October 2022
30 ArticlesClinical Insights
Structural evolution of severe acute respiratory syndrome coronavirus 2: Implications for adhesivity to angiotensin-converting enzyme 2 receptors and vaccines
The Omicron BA.5 variant currently accounts for the majority of cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (https://covid.cdc.gov/covid-data-tracker/#variant-... more
Commentary
Ultrafiltration in decompensated heart failure: Is time to look forward?
Heart failure (HF) is a chronic condition resulting in more than 1 million hospitalizations annually in both the United States and Europe [1]. Because the natural history of HF is characterised by... more
Assessment of cardiovascular risk with C-reactive protein in rheumatoid arthritis patients
Over the past decades, it has become increasingly accepted that the risk of cardiovascular (CV) morbidity and mortality is noticeably augmented in rheumatoid arthritis (RA) patients [1]. When... more
Internal Medicine Flashcard
Dorsal pigmentation of tongue
A 56-year-old male patient with diabetes presented with black discolouration of the tongue 7 days after extraction of two mandibular molars (Fig. 1). Prophylactic oral amoxicillin 750 mg was started... more
Generalized erythematous scaly rash after glucocorticoids
A 65-years-old woman with a medical history of idiopathic thrombocytopenic purpura and psoriasis in treatment with topical glucocorticoids presented with a three-month history of burning, generalized... more
Interstitial pneumonia with subpleural sparing and weight loss
A 36-years-old man from West Africa was admitted to our ED with respiratory failure and a 15 days history of fatigue and peevish cough. He reported watery diarrhea and a 30 kg weight loss in the last... more
Malar rash with pancytopenia
A 35-year-old Japanese man presented with a four-month history of persistent flushing and persistent high fever (≥38 °C) for the past several weeks.
Letter to the Editor
Non-invasive respiratory supports on inspiratory effort in COVID-19: How and when is it matter of selection? Author's reply.
Dear Editor,
Non-invasive respiratory supports on inspiratory effort in Covid-19: how and when is it matter of selection?
Dear editor,
The underutilization of medications for alcohol use disorders is a sensible choice
Dear Editor,
COVID-19 mRNA vaccination in patients with previous myocarditis
Dear Editor,
The impact of co-working with an Internist in a high-speciality division of cardiology in a third-level centre. Experience with a new organization model
Despite remarkable international differences, most European health care systems rely on a primary care, a secondary care and more specialized or tertiary institutions, which often focus mainly on one... more
Sodium-glucose cotransporter 2 inhibitors reduce cardiovascular events in acute heart failure. A real-world analysis
Since the recent past, sodium-glucose cotransporter type 2 inhibitors (SGLT2i) have been recommended as mainstay therapy for patients with chronic heart failure (HF) and reduced ejection fraction (... more
Serum and urine angiopoietin-like protein 4 levels correlate with different degrees of dislipidemea and proteinuria in patients with primary nephrotic syndrome
Primary nephrotic syndrome (PNS) is characterized by massive proteinuria, hypoproteinemia, edema and hyperlipidemia. Angiopoietin like protein 4 (ANGPTL4) is a secretory glycoprotein and belongs to... more
Supine vs prone position in mild to moderate COVID-19 pneumonia: The impact of proning on computed tomography findings
Dear Editor,
Blood pressure increase during hospitalization for COVID-19
The first report of a rise in blood pressure (BP) associated with vaccination for coronavirus disease 2019 (COVID-19) was provided by Meylan et al. [1]. These authors published a series of subjects... more
Effects of statins on clinical outcomes in hospitalized patients with COVID-19
Statins are lipid-lowering drugs that have been evaluated as a potential treatment for COVID-19 due to their pleiotropic effects, including anti-inflammatory, immunomodulatory, antioxidant,... more
Systemic diseases associated with a diagnosis of achalasia: A case-control study with the All of Us research program
Esophageal achalasia is an idiopathic disorder characterized by degeneration of neurons in the myenteric plexus of the esophagus [1]. Enteric neuropathies, primary and secondary, have been proposed... more
Original Article
Physicians’ responsibility toward environmental degradation and climate change: A position paper of the European Federation of Internal Medicine
The 2021 Assessment of the United Nations Intergovernmental Panel on Climate Change (IPCC) was the sixth in a series of reports of the latest scientific and socioeconomic data on climate change [1].... more
Varicella-Zoster virus reactivation following severe acute respiratory syndrome coronavirus 2 vaccination or infection: New insights
Coronavirus disease-2019 (COVID-19) is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. The systemic manifestations of COVID-19 comprise respiratory,... more
A machine learning approach to characterize patients with asthma exacerbation attending an acute care setting
Asthma is a respiratory disease with a wide spectrum of clinical presentations. The prevalence in adults is 8.2% and 9.4% in children in the European Union [1]. Severe asthma is a clinical condition... more
Host response dysregulations amongst adults hospitalized by influenza A H1N1 virus pneumonia: A prospective multicenter cohort study
The influenza virus affects the respiratory tract through direct damage, or indirectly through the inflammatory response. While the inflammatory and immune response produced after influenza infection... more
Nutritional status in patients with hepatocellular carcinoma: Potential relevance for clinical outcome
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Different profiles of advanced heart failure among patients with and without diabetes mellitus. Findings from the EPICTER study
Heart failure (HF), the representative end-stage of most heart diseases, has a heterogeneous course that makes it difficult to know with certainty whether a patient is in the advanced stage of the... more
C-reactive protein and 10-year cardiovascular risk in rheumatoid arthritis
Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease compared with the general population [1]. The increased risk of cardiovascular disease in patients with RA is... more
Safety and efficacy of ultrafiltration versus diuretics in patients with decompensated heart failure: A systematic review and meta-analysis
Acute decompensated heart failure, a constellation of dyspnea, edema, and fatigue due to volume overload, accounts for the high healthcare costs, projected to increase from $21 billion in 2012 to $70... more
Review Article
Monkeypox infection: An update for the practicing physician
As of August 5, 2022, >26,000 cases of monkeypox have been diagnosed worldwide and the steep increase of cases has spurred renewed concern about the risk for another viral pandemic. In this... more
Sudden death in young athletes: Is it preventable?
Sudden deaths in athletes (SDA) are rare but devastating events, with huge social impact and vast echo in the media. Elite athletes are contemporary icons epitomizing health and success, promoting... more
Adult-onset type 1 diabetes: A changing perspective
Diabetes represents a disease state, irrespective of the presence of clinical symptoms, determined by raised glucose or HbA1c levels. Diabetes has surged in prevalence in recent years, whether type 1... more
Epidemiology of portal vein thrombosis in liver cirrhosis: A systematic review and meta-analysis
Liver cirrhosis is the 11th most common cause of death worldwide [1]. The number of deaths from liver cirrhosis increased from 899,000 in 1990 to 1,320,000 in 2017, constituting 2.4% of total deaths... more