November 2019
38 ArticlesNo Section
Proton pump inhibitors and cardiovascular adverse effects: Real or surreal worries?
Proton pump inhibitors (PPIs) are among the most widely prescribed agents [1]. For over 30 years, guidelines promote PPIs as the best treatment of gastroesophageal reflux disease (GERD), esophagitis... more
Preemptive plasma therapy prevents atypical hemolytic uremic syndrome relapse in kidney transplant recipients
Atypical hemolytic syndrome (aHUS) is a rare cause of thrombotic microangiopathy (TMA) that can lead to end-stage renal disease (ESRD) (1). Without preemptive therapy early recurrence after kidney... more
Depression is independently associated with increased length of stay and readmissions in multimorbid inpatients
Little is known about the impact of depression across a broad range of multimorbid patients hospitalized for reasons other than depression. The objective of the study was to investigate in a large... more
The relationship among frailty, delirium and attentional tests to detect delirium: a cohort study
Frailty and delirium are two medical conditions of older people that have been described as geriatric giants (1). Frailty is characterized by a decrease of functional reserves due to a multisystemic... more
Predictive value of the Canada Acute Coronary Syndrome risk score for post-acute myocardial infarction infection
Infection in patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) significantly increases mortality, prolongs the length of hospital stay, and... more
Renal function and delirium in older fracture patients: different information from different formulas?
the association between renal function and delirium has not been investigated in older fracture patients. Creatinine is frequently low in these subjects, which may influence the association between... more
Hepatitis C virus (HCV) infection and cardiovascular disease: Hepatologists and cardiologists need to talk!
Several studies reported adverse cardiovascular outcomes in patients with hepatitis C virus (HCV) infection [1]. In our opinion, this should prompt consequences in the work-up of both patients with... more
Heart failure etiologies and clinical factors precipitating for worsening heart failure: Findings from BIOSTAT-CHF
Heart failure (HF) therapies have improved patient outcome over the last decades, however those with worsening symptoms and/or signs of HF still have a poor prognosis [1,2]. Both the etiology of HF... more
The prognostic effect of left ventricular thrombus formation after acute myocardial infarction in the contemporary era of primary percutaneous coronary intervention: A meta-analysis
: The prognosis and management of left ventricular thrombus (LVT) following acute myocardial infarction (AMI) have not been well evaluated since the advent of primary percutaneous coronary... more
Apixaban-induced fatal liver injury with a cholestatic pattern
The hepatobiliary effects of direct oral anticoagulants (DOACs) have been under close surveillance since hepatotoxicity was demonstrated with ximelagatran during the post marketing phase,... more
A rare cause of dysphagia
An 80-year-old male patient, with a history of Alzheimer's disease and recurrent idiopathic angioedema, was evaluated at the emergency room for another episode of angioedema. He also mentioned slowly... more
Commentary
Management of venous thromboembolism in cancer patients: Considerations about the clinical practice guideline update of the American society of clinical oncology
Venous thromboembolism (VTE) is a common complication in patients with cancer. About 15% of patients with cancer experience one or more episodes of acute VTE during the course of their disease, while... more
Precision medicine in heart failure no longer a visual theory but a realistic opportunity?
Over the last decades, major advances in the understanding of pathophysiology in a wide spectrum of cardiovascular diseases provided several effective pharmacological and non-pharmacological... more
Post myocardial infarction infection: Can we predict it or not?
We read with interest the study of Liu et al. [1], investigating the predictive value of the Canada Acute Coronary Syndrome (C-ACS) risk score for post-infarction infection among patients... more
Hypertensive urgencies and emergencies: Misconceptions and pitfalls
Hypertension remains the dominant risk factor for premature cardiovascular disease worldwide [1,2]. It increases the short- and long-term risk of a variety of cardiovascular complications, including... more
Editorial
A new approach for anemia in kidney disease
Anemia represents an almost obligatory complication in patients with chronic kidney disease (CKD) and, if ineffectively treated, is associated with increased cardiovascular (CV) mortality, a reduced... more
Prognostication by concomitant organ failure in mechanically ventilated patients in ICU: Important issue to face with
Acute Physiology And Chronic Health Evaluation-2 (APACHE II) and Simplified Acute Physiology Score II (SAPS2) have been developed to assess the risk stratification of patients admitted to the... more
Internal Medicine Flashcard
A woman with an alarming electrocardiogram
An 86-year-old woman is evaluated for an abnormal electrocardiogram (ECG) during admission for hemoptysis (Figure 1-A). She denied any chest pain. Other medical problems include bronchiectasis,... more
Strange cutaneous abnormalities and polyposis in an Asiatic man
A 56-year-old-man, born in Laos, was hospitalized for weight loss to 9 kg in 3 months, asthenia, pruritus and a skin and nails changed color. He had no significant past medical history. He described... more
Lung fibrosis and painful fingers
A 38-year-old man with no previous medical illness presented with 2-month history of dry cough and dyspnoea. There was no hemoptysis or fever. He was a non-smoker. Of note, he started to have burning... more
A schizophrenic man with severe disorders of consciousness
A 48-year-old man with severe disorders of consciousness and fever up to 38 °C was transferred from a psychiatric hospital to the author's hospital. He had suffered from schizophrenia for 15 years... more
Letter to the Editor
H63/H63D genotype and the H63D allele are associated in patients with hyperferritinemia to the development of metabolic syndrome
The metabolic syndrome (MtS) is present in the 25% of the population of Western countries [1]. MtS is frequently associated with hyperferritinemia (HF) and this can be produced by mutations in the... more
SAPHO syndrome and subclavian thrombosis: Simple fortuitous association?
The SAPHO syndrome (Synovitis, Acne, Pustulose, Hyperostosis, Osteitis) described in 1987 associates joint, skin and especially bone damage. It is a rare disease, included in the group of... more
Thyroid dysfunction in adult patients with biopsy-proved myocarditis: Screening and characterization
Myocarditis is a complex inflammatory disease, usually secondary to viral infections or autoimmune processes selectively involving the myocardium [1]. Thyroid dysregulation, often triggered by... more
Identification of EML4-ALK fusion in a sporadic case of cholangiocarcinoma
Cholangiocarcinoma (CCA) are a heterogeneous group of malignant epithelial neoplasia arising from the epithelial cell lining the intra and extra-hepatic biliary tree, which represent the second most... more
Equity, diversity, and inclusion in academic internal medicine at US medical schools
As minority populations continue to increase in the United States (US), diversification of medical faculty and professionals remains critical to effectively serving minority groups and improving... more
Contributors to survival benefit of dual versus single antithrombotic therapy in chronic coronary syndrome
In randomized trials the use of dual antithrombotic therapy (DAT) versus single antithrombotic therapy (SAT) in patients with chronic coronary syndrome (CCS) reduced the risk of major adverse... more
Do we have enough evidence to support the use of SGLT2 inhibitors for MACE reduction in patients with advance kidney disease?
Sodium-Glucose co-transporter 2 inhibitors (SGLT2i) are novel therapeutic agents used for the treatment of type 2 diabetes mellitus (T2DM) and have reno-protective effects in patients with T2DM with... more
Magnesium disorders: Myth or facts?
Dear Editor,
Protective activity of Ticagrelor against bacterial infection in acute myocardial infarction patients
Dear Editor,
Narrative Review
Comorbidities in chronic heart failure: An update from Italian Society of Cardiology (SIC) Working Group on Heart Failure
The Prevalence of Heart Failure (HF) in the western world is around 1-2% and more than 10% over 70 years of age and the incidence is about 5–10 per 1000 persons per year, representing the leading... more
Original Article
Increased serum uric acid level predicts poor prognosis in mildly severe chronic heart failure with reduced ejection fraction. An analysis from the MECKI score research group
The association between elevated serum uric acid (SUA) levels and risk of cardiovascular (CV) disease has gained a lot of attention over the last years, considering that using the cut-off levels... more
Comparative influence of Acute Illness Severity and comorbidity on mortality
Acute Medicine is concerned with the immediate specialist management of urgent medical presentations [1]. Acute Medicine practitioners have an intuitive or experiential feel of major outcome... more
Short and long-term mortality in elderly patients with suspected not confirmed pulmonary embolism
Pulmonary embolism (PE) is a leading cause of mortality [1] and both its incidence and mortality increase with age [2–4]. After pursuing Emergency Department (ED) diagnostic work-up, the prevalence... more
Effects of benzodiazepines on orthostatic blood pressure in older people
Psychoactive medications are widely used in older people [1–3], despite increasing concerns about their safety profile in this population. In particular, benzodiazepines (BDZs) are commonly... more
Impact of stable angina on health status and quality of life perception of currently treated patients. The BRIDGE 2 survey
Stable Angina (SA) is a common condition in patients with coronary heart disease, with a prevalence of around 2–4% of the general population in western European countries. In patients with... more
Diagnosis and treatment of hypertensive emergencies and urgencies among Italian emergency and intensive care departments. Results from an Italian survey: Progetto GEAR (Gestione dell'Emergenza e urgenza in ARea critica)
Hypertensive emergencies (HE) and urgencies (HU) are defined as a blood pressure (BP) elevation usually above 180 mmHg for systolic (SBP) and/or above 120 mmHg for diastolic (DBP) and differ by the... more
Review Article
Creatinine: From physiology to clinical application
Estimating static kidney function accurately and detecting changes in kidney function in a timely fashion are challenging and critically important.