counteract the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)[1]. Since April 2020, it has also been utilised in the treatment of... more

Renal outcomes associated with glucose-lowering agents: Systematic review and meta-analysis of randomized outcome trials

22 December 2021
Author(s): Chalmoukou Konstantina, Polyzos Dimitris, Manta Eleni, Tatakis Fotis, Konstantinidis Dimitris, Thomopoulos Costas, Tsioufis Costas

Large-scale cardiovascular outcome trials and meta-analyses of new antihyperglycemic agents in patients with type 2 diabetes mellitus (DM) demonstrated that these new agents reduce cardiovascular... more

Generalist vs specialist acute medical admissions - What is the impact of moving towards acute medical subspecialty admissions on efficacy of care provision?

22 December 2021
Author(s): Hannah Smyth, Sarah Gorey, Hannah O'Keeffe, Joanna Beirne, Shaunna Kelly, Cathal Clifford, Hilary Kerr, Martin Mulroy, Tomás Ahern

In an era of increasing hospital admissions and a growing older population with multiple co-morbidities [1], the discussion surrounding generalist versus specialist medical acute admissions continues... more

Neutrophil count, lymphocyte count and neutrophil-to-lymphocyte ratio in relation to response to adjunctive dexamethasone treatment in community-acquired pneumonia

12 November 2021
Author(s): Esther Wittermans, Ewoudt MW van de Garde, G Paul Voorn, Arnoud F Aldenkamp, Rob Janssen, Jan C Grutters, Willem Jan W Bos, Santeon-CAP study group

The cornerstones of community-acquired pneumonia (CAP) treatment are early diagnosis and timely initiation of appropriate antibiotic treatment [1]. Despite advances in antibiotic treatment, CAP... more

The high-risk bleeding category of different scores in patients with venous thromboembolism: Systematic review and meta-analysis

1 November 2021
Author(s): Miguel Marques Antunes, Mariana Alves, Fausto J. Pinto, Giancarlo Agnelli, Daniel Caldeira

Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), is a potentially life-threatening condition associated with a high case-fatality rate [1], and... more

Left ventricular global longitudinal strain in secondary hypertension: A meta-analysis of echocardiographic studies

26 October 2021
Author(s): Marijana Tadic, Carla Sala, Stefano Carugo, Giuseppe Mancia, Guido Grassi, Cesare Cuspidi

Secondary hypertension defines a wide range of clinical conditions in which the increase in blood pressure (BP) is due, unlike primary hypertension, to an identifiable cause [1]. Although definition... more

Association between air temperature, air pollution and hospital admissions for pulmonary embolism and venous thrombosis in Italy

23 October 2021
Author(s): Chiara Di Blasi, Matteo Renzi, Paola Michelozzi, Francesca de’ Donato, Matteo Scortichini, Marina Davoli, Francesco Forastiere, Pier Mannuccio Mannucci, Massimo Stafoggia

Cardiovascular diseases (CVD) are the leading cause of death in the world [1], as well as in Europe and Italy [2], accounting for more than 1.8 million deaths (36% of total) every year. It has been... more

Risk factors for community-onset pneumonia caused by drug-resistant pathogens: A prospective cohort study

18 October 2021
Author(s): J. Vasco Barreto, Cláudia Camila Dias, Teresa Cardoso

It is presumed that 70% of Community-Acquired Pneumonias (CAP) are caused by bacteria [1], but, in clinical practice, microbial etiology remains unknown in at least 60% of the cases [2]. One of the... more

Estimated 10-year cardiovascular risk in a large Italian cohort of rheumatoid arthritis patients: Data from the Cardiovascular Obesity and Rheumatic DISease (CORDIS) Study Group

14 October 2021
Author(s): Fabio Cacciapaglia, Francesca Romana Spinelli, Matteo Piga, Gian Luca Erre, Garifallia Sakellariou, Andreina Manfredi, Ombretta Viapiana, Marco Fornaro, Sergio Colella, Alberto Floris, Arduino Aleksander Mangoni, Floriana Castagna, Caterina Vacchi, Giovanni Orsolini, Serena Bugatti, Giacomo Cafaro, Alberto Cauli, Elisa Gremese, Fabiola Atzeni, Elena Bartoloni

Rheumatoid Arthritis (RA) is a chronic, systemic inflammatory disease characterized by a relatively high risk of atherosclerotic cardiovascular (CV) events. Notably, such risk has been reported to be... more

Effectiveness of telemedicine in patients with heart failure according to frailty phenotypes: Insights from the iCOR randomised controlled trial

13 October 2021
Author(s): Sergi Yun, Cristina Enjuanes, Esther Calero-Molina, Encarnación Hidalgo, Núria José, Elena Calvo, José María Verdú-Rotellar, Paloma Garcimartín, David Chivite, Francesc Formiga, Santiago Jiménez-Marrero, Alberto Garay, Lídia Alcoberro, Pedro Moliner, Xavier Corbella, Josep Comín-Colet

Heart failure (HF) is a worldwide global healthcare problem due to its high prevalence, incidence and associated mortality and morbidity [1,2]. Moreover, HF is associated with impaired health-related... more

Extended venous thromboprophylaxis in patients hospitalized for acute ischemic stroke: A systematic review and meta-analysis

11 October 2021
Author(s): Emanuele Valeriani, Nicola Potere, Matteo Candeloro, Silvia Spoto, Ettore Porreca, Anne WS Rutjes, Marcello Di Nisio

Acute ischemic stroke is a major health burden worldwide due to high rates of ensuing hospitalizations, complications, disability, dependency, and death [1]. Venous thromboembolism (VTE), which... more

Clinical outcomes associated with the emergency treatment of hyperkalaemia with intravenous insulin-dextrose

5 October 2021
Author(s): Toby J.L. Humphrey, Glen James, Ian B Wilkinson, Thomas F. Hiemstra

Hyperkalaemia is a common, life-threatening electrolyte abnormality present in up to 10% of acute hospital admissions [1]. In patients receiving treatment with renin-angiotensin-aldosterone system (... more

Response to mepolizumab according to disease manifestations in patients with eosinophilic granulomatosis with polyangiitis

14 September 2021
Author(s): Roberto Ríos-Garcés, Sergio Prieto-González, José Hernández-Rodríguez, Ebymar Arismendi, Isam Alobid, Alessandra E. Penatti, María C. Cid, Georgina Espígol-Frigolé

Eosinophilic granulomatosis with polyangiitis

Sex differences in clinical presentation and risk stratification in the Emergency Department: An observational multicenter cohort study

12 September 2021
Author(s): Bart GJ Candel, Saimi Dap, Wouter Raven, Heleen Lameijer, Menno I Gaakeer, Evert de Jonge, Bas de Groot

Sex differences affect patient outcomes in many diseases, such as Coronavirus Disease 2019 (COVID-19), acute myocardial infarction, acute ischemic stroke and infectious diseases, while outcome... more

Prognostic value of NT-proBNP and CA125 across glomerular filtration rate categories in acute heart failure

7 September 2021
Author(s): Rafael de la Espriella, Antoni Bayés-Genís, Pau Llàcer, Patricia Palau, Gema Miñana, Enrique Santas, Mauricio Pellicer, Miguel González, José Luis Górriz, Vicent Bodi, Juan Sanchis, Julio Núñez

Heart and kidney function are heavily intertwined, and once both organs are affected, the patient's prognosis worsens dramatically [1–3]. Natriuretic peptides (NP) (brain natriuretic peptide [BNP]... more

Predictors of long-term mortality in left-sided infective endocarditis: an historical cohort study in 414 patients

31 August 2021
Author(s): Emanuele Durante-Mangoni, Giuseppe Giuffrè, Maria Paola Ursi, Domenico Iossa, Lorenzo Bertolino, Alessandra Senese, Pia Clara Pafundi, Fabiana D’Amico, Rosina Albisinni, Rosa Zampino

Infective endocarditis (IE) is a life-threatening disease associated, in 2010, with 1.58 millions of disability-adjusted life years lost due to death, concurrent illnesses and functional impairment [... more

Clinical presentation of secondary infectious complications in COVID-19 patients in intensive care unit treated with tocilizumab or standard of care

29 August 2021
Author(s): Lucia Taramasso, Laura Magnasco, Federica Portunato, Federica Briano, Antonio Vena, Daniele R. Giacobbe, Chiara Dentone, Chiara Robba, Lorenzo Ball, Maurizio Loconte, Nicolò Patroniti, Paolo Frisoni, Raffaele D'Angelo, Silvia Dettori, Malgorzata Mikulska, Paolo Pelosi, Matteo Bassetti

Tocilizumab is a recombinant humanized monoclonal antibody developed against soluble and membrane-bound isoforms of the interleukin-6 [IL-6] receptor. It prevents the binding of IL-6 to its receptor... more

Diagnostic yield of endoscopy in irritable bowel syndrome: A nationwide prevalence study 1987–2016

19 August 2021
Author(s): Kyle Staller, Ola Olén, Jonas Söderling, Bjorn Roelstraete, Hans Törnblom, Hamed Khalili, Mingyang Song, Jonas F Ludvigsson

Irritable bowel syndrome (IBS) affects 11.2% of the global population  [1], with significant impacts on patients’ quality of life despite no increased risk of mortality  [2]. Among this sizeable... more

Oral anticoagulants vs antiplatelets in cryptogenic stroke with potential cardiac emboli: Meta-analysis

18 August 2021
Author(s): Wen-Yi Huang, Bruce Ovbiagele, Meng Lee

Cryptogenic strokes are cerebral infarcts for which no probable underlying pathophysiologic cause is identified after adequate diagnostic evaluation [1]. However, it's been shown that some strokes... more

Dediagnosing – a novel framework for making people less ill

17 August 2021
Author(s): Marianne Lea, Bjørn Morten Hofmann

The vast progress in science and technology has greatly increased the number of diseases. Today, the International Classification of Diseases (ICD-11) consists of approximately 55,000 unique codes... more

Examination of the relationship between emergency department presentations and population mortality: a multicenter analysis of emergency department presentations during the COVID-19 pandemic

15 August 2021
Author(s): Monica Solbiati, Lorenzo Russo, Anna Beverina, Paolo Groff, Andrea Strada, Ludovico Furlan, Nicola Montano, Giorgio Costantino, Giovanni Casazza

The first deaths outside of China due to COVID-19 (coronavirus disease 2019), caused by the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), occurred in February 2020 [1]. Subsequently,... more

The role of minor salivary glands’ biopsy in the diagnosis of Sjögren's syndrome and other systemic diseases

9 August 2021
Author(s): Ana Isabel Lopes, Raquel Machado-Neves, Mrinalini Honavar, P. Ricardo Pereira

Minor salivary gland biopsy (MSGB) is a minimally invasive, safe and low-cost diagnostic procedure. It is mainly used for the diagnosis of Sjögren's syndrome (SS), by identifying the presence of... more

Multidisciplinary team led by internists improves diabetic foot ulceration outcomes a before-after retrospective study

26 July 2021
Author(s): Gida Ayada, Yonatan Edel, Alon Burg, Adi Bachar, Yehiel Hayun, Tzippy Shochat, Jihad Bishara, Dafna Yahav, Alaa Atamna, Avishay Elis

Diabetic foot ulceration (DFU), one of the most serious complications of diabetes mellitus (DM), affects 25% of all patients with diabetes and is associated with high morbidity and mortality [1-5].... more

Review Article

The identity of the internist: A U.S. perspective

20 January 2022
Author(s): Gregory C. Kane, Heather E. Gantzer, Jacqueline W. Fincher

The etymology of Internal Medicine dates to an important development in the approach to patient care arising in 19th Century Germany and reflected by the term, Innere Medezin. This marked the... more

A systematic review of the discrimination and absolute mortality predicted by the National Early Warning Scores according to different cut-off values and prediction windows

31 December 2021
Author(s): Mark Holland, John Kellett

Early warning scores (EWS) were originally proposed by Morgan et al. to help identify patients who need immediate life-saving interventions, but not to predict their outcomes [1]. Ironically outcome... more

Drug-induced liver injury: Pathogenesis, epidemiology, clinical features, and practical management

9 November 2021
Author(s): HK Björnsson, ES Björnsson

Drug-induced liver injury (DILI), an injury to the liver or biliary system associated with intake of hepatotoxic drugs, is the most common cause of acute liver failure in the Western world [1,2]. A... more

Sepsis-driven atrial fibrillation and ischaemic stroke. Is there enough evidence to recommend anticoagulation?

8 November 2021
Author(s): Isuru Induruwa, Eleanor Hennebry, James Hennebry, Mrinal Thakur, Elizabeth A. Warburton, Kayvan Khadjooi

Atrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice and is associated with significant morbidity and mortality [1]. Currently, it is estimated that between 2 and... more

One year after the ESC/EAS guidelines on cholesterol control. What's the new evidence? What's missing?

30 October 2021
Author(s): Maurizio Averna, Alberico L. Catapano

The recent ESC/EAS 2019 Guidelines for the management of dyslipidaemias are centred on the causal role of low density lipoprotein (LDL), or more generally apolipoprotein B (apoB)-containing... more

The impact of nutrition and lifestyle modification on health

17 October 2021
Author(s): Lèlita Santos

According to the World Health Organization (WHO), Noncommunicable Diseases (NCDs), heart disease, stroke, diabetes, obesity, metabolic syndrome, chronic obstructive pulmonary disease, and some types... more

Electrocardiographic features of patients with COVID-19: One year of unexpected manifestations

14 October 2021
Author(s): Fabio Angeli, Gianpaolo Reboldi, Antonio Spanevello, Roberto De Ponti, Dina Visca, Jacopo Marazzato, Martina Zappa, Monica Trapasso, Sergio Masnaghetti, Leonardo M. Fabbri, Paolo Verdecchia

Coronavirus Disease 2019 (COVID-19) is the clinical manifestation of infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) [1 -3]. COVID-19 is frequently characterized by... more

Colchicine – new horizons for an ancient drug. Review based on the highest hierarchy of evidence

14 October 2021
Author(s): Ami Schattner

Colchicine is a tricyclic alkaloid with anti-inflammatory properties extracted from the herbaceous Colchicum autumnale plant and first isolated and synthesized in the 19th century [1]. It is one of... more

Toxic nephropathy: Adverse renal effects caused by drugs

1 October 2021
Author(s): Robert J. Unwin

This is a brief overview of toxic nephropathy, which is an increasingly recognised problem with the continual introduction of new drugs and novel drug modalities, especially in oncology, and the... more

Should we continue surveillance for hepatocellular carcinoma and gastroesophageal varices in patients with cirrhosis and cured HCV infection?

23 September 2021
Author(s): Cas J. Isfordink, Raoel Maan, Robert A. de Man, Karel J. van Erpecum, Adriaan J. van der Meer


Recent advances in pericarditis

20 September 2021
Author(s): Emanuele Bizzi, Chiara Picchi, Greta Mastrangelo, Massimo Imazio, Antonio Brucato

Pericardial diseases are a heterogeneous group of entities, ranging from acute pericarditis (AP) to asymptomatic pericardial effusions. Diagnosis of AP can be made when two of the following criteria... more

Translational medicine in hereditary hemorrhagic telangiectasia

16 September 2021
Author(s): A. Riera-Mestre, P. Cerdà, A. Iriarte, M. Graupera, F. Viñals

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

Popular procedures without evidence of benefit: A case study of percutaneous coronary intervention for stable coronary artery disease

14 September 2021
Author(s): Vinay Guduguntla, Rita F. Redberg

Coronary artery disease is common, affecting more than an estimated 125 million people worlwide [1,2]. More than half of all patients with coronary artery disease (CAD) have anginal symptoms [3].... more


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