July 2019
25 ArticlesNo Section
Cytopenia induced by low-dose methotrexate: An analysis of 433 cases from the French pharmacovigilance database
Up to 5% of individuals exposed to low-dose methotrexate (MTX) (i.e., ≤30 mg/week) may develop cytopenia. However, MTX-induced cytopenia have been poorly described.
Commentary
Role of ultrasound in the diagnosis of tuberculosis
Tuberculosis (TB) is one of the most important infectious diseases affecting a sobering 10 million people worldwide per year and causing 1.6 million deaths annually [1]. The large majority of cases... more
Editorial
Screening for atrial fibrillation: Need for an integrated, structured approach
Atrial fibrillation (AF) is a very common disease, particularly in the elderly, and the number of affected patients has been predicted to increase in the next decades [1,2]. The existence of a link... more
North America anticoagulation forum guidance on reversal of direct oral anticoagulants
The direct oral anticoagulants (DOACs) (apixaban, rivaroxaban, betrixaban, edoxaban and dabigatran) have gradually replaced vitamin K antagonists (VKAs) as the mainstay anticoagulation therapy.... more
Continued evolution of hospital medicine
On August 15, 1996 in the New England Journal of Medicine, R.M. Wachter and L. Goldman anticipated the rapid growth of a new group of physicians and coined the term “hospitalist”. These inpatient... more
Internal Medicine Flashcard
A young man with orange hands
A 26-year-old Caucasian man with previous history of medullary sponge kidney (also known as Cacchi-Ricci disease) presented to the outpatient clinic for routine follow-up. While his kidney disease... more
Unusual bleeding
A 15-year-old woman presented to the department for recurrent otorrhagia (panel A), bleeding from the nipples, bleeding from the forehead (panel B), bleeding from the navel (panel C) and epistaxis (... more
Pigmentation on the oral mucosa, hands, and feet
A 56-year-old female presented to the dermatology clinic with pigmentation on the lips, gums and tongue for 5 years. The amout and range of lesions gradually increased. The patient denied having... more
Elderly patient of Crohn's disease with dementia and edematous red plaques on dorsum of hands
An elderly man sought dermatology consultation for gradually progressive, mildly itchy, photosensitive rash on dorsum of hands for a month. Apart from the skin lesions, he also complained of... more
Letter to the Editor
Lung ultrasonography in pulmonary tuberculosis: Integrating chest radiology?
We read with interest the article by Montuori et al. evaluating the role of lung ultrasonography (LUS) in pulmonary tuberculosis (PTB). Authors conclude that “chest ultrasonography may be a promising... more
Is serum neutrophil gelatinase-associated lipocalin a useful marker in acute pancreatitis?
Acute pancreatitis (AP) is the reversible inflammation of pancreas. Annually from 4.9 to 35 cases per 100,000 of AP is reported. About one-fourth of patients with AP, develop severe acute... more
Is it possible to quickly identify acutely unwell patients who can be safely managed as outpatients? The need for a “Universal Safe to Discharge Score”
If scores or algorithms were developed that quickly identified patients who are bound to have 100% survival, if even only for a few days, more patients could be safely discharged from emergency... more
HIV-Tuberculosis co-infection: A growing public health issue and the need for guidelines development
Tuberculosis (TB) is the main cause of death amongst human immunodeficiency virus (HIV)-infected individuals worldwide, while 14 million people are estimated to be dually infected [1]. In Europe only... more
Predictors of mortality of bloodstream infections among internal medicine patients: Mind the complexity of the septic population!
We read with great interest the article by Papadimitriou-Olivgeris and colleagues [1] aiming to evaluate the predictors of mortality among internal medicine patients with bloodstream infections (BSIs... more
Looking for safety but overlooking efficacy: Non-inferiority trials of anti-diabetics
Testing new interventions against placebo when effective treatments are already available is considered unethical [1] and dangerous for patients [2], so testing non-inferiority which aims at... more
Infective endocarditis in patients with cardiac implantable electronic devices: Impact of comorbidities on outcome
We read with interest the paper by Armiñanzasa et al., recently published in the European Journal of Internal Medicine [1]. The authors provided an important analysis of a large, prospectively... more
Original Article
Occurrence of atrial fibrillation in pacemaker patients and its association with sleep apnea and heart rate variability
Sleep apnea (SA) is a risk factor for atrial fibrillation (AF) occurrence. Sympathovagal imbalance is a mechanism that predisposes to the development of AF and that occurs in SA. Some pacemakers can... more
Acute heart failure and adverse events associated with the presence of renal dysfunction and hyperkalaemia. EAHFE- renal dysfunction and hyperkalaemia
To study the outcomes of patients with acute heart failure (AHF) presenting renal dysfunction (RD) or hyperkalaemia (Hk) alone or in combination.
Long term prognosis of acute pulmonary embolism
Acute pulmonary embolism (PE) can be fatal if left untreated. Long-term prognosis of acute PE in the 21st century has not been fully reported. We aimed to determine the long-term prognosis of... more
Prevalence of atrial fibrillation and stroke risk assessment based on telemedicine screening tools in a primary healthcare setting
Worldwide atrial fibrillation (AF) prevalence varies between 0.1% and 4.0%, and has been increasing. Little is known about the prevalence of AF in Brazil. Our objective was to estimate the prevalence... more
Associations between early handoffs, length of stay and complications in internal medicine wards: A retrospective study
In US healthcare system, handoffs are associated with an increase in medical error and in hospital length of stay. In non-US healthcare systems, this phenomenon has not been well studied. We studied... more
The cost-effectiveness of omega-3 polyunsaturated fatty acids – The Australian healthcare perspective
To examine the cost-effectiveness of a triglyceride lowering medication–icosapent ethyl added on to statin from Australian healthcare system perspective.
Rituximab-induced serum sickness is more frequent in autoimmune diseases as compared to hematological malignancies: A French nationwide study
Rituximab induced serum sickness (RISS) is a rare delayed hypersensitivity reaction. The aim of this study was to describe the epidemiological and clinical characteristics of the RISS cases reported... more
Review Article
Cardiac amyloidosis: An underdiagnosed/underappreciated disease
Cardiac amyloidosis or amyloid cardiomyopathy (ACM), commonly resulting from extracellular deposition of amyloid fibrils consisted of misfolded immunoglobulin light chain (AL) or transthyretin (TTR)... more
Blood eosinophils as biomarkers of therapeutic response to chronic obstructive pulmonary disease: Still work in progress
Disease phenotyping is a key step towards an increasingly personalized approach to chronic obstructive pulmonary disease (COPD), leading to a more precise assessment, treatment and definition of... more