September 2020

35 Articles

No Section

Effects of Anti-vitamin k oral anticoagulants on bone and cardiovascular health

15 June 2020
Author(s): Marco Marietta, Valeria Coluccio, Giuseppe Boriani, Mario Luppi

Vitamin K antagonist oral anticoagulants (VKAs) have been proven over 50 years to be highly effective and acceptably safe in many settings and are still used by millions of people worldwide.The main... more

Direct oral anticoagulants versus vitamin K antagonists in antiphospholipid syndrome: A meta-analysis.

29 May 2020
Author(s): Pau Cerdà, Cecilia Becattini, Adriana Iriarte, Josefina Cortés Hernández, Xavier Corbella, Antoni Riera-Mestre

Anticoagulant treatment is recommended in patients with thrombosis and antiphospholipid syndrome (APS). Conflicting results have been reported on the role of direct oral anticoagulants (DOACs) in... more


Is aspirin safer than a direct oral anticoagulant for patients with atrial fibrillation at high risk of bleeding?

6 August 2020
Author(s): Alexander P. Benz, John W. Eikelboom

Alexander P. Benz reports a personal research grant from the German Heart Foundation (Deutsche Herzstiftung e.V.). John W. Eikelboom received grants and/or research support from AstraZeneca, Bayer,... more

Relevance and diagnosis of disseminated intravascular coagulation associated with cardiovascular disease

4 August 2020
Author(s): Marcel Levi

Disseminated intravascular coagulation (DIC) is a complication of a myriad of disorders that are all associated with a systemic inflammatory response. DIC is considered as an important pathogenetic... more

Oral anticoagulants in thrombotic antiphospholipid syndrome: Leave the old road for a new trail?

4 August 2020
Author(s): Vittorio Pengo

I read with interest the meta-analysis by Pau Cerdà et al. on direct oral anticoagulants compared to vitamin K antagonists in antiphospholipid syndrome (APS) [1]. Overall, I agree with the Authors’... more

The expanding potential of functional liver imaging: From research tools to clinical practice in oncology and internal medicine

15 July 2020
Author(s): Fabio Piscaglia, Emanuela Marcelli

In this issue of the European Journal of Internal Medicine, M.N. Cruz and colleagues present a review of current liver imaging techniques [1], the potential of which has expanded from mere imaging,... more

Internal Medicine Flashcard

McGinn-White pattern

13 July 2020
Author(s): Miguel F Carrascosa, Rubén Gómez Izquierdo, Marta Cano Hoz

A 52-year-old man presented to the emergency department with a 2-month history of worsening dyspnea which intensified during the last 3 days. On physical examination, his blood pressure was 119/68 mm... more

Beware of the air when diabetes is there

8 July 2020
Author(s): Beatriz Fernandes, Filipa Taborda, Maria João Lobão

A 73-year-old woman with past history of dementia and type 2 diabetes mellitus (DM) was admitted to the emergency department because of drowsiness and hyperglycaemia. The capillary blood glucose was... more

A spontaneous hematoma in a healthy young woman

8 July 2020
Author(s): Sylvain Lescuyer, Aurore Meyer, Jean-Christophe Weber

A 40-year-old woman presented herself with a large hematoma of her left lower limb which appeared spontaneously three weeks prior to her visit. The hematoma was responsible for a symptomatic anemia,... more

Letter to the Editor

Published evidence on COVID-19 in top-ranked journals: A descriptive study

9 July 2020
Author(s): Juan M Pericàs, Andrea Arenas, Orla Torrallardona-Murphy, Helena Valero, David Nicolás

The COVID-19 pandemic has generated an unprecedented global scientific effort to provide swift answers to pressing health needs. While many hospitals turned into almost exclusive COVID-19 centres... more

Does lowering p value threshold to 0.005 impact on evidence-based medicine? An analysis of current European Society of Cardiology guidelines on STEMI

4 June 2020
Author(s): Francesco Piroli, Filippo Angelini, Fabrizio D'Ascenzo, Gaetano M. De Ferrari

When dealing with scientific evidence, the issue of reproducibility and replicability of scientific conclusions has been largely debated. In particular, several authors raised concerns about the... more

Is natriuretic peptide lowering strategy superior to symptomatically based management of chronic heart failure with reduced ejection fraction?

26 May 2020
Author(s): Samarthkumar Thakkar, Rajkumar Doshi, Mariam Shariff, Igor Pedreira Vaz, Devina Adalja, Monil Majmundar, Ashish Kumar

Despite significant furtherance in the medical management of heart failure (HF), readmission and mortality following HF hospitalization are significantly high. Traditionally, optimization of medical... more

Left ventricular ejection fraction and global longitudinal strain in patients with acute myocardial infarction after percutaneous revascularization: standard 2D vs triplane and 3D imaging

23 May 2020
Author(s): Raluca Tomoaia, Ruxandra-Ștefana Beyer, Dumitru Zdrenghea, Alexandra Dădârlat-Pop, Dana Pop

Left ventricular ejection fraction (LVEF) is one of the main determinants in the prognostic of patients with myocardial infarction (MI) [1]. Three-dimensional (3D) measurement of the LV volumes and... more

A surveillance study of the prevalence of Hepatitis B, C, and D markers among hospitalized patients at an Internal Medicine Department of a Greek Hospital

21 May 2020
Author(s): Vassilios A. Sevastianos, Charalampia V. Geladari, Theodoros A. Voulgaris, Anna I. Georgantoni, Emmanuel A. Andreadis

Viral hepatitis is a leading cause of morbidity and mortality worldwide [1]. Vaccination programs, demographic and socioeconomic changes, safer medical and nursing practices, screening of blood... more

Prevention of infective endocarditis and clinical practice guidelines: From theory to real clinical practice.

10 May 2020
Author(s): Dr. María Sánchez Ledesma, Dr. Borja Arias-Peso, Dr. David González Call, Dr. Ana Elvira Laffond, Dr. Eduardo Villacorta Argüelles

In spite of current diagnostic techniques and therapeutic approaches, infective endocarditis (IE) is still associated with high rates of morbidity and mortality [1].

Protective role of statins during anticoagulation for venous thromboembolism: beyond their lipid lowering effect?

7 May 2020
Author(s): Carmine Siniscalchi

Venous thromboembolism (VTE) is a leading cause of morbidity and mortality [1]. VTE represents a major health problem for high prevalence, incidence, and costs [2]. The number of people affected by... more

Long-term proton-pump inhibitor use in older adults with mild-to-moderate Alzheimer's disease: Are there cognitive consequences?

7 May 2020
Author(s): Adam H Dyer, Claire Murphy, Brian Lawlor, Sean P Kennelly, NILVAD Study Group⋆⋆

Proton-Pump Inhibitors (PPIs) are commonly prescribed medications indicated for the treatment of various acid-related disorders including duodenal/gastric ulcers, erosive oesophagitis and... more

Prognostic value of adiponectin in patients with stable coronary artery disease in the era of statins

29 April 2020
Author(s): Loukianos S Rallidis, Andreas Katsimardos, Nikolaos Kosmas, Taxiarchoula Rallidi, Antonia Kountouri

Adiponectin is a circulating cytokine produced by the adipose tissue. Experimental data suggest that adiponectin exerts beneficial effects on insulin sensitivity, chronic low-grade inflammation,... more

Validation of hemolytic anemia discharge diagnosis codes in the French hospital database

24 April 2020
Author(s): Julien Maquet, Hélène Derumeaux, Maryse Lapeyre-Mestre, Laurent Sailler, Guillaume Moulis

Hemolytic anemia (HA) is a group of rare diseases that can be congenital such as thalassemia, sickle-cell anemia, enzyme-deficiency hemolytic anemia and spherocytosis, or acquired such as autoimmune... more

HIV Testing In Patients Diagnosed With Community Acquired Pneumonia Or Primary Lung Cancer From 2014 To 2018 In A Teaching Hospital In Spain

23 April 2020
Author(s): Joao Luis Modesto Dos Santos, Aitziber Aguinaga Perez, María Eransus Garzarón, Marta Adelantado Lacasa, Carmen Martín Salas, Julio Sánchez Alvarez

Human immunodeficiency virus (HIV) is one of the most frequent causes of acquired immunodepression. The World Health Organization intends to diagnose 90% of HIV infected patients until 2020 (1),... more

Guideline directed low-density lipoprotein cholesterol goal achievement: A real-world study from a cardiology ward

21 April 2020
Author(s): Haiyang Gao, Chenguang Yang, Jiefu Yang, Fang Wang

This manuscript has been thoroughly edited by a native English speaker from an editing company. Editing Certificate will be provided upon request.

Clinical trials: generalizability is much more than representativeness

18 April 2020
Author(s): Rafael Dal-Ré

Recently, Anderson et al [1] reported on the generalizability of trials supporting the 2017 American College of Cardiology/American Heart Association blood pressure guideline. They are correct when... more

Letter to the Editor (European Journal of Internal Medicine).

Strengthening the continuity of medical care through the hospital discharge multimedia report

21 May 2020
Author(s): Nando Campanella, Roberto Campagnacci, Harold Martin Wright, Pierpaolo Morosini

Dear Sir,

Original Article

Impact of point of care ultrasound on the number of diagnostic examinations in elderly patients admitted to an internal medicine ward

20 July 2020
Author(s): M. Barchiesi, M. Bulgheroni, C. Federici, F. Casella, M. Del Medico, D. Torzillo, V. Popescu Janu, R. Tarricone, C. Cogliati

In recent year the miniaturization of devices has allowed a broadly spread of the use of ultrasound (US) technology at patients’ bedside.

The ISTH DIC score predicts outcome in non-septic patients admitted to a cardiovascular intensive care unit

1 July 2020
Author(s): Jürgen Grafeneder, Konstantin A. Krychtiuk, Nina Buchtele, Christian Schoergenhofer, Georg Gelbenegger, Max Lenz, Johann Wojta, Gottfried Heinz, Kurt Huber, Christian Hengstenberg, Bernd Jilma, Walter S. Speidl

The International Society of Thrombosis and Haemostasis (ISTH) disseminated intravascular coagulation (DIC) score is widely used to predict mortality in critically ill - typically septic - patients.... more

Pre-transplant diabetes predicts atherosclerotic vascular events and cardiovascular mortality in liver transplant recipients: a long-term follow-up study

30 June 2020
Author(s): Stefano Gitto, Nicola De Maria, Luca Marzi, Paolo Magistri, Margherita Falcini, Giovanni Vitale, Tiziana Olivieri, Gian Piero Guerrini, Valentina Serra, Paolo Forte, Paola Carrai, Paolo De Simone, Andrea Mega, Heinz Zoller, Guido Piai, Filippo Schepis, Margherita Marocchi, Erica Villa, Fabio Marra, Pietro Andreone, Fabrizio Di Benedetto, other members of MEDITRA research group

Liver transplantation (LT) is an effective treatment for patients with acute liver failure, end-stage liver disease, and non-resectable hepatocellular carcinoma (HCC) [1]. Early after surgery, LT... more

Hospital admissions for community-acquired, ventilator-associated and nonventilator hospital-acquired pneumonia in COPD patients in Spain (2016-2017).

29 June 2020
Author(s): Javier de Miguel-Diez, Romana Albaladejo-Vicente, Valentín Hernández-Barrera, Zichen Ji, Marta Lopez-Herranz, Rodrigo Jimenez-Garcia, Ana López-de-Andrés

Pneumonia is a major cause of morbidity and mortality around the world [1]. The setting in which pneumonia is acquired, i.e., in the community or in the hospital, heavily influences diagnostic and... more

Intermountain chronic disease risk score (ICHRON) validation for prediction of incident chronic disease diagnoses in an australian primary prevention population

17 June 2020
Author(s): Heidi T. May, Jeffrey L. Anderson, Joseph B. Muhlestein, Kirk U. Knowlton, Benjamin D. Horne

Chronic diseases (ChrD) are lifelong conditions that have long-term effects. They account for 41 million deaths annually (71% of all deaths world-wide) [1]. The rising prevalence of ChrD is... more

Systematic COronary Risk Evaluation (SCORE) and 20-year risk of cardiovascular mortality and cancer

10 June 2020
Author(s): Peter Wohlfahrt, Jan Bruthans, Alena Krajčoviechová, Pavel Šulc, Aleš Linhart, Jan Filipovský, Otto Mayer Jr, Jiří Widimský Jr, Milan Blaha, Jitka Abrahámová, Renata Cífková

Cardiovascular disease (CVD) remains the leading cause of death in developed countries[1]. For the prevention of CVD, accurate identification of individuals at increased CVD risk is essential, in... more

Impact of acute kidney injury on in-hospital outcomes among patients hospitalized with acute heart failure – A propensity-score matched analysis

5 June 2020
Author(s): Suchith Shetty, Aaqib H Malik, Abbas Ali, Ying Chi Yang, Wilbert S Aronow, Alexandros Briasoulis

Acute kidney injury (AKI) is frequently present in patients admitted for acute heart failure (AHF). Several studies have evaluated the mortality risk attributed to AKI in patients admitted for AHF [1... more

Hyperhomocysteinemia in patients with acute porphyrias: A potentially dangerous metabolic crossroad?

31 May 2020
Author(s): Paolo Ventura, Elena Corradini, Elena Di Pierro, Stefano Marchini, Matteo Marcacci, Chiara Cuoghi, Elena Buzzetti, Antonello Pietrangelo

Acute porphyrias (AP) are a group of metabolic disorders resulting from deficiency of four different enzymes of the heme biosynthetic pathway (Fig. 1) [1,2]. Carriers of these enzymatic defects are... more

Differences in clinical features between small fiber and sensitive large fiber neuropathies in Sjögren's syndrome

27 May 2020
Author(s): Carole Lacout, Julien Cassereau, Pierre Lozac'h, Aline Gury, Alaa Ghali, Christian Lavigne, Franck Letournel, Geoffrey Urbanski

To distinguish large (LFN) and small fiber neuropathies (SFN) in Sjögren's syndrome (SS) requires electroneuromyography (EMG) first, but this is time-consuming and has sometimes a limited... more

Early procalcitonin determination in the emergency department and clinical outcome of community-acquired pneumonia in old and oldest old patients

12 May 2020
Author(s): Marcello Covino, Andrea Piccioni, Nicola Bonadia, Graziano Onder, Luca Sabia, Luigi Carbone, Marcello Candelli, Veronica Ojetti, Rita Murri, Francesco Franceschi

Community-acquired pneumonia (CAP) is a frequent cause of morbidity in the adult population, with a mortality rate reaching 20% of hospitalized patients [1]. A diagnosis of CAP is given to 5-12% of... more

Bleeding risk comparison between direct oral anticoagulants at doses approved for atrial fibrillation and aspirin: systematic review, meta-analysis and meta-regression

11 May 2020
Author(s): Dimitrios Sagris, Ioannis Leventis, Georgios Georgiopoulos, Eleni Korompoki, Konstantinos Makaritsis, Konstantinos Vemmos, Haralampos Milionis, Gregory Y.H. Lip, George Ntaios

Aspirin was recommended in the past as an alternative to oral anticoagulation for the prevention of thromboembolism in patients with atrial fibrillation (AF) and a CHA2DS2-VASc score of 1 [1]. The... more

Review Article

New boundaries of liver imaging: from morphology to function

19 June 2020
Author(s): Manuel Cruz, Ana Aguiar Ferreira, Nikolaos Papanikolaou, Rajarshi Banerjee, Filipe Caseiro Alves

Magnetic resonance imaging (MRI), computed tomography (CT) and ultrasound (US) are the cornerstone for noninvasive imaging evaluation of the liver and are routinely used to evaluate focal and diffuse... more


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