June 2022

118 Articles

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Participants’ informed consent in adaptive, platform drug trials in hospitalized COVID-19 patients: not all approaches are ethically acceptable

27 June 2022
Author(s): Rafael Dal-Ré, Arthur L Caplan, Teck Chuan Voo

One of the most exciting bits of news that the COVID-19 pandemic has provided in the clinical research arena is demonstrating that adaptive, platform randomized controlled trials (ad-RCTs) provided... more

The case of diabetes mellitus and atrial fibrillation: Underlining the importance of non-cardiovascular comorbidities

27 June 2022
Author(s): Marco Proietti, Giulio Francesco Romiti, Stefania Basili

In the currently changing scenario, in which our patients are progressively older and more likely burdened by concomitant chronic long-term conditions [1], diabetes mellitus (DM) play a prominent... more

Nebivolol protects erectile functions compared to Metoprolol in hypertensive men with atherogenic, venogenic, psychogenic erectile dysfunction: A prospective, randomized, cross-over, clinical trial

23 June 2022
Author(s): Gokhan Gungor, Hakki Perk, Sedat Soyupek, Bahattin Baykal, Murat Demir, Mehmet Tugrul Sezer

Erectile dysfunction (ED) is defined as the inability to achieve or maintain a sufficient erection to engage in sexual intercourse [1]. Erectile functions are related to the quality of life of... more

Durable functional limitation in patients with coronavirus disease-2019 admitted to intensive care and the effect of intermediate-dose vs standard-dose anticoagulation on functional outcomes

19 June 2022
Author(s): Sadeghipour, Bikdeli

Coronavirus disease-2019 (COVID-19) has post-acute manifestations that may impact the everyday life functional and the mental health status of the affected patients (1). In a cross-sectional global... more

High risk of complications and mortality in cirrhotic patients with acute pancreatitis

17 June 2022
Author(s): Karel J. van Erpecum, Paul Didden, Robert C. Verdonk

Acute pancreatitis is one of the most common gastrointestinal diseases requiring acute hospital admission. Gallstones (50%) and alcohol (20%) are the most frequent underlying causes. Medication,... more

Adult-onset type 1 diabetes: A changing perspective

16 June 2022
Author(s): J Burahmah, D Zheng, RD Leslie

Diabetes represents a disease state, irrespective of the presence of clinical symptoms, determined by raised glucose or HbA1c levels. Diabetes has surged in prevalence in recent years, whether type 1... more

Clinical characteristics of BRASH syndrome: Systematic scoping review

5 June 2022
Author(s): Parthav Shah, Maan Gozun, Koichi Keitoku, Nobuhiko Kimura, Jihun Yeo, Torrey Czech, Yoshito Nishimura

Bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia (BRASH) syndrome is a recently-established entity precipitated by medication-induced AV nodal blockade.... more

High risk of complications and acute-on-chronic liver failure in cirrhosis patients with acute pancreatitis

4 June 2022
Author(s): Michael Vogel, Hanno Ehlken, Stefan Kluge, Thomas Roesch, Ansgar W. Lohse, Samuel Huber, Martina Sterneck, Peter Huebener

Lay summary: Acute pancreatitis (AP) and advanced chronic liver disease are severe and increasingly prevalent disorders with overlapping risk factors. We demonstrate for the first time that the... more

Safety and efficacy of ultrafiltration versus diuretics in patients with decompensated heart failure: A systematic review and meta-analysis

27 May 2022
Author(s): Waqas Ullah, Muhammad Khawar Sana, Hamza Usman Mustafa, Harigopal Sandhyavenu, Alexander Hajduczok, Tanveer Mir, David L. Fischman, Mahek Shah, Yevgeniy Brailovsky, Indranee N. Rajapreyar

Acute decompensated heart failure, a constellation of dyspnea, edema, and fatigue due to volume overload, accounts for the high healthcare costs, projected to increase from $21 billion in 2012 to $70... more

Personal protective equipment portraits in the era of COVID-19

26 May 2022
Author(s): Christopher Hansen-Barkun, Omar Kherad, Adamo A Donovan, Anupa J Prashad, Maida J Sewitch

Use of personal protective equipment (PPE) aims to prevent SARS CoV-2 transmission in the healthcare setting. However, PPE limits human connection and non-verbal communication by masking individuals... more

Lights and shadows on JAK inhibitors for Ankylosing Spondylitis

20 May 2022
Author(s): Giovanni Benanti, Lorenzo Dagna, Corrado Campochiaro

Ankylosing Spondylitis (AS) is an autoimmune disease characterized by inflammation of the spine and sacroiliac joints, historically described in young males with progressive structural damage of the... more

Diagnostic approaches to syncope in Internal Medicine Departments and their effect on mortality

20 May 2022
Author(s): Ehud Galron, Orli Kehat, Ahuva Weiss-Meilik, Raffaello Furlan, Giris Jacob

Syncope is defined as a transient loss of consciousness (TLOC) due to cerebral hypoperfusion, characterized by a rapid onset, short duration, and spontaneous complete recovery [1]. The main... more

Validation of anti-neutrophil cytoplasm antibodies associated vasculitides diagnosis codes from the electronic health records of two French university hospitals

18 May 2022
Author(s): Camille Mettler, Samir Bouam, Sandra Liva-Yonnet, Gregory Pugnet, Benjamin Terrier

ANCA-associated vasculitides (AAV) are necrotizing vasculitis, with few or no immune deposit, predominantly affecting small vessels. Among AAV, granulomatosis with polyangiitis (GPA) is characterized... more

Impact of cardiac amyloidosis on outcomes of patients hospitalized with heart failure

16 May 2022
Author(s): Sebastian Göbel, Lukas Hobohm, Alexander Desuki, Tommaso Gori, Thomas Münzel, Rapezzi Claudio, Philip Wenzel, Karsten Keller

Amyloidosis is a multi-systemic disease resulting from deposition of misfolded proteins as insoluble fibrils in the interstitium of affected organs, subsequently leading to organ failure. Cardiac... more

An unusual cause of severe watery diarrhea

16 May 2022
Author(s): Yusaku Kajihara

A 75-year-old man presented to the gastroenterology department with a 4-week history of severe watery diarrhea (at least 20 times a day) and appetite loss. He had been taking amlodipine 5 mg once... more

A HIV-positive subject with dermatomal and generalized vesicular skin lesions

13 May 2022
Author(s): Andrea Poloni, Maria Vittoria Cossu, Spinello Antinori

A 58-year old man with HIV infection diagnosed in 2018 presented in July 2021 with a 7-day history of vesicular skin lesions localized to the right side of abdomen and diffuse vesicular lesions on... more

Skin rash following amoxicillin treatment

13 May 2022
Author(s): Yuya Ando, Satoko Senda, Yosuke Ono

A 26-year-old woman presented with a chief complaint of nausea for 2 days. On the previous day, she had been diagnosed with tonsilitis by her previous doctor because of fever and sore throat, and had... more

Developing a simple and practical decision model to predict the risk of incident type 2 diabetes among the general population: The Di@bet.es Study

12 May 2022
Author(s): Sergio Martínez-Hervás, María M. Morales-Suarez-Varela, Irene Andrés-Blasco, Francisco Lara-Hernández, Isabel Peraita-Costa, José T. Real, Ana-Bárbara García-García, F. Javier Chaves

The prevalence and incidence of type 2 diabetes mellitus (T2DM) are increasing worldwide, and an estimated 50% of patients remain unaware of their disease [1]. T2DM is a highly prevalent chronic... more

Treatment strategies of COVID-19: A rheumatology perspective

11 May 2022
Author(s): Alexandros A. Drosos, Eleftherios Pelechas, Paraskevi V. Voulgari

Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2), the cause of coronavirus disease 2019 (COVID-19), emerged in China at the end of 2019 and has developed into a pandemic. The disease has... more

Sarcomere protein modulation: The new frontier in cardiovascular medicine and beyond

6 May 2022
Author(s): Cristina Morelli, Gessica Ingrasciotta, Daniel Jacoby, Ahmad Masri, Iacopo Olivotto

In recent years, constant progress in science and technology has resulted in innovative molecules addressing core mechanisms of myocardial disease affecting millions worldwide [1]. A targeted... more

Atrial cardiomyopathy markers and new-onset atrial fibrillation risk in patients with acute myocardial infarction

2 May 2022
Author(s): Zhitong Li, Quanbo Liu, Fei Liu, Tesfaldet H. Hidru, Yiheng Yang, Shihao Wang, Lan Bai, Jing Chen, Xiaolei Yang, Yunlong Xia

Acute myocardial infarction (AMI) remains one of the leading causes of mortality globally, new-onset AF (NOAF) after AMI is a common complication of AMI, with an incidence of 6% to 21% [1], which is... more

Serum-ascites albumin gradient – A false dichotomy in the approach to ascites

15 April 2022
Author(s): Isaac Núñez, Fernando Solis-Huerta, Adrian Soto-Mota

Ascites is a clinical scenario frequently encountered in primary care, internal medicine and gastroenterology. Formal guidelines on its approach and management exist and recommend measuring the serum... more

Adult anaphylaxis: To the heart of the matter

2 April 2022
Author(s): Antonio Mirijello, Salvatore De Cosmo

Dear Editor, we want to congratulate with Rossi and colleagues [1] for their state-of-the-art review summarizing pathophysiological mechanisms, diagnostic criteria, classification and clinical... more

Deployment of guideline-based therapy for heart failure with reduced ejection fraction: A word of caution for older patients

21 March 2022
Author(s): Mario Bo, Enrico Brunetti, Cecilia Noviello, Giuseppe Scala, Niccolò Marchionni

Dear Editor,

Is malignancy cancer an adverse factor of in-hospital clinical outcome in post-cardiac arrest?

16 February 2022
Author(s): Jun Chen, Mei Yu, Rui Zeng, Yimin Wang, Qiang Liu

With the continuous development of cancer treatment, patients with cancer have dramatically improved, with several cancer populations experiencing a median survival well beyond 5 years.1 However,... more

Double-gloving in an Intensive Care Unit during the COVID-19 pandemic

13 February 2022
Author(s): Ori Galante, Abraham Borer, Yaniv Almog, Lior Fuchs, Lisa Saidel-Odes

Dear Editor,

Beyond the Guidelines

Comparing atrial fibrillation guidelines: Focus on stroke prevention, bleeding risk assessment and oral anticoagulant recommendations

4 May 2022
Author(s): Jacopo Francesco Imberti, Davide Antonio Mei, Marco Vitolo, Niccolò Bonini, Marco Proietti, Tatjana Potpara, Gregory Y.H. Lip, Giuseppe Boriani

Clinical practice in atrial fibrillation (AF) patient management is constantly evolving. Non-vitamin K antagonist oral anticoagulants (NOACs) showed a favorable risk-benefit profile as compared to... more

Clinical Insights

Anticoagulation as secondary prevention of massive lung thromboses in hospitalized patients with COVID-19

12 April 2022
Author(s): Rosaria Sofia, Mattias Carbone, Giovanni Landoni, Alberto Zangrillo, Lorenzo Dagna

Since February 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been responsible for one of the major pandemic we have experienced in the last 100 years [1]. The most... more

Atrial cardiomyopathy: Pathophysiology and clinical implications

11 March 2022
Author(s): Antonella Tufano, Patrizio Lancellotti

The term atrial cardiomyopathy appears sporadically in the medical literature, and generally has been used in conjunction with atrial fibrillation (AF), or as “atrial fibrotic cardiomyopathy”, a... more


Conservative versus aggressive blood pressure reduction: Do we have a winner?

14 June 2022
Author(s): Dragan Lovic, Michael Doumas

Arterial hypertension is an established cardiovascular risk factor [1], while antihypertensive therapy is associated with substantial cardiovascular benefits [2]. Therefore, research in the field of... more

Intensive blood pressure control and cognitive impairment in chronic kidney disease: The jury is still out

29 May 2022
Author(s): Giorgio Gentile, Kathryn Mckinney, Gianpaolo Reboldi

Globally, 55 million people suffer from dementia, mainly Alzheimer's disease (60–70% of cases), and over 60% of patients live in low- or middle-income countries. This number is estimated to rise to... more

The search for a gold standard to clinically diagnose and monitor atrial cardiomyopathy

20 May 2022
Author(s): Giuseppe Boriani, Marco Vitolo, Jacopo Francesco Imberti

: Tufano A, Lancellotti P. "Atrial cardiomyopathy: Pathophysiology and clinical implications". Eur J Intern Med. 2022 Mar 11:S0953–6205(22)00097–8. doi: 10.1016/j.ejim.2022.03.007. Epub ahead of... more

Interleukin 6 inhibition in severe COVID-19: Another piece of the puzzle

24 April 2022
Author(s): Nicola Farina, Lorenzo Dagna

More than two years have passed since the beginning of the coronavirus disease 2019 (COVID-19) pandemic. Extensive efforts have been invested into better understanding the pathogenesis of this... more

Dual antiplatelet treatment for minor acute ischemic stroke and high-risk transient ischemic attack: have we reached the limit of antithrombotic management?

18 April 2022
Author(s): Georgios Tsivgoulis, Aristeidis H. Katsanos

In this issue of the European Journal of Internal Medicine Pomero et al. present their systematic review and meta-analysis evaluating the early use of clopidogrel and ticagrelor in addition to... more

Ultrasound evaluation of bowel vasculopathy in systemic sclerosis but…

12 April 2022
Author(s): Isabel Almeida, João Amorim, Carlos Vasconcelos

The gastrointestinal (GI) tract is affected in up to 90% of patients with systemic sclerosis (SSc). SSc is a key contributor to impairment and disability, leading to remarkable abnormal social... more

The importance of consensus statements on the prevention and treatment of cancer-associated thrombosis

28 March 2022
Author(s): M Carrier, TF Wang

Venous thromboembolism (VTE) is a common complication among patients with cancer. The 6-month risk of VTE complication for cancer patients is 12-fold higher and as much as 23-fold higher in those... more

The unresolved issues in the management of mucormycosis

26 March 2022
Author(s): Frederic Lamoth

Mucormycosis represents the second most frequent invasive mold infection after invasive aspergillosis and its incidence tends to increase around the world [1]. The disease not only affects patients... more

Ideas and Opinions

Reflections on experimentation in medicine

5 April 2022
Author(s): Tilman Sauerbruch

Empirical medicine – over centuries - has been based on close observation of the patient`s history and the sick body. Thus, the ancient Greeks had already concepts of human anatomy, organ functions... more

Internal Medicine Flashcard

A diabetic patient with finger gangrene

20 May 2022
Author(s): Sho Osonoi, Kiho Hamaura, Hiroshi Murakami

A 72-year-old male with type 2 diabetes and end-stage renal disease (ESRD) receiving hemodialysis (HD) for 10 months presented to hospital with one week of worsening pain, swelling, and bluish-black... more

Necrotic ulcers in an immunocompromised patient

19 May 2022
Author(s): Wan Syazween Lyana Wan Ahmad Kammal, Nur Shairah Mohamad Fazial, Adawiyah Jamil

A 68-year-old man presented to dermatology clinic with extensive ulcers for one-week duration. Patient had underlying uncontrolled Type II Diabetes Mellitus and pemphigus foliaceous. His medications... more

Heart failure: An autopsy case

15 May 2022
Author(s): Noemí Ramos-López, Melchor Saiz-Pardo Sanz, Isidre Vilacosta

A 78-year-old man with a history of bilateral carpal tunnel syndrome was admitted to our hospital with congestive heart failure. On physical examination a systolic ejection murmur was documented. B-... more

Persistent fever, bloody diarrhea, and skin necrosis in a young female

13 May 2022
Author(s): Eva Čubrić, Marijana Šupe, Ivan Krečak

A 28-year-old Caucasian female presented with a two-month history of low-grade fevers, abdominal cramps, occasional bloody stools, weight loss, high C-reactive protein (234 mg/L), and with a newly-... more

Hemolytic anemia in a patient with cirrhosis: Hiding in the smear!

25 March 2022
Author(s): Kyle Barron, Poornima Ramadas, Udhayvir Singh Grewal

A 41-year-old female with alcoholic liver cirrhosis presented to the emergency department with worsening abdominal pain and progressively worsening shortness of breath for two weeks. Laboratory... more

Diffuse pulmonary ill-defined centrilobular opacities: Not only bronchiolitis

25 March 2022
Author(s): S Piciucchi, V Poletti

metastatic pulmonary calcification

Vanishing tumor of the stomach

22 March 2022
Author(s): Yusaku Kajihara

A previously healthy Japanese 36-year-old man presented to the gastroenterology department with a 2-day history of acute-onset severe epigastric pain after eating flounder sashimi. His vital signs... more

Chilblain-like acral lesions

22 March 2022
Author(s): Hanlin Yin, Liangjing Lu

A 70-year-old Asian female presented to the rheumatology clinic with a 5-year history of tender papules on fingers and toes aggravated under cold exposure. She also reported polyarthralgia and... more

Granulomatous lesions of the skin: Do not fall into the trap

21 March 2022
Author(s): E. Hoornaert, L. Marot, H. Yildiz

A 51-year-old woman was referred to investigate skin lesions present on her backside.

A man with fever and aortitis

21 March 2022
Author(s): Nana Akazawa, Naoya Itoh, Masashi Ando

A 54-year-old man presented with a chief complaint of fever and pain around the left clavicle. He had a primary germ cell tumor of the mediastinum and had been undergoing chemotherapy for... more

Letter to Editor

General practitioner agreement and adherence to the Swiss Choosing wisely top 5 list: A cross-sectional survey

21 April 2022
Author(s): Mae Cuérel, Marc-André Raetzo, Kevin Selby, Omar Kherad

Choosing Wisely (CW) campaigns have spread around the world to stimulate conversations between physicians and patients about unnecessary tests, treatments, and procedures that account for up to 20%... more

Letter to the Editor

Sodium-glucose cotransporter 2 inhibitors reduce cardiovascular events in acute heart failure. A real-world analysis

27 June 2022
Author(s): Raquel López-Vilella, Víctor Donoso Trenado, Borja Guerrero Cervera, Ignacio Sánchez-Lázaro, Luis Almenar Bonet

Since the recent past, sodium-glucose cotransporter type 2 inhibitors (SGLT2i) have been recommended as mainstay therapy for patients with chronic heart failure (HF) and reduced ejection fraction (... more

Serum and urine angiopoietin-like protein 4 levels correlate with different degrees of dislipidemea and proteinuria in patients with primary nephrotic syndrome

24 June 2022
Author(s): Yue Li, Huajie Liu, Jingzhi Wang, Wangqiu Gong, Xia Gao

Primary nephrotic syndrome (PNS) is characterized by massive proteinuria, hypoproteinemia, edema and hyperlipidemia. Angiopoietin like protein 4 (ANGPTL4) is a secretory glycoprotein and belongs to... more

Supine vs prone position in mild to moderate COVID-19 pneumonia: The impact of proning on computed tomography findings

16 June 2022
Author(s): S Piciucchi, ML Garo, S Tomassetti, C Ravaglia, V Poletti

Dear Editor,

Blood pressure increase during hospitalization for COVID-19

15 June 2022
Author(s): Fabio Angeli, Martina Zappa, Federico Mattia Oliva, Antonio Spanevello, Paolo Verdecchia

The first report of a rise in blood pressure (BP) associated with vaccination for coronavirus disease 2019 (COVID-19) was provided by Meylan et al. [1]. These authors published a series of subjects... more

Effects of statins on clinical outcomes in hospitalized patients with COVID-19

8 June 2022
Author(s): Paulo Ricardo Martins-Filho, José Augusto Soares Barreto-Filho, Antônio Carlos Sobral Sousa

Statins are lipid-lowering drugs that have been evaluated as a potential treatment for COVID-19 due to their pleiotropic effects, including anti-inflammatory, immunomodulatory, antioxidant,... more

Trends of thrombo-inflammation biomarkers after Tocilizumab predict treatment failure better than scores in patients with severe SARS-CoV2 related respiratory failure

5 June 2022
Author(s): Luca Masotti, Elisa Cioni, Elisa Grifoni, Francesco Cei, Roberto Tarquini

Cytokine antagonists are now concrete therapeutic options in patients with severe SARS-CoV2 respiratory failure. The Interleukin-6 (IL-6) inhibitor tocilizumab (TCZ) has shown to significantly reduce... more

Janus kinase inhibitors in patients with ankylosing spondylitis: Great news, but some concerns on cardiovascular disease risk still exist

3 June 2022
Author(s): Athina Dimosiari, Theodoros Michailidis, Dimitrios Patoulias

We have read with great interest the results of the meta-analysis conducted by Li and colleagues [1], demonstrating that Janus kinase (JAK) inhibitors are a safe treatment option for patients with... more

Systemic diseases associated with a diagnosis of achalasia: A case-control study with the All of Us research program

1 June 2022
Author(s): Erik Almazan, Gayane Yenokyan, Kenneth Ng

Esophageal achalasia is an idiopathic disorder characterized by degeneration of neurons in the myenteric plexus of the esophagus [1]. Enteric neuropathies, primary and secondary, have been proposed... more

Ten year anniversary of choosing wisely campaigns

31 May 2022
Author(s): Omar Kherad, Antonio Vaz Carneiro

We read with interest the perspective letter “Ten Years of Choosing Wisely to Reduce Low-Value Care” by Elizabeth J. Rourke [1]. As campaign leaders and members of the Choosing Wisely (CW) working... more

Syndrome of inappropriate antidiuresis as a maladaptive stress response shared by coronavirus disease 2019 and other cytokine storm disorders

30 May 2022
Author(s): Lorenzo Muccioli, Umberto Pensato, Maria Guarino, Francesca Bisulli, Marco Faustini Fustini

Dear Editor,

The Omicron wave and the waning of COVID-19 vaccine effectiveness. Influence of vaccine booster and age on confirmed infection incidence

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

Dear Editor,

Efficacy and safety of molnupiravir for COVID-19 patients

25 May 2022
Author(s): Maurish Fatima, Saleha Azeem, Junaid Saeed, Abia Shahid, Huzaifa Ahmad Cheema, on behalf of the COVID-19 Therapeutics Study Group

Dear Editor,

Disease phenotype and outcomes of very early-onset inflammatory bowel disease

6 May 2022
Author(s): Valeria Dipasquale, Giovanna Lo Presti, Claudio Romano

Dear Editor,

Exploring the recovery curve for long-term post-COVID dyspnea and fatigue

28 April 2022
Author(s): César Fernández-de-las-Peñas, José D. Martín-Guerrero, Ignacio Cancela-Cilleruelo, Paloma Moro-López-Menchero, Oscar J. Pellicer-Valero

Dear Editor

Risk factors for chronic thromboemboli after pulmonary thromboembolism

22 April 2022
Author(s): N Leal, A Freitas, F Leal, J Pimenta, T Gregório

Pulmonary thromboembolism is the third leading cause of cardiovascular death, after coronary artery disease and stroke [1].

Adult anaphylaxis: To the heart of the matter. Author's reply

18 April 2022
Author(s): Carlo Maria Rossi, Marco Vincenzo Lenti, Antonio Di Sabatino

we read with interest the letter by Mirijello et al. [1] which emphasizes the importance of Kounis syndrome (KS), Takotsubo syndrome and their copresence in ATAK syndrome among cardiovascular... more

Experience with procalcitonin use during the COVID-19 pandemic

13 April 2022
Author(s): Laura Gonzalez, Thomas Holman, Daniel Wait, Pearl Abenojar

Procalcitonin (PCT) is a protein precursor of calcitonin that has been proposed to differentiate systemic inflammation of bacterial origin from viral. The lack of rise in viral infections may be due... more

Hospitalized patients are needlessly over-tested for heparin induced thrombocytopenia

11 April 2022
Author(s): Udhayvir Singh Grewal, Shiva Jashwanth Gaddam, Sahith Reddy Thotamgari, Tyiesha Brown, Kavitha Beedupalli, Glenn Morris Mills

Heparin-induced thrombocytopenia (HIT) is an immune complication of heparin therapy caused by antibodies to complexes of platelet factor 4 (PF4) and heparin. Patients with HIT present with a decline... more

Concerns regarding result analysis and the corresponding risk of pulmonary embolism severity and in-hospital mortality

2 April 2022
Author(s): H Shafeeq Ahmed

I read with great interest the article by Miró et al., [1] as the paper discusses an important aspect of clinical medicine which is of great importance in the current coronavirus disease 2019 (COVID-... more

Lipoprotein Z, an abnormal LDL-like lipoprotein, independently predicts mortality in cirrhosis

1 April 2022
Author(s): Eline H. van den Berg, José Luis Flores-Guerrero, Robin P.F. Dullaart

Decreased plasma concentrations of high-density lipoproteins (HDL) make part of the lipoprotein abnormalities encountered in end-stage liver disease [1,2]. The liver plays a central role in both the... more

Community care reform in Italy: Get a move on!

18 March 2022
Author(s): Livio Garattini, Marco Badinella Martini, Alessandro Nobili

Dear editor

The role of heparin in reducing in-hospital complications and three-month mortality rates in hospitalized COVID-19 patients

16 March 2022
Author(s): F. Calabretta, P.S. Preti, M. Russo, C. Klersy, A. Di Sabatino

Many COVID-19 patients develop a coagulopathy characterized by thrombocytopenia, minor prolongation of bleeding times and elevated serum d-dimer and fibrinogen levels, similar to consumption... more

Doubtful clinical benefit of casirivimab-imdevimab treatment for disease severity outcome of high-risk patients with SARS-CoV-2 delta variant infection

13 March 2022
Author(s): Noah Shopen, Michal Dekel, Michal Mizrahi, Efrat Zandberg, Daniel Talmud, Neta Cohen, Tel Aviv Sourasky Medical Center Emergency Department study group

To the editor,

Assessment of the clinical characteristics of ampicillin-susceptible Enterococcus faecium infection

12 March 2022
Author(s): Hiroshi Ito, Masahiro Watanabe, Ryoko Ogawa, Nobutake Shimojo

Dear Editor,

The precautionary principle in the COVID-19 vaccination campaign: The complicated relationship between the scientific community, medicines regulatory agencies and citizens

10 March 2022
Author(s): Paola Aurora Lobello, Alessandro Squizzato, Mario Picozzi

COronaVIrus Disease 19 (COVID-19) pandemia and vaccination campaign showed a frail relationship between the scientific community, medical authorities, and citizens. This clearly emerged when... more

Health-care associated infections surveillance in elderly patients

8 March 2022
Author(s): Andrea Zanichelli, Stefano Pietro Sgobba, Andrea Merlo, Chiara Beatrice Cogliati

Dear Editor, according with the WHO, Health-Care Associated Infections (HCAIs) are the most frequent adverse events during care delivery and represent a great clinical and economic burden [1]. In... more

Diabetes influences the performance of creatinine-based equations for estimating glomerular filtration rate in the elderly population

20 February 2022
Author(s): Yuanyuan Jiao, Shimin Jiang, Jiahui Zhou, Danyang Zhang, Wenge Li

The number of people older than 65 years with diabetes was 135.6 million in 2019, and will reach 276.2 million by 2045 [1]. Additionally, the estimated prevalence of diabetes in adults today has... more

Impact of therapeutic plasma exchange on acquired vaccinal anti-SARS-CoV-2 antibodies

13 February 2022
Author(s): Catherine Lambert, Anais Scohy, Jean Cyr Yombi, Eric Goffin, Arnaud Devresse

As of December 2021, more than 276 million affected cases and 5 million deaths were reported by the World Health Organization, due to the COVID-19 pandemic [1]. Following the outbreak's beginning,... more

Is the number of long-term post-COVID symptoms relevant in hospitalized COVID-19 survivors?

13 February 2022
Author(s): César Fernández-de-las-Peñas, Umut Varol, Stella Fuensalida-Novo, Susana Plaza-Canteli, Juan Antonio Valera-Calero

Dear editor,

Perspectives of European internists on multimorbidity. A multinational survey

11 February 2022
Author(s): M Bernabeu-Wittel, M Holecki, A Tuttolomondo, J Chudek, E Battegay, on behalf of the EFIM Multimorbidity Working Group

Dear Editor,

Original Article

IgA nephropathy with acute kidney disease: Characteristics, prognosis, and causes

28 June 2022
Author(s): Xutong Wang, Zuishuang Guo, Bo Huang, Minhua Xie, Jingjing Ren, Yuze Zhu, Haonan Guo, Yongli Wang, Dan Yu, Junjun Zhang, Linqi Zhang

The clinical manifestations and prognosis of IgA nephropathy (IgAN) are diverse. Some patients may present with kidney dysfunction lasting shorter than 3 months and meet the acute kidney disease (AKD... more

Physician care access plays a significant role in extending global and regional life expectancy

14 June 2022
Author(s): Wenpeng You, Frank Donnelly

Life expectancy is a statistical measure for the average number of years a person in a population could expect to live based on current age and sex-specific death rates [1]. It has been the most... more

Do we need blood culture stewardship programs? A quality control study and survey to assess the appropriateness of blood culture collection and the knowledge and attitudes among physicians in Swiss hospitals

14 June 2022
Author(s): Sarah Dräger, Céline Giehl, Kirstine Kobberøe Søgaard, Adrian Egli, Mirjam de Roche, Lars C. Huber, Michael Osthoff

As bloodstream infections (BSI) are associated with a mortality of 14% and up to 35% in critically ill patients, physicians often have a low threshold to collect blood cultures (BC) [1–3]. But... more

External validation of risk scores to predict in-hospital mortality in patients hospitalized due to coronavirus disease 2019

7 June 2022
Author(s): Shermarke Hassan, Chava L. Ramspek, Barbara Ferrari, Merel van Diepen, Raffaella Rossio, Rachel Knevel, Vincenzo la Mura, Andrea Artoni, Ida Martinelli, Alessandra Bandera, Alessandro Nobili, Andrea Gori, Francesco Blasi, Ciro Canetta, Nicola Montano, Frits R. Rosendaal, Flora Peyvandi, LUMC‐COVID‐19 Research Group, COVID-19 Network working group

The coronavirus disease 2019 (COVID-19) epidemic, which started in early December 2019, presents an important threat to global health. As of October 18th 2021, the number of patients confirmed to... more

T-cell immune response predicts the risk of critical SARS-Cov2 infection in hospitalized COVID-19 patients

2 June 2022
Author(s): Maxime Samson, Barbara Nicolas, Marion Ciudad, Hélène Greigert, Alexandre Guilhem, Claudie Cladiere, Cécile Straub, Mathieu Blot, Lionel Piroth, Thomas Rogier, Hervé Devilliers, Patrick Manckoundia, Thibault Ghesquiere, Stéphanie Francois, Daniela Lakomy, Sylvain Audia, Bernard Bonnotte

Assessment of Th17 cells could help target patients in need of anti-IL6R therapy.

A prediction model for central venous catheter-related thrombosis in patients with newly-diagnosed acute myeloid leukemia: A derivation cohort analysis

5 May 2022
Author(s): Shay Perek, Alaa Khatib, Niv Izhaki, Ali Sleman Khalaila, Benjamin Brenner, Netanel A. Horowitz

Venous thromboembolism (VTE) is a major cause of morbidity and mortality in cancer patients. In a large population-based cohort study from Denmark, the VTE incidence within the first 6 months after... more

Hepatitis C Elimination in the Netherlands (CELINE): How nationwide retrieval of lost to follow-up hepatitis C patients contributes to micro-elimination

5 May 2022
Author(s): Cas J. Isfordink, Marleen van Dijk, Sylvia M. Brakenhoff, Patricia A.M. Kracht, Joop E. Arends, Robert J. de Knegt, Marc van der Valk, Joost P.H. Drenth, on behalf of CELINE Study Group

Achieving hepatitis C virus (HCV) elimination as a global health threat has been a priority of many countries since the World Health Organisation published their elimination targets [1]. In low-... more

Impact of diabetes on the management and outcomes in atrial fibrillation: an analysis from the ESC-EHRA EORP-AF Long-Term General Registry

5 May 2022
Author(s): Wern Yew Ding, Agnieszka Kotalczyk, Giuseppe Boriani, Francisco Marin, Carina Blomström-Lundqvist, Tatjana S. Potpara, Laurent Fauchier, Gregory.Y.H. Lip, ESC-EHRA EORP-AF Long-Term General Registry Investigators

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, frequently associated with other conditions such as diabetes mellitus [1,2], and confers major healthcare costs [3]. Given... more

Impact of eGFR rate on 1-year all-cause mortality in patients with stable coronary artery disease

2 May 2022
Author(s): Leonardo De Luca, Francesca Cappadona, Pier Luigi Temporelli, Lucio Gonzini, Antonietta Ledda, Arturo Raisaro, Francesca Viazzi, Domenico Gabrielli, Furio Colivicchi, Michele Massimo Gulizia, Roberto Pontremoli, On-Behalf-of-the-START-Investigators

The prevalence of chronic kidney disease (CKD) is currently around 10% in the general population, a figure that grows up to 30-50% in at-risk subgroups such as those with diabetes, hypertension or... more

Epidemiological and genetic features of anti-3‑hydroxy-3-methylglutaryl-CoA reductase necrotizing myopathy: Single-center experience and literature review

26 April 2022
Author(s): Diana Prieto-Peña, Javier G. Ocejo-Vinyals, Joel Mazariegos-Cano, Ana L. Pelayo-Negro, Sara Remuzgo-Martínez, Fernanda Genre, Alicia García-Dorta, Mónica Renuncio-García, Víctor M. Martínez-Taboada, Carmen García-Ibarbia, Julio Sánchez-Martín, Marcos López-Hoyos, Ricardo Blanco, Miguel A. González-Gay, José L. Hernández

alanine aminotransferase

Usefulness of telemedicine-based heart failure monitoring according to ‘eHealth literacy’ domains: Insights from the iCOR randomized controlled trial

25 April 2022
Author(s): Sergi Yun, Cristina Enjuanes, Esther Calero-Molina, Encarnación Hidalgo, Núria José-Bazán, Marta Ruiz, José María Verdú-Rotellar, Paloma Garcimartín, Santiago Jiménez-Marrero, Alberto Garay, Mar Ras, Raúl Ramos, Alexandra Pons-Riverola, Pedro Moliner, Xavier Corbella, Josep Comín-Colet

Notwithstanding new pharmacological and non-pharmacological approaches, such as optimising care using new monitoring strategies,[1,2] heart failure (HF) remains a huge public health problem worldwide... more

Effects of non-invasive respiratory supports on inspiratory effort in moderate-severe COVID-19 patients. A randomized physiological study

21 April 2022
Author(s): Gioacchino Schifino, Maria L Vega, Lara Pisani, Irene Prediletto, Vito Catalanotti, Vittoria Comellini, Ilaria Bassi, Maurizio Zompatori, Marco Vito Ranieri, Stefano Nava

Non-invasive respiratory support (NRS), such as, Continuous Positive Airway Pressure (CPAP), High Flow Nasal Cannula (HFNC) or non-invasive ventilation (NIV), have been successfully applied to manage... more

Efficacy and safety of Janus kinase inhibitors in patients with ankylosing spondylitis: A systematic review and meta-analysis

20 April 2022
Author(s): Shu Li, Fen Li, Ni Mao, Jia Wang, Xi Xie

Ankylosing spondylitis (AS), also known as radiographic axial spondyloarthritis, is the advanced disease stage of axial spondyloarthritis (axSpA) [1]. It was characterized by enthesitis involving the... more

Echocardiographic markers of early alcoholic cardiomyopathy: Six-month longitudinal study in heavy drinking patients

10 April 2022
Author(s): Antonio Mirijello, Luisa Sestito, Christian Lauria, Claudia Tarli, Gabriele Angelo Vassallo, Mariangela Antonelli, Cristina d'Angelo, Anna Ferrulli, Filippo Crea, Anthony Cossari, Lorenzo Leggio, Salvatore De Cosmo, Antonio Gasbarrini, Giovanni Addolorato

Alcoholic cardiomyopathy (ACM) represents one of the leading causes of non-ischemic dilated myocardial disease in Western Countries [1]. ACM significantly contributes to the global burden of... more

Asymptomatic coronary artery disease assessed by coronary computed tomography in patients with systemic lupus erythematosus: A systematic review and meta-analysis

8 April 2022
Author(s): Claudia Mendoza-Pinto, Pamela Munguía-Realpzo, Mario García-Carrasco, Karla Godinez-Bolaños, Adriana Rojas-Villarraga, Ivet Morales-Etchegaray, Jorge Ayón-Aguilar, Socorro Méndez-Martínez, Ricard Cervera

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with female predominance: cardiovascular disease (CVD) is the leading cause of morbidity and mortality. Accelerated atherosclerosis... more

Benefits of more intensive versus less intensive blood pressure control. Updated trial sequential analysis

6 April 2022
Author(s): Gianpaolo Reboldi, Fabio Angeli, Giorgio Gentile, Paolo Verdecchia

High blood pressure (BP) remains a dominant risk factor for cardiovascular disease and death worldwide [1,2]. The progressive decline in the incidence of cardiovascular disease, particularly stroke,... more

Interleukin-6 inhibitors reduce mortality in coronavirus disease-2019: An individual patient data meta-analysis from randomized controlled trials

6 April 2022
Author(s): Panagiotis T. Tasoudis, Christina K. Arvaniti, Anastasia T. Adamou, Ioannis Belios, John H. Stone, Nora Horick, Dimitrios Sagris, George N. Dalekos, George Ntaios

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019 and was declared a pandemic in March 2020 by the World Health Organization (WHO) [1]. Clinical manifestations... more

Reconsidering the Edelman equation: impact of plasma sodium concentration, edema and body weight

4 April 2022
Author(s): Jetta J. Oppelaar, Mart D. Vuurboom, Eliane F.E. Wenstedt, Frans J. van Ittersum, L. Vogt, Rik H.G. Olde Engberink

Hypernatremia and hyponatremia, are commonly encountered electrolyte disturbances in clinical practice [1,2]. The pathophysiology underlying these disturbances is complex and clinicians often face... more

Non-alcoholic fatty liver disease: identical etiologic factors in patients with type 1 and type 2 diabetes

3 April 2022
Author(s): Marieke de Vries, Fatima El-Morabit, Karel J. van Erpecum, Jan Westerink, Simon T. Bac, H.A.H. (Karin) Kaasjager, Harold W. de Valk

Alongside the obesity-epidemic, non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide, with an estimated prevalence of 25% in the general population [1... more

Incidence of endocrine and exocrine insufficiency in patients with autoimmune pancreatitis at diagnosis and after treatment: a systematic review and meta-analysis

30 March 2022
Author(s): Marco Lanzillotta, Matteo Tacelli, Massimo Falconi, Paolo Giorgio Arcidiacono, Gabriele Capurso, Emanuel Della-Torre

Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis that can lead to end-stage organ damage if left untreated [1]. To date, at least two different subtypes of AIP have been... more

P2Y12 inhibitors plus aspirin for acute treatment and secondary prevention in minor stroke and high-risk transient ischemic attack: A systematic review and meta-analysis

21 March 2022
Author(s): Fulvio Pomero, Eleonora Galli, Marta Bellesini, Lorenzo Maroni, Alessandro Squizzato

Stroke is a leading cause of mortality and disability worldwide [1] and approximately 20 to 25% of ischemic stroke are anticipated by transient ischemic symptoms [2]. The risk of ischemic stroke... more

Association between admission ECG changes and long-term mortality in patients with an incidental myocardial infarction: Results from the KORA myocardial infarction registry

19 March 2022
Author(s): Timo Schmitz, Bastian Wein, Heiko Methe, Jakob Linseisen, Margit Heier, Annette Peters, Christa Meisinger

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in Germany and worldwide [1,2]. It is grouped into two main categories according to admission ECG: ST-Elevation... more

Survival in rhino-orbito-cerebral mucormycosis: An international, multicenter ID-IRI study

15 March 2022
Author(s): Yasemin Cag, Hakan Erdem, Mehmet Gunduz, Suheyla Komur, Handan Ankarali, Serap Ural, Meltem Tasbakan, Pierre Tattevin, Anil Tombak, Derya Ozturk-Engin, Ayse Sagmak Tartar, Ayse Batirel, Recep Tekin, Fazilet Duygu, Hulya Caskurlu, Behice Kurtaran, Bulent Durdu, Demet Haciseyitoglu, Jordi Rello, ID-IRI Mucormycosis Study Group

Mucormycosis is an aggressive mold infection that mostly attacks patients with certain underlying conditions such as diabetes, hematological malignancies, neutropenia, major solid organ... more

Consensus on prevention and treatment of cancer-associated thrombosis (CAT) in controversial clinical situations with low levels of evidence

25 February 2022
Author(s): Paula Jiménez-Fonseca, Enrique Gallardo, Fernando Arranz Arija, Jesús Manuel Blanco, Ana Callejo, Diego Cacho Lavin, Marinha Costa Rivas, Joaquín Mosquera, Alberto Rodrigo, Raúl Sánchez Morillas, María Vares Gonzaléz, Andrés Muñoz, Alberto Carmona-Bayonas

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality among cancer patients. They develop more VTE than those without cancer and experience higher rates of VTE recurrence and... more

Ultrasound evaluation of bowel vasculopathy in systemic sclerosis

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

Review Article

COVID-19, vaccines and deficiency of ACE2 and other angiotensinases. Closing the loop on the "Spike effect"

21 June 2022
Author(s): Fabio Angeli, Gianpaolo Reboldi, Monica Trapasso, Martina Zappa, Antonio Spanevello, Paolo Verdecchia

The role of a dysregulated renin-angiotensin system (RAS) in the pathogenesis of COVID-19 is well recognized. The imbalance between angiotensin II (Ang II) and Angiotensin1-7 (Ang1,7) caused by the... more

Sudden death in young athletes: Is it preventable?

17 June 2022
Author(s): Pietro Amedeo Modesti, Giancarlo Casolo, Iacopo Olivotto, Alessio Pellegrino

Sudden deaths in athletes (SDA) are rare but devastating events, with huge social impact and vast echo in the media. Elite athletes are contemporary icons epitomizing health and success, promoting... more

From mid-range to mildly reduced ejection fraction heart failure: A call to treat

13 June 2022
Author(s): Davide Stolfo, Enrico Fabris, Lars H. Lund, Gianluigi Savarese, Gianfranco Sinagra

The historical classification of heart failure (HF) has considered two distinct subgroups, HF with reduced ejection fraction (HFrEF), generally classified as EF below 40%, and HF with preserved... more

Epidemiology of portal vein thrombosis in liver cirrhosis: A systematic review and meta-analysis

7 June 2022
Author(s): Jiahui Pan, Le Wang, Fangbo Gao, Yang An, Yue Yin, Xiaozhong Guo, Filipe Gaio Nery, Eric M. Yoshida, Xingshun Qi

Liver cirrhosis is the 11th most common cause of death worldwide [1]. The number of deaths from liver cirrhosis increased from 899,000 in 1990 to 1,320,000 in 2017, constituting 2.4% of total deaths... more

Evolving concepts in the management of antithrombotic therapy in patients undergoing transcatheter aortic valve implantation

24 May 2022
Author(s): Dirk Jan van Ginkel, Willem L. Bor, Leo Veenstra, Arnoud W.J. van 't Hof, Enrico Fabris

Transcatheter aortic valve implantation (TAVI) is an effective and less invasive treatment option compared with conventional surgical aortic valve replacement (SAVR), and is the standard of care for... more

Perspectives on the pharmacological management of alcohol use disorder: Are the approved medications effective?

18 May 2022
Author(s): Mariangela Antonelli, Luisa Sestito, Claudia Tarli, Giovanni Addolorato

Alcohol use disorder (AUD) is characterized by a large consumption of alcoholic beverages, which can determine the onset of alcohol-related diseases and an overall increase of morbidity and mortality... more

Low serum albumin: A neglected predictor in patients with cardiovascular disease

7 May 2022
Author(s): Antonis A. Manolis, Theodora A. Manolis, Helen Melita, Dimitri P. Mikhailidis, Antonis S. Manolis

Albumin, the most abundant circulating protein in blood (accounting for 50% of the plasma proteins), composed of 585 amino acids with a molecular weight of 66 kDa, binds and transports various drugs... more

Acute kidney injury associated with non-steroidal anti-inflammatory drugs

6 May 2022
Author(s): Nattawat Klomjit, Patompong Ungprasert

Non-steroidal anti-inflammatory drugs (NSAIDs) are ones of the commonly prescribed drugs worldwide. They primarily inhibit cyclooxygenase (COX) enzyme which is responsible for conversion of... more

Uric acid in metabolic syndrome: Does uric acid have a definitive role?

1 May 2022
Author(s): Sidar Copur, Atalay Demiray, Mehmet Kanbay

The final product of purine metabolism is uric acid (UA) which is produced by xanthine oxidase (XO). Although most mammalian species can also oxidize UA to allantoin via uricase, humans are thought... more

Renin-angiotensin-aldosterone system inhibition in patients affected by heart failure: efficacy, mechanistic effects and practical use of sacubitril/valsartan. Position Paper of the Italian Society of Cardiology

22 April 2022
Author(s): Pasquale Perrone-Filardi, Stefania Paolillo, Piergiuseppe Agostoni, Christian Basile, Cristina Basso, Francesco Barillà, Michele Correale, Antonio Curcio, Massimo Mancone, Marco Merlo, Marco Metra, Saverio Muscoli, Savina Nodari, Alberto Palazzuoli, Roberto Pedrinelli, Roberto Pontremoli, Michele Senni, Massimo Volpe, Ciro Indolfi, Gianfranco Sinagra

Renin-angiotensin-aldosterone system (RAAS) activation is one the main pathophysiological mechanisms involved in the development and progression of heart failure (HF) and its inhibition is a mainstay... more

Intensive blood pressure control on dementia in patients with chronic kidney disease: Potential reduction in disease burden

21 April 2022
Author(s): Sidar Copur, Metehan Berkkan, Pantelis Sarafidis, Mehmet Kanbay

Chronic kidney disease (CKD) is defined by either presence of a decline in renal function, mostly assessed via creatinine or cystatin C-based estimated glomerular filtration rate (eGFR) measurements... more

Sodium glucose cotransporter-2 inhibitors protect the cardiorenal axis: Update on recent mechanistic insights related to kidney physiology

9 April 2022
Author(s): Charlotte C. van Ruiten, Anne C. Hesp, Daniël H. van Raalte

Diabetic kidney disease (DKD) is a common complication of diabetes, affecting ∼ 40% of patients with type 2 diabetes (T2D) [1]. DKD is characterized by increased urinary albumin excretion and/or... more

Adult anaphylaxis: A state-of-the-art review

6 March 2022
Author(s): Carlo Maria Rossi, Marco Vincenzo Lenti, Antonio Di Sabatino

Anaphylaxis is an acute, usually rapidly developing, systemic (involving multiple organs) allergic reaction and, among the various clinical forms of allergy, it is the most severe and potentially... more


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