November 2024

34 Articles

Clinical Insights

Oropouche virus infection: What internal medicine physicians should know

9 August 2024
Author(s): Lorenzo Bertolino, Fabian Patauner, Emanuele Durante-Mangoni

Not required for Clinical Insight

Internal medicine in the 21st century: Back to the future

2 August 2024
Author(s): Ricardo Gómez-Huelgas, George N. Dalekos, Dror Dicker, Nicola Montano

Healthcare systems face multiple challenges arising from demographic factors (population aging) and epidemiological factors (rise of chronic diseases and patients with multimorbidity) as well as... more

Commentary

Deprescribing in reflex syncope

29 August 2024
Author(s): Alessandra Fusco, Monica Solbiati, Giorgio Costantino

Reflex syncope is generally considered a benign condition. It is due to a reflex response (parasympathetic enhancement and decreased sympathetic tone) to several stimuli (e.g. micturition, defecation... more

It is time to get all the job done: For patients’ sake

17 August 2024
Author(s): Angelo Avogaro

Guidelines prioritize cardiovascular (CV) prevention by controlling all risk factors: this is a commitment for every healthcare professional following patients with type 2 diabetes. Not doing so... more

Unmasking eosinophilic granulomatosis with polyangiitis (EGPA)

10 August 2024
Author(s): Luca Moroni, Gabriele Gallina, Lorenzo Dagna

Eosinophilic granulomatosis with polyangiitis (EGPA) remains a challenging diagnosis due to its rarity and heterogeneous presentation. The article by Solans-Laqué et al. represents a significant step... more

Navigating the bleeding risk dilemma in patients with atrial fibrillation on therapy with direct-acting oral anticoagulants: Comparing the HAS-BLED vs. DOAC Score

27 July 2024
Author(s): Eva Soler-Espejo, José Miguel Rivera-Caravaca

Oral anticoagulation (OAC) is pivotal in preventing stroke in atrial fibrillation (AF), but its use poses inherent risks, notably an increased susceptibility to bleeding, especially in clinically... more

Internal Medicine Flashcard

Diagnostic challenge of hemoptysis in a hemodialysis patient

23 July 2024
Author(s): Fullana Martin, Aliaga Leandro, Verni Giuliana

A 60-year-old male with a history of chronic kidney disease (CKD) diagnosed 3 years ago, on thrice-weekly hemodialysis, presented to the emergency department with a one-month history of hemoptysis... more

Man with progressed cognitive impairment

23 July 2024
Author(s): Jia-Qi Chen, Wei-Nv Fan

A 69-year-old man presented to the neurology department with progressed cognitive impairment for two years. He had medical history of diabetes but without remarkable family history of dementia. On... more

Invited Review Article

Managing and discharging COPD patients hospitalized because of an exacerbation of respiratory symptoms: An opportunity to improve outcomes

5 September 2024
Author(s): Alvar Agusti, Bartolome R. Celli, Leonardo Fabbri, Claus Vogelmeier

Many patients with chronic obstructive pulmonary disease (COPD) develop episodes of exacerbation of respiratory symptoms (ECOPD) that may require hospitalization (H-ECOPD). Long-term prognosis during... more

Advances in the pathophysiology, diagnosis and management of chronic diarrhoea from bile acid malabsorption: a systematic review

27 July 2024
Author(s): Agostino Di Ciaula, Mohamad Khalil, Gyorgy Baffy, Piero Portincasa

Excessive biosynthesis or secretion of bile acids (BAs) and their malabsorption (BAM) in the terminal ileum or the colon [1] generates chronic diarrhoea (cholorrhea). This symptom depends on a... more

Letter to the Editor

Antimicrobial therapy and patient management for severe Legionnaires’ pneumonia

13 August 2024
Author(s): Jordi Rello, Joan Sabater-Riera

Legionellosis (LD) becomes a major public health problem, predominantly presenting as Pontiac fever or pneumonia with predominance of Legionella pneumophila (Lp) throughout the world, as reported in... more

Challenges in using the clock drawing test for prognosis prediction in patients with non-specific complaints

9 August 2024
Author(s): Hiroshi Ito

Espejo and colleagues, using data from a prospective cross-sectional study, discovered that patients visiting the emergency department with non-specific complaints who had poor results on the Clock... more

Quinolones or macrolides for adults with Legionnaires’ disease and respiratory failure?

29 July 2024
Author(s): Lorna Pairman, Stephen T. Chambers

We recently read the systematic review entitled “Legionella pneumonia in hospitalized adults with respiratory failure: Quinolones or macrolides?” by Ruiz-Spinelli A, and Rello J published in the... more

Predictive performance of HAS-BLED, ORBIT, ABC, and DOAC scores for major bleeding in atrial fibrillation patients on DOACs

4 July 2024
Author(s): Shan Zeng, Wengen Zhu, Siyu Guo, Hong Hong

Atrial fibrillation (AF) is the most common type of irregular heartbeat in clinical practice. It has been found to increase the risk of ischemic stroke by 5 times. To mitigate this risk, oral... more

Clostridioides difficile infection as a potential trigger for Familial Mediterranean Fever attacks and fecal transplantation as a rescue

7 June 2024
Author(s): Sophie Georgin-Lavialle, Marion Delplanque, Claude Bachmeyer, Léa Savey, Harry Sokol, FMF Clostridium Study Group

Sir,

Definition of an algorithm to identify patients with sickle-cell disease in the French National Health Database

31 May 2024
Author(s): Ondine Walter, Pierre Cougoul, Yoann Zadro, Guillaume Moulis, Margaux Lafaurie

Sickle cell disease (SCD) is the most frequent inherited disease with monogenic transmission (300,000 newborns per year in the world) [1]. SCD is due to a mutation on both alleles of the gene coding... more

Navigating the challenges: Would onboarding bootcamps enhance comfort and wellbeing of residents in medicine?

28 May 2024
Author(s): Jonathan Assouly, Margaret Hayes, Blaise Debien, Camille Roubille, Boris Jung

Medical interns (first-year residents) and residents (second-to fourth-year residents) in France are junior medical staff in charge of overseeing up to 200 medicine beds during night shifts, with no... more

Dual tobacco smoking, electronic cigarette use and COVID-19 outcomes

27 May 2024
Author(s): Tahlia Grammatopoulos, Ellana Yeoh, Nouhad El-Haddad, Kristin Carson-Chahhoud, Freddy Sitas

We congratulate Scala and colleagues on the publication of their paper on electronic cigarette (e-cigarette) use and Coronavirus Disease 2019 (COVID-19) outcomes [1]. Scala et al. focused on e-... more

Survival analysis of diabetes cardiovascular outcome trials using reconstructed Kaplan-Meier curves

25 May 2024
Author(s): Marko Skelin, Bruna Perkov-Stipičin, Marko Lucijanić, Eugen Javor, Ivan Krečak

The management of type 2 diabetes mellitus (T2DM) has witnessed a treatment paradigm in the light of recent cardiovascular outcomes trials (CVOTs) which have placed more emphasis on cardiovascular... more

Multi-organ abnormalities assessed by a single MRI scan in individuals with blood cancer

24 May 2024
Author(s): Sophie Reed, Michele Pansini, Charlie Diamond, Amitava Banerjee, Helena Thomaides Brears, Onima Chowdhury

During the COVID-19 pandemic individuals with all blood cancers were classified as clinically vulnerable and at high risk of complications and death. Our study sought to determine if individuals with... more

The association between long-acting muscarinic antagonist-based therapy and the risk of urinary tract infection in patients with chronic obstructive pulmonary disease

24 May 2024
Author(s): Ping Li, Jianjun Luo, Jun Chen, Yongchun Shen, Fuqiang Wen

Chronic obstructive pulmonary disease (COPD) is a common respiratory disease featuring persistent respiratory symptoms and progressive airflow limitation. Long-acting muscarinic antagonists (LAMAs)... more

Self-publishing in the history of medicine: The paradoxical case of Edward Jenner's science-changing monograph (1798)

13 May 2024
Author(s): Francesco M. Galassi, Elena Varotto, Domenico Ribatti

According to the Cambridge Dictionary, self-publishing is regarded as the act of arranging or paying for one's ‘own book to be published, rather than having it done by a publisher’ [1]. Whether it be... more

Original Article

Long-term inhaled corticosteroid treatment in patients with chronic obstructive pulmonary disease, cardiovascular disease, and a recent hospitalised exacerbation: The ICSLIFE pragmatic, randomised controlled study

8 July 2024
Author(s): Alberto Papi, Giacomo Forini, Mauro Maniscalco, Elena Bargagli, Claudia Crimi, Pierachille Santus, Antonio Molino, Valeria Bandiera, Federico Baraldi, Silvestro Ennio D'Anna, Mauro Carone, Maurizio Marvisi, Corrado Pelaia, Giulia Scioscia, Vincenzo Patella, Maria Aliani, Leonardo M Fabbri, ICSLIFE Study Group

Patients with chronic obstructive pulmonary disease (COPD) are typically older [1], and have multiple comorbidities, including heart failure, ischaemic heart disease, and arrhythmias [2–5]. The... more

Performance of HAS-BLED and DOAC scores to predict major bleeding events in atrial fibrillation patients treated with direct oral anticoagulants: A report from a prospective European observational registry

4 July 2024
Author(s): Davide Antonio Mei, Jacopo Francesco Imberti, Niccolò Bonini, Giulio Francesco Romiti, Bernadette Corica, Marco Proietti, Marco Vitolo, Gregory Y.H. Lip, Giuseppe Boriani

Atrial fibrillation (AF) is the most common arrhythmia worldwide and it is associated with a 3–5-fold higher risk of stroke [1]. This risk has been significantly reduced after the introduction of... more

Metabolic health and genetic predisposition in inflammatory bowel disease: Insights from a prospective cohort study

2 July 2024
Author(s): Ningning Mi, Qiangsheng He, Yuyao Liu, Yingmei Li, Ying Li, Yingjie Wu, Man Yang, Yingya Zhao, Peng Xie, Wenjing Li, Siqin Wu, Zijun Li, Danni Wang, Xiwen Qin, Jinqiu Yuan, Pingguang Lei, Jian Qi, Bin Xia

Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory disease of the gastrointestinal tract driven by an inappropriate and... more

Red flags for clinical suspicion of eosinophilic granulomatosis with polyangiitis (EGPA)

15 June 2024
Author(s): R. Solans-Laqué, I. Rúa-Figueroa, M. Blanco Aparicio, I. García Moguel, R. Blanco, F. Pérez Grimaldi, A. Noblejas Mozo, M. Labrador Horrillo, J.M. Álvaro-Gracia, C. Domingo Ribas, G. Espigol-Frigolé, F. Sánchez-Toril López, F.M. Ortiz Sanjuán, E. Arismendi, M.C. Cid

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome [1], is a systemic vasculitis classified as an anti-neutrophil cytoplasm antibody (ANCA)-associated... more

Beta-cell function and glucose metabolism in patients with chronic pancreatitis

12 June 2024
Author(s): Gea Ciccarelli, Gianfranco Di Giuseppe, Laura Soldovieri, Giuseppe Quero, Enrico Celestino Nista, Michela Brunetti, Francesca Cinti, Simona Moffa, Umberto Capece, Vincenzo Tondolo, Andrea Mari, Antonio Gasbarrini, Alfredo Pontecorvi, Sergio Alfieri, Andrea Giaccari, Teresa Mezza

Diabetes of the exocrine pancreas (DEP), - also defined as pancreatic, pancreatogenic, or type 3c diabetes - arises from the structural or functional loss of insulin secretion secondary to exocrine... more

Diagnosis of acute aortic syndromes with ultrasound and d-dimer: the PROFUNDUS study

12 June 2024
Author(s): Fulvio Morello, Paolo Bima, Matteo Castelli, Elisa Capretti, Alexandre de Matos Soeiro, Alessandro Cipriano, Giorgio Costantino, Simone Vanni, Bernd A. Leidel, Beat A. Kaufmann, Adi Osman, Marcello Candelli, Nicolò Capsoni, Wilhelm Behringer, Marialessia Capuano, Giovanni Ascione, Tatiana de Carvalho Andreucci Torres Leal, Lorenzo Ghiadoni, Emanuele Pivetta, Stefano Grifoni, Enrico Lupia, Peiman Nazerian, PROFUNDUS Study Investigators

Acute aortic syndromes (AASs), including aortic dissection (AD), intramural aortic haematoma (IMH) and penetrating aortic ulcer (PAU), affect 5–7/100,000 individuals/year [1]. They are time-dependent... more

A group-based intervention for diabetes-related emotional distress among emerging adults with type 1 diabetes: A pilot study

8 June 2024
Author(s): Anne-Sofie Kortegaard, Rikke B. Rokkjær, Hanne Marie H. Harboe, Sten Lund, Anette Andersen, Mette Bohl

Emerging adulthood is a critical period with increased risk of acute and chronic health complications, psychological problems, and psychosocial issues for emerging adults with type 1 diabetes (T1D) [... more

Relationship between degree of risk factor control and all-cause mortality in individuals with type 2 diabetes: A prospective cohort study

5 June 2024
Author(s): Monia Garofolo, Giuseppe Penno, Anna Solini, Emanuela Orsi, Martina Vitale, Veronica Resi, Enzo Bonora, Cecilia Fondelli, Roberto Trevisan, Monica Vedovato, Antonio Nicolucci, Giuseppe Pugliese, Renal Insufficiency And Cardiovascular Events (RIACE) Study Group

Risk of death is approximately twice higher in people with diabetes than in those without, mainly though not exclusively due to an increased risk of cardiovascular disease (CVD) [1]. However, death... more

Association between socioeconomic and psychosocial factors with use of interventional and surgical treatments and outcomes in patients with myocardial infarction – Inpatient data of the largest European health care system

4 June 2024
Author(s): Omar Hahad, Lukas Hobohm, Sadeer Al-Kindi, Volker H. Schmitt, Fawad Kazemi-Asrar, Donya Gilan, Katja Petrowski, Tommaso Gori, Philipp Wild, Klaus Lieb, Andreas Daiber, Philipp Lurz, Thomas Münzel, Karsten Keller

Myocardial infarction (MI) remains a leading contributor for morbidity and mortality worldwide [1,2]. While the medical progress regarding diagnostic and therapeutic approaches has improved outcomes... more

Targets for deprescribing in patients with hypertension and reflex syncope

24 May 2024
Author(s): Antonella Groppelli, Giulia Rivasi, Artur Fedorowski, Frederik de Lange, Vincenzo Russo, Roberto Maggi, Marco Capacci, Sara Nawaz, Angelo Comune, Andrea Ungar, Gianfranco Parati, Michele Brignole

In hypertensive patients with reflex syncope, detection of transient hypotension as possible trigger mechanism of syncope may prompt deprescribing of hypotensive medications to counteract the risk of... more

Early palliative care program in idiopathic pulmonary fibrosis patients favors at-home and hospice deaths, reduces unplanned medical visits, and prolongs survival: A pilot study

23 May 2024
Author(s): Ilaria Bassi, Stefania Pastorello, Aldo Guerrieri, Gilda Giancotti, Anna Maria Cuomo, Chiara Rizzelli, Maria Coppola, Danila Valenti, Stefano Nava

Idiopathic Pulmonary Fibrosis (IPF) is a relentlessly progressive fibrotic interstitial lung disease (ILD) with an unfavourable prognosis1. The median survival is 3 to 5 years form the time of... more

Review Article

Exploring Cardiovascular Risk Factors and Atherosclerosis in Rheumatoid Arthritis

23 July 2024
Author(s): Alexandros A. Drosos, Aliki A. Venetsanopoulou, Eleftherios Pelechas, Paraskevi V. Voulgari

Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the synovium of the joints, leading to joint destruction and bone damage. It affects 0, 5–1 % of the general population,... more

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