March 2023

112 Articles

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Intravenous pulse methylprednisolone for the treatment of severe COVID-19

16 February 2023
Author(s): Dimitrios Patoulias, Athina Dimosiari

Corticosteroids still represent one of the cornerstone treatment options for subjects hospitalized with coronavirus disease 2019 (COVID-19), especially for those suffering from a severe form of the... more

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

Clinical pearls and pitfalls of SARS-CoV-2 serology

20 March 2023
Author(s): Giuseppe Lippi, Brandon M. Henry

Although the effort to provide updated and reliable statistics about coronavirus disease 2019 (COVID-19) remains a challenging enterprise due to the ongoing epidemiologic evolution and an almost... more

The relationship between COVID-19 vaccines and increased blood pressure: A word of caution

6 March 2023
Author(s): Giacomo Buso, Claudia Agabiti-Rosei, Maria Lorenza Muiesan

COVID-19 vaccines substantially changed the course of the pandemic, saving millions of lives on a global scale [1]. According to the latest evidence, 64.85% of the world's population has been fully... more


Combination therapy as a first step of treatment in diabetes: Changing the paradigm in KDIGO guidelines?

15 March 2023
Author(s): Nicolás Roberto Robles, Alvaro Alvarez, Francesco Fici

The use of more than one drug in the initial management of hypertension under certain instances has been recognized as paramount and is featured in several clinical guidelines for high blood pressure... more

The environmental impact of unnecessary imaging: Why less is more

4 March 2023
Author(s): Rohini V. Kopparam, Rita F. Redberg

Global warming is a global health crisis of epidemic proportions. As glaciers melt, oceans and rivers rage and catastrophic weather events become more common, it is critical to do all we can to slow... more

Network meta-analysis: A map to navigate the maze of treatment for advanced hepatocellular carcinoma

22 February 2023
Author(s): Antonio D'Alessio, Antonella Cammarota, Lorenza Rimassa

The treatment landscape of advanced hepatocellular carcinoma (HCC) has become increasingly complex over the past few years [1]. After the decade-long multi-kinase inhibitor (MKI) monopoly of... more

Lung ultrasound must be the first-line image technique in COVID-19 patients

19 February 2023
Author(s): Juan Torres-Macho, Miguel Angel Casado-Suela, Mercedes Duffort-Falcó

Lung ultrasound (LUS) is a paradigm of Point of Care Ultrasound values. First, it has no “owner” because its use has been developed by different specialties such as Intensive Care Medicine, Emergency... more

De-escalation in intensity or duration of dual antiplatelet therapy in patients with coronary artery disease: More than alternative treatment options

19 February 2023
Author(s): Antonio Landi, Serena Caglioni, Marco Valgimigli

Antithrombotic therapy represents the mainstay of pharmacological treatments in patients with acute or chronic coronary syndrome (CCS) undergoing percutaneous coronary intervention (PCI) [1]. Since... more

Endovascular therapy for basilar occlusion: Is there robust evidence?

6 February 2023
Author(s): Maurizio Paciaroni

The combined rate of mortality and severe disability for patients with acute basilar artery occlusion is as high as 90% [1,2]. Observational studies report that with revascularization therapies this... more

Identifying patients at risk for chronic thromboembolic pulmonary hypertension

25 January 2023
Author(s): Marcel Levi

Patients with chronic thromboembolic pulmonary hypertension represent a subgroup of patients suffering from pulmonary hypertension. The disease is characterized by chronic, non-resolving... more

Antimicrobial stewardship at the emergency department: Dead bugs do not mutate!

19 January 2023
Author(s): Jordi Rello, José Artur Paiva

Detecting organisms in blood is a key determinant in sepsis management [1] and in optimizing antimicrobial use in hospitalized patients [2]. Conway et al. [3] reported that blood cultures were... more

Ideas and Opinions

General health check-ups: To check or not to check? A question of choosing wisely

4 January 2023
Author(s): Omar Kherad, Antonio Vaz Carneiro, On behalf of Choosing wisely working group of the European Federation of Internal Medicine

In high-income countries, regular general health check-ups are part of the fabric of the health care systems. The hidden concept of general health check-ups, promoted for more than a century, is to... more

Internal Medicine Flashcard

Yellow-Tinted Dialysis Drainage

19 March 2023
Author(s): Masatoshi Inoue

A 69-year-old woman, with end-stage renal disease and in a hemodialysis program for 11 years, presented to a dialysis treatment center for maintenance hemodialysis without symptoms. We started... more

Peculiar genital lesions

15 March 2023
Author(s): Govind Srivastava, Gautam Srivastava

A 25-year-old university student presented with a 3-day history of malaise, sore throat, and one-day history of skin lesions on the penis with isolated lesions on the arms and palms. He has a history... more

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

Secondary amenorrhoea with absent axillary hair

11 March 2023
Author(s): Anand K Annamalai, K.G. Srinivasan, M. Gurnell

A 39-year-old female presented with progressive fatigue, extreme tiredness, muscle pain, giddiness and shortness of breath for six months. On further questioning she reported lack of menses for 19... more

Sudden erythematous cutaneous eruption

11 March 2023
Author(s): Alvaro Prados-Carmona, Marta Cebolla-Verdugo, Ricardo Ruiz-Villaverde

A 43-year-old male with a history of hypertension, diabetes and obesity (BMI > 55) presented to the Emergency Department with a pruritic palpable rash for several days. It had started suddenly as... more

Eruptive yellowish red papules in a fat youth

27 January 2023
Author(s): Li-wen Zhang, Tao Chen, Rong-hua Xu

A 22-year-old man presented with a 6-week history of generalized asymptomatic papules (Fig. 1A). The rashes were increasing gradually and predominantly distributed on the back and the extensor... more

Hepatobiliary diseases

10 January 2023
Author(s): Yuanhao Xia, Hao Guo, Heng Ma

A 60-year-old woman had been diagnosed with Gallstone five years previously. The patient's symptoms were relieved following anti-inflammatory therapy for one week. She was now admitted to... more

Zosteriform erythematous rash

28 December 2022
Author(s): Siddhartha Dash, Biswanath Behera, Vishal Thakur

A 70-years-old male presented with unilateral rash below the right axilla of one-month duration. The patient gave history of cough with shortness of breath for the last two years and pain in the... more

Peculiar form of rapidly progressive pneumonia in healthy man

25 December 2022
Author(s): Valeria Bellelli, Gabriella De Girolamo, Giovanni Talerico

A healthy 53–years-old male presented to ED with fever and arthralgia for two days. On admission the patient was alert, oriented, febrile; thoracic exam revealed crackles in left basal area. Blood... more

A plaque on the right retropharyngeal wall

24 December 2022
Author(s): Yu-Kun Zhao, Jing-Fa Lu, Di-Qing Luo

A 25-year-old unmarried man was referred because of 1-week history of mildly sore throat, without association of systemic symptoms. He had an oral sex with a man 3 weeks before his presentation. His-... more

Dyspnea with chylothorax: Importance of examining the nails

23 December 2022
Author(s): Maud Pichon, Ines Zaraa, Françoise Le Pimpec-Barthes

A previously healthy 53-year-old man presented to our department with 2 months of dyspnea. Lung examination revealed a left-sided pleural effusion confirmed on the chest radiograph (Fig. 1A) and CT... more

Internal Medicine Flashcards

Multiple pulmonary opacities. An alarming sign?

13 March 2023
Author(s): Shay Brikman, Guy Dori

A 60-year-old man with a history of chronic transfusion-dependent β-thalassemia intermedia, splenectomy and secondary hemochromatosis was admitted due to one week of fever and non-respiratory... more

Letter to the Editor

Differences in reporting of adverse drug reactions due to COVID-19 vaccines depending on the reporter

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

The pandemic of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 provoked the rapid generation and mass production of vaccines against the virus. In this serious situation, the European... more

C-reactive protein level association with future cardiovascular events assessed by different risk scores among rheumatoid arthritis patients

21 March 2023
Author(s): Gian Luca Erre, Elena Bartoloni, Ombretta Viapiana, Elisa Gremese, Fabiola Atzeni, “Cardiovascular, Obesity and Rheumatic Disease Study (CORDIS) Group” of the Italian Society of Rheumatology (SIR)

We appreciate the interest of Noriaki Kou and colleagues [1] in our article [2], and we fully agree that beside disease activity, therapies, and systemic inflammation other non-traditional... more

Characteristics and trends of publications in the European Journal of Internal Medicine

19 March 2023
Author(s): Thomas Gamstaetter

Scientific journals play a central role in informing the science and practice of Internal Medicine, in particular through the publication of clinical trials and systematic reviews [1]. The relevancy... 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,

Safety and efficacy of colchicine for the prevention of recurrent atrial fibrillation post-catheter ablation

15 February 2023
Author(s): Siddharth Agarwal, Muhammad Bilal Munir, Zain Ul Abideen Asad

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

Treatment of acute alcohol intoxication: The role of metadoxine

14 February 2023
Author(s): Antonio Mirijello, Giovanni Addolorato

Dear Editor,

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

Evolution of the SARS-CoV-2 epidemic: From genomic surveillance to new health needs

10 February 2023
Author(s): Andrea Giacomelli, Anna Lisa Ridolfo, Letizia Oreni, Giuliano Rizzardini, Spinello Antinori

Dear editor

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,

Lower risks of incident colorectal cancer in SGLT2i users compared to DPP4i users: A propensity score-matched study with competing risk analysis

31 January 2023
Author(s): Raymond Ngai Chiu Chan, Robert Ngai Fung Chan, Oscar Hou In Chou, Gary Tse, Sharen Lee

Dear Editor,

Effectiveness and persistence with selexipag in pulmonary arterial hypertension in the real-life setting

30 January 2023
Author(s): R. Del Pozo, I. Blanco, M. López-Meseguer, P. Escribano-Subías, A. Cruz Utrilla

The prostanoid analog epoprostenol, the first approved targeted therapy for pulmonary arterial hypertension (PAH), is also the only one that has shown any benefit for survival vs. placebo in PAH... more

Point of care ultrasound in internal medicine in Portugal – where we are and where we should go?

30 January 2023
Author(s): Miguel Romano, José Mariz

Point-of-care ultrasound (POCUS) is growing rapidly across a broad span of specialties in Medicine as a whole, worldwide. Further, POCUS is driving a revolution in every aspect of clinical practice [... more

The impact of atrial fibrillation on outcomes in patients hospitalized with COVID-19

25 January 2023
Author(s): Siddharth Agarwal, Muhammad Bilal Munir, Stavros Stavrakis, Jonathan P Piccini, Zain Ul Abideen Asad

Studies have shown that coronavirus disease 19 (COVID-19) is an independent predictor of incident atrial fibrillation (AF) but the impact of pre-existing AF on the outcomes of patients hospitalized... more

Which events to consider in the study of venous thromboses in pancreatic cancer patients? Authors' reply

17 January 2023
Author(s): Silvia García Adrián, Vanessa Pachón Olmos, Purificación Martínez del Prado, Andrés J. Muñoz Martín

We appreciate the comments made by Debourdeau et al. [1] regarding our recent publication “Incidence, risk factors, and evolution of venous thromboembolic events in patients diagnosed with pancreatic... more

Hyperglycemia drives the transition from pre-frailty to frailty: The Monteforte study

10 January 2023
Author(s): Pasquale Mone, Stefano De Gennaro, Salvatore Frullone, Anna Marro, Gaetano Santulli

Pre-frailty is a condition that precedes frailty; in 2001, Linda Fried and colleagues defined pre-frailty as the presence of 1 or 2 out of the 5 Fried criteria [1]. Hence, pre-frail older adults... more

Anakinra for macrophage activation syndrome

5 January 2023
Author(s): Dimitrios Patoulias

Macrophage activation syndrome (MAS) is a serious, life-threatening, complication, characterized by generalized, multisystem, inflammatory response, which can affect almost every organ system,... more

Characteristics and outcomes of unvaccinated and vaccinated COVID-19 patients with acute respiratory failure treated with CPAP in a medical intermediate care unit

4 January 2023
Author(s): Silvia Accordino, Ciro Canetta, Francesco Blasi

Vaccinations against coronavirus disease 2019 (COVID-19) have undoubtedly conferred widespread protection against infection worldwide and are strongly associated with prevention of serious illness,... more

Outcomes of patients with cardiac arrest with and without COVID-19 in the United States

4 January 2023
Author(s): Agam Bansal, Mohammed Faisaluddin, Raunak Nair, Siddharth Agarwal

Cardiac arrest (CA) remains associated with very high mortality, with only one in ten patients surviving to hospital discharge [1–3]. Over the last three years, the widespread prevalence of COVID-19... more

Treatment efficacy of fecal microbiota-based live biotherapeutics (RBX2660) for the prevention of recurring Clostridioides difficile infection

28 December 2022
Author(s): Qurat ul Ain Javed, Muhammad Afzal, Khola Ilyas, Azza Sarfraz, Zouina Sarfraz

Dear Editor, A first-in-class microbiota-based live biotherapeutic, originally termed RBX2660, was approved by the U.S. Food and Drug Administration (FDA), on November 30, 2022 [1]. RBX2660 works by... more

Long-term prognostic capacity of multi-comorbid indices in chronic obstructive pulmonary disease

26 December 2022
Author(s): Rocio Reinoso-Arija, Laura Carrasco-Hernandez, Candelaria Caballero Eraso, Esther Quintana-Gallego, Jose Luis López-Campos

Dear Editor,

Risk of obstructive sleep apnea in idiopathic pulmonary fibrosis

22 December 2022
Author(s): Tang-Chuan Wang, Te-Chun Shen, Cheng-Li Lin, Chung Y. Hsu

To the editor,

Prognostic value of positive blood cultures and culture results on outcomes in emergency medical admissions

17 December 2022
Author(s): Richard Conway, Declan G. Byrne, Deirdre O'Riordan, Bernard Silke

Blood cultures are commonly performed in emergency medical admissions but the extent to which they improve established prognostic algorithms has been infrequently studied [1]. We report on a large... more

Timeline analysis of clinical severity of COVID-19 in the general population

16 December 2022
Author(s): Camilla Mattiuzzi, Giuseppe Lippi

We read with interest the recent article of Giacomelli et al. [1], who showed that the main characteristics of patients hospitalised with coronavirus disease 2019 (COVID-19) have substantially... more

Trend in the proportion of subjects with SARS-CoV-2 infection without COVID-19 specific symptoms among patients admitted to a COVID-19 referral hospital

5 December 2022
Author(s): Andrea Giacomelli, Anna Lisa Ridolfo, Letizia Oreni, Giuliano Rizzardini, Spinello Antinori, COVID-Sacco Study group

The clinical and epidemiological characteristics of COVID-19 gradually changed during different waves [1]. The highly transmissible omicron variant that has globally dominated during 2022 has led to... more

An elevated C-reactive protein level was associated with cardiovascular events among rheumatoid arthritis patients: What's next?

1 December 2022
Author(s): Noriaki Kou, Tomonari Shimoda, Ryusuke Imanishi, Hirofumi Kanazawa, Hiroshi Ito

Although the Expanded Cardiovascular Risk Prediction Score for Rheumatoid Arthritis (ERS-RA) is frequently used to estimate cardiovascular risk among rheumatoid arthritis (RA) patients, it does not... more

Lack of efficacy of Interferon β-1a in COVID-19 patients with mild to moderate pneumonia

1 December 2022
Author(s): Carlo Bosi, Roberto Ferrarese, Rebecca De Lorenzo, Nicasio Mancini, Emanuele Bosi, INTERCOP study group

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome virus 2 (SARS-CoV-2), poses an unprecedented threat for global health. Even in the context of intensified vaccine... more

Hypersensitivity reactions associated with iron isomaltoside and ferric carboxymaltose

30 November 2022
Author(s): Carmelo Aguirre, Itziar Palacios-Zabalza, Igor Ceruelo, Ainhoa Txintxurreta-Albizua, Montserrat García

Dear editor,

Which events to consider in the study of venous thromboses in pancreatic cancer patients?

25 November 2022
Author(s): Philippe Debourdeau, Simon Launay, Malika Chaouche

The incidence of Venous Thromboembolism (VTE) in patients with pancreatic cancer is high, especially in individuals with locally advanced or metastatic disease treated with chemotherapy, as outlined... more

Hip involvement in familial Mediterranean fever

24 November 2022
Author(s): François Rodrigues, Jérémie Sellam, Pierre Quartier, Stéphanie Ducharme-Bénard, Sophie Georgin-Lavialle

Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disorder that is linked to homozygous mutations of the MEFV gene [1]. The field of FMF is expanding as many patients with FMF... more

Aspirin and P2Y12 inhibitors in treating COVID-19

22 November 2022
Author(s): Amirmohammad Khalaji, Amir Hossein Behnoush, Soheil Peiman

Dear Editor,

Endovascular Thrombectomy in Basilar-Artery Occlusion Stroke

21 November 2022
Author(s): Rahul Gupta, Amir Hossein Behnoush, Amirmohammad Khalaji, Aaqib H Malik, Bryan Kluck, Cardiovascular Research Study Group

Dear Editor;

Non-infectious gastrointestinal manifestations of Good syndrome

19 November 2022
Author(s): Chen Wang, Yiyun Shi

Good syndrome is a rare adult-onset immunodeficiency syndrome, typically characterized by thymoma and hypogammaglobulinemia. Its clinical manifestations are highly variable, and concurrent non-... more

The effects of different types of resistance training in patients with coronary artery disease

18 November 2022
Author(s): Tim Kambic, Vedran Hadžić, Mitja Lainscak

Exercise-based cardiac rehabilitation in patients with coronary artery disease (CAD) reduces all-cause mortality, reinfarction and revascularisation rates, and rehospitalizations for cardiovascular... more

Safety and efficacy of interleukin-1 antagonists in hospitalized patients with COVID-19

15 November 2022
Author(s): Athina Dimosiari, Dimitrios Patoulias, Ioannis Pantazopoulos, Epaminondas Zakynthinos, Demosthenes Makris

the ongoing pandemic of coronavirus disease-2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection still represents a major public health concern. Severe COVID-... more

Discordance in perception of disease severity between patient and physicians

13 November 2022
Author(s): Valencia Long, Xer Min Nicole Lau, Clara Xinyi Ng, Phillip Phan, Ci En Ellie Choi

Dear Editor,

Impact of chronic lung disease on long-term clinical outcomes in patients with venous thromboembolism: From the COMMAND VTE registry

5 November 2022
Author(s): Shinya Ikeda, Yugo Yamashita, Takeshi Morimoto, Koh Ono, Takeshi Kimura, COMMAND VTE Registry Investigators

Chronic lung disease (CLD), such as asthma, chronic obstructive pulmonary disease (COPD), and restrictive lung diseases, has been reported to be a moderate risk factor for the development of venous... more

Fostering the intersection between primary care and hospital: hints from a survey and the PRIME (PRIMary care-hospital Embedding) project

3 November 2022
Author(s): Marco Montagna, Nuccia Morici, Tobias Tritschler, Patrizia Rovere Querini

great debate is ongoing in Italy and in other countries about the challenges faced by primary care, among which its reduced efficacy and lack of workforce turnover [1–3]. Some even envisage “the end... more

Prognostic value of clusterin/apolipoprotein J in patients with reperfused ST-segment elevation myocardial infarction

28 October 2022
Author(s): Shiru Zhang, Yundi Jiao, Yang Hou, Zhijun Sun, Zhaoqing Sun

Dear Editor,

The management of erythrocytosis during testosterone therapy: A practical approach

28 October 2022
Author(s): Milou C. Madsen, Marielle J. Wondergem, Elfi B. Conemans, Abel Thijs, Martin den Heijer

Testosterone is the primary sex hormone and anabolic steroid in men. It is a widely used drug which is used by males as an anabolic–androgenic steroid but it is also the cornerstone in treatment of... more

Original Article

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

Association of IgG4-related disease and systemic rheumatic disorders

17 March 2023
Author(s): Veronica Batani, Marco Lanzillotta, Jasmin Mahajne, Federica Pedica, Diego Palumbo, Elena Venturini, Paola Mapelli, Paola Bossi, Lorenzo Dagna, Della-Torre Emanuel

Autoimmune disorders are the result of largely unknown hypersensitivity reactions. As such, diverse rheumatic conditions with specific clinical manifestations can co-exist in the same individuals... 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

The influence of comorbidities on the prognosis after an acute heart failure decompensation and differences according to ejection fraction: Results from the EAHFE and RICA registries

12 March 2023
Author(s): Òscar Miró, Alicia Conde-Martel, Pere Llorens, Prado Salamanca-Bautista, Víctor Gil, Álvaro González-Franco, Javier Jacob, Jesús Casado, Josep Tost, Manuel Montero-Pérez-Barquero, Aitor Alquézar-Arbé, Joan Carles Trullàs, EAHFE and the RICA research investigators

Heart failure (HF) is highly prevalent in people over the age of 65 years and constitutes a leading cause of hospitalization and death in this population [1,2]. Decompensations are a crucial point in... more

Predictors of relapse in Takayasu arteritis

11 March 2023
Author(s): Shiping He, Ruofan Li, Shangyi Jin, Yanhong Wang, Hongbin Li, Xinwang Duan, Lili Pan, Lijun Wu, Yongfu Wang, Yan Zhang, Zhenbiao Wu, Jing Li, Yunjiao Yang, Xinping Tian, Xiaofeng Zeng

Takayasu arteritis (TAK) is a chronic systemic large vessel vasculitis characterized by damage to the aorta and its major branches. TAK primarily occurs in young women in Asia, with a male-to-female... more

Hypertriglyceridemia is associated with decline of estimated glomerular filtration rate and risk of end-stage kidney disease in a real-word Italian cohort: Evidence from the TG-RENAL Study

10 March 2023
Author(s): Roberto Pontremoli, Giovambattista Desideri, Marcello Arca, Pier Luigi Temporelli, Valentina Perrone, Melania Dovizio, Claudio Borghi, Luca Degli Esposti, on the behalf of Local Health Units Group

This analysis investigated the role of hypertriglyceridemia on renal function decline and development of end-stage kidney disease (ESKD) in a real-world clinical setting.

Temporal relationship between hyperuricemia and hypertension and its impact on future risk of cardiovascular disease

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

Hyperuricemia and hypertension are important risk factors for cardiovascular disease (CVD), which is the leading cause of death in China and accounts for more than 40% of all deaths in both rural and... more

Association between cannabis use and ten-year estimated atherosclerotic cardiovascular disease risk in a middle-aged population survey

27 February 2023
Author(s): Alexandre Vallée

Cannabis is the most used illicit drug. There is a worldwide trend to legalize cannabis, therefore, it is important to better understand the health impacts associated with its regular use. Recent... more

Patients with Whipple's disease have a high prevalence of Helicobacter pylori infection

21 February 2023
Author(s): Davide Scalvini, Patrizia Cambieri, Annalisa Schiepatti, Stiliano Maimaris, Francesca Lusetti, Claudia Vattiato, Piero Marone, Laura Villani, Federico Biagi

Whipple's disease (WD) is a chronic systemic infection due to Tropheryma whipplei (T. whipplei), a Gram-positive rod-shaped bacterium widespread in the environment, characterized by severe... more

High prevalence of incidental endoscopic findings at routine endoscopy after atrial fibrillation ablation: Do we need a screening endoscopy for the upper gastrointestinal tract in the general population?

14 February 2023
Author(s): Christian Meinhardt, Stephan List, Alexander Elias Chamieh, Hinrich Fehrendt, Volker Meves, Moustafa Mohamed, Julian Müller, Thomas Deneke, Claudia Geismann, Albrecht Elsässer, Alexander Arlt, Philipp Halbfass

Atrial fibrillation (AF) represents the most common cardiac arrhythmia. It is associated with a 1.5- to 3.5-fold increase in mortality in conjunction with accompanying heart failure and other... 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

Prevalence of non-alcoholic fatty liver disease in a multicentre cohort of people living with HIV in Spain.

8 February 2023
Author(s): Jordi Navarro, Adrian Curran, Berta Raventós, Jorge García, Paula Suanzes, Vicente Descalzo, Patricia Álvarez, Nuria Espinosa, Marisa Luisa Montes, Inés Suárez-García, Concha Amador, Roberto Muga, Vicenç Falcó, Joaquín Burgos, Spanish HIV Research Network (CoRIS)

Since the beginning of the history of HIV infection, liver disease has been one of the major causes of morbidity and mortality in people living with HIV (PLWH) [1]. Even though the emergence of the... more

Functional outcome after cardiac rehabilitation and its association with survival in heart failure across the spectrum of ejection fraction

7 February 2023
Author(s): Domenico Scrutinio, Pietro Guida, Maria Teresa La Rovere, Maurizio Bussotti, Ugo Corrà, Giovanni Forni, Rosa Raimondo, Simonetta Scalvini, Andrea Passantino

Heart failure (HF) is an increasingly prevalent clinical syndrome and a major cause of cardiovascular mortality and morbidity [1,2]. Functional disability and loss of independence are hallmark... more

The environmental cost of unwarranted variation in the use of magnetic resonance imaging and computed tomography scans

7 February 2023
Author(s): Ludovico Furlan, Pietro Di Francesco, Eleonora Tobaldini, Monica Solbiati, Giorgio Colombo, Giovanni Casazza, Giorgio Costantino, Nicola Montano

Pollution and related climate changes have a major impact on global health. In 2015 pollution accounted for an estimated 9 million premature deaths and 16% of all deaths globally [1,2]. Humanity is... more

Trends in prevalence and all-cause mortality of metabolic dysfunction-associated fatty liver disease among adults in the past three decades: Results from the NHANES study

6 February 2023
Author(s): Zhi-Qin Xie, Hong-Xia Li, Bing-Kun Wang, Zhao-Ming Yang, Zi-Yu Zhang, Wen-Liang Tan, Wen-Xin Li, Qing-Bin Wang, Lei Yang, Hong-Kai Zhuang, Chen-Wei Tang, Chang-Zhen Shang, Ya-Jin Chen

Non-alcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease, with an overall prevalence of 25%–32.4% worldwide, imposing a considerable health and economic burden [1,2]. Given... more

Circulating GDF-15 in relation to the progression and prognosis of chronic kidney disease: A systematic review and dose-response meta-analysis

3 February 2023
Author(s): Zhongwei Zhou, Hongli Liu, Huixiang Ju, Hongmei Chen, Hao Jin, Mingzhong Sun

Chronic kidney disease (CKD) has been a health problem worldwide that is characterized by the high incidence, poor prognosis, and large healthcare cost [1]. Since CKD has insidious onset and atypical... more

Higher diagnostic yield of 18F-FDG PET in inflammation of unknown origin compared to fever of unknown origin

2 February 2023
Author(s): Albrecht Betrains, Lennert Boeckxstaens, Lien Moreel, William F. Wright, Daniel Blockmans, Koen Van Laere, Steven Vanderschueren

18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging often plays an important role in the workup of fever of unknown origin (FUO) and inflammation of unknown origin (IUO),... more

The efficacy and safety of tacrolimus in patients with dermatomyositis/polymyositis: A meta-analysis and systematic review

30 January 2023
Author(s): Jiafen Liao, Xiaofei Peng, Jiayi Liu, Xi Xie, Jia Wang

Idiopathic inflammatory myopathies (IIMs) are a group of autoimmune inflammatory muscle disorders characterized by muscle weakness and multisystem involvement, especially in skin and lungs.... more

Comparison of missed adenomas in deep-sedated and unsedated colonoscopy: A multicenter retrospective study

27 January 2023
Author(s): Yue Sui, Yanhua Zheng, Qing Wang, Jieping Lv, Hongjin Wang, Qing Wen, Zhenzhen Wang, Guanfeng Wang, Hui Jia, Fengzhen Cao, Naping Wang, Junlian Hao, Yiping Zhang, Xiaopeng Wu, Haihua Chen, Junhui Lu, Xing Chen

According to the Global Cancer Report 2020, colorectal cancer ranks third in incidence and second in mortality of cancer-related diseases worldwide [1]. Colonoscopy is currently considered the gold... more

Patterns of immunosuppressive drug use during pregnancy in women with systemic vasculitis: A nationwide population-based cohort study

24 January 2023
Author(s): Camille Mettler, Nathanael Beeker, Mathis Collier, Véronique Le Guern, Benjamin Terrier, Laurent Chouchana

Systemic vasculitis are characterized by inflammation of the vessel wall, classified according to clinical, biological and histological criteria [1]. Systemic vasculitis can be severe and even life-... more

Competences of internal medicine specialists for the management of patients with multimorbidity. EFIM multimorbidity working group position paper

17 January 2023
Author(s): M Bernabeu-Wittel, O Para, J Voicehovska, R Gómez-Huelgas, J Václavík, E Battegay, M Holecki, B.C. van Munster, EFIM Multimorbidity Working Group

By 2060, the number of Europeans above age 65 is projected to increase from 88 to 153 million [1]. In consequence, the true challenge for European health care systems is to prepare for this... more

Active fluid de-resuscitation in critically ill patients with septic shock: A systematic review and meta-analysis

11 January 2023
Author(s): Anna S. Messmer, Tatjana Dill, Martin Müller, Carmen A. Pfortmueller

Adequate initial fluid resuscitation

The clinical presentation of syncope influences the head-up tilt test responses

11 January 2023
Author(s): Vincenzo Russo, Erika Parente, Angelo Comune, Nunzia Laezza, Anna Rago, Paolo Golino, Gerardo Nigro, Michele Brignole

The nitroglycerin (NTG) potentiated head-up tilt test (HUTT) positivity rate was about 1.5 times higher in patients with classical vasovagal (VVS) compared to those with non-classical VVS. The higher... more

Is the steady-state concentration, duration of action, or molecular weight of GLP-1RA associated with cardiovascular and renal outcomes in type 2 diabetes?

9 January 2023
Author(s): Shuzhen Bai, Chu Lin, Ruoyang Jiao, Xiaoling Cai, Suiyuan Hu, Fang Lv, Wenjia Yang, Xingyun Zhu, Linong Ji

Patients with type 2 diabetes (T2D) suffer from a higher risk of cardiovascular events and renal events, which are strongly associated with morality [1–3]. The novel anti-hyperglycemic agent,... more

Associations of relative fat mass, a new index of adiposity, with type-2 diabetes in the general population

3 January 2023
Author(s): Navin Suthahar, Kan Wang, Victor W. Zwartkruis, Stephan J.L. Bakker, Silvio E. Inzucchi, Laura M.G. Meems, Tim R. Eijgenraam, Fariba Ahmadizar, Eric G. Sijbrands, Ron T. Gansevoort, Lyanne M. Kieneker, Dirk J. van Veldhuisen, Maryam Kavousi, Rudolf A. de Boer

Associations of adiposity measures with incident type-2 diabetes in the total population and across multiple age categories. Adiposity indices were standardized sex specifically. Abbreviations: RFM,... more

Dual immune checkpoint inhibitors or combined with anti-VEGF agents in advanced, unresectable hepatocellular carcinoma

31 December 2022
Author(s): Bo Zhang, Baorui Tao, Yitong Li, Chenhe Yi, Zhifei Lin, Yue Ma, Jiahao Han, Weiqing Shao, Zhenmei Chen, Jing Lin, Jinhong Chen

Hepatocellular carcinoma is a worldwide common cancer with the fourth leading cause of cancer-related death [1,2]. Although the surgical resection, radiofrequency ablation or liver transplantation... more

Impact of adherence to EULAR quality indicators on the quality of life of patients with systemic lupus erythematosus

28 December 2022
Author(s): Nadim Taheri, Arthur Mageau, Marie-Paule Chauveheid, Antoine Dossier, Fatima Farhi, Celine Mendes, Thomas Papo, Tiphaine Goulenok, Karim Sacre

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide range of manifestations affecting health-related quality of life [1]. In recent years recommendations have been... more

The effect of sex inequality on solid organ transplantation: A systematic review and meta-analysis

28 December 2022
Author(s): Sofia Tejada, Raquel Martinez-Reviejo, Taísa A. Nogueira, Aroa Gómez, Teresa Pont, Xuelian Liao, Zheng Zhang, Oriol Manuel, Jordi Rello

Solid organ transplantation (SOT) is the preferred treatment option for patients with end-stage diseases [1]. The prognosis of these patients is influenced by many factors such as infection [2],... more

Efficacy of endovascular therapy for basilar and vertebral artery occlusion: A systematic review and meta-analysis of randomized controlled trials

24 December 2022
Author(s): Chun-Hsien Lin, David S Liebeskind, Bruce Ovbiagele, Meng Lee, Jeffrey L Saver

The best management for acute basilar artery occlusion (BAO) has increasingly been clarified by recent randomized controlled trials (RCTs). We conducted a systematic review and meta-analysis of RCTs... more

Cardiovascular outcomes and mortality after incident ischaemic stroke in patients with a recent cancer history

21 December 2022
Author(s): Ralph K. Akyea, Barbara Iyen, Georgios Georgiopoulos, Joe Kai, Nadeem Qureshi, George Ntaios

Evidence from previous studies suggests a relationship between ischaemic stroke and cancer such that 1 in 10 patients with ischaemic stroke has been shown to have comorbid cancer [1–3]. The most... more

Role of anti-tumor necrosis factor-alpha agents in treatment of sarcoidosis: A meta-analysis

14 December 2022
Author(s): Malihe Rezaee, Moein Zangiabadian, Amirali Soheili, Tess Moore Calcagno, Maryam Rahmannia, Roshan Dinparastisaleh, Mohammad J. Nasiri, Mehdi Mirsaeidi

Sarcoidosis is a chronic multisystem inflammatory disorder characterized by noncaseating granulomas. The exact etiology and underlying mechanisms of sarcoidosis have not been fully elucidated. It is... more

Long-term lung ultrasound follow-up in patients after COVID-19 pneumonia hospitalization: A prospective comparative study with chest computed tomography

7 December 2022
Author(s): Greta Barbieri, Luna Gargani, Vittoria Lepri, Stefano Spinelli, Chiara Romei, Annalisa De Liperi, Davide Chimera, Francesco Pistelli, Laura Carrozzi, Francesco Corradi, Lorenzo Ghiadoni, Pisa COVID-19 Study Group

From December 2019, the medical scenario has been characterized by the SARS-CoV-2 pandemic that put a strain on the healthcare systems all around the world. Human-to-human aerosol transmission as... more

Review Article

Metabolically healthy obesity: Misleading phrase or healthy phenotype?

6 March 2023
Author(s): Cem Tanriover, Sidar Copur, Abduzhappar Gaipov, Batu Ozlusen, Rustu E. Akcan, Masanari Kuwabara, Mads Hornum, Daniel H. Van Raalte, Mehmet Kanbay

A tripling of obesity in the last 50 years has resulted in more than 650 million individuals being obese worldwide [1],[2]. Obesity is associated with several important non-communicable diseases... 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

Antiphospholipid antibodies in chronic thromboembolic pulmonary hypertension

13 January 2023
Author(s): Rui Zhu, Gang-Yi Cheng, Gentian Denas, Vittorio Pengo

Pulmonary hypertension (PH) is a chronic progressive condition characterized by an increase of mean pulmonary artery pressure above 25 mmHg at rest. Chronic thromboembolic pulmonary hypertension (... more

How low should blood pressure be in patients with chronic coronary and cerebrovascular diseases

9 January 2023
Author(s): A.J. Manolis, M.S. Kallistratos, M. Camafort, A. Coca

Cardiovascular disease (CVD) represents the leading cause of morbidity and mortality worldwide. More than 18 million deaths are attributed to CVD in 2019 while the global trends for disability-... more

Pathophysiology of cough with angiotensin-converting enzyme inhibitors: How to explain within-class differences?

9 January 2023
Author(s): Claudio Borghi, Arrigo FG Cicero, Davide Agnoletti, Giulia Fiorini

Angiotensin-converting enzyme inhibitors (ACEi) are largely used for the prevention and treatment of cardiovascular and renal diseases [1]. The rationale supporting the use of ACEi is based on... more

De-escalation of antiplatelet therapy in patients with coronary artery disease: Time to change our strategy?

25 December 2022
Author(s): Pierre Sabouret, Luigi Spadafora, David Fischman, Waqas Ullah, Michel Zeitouni, Martha Gulati, Salvatore De Rosa, Michael P. Savage, Juan Pablo Costabel, Maciej Banach, Giuseppe Biondi-Zoccai, Mattia Galli

Since more than two decades, dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 receptor inhibitor is considered the gold standard for patients with acute coronary syndrome (ACS) as well as... more

The spike effect of acute respiratory syndrome coronavirus 2 and coronavirus disease 2019 vaccines on blood pressure

12 December 2022
Author(s): Fabio Angeli, Martina Zappa, Gianpaolo Reboldi, Giorgio Gentile, Monica Trapasso, Antonio Spanevello, Paolo Verdecchia

Data accrued over the last 2 years reported that specific comorbidities are associated with increased risk of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and worse... more

Reshaping care in the aftermath of the pandemic. Implications for cardiology health systems

30 November 2022
Author(s): Antonio Jordan-Rios, Vincenzo Nuzzi, Daniel I Bromage, Theresa McDonagh, Gianfranco Sinagra, Antonio Cannata

Since the COVID-19 pandemic commenced more than two years ago, it has taken the lives of more than six million people around the globe [1]. In parallel with high mortality rates, health care delivery... more


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