May 2022

30 Articles

Clinical Insights

Saving the kidneys in the lupus patient: Beyond immunosuppression, the need to collaborate across multiple disciplines

19 March 2022
Author(s): Gema M. Lledó, Marc Xipell, Adriana García-Herrera, Laura Bueno, Ricard Cervera, Maria Galindo, Jose A. Gómez-Puerta, Enrique Morales, Manuel Praga, Jorge E. Rojas, Guillermo Ruiz-Irastorza, Olga Sánchez Pernaute, David Jayne, Gerard Espinosa, Luis F. Quintana, Multidisciplinary Group for the Study of Lupus Nephritis

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


Preventing re-admission: Are general practitioners the solution?

17 March 2022
Author(s): Geno Merli

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

19 February 2022
Author(s): George Ntaios, Eleni Korompoki

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

17 February 2022
Author(s): Alessandro Mengozzi, Agostino Virdis

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

6 February 2022
Author(s): Francesco Notaristefano, Claudio Cavallini

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

Internal Medicine Flashcard

Chest pain in a Ukrainian woman living in Italy immediately after news of homeland Russian invasion.

10 March 2022
Author(s): Michele Golino, Gianmarco Angelini, Vittoria Errigo, Andrea Farina, Stefano Savonitto

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?

10 February 2022
Author(s): Bernardo Canhão, André Trigo, João Madaleno

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

2 February 2022
Author(s): Alejandro Morales-Ortega, Javier Martín-Alcalde, David Bernal-Bello

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

10 January 2022
Author(s): Yusaku Kajihara

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 the Editor

Advocating early identification and diagnosis of IgG4-related disease in various clinical specialties

2 March 2022
Author(s): Jiao Jian, Shanshan Zhang, Jun Zhang, Yifang Li

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.

25 February 2022
Author(s): Nikolaos Stalikas, Ioannis Doundoulakis, Efstratios Karagiannidis, Georgios Sianos, George Giannakoulas

Dear Editor,

P-wave dispersion as a marker of atrial cardiopathy in embolic stroke of undetermined source

4 February 2022
Author(s): Maurizio Acampa, Pietro Enea Lazzerini, Giuseppe Martini

Dear editor,

Acute coronary syndromes during the first and the second wave of COVID-19

2 February 2022
Author(s): Marco Ferlini, Diego Castini, Luigi Oltrona Visconti, Stefano Carugo, COVID-19 Lombardy Macro-Hubs Investigators

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

23 January 2022
Author(s): Jade Heitz, Jerome Razanamahery, Sylvain Audia, Jean-Baptiste Bour, Julien Guy, Sabine Berthier, Vanessa Leguy, Thibault Ghesquiere, Barbara Nicolas, Maxime Samson, Bernard Bonnotte

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

20 January 2022
Author(s): Jose F Varona, Elena Núñez, Borja M. Fernández Félix, Jose María Castellano Vázquez, Antonio Cubillo

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

20 January 2022
Author(s): Andreana Foresta, Pierluca Colacioppo, Marta Baviera, Luisa Ojeda-Fernandez, Claudio Cimminiello

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

15 January 2022
Author(s): Giovanni Vitale, Kimberly Coscia, Guido Zavatta, Maria Cristina Morelli, Valentina Vicennati

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

7 January 2022
Author(s): Andrea Rubboli, Nuccia Morici, Gregory Y.H. Lip

Direct oral anticoagulants; Apixaban; Dabigatran; Edoxaban; Rivaroxaban

One-year mepolizumab for Allergic bronchopulmonary aspergillosis: Focus on steroid sparing effect and markers of response

6 January 2022
Author(s): Marco Caminati, Veronica Batani, Lucia Guidolin, Giuliana Festi, Gianenrico Senna

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

Physical decline and cognitive impairment in frail hypertensive elders during COVID-19

13 March 2022
Author(s): Pasquale Mone, Antonella Pansini, Salvatore Frullone, Antonio de Donato, Veronica Buonincontri, Paolo De Blasiis, Anna Marro, Maria Morgante, Antonio De Luca, Gaetano Santulli

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

8 March 2022
Author(s): Marcelo Gabriel Vallone, Andre Luis Falcón, Horacio Matias Castro, Augusto Ferraris, Ramiro Francisco Cantarella, María Inés Staneloni, Valeria Ines Aliperti, Analia Ferloni, Daniela Mezzarobba, Fernando Javier Vázquez, María Florencia Grande Ratti

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

28 February 2022
Author(s): Luigi Tavazzi, Aldo P. Maggioni, Claudio Rapezzi, Roberto Ferrari

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

Cardiac troponins and adverse outcomes in European patients with atrial fibrillation: A report from the ESC-EHRA EORP atrial fibrillation general long-term registry

14 February 2022
Author(s): Marco Vitolo, Vincenzo L. Malavasi, Marco Proietti, Igor Diemberger, Laurent Fauchier, Francisco Marin, Michael Nabauer, Tatjana S. Potpara, Gheorghe-Andrei Dan, Zbigniew Kalarus, Luigi Tavazzi, Aldo Pietro Maggioni, Deirdre A. Lane, Gregory Y.H. Lip, Giuseppe Boriani, ESC-EHRA EORP-AF Long-Term General Registry Investigators

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

10 February 2022
Author(s): Sofía Tejada, Marta Leal-dos-Santos, Yolanda Peña-López, Stijn Blot, Emine Alp, Jordi Rello

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

9 February 2022
Author(s): Giacomo Buso, Roger Darioli, Luca Calanca, Michèle Depairon, Jürg Schwitter, Lucia Mazzolai, Adriano Alatri

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

19 January 2022
Author(s): Nikolaos Stalikas, Ioannis Doundoulakis, Efstratios Karagiannidis, Anastasios Kartas, Maria Gavriilaki, George Sofidis, Eleftherios Panteris, Andreas S. Papazoglou, Anna-Bettina Haidich, Georgios Sianos, George Giannakoulas

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

Uric acid associated with acute heart failure presentation in Acute Coronary Syndrome patients

17 January 2022
Author(s): Paola Rebora, Marco Centola, Nuccia Morici, Alice Sacco, Giuseppe Occhino, Giovanna Viola, Jacopo Oreglia, Diego Castini, Simone Persampieri, Ludovico Sabatelli, Giulia Ferrante, Stefano Lucreziotti, Stefano Carugo, Maria Grazia Valsecchi, Fabrizio Oliva, Cristina Giannattasio, Alessandro Maloberti

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

13 January 2022
Author(s): Gregor John, Loïc Payrard, Jacques Donzé

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

Optimizing antibiotic therapies to reduce the risk of bacterial resistance

21 January 2022
Author(s): Stefano Bassetti, Sarah Tschudin-Sutter, Adrian Egli, Michael Osthoff

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

12 January 2022
Author(s): Alberto Maria Marra, Leonardo Bencivenga, Roberta D'Assante, Giuseppe Rengo, Antonio Cittadini

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


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