May 2022
114 ArticlesNo Section
The search for a gold standard to clinically diagnose and monitor atrial cardiomyopathy
: Tufano A, Lancellotti P. "Atrial cardiomyopathy: Pathophysiology and clinical implications". Eur J Intern Med. 2022 Mar 11:S0953–6205(22)00097–8. doi: 10.1016/j.ejim.2022.03.007. Epub ahead of... more
Lights and shadows on JAK inhibitors for Ankylosing Spondylitis
Ankylosing Spondylitis (AS) is an autoimmune disease characterized by inflammation of the spine and sacroiliac joints, historically described in young males with progressive structural damage of the... more
Diagnostic approaches to syncope in Internal Medicine Departments and their effect on mortality
Syncope is defined as a transient loss of consciousness (TLOC) due to cerebral hypoperfusion, characterized by a rapid onset, short duration, and spontaneous complete recovery [1]. The main... more
Validation of anti-neutrophil cytoplasm antibodies associated vasculitides diagnosis codes from the electronic health records of two French university hospitals
ANCA-associated vasculitides (AAV) are necrotizing vasculitis, with few or no immune deposit, predominantly affecting small vessels. Among AAV, granulomatosis with polyangiitis (GPA) is characterized... more
Impact of cardiac amyloidosis on outcomes of patients hospitalized with heart failure
Amyloidosis is a multi-systemic disease resulting from deposition of misfolded proteins as insoluble fibrils in the interstitium of affected organs, subsequently leading to organ failure. Cardiac... more
An unusual cause of severe watery diarrhea
A 75-year-old man presented to the gastroenterology department with a 4-week history of severe watery diarrhea (at least 20 times a day) and appetite loss. He had been taking amlodipine 5 mg once... more
Heart failure: An autopsy case
A 78-year-old man with a history of bilateral carpal tunnel syndrome was admitted to our hospital with congestive heart failure. On physical examination a systolic ejection murmur was documented. B-... more
A HIV-positive subject with dermatomal and generalized vesicular skin lesions
A 58-year old man with HIV infection diagnosed in 2018 presented in July 2021 with a 7-day history of vesicular skin lesions localized to the right side of abdomen and diffuse vesicular lesions on... more
Skin rash following amoxicillin treatment
A 26-year-old woman presented with a chief complaint of nausea for 2 days. On the previous day, she had been diagnosed with tonsilitis by her previous doctor because of fever and sore throat, and had... more
Developing a simple and practical decision model to predict the risk of incident type 2 diabetes among the general population: The Di@bet.es Study
The prevalence and incidence of type 2 diabetes mellitus (T2DM) are increasing worldwide, and an estimated 50% of patients remain unaware of their disease [1]. T2DM is a highly prevalent chronic... more
Treatment strategies of COVID-19: A rheumatology perspective
Severe acute respiratory syndrome coronavirus-2 (SARS-COV-2), the cause of coronavirus disease 2019 (COVID-19), emerged in China at the end of 2019 and has developed into a pandemic. The disease has... more
Sarcomere protein modulation: The new frontier in cardiovascular medicine and beyond
In recent years, constant progress in science and technology has resulted in innovative molecules addressing core mechanisms of myocardial disease affecting millions worldwide [1]. A targeted... more
Atrial cardiomyopathy markers and new-onset atrial fibrillation risk in patients with acute myocardial infarction
Acute myocardial infarction (AMI) remains one of the leading causes of mortality globally, new-onset AF (NOAF) after AMI is a common complication of AMI, with an incidence of 6% to 21% [1], which is... more
Usefulness of telemedicine-based heart failure monitoring according to ‘eHealth literacy’ domains: Insights from the iCOR randomized controlled trial
Notwithstanding new pharmacological and non-pharmacological approaches, such as optimising care using new monitoring strategies,[1,2] heart failure (HF) remains a huge public health problem worldwide... more
Intensive blood pressure control on dementia in patients with chronic kidney disease: Potential reduction in disease burden
Chronic kidney disease (CKD) is defined by either presence of a decline in renal function, mostly assessed via creatinine or cystatin C-based estimated glomerular filtration rate (eGFR) measurements... more
Serum-ascites albumin gradient – A false dichotomy in the approach to ascites
Ascites is a clinical scenario frequently encountered in primary care, internal medicine and gastroenterology. Formal guidelines on its approach and management exist and recommend measuring the serum... more
Echocardiographic markers of early alcoholic cardiomyopathy: Six-month longitudinal study in heavy drinking patients
Alcoholic cardiomyopathy (ACM) represents one of the leading causes of non-ischemic dilated myocardial disease in Western Countries [1]. ACM significantly contributes to the global burden of... more
Adult anaphylaxis: To the heart of the matter
Dear Editor, we want to congratulate with Rossi and colleagues [1] for their state-of-the-art review summarizing pathophysiological mechanisms, diagnostic criteria, classification and clinical... more
Deployment of guideline-based therapy for heart failure with reduced ejection fraction: A word of caution for older patients
Dear Editor,
Is malignancy cancer an adverse factor of in-hospital clinical outcome in post-cardiac arrest?
With the continuous development of cancer treatment, patients with cancer have dramatically improved, with several cancer populations experiencing a median survival well beyond 5 years.1 However,... more
Double-gloving in an Intensive Care Unit during the COVID-19 pandemic
Dear Editor,
Clinical Insights
Anticoagulation as secondary prevention of massive lung thromboses in hospitalized patients with COVID-19
Since February 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been responsible for one of the major pandemic we have experienced in the last 100 years [1]. The most... more
Saving the kidneys in the lupus patient: Beyond immunosuppression, the need to collaborate across multiple disciplines
Systemic lupus erythematosus (SLE) is the classical systemic autoimmune disease with heterogeneous manifestations and unpredictable behaviour in which almost 70% may have a relapsing-remitting course... more
Atrial cardiomyopathy: Pathophysiology and clinical implications
The term atrial cardiomyopathy appears sporadically in the medical literature, and generally has been used in conjunction with atrial fibrillation (AF), or as “atrial fibrotic cardiomyopathy”, a... more
Commentary
Interleukin 6 inhibition in severe COVID-19: Another piece of the puzzle
More than two years have passed since the beginning of the coronavirus disease 2019 (COVID-19) pandemic. Extensive efforts have been invested into better understanding the pathogenesis of this... more
Dual antiplatelet treatment for minor acute ischemic stroke and high-risk transient ischemic attack: have we reached the limit of antithrombotic management?
In this issue of the European Journal of Internal Medicine Pomero et al. present their systematic review and meta-analysis evaluating the early use of clopidogrel and ticagrelor in addition to... more
Ultrasound evaluation of bowel vasculopathy in systemic sclerosis but…
The gastrointestinal (GI) tract is affected in up to 90% of patients with systemic sclerosis (SSc). SSc is a key contributor to impairment and disability, leading to remarkable abnormal social... more
The importance of consensus statements on the prevention and treatment of cancer-associated thrombosis
Venous thromboembolism (VTE) is a common complication among patients with cancer. The 6-month risk of VTE complication for cancer patients is 12-fold higher and as much as 23-fold higher in those... more
The unresolved issues in the management of mucormycosis
Mucormycosis represents the second most frequent invasive mold infection after invasive aspergillosis and its incidence tends to increase around the world [1]. The disease not only affects patients... more
Preventing re-admission: Are general practitioners the solution?
In the United States the Hospital Readmissions Reduction Program (HRRP) is a Medicare value-based purchasing program that encourages hospitals to improve communication and care coordination to better... more
Embolic stroke of undetermined source and atrial cardiopathy: Towards a personalized antithrombotic strategy for secondary stroke prevention
An 82-year-old hypertensive woman with a history of myocardial infarction is admitted with aphasia and weakness of the right arm and leg. Admission electrocardiogram shows sinus rhythm. During... more
Uric acid and cardiovascular risk stratification in the acute coronary syndromes: a friend we should mind
Uric acid (UA) is the end product of purine metabolism. Whilst being primarily known as the leading risk factor for the onset of gout [1], UA has also been acknowledged as a significant CV risk... more
Atrial fibrillation and troponin elevation: It's time to give up the chase to diagnosis and step forward with prognosis
Atrial fibrillation (AF) is the most common sustained arrhythmia with an estimated prevalence in adults as high as 4%. AF negatively affects the quality of life and it is associated with incident... more
Ideas and Opinions
Reflections on experimentation in medicine
Empirical medicine – over centuries - has been based on close observation of the patient`s history and the sick body. Thus, the ancient Greeks had already concepts of human anatomy, organ functions... more
Internal Medicine Flashcard
A diabetic patient with finger gangrene
A 72-year-old male with type 2 diabetes and end-stage renal disease (ESRD) receiving hemodialysis (HD) for 10 months presented to hospital with one week of worsening pain, swelling, and bluish-black... more
Necrotic ulcers in an immunocompromised patient
A 68-year-old man presented to dermatology clinic with extensive ulcers for one-week duration. Patient had underlying uncontrolled Type II Diabetes Mellitus and pemphigus foliaceous. His medications... more
Persistent fever, bloody diarrhea, and skin necrosis in a young female
A 28-year-old Caucasian female presented with a two-month history of low-grade fevers, abdominal cramps, occasional bloody stools, weight loss, high C-reactive protein (234 mg/L), and with a newly-... more
Hemolytic anemia in a patient with cirrhosis: Hiding in the smear!
A 41-year-old female with alcoholic liver cirrhosis presented to the emergency department with worsening abdominal pain and progressively worsening shortness of breath for two weeks. Laboratory... more
Diffuse pulmonary ill-defined centrilobular opacities: Not only bronchiolitis
metastatic pulmonary calcification
Vanishing tumor of the stomach
A previously healthy Japanese 36-year-old man presented to the gastroenterology department with a 2-day history of acute-onset severe epigastric pain after eating flounder sashimi. His vital signs... more
Chilblain-like acral lesions
A 70-year-old Asian female presented to the rheumatology clinic with a 5-year history of tender papules on fingers and toes aggravated under cold exposure. She also reported polyarthralgia and... more
Granulomatous lesions of the skin: Do not fall into the trap
A 51-year-old woman was referred to investigate skin lesions present on her backside.
A man with fever and aortitis
A 54-year-old man presented with a chief complaint of fever and pain around the left clavicle. He had a primary germ cell tumor of the mediastinum and had been undergoing chemotherapy for... more
Chest pain in a Ukrainian woman living in Italy immediately after news of homeland Russian invasion.
A 54-year-old Ukrainian woman without cardiovascular risk factors presented with left-sided chest pain. The symptom appeared as soon as she got the news from her relatives in Ukraina of the beginning... more
Extrapyramidal dysfunction in cirrhosis: Is hepatic encephalopathy the only answer?
A 68-year-old male with a history of alcohol-related cirrhosis presented with persistent tremor, gait ataxia and choreiform movements of upper limbs over the past 4 days. The patient, that assured... more
Telangiectasias in a row
A 29-year-old man presented with an 11-year history of asymptomatic venous telangiectasias forming a sinuous line along the anterolateral part of the thorax at the level of the lower ribs and xiphoid... more
A diagonal earlobe crease
A 67-year-old man had a medical history of type 2 diabetes mellitus, dyslipidemia, hypertension, and alcohol-related liver disease. His vital signs were normal, and he had no symptoms. On physical... more
Letter to Editor
General practitioner agreement and adherence to the Swiss Choosing wisely top 5 list: A cross-sectional survey
Choosing Wisely (CW) campaigns have spread around the world to stimulate conversations between physicians and patients about unnecessary tests, treatments, and procedures that account for up to 20%... more
Letter to the Editor
Concerns regarding result analysis and the corresponding risk of pulmonary embolism severity and in-hospital mortality. Author's reply
Dear Editor,
Disease phenotype and outcomes of very early-onset inflammatory bowel disease
Dear Editor,
Exploring the recovery curve for long-term post-COVID dyspnea and fatigue
Dear Editor
Risk factors for chronic thromboemboli after pulmonary thromboembolism
Pulmonary thromboembolism is the third leading cause of cardiovascular death, after coronary artery disease and stroke [1].
Adult anaphylaxis: To the heart of the matter. Author's reply
we read with interest the letter by Mirijello et al. [1] which emphasizes the importance of Kounis syndrome (KS), Takotsubo syndrome and their copresence in ATAK syndrome among cardiovascular... more
Experience with procalcitonin use during the COVID-19 pandemic
Procalcitonin (PCT) is a protein precursor of calcitonin that has been proposed to differentiate systemic inflammation of bacterial origin from viral. The lack of rise in viral infections may be due... more
Hospitalized patients are needlessly over-tested for heparin induced thrombocytopenia
Heparin-induced thrombocytopenia (HIT) is an immune complication of heparin therapy caused by antibodies to complexes of platelet factor 4 (PF4) and heparin. Patients with HIT present with a decline... more
Concerns regarding result analysis and the corresponding risk of pulmonary embolism severity and in-hospital mortality
I read with great interest the article by Miró et al., [1] as the paper discusses an important aspect of clinical medicine which is of great importance in the current coronavirus disease 2019 (COVID-... more
Lipoprotein Z, an abnormal LDL-like lipoprotein, independently predicts mortality in cirrhosis
Decreased plasma concentrations of high-density lipoproteins (HDL) make part of the lipoprotein abnormalities encountered in end-stage liver disease [1,2]. The liver plays a central role in both the... more
Community care reform in Italy: Get a move on!
Dear editor
The role of heparin in reducing in-hospital complications and three-month mortality rates in hospitalized COVID-19 patients
Many COVID-19 patients develop a coagulopathy characterized by thrombocytopenia, minor prolongation of bleeding times and elevated serum d-dimer and fibrinogen levels, similar to consumption... more
Doubtful clinical benefit of casirivimab-imdevimab treatment for disease severity outcome of high-risk patients with SARS-CoV-2 delta variant infection
To the editor,
Assessment of the clinical characteristics of ampicillin-susceptible Enterococcus faecium infection
Dear Editor,
The precautionary principle in the COVID-19 vaccination campaign: The complicated relationship between the scientific community, medicines regulatory agencies and citizens
COronaVIrus Disease 19 (COVID-19) pandemia and vaccination campaign showed a frail relationship between the scientific community, medical authorities, and citizens. This clearly emerged when... more
Health-care associated infections surveillance in elderly patients
Dear Editor, according with the WHO, Health-Care Associated Infections (HCAIs) are the most frequent adverse events during care delivery and represent a great clinical and economic burden [1]. In... more
Advocating early identification and diagnosis of IgG4-related disease in various clinical specialties
IgG4-related disease (IgG4-RD) is a multi-system immune disease. An elevated serum level of IgG4 is one of the characteristics of IgG4-RD and can be used as an index for preliminary screening. While... more
P-wave dispersion as a marker of atrial cardiopathy in embolic stroke of undetermined source. Author's reply.
Dear Editor,
Diabetes influences the performance of creatinine-based equations for estimating glomerular filtration rate in the elderly population
The number of people older than 65 years with diabetes was 135.6 million in 2019, and will reach 276.2 million by 2045 [1]. Additionally, the estimated prevalence of diabetes in adults today has... more
Impact of therapeutic plasma exchange on acquired vaccinal anti-SARS-CoV-2 antibodies
As of December 2021, more than 276 million affected cases and 5 million deaths were reported by the World Health Organization, due to the COVID-19 pandemic [1]. Following the outbreak's beginning,... more
Is the number of long-term post-COVID symptoms relevant in hospitalized COVID-19 survivors?
Dear editor,
Perspectives of European internists on multimorbidity. A multinational survey
Dear Editor,
P-wave dispersion as a marker of atrial cardiopathy in embolic stroke of undetermined source
Dear editor,
Acute coronary syndromes during the first and the second wave of COVID-19
The deleterious side effects of the coronavirus disease 2019 (COVID-19) pandemic on cardiovascular disease have been widely reported [1–3]. However, most data refer to March and April 2020.... more
T-cell response to 3 doses of Sars-Cov2 BNT162b2 Pfizer vaccine in long term rituximab treated patients
B-depleting therapies increase the risk of severe COVID-19 [1] and have been shown to induce an impaired immune response to the SARS-COV2 vaccine [2]. There is a lack of data exploring the T-cell... more
Efficacy and safety of therapeutic vs. prophylactic bemiparin in noncritically ill patients with COVID-19 pneumonia
Thrombotic and thromboembolic phenomena are one of the leading complications and causes of poor outcomes in COVID-19 patients admitted to hospital [1]. In the pathophysiology of pulmonary and... more
The impact of oral anticoagulant drugs for arterial thromboembolism in patients with cancer
cancer is a known independent risk factor for venous thromboembolism (VTE)[1]. However, in recent years, its role also as a risk factor for arterial thrombotic events (ATE) has been elucidated[2].... more
Secondary hyperaldosteronism and liver fibrosis in patients with compensated chronic liver disease or portal hypertension
Among edematous disorders, liver cirrhosis (LC) is considered one of the main models of secondary hyperaldosteronism (SH), as pointed out by several studies in the past [1]. Aldosterone is expected... more
Appropriate dosing of the individual direct oral anticoagulants in atrial fibrillation: Differences in the questions to be answered
Direct oral anticoagulants; Apixaban; Dabigatran; Edoxaban; Rivaroxaban
One-year mepolizumab for Allergic bronchopulmonary aspergillosis: Focus on steroid sparing effect and markers of response
Allergic bronchopulmonary aspergillosis (ABPA) is a complex hypersensitivity reaction to Aspergillus fumigatus, mainly characterized by severe asthma symptoms, hyper eosinophilia in blood, lung and... more
Original Article
A prediction model for central venous catheter-related thrombosis in patients with newly-diagnosed acute myeloid leukemia: A derivation cohort analysis
Venous thromboembolism (VTE) is a major cause of morbidity and mortality in cancer patients. In a large population-based cohort study from Denmark, the VTE incidence within the first 6 months after... more
Hepatitis C Elimination in the Netherlands (CELINE): How nationwide retrieval of lost to follow-up hepatitis C patients contributes to micro-elimination
Achieving hepatitis C virus (HCV) elimination as a global health threat has been a priority of many countries since the World Health Organisation published their elimination targets [1]. In low-... more
Impact of diabetes on the management and outcomes in atrial fibrillation: an analysis from the ESC-EHRA EORP-AF Long-Term General Registry
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, frequently associated with other conditions such as diabetes mellitus [1,2], and confers major healthcare costs [3]. Given... more
Impact of eGFR rate on 1-year all-cause mortality in patients with stable coronary artery disease
The prevalence of chronic kidney disease (CKD) is currently around 10% in the general population, a figure that grows up to 30-50% in at-risk subgroups such as those with diabetes, hypertension or... more
Epidemiological and genetic features of anti-3‑hydroxy-3-methylglutaryl-CoA reductase necrotizing myopathy: Single-center experience and literature review
alanine aminotransferase
Effects of non-invasive respiratory supports on inspiratory effort in moderate-severe COVID-19 patients. A randomized physiological study
Non-invasive respiratory support (NRS), such as, Continuous Positive Airway Pressure (CPAP), High Flow Nasal Cannula (HFNC) or non-invasive ventilation (NIV), have been successfully applied to manage... more
Efficacy and safety of Janus kinase inhibitors in patients with ankylosing spondylitis: A systematic review and meta-analysis
Ankylosing spondylitis (AS), also known as radiographic axial spondyloarthritis, is the advanced disease stage of axial spondyloarthritis (axSpA) [1]. It was characterized by enthesitis involving the... more
Asymptomatic coronary artery disease assessed by coronary computed tomography in patients with systemic lupus erythematosus: A systematic review and meta-analysis
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with female predominance: cardiovascular disease (CVD) is the leading cause of morbidity and mortality. Accelerated atherosclerosis... more
Benefits of more intensive versus less intensive blood pressure control. Updated trial sequential analysis
High blood pressure (BP) remains a dominant risk factor for cardiovascular disease and death worldwide [1,2]. The progressive decline in the incidence of cardiovascular disease, particularly stroke,... more
Interleukin-6 inhibitors reduce mortality in coronavirus disease-2019: An individual patient data meta-analysis from randomized controlled trials
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019 and was declared a pandemic in March 2020 by the World Health Organization (WHO) [1]. Clinical manifestations... more
Reconsidering the Edelman equation: impact of plasma sodium concentration, edema and body weight
Hypernatremia and hyponatremia, are commonly encountered electrolyte disturbances in clinical practice [1,2]. The pathophysiology underlying these disturbances is complex and clinicians often face... more
Non-alcoholic fatty liver disease: identical etiologic factors in patients with type 1 and type 2 diabetes
Alongside the obesity-epidemic, non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide, with an estimated prevalence of 25% in the general population [1... more
Incidence of endocrine and exocrine insufficiency in patients with autoimmune pancreatitis at diagnosis and after treatment: a systematic review and meta-analysis
Autoimmune pancreatitis (AIP) is a rare form of chronic pancreatitis that can lead to end-stage organ damage if left untreated [1]. To date, at least two different subtypes of AIP have been... more
P2Y12 inhibitors plus aspirin for acute treatment and secondary prevention in minor stroke and high-risk transient ischemic attack: A systematic review and meta-analysis
Stroke is a leading cause of mortality and disability worldwide [1] and approximately 20 to 25% of ischemic stroke are anticipated by transient ischemic symptoms [2]. The risk of ischemic stroke... more
Association between admission ECG changes and long-term mortality in patients with an incidental myocardial infarction: Results from the KORA myocardial infarction registry
Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in Germany and worldwide [1,2]. It is grouped into two main categories according to admission ECG: ST-Elevation... more
Survival in rhino-orbito-cerebral mucormycosis: An international, multicenter ID-IRI study
Mucormycosis is an aggressive mold infection that mostly attacks patients with certain underlying conditions such as diabetes, hematological malignancies, neutropenia, major solid organ... more
Physical decline and cognitive impairment in frail hypertensive elders during COVID-19
Frailty is a biological syndrome of decreased physiological reserves with incremented vulnerability to stressors and its prevalence among older adults has been estimated at ∼10% [1]. Hypertension is... more
Thrombotic events following Covid-19 vaccines compared to Influenza vaccines
The actual risk of thrombotic events after Covid-19 vaccination is unknown.
Heart failure and catheter ablation of atrial fibrillation: Navigating the difficult waters of heart failure phenotypes
The use of catheter ablation of atrial fibrillation (AFA) is increasing and it has now been extended to include higher risk patients, e.g. those with heart failure (HF). Most observational studies... more
Consensus on prevention and treatment of cancer-associated thrombosis (CAT) in controversial clinical situations with low levels of evidence
Venous thromboembolism (VTE) is a leading cause of morbidity and mortality among cancer patients. They develop more VTE than those without cancer and experience higher rates of VTE recurrence and... more
Cardiac troponins and adverse outcomes in European patients with atrial fibrillation: A report from the ESC-EHRA EORP atrial fibrillation general long-term registry
Cardiac troponins (cTn) are the preferred biomarkers for the detection of myocardial injury and the diagnosis of myocardial infarction (MI) [1–3]. However, with the advent of high-sensitivity (hs)-... more
Antiseptic barrier caps in central line-associated bloodstream infections: A systematic review and meta-analysis
Central venous access devices are indispensable in modern healthcare but their use come with an inherent patient safety risk [1,2]. Catheter-associated bloodstream infections represent 10%-20% of all... more
In postmenopausal women, lower limb peripheral arterial disease, assessed by ankle-brachial index, may be a strong predictor of cardiovascular risk
Lower limb peripheral arterial disease (PAD) is the third most common clinical manifestation of atherosclerosis after ischemic heart disease and stroke [1]. It is associated with both significant... more
Prevalence of markers of atrial cardiomyopathy in embolic stroke of undetermined source: A systematic review
The majority of cryptogenic strokes are likely embolic; these have been termed “embolic strokes of undetermined source’’ (ESUS) [1]. One out of four ischemic strokes occurring in young (≤50 years)... more
Ultrasound evaluation of bowel vasculopathy in systemic sclerosis
Systemic sclerosis (SSc) is a complex disease with a heterogenous clinical spectrum and a complex pathophysiology characterized by immune activation and diffuse microvascular injury resulting in... more
Uric acid associated with acute heart failure presentation in Acute Coronary Syndrome patients
Uric Acid (UA) has been related to the development of fatal and non-fatal Cardio-Vascular (CV) events in the general population [1] as well as in patients experiencing an Acute Coronary Syndromes (... more
Associations between post-discharge medical consultations and 30-day unplanned hospital readmission: A prospective observational cohort study
Early readmission after hospital discharge is frequent, partly preventable, and puts a heavy burden on healthcare systems [1,2]. Many risk factors—like adverse drug events [3], physician workload [4... more
Review Article
Perspectives on the pharmacological management of alcohol use disorder: Are the approved medications effective?
Alcohol use disorder (AUD) is characterized by a large consumption of alcoholic beverages, which can determine the onset of alcohol-related diseases and an overall increase of morbidity and mortality... more
Low serum albumin: A neglected predictor in patients with cardiovascular disease
Albumin, the most abundant circulating protein in blood (accounting for 50% of the plasma proteins), composed of 585 amino acids with a molecular weight of 66 kDa, binds and transports various drugs... more
Acute kidney injury associated with non-steroidal anti-inflammatory drugs
Non-steroidal anti-inflammatory drugs (NSAIDs) are ones of the commonly prescribed drugs worldwide. They primarily inhibit cyclooxygenase (COX) enzyme which is responsible for conversion of... more
Comparing atrial fibrillation guidelines: Focus on stroke prevention, bleeding risk assessment and oral anticoagulant recommendations
Clinical practice in atrial fibrillation (AF) patient management is constantly evolving. Non-vitamin K antagonist oral anticoagulants (NOACs) showed a favorable risk-benefit profile as compared to... more
Uric acid in metabolic syndrome: Does uric acid have a definitive role?
The final product of purine metabolism is uric acid (UA) which is produced by xanthine oxidase (XO). Although most mammalian species can also oxidize UA to allantoin via uricase, humans are thought... more
Renin-angiotensin-aldosterone system inhibition in patients affected by heart failure: efficacy, mechanistic effects and practical use of sacubitril/valsartan. Position Paper of the Italian Society of Cardiology
Renin-angiotensin-aldosterone system (RAAS) activation is one the main pathophysiological mechanisms involved in the development and progression of heart failure (HF) and its inhibition is a mainstay... more
Sodium glucose cotransporter-2 inhibitors protect the cardiorenal axis: Update on recent mechanistic insights related to kidney physiology
Diabetic kidney disease (DKD) is a common complication of diabetes, affecting ∼ 40% of patients with type 2 diabetes (T2D) [1]. DKD is characterized by increased urinary albumin excretion and/or... more
Adult anaphylaxis: A state-of-the-art review
Anaphylaxis is an acute, usually rapidly developing, systemic (involving multiple organs) allergic reaction and, among the various clinical forms of allergy, it is the most severe and potentially... more
Optimizing antibiotic therapies to reduce the risk of bacterial resistance
The incidence of infections caused by bacteria that are resistant to antibiotics is constantly increasing. Infections with resistant bacteria are associated with higher morbidity, mortality and costs... more
Heart failure with preserved ejection fraction: Squaring the circle between comorbidities and cardiovascular abnormalities
The original descriptions of Heart Failure (HF) with preserved ejection fraction (HFpEF) dates back to the mid-1980s, and, for approximatively a decade, studies on this HF subtype consisted of... more