May 2023

32 Articles

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

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 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

Commentary

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

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

Internal Medicine Flashcard

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

Letter to the Editor

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

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,

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

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

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

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

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

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

Original Article

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, Emanuel Della-Torre

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

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

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

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

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

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

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