June 2023

33 Articles

No Section

Treatment of recurrent pericarditis in elderly

16 February 2023
Author(s): Maria Grazia MASSARO, Antonella GALLO, Massimo MONTALTO, Raffaele MANNA, Gemelli-Against-Pericarditis Group

Dear Editor,

Clinical Insights

Searching the literature to explain unexpected clinical observations: all that glitters is not gold

12 April 2023
Author(s): T.E. van Mens, F.A. Klok, M. Levi

Curiosity is a core quality of healthcare professionals. When confronted with an unexpected clinical observation, for instance a remarkable symptom in a patient with an apparently unrelated disease,... more

Safety of COVID-19 vaccines

10 April 2023
Author(s): Rasi Virginia, Rasi Guido

Coronavirus disease 2019 (COVID-19) vaccines deployed in the European Union (EU) and assessed by the European Medicines Agency (EMA) have been developed and approved in less than 12 months, still... more


Novel LDL-cholesterol lowering therapies: A step forward a personalized medicine

1 May 2023
Author(s): Maurizio Averna, Angelo B. Cefalù

The Low-density lipoproteins (LDL) as well as all the ApoB-containing lipoproteins (VLDL remnants and Lp(a)) are etiological factors of atherosclerotic cardiovascular diseases (ASCVD). Several... more

Mortality and causes of death in systemic lupus erythematosus revisited

8 April 2023
Author(s): Giuseppe Barilaro, Ricard Cervera

Since the first description of the bimodal mortality pattern in systemic lupus erythematosus (SLE) in 1976 [1], it seemed clear that disease activity, renal involvement and infections played a major... more

Decoding risk: Caravaggio's insights into risk factors for anticoagulation in cancer-associated thrombosis

28 March 2023
Author(s): Javier López Robles, Alberto Carmona-Bayonas, Paula Jiménez-Fonseca

Predicting the risk of rethrombosis and hemorrhage in cancer patients with venous thromboembolism (VTE) poses a considerable challenge. The wide range of individual differences in this population... more

Clinical implications of the biological ambivalence of uric acid

27 March 2023
Author(s): Giovambattista Desideri, Giorgio Sesti

Uric acid has historically been viewed as an inert waste product of purine metabolism, just like urea for proteins, able to crystallize at high concentrations, thus causing gouty arthritis and renal... more

Internal Medicine Flashcard

A typical but rare cause of hemoptysis

12 March 2023
Author(s): Fang Wang, Gui-bin Zhuang, Hao Guo

A 51-year-old female patient was admitted to our institution because of abnormal lung shadows that were accidentally found during her health examination. The patient did not experience fever, cough,... more

Bilateral enlarged ovarian masses and hypothyroidism

12 March 2023
Author(s): Anand K. Annamalai, Rajamanikkam Hemamalini, Mark Gurnell

A 15-year-old female, with irregular menses, presented with a two-week history of abdominal pain and enlargement. She had no past medical history and she was not taking any medications. On clinical... more

A female with left lower limb deep vein thrombosis

12 March 2023
Author(s): A. Ledain, P. Kauffmann, P. Le Borgne

A 42-year-old female patient presented to the Emergency Department (ED) for unilateral edema involving the entire left lower limb that had been rapidly progressing in the last 24 h. It was associated... more

Letter to the Editor

Solid organ transplantation: Need of a new paradigm integrating biological sex

12 April 2023
Author(s): Jordi Rello, Oriol Manuel, Teresa Pont

Dear Editor,

Does biological sex matter in solid organ transplantation?

5 April 2023
Author(s): Francesca Rubulotta, Thomas Hemmerling

Solid organ transplantation (SOT) has become an increasingly common procedure in the management of end-stage organ disease. While sex is a biologically determined characteristic that affects the... more

COVID-19 vaccines and increased blood pressure

29 March 2023
Author(s): Amnuay Kleebayoon, Viroj Wiwanitkit

Dear Editor, we would like to share some ideas on the article “The relationship between coronavirus disease 2019 (COVID-19) vaccines and increased blood pressure: A word of caution. [1].”Although... more

Severe acute respiratory syndrome coronavirus 2 evolution: How mutations affect XBB.1.5 variant

29 March 2023
Author(s): Martina Zappa, Paolo Verdecchia, Fabio Angeli

The ongoing Coronavirus Disease 2019 (COVID-19) pandemic is currently driven by the highly infectious Omicron variant of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which was first... more

Clinical outcomes of patients with incident atrial fibrillation diagnosed by cardiologists compared to non-cardiologists

10 March 2023
Author(s): Shin-Huei Liu, Tze-Fan Chao, Yi-Hsin Chan, Jo-Nan Liao, Shih-Ann Chen

Dear Editor,

Therapeutic adherence in hyperlipidemia: When one size doesn't fit all

7 March 2023
Author(s): Beatrice Dal Pino, Francesco Sbrana

Dear Editor,

Telemedicine in internal medicine: A statement by the European Federation of Internal Medicine.

3 March 2023
Author(s): Pietrantonio Filomena, Kuhn Sebastian, Kärberg Kati, Leung Tiffany, Said-Criado Ismael, EFIM Telemedicine, Innovative Technologies and Digital Health Working Group

The World Health Organization defines telemedicine as “the delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication... more

Safety of arterial catheters in internal medicine ward: A new competence for the internist?

3 March 2023
Author(s): O. Para, L. Caruso, I. Merilli, C. Carleo, F. Bucci, C. Nozzoli

Dear editor,

Colchicine and mortality outcomes in patients with coronavirus disease (COVID-19)

15 February 2023
Author(s): Mohammed I. Danjuma, Ridhima Kaul, Tamader Alyaarabi, Basant Elsayed, Mohamed Elshafei

One of the therapeutic hallmarks of the ongoing (COVID-19) pandemic has been the different iterations of successful and sometimes unsuccessful attempts at re-purposing of drugs with pre-existing... more

Safety of COVID-19 vaccines: A comparison between adverse drug reactions among vaccines marketed in Europe

12 February 2023
Author(s): Alfredo Jose Pardo-Cabello, Victoria Manzano-Gamero, Juan de Dios Luna

The current pandemic of coronavirus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome CoronaVirus-2 (SARS-CoV-2) prompted the rapid production of vaccines against the virus. In view... more

Statistical models to predict clinical outcomes with anakinra vs. tocilizumab treatments for severe pneumonia in COVID19 patients

5 February 2023
Author(s): Stefania Piconi, Silvia Pontiggia, Marco Franzetti, Francesco Branda, Davide Tosi

Dear Editor,

Original Article

Can we predict the treatment doses of THC and CBD and does it matter?

30 March 2023
Author(s): Nitzan Halamish, Lihi Bar-Lev Schleider, Sydney McGuire, Victor Novack

Of the hundreds of cannabinoids that have been identified in the cannabis plant, the most well-known are Δ9-Tetra-Hydrocannabinol (Δ9-THC) and cannabidiol (CBD) [1,2]. Cannabis chemovars are... more

Prevalence, awareness, and treatment of isolated diastolic hypertension in the United States

29 March 2023
Author(s): Xuexue Zhang, Xujie Wang, Miaoran Wang, Hua Qu, Biaoyan Hu, Qiuyan Li

Isolated diastolic hypertension (IDH) is a subtype of hypertension that is relatively uncommon, accounting for less than 20% of all hypertension cases [1]. It is highly prevalent in the young and... more

Older patients with nonspecific complaints at the Emergency Department are at risk of adverse health outcomes

29 March 2023
Author(s): C.S. van Dam, M.J.L. Peters, E.O. Hoogendijk, P.W.B. Nanayakkara, M. Muller, M.C. Trappenburg

Older adults who visit the Emergency Department (ED) often present with nonspecific complaints (NSC) due to age related physiologic changes, reduced functional reserves, comorbidities and cognitive... more

Spontaneous portosystemic shunts outside the esophago-gastric region: Prevalence, clinical characteristics, and impact on mortality in cirrhotic patients: A systematic review and meta-analysis

27 March 2023
Author(s): Qiao Ke, Jian He, Xinhui Huang, Ling Li, Jingfeng Liu, Wuhua Guo

Cirrhosis is the terminal stage of various chronic liver diseases [1,2]. Patients with compensated cirrhosis are usually asymptomatic, while those in the decompensated stage have clinical... more

The initial timing and dosage pattern of sacubitril/valsartan in patients with acute myocardial infarction undergoing percutaneous coronary intervention

27 March 2023
Author(s): Jun Gu, Yue Wang, Chang-qian Wang, Jun-feng Zhang

Despite the development of coronary intervention techniques and advances in medication, acute myocardial infarction (AMI) remains the main cause of death from coronary artery disease [1].... more

Association between cumulative dose of hydroxychloroquine and electrocardiographic abnormalities in patients with systemic lupus erythematosus

20 March 2023
Author(s): Jon Zubiaur, Alba Herrero-Morant, Adrián Margarida de Castro, Raquel Pérez-Barquín, Ivan Ferraz-Amaro, Javier Loricera, Santos Castañeda, Ricardo Blanco

Systemic lupus erythematosus (SLE) is a chronic, multisystemic disease with a variable and potentially severe prognostic course [1]. Antimalarial agents, such as chloroquine (CQ) and, mainly,... more

Current evidence and clinical utility of phenobarbital for alcohol withdrawal syndrome

17 March 2023
Author(s): Yoshito Nishimura, Horyun Choi, Bridget Colgan, Harrison Kistler, Francisco Mercado

Alcohol is the most commonly abused substance in the United States, with an estimated 1.2 million hospital admissions being related to the abuse. Approximately 500,000 episodes of withdrawal symptoms... more

Risk factors for recurrence and major bleeding in patients with cancer-associated venous thromboembolism

9 February 2023
Author(s): Maria Cristina Vedovati, Michela Giustozzi, Andrés Munoz, Laurent Bertoletti, Alexander T. Cohen, Frederikus A. Klok, Jean M. Connors, Rupert Bauersachs, Benjamin Brenner, Mauro Campanini, Cecilia Becattini, Giancarlo Agnelli

Cancer and venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), are linked by a two-way association [1]. On one hand, 15–20% of patients who are... more

Mortality and causes of death in systemic lupus erythematosus over the last decade: Data from a large population-based study

9 February 2023
Author(s): Margherita Zen, Laura Salmaso, Claudio Barbiellini Amidei, Ugo Fedeli, Stefania Bellio, Luca Iaccarino, Andrea Doria, Mario Saia

Systemic lupus erythematosus (SLE) is a complex, severe autoimmune disease which can potentially lead to life-threatening manifestations and therapy-associated complications. Common causes of death... more

Serum uric acid variation and the risk of cardiovascular disease: A prospective cohort study

9 February 2023
Author(s): Xue Tian, Shuohua Chen, Yijun Zhang, Xiaoli Zhang, Qin Xu, Penglian Wang, Shouling Wu, Yanxia Luo, Anxin Wang

Serum uric acid (SUA) is an end product of purine nucleotide catabolism arising from endogenous and exogenous sources [1,2]. The SUA levels are rigorously controlled by the balance between SUA... more

Review Article

Vasovagal syncope: An overview of pathophysiological mechanisms

6 April 2023
Author(s): Susanna Longo, Jacopo M. Legramante, Stefano Rizza, Massimo Federici

Syncope is a transient loss of consciousness, characterized by amnesia, loss of postural tone, occasional disturbances of smooth muscle control, which is spontaneously reversible [1]. According to... more

Current and future options in cholesterol lowering treatments

20 February 2023
Author(s): Avishay Elis

The relative risk reduction of cardiovascular events is proportional to the absolute reduction in LDL-C levels, the primary target of therapy, no matter the way of reduction. During the last decades... more


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