Volume Number
272 ArticlesNo Section
Do statins prevent Alzheimer's disease? A narrative review
Alzheimer's disease is the most common cause of dementia and occurs commonly in patients 65 and older. There is an urgent need to find an effective management that could help prevent or at least slow... more
Rituximab in autoimmune thrombotic thrombocytopenic purpura: A success story
Despite a significant improvement of thrombotic thrombocytopenic purpura (TTP) prognosis since the use of plasma exchange, morbidity and mortality remained significant because of poor response to... more
Peripheral neuropathy: An underreported neurologic manifestation of inflammatory bowel disease
One of the most frequent neurologic complications reported in inflammatory bowel disease population is peripheral neuropathy; however, clinical aspects of peripheral nerve damage are not well... more
Hyponatremia in hospitalised patients with heart failure in internal medicine: Analysis of the Spanish national minimum basic data set (MBDS) (2005–2011)
Hyponatremia is the most common electrolyte disorder seen in clinical practice. Numerous studies have reported increased inhospital mortality associated to this condition, which is also an... more
Gout is associated with organic and psychogenic erectile dysfunction
Gout is a deposition disease with an inflammatory response that can increase the risk of cardiovascular disease. Gout is stressful for affected individuals, and can cause erectile dysfunction (ED).... more
Corrigendum to “Statins decrease thrombin generation in patients with hypercholesterolemia” [Eur J Intern Med 25(5), 449-451]
Due to an author error the affiliation of Alberico Catapano was incorrect in the published article. The correct affiliation is given above.
Time to face the challenge of multimorbidity. A European perspective from the joint action on chronic diseases and promoting healthy ageing across the life cycle (JA-CHRODIS)
Research on multimorbidity has rapidly increased in the last decade, but evidence on the effectiveness of interventions to improve outcomes in patients with multimorbidity is limited. The European... more
Ebola seen up-close
EMERGENCY is an Italian non-governmental organization founded in 1994 in order to provide free-of-charge health care to civilians victims of wars and poverty. Since its foundation EMERGENCY provided... more
Improving antimicrobial dosing in critically ill patients receiving continuous venovenous hemofiltration and the effect of pharmacist dosing adjustment
Appropriate antimicrobial dosing for patients receiving continuous venovenous hemofiltration (CVVH) is complex. Pharmacist participation in antimicrobial dosing adjustment for patients receiving CVVH... more
A calculator for temporal artery biopsy result prediction in giant cell arteritis suspects
Giant cell arteritis (GCA), also known as temporal arteritis or Horton disease, is a form of systemic vasculitis of unknown etiology that usually involves large and medium-sized arteries of the... more
Delphi consensus on the current clinical and therapeutic knowledge on Anderson–Fabry disease
Management of Anderson–Fabry disease (AFD) is contentious, particularly regarding enzyme replacement therapy (ERT). We report results of a Delphi consensus panel on AFD management.
Venous thromboembolism prophylaxis in acutely ill hospitalized medical patients. A retrospective multicenter study
To analyze the incidence of VTE in hospitalized medical patients and prophylaxis applied in accordance with the 8th ACCP guidelines and the National PRETEMED guide for thromboprophylaxis.
Managing ambulatory ulcerative colitis patients with infliximab: A long-term follow-up study in primary gastroenterology centers
Infliximab (IFX) is the key treatment for ulcerative colitis (UC) unresponsive to standard treatments. The aim of the present study was to assess the efficacy and safety of IFX in treating ambulatory... more
Complementary alternative medicine, plausibility and statistics
Pandolfi and Carreras stated that the outcome, that is: the ‘p-value’, of randomized controlled trials (RCTs) is over-estimated [1]. In the case of complementary alternative medicine (CAM) it should... more
Itchy erythroderma in a neoplastic patient—mind the mite!
A 75year-old Caucasian man presented with an itchy erythrodermic dermatosis showing scaling in the arms and in the gluteal region (Fig. 1A, upper panel). He was undergoing a multidrug therapy with... more
Personalised medicine: The cognitive side of patients
Although the fashion for the “personalised” or “stratified” approach to medicine is valuable in exploiting the omic signatures of the individual patient, too little attention has been paid to the... more
Gender-differences in disease distribution and outcome in hospitalized elderly: Data from the REPOSI study
Women live longer and outnumber men. On the other hand, older women develop more chronic diseases and conditions such as arthritis, osteoporosis and depression, leading to a greater number of years... more
Fluticasone propionate/formoterol: A fixed-combination therapy with flexible dosage
International guidelines describe asthma control as the main outcome of asthma management. Prevention of symptoms, improved quality of life, and reduction of exacerbations are the main components,... more
A pragmatic triage system to reduce length of stay in medical emergency admission: Feasibility study and health economic analysis
Departments of Internal Medicine tend to treat patients on a first come first served basis. The effects of using triage systems are not known.
Thromboprophylaxis in patients with stroke: A delicate decision
Acute ischemic stroke (AIS) is a leading cause of morbidity and mortality worldwide [1]. In addition to cerebral damage, medical complications such as pneumonia and venous thromboembolism (VTE),... more
Pulmonary embolism, where are the thrombi?
A 44-year-old man was admitted to the emergency service because of an acute onset of dyspnoea and unspecific abdominal pain during the previous 4days. His medical history was unremarkable. He was in... more
Altered mental status in older adults with histamine2-receptor antagonists: A population-based study
Compared to a lower dose, initiation of the current standard dose of H2RA in older adults is associated with a small absolute increase in the 30-day risk of altered mental status (using neuroimaging... more
The role of tenofovir in preventing and treating hepatitis B virus (HBV) reactivation in immunosuppressed patients. A real life experience from a tertiary center
Patients who present HBV reactivation during immunosuppressive treatment are prone to develop life threatening decompensation of the liver function, therefore prophylaxis and treatment are strongly... more
Severe acute kidney injury and multiple myeloma: Evaluation of kidney and patient prognostic factors
Endovascular stroke therapy
Flashcard: A 57-year-old woman with pleural effusion following percutaneous nephrolithotripsy
Prospective randomized trial: Endoscopic follow up 3 vs 6months after esophageal variceal eradication by band ligation in cirrhosis
Recurrent hospitalizations with moderate to severe hyponatremia in older adults and its associated mortality
Efficacy of intravenous propacetamol hydrochloride in the treatment of an acute attack of migraine
Incidence and risk factors of atherosclerotic cardiovascular accidents in dialysis chronic renal failure patients
Multimorbidity and functional status in community-dwelling older adults
Acute admissions to medical departments in Denmark: Diagnoses and patient characteristics
Nutraceuticals for the treatment of hypercholesterolemia
A ‘full moon’ shadow in the abdomen
Alcohol withdrawal recognition and screening in the acute medical setting
Prognostic value of worsening renal function in outpatients with chronic heart failure
Further insights into the metabolically healthy obese phenotype: The role of magnesium
Managing venous thromboembolism with novel oral anticoagulants in the elderly and other high-risk patient groups
Factors predicting the hospital episode costs of emergency medical admissions
Timing of acute kidney injury — does it matter? A single-centre experience from the United Kingdom
Clinical characteristics and prognostic significance of changes in platelet count in an internal medicine ward
Infective endocarditis due to multidrug resistant gram-negative bacilli: Single centre experience over 5years
The faulty statistics of complementary alternative medicine (CAM)
Normal weight obesity and functional outcomes in older adults
Inflammatory bowel diseases increase future ischemic stroke risk: A Taiwanese population-based retrospective cohort study
Diffuse large B-cell lymphoma in elderly patients: A retrospective analysis
The importance of the costoclavicular space in upper limb primary deep vein thrombosis, a study with magnetic resonance imaging (MRI) technique enhanced by a blood pool agent
Polyclonal intravenous immunoglobulin: An important additional strategy in sepsis?
Platelet indices in differential diagnosis of pancreatic neuroendocrine tumors from pancreatic adenocarcinomas
Relation of resistin, leptin and adiponectin — Trinity of adipose tissue dysfunction assessment
Elevated plasma homocysteine level is associated with ischemic stroke in Chinese hypertensive patients
Influence of inadequate antimicrobial therapy on prognosis in elderly patients with severe urinary tract infections
Low seroprevalance of diphtheria, tetanus and pertussis in ambulatory adult patients: the need for lifelong vaccination
Mortality risk score for bacteraemia
Early detection and diagnosis of vascular calcification in patients with chronic kidney disease
A challenging diagnosis for potential fatal diseases: Recommendations for diagnosing acute porphyrias
Is it time to change the neurofibromatosis 1 diagnostic criteria?
Takotsubo cardiomyopathy and acute coronary syndrome — Overlapping diagnoses will lead to confusion
Sporadic porphyria cutanea tarda: Treatment with chloroquine decreases hyperglycemia and reduces development of metabolic syndrome
Platelet indices in differential diagnosis of pancreatic neuroendocrine tumors from pancreatic adenocarcinomas
Commentary
Appropriateness of antithrombotic prophylaxis in the oldest old with non-valvular atrial fibrillation: ARAPACIS and REPOSI
In the frame of the Atrial Fibrillation Registry for Ankle–Brachial Index Prevalence Assessment-Collaborative Italian Study (ARAPACIS) involving 93 Internal Medicine wards, Pignatelli et al. [1]... more
Developments in Internal Medicine
What is the role of general internists in the tertiary or academic setting?
The changing demography of European populations mandates a vital role for internists in caring for patients in each level of healthcare. Internists in the tertiary or academic setting are highly... more
Editorial
Editorial: Care of adults with Down syndrome: Gaps and needs
In their recent article, Real de Asua et al. [1] identified the most common conditions diagnosed in a population of Spanish adults with Down syndrome (DS). DS has historically represented a pediatric... more
Internal Medicine Flashcard
A young woman with a heart attack?
A 38year-old nulliparous woman with no cardiac risk factors abruptly developed chest discomfort during a routine exercise run. The discomfort recurred with minimal exertion for the next three days,... more
A 64-year old woman with right hand swelling and paresthesia
A 64-year old woman presented to the emergency department with a 6-month history of right lateral cervical pain and a 2-week history of erythema and swelling of her right hand and wrist, accompanied... more
Malignant syphilis
A previously healthy 54-year-old bisexual man presented with a 2-week history of generalized nonpruritic skin rash and painless genital ulcerations. He reported low-grade fever, and admitted having... more
Unilateral calf swelling
An 81-year-old man presented to the emergency department with left calf painful swelling for 4days. He has a history of hypertension and ischemic heart disease. He denied any injury. Physical... more
Memory of an exotic holiday
A 66-year-old man with no particular medical history and back from a 10-day trip to South Africa, consulted for headache, myalgia, odynophagia and low-grade fever (38°), which had lasted for 3days.... more
An umbilical nodule in a patient with enlarged uterus
A previously healthy 59-year-old female presented with weakness in the lower extremities and abdominal distension of one month. She also experienced unintentional weight loss of 20 pounds within... more
An unusual emphysema
An 87year-old woman with a history of hypertension, type 2 diabetes and post-menopausal osteoporosis presented with a 5-day history of low-grade intermittent fever, epigastric pain and shortness of... more
The brain of STEMI
An 83y/o African American male with a history of hypertension and chronic kidney disease presented following a fall. The fall occurred while he was trying to get up from a sitting position. The... more
Back pain: An old cause in a young adult
A 23-year-old man from the Philippines was admitted to our emergency department for a three-weeks-lasting thoracic back pain, followed by an onset of postural instability; he also complained about... more
An uncommon case of post partum seizures
A 30-year-old woman was admitted for headaches and altered somnolence and agitation few days after uncomplicated vaginal delivery. No complications occurred during this first pregnancy. Four days... more
Calcified pulmonary nodules
A 78-year-old female with stroke and hydrocephalus post-ventriculo-peritoneal shunt insertion presented with shortness of breath, productive cough, and fever that had been present for several days.... more
The dark side of a pneumonia
A 92-year old woman was admitted to our internal medicine ward for dyspnea and asthenia. Oxygen saturation (SpO2) was 82%, blood pressure was 100/60mmHg, heart rate was 78bpm and body temperature was... more
“Cor bovinum”: An ambiguous chest radiography
A 65-year-old woman, affected by Type II diabetes mellitus with no history of cardiac illness, referred to our hospital with a suspected diagnosis of “angina pectoris” for a cardiovascular evaluation... more
Abdominal cause of asymmetric lower limb oedema
A 94year-old Caucasian woman presented to the Emergency Department with right inferior limb oedema. Erythema, pallor and pain were not present neither other signs nor symptoms. The patient had... more
Multiple nodules on the bilateral lower extremities
A 55-year-old female with a history of asthma, diabetes mellitus and hypertension presented with a 2-month history of multiple tender nodules on the bilateral lower extremities. She suffered from... more
A man with acute epigastric pain
A 68-year-old man with history of hypertension presented with 1day of epigastric pain, vomiting and chills. Physical examination was notable for a febrile, toxic-looking patient in distress; there... more
Respiratory failure after treatment of pneumothorax
A 40-year-old man presented with an eight day history of left-side pleuritic chest pain and dyspnea. Chest examination revealed decreased air entry at the left lung. Chest X-ray examination revealed... more
Internal Medicine Flashcards
A patient presenting with an acute shortness of breath
A 37-year-old woman presented with shortness of breath, cough, and fever that began a few days earlier. Her pulse rate was high (110bpm) with a body temperature of 38.6°C. Pulmonary auscultation... more
Letter to the Editor
Efficacy but not effectiveness of sublingual immunotherapy for grass pollen allergy: Time to avoid waste in health-care expenditure
Last June JAMA Internal Medicine published an excellent systematic review and meta-analysis of clinical trials of sublingual immunotherapy for grass pollen allergy [1]. The team of Di Lorenzo of the... more
Anticholinergic risk: Use and limitations of anticholinergic scales
The side effects of anticholinergic drugs are well known. Peripheral adverse effects are, amongst others: dry mouth, dry eyes, blurred vision, constipation, fecal impaction, urinary retention and... more
Circadian aspects of myocardial infarction among young STEMI patients
We read with interest the recent publication of Rallidis et al. [1] reporting the circadian pattern of symptoms onset in patients presenting with ST-segment elevation myocardial infarction (STEMI).... more
Depressive symptomatology in patients with metabolic syndrome: A cross-sectional study of stable coronary artery disease patients
The metabolic syndrome is a common disorder, which includes the presence of at least 3 out of 5 metabolic risk factors according to the National Cholesterol Education Program Adult Treatment Panel... more
Next Accreditation System outcomes and Special Review as part of Graduate Medical Oversight of Internal Medicine Programs in the United States: A review
The Accreditation Council on Graduate Medical Education (ACGME) previously evaluated programs with direct site visits, every 1–5years. The length of time between visits would depend on program data... more
The value of software that provides clinically relevant information on drug interactions
Potential drug–drug interactions (pDDIs) are critical issues in the management of the elderly. The development of multiple diseases with increasing age leads to therapies based upon many concomitant... more
History of alcohol abuse after major non-cardiac surgery and postoperative cognitive dysfunction
The risk factors for postoperative cognitive dysfunction (POCD) after non-cardiac surgery include advanced age and preexisting cognitive impairment.
Proton pump inhibitors and risk of hypomagnesemia
Proton pump inhibitors (PPIs) are among the most commonly prescribed medicines and overuse is widespread in both primary and secondary care [1]. Although generally well tolerated, PPIs can cause... more
Deprescribing in patients with multimorbidity: A necessary process
As featured in several publications, the term deprescribing has not yet been standardized [1], and different points of view have thus been used to define it. One of the first concepts came from... more
Whatever happened to the doctor's opinion?
A year or so ago I spent a short while in Africa collaborating on a validation study of the National Early Warning Score [1]. As I went over the results of the study it was clear that African... more
Fibromyalgia is frequent in obstructive sleep apnea and responds to CPAP therapy
Fibromyalgia is a common disorder characterized by widespread musculoskeletal pain, stiffness, paresthesia and proneness to fatigue. The prevalence has been reported to be 3.4 percent in women and 0.... more
Citation analysis of the ‘Big Six’ journals in Internal Medicine
The current scientific culture is strongly driven by publication prestige and impact, epitomized in the “publish or perish” maxim. In the field of general medicine, six journals have historically... more
Sarcopenia evaluated by fat-free mass index in patients with chronic heart failure
The article published by Narumi et al. is important as they reveal a connection between fat-free mass index (FFMI) and cardiac prognosis in cardiac failure patients [1]. However, we think that there... more
Prognostic value of multidimensional indices in ambulatory COPD patients
The Global Initiative for Chronic Obstructive Lung Disease (GOLD) advocates the use of multidimensional prognostic indices for staging, monitoring and guiding decision-making in chronic obstructive... more
More on homeopathy
Finally a government body has had the courage to express a clear opinion on homeopathy. The Australian National Health and Medical Research Council has declared that homeopathy is not an effective... more
Treatment management and glycaemic control in a simple of 60 frail elderly diabetics with comorbidities. A retrospective chart review
Based on epidemiological estimates, the prevalence of diabetes (DM) is increasing every year, and it also increases with age, thus forecasting a poor scenario for the coming decades. At the same time... more
Hospital preparedness for knowledge-based response to Ebola and other emerging infectious diseases: A continuous challenge
The comment from Wiwanitkit stimulates some interesting remarks. Indeed, we agree that a “preparedness for knowledge” is essential for effective actions, especially in the case of an emerging disease... more
Association of tuberculosis and deep venous thromboembolism in patients with autoimmune diseases
Tuberculosis (TB) can complicate the course of various autoimmune diseases, especially with prolonged use of immunosuppressive treatment [1–9]. Limited data are currently available regarding risk... more
Preparedness for the management of a patient with Ebola
Di Caro et al. reported an interesting article on “preparedness for the management of a patient with Ebola [1].” Di Caro et al. discussed on the added value of long-lasting preparedness. Indeed,... more
No increase in synovial fluid level of matrix metalloproteinase-3 by systemic administration of glucocorticoids in rheumatoid arthritis
Matrix metalloproteinase-3 (MMP-3) is produced by fibroblasts, synovial cells, and chondrocytes in response to cytokines like interleukin-1 and tumor necrosis factor-α [1,2]. In rheumatoid arthritis... more
The added value of long-lasting preparedness for the management of a patient with Ebola
In the interesting description of his experience in Sierra Leone, Satolli refers to an Italian physician from the Emergency team who developed the infection in Africa and was urgently airlifted by... more
Liver injury is uncommon in chronic gastrointestinal ischemia
Hypoxic liver injury in an acute setting of cardiac, circulatory or respiratory failure, also known as hypoxic or ischemic hepatitis, is caused by insufficient oxygen uptake by hepatocytes and is... more
Association between polymorphism within the receptor and development of statin-associated myalgia/myopathy in the Czech population
Statins are the most common drugs used in both primary and secondary cardiovascular prevention. They lower plasma cholesterol levels by inhibiting the key enzyme of cholesterol synthesis, 3-hydroxy 3... more
Portal vein thrombosis significantly improves the survival of cirrhotic patients awaiting liver transplantation: Should we accept the statistical results?
Traditionally, the presence of occlusive portal vein thrombosis (PVT) is a negative clinical prognostic factor for liver cirrhosis [1,2]. This is primarily attributed to the following considerations... more
Circulating homocysteine in nonalcoholic fatty liver disease
We read with interest the study of Leach et al. [1], showing higher serum homocysteine (Hcy) levels in patients with biopsy-proven nonalcoholic steatohepatitis (NASH) than apparently healthy controls... more
Involvement of family physicians in structured programs for chronic diseases or multi-morbidity in Switzerland
The increasing prevalence of chronic diseases and multi-morbidity [1] represents challenges for health systems worldwide. In that perspective, the current organization of healthcare delivery,... more
The survival of patients admitted because of health-care-related adverse events is similar to that after admission for other reasons
Admissions through the emergency department (ED) because of health-care-related adverse events (AEs), which should not be confused with (blameworthy) medical errors, are common [1–6]. These AEs,... more
Do persons with stroke benefit from statin–fibrate combination therapy?
Treatment with statins reduces the rate of cardiovascular events in high-risk patients, but residual risk persists. At least part of that risk may be attributable to atherogenic dyslipidemia... more
ST2 marker might help to stratify in-hospital high risk patients with Tako-tsubo cardiomyopathy
ST2 is a receptor of the interleukin (IL)-1 family, a biomarker of inflammatory and cardiovascular disease with transmembrane (ST2L) and soluble (sST2) isoforms, released by cardiomyocytes in... more
Epithelial–mesenchymal transition: A key mechanism for cigarette smoke-associated pulmonary fibrosis in COPD?
Chronic obstructive pulmonary disease (COPD) is a worldwide disease, featured by not fully reversible and progressive airflow limitation, leading to the concurrence of persistent chronic airway... more
Abstract-to-publication ratio and predictors for publication success for papers presented at the Italian Emergency Medicine Meeting: A cross-sectional study
It has been suggested that the quality of research output from a scientific meeting may be roughly estimated through the rate of presented abstracts which are subsequently published as full-text... more
A European Emergency Card for adrenal insufficiency can save lives
Adrenal insufficiency (AI) is a life threatening disease that has several underlying causes. In primary AI (PAI) the adrenal cortex itself is destroyed and the most common cause is autoimmune... more
Statins do not improve lung function decline in COPD?
Chronic obstructive pulmonary disease (COPD), the fourth leading cause of mortality worldwide, is characterized by persistent and progressive airflow limitation, due to chronic inflammatory response... more
Cryptogenic stroke, atrial fibrillation and primary prevention
Few studies are as striking in their immediate applicability and impact as do the recent randomized controlled trials (RCTs) on prolonged heart rate monitoring in patients with cryptogenic stroke or... more
Proper cut-off points to distinguish patients with NASH from non-NASH
We read with great interest the recently published article by Leach et al. [1]. In this study, it was aimed to evaluate serum homocysteine (Hcy) levels and oxidative stress status in patients with... more
An emerging crisis in Greece's medical research output
Publications are the major output of scientific research and their metrics are extensively used in evaluating the countries' scientific performance. We analyzed bibliometric data from Scopus derived... more
Exclusion criteria for sarcoidosis: A novel approach for an ancient disease?
The differentiation between sarcoidosis and sarcoid-like reactions still remains a debated issue. Current diagnostic criteria for cutaneous sarcoidosis are not adequately implemented in the clinical... more
An inverse-to-anticipated relationship of Lp-PLA activity in diabetes: Reflection of underlying autoimmune activation
The study by Mayer Jr. and associates [1] investigating the relationship between impaired glucose metabolism and lipoprotein-associated phospholipase A2 activity (aLp-PLA2) contributes to current... more
Improving Acute Kidney Injury (AKI) outcomes through the use of automated electronic alerts
We read the letter of Cheshire et al. [1] with interest, in response to our recent publication “Timing of acute kidney injury — does it matter? A single-centre experience from the United Kingdom” [2... more
Long-term follow-up after anticoagulant treatment withdrawal in patients with deep venous thrombosis and inferior vena cava agenesis
Inferior vena cava (IVC) agenesis is a rare congenital disease in which venous return from the lower limbs is achieved through collateral veins, mainly thorough the azygos and hemiazygos veins [1].... more
Causes of protidemia above 100g/L
Multiple myeloma-related monoclonal gammopathy is a well-known cause of highly elevated serum protein [1]. However, other diseases inducing major polyclonal immunoglobulin production can be... more
Research and common sense
As far as we understand, Lilli [1] maintains that we may lessen our skepticism toward a research hypothesis following a succession of positive results. He mentions the example of a diagnostic test... more
Relevance of clotting screen requests
Coagulation screening tests have become the part and parcel of the array of blood tests performed routinely in most hospitals. The definite indications for ordering these tests include haemorrhagic... more
Data about (complementary and alternative) medicine are irrelevant, because we are all Bayesians
Pandolfi and Carreras are to be congratulated on their argument in favor of a Bayesian view on medical decision making and statistics [1]. The authors rightly point out that, given a mildly skeptical... more
Logical reasoning alone is often not enough
We do not doubt that “Millions of patients experience an effect of CAM, often after conventional medicine failed”, as Rutten and Stolper say [1]. The question, as our paper maintains [2], is whether... more
From p-value to Bayesian analysis: Should we renounce the study of the “unknown”?
I read with interest the article by Pandolfi and Carreras about aspects in statistics which a clinician should consider to give the right weight to evidence, with particular attention to... more
Evaluation of the common mistakes made by patients in the use of Levothyroxine
Hypothyroidism is a common disorder [1] whose diagnosis frequency has gradually risen. Although synthetic thyroxine (T4), L-triiodothyronine (T3), and T3/T4 combinations are available for correction... more
Letters to the Editor
The issue of dual infection with m.tuberculosis and non-mycobacterial pathogens
In order to address more fully the mortality rate associated with pneumonia in the elderly, attention should be paid, not only to adherence to guidelines [1], but, also to the misdiagnosis of... more
Simple measurement popularizes sarcopenia evaluation in patients with heart failure
Dear Editor.
The added value of preparedness for aeromedical evacuation of a patient with Ebola
Having read the article of Satolli that mentions the transport from Sierra Leone to Italy of an Italian patient infected with Ebola [1], we find it useful to emphasize the value of preparedness —... more
Choosing ACE-inhibitors instead of sartans: Encouraging results of an evidence-based policy in Emilia-Romagna, Italy
Pharmaceutical policies favoring appropriate prescribing must be based on solid evidence on drug effectiveness and safety, better if shared with relevant stakeholders [1]. To translate this knowledge... more
A brief history of uric acid: From gout to cardiovascular risk factor
The organic heterocyclic compound uric acid, discovered by the Swedish chemist Carl Wilhelm Scheele (1742–1786) and represented by the formula H2(C5H2N403), is the final product of purine catabolism... more
Are physicians identifying acute kidney injury?
The recent publication by Pang et al. demonstrated significantly worse dialysis dependence for community acquired acute kidney injury (c-AKI) [1]. The severity of AKI in this paper was predominantly... more
Original Article
Social deprivation, population dependency ratio and an extended hospital episode — Insights from acute medicine
Patients from deprived backgrounds have a higher in-patient mortality following an emergency medical admission; this study aimed to investigate the extent to which Deprivation status and the... more
Thromboembolic events in patients with severe pandemic influenza A/H1N1
The 2009 pandemic influenza A/H1N1 developed as a novel swine influenza which caused more diseases among younger age groups than in the elderly. Severe hypoxemic respiratory failure from A/H1N1... more
Approvals of drugs with uncertain benefit–risk profiles in Europe
This paper examines conditional approvals that allow the marketing of medicines with unsettled benefit–risk profiles in the European Union.
Under-detection of delirium and impact of neurocognitive deficits on in-hospital mortality among acute geriatric and medical wards
Delirium is a neuropsychiatric disorder, triggered by medical precipitants causes. Study aims were to describe the prevalence and impact on in-hospital mortality of delirium identified through ICD-9... more
Medical teleconsultation to general practitioners reduces the medical error vulnerability of internal medicine patients
e-Health strategies are supposed to improve the performance of national health systems. Medical teleconsultation (MT) is an important component of such e-Health strategies.
Functional status and mortality at month and year in nonagenarians hospitalized due to acute medical illness
To analyze risk factors associated with short and long-term mortality in nonagenarians hospitalized due to acute medical conditions.
Incremental value of exercise echocardiography over exercise electrocardiography in a chest pain unit
Limited data are available on the added value of exercise echocardiography (ExEcho) over exercise electrocardiography (ExECG) in patients with suspected acute coronary syndromes (ACS) referred to a... more
Cost-effectiveness analysis of preoperative treatment of acromegaly with somatostatin analogue on surgical outcome
There is no uniform standard of care for acromegaly. Due to the high costs involved, steps must be taken to ensure the cost-effective delivery of treatment.
Clinical implications and outcome prediction in chronic hemodialysis patients with lower serum potassium×uric acid product
The aims of this study were to evaluate correlations between serum potassium (S[K]) and uric acid (S[UA]) in hemodialysis patients and to determine whether lower levels of both S[K] and S[UA] were... more
Comparison of risk factors for acute worsening renal function in heart failure patients with and without preserved ejection fraction
We compared the risk factors for acute worsening renal function (AWRF) in patients with acute decompensated heart failure with preserved ejection fraction (HFpEF) versus those with reduced ejection... more
Perceived stress status and sympathetic nervous system activation in young male patients with coronary artery disease in China
Young Chinese male adults have faced increasing psychological stress. Whether this is associated with the increased risk of coronary artery disease (CAD) in young Chinese males remains unclear. This... more
Increased circulating adiponectin in males with chronic HCV hepatitis
Increased levels of adiponectin, a major adipokine with insulin sensitizing properties showing a strong sexual dimorphism, have been reported in individuals with chronic HCV infection (CHC), but data... more
Malignant transformation and overall survival of morphological subtypes of intraductal papillary mucinous neoplasms of the pancreas: A network meta-analysis
Emerging evidence suggests the predictive role of morphological subtypes (gastric, intestinal, pancreatobiliary, and oncocytic) of intraductal papillary mucinous neoplasms (IPMNs) in malignant... more
Prognostic significance of changes in red cell distribution width in an internal medicine ward
The prognostic significance of red cell distribution width (RDW) during hospitalization in internal medicine wards was not sufficiently investigated.
The effect of statins on the occurrence of peptic ulcer
This study was to determine the association between the use of statins and the occurrence of peptic ulcer diseases (PUD).
Gender difference in drug use in hospitalized elderly patients
The aims of this study were to evaluate whether or not there are gender differences in drug use at hospital admission and prescription at discharge and to evaluate the effect of hospitalization on... more
Development and multi-centre evaluation of a method for assessing the severity of potential harm of medication reconciliation errors at hospital admission in elderly
Medication reconciliation is a powerful process to correct medication errors (ME) resulting from miscommunicated information at transitions of care. This study aims to develop and evaluate a scoring... more
The diagnostic usefulness of fecal lactoferrin in the assessment of Crohn's disease activity
Diagnosis and monitoring of Crohn's disease (CD) is difficult and time-consuming. In recent years, diagnostic usefulness of fecal calprotectin has been proven. However, data on the utility of other... more
Online combination algorithm for non-invasive assessment of chronic hepatitis B related liver fibrosis and cirrhosis in resource-limited settings
The use of commercially available noninvasive markers for chronic hepatitis B (CHB) related fibrosis is not widely available in developing countries so clinicians in those countries frequently use... more
The influence of gender on the communication skills assessment of medical students
Opinions on the interaction between the genders of standardized patients and examinees are controversial. Our study sought to determine the influence of gender on communication skills assessment in... more
Oral health information from the dentist to the diabetologist
Diabetes care includes annual evaluation of micro- and macrovascular complications, however, oral pathologies are not included. We studied retrieving oral health information, in particular... more
Duration of clopidogrel-based dual antiplatelet therapy and clinical outcomes after endeavor sprint zotarolimus-eluting stent implantation in patients presenting with acute coronary syndrome
The optimal duration of dual antiplatelet therapy (DAPT) remains controversial in patients with acute coronary syndrome (ACS). We sought to compare outcomes after the implantation of zotarolimus-... more
Venous thromboembolism and preoperative steroid use: Analysis of the NSQIP database to evaluate risk in surgical patients
Despite several prophylactic strategies, postoperative venous thromboembolism (VTE) remains a major cause of morbidity and mortality. Therefore, the search for modifiable preoperative risk factors is... more
Long-term risk of pancreatitis and diabetes after cholecystectomy in patients with cholelithiasis but no pancreatitis history: A 13-year follow-up study
Patients with biliary pancreatitis are suggested to undergo cholecystectomy to prevent the recurrence of pancreatitis. However, it remains controversial whether cholecystectomy is associated with... more
Predicting prolonged length of hospital stay in older emergency department users: Use of a novel analysis method, the Artificial Neural Network
To examine performance criteria (i.e., sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV], likelihood ratios [LR], area under receiver operating characteristic... more
Circadian pattern of symptoms onset in patients ≤35years presenting with ST-segment elevation acute myocardial infarction
There are scarce data regarding the circadian pattern of symptoms onset in young patients presenting with acute myocardial infarction (AMI). We explored whether young patients with ST-segment... more
Reducing weight in an internal medicine outpatient clinic using a lifestyle medicine approach: A proof of concept
Chronic non-communicable diseases represent the major drivers of disease burden, being responsible for the majority of health care cost and deaths. Almost half of premature deaths is due to behaviors... more
Is chronic neutropenia always a benign disease? Evidences from a 5-year prospective study
To evaluate infections and oncohematologic evolution in adult patients with chronic idiopathic and autoimmune neutropenia in a prospective study.
Drug-related problems identification in general internal medicine: The impact and role of the clinical pharmacist and pharmacologist
Patients admitted to general internal medicine wards might receive a large number of drugs and be at risk for drug-related problems (DRPs) associated with increased morbidity and mortality. This... more
Chronic osteomyelitis correlates with increased risk of acute pancreatitis in a case–control study in Taiwan
The objective of this study was to examine the relationship between chronic osteomyelitis and acute pancreatitis in Taiwan.
New onset of diabetes after transplantation is associated with improved patient survival after liver transplantation due to confounding factor
The influence of NODAT on survival of liver transplant recipients has not been clarified. Therefore, we evaluated the effect of NODAT on survival in LT recipients.
Does coronary Atherosclerosis Deserve to be Diagnosed earlY in Diabetic patients? The DADDY-D trial. Screening diabetic patients for unknown coronary disease
To evaluate if screening and treatment of asymptomatic coronary artery disease (CAD) are effective in preventing first cardiac event in diabetics.
Thalassemia and risk of dementia: A nationwide population-based retrospective cohort study
This study is a nationwide population-based retrospective cohort study to investigate the risk for developing dementia in thalassemia population.
Pre-existing diabetes and risks of morbidity and mortality after liver transplantation: A nationwide database study in an Asian population
Whether diabetes mellitus (DM) is associated with a higher risk of perioperative mortality and mortality after liver transplantation (LTx) remains unclear.
Hypermagnesemia is a strong independent risk factor for mortality in critically ill patients: Results from a cross-sectional study
Patients with electrolyte imbalances or disorders have a high risk of mortality. It is unknown if this finding from sodium or potassium disorders extends to alterations of magnesium levels.
Inpatient versus outpatient onsets of acute myocardial infarction
There are few studies on patients suffering acute myocardial infarction (AMI) when already in hospital for other reasons; therefore, this study aimed to compare patients with in-hospital-onset AMI... more
Prognostic role of atrial fibrillation in patients affected by chronic heart failure. Data from the MECKI score research group
Atrial fibrillation (AF) is common in heart failure (HF). It is unclear whether AF has an independent prognostic role in HF. The aim of the present study was to assess the prognostic role of AF in HF... more
Clinical profile and main comorbidities of Spanish adults with Down syndrome
The life expectancy of adults with Down syndrome (DS) has significantly increased in the last decades. We aim to describe the main demographic and clinical characteristics of a cohort of adults with... more
Short and long term survival following hospitalization with a primary versus non-primary diagnosis of acute heart failure
To compare the short-term and long-term outcomes of patients hospitalized with a primary diagnosis of acute heart failure (AHF) versus AHF associated with an alternative principal diagnosis.
Risk of psychiatric disorders following gastroesophageal reflux disease: A nationwide population-based cohort study
Recent studies have shown that the peripheral inflammation may cause the up-regulation of central nervous system inflammation and therefore possibly plays a vital role in the pathophysiology of... more
Prior statin use and the outcomes in patients with first-attack acute pancreatitis: A retrospective cohort study
We investigated whether prior stain use before admission for a first-attack AP would reduce the severity and mortality rate of a first-attack of AP with a dose–response relationship.
Eosinophilic granulomatosis with polyangiitis (Churg–Strauss) (EGPA) Consensus Task Force recommendations for evaluation and management
To develop disease-specific recommendations for the diagnosis and management of eosinophilic granulomatosis with polyangiitis (Churg–Strauss syndrome) (EGPA).
Hyperglycemia management in patients admitted to internal medicine in Spain: A point-prevalence survey examining adequacy of glycemic control and guideline adherence
Despite the increasing prevalence of hospitalized diabetic patients, there are few studies that evaluate the glycemic control and the rate of adherence to clinical practice guidelines for glucose... more
Initiation of rivaroxaban in patients with nonvalvular atrial fibrillation at the primary care level:
Rivaroxaban has become an alternative to vitamin-K antagonists (VKA) for stroke prevention in non-valvular atrial fibrillation (AF) patients due to its favourable risk–benefit profile in the... more
New onset heart failure — Clinical characteristics and short-term mortality. A RICA (Spanish registry of acute heart failure) study
Heart failure (HF) is a growing global epidemic. The main study aims is to evaluate the differences between new-onset and chronic-decompensated HF patients. Secondary objectives related only to new-... more
Predicting the emergence of anemia — A large cohort study
We aimed to find predictors for development of anemia in a large cohort of adults.
Using white blood cell counts to predict metabolic syndrome in the elderly: A combined cross-sectional and longitudinal study
Metabolic syndrome (MetS) has an important implication from a preventive medicine perspective as early recognition and intervention will reduce associated mortality and morbidity. To better identify... more
Effects of a long-term lifestyle intervention program with Mediterranean diet and exercise for the management of patients with metabolic syndrome in a primary care setting
The impact of a lifestyle intervention (LSI) program for the long-term management of subjects with metabolic syndrome in a primary care setting is not known.
Patients' characteristics associated with the decision of “do not attempt cardiopulmonary resuscitation” order in a Swiss hospital
According to Swiss legislation, do not attempt cardiopulmonary resuscitation (DNACPR) order can be made at any time by patients only, unless the resuscitation is considered as futile, based on the... more
Pulmonary Langerhans cell histiocytosis: A comprehensive analysis of 40 patients and literature review
Pulmonary Langerhans cell histiocytosis (PLCH) is a rare interstitial disease affecting primarily young adult smokers. In order to highlight the clinical features of the disease, we conducted a... more
Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia
Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of... more
Evidence for the presence of autochthonous (locally acquired) cases of acute hepatitis E virus infections in Italy since the 80s
Autochthonous (locally acquired) cases of acute hepatitis E virus have been recently reported in several developed countries.
Efficacy and safety of pegylated interferon base treatment in patients with chronic hepatitis C on dialysis
Patients with chronic hepatitis C (CHC) and end-stage renal disease (ESRD) on dialysis are difficult to treat and show higher dropout rates during treatment. The aim of this study was to analyze the... more
High rate of abnormal blood values and vascular complications before diagnosis of myeloproliferative neoplasms
Vascular complications occurring before the diagnosis of myeloproliferative neoplasms (MPN) in 612 patients from four centers in Sweden, Denmark and France were retrospectively studied.
Individual non-steroidal anti-inflammatory drugs and risk of acute kidney injury: A systematic review and meta-analysis of observational studies
The association between acute kidney injury (AKI) and use of non-steroidal anti-inflammatory drugs (NSAIDs) is well established. However, little is known about the comparative risk of individual... more
Higher risk of developing a subsequent migraine in adults with nonapnea sleep disorders: A nationwide population-based cohort study
This nationwide population-based cohort study evaluated the effect of nonapnea sleep disorders (NSDs) on the subsequent development of a migraine.
“Multidrug-resistant tuberculosis” may be nontuberculous mycobacteria
Multidrug resistant tuberculosis (MDR-TB) presents a great challenge to public health, especially for developing countries. Some nontuberculous mycobacteria (NTM) cause the similar clinical and... more
Decline of the lung function and quality of glycemic control in type 2 diabetes mellitus
The aim of this study was to verify to which extent in type 2 diabetes mellitus respiratory function and respiratory muscle efficiency decline over time in relation to the quality of glycemic control... more
Statin adherence and LDL cholesterol levels. Should we assess adherence prior to statin upgrade?
Adherence to statin therapy has been shown to be suboptimal. In statin-treated patients with residual elevated low density lipoprotein cholesterol (LDL-C) levels the physician must decide whether to... more
Global health care use by patients with type-2 diabetes: Does the type of comorbidity matter?
To identify patterns of health care use among diabetic patients with multimorbidity across primary, specialised, hospital and emergency care, depending on their type of chronic comorbidity.
Multimorbidity in risk stratification tools to predict negative outcomes in adult population
Risk stratification tools were developed to assess risk of negative health outcomes. These tools assess a variety of variables and clinical factors and they can be used to identify targets of... more
Rheumatoid arthritis affects left ventricular mass: Systematic review and meta-analysis
Cardiovascular disease represents one of the most important extra-articular causes of morbidity and mortality in patients with rheumatoid arthritis (RA). Evidences showed that several cardiac... more
Clinical and lifestyle-related risk factors for incident multimorbidity: 10-year follow-up of Finnish population-based cohorts 1982–2012
Multimorbidity is a huge burden to individuals and societies and more attention should be paid on its risk factors and prevention possibilities. The aim of this study was to investigate which... more
Brain and kidney, victims of atrial microembolism in elderly hospitalized patients? Data from the REPOSI study
It is well known that atrial fibrillation (AF) and chronic kidney disease (CKD) are associated with a higher risk of stroke, and new evidence links AF to cognitive impairment, independently from an... more
Factors associated with length of stay following an emergency medical admission
Hospitals are under pressure to use resources in the most efficient manner. We have examined the factors predicting Length of Stay (LOS) in one institution, using a database of all episodes of... more
Multimorbidity — Is this a special condition, or just another chronic disease? National multimorbidity overview based on Lithuania's national database
Chronic multiple conditions have become a major threat to world healthcare systems within the last years.
Chronic conditions, disability, and quality of life in older adults with multimorbidity in Spain
As the population ages, the prevalence of multimorbidity also increases, with consequences to several health outcomes such as disability and quality of life (QoL). This study aimed at analyzing the... more
Health-related quality of life and multimorbidity in community-dwelling telecare-assisted elders in the Basque Country
Multimorbidity is more common in the elderly population and negatively affects health-related quality of life (QoL). The aims of the study were to report the QoL of users of the Basque telecare... more
Serum uric acid and other short-term predictors of electrocardiographic alterations in the Brisighella Heart Study cohort
Recent studies show that serum uric acid (SUA) is a predictor of atrial fibrillation, while its association with other kinds of arrhythmias is not yet established. We aimed to evaluate the incidence... more
Health care utilization of patients with multiple chronic diseases in The Netherlands: Differences and underlying factors
To examine health care utilization of people with multiple chronic diseases in The Netherlands compared to people with one chronic disease, and to identify different subgroups of multimorbid patients... more
Risk of coronary artery disease in transfusion-naïve thalassemia populations: A nationwide population-based retrospective cohort study
Few studies have focused on the association between coronary artery disease (CAD) and transfusion naïve thalassemia populations (this term means silent carrier, thalassemia minor or intermedia), who... more
Multimorbidity in people with type 2 diabetes in the Basque Country (Spain): Prevalence, comorbidity clusters and comparison with other chronic patients
Multimorbidity is a common problem in ageing societies and has a wide range of individual and social consequences. The objective of this study was to compare multimorbidity in a population with type... more
Prevalence of DNA-confirmed Familial Hypercholesterolaemia in young patients with myocardial infarction
To report the prevalence of DNA-confirmed Familial Hypercholesterolaemia (FH) in young patients with acute myocardial infarction, the relative contribution of smoking and diabetes and to compare... more
Long-term survival in the randomized trial of drug treatment in mild to moderate hypertension of the Oslo study 1972–3
In the Oslo cardiovascular study of 1972–3 a 5-year randomized trial in mild to moderate hypertension was performed. Several changes in treatment practices have been recommended since that time. We... more
Sarcopenia evaluated by fat-free mass index is an important prognostic factor in patients with chronic heart failure
Chronic heart failure (CHF) is a major cause of morbidity and mortality, and cardiac cachexia and sarcopenia are serious complications associated with weight loss and increased catabolism. Fat-free... more
Self-administered outpatient parenteral antimicrobial therapy (S-OPAT) for infective endocarditis: A safe and effective model
The safety and efficacy of treatment of infectious endocarditis (IE) was evaluated within a program of hospital-in-home (HIH) based on self-administered outpatient parenteral antimicrobial therapy (S... more
Factor V Leiden mutation and high FVIII are associated with an increased risk of VTE in women with breast cancer during adjuvant tamoxifen — Results from a prospective, single center, case control study
Estimates of the risk ratio of tamoxifen-associated venous thromboembolism (VTE) in breast cancer patients range from 2.4 to 7.1. The occurrence of thrombosis in patients with breast cancer... more
Procalcitonin and long-term prognosis after an admission for acute heart failure
Traditionally, procalcitonin (PCT) is considered a diagnostic marker of bacterial infections. However, slightly elevated levels of PCT have also been found in patients with heart failure. In this... more
Cardiovascular profile in critically ill elderly medical patients: Prevalence, mortality and length of stay
Data are demonstrating the increase in utilization of critical care by the elderly. Around 11% of ICU patients are ≥80years-old.
Anticoagulation for the treatment of portal vein thrombosis in liver cirrhosis: A systematic review and meta-analysis of observational studies
Systematic review and meta-analysis were performed to evaluate the safety and efficacy of anticoagulation for the treatment of portal vein thrombosis (PVT) in cirrhotic patients.
Prevalence of steatosis and insulin resistance in patients with chronic hepatitis B compared with chronic hepatitis C and non-alcoholic fatty liver disease
The association of NAFLD with chronic hepatitis C (CHC) has been extensively studied but little is known about its coexistence with chronic hepatitis B (CHB).
Knowledge of the diagnostic algorithm for pulmonary embolism in primary care
Diagnostic algorithms for pulmonary embolism (PE) have been validated in patients attending hospital emergency departments. However, general practitioners (GPs) are often the professionals of first... more
The effect of fatty pancreas on serum glucose parameters in patients with nonalcoholic steatohepatitis
Fatty pancreas (FP) is related to obesity, and may have some clinical implications on glucose metabolism. The frequency and importance of FP in patients with nonalcoholic steatohepatitis (NASH) are... more
Follow-up of patients with hyperglycemia in the emergency department without a history of diabetes mellitus
The aim of this study is to determine the prevalence of hyperglycemia in emergency department patients without a history of diabetes mellitus, and to investigate whether these patients were referred... more
When should a doctor see me when I get sick? A study of the time of day acutely ill medical patients present and the time they wait to see a doctor
Reconfiguration of the Irish Health Service has diverted of large numbers of acutely ill medical patients to a reduced number of hospitals and may have caused in delays in treatment. Although prompt... more
Rate and patient features associated with recurrence of acute myocarditis
Rate and patient features associated with recurrence after acute myocarditis are largely unknown.
Developing a list of high-alert medications for patients with chronic diseases
Patients with chronic diseases often receive multiple medications and are associated with increased vulnerability to medication errors. Identifying high-alert medications for them would help to... more
Adult asthmatics increase the risk of acute coronary syndrome: A nationwide population-based cohort study
Few studies have examined the risk of acute coronary syndrome (ACS) in asthmatics. We investigate the effects of asthma on the risk of ACS development in an Asian population.
Increased risk of end-stage renal disease among hip fracture patients
Inflammation-related microvasculr disease, albuminuria, and rapid deterioration of renal function can accelerate the development of end-stage renal disease (ESRD). The role of hip fracture (HFr), a... more
Weight loss and metabolic outcomes of bariatric surgery in men versus women — A matched comparative observational cohort study
Despite the high prevalence of morbid obesity, the global frequency of bariatric surgery in men is significantly lower than in women. It is unclear if this is due to the perception of poorer outcomes... more
Low ALT blood levels predict long-term all-cause mortality among adults. A historical prospective cohort study
Increased blood levels of alanine amino transferase (ALT, also known as SGPT; serum glutamic pyruvic transaminase) serve as a marker of liver injury by various mechanisms. Less is known about the... more
Risk factors of 30-days re-hospitalization after Hospital at Home in a cohort of patients treated with parenteral therapy
Hospital at Home provides acute medical treatment in the patient's home. To prevent re-hospitalization in these outpatients, it is decisive to identify high-risk groups. This study aimed to identify... more
People with tuberculosis are associated with a subsequent risk of depression
There is some evidence that the prevalence of depression in patients with tuberculosis (TB) is higher than those in the general population. However, the incidence of depression after Mycobacterium... more
Elevated serum homocysteine is a predictor of accelerated decline in renal function and chronic kidney disease: A historical prospective study
To estimate the effect of elevated serum homocysteine level on renal function decline and on the incidence of chronic kidney disease (CKD) in the general population.
Prediction of prognosis to lamivudine in patients with spontaneous reactivation of hepatitis B virus-related acute-on-chronic liver failure: Using virologic response at week 4
Current results had demonstrated lamivudine (LAM) contributed to improve liver function and short-term prognosis in patients with hepatitis B virus-related acute-on-chronic liver failure (ACLF), but... more
Gout, allopurinol intake and clinical outcomes in the hospitalized multimorbid elderly
Increased serum uric acid has been considered a cardiovascular risk factor but no study has assessed its relation with hospital mortality or length of stay. On the basis of data obtained from a... more
A predictive rule for mortality of inpatients with bacteraemia: A classification and regression tree analysis
To create a predictive rule to identify risk factors for mortality among patients with Staphylococcus aureus bacteraemia (SAB).
Understanding adverse drug reactions in older adults through drug–drug interactions
The aims of this study are to evaluate prevalence and characteristics of adverse drug reactions (ADRs) and to evaluate the potential contribution of specific medications, therapeutic categories and... more
Should mild hypogammaglobulinemia be managed as severe hypogammaglobulinemia? A study of 389 patients with secondary hypogammaglobulinemia
Although secondary hypogammaglobulinemia is more frequent than primary hypogammaglobulinemia, its etiology and management are poorly described, particularly for mild hypogammaglobulinemia.
Ejection fraction in patients with heart failure and preserved ejection fraction is greater than in healthy controls: A meta-analysis
Ejection fraction (EF) slightly declines with age in healthy control (HC) subjects. Yet, studies of heart failure with preserved ejection fraction (HFPEF) often report EF values which are... more
End stage renal disease risk and neighbourhood deprivation: A nationwide cohort study in Sweden
Chronic kidney disease has been associated with socioeconomic disparities and neighbourhood deprivation. We aimed to determine whether there is an association between neighbourhood deprivation and... more
Clinical outcome in patients with venous thromboembolism receiving concomitant anticoagulant and antiplatelet therapy
Patients with arterial disease receiving antiplatelet agents may develop venous thromboembolism (VTE) and need anticoagulant therapy, although concomitant use of these drugs may increase bleeding... more
Impact of admission medication reconciliation performed by clinical pharmacists on medication safety
Many activities contribute to reduce drug-related problems. Among them, the medication reconciliation (MR) is used to compare the best possible medication history (BPMH) and the current admission... more
Pre-angiography total ST-segment resolution is not a reliable predictor of an open infarct-related artery
While the cutoffs of predictive value for ST-segment elevations resolution (STSR) following thrombolysis and/or primary PCI were well documented, the impact of pre-angiography STSR has not been... more
Reflections in Internal Medicine
Reducing the risk of hospital admission: A call to action from the Italian Society of Internal Medicine
The belief that hospital stays may constitute per se a risk for patients is not widespread among patients and health care professionals. In the balance between advantages and disadvantages of... more
Can and should carotid ultrasound be used in cardiovascular risk assessment?
Cardiovascular risk management is a major and challenging task for internists. Risk scores using algorithms based on traditional risk factors are helpful in identifying patients in whom intensive... more
Review Article
Acute Complex Care Model: An organizational approach for the medical care of hospitalized acute complex patients
Chronic diseases are the major cause of death (59%) and disability worldwide, representing 46% of global disease burden. According to the Future Hospital Commission of the Royal College of Physicians... more
Thyroid disorders and gastrointestinal and liver dysfunction: A state of the art review
Thyroid disorders commonly impact on the gastrointestinal system and may even present with gastrointestinal symptoms in isolation; for example, metastatic medullary thyroid carcinoma typically... more
Multidisciplinary care in patients with chronic kidney disease: A systematic review and meta-analysis
Multidisciplinary care (MDC) was widely used in multiple chronic illnesses but the effectiveness of MDC in patients with chronic kidney disease (CKD) was inconclusive. The aim of this meta-analysis... more
Effect of routine diagnostic imaging for patients with musculoskeletal disorders: A meta-analysis
The increasing use of diagnostic imaging has led to high expenditures, unnecessary invasive procedures and/or false-positive diagnoses, without certainty that the patients actually benefit from these... more
Challenges and misconceptions in the aetiology and management of atrial fibrillation-related strokes
Strokes, whether ischaemic or haemorrhagic, are the most feared complications of atrial fibrillation (AF) and its treatment. Vitamin K antagonists have been the mainstay of stroke prevention.... more
Why use long acting bronchodilators in chronic obstructive lung diseases? An extensive review on formoterol and salmeterol
Long-acting β2-adrenoceptor agonists, formoterol and salmeterol, represent a milestone in the treatments of chronic obstructive lung diseases. Although no specific indications concerning the choice... more
Muscular strength as a strong predictor of mortality: A narrative review
Muscular strength, an important component of physical fitness, has an independent role in the prevention of chronic diseases whereas muscular weakness is strongly related to functional limitations... more
Erdheim-Chester disease
Erdheim-Chester disease (ECD) is rare form of non-Langerhans cells histiocytosis with multiorgan involvement. Individuals are more frequently affected in their fifth decade and there is a slight male... more
The clinical and laboratory evaluation of the patient with erythrocytosis
Erythrocytosis is frequently encountered as an incidental abnormality on laboratory testing that reveals persistent elevation of the hematocrit level (>52% in men and >48% in women). In many... more
Heart rate and cardiovascular protection
Recent large epidemiological studies have confirmed that an elevated resting heart rate is an independent predictor of cardiovascular and overall mortality in the general population as well as in... more
Postoperative hyperkalemia
Hyperkalemia occurs frequently in hospitalized patients and is of particular concern for those who have undergone surgery, with postoperative care provided by clinicians of many disciplines. This... more
Renal denervation: A narrative review
Renal denervation (RDN) has, within recent years, been suggested as a novel treatment option for patients with resistant hypertension. This review summarizes the current knowledge on this procedure... more
Risk identification and possible countermeasures for muscle adverse effects during statin therapy
The use of statins for cardiovascular disease prevention is clearly supported by clinical evidence. However, in January 2014 the U.S. Food and Drug Administration released an advice on statin risk... more
Drug treatment of obesity: Current status and future prospects
Obesity is a growing epidemic and a major contributor to the global burden of disease. Obesity strains the healthcare systems and has profound economic and psychosocial consequences. Historically,... more
Impact on human health of climate changes
There is increasing evidence that climate is rapidly changing. These changes, which are mainly driven by the dramatic increase of greenhouse gas emissions from anthropogenic activities, have the... more
The 2014 United States NRMP data for primary care programs: A review
The paper focuses on the past five years of National Residency Match Program (NRMP) information in the Unites States with a comparison point of twenty years ago utilized because of a referenced... more
Management of non-small cell lung cancer in the elderly
Most developed countries accepted the chronological age of 70years as the definition of “elderly” and there is a general consensus in clinical practice to consider this age as the threshold in risk... more
Fat, epigenome and pancreatic diseases. Interplay and common pathways from a toxic and obesogenic environment
The worldwide obesity epidemic is paralleled by a rise in the incidence of pancreatic disorders ranging from “fatty” pancreas to pancreatitis and cancer. Body fat accumulation and pancreatic... more
Improving the quality and safety of care on the medical ward: A review and synthesis of the evidence base
Despite its place at the heart of inpatient medicine, the evidence base underpinning the effective delivery of medical ward care is highly fragmented. Clinicians familiar with the selection of... more
Cystic fibrosis — What are the prospects for a cure?
Significant improvements in the treatment of cystic fibrosis over the last few decades have altered this lethal disease in children to a multisystem disorder with survival into adult life now common... more
Implementation strategies of Systems Medicine in clinical research and home care for cardiovascular disease patients
Insights from the “-omics” science have recently emphasized the need to implement an overall strategy in medical research. Here, the development of Systems Medicine has been indicated as a potential... more
Clinical implications of the hyperdynamic syndrome in cirrhosis
The hyperdynamic syndrome is a late consequence of portal hypertension in cirrhosis. The principal hemodynamic manifestations of the hyperdynamic syndrome are high cardiac output, and increased heart... more
Special Article
Managing a research hospital at the time of a global economics crisis: Cruising between Scylla and Charybdis
Recently in this journal Riva and Cesana reported on the origin and evolution of hospitals in Europe [1]. In this frame they described the pioneering vision of the Duke of Sforza, who during his rule... more
The contradictions of homeopathy legislation
Is it possible to regulate a pharmaceutical product that does not contain any active principle? Believe it or not, it is. National laws and European Directives establish the conditions — with many... more