March 2022
56 ArticlesNo Section
Convalescent plasma for COVID-19. TSUNAMI is not the final word
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].
Autosplenectomy
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
An unusual cause of colitis
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
The age-adjusted D-dimer cutoff level to rule out pulmonary embolism in patients with syncope
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
Real-life data on the impact of successful downstaging in patients with hepatocellular carcinoma: A Dutch Multicenter Study
Hepatocellular Carcinoma
The relevance of nutritional and metabolic derangements in COVID-19 patients
Dear Editor,
Correlation of non-invasive oxygenation parameters with paO2/FiO2 ratio in patients with COVID-19 associated ARDS
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
GDF-15: A biomarker-based prediction for bleeding-cardiovascular death
Dear Editor,
Sleep disturbances and related factors: Mechanism and treatment
Dear Editor,
Factors associated with persistence of symptoms 1 year after COVID-19: A longitudinal, prospective phone-based interview follow-up cohort study
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
Short term blood pressure alterations in recently COVID-19 vaccinated patients
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
Procedural myocardial infarction and major myocardial injury after percutaneous coronary interventions in chronic coronary syndrome: Is the fog really waning?
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
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
Representativity of women and racial/ethnic minorities in randomized clinical trials on bempedoic acid: Positive efforts and lacking data
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
Learning in times of stress: Lessons from COVID-19 that will last throughout this century
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
Dear Editor,
Hematuria and subsequent long-term risk of end-stage kidney disease: A Danish population-based cohort study
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
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
A year later
Anticoagulant therapy for COVID-19: What we have learned and what are the unanswered questions?
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
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
The 2021 ESC guidelines on cardiovascular prevention: Whether the ends justify the means
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
Clinical Insights
Does early systemic sclerosis really exist?
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
Commentary
Pregnancy-related venous thromboembolism: Progress but questions remain
The care of pregnant persons at risk for or with known or suspected venous thromboembolism (VTE) has many challenges; including specialized content knowledge, a limited high-quality evidence base... more
Gender distribution in boards of internal medicine societies and paper authorship: Networking is the key to success
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
The effect of telemedicine in heart failure based on frailty phenotypes
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”
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?
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
Concise report
Off-label use of biologics for the treatment of refractory and/or relapsing granulomatosis with polyangiitis
Granulomatosis with polyangiitis (GPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAVs), characterized by granulomatous necrotizing vasculitis of small vessels [1].... more
Internal Medicine Flashcard
Abdominal aortic aneurysm and gas in the kidney in a diabetes patient
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
Acute abdominal pain following esophagogastroduodenoscopy
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
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
Darier's sign
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
Letter to the Editor
COVID-19 infection survivors and the risk of depression and anxiety symptoms: A nationwide study of adults in the United States
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
Return to work after hospitalisation for COVID-19 infection
Dear Editor
SARS-CoV-2 antibody response eight months after vaccination with mRNA vaccines. Influence of prior SARS-CoV-2 exposure
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
Colchicine for the prevention of COVID-19 “hard” outcomes: All that glitters is not gold
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
Trends and outcomes of opioid-related cardiac arrest in a contemporary US population
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
Colchicine for COVID-19: Hype or hope?
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
Gender gap in authorship: a study of 44,000 articles published in 100 high-impact general medical journals
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
Original Article
The Birmingham and Black Country cohort of Venous Thromboembolism (BBC-VTE) registry: Rationale, design and preliminary results
Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE) is a severe condition which causes significant morbidity and mortality in hospitalised patients as... more
Real world comparison of spironolactone and eplerenone in patients with heart failure
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
Outcome of SARS CoV-2 inpatients treated with convalescent plasma: One-year of data from the Veneto region (Italy) Registry
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
Interstitial pneumonia with autoimmune features: Evaluation of connective tissue disease incidence during follow-up
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
Renal outcomes associated with glucose-lowering agents: Systematic review and meta-analysis of randomized outcome trials
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
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
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
Neutrophil count, lymphocyte count and neutrophil-to-lymphocyte ratio in relation to response to adjunctive dexamethasone treatment in community-acquired pneumonia
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
Left ventricular global longitudinal strain in secondary hypertension: A meta-analysis of echocardiographic studies
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
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
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
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
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
Review Article
Venous thromboembolism during pregnancy and postpartum period
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
Drug-induced liver injury: Pathogenesis, epidemiology, clinical features, and practical management
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
The impact of nutrition and lifestyle modification on health
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
Colchicine – new horizons for an ancient drug. Review based on the highest hierarchy of evidence
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
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