May 2021

54 Articles

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Influence of gender on the performance of urine dipstick and automated urinalysis in the diagnosis of urinary tract infections at the emergency department

25 March 2021
Author(s): S.J.M. Middelkoop, L.J. van Pelt, G.A. Kampinga, J.C. ter Maaten, C.A. Stegeman

Urinary tract infections (UTIs) are generally more common in women compared to men [1-3]. Beside incidence, also differences in presentation and course of UTI exist between men and women. This is due... more

When and how did the air come in?

21 March 2021
Author(s): Jin Ikeda

An 84-year-old man with cognitive dysfunction was taken to the emergency room because of a change in consciousness. He came in with a Glasgow Coma Scale (GCS) score of E4V4M5. According to his family... more

SGLT2 inhibitors should be recommended in patients with one or more of the three diseases: type 2 diabetes, chronic kidney disease, and HFrEF

12 March 2021
Author(s): Li-Min Zhao, Liang-Liang Ding, Ze-Lin Zhan, Mei Qiu

Patoulias and colleagues have made a relevant commentary entitled “Chronic kidney disease and diabetes status do not affect efficacy of SGLT-2 inhibitors in patients with heart failure with reduced... more

Infective endocarditis in patients with solid organ transplantation. A nationwide descriptive study

5 March 2021
Author(s): Manuel Martínez-Sellés, Maricela Valerio-Minero, María Carmen Fariñas, Hugo Rodríguez-Abella, María Luisa Rodríguez, Aristides de Alarcón, Encarnación Gutiérrez-Carretero, Manuel Cobo-Belaustegui, Miguel Ángel Goenaga, Asunción Moreno-Camacho, Fernando Domínguez, Laura García-Pérez, Laura Domínguez-Pérez, Patricia Muñoz, on behalf of the Spanish Collaboration on Endocarditis—Grupo de Apoyo al Manejo de la Endocarditis infecciosa en ESpaña (GAMES)

Infective endocarditis (IE) is a serious condition with a poor prognosis [1,2]. Solid organ transplantation (SOT) is an established and practical definitive treatment option for patients with end-... more

Estimated glomerular filtration rate and renal resistive index as possible predictive markers of mortality in systemic sclerosis

13 February 2021
Author(s): Giorgia Leodori, Chiara Pellicano, Antonietta Gigante, Edoardo Rosato

Systemic sclerosis (SSc) is an autoimmune disease characterized by immune system activation, microvascular damage and fibrosis of skin and internal organs. Renal manifestations of SSc include... more

Risk factors and current management of venous thromboembolism in patients with primary immune thrombocytopenic purpura.

7 February 2021
Author(s): Marco Tana, Claudio Tana, Giulia Rizzo, Fabrizio Ricci, Ettore Porreca

immune thrombocytopenic purpura (ITP) is a rare hematologic disorder characterized by isolated thrombocytopenia due to platelet destruction, without abnormalities of erythrocyte or leukocyte number... more

Pulmonary congestion and mortality during venoarterial extracorporeal membrane oxygenation (VA-ECMO): does time matter?

19 December 2020
Author(s): Pieter S. van der Wal, Peter-Paul Zwetsloot, Olaf L. Cremer, Dirk W. Donker, Christiaan L. Meuwese

In a recent edition of this Journal, an intriguing study was published which examined the association between (development of) pulmonary congestion (PC) and mortality in patients with post-cardiotomy... more


SGLT2 inhibitors: Do we need other evidences?

6 April 2021
Author(s): Angelo Avogaro

The five cardiovascular outcome trials (CVOT) conducted in patients with type 2 diabetes mellitus so far have shown that renal sodium-glucose cotransporters two inhibitors (SGLT2i) are cardiovascular... more

Colorectal cancer and cardiovascular disease: A thrombo-inflammatory link?

26 March 2021
Author(s): Hugo ten Cate

One of the few advantages of the Covid-19 pandemic is a renewed focus on the benefits of a healthy lifestyle, as a way to reduce both the risk of contracting SARS-CoV-2 infection and, in case of... more

Colorectal cancer and cardiovascular diseases: Are we closing the gap between knowledge and action?

26 March 2021
Author(s): Mario Mandalà, Fausto Roila

Colorectal cancer (CRC) and cardiovascular diseases (CVD) are amongst the two leading causes of death in western countries and have dramatic impact on the financial sustainability of the health... more

When is it reasonable to extrapolate during a pandemic?: The case of broad UK labeling for AstraZeneca COVID-19 vaccine

18 March 2021
Author(s): Rafael Dal-Ré, Rita Banzi

Amid an unprecedented surge of COVID-19 cases in the UK, with an increasing number due to a novel more infectious SARS-CoV-2 variant,[1] the UK regulatory agency (MHRA) granted emergency approval to... more

Venous lactate: The new “magic marker” for stratification in intermediate-risk pulmonary embolism?

18 March 2021
Author(s): Nicolas Meneveau

Risk stratification in patients with acute pulmonary embolism (PE) is essential to guide the choice of appropriate therapy. The stratification of risk is first and foremost based on the presence of... more


Implementation of Guidelines on Atrial Fibrillation Management in the Global Arena: So Many Actors on Stage!

7 April 2021
Author(s): Riccardo Cappato

According to the seminal definition by the Institute of Medicine released in 1990, clinical guidelines represent “systematically developed statements to assist practitioner and patient decisions... more

Internal Medicine Flashcard

No more than meets the eye

1 April 2021
Author(s): Louis-Philippe Dormegnie, Adrien Henry, Jean-Hugues Salmon, Yohan N'Guyen

A 33-year old Ivorian woman was admitted for fever and thrombocytopenia. She had been previously treated in France by tocilizumab then anti TNF-α for rheumatoid arthritis since 7 and 2 years... more

Atypical cause of episodic abdominal pain and unintentional weight loss

21 March 2021
Author(s): Dhairya A. Lakhani, Aneri B. Balar, Abdul R. Tarabishy

A 23-year-old female with past medical history of generalized anxiety disorder and migraine presents to the clinic with unintentional weight loss of approximately 20 lbs and chronic episodic... more

The long toenail sign in older adults

21 March 2021
Author(s): Kirstyn James, Ariela R Orkaby, Andrea Wershof Schwartz

A 78 year old male attended a geriatric medicine outpatient clinic accompanied by his son. He described a history of falls, memory impairment and difficulty completing activities of daily living... more

Letter to the Editor

The power of choice: Experimental evidence that freedom to choose a vaccine against COVID-19 improves willingness to be vaccinated

18 March 2021
Author(s): Philipp Sprengholz, Sarah Eitze, Lars Korn, Regina Siegers, Cornelia Betsch

Ending the COVID-19 pandemic will require rapid and large-scale uptake of vaccines against the disease. The European Commission has authorized three vaccines so far, and first doses have already been... more

Chronic kidney disease and diabetes status do not affect efficacy of SGLT-2 inhibitors in patients with heart failure with reduced ejection fraction

22 February 2021
Author(s): Dimitrios Patoulias, Christodoulos Papadopoulos, Michael Doumas

We have read with great interest the meta-analysis performed by Qiu et al. [1] published in the European Journal of Internal Medicine, assessing the cardio-renal efficacy of different sodium-glucose... more

Acute coronary syndrome-related hospital admissions during and after lockdown in Southern Germany

22 February 2021
Author(s): Stefan Brunner, Bruno C. Huber, Georg Kanz, Viktoria Bogner-Flatz

The Covid-19 pandemic has affected all aspects of our daily life and challenged our health care system in an unprecedented manner [1]. The crisis even altered the health behavior resulting in... more

Cor homini lupus? Identification of risk factors implicated in cardiovascular events in patients with Systemic Lupus Erythematosus in Romania

17 February 2021
Author(s): Ergina Syrigou, Dimitrios V. Moysidis, Andreas S. Papazoglou, Christos Tsagkaris, Anna Maria Louka, Anca Bobirca

Cardiovascular disease (CVD) accounts for up to 35% of mortality in patients with systemic lupus erythematosus (SLE) [1]. Emerging evidence supports that SLE disease activity is associated with up to... more

Treating life-threatening TAFRO syndrome with interleukin-1 inhibition

16 February 2021
Author(s): Marco Lanzillotta, Miriam Sant'Angelo, Naoki Kaneko, Shiv Pillai, Maurilio Ponzoni, Emanuel Della-Torre

TAFRO syndrome (Thrombocytopenia, Anasarca, Fever, Reticulin fibrosis, and Organomegaly) is a newly recognized variant of idiopathic - human herpesvirus-8 (HHV-8) negative - Multicentric Castleman... more

Diagnosis of infection by SARS-COV-2: Is one molecular test enough?

12 February 2021
Author(s): Antonella Mencacci, Maria Cristina Vedovati, Barbara Camilloni, Elio Cenci, Cecilia Becattini

A pandemic phase of SARS-CoV-2 infection is currently ongoing, with a particular diffusion in Italy [1]. Accurate diagnosis of asymptomatic carriers of the virus as well as of patients with acute... more

“Let me choose my COVID-19 vaccine”

3 February 2021
Author(s): Rafael Dal-Ré, Richard Stephens, Nadarajah Sreeharan

In the first half of 2021, many millions of Europeans will be offered vaccination against SARS -CoV-2. Four vaccines, two mRNA-based vaccines (Pfizer-BioNTech and NIH-Moderna) and two non-replicating... more

SARS-CoV-2 seroprevalence in the Vatican City State

3 February 2021
Author(s): Massimo Ralli, Andrea Arcangeli, Paolo Maurizio Soave, Maria Cristina Voglino, Fabio De-Giorgio

The ongoing Coronavirus Disease 19 (COVID-19) pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has affected so far 218 countries with over 94 million cases, about 2... more

How specific are elevated IgG4 levels for IgG4-related disease?

1 February 2021
Author(s): M. Schils, A. Betrains, S. Vanderschueren, X. Bossuyt, D. Blockmans

IgG4-Related Disease (IgG4-RD) is a systemic inflammatory disorder with potential to affect almost every organ [1]. The diagnosis of IgG4-RD is primarily based upon characteristic histological... more

A systematic bias assessment of top-cited full-length original clinical investigations related to COVID-19

22 January 2021
Author(s): Islam Y. Elgendy, Nayef Nimri, Amr F. Barakat, Joseph Ibrahim, John Mandrola, Andrew Foy

With the emergence of coronavirus disease 2019 (COVID-19) pandemic, there has been an exponential rise in the number of scientific publications to convey relevant information about this novel disease... more

Vertebral level identified by the intercristal line: Confirmation by ultrasound

22 January 2021
Author(s): Drew Brotherston, Janeve Desy, Irene W.Y. Ma

Prior to performing a lumbar puncture (LP) at the bedside, the intercristal line, formed posteriorly between the superior aspect of the iliac crests, commonly serves as a landmark to identify the L4... more

Longitudinal trends and outcomes of adult heart transplantation in the U.S.

22 January 2021
Author(s): Emmanuel Akintoye, Rabea Asleh, Paulino Alvarez, Alexandros Briasoulis

Heart transplantation is the treatment of choice for patients with end-stage heart failure [1, 2]. Evaluation of outcome trends is imperative to identifying areas of improvement and making goal-... more

Do four SGLT2 inhibitors lead to different cardiorenal benefits in type 2 diabetes, in chronic heart failure, and in chronic kidney disease?

20 January 2021
Author(s): Mei Qiu, Liang-Liang Ding, Ze-Lin Zhan, Hai-Rong Zhou

Large randomized trials have confirmed the cardiorenal benefits from sodium-glucose transporter 2 (SGLT2) inhibitors for patients with type 2 diabetes (T2D), for patients with chronic heart failure... more

Less is more: Perspectives from the European Code Against Cancer

16 January 2021
Author(s): Christos Tsagkaris, Parvathy Mohanan

We have read the article of Kherad et al. with great interest. The authors elaborate on the “less is more” principle, which has become quite relevant in various areas of medicine including cancer [1... more

Flying higher than politics: The goal of preventive medicine at the time of the COVID-19 pandemic

1 January 2021
Author(s): Francesco M. Galassi, Michael E. Habicht, F. Donald Pate, Elena Varotto

The present SARS-CoV-2-caused COVID-19 pandemic [1] has clearly shown that great health crises can elicit heated political and scientific debates. The history of medicine teaches us how, throughout... more

Heart rate turbulence in obstructive sleep apnea syndrome: The effect of short-term CPAP therapy

31 December 2020
Author(s): Giovanni D'Addio, Alberto De Felice, Leandro Donisi, Alberto Braghiroli, Mauro Maniscalco

Patients affected by obstructive sleep apnea (OSA) present an increased risk of cardiovascular (CV) events [1]. This is likely due to the imbalance in the autonomic nervous system, with cardiac... more

Low influenza vaccination coverage among hospitalized COVID-19 patients in Milan: A gap to be urgently filled

29 December 2020
Author(s): Anna Lisa Ridolfo, Laura Milazzo, Andrea Giacomelli, Letizia Oreni, Catia Borriello, Spinello Antinori

The first wave of the COVID-19 epidemic in Italy during March and April 2020 put extreme pressure on the national healthcare system, particularly on the hospitals in the most affected regions of... more

Original Article

Effect of SGLT-2 inhibitors on cardiovascular outcomes in heart failure patients: A meta-analysis of randomized controlled trials

3 April 2021
Author(s): Yuan Lu, Fei Li, Yong Fan, Yu Yang, Minglong Chen, Jue Xi

Heart failure (HF) is a highly prevalent disease with considerable morbidity and mortality. It is estimated that approximately 50 million people are afflicted with this disease worldwide. The disease... more

TGF-β1 +869T/C (rs1982073) gene polymorphism and susceptibility to rheumatoid arthritis: Updated systematic review and meta-analysis

22 February 2021
Author(s): Haiyan Zeng, Wuniu Wan, Jin Li, Chengsong He

Rheumatoid arthritis (RA) is a complex autoimmune disease that affects about 1% of the world's population, which is characterized by the erosion and destruction of cartilage and bone [1,2]. As a... more

Incidence and risk factors for preneoplastic and neoplastic lesions of the colon and rectum in patients under 50 referred for colonoscopy

17 February 2021
Author(s): Simona Agazzi, Marco Vincenzo Lenti, Catherine Klersy, Elena Strada, Lodovica Pozzi, Laura Rovedatti, Marco Bardone, Aurelio Mauro, Martina Costetti, Stefania Costa, Federico De Grazia, Antonio Di Sabatino

According to estimates from the International Agency for Research on Cancer (2018), colorectal cancer (CRC) occurred in approximately 1.8 million patients and accounted for 900000 deaths worldwide,... more

Non–Specific Clinical Presentations are Not Prognostic and do not Anticipate Hospital Length of Stay or Resource Utilization

16 February 2021
Author(s): Richard Conway, Declan Byrne, Deirdre O'Riordan, Bernard Silke

Up to 20% of patients arriving at an emergency department (ED) may have a non-specific presentation (NSP). Previous studies have suggested that a NSP, despite the similarity of patient demographics... more

Prediction and primary prevention of major vascular complications in systemic sclerosis

5 February 2021
Author(s): Cosimo Bruni, Laura Cometi, Antonietta Gigante, Edoardo Rosato, Marco Matucci-Cerinic

Systemic Sclerosis (SSc) is a chronic autoimmune disease, characterized by immune system activation, vascular abnormalities and uncontrolled fibrotic response in the skin and internal organs [1]. The... more

Venous lactate improves the prediction of in-hospital adverse outcomes in normotensive pulmonary embolism

5 February 2021
Author(s): Matthias Ebner, Charlotta F. Pagel, Carmen Sentler, Veli-Pekka Harjola, Héctor Bueno, Markus H. Lerchbaumer, Karl Stangl, Burkert Pieske, Gerd Hasenfuß, Stavros V. Konstantinides, Mareike Lankeit

Pulmonary embolism (PE) is associated with high morbidity and mortality, making it a major contributor to global disease burden. [1,2] Thus, current guideline recommendations emphasize the importance... more

Long-term effectiveness and safety of anticoagulation therapy in oldest old, frail people with atrial fibrillation

4 February 2021
Author(s): Valeria Calsolaro, Chukwuma Okoye, Rachele Antognoli, Umberto Dell'Agnello, Alessia Maria Calabrese, Fabio Monzani

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice [1] with a prevalence destined to progressively increase due to population aging [2]. As a fact, AF represents a... more

Anakinra for patients with COVID-19: a meta-analysis of non-randomized cohort studies.

4 February 2021
Author(s): Laura Pasin, Giulio Cavalli, Paolo Navalesi, Nicolò Sella, Giovanni Landoni, Andrey G. Yavorovskiy, Valery V. Likhvantsev, Alberto Zangrillo, Lorenzo Dagna, Giacomo Monti

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affected 104.956.439 people worldwide and caused the death of 2.290.488 as of February 7, 2121[1]. Life-threatening cases of the... more

Assessing the impact of COVID-19 on the health of geriatric patients: The European GeroCovid Observational Study

30 January 2021
Author(s): Caterina Trevisan, Susanna Del Signore, Stefano Fumagalli, Pietro Gareri, Alba Malara, Enrico Mossello, Stefano Volpato, Fabio Monzani, Alessandra Coin, Giuseppe Bellelli, Gianluca Zia, Anette Hylen Ranhoff, Raffaele Antonelli Incalzi, the GeroCovid Working Group

Older adults have been the part of the population most burdened by COVID-19 pandemic. Indeed, the disease mortality rate was reported to rise, in men and women, from 4.6% and 2.5% among those aged 30... more

Age-Related Changes in Clinical Presentation of Covid-19: the EPICOVID19 Web-Based Survey

29 January 2021
Author(s): Caterina Trevisan, Marianna Noale, Federica Prinelli, Stefania Maggi, Aleksandra Sojic, Mauro Di Bari, Sabrina Molinaro, Luca Bastiani, Andrea Giacomelli, Massimo Galli, Fulvio Adorni, Raffaele Antonelli Incalzi, Claudio Pedone, on behalf of the EPICOVID19 Working Group

The burden posed by the Covid-19 pandemic on healthcare systems requires strategies to identify high-risk people in order to better allocate the available health resources and plan targeted care... more

Impact of the number of comorbidities on cardiac sympathetic derangement in patients with reduced ejection fraction heart failure

20 January 2021
Author(s): Leonardo Bencivenga, Klara Komici, Grazia Daniela Femminella, Stefania Paolillo, Paola Gargiulo, Roberto Formisano, Roberta Assante, Carmela Nappi, Brunella Puzone, Immacolata Sepe, Antonio Cittadini, Dino Franco Vitale, Nicola Ferrara, Alberto Cuocolo, Pasquale Perrone Filardi, Giuseppe Rengo

Heart failure (HF) is a very prevalent condition associated with high morbidity and mortality rates, thus representing a relevant global health burden. It affects more than 26 million people... more

Cannabis is associated with blood pressure reduction in older adults – A 24-hours ambulatory blood pressure monitoring study

20 January 2021
Author(s): Ran Abuhasira, Yosef S. Haviv, Merav Leiba, Adi Leiba, Larisa Ryvo, Victor Novack

Background: Medical cannabis use is increasing rapidly in the past several years, with older adults being the fastest growing group. Nevertheless, the evidence for cardiovascular safety of cannabis... more

Non-retrieved inferior vena cava filters: causes and long-term follow-up

6 January 2021
Author(s): Jesús Ribas, Esther Alba, Yuliana Pascual-González, Yolanda Ruíz, Adriana Iriarte, José María Mora-Luján, Joana Valcárcel, Xavier Corbella, Salud Santos, Elena Escalante, Antoni Riera-Mestre

Inferior vena cava (IVC) filters are implantable devices created to trap thrombi from the lower extremities and prevent clinically significant pulmonary embolism (PE). According to guidelines, the... more

Predictors of mortality among adult, old and the oldest old patients with bloodstream infections: An age comparison

4 January 2021
Author(s): Francesca Giovannenze, Rita Murri, Claudia Palazzolo, Francesco Taccari, Marta Camici, Teresa Spanu, Brunella Posteraro, Maurizio Sanguinetti, Roberto Cauda, Graziano Onder, Massimo Fantoni

In recent years, incidence of bloodstream infections (BSIs) has been increasing worldwide, with over 1.2 million estimated episodes of BSI per year in Europe and around 600 000 in North America [1].... more

Neuraminidase inhibitors are effective and safe in reducing influenza complications: meta-analysis of randomized controlled trials.

21 December 2020
Author(s): Sofía Tejada, Miia Jansson, Candela Solé-Lleonart, Jordi Rello

Influenza is an infection of variable severity resulting in high accumulated mortality worldwide [1]. Seasonal influenza deaths occur mainly in young children and the elderly, while during influenza... more

Is there excessive troponin testing in clinical practice? Evidence from emergency medical admissions

19 December 2020
Author(s): Richard Conway, Declan Byrne, Seán Cournane, Deirdre O'Riordan, Seamus Coveney, Bernard Silke

Troponin assays are a relatively common laboratory diagnostic request in emergency medical admissions. Following cardiac injury these macromolecules diffuse into the cardiac interstitium with... more

Review Article

Non-invasive respiratory support in the treatment of acute hypoxemic respiratory failure secondary to CoViD-19 related pneumonia

25 February 2021
Author(s): Paolo Groff, Rodolfo Ferrari

While many of the epidemiological aspects and clinical characteristics of CoViD-19 disease have been understood [1-3], little has been clarified regarding the best ventilatory support to offer to... more

Sustainable and personalized nutrition: From earth health to public health

25 February 2021
Author(s): C. Agostoni, S Boccia, S Banni, P.M. Mannucci, A Astrup

In the difficult times amidst the SARS-CoV-2 pandemic, the whole world has become more conscious of the importance of primary and secondary prevention. COVID-19 is already having a triple hit on... more

Multidisciplinary prevention and management strategies for colorectal cancer and cardiovascular disease

17 February 2021
Author(s): Seamus P. Whelton, Philipp Berning, Roger S. Blumenthal, Catherine Handy Marshall, Seth S. Martin, Martin Bødtker Mortensen, Michael J. Blaha, Omar Dzaye

Colorectal cancer (CRC) and Cardiovascular disease (CVD) represent leading causes of morbidity and mortality in industrialized countries [1]. While they are typically thought of as separate disease... more

Beyond the 2020 guidelines on atrial fibrillation of the European society of cardiology

28 January 2021
Author(s): Giuseppe Boriani, Marco Vitolo, Deirdre A Lane, Tatjana S Potpara, Gregory YH Lip

The history of guidelines began in 1990 when the Institute of Medicine (IOM) published a report defining guidelines as "systematically developed statements to assist practitioner and patient... more


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