September 2023
131 ArticlesNo Section
Safety of SARS-CoV-2 mRNA vaccines and effects of immunosuppressive drugs on adverse reactions in patients with rheumatic diseases
Patients with rheumatic diseases (RD) have a higher rate of poor outcomes of coronavirus disease 2019 (COVID-19) [1]. The American College of Rheumatology (ACR) and the European League Against... more
A year later
Immune regulators for the treatment of COVID-19: A critical appraisal after two years
More than three years have elapsed since the onset of the Coronavirus Disease 2019 (COVID-19) pandemic. Following the identification of this novel and intricate disease, clinicians and scientists... more
Beyond the Guidelines
2023 ESH Guidelines. What are the main recommendations?
Generally, Clinical Practice Guidelines (CPG) are evidence-based recommendations, presented as summaries of the best available literature, which are aimed to assist doctors and other health care... more
Clinical Insights
Body Mass Index (BMI): Still be used?
The Body Mass Index (BMI) is a commonly used measure that calculates an individual's body weight in relation to their height [1]. It was developed by Adolphe Quetelet in the early 19th century and... more
One year later: Prevalence of long-COVID symptoms
It has been two years since the publication of one of the first meta-analyses investigating the prevalence of post-COVID symptomatology but differentiating between hospitalized and non-hospitalized... more
The spectrum of hospitalization-associated harm in the elderly
Hospital admission constitutes the standard of care for significant acute illness and have shown a marked and consistent worldwide increase over the last years. Nevertheless, not all admissions are... more
COVID-19 and smoking: Considerations after two years
Although both virulence and pathogenicity of SARS-CoV-2 have considerably declined over time, the number of coronavirus disease 2019 (COVID-19) cases and the consequent clinical burden remain... more
Commentary
Standing up for equitable treatment of coronary microvascular dysfunction and myocardial infarction with non-obstructive coronary arteries
Myocardial infarction (MI) with normal coronary arteries (MINOCA) and ischemia with normal coronary arteries (INOCA) are syndromes characterized by evidence of myocardial necrosis or myocardial... more
Renal denervation trials in hypertension – what we wait for in 2023/2024
Arterial hypertension is the most frequent modifiable cardiovascular risk factor and remains a leading cause of premature death worldwide with increasing prevalence [1]. Epidemiologic studies suggest... more
AMA-positivity in AIH-patients with bile duct lesions running in between. Novel findings and perspectives
Autoimmune hepatitis (AIH) is a chronic, progressive inflammatory liver disease characterized by circulating autoantibodies and elevated serum globulin levels. If left untreated, AIH may progress to... more
Atherosclerosis in autoimmune rheumatic diseases
Autoimmune rheumatic and musculoskeletal diseases (RMDs) including rheumatoid arthritis (RA) and systemic sclerosis (SSc) and others have been associated with increased cardiovascular (CV) risk,... more
Gastrointestinal bleeding, a preventable cause of hospital admission: Time for specific studies in patients on antithrombotic therapy
Gastrointestinal bleeding (GIB) is a major cause of hospital admission, and in most cases has a iathrogenic cause. Administrative data from the United States report more than 400,000 hospital... more
Inflammatory puzzle: Unveiling the role of D-Dimer in acute pericarditis and thromboinflammation
In this issue of the European Journal of Internal Medicine, Lazaros et al. present the results of a prospective clinical study conducted in a tertiary referral center to investigate the potential... more
Modern technology meets established health care. Challenges and opportunities in fulfilling the promises of remote device monitoring in heart failure
In 1961, American astronaut Alan Shepard became the second human being travelling into space. Onboard the spacecraft, some of his vital parameters, heart rate and rhythm, body temperature and... more
Unwarranted clinical practice variation and resource overutilization in medical care: The example of transfusion practices in elderly hospital patients
Clinical practice variation refers to the differences in healthcare practices and treatment decisions among healthcare providers, for patients with similar clinical conditions [1]. These variations... more
The arduous challenge of seeking for biomarkers in rare diseases
Hereditary haemorrhagic telangiectasia (HHT) is a rare genetic vascular disease that can significantly impair the quality of life of affected patients [1]. Medical management is mainly aimed at... more
Corrigendum
Corrigendum to ‘Clinical outcomes associated with the emergency treatment of hyperkalaemia with intravenous insulin-dextrose’ [European Journal of Internal Medicine 95C (2021) 87-92]
The authors regret that the supplementary material was not published with their above article.
Corrigendum to ‘Creatinine: From physiology to clinical application’[European Journal of Internal Medicine 72C (2020) 9-14]
The authors regret that there was an error in Figure 1 of the above published article. In this figure, the second yellow box from the top reads "Creatinine Phosphate," while it should read "Creatine... more
Editorial
The new international nomenclature for steatotic liver disease: One step forward towards enhanced awareness for healthier life
Steatotic liver disease (SLD) is the most common liver disease worldwide and a leading cause of liver-related morbidity and mortality. Current prevalence of SLD is approximately 30 % of the global... more
Ideas and Opinions
Addressing the paradox: Health expansion threatening sustainable healthcare
We need to address the paradox that health expansion threatens sustainable healthcare as anti-aging drugs are on the trail from trial to the market and come together with health enhancement measures... more
Internal Medicine Flashcard
Sudden onset of left hemiplegia
A 65-year-old male presented with sudden onset of left hemiplegia for four hours, he was confused, blood pressure 158/109 mmHg, slightly delayed response, dysarthria, the muscle strength was 4/5 in... more
Respiratory failure following upper gastrointestinal endoscopy: A rare and unanticipated outcome to look out for
A 67-year-old male patient was admitted to the Emergency Department with a one-week history of hematemesis and melaena. He was known to have liver cirrhosis secondary to alcoholic liver disease. Upon... more
Young woman with red eyes and shock
A 21-year-old previously healthy Japanese woman with one-week history of fever, sore throat, chills, nausea, vomiting, abdominal pain, and watery diarrhea presented to our emergency department.... more
Ring-like late gadolinium enhancement
Dear Editor,
Unusual cause of chronic cough and bloody phlegm with Atypical pulmonary CT findings
A 42-year-old man with 3-month history of chronic dry cough and bloody phlegm was presented to our respiratory outpatient department. He had no previous significant medical history. He also denied... more
Continuous annular calcification of intestinal wall
A 49-year-old female patient received peritoneal dialysis (PD) for six years but has switched to hemodialysis for two years due to poor peritoneal ultrafiltration. She was admitted because of nausea... more
A man with widespread subcutaneous fat necrosis and osteonecrosis
A man in his forties with a history of alcohol abuse (200 g/day) presented with progressive multiple joint pain. He did not have abdominal, respiratory or urinary complaints. Physical examination... more
Unusual cause of acute severe epigastric pain in a Japanese woman
A 42-year-old woman with 2-day history of acute onset severe epigastric pain, nausea, and vomiting presented to our emergency department. She had no previous significant cardiovascular or... more
A man with bright-golden orange phlegm
A 57-year-old Japanese man with a history of hypertension was admitted to our hospital complaining of headache and fatigue that started 3 days before. On admission, his consciousness was clear. He... more
Bad luck comes in threes
An 84-year-old Caucasian woman presented to our clinic with a diffuse erythematous skin eruption associated with fever and fatigue. The patient has a two-month-old diagnosis of cortico-resistant... more
Letter to the Editor
Non-invasive high-frequency oscillatory ventilation for carbon dioxide clearance in a hypercapnic lung model of chronic obstructive pulmonary disease and healthy subjects
Dear editor,
Interleukin-6 inhibition for the treatment of IgG4 related vasculitis
Dear Editor
CHEDDAR score versus YEARS algorithm for suspected pulmonary embolism in SARS-CoV-2-infected patients: A comparison of two strategies
Patients with clinically suspected pulmonary embolism (PE) should be managed according to standardized flowcharts. These flowcharts include validated algorithms to determine pretest probability, d-... more
Comparison of cardiovascular risk in co-existent primary aldosteronism and obstructive sleep apnea with neither or either alone in hypertension
Dear Editor,
Performance of multi-biomarker panels based on urinary N-terminal osteopontin for prediction of diabetic kidney disease in patients with diabetes mellitus
Diabetic kidney disease (DKD), defined as chronic kidney disease (CKD) attributed to diabetes mellitus (DM), is the leading cause of end-stage renal disease (ESRD) and is associated with increased... more
The old and the new: The EG.5 (‘Eris’) sub-variant of Coronavirus
In the last year of pandemic, several variants of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) have been identified and monitored. Indeed, the persisting challenges of SARS-CoV-2 to... more
Extreme anemia (hemoglobin < 5 G/DL) at the emergency department
Dear Editor,
Exploring sarcoidosis systemic treatment: Patient factors and therapeutic strategies
Dear Editor,
Long-term efficacy and safety of secukinumab in patients with psoriatic arthritis
Psoriatic arthritis (PsA) is a chronic inflammatory autoimmune disease that can adversely affect functional capabilities, if left untreated, leading to irreparable damage to joint spaces [1].... more
Dosing of iodixanol for predicting acute kidney injury in patients undergoing elective percutaneous coronary intervention
A dose of iodinated contrast over the maximum allowable contrast dose (MACD) of 300 mL has been considered as a major factor leading to acute kidney injury (AKI) [1]. However, we found that the... more
Fixing the Achilles heel of electronic medical records: Vital information must be defined, concise, accurate and easily accessible
Although electronic medical records (EMR) have many potential benefits, one of their unintended consequences it that many physicians may now spend most of their working hours at a computer screen... more
Does a multidisciplinary team involving internists specialized in hypertension and obstetric medicine improve pregnancy outcomes?
The prevalence of hypertensive disorders of pregnancy (HDP) steadily increased in past years partly because of advanced maternal age and partly because of ever-wider access to assisted reproduction... more
Polyautoimmunity in IgG4-related disease
Dear Editor,
Diagnoses associated with temporal arteritis
The diagnosis of giant cell arteritis (GCA), the most common vasculitis after the age of 50, relies on a body of evidence, among which temporal arteritis (TA) remains a cornerstone [1]. However, TA... more
Spontaneous coronary artery dissection and Takotsubo syndrome
Spontaneous coronary artery dissection (SCAD) and Takotsubo syndrome (TTS) are increasingly recognized. Both conditions predominantly affect females, with an incidence of up to 4% in patients... more
Undiagnosed cognitive impairment in older adults hospitalized in internal medicine wards: Data from the REPOSI registry
Dear Editor,
Prognostic role of the left ventricular global function index companion in patients with chronic heart failure
Heart failure (HF) is characterized by significant morbidity, mortality, economic burden and low quality of life. The global prevalence of HF among patients aged 50 years and older averages 8.3%, the... more
The higher the serum albumin, the better? Findings from the PRACTICE study
The relation between hypoalbuminemia and coronary artery disease (CAD) has been established. However, the association of increased albumin level and outcomes of CAD has not been investigated.
COVID-19 research waste: An analysis on terminated clinical trials on medicines on ClinicalTrials.gov
Dear Editor,
Autoantibodies against an immunodominant epitope from apolipoprotein B and risk of cardiovascular events in subjects with type 2 diabetes
Patients with diabetes mellitus (DM) have accelerated atherosclerosis progression and increased cardiovascular morbidity and mortality. Therefore, patients with type 2 DM (T2DM) are increasing in the... more
Risk factors for high-risk human papillomavirus cervical infection and clearance in patients with systemic lupus erythematosus
Women with systemic lupus erythematosus (SLE) are at higher risk of high grade cervical squamous intraepithelial lesions [1]. Inadequate immune response may impair the clearance of cervical human... more
Ethics of death pronouncement
Death is the only certainty we have in life. While everyone knows that human life is supposed to end but no one is fully prepared to embrace it, neither his own nor his loved ones. The death of a... more
Causal diagrams to compare randomized trials: The case of Early Goal-Directed Therapy for sepsis
Performing a randomized controlled trial (RCT) is considered the best way to answer a causal question in clinical research [1]. While RCTs are frequently designed in close collaboration by physicians... more
B-cell depletion with obinutuzumab for the treatment of IgG4-related disease
IgG4-related disease (IgG4-RD) is an increasingly recognized fibro-inflammatory disorder that can lead to end-stage organ damage if left untreated [1]. Glucocorticoids have been historically... more
Inotropes administration in patients with acute infective endocarditis and indication for urgent cardiac surgery
Heart failure (HF) is the most common complication of acute infective endocarditis (IE), occurring in 42–60% of patients [1–2]. HF is mainly related to aortic or mitral regurgitation, but associated... more
Persistently raised blood pressure following coronavirus disease 2019 vaccines: Implication for future systematic research and monitoring
During the global coronavirus disease 2019 (COVID-19) pandemic, an extensive immunisation programme was initiated worldwide. Subsequent to a comprehensive vaccination campaign, emerging evidence... more
Acute venous thromboembolism in the emergency department: Inpatient versus outpatient management trends from 2016 to 2019
Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE), poses a significant public health concern [1]. It stands as the primary cause of morbidity and... more
Prevalence and characteristics of post COVID-19 condition five months after SARS-COV-2 infection in inpatients and outpatients.
We are well aware of the worldwide problems caused by the COVID-19 pandemic and thanks to health measures such as vaccination this situation has been positively controlled.
The efficacy and safety of out-hospital anticoagulation therapy with direct oral anticoagulant for COVID-19
As coronavirus disease 2019 (COVID-19) has caused unprecedented morbidity and mortality in the global pandemic, effective strategies to treat and prevent the disease are urgently needed.... more
Clinically significant contrast-associated acute kidney injury after emergent computed tomography angiography of the cerebral arteries
Contrast associated acute kidney injury (CA-AKI) is defined as a sudden deterioration in renal function within 48 h following the intravascular administration of iodinated contrast medium[1]. CA-AKI... more
Incidence of myocarditis and pericarditis considered as separate clinical events over the years and post-SARS-CoV2 vaccination in adults and children
Dear Editor,
Association between diagnostic outcomes and symptom pattern in fever and inflammation of unknown origin
Fever of unknown origin (FUO) and inflammation of unknown origin (IUO) are syndromes that share a similar spectrum of causes and that are separated by an arbitrary temperature threshold [1]. They... more
A higher BMI is positively associated with advanced neck lymphoma at diagnosis
Lymphomas comprise a heterogeneous group of malignancies which can arise in different nodal and extranodal sites in the head and neck in which cervical lymphadenopathy is the most common head and... more
Comprehensive diagnostic evaluation of palpatory method of blood pressure measurement
Dear Editor,
Frailty in nursing home residents
Dear Editor,
Impact of the COVID-19 pandemic on the occurrence and outcome of cardiogenic shock complicating acute myocardial infarction
SARS-CoV-2 predisposes patients to thrombotic disease due to excessive inflammation, platelet activation, endothelial dysfunction, and stasis [1]. The infection was recognized as an independent risk... more
Characteristics and outcomes of COVID-19-associated pulmonary embolism
Pulmonary embolism (PE) in the setting of COVID-19 is related to the procoagulant state as evidenced by the increased d-dimer levels and in situ thrombosis [1,2] and it usually involves the segmental... more
Original Article
Asymptomatic vs. symptomatic atrial fibrillation: Clinical outcomes in heart failure patients
Atrial fibrillation (AF) is the most common arrhythmia worldwide, afflicting patients’ prognosis and symptoms. The European Heart Rhythm Association (EHRA) proposed the EHRA score for grading the... more
Legionella pneumonia in hospitalized adults with respiratory failure: Quinolones or macrolides?
Legionellosis represents an important public health problem throughout the world, although it is considered as an underdiagnosed and underreported disease. Morbidity and mortality remain high, as... more
Impact of bronchoalveolar lavage on the management of immunocompromised hosts
BAL leads to changes in management in the majority of immunosuppressed patients. There is a high prevalence of multimicrobial infections and respiratory viral infections in immunocompromised patients... more
New genetic drivers in hemorrhagic hereditary telangiectasia
Hereditary hemorrhagic telangiectasia (HHT) or Rendu–Osler–Weber syndrome (ORPHA:774) is a rare autosomal dominant vascular disease characterized by the presence of telangiectases and larger vascular... more
Prognostic significance of quantitative electrocardiographic parameters in patients with non-high-risk pulmonary embolism
Acute pulmonary embolism (PE), a common acute cardiovascular disease, has an annual incidence of 39∼120 cases per 100 000 population [1,2]. The incidence is increasing because of global population... more
Abatacept in usual and in non-specific interstitial pneumonia associated with rheumatoid arthritis
Interstitial lung disease (ILD) is a severe and frequent extraarticular manifestation of rheumatoid arthritis (RA). A higher mortality rate in patients with RA-ILD in comparison with those without... more
The Long-COVID autonomic syndrome in hospitalized patients: A one-year prospective cohort study
A growing body of evidence [1–6] suggests that some patients who survive an acute SARS-CoV-2 viral infection (COVID-19) may experience persistent symptoms for months, resulting in a clinical syndrome... more
Novel potassium binders to optimize RAASi therapy in heart failure: A systematic review and meta-analysis
Heart failure (HF) is a major cause of cardiovascular (CV) mortality and morbidity, resulting in more than one million hospitalizations per year. In patients affected by HF with reduced ejection... more
Efficacy and safety of direct oral anticoagulants vs vitamin K antagonists in patients with atrial fibrillation and end-stage renal disease on hemodialysis: A systematic review and meta-analysis
The prevalence of atrial fibrillation (AF) in individuals with end stage renal disease (ESRD) who are on chronic hemodialysis is increasing, exceeding that of the general population and resulting in... more
Renin‐angiotensin-aldosterone system inhibitors and mortality risk in elderly patients with atrial fibrillation. Insights from the nationwide START registry
The estimated prevalence of atrial fibrillation (AF) in the general population is about 1–4% and rises according to aging [1]. Cardiovascular comorbidities are utmost prevalent in patients with AF,... more
Infarct severity and outcomes in ST-elevation myocardial infarction patients without standard modifiable risk factors – A multicenter cardiac magnetic resonance study
Ischemic heart disease remains a leading contributor to the burden of cardiovascular disease with 1.8 million annual deaths in Europe [1]. The annual incidence of hospital admissions for acute... more
Predictive value of Killip classification in MINOCA patients
In the last two decades, the better understanding of acute myocardial infarction (AMI) pathophysiology as well as the advances in medical therapy and hemodynamical techniques led to a decrease in the... more
Value of inflammatory response and oxidative damage in the diagnosis of infections in severe alcoholic hepatitis
Alcohol is one of the most consumed substances in the world. Among the organic lesions produced by alcohol consumption, liver disease has been the most studied and documented. Alcohol use disorder is... more
Impact of antimicrobial stewardship in organisms causing nosocomial infection among COVID-19 critically ill adults
Since the firsts reports of a novel viral respiratory illness emerged in December 2019 in Hubei province, China [1], the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has infected... more
Anticoagulation strategies and long-term recurrence in patients with venous thromboembolism in the era of direct oral anticoagulants
Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is a major health problem all over the world [1]. VTE has a long-term risk of recurrence, and the... more
Immunosuppressive therapy and oral anticoagulation in kidney transplant recipients: Direct oral anticoagulants versus vitamin-k antagonists
Kidney transplant recipients (KRTs), have an increased risk of atrial fibrillation that has an incidence of about 7% in the first 3 years after transplantation 1. Moreover, the risk of thromboembolic... more
Haemoglobin levels as a predictor for the occurrence of future cardiovascular events in adults–Sex-dependent results from the EPIC trial
Anemia, defined by the World Health Organization (WHO) as hemoglobin (HGB) levels
Elevated levels of IL-6 in IgA nephropathy patients are induced by an epigenetically driven mechanism modulated by viral and bacterial RNA
Immunoglobulin A nephropathy (IgAN), also known as Berger's disease, is the most frequent primary glomerulonephritis characterized by the presence of IgA immune complexes in the glomeruli [1]. It... more
Clinical features and immune mechanisms directly linked to the altered liver function in patients with rheumatoid arthritis
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that mainly affects the synovial membrane, cartilage, and bone tissue, and is associated with progressive disability, systemic... more
Catheter-based renal artery denervation: facts and expectations
Some clinical studies published before year 2014 raised consistent expectations worldwide on a promising role of catheter-based renal artery denervation (RAD) in the management of patients with... more
Performance of admission pathways within acute medicine services: Analysis from the Society for Acute Medicine Benchmarking Audit 2022 and comparison with performance 2019 - 2021
Healthcare services are under huge strain, with rising Emergency Department (ED) attendances, increased waiting times for ED assessment and increasing pressures within inpatient services in acute... more
Relationships between education and non-alcoholic fatty liver disease
Affecting up to 30% of the adult population in western countries, non-alcoholic fatty liver disease (NAFLD) is a worldwide public health problem [1,2]. Because 5% of individuals with NAFLD suffer... more
Short-term prognosis of changes in plasma potassium following an episode of hyperkalaemia in patients with chronic heart failure
Chronic heart failure (HF) is an increasing problem in public healthcare and is associated with considerable morbidity and mortality [1]. HF affects approximately 23 million people worldwide,... more
Non-eligibility for pivotal HFpEF/HFmrEF outcome trials and mortality in a contemporary heart failure cohort
Heart failure with preserved (HFpEF) and mildly reduced ejection fraction (HFmrEF) account for more than half of all heart failure decompensations [1]. Patients are exposed to a high risk of... more
Thymic stromal lymphopoietin (TSLP) is a substrate for tryptase in patients with mastocytosis
Mastocytosis is a heterogeneous, rare disease associated with uncontrolled proliferation, accumulation, and increased survival of mast cells (MCs) in different organs [1]. This pathological condition... more
Six-month cardiovascular prognostic impact of type 1 And type 2 myocardial infarction in patients hospitalized for gastrointestinal bleeding
Gastrointestinal bleeding (GIB) is a major healthcare concern that poses significant clinical and economic burden. It is associated with high morbidity, mortality, and healthcare expenditure. In the... more
Predicting acute and long-term mortality in a cohort of pulmonary embolism patients using machine learning
Venous thromboembolism (VTE), including both pulmonary embolism (PE) and deep vein thrombosis (DVT), is a severe condition that causes significant mortality and morbidity in the acute phase, with a... more
GLIM-diagnosed malnutrition predicts mortality and risk of hospitalization in systemic sclerosis: A retrospective study
Systemic sclerosis (SSc) is an autoimmune disease characterized by microcirculation dysfunction, autoantibodies production, progressive skin and multiorgan fibrosis with potentially life-threatening... more
Prevalence of anti-synthetase antibodies among systemic sclerosis patients
Systemic sclerosis (SSc) is a rare, multisystem autoimmune disease. It is divided according to the extent of skin involvement, into limited cutaneous SSc (lcSSc) and diffuse cutaneous SSc (dcSSc) [1...
Clinicopathological characteristics, risk factors and prognostic value of intrarenal vascular lesions in IgA nephropathy
IgA nephropathy (IgAN) is the most prevalent primary glomerulonephritis worldwide, which is characterized by the predominant deposition of IgA in the glomerular mesangium. Although prevalence of... more
Intravenous immunoglobulin therapy in antineutrophil cytoplasmic antibody-associated vasculitis
According to the International Chapel Hill Consensus Conference 2012 (CHCC2012), anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) is a group of necrotizing vasculitis, with... more
Aortic stiffness plays a role in the discrepancy between mitral valve lesion severity and hemodynamic burden of secondary mitral regurgitation.
The disproportionate/proportionate nature of secondary mitral regurgitation (sMR) has been recently introduced to explain the different outcomes of patients undergoing percutaneous mitral valve... more
Intravenous continuous home inotropic therapy in advanced heart failure: Insights from an observational retrospective study
Advanced heart failure (AHF) represents 1 to 10% of the overall heart failure (HF) spectrum, with prevalence increasing due to the improvement of survival provided by guideline directed medical... more
Multiple autoimmune syndrome: Clinical, immunological and genotypic characterization
Autoimmune diseases (AIDs) are a heterogeneous group [1–13] with different phenotypes (organ-specific vs. systemic or non-organ specific) [14] and an estimated world prevalence of 3–9.4% [14–17].... more
D-dimer as a diagnostic and prognostic plasma biomarker in patients with a first episode of acute pericarditis
Acute pericarditis (AP) is the most common inflammatory heart disorder [1]. AP has recently attracted increasing attention from the medical community and social media during the COVID-19 pandemic... more
Safety and efficacy of non-insulin therapy in non-critically ill hospitalized patients with type 2 diabetes mellitus
Clinical guidelines recommend insulin as the mainstay of therapy for hospitalized patients with diabetes mellitus. The aim of the current study is to evaluate safety and efficacy of non-insulin anti-... more
How does current disease activity in rheumatoid arthritis affect the short-term risk of acute coronary syndrome? A clinical register based study from Sweden and Norway
Cardiovascular (CV) disease (CVD) co-morbidity and mortality is one of the largest drivers of the excess morbidity and pre-term mortality in patients with rheumatoid arthritis (RA) [1–3]. The... more
Pulmonary rehabilitation and endothelial function in patients with chronic obstructive pulmonary disease: A prospective cohort study
Chronic obstructive pulmonary disease (COPD) is an increasing cause of global morbidity and mortality [1], and cardiovascular (CV) disease accounts for approximately 30% of excess mortality in this... more
Histamine elevation in familial Mediterranean fever: A study from the Juvenile Inflammatory Rheumatism cohort
Autoinflammatory diseases (AID) are defined according to the International Society of Auto-Inflammatory Diseases as abnormal activation of the innate immunity in the absence of infection or... more
Phenotypic Profiles Among 72 Caucasian and Afro-Caribbean Patients with Antisynthetase Syndrome Involving Anti-PL7 or Anti-PL12 Autoantibodies
Antisynthetase syndrome (ASyS), a rare and heterogeneous systemic autoimmune disease, is classified as a subtype of idiopathic inflammatory myopathy (IIM). It is associated with at least one of the... more
Recurrence rates and risk factors for recurrence after first episode of acute pancreatitis: A systematic review and meta-analysis
Acute pancreatitis (AP) has become a prevalent gastrointestinal disorder over the past few decades, with a growing impact on healthcare [1,2]. While most patients with AP experience mild symptoms and... more
Impact of thoracoabdominal imaging on diagnosis and management in patients with suspected infective endocarditis
A common feature of infective endocarditis (IE) is the risk of organ embolization with approximately 30% of IE patients presenting at least one embolic event (EE), with the most common site of... more
Efficacy and safety assessment of mineralocorticoid receptor antagonists in patients with chronic kidney disease
As a global health concern, chronic kidney disease (CKD) is threatening the health of 843.6 million people worldwide and is expected to become the 5th leading cause of death in 2040 [1,2]. CKD is... more
Subclinical coronary atherosclerosis, detected by computer tomography with coronary calcium score, and the occurrence of major cardiovascular events at 5 years of follow-up in a cohort of patients with systemic sclerosis
Systemic sclerosis (SSc) is a rare disease, with a not well known pathogenesis based on autoimmune dysregulation, charcaterized by clinical triad of vasculopathy, fibrosis of diverse organs, and... more
Early glomerular filtration rates changes and risk of mortality in acute heart failure. The modifying role of admission renal function and decongestion
The pathophysiology of changes in estimated glomerular filtration rate (eGFR) in acute heart failure (AHF) is complex and multifactorial. We evaluated the associated mortality risk of early changes... more
Prevalence and significance of antimitochondrial antibodies in autoimmune hepatitis (AIH): Results from a large multicentre study of the International AIH Group
Autoimmune hepatitis (AIH) is a chronic progressive liver disease leading to end-stage liver disease and/or death, if left untreated [1–3]. Within the spectrum of AIH, some patients exhibiting... more
Ventricular arrhythmias and cardiac arrest in atrial fibrillation patients with pacemakers and implantable cardioverter-defibrillators
Atrial fibrillation (AF) continues to be a growing epidemic due to its increasing incidence, prevalence, and detrimental consequences. In 2017, the Global Burden of Disease study revealed 37.57... more
Incidence, mortality, and risk factors of acute kidney injury after immune checkpoint inhibitors: Systematic review and meta-analysis of real-world evidence
Immune checkpoint inhibitors (ICI) constitute an important breakthrough in anticancer treatments, which has been rapidly and widely prescribed worldwide [1]. There are a variety of ICIs currently... more
Anemia management and transfusion strategy in internal medicine units: Less is more
Anemia is a global public health problem affecting subjects of all ages and gender, with significant consequences for human health and an impact on social and economic aspects. The aging of the... more
Genetic and clinical features of familial mediterranean fever (FMF) in a homogeneous cohort of patients from South-Eastern Italy
Hereditary recurrent fevers represent a heterogenous group of disorders considered systemic auto inflammatory diseases, caused mostly by monogenic mutations. Familial Mediterranean Fever (FMF), in... more
Review Article
A novel risk factor for malignancy: Albuminuria
Cancer is a global health concern with 23.6 million new cases globally in 2019, a 26.2 % increase from 2010 [1]. It is the second leading cause of death in adults after cardiovascular diseases,... more
What changed after the 2022 guidelines for pulmonary hypertension?
With an estimated prevalence of around 1%, pulmonary hypertension (PH) presents a relevant burden worldwide. The revised European Society of Cardiology (ESC) /European Respiratory Society (ERS)... more
A new strategy for anticoagulation: The factor XI inhibitors
In the last decade, new oral anticoagulant agents with a direct inhibition of specific clotting factors (DOACs) have been claimed as first-choice therapy for the prevention of cardioembolic events in... more
Cannabidiol's impact on drug-metabolization
Cannabis and cannabis-derived substances are worldwide the most frequently consumed psychopharmaceuticals [1]. Over the past decade, attitudes toward the recreational and medicinal use of cannabis... more
Coronary microvascular dysfunction and myocardial infarction with non-obstructive coronary arteries: Where do we stand?
The term myocardial infarction with non-obstructive coronary arteries (MINOCA) was first coined in 2013 [1] and was globally recognized in an expert position paper as a clinically heterogeneous... more
The role of adherence in patients with chronic diseases
In the long-term management of chronic diseases, adherence and persistence to prescribed medications are continuous challenges in order to obtain all the potential benefits of drug therapies.... more
Albumin administration in internal medicine: A journey between effectiveness and futility
Human albumin is the most abundant circulating protein and accounts for approximately 50–60% of all total plasma proteins in healthy individuals. The molecule is composed of 585 amino acids organised... more
Management of diabetic ketoacidosis
Diabetic ketoacidosis (DKA) is an acute life-threatening emergency in patients with diabetes, characterized by hyperglycemia, metabolic acidosis and ketonemia, it can result in serious morbidity and... more
Axial Spondyloarthritis: Evolving concepts regarding the disease's diagnosis and treatment
Spondyloarthritis (SpA) is a group of inflammatory diseases characterized by the involvement of the axial skeleton (axSpA) and/or the peripheral joints (p-SpA). It affects young adults of both sexes... more
Management of thyroid dysfunction and thyroid nodules in the ageing patient
Nowadays, people worldwide are living longer, and every country in the world is experiencing growth in both the size and the proportion of older persons in the population. In line with this, by 2030... more
Ultrasonography as a diagnostic tool for sarcopenia in patients with cirrhosis: Examining the pros and cons
Skeletal muscle abnormalities, including sarcopenia (pathological muscle mass depletion) and myosteatosis (abnormal fat accumulation in the muscles) are common features in patients with cirrhosis.... more
Future treatments in hypertension: Can we meet the unmet needs of patients?
The prevalence of arterial hypertension, defined as a persistent systolic blood pressure ≥ 130 mm Hg and/or diastolic blood pressure ≥ 80 mm Hg according to American College of Cardiology (ACC) and... more
Potential angiogenic biomarkers in hereditary hemorrhagic telangiectasia and other vascular diseases
Vascular diseases are the main cause of death in developed countries [1]. Despite much progress has been made to improve the management of these diseases, it is difficult to predict those patients at... more
Remote multiparametric monitoring and management of heart failure patients through cardiac implantable electronic devices
Heart failure (HF) is currently an important driver of hospitalizations and re-hospitalizations. It is associated with a high risk of adverse cardiovascular outcomes including death, inducing also an... more