August 2024
28 ArticlesClinical Insights
Recommendations for an Interdisciplinary Patient Review for patients with multiple long-term conditions in the hospital
An estimated 32 % of the European population live with multiple long-term conditions (MLTC), defined as two or more chronic conditions [1]. Patients with MLTC require integrated, tailored care, which... more
Commentary
Blood pressure control in the hypertensive population. Factors involved and perspectives
This issue of the European Journal of Internal Medicine includes a paper by Coca and collaborators [1] which focuses on a problem of crucial importance for public health. That is, the persistent... more
Statins to prevent anthracycline-related myocardial toxicity: The jury is still out
Anthracyclines are cytostatic antibiotics [1] that have been used since the 1970s. These anticancer agents still represent the backbone of many chemotherapy-based strategies with a curative intent in... more
Internal Medicine Flashcard
Black fingernails
A 60-year-old man presented with a 2-weeks history of darkening and tenderness of fingernails. He was diagnosed with local advanced squamous cell lung cancer and initiated neoadjuvant chemotherapy (... more
A man with fever, headache, and ulcers
A 25-year-old male attended our department because of a 2-week history of malaise, severe headache, myalgia, and low-grade to spiking fevers. He had no medical history, was not taking any medications... more
Letter to the Editor
Environmental costs of noninvasive cardiac testing for acute chest pain after ED discharge
Acute chest pain (ACP) accounts for more than 7 million Emergency Department (ED) visits each year in the US [1]. Patient management initially relies on the estimated risk of short term... more
Prevalence and outcome of occult giant cell arteritis
Giant cell arteritis (GCA) is a large vessel vasculitis that preferentially affects the cranial arteries and the aorta and its proximal branches [1]. Presenting features of GCA may include symptoms... more
Use of direct oral anticoagulants in patients with left ventricular thrombus
Left ventricular thrombus (LVT), one of the most feared and common complications of acute myocardial infarction (AMI), still causes morbidity and mortality in a proportion of patients despite the... more
Short-term trends in gastric cancer incidence after insurance coverage expansion for Helicobacter pylori eradication in Japan
Helicobacter pylori (H. pylori) infection is a risk factor for gastric cancer (GC). The International Agency for Research on Cancer has recommended population-based screening and eradication of H.... more
Synergistic effect of spironolactone/ARB on cardiovascular endpoints in heart failure patients with preserved ejection
Currently, treatment options for HFpEF are limited. Several randomized controlled trials of RAAS inhibitors for HFpEF, including perindopril, candesartan, irbesartan, and spironolactone, have yielded... more
Effect of direct oral anticoagulants in patients with cerebral venous thrombosis
Cerebral venous thrombosis (CVT) is a rare clotting disorder that mainly affects younger females. In order to achieve recanalization of cerebral veins and reduce the risk of venous thromboembolism (... more
‘Impact of Haemophilus spp. as a sexually transmitted disease’
Despite the increasing prevalence of Haemophilus spp. isolates in urethral exudates in our health area, a city with more than 160,000 inhabitants in the south of Madrid, there are still uncertainties... more
The clinical spectrum of thymoma-associated immunodeficiency: Good syndrome and beyond
Good syndrome (GS) is an acquired adult-onset combined immunodeficiency typically characterized by thymoma and hypogammaglobulinemia. Other clinical manifestations include recurrent infections,... more
Interaction between age and efficacy of dual antiplatelet therapy in non-cardioembolic minor acute ischemic stroke or high-risk transient ischemic attack
Short-term (21–90 days) dual antiplatelet therapy (DAPT) with aspirin plus clopidogrel is recommended for patients with minor non-cardioembolic ischemic stroke [National Institutes of Health Stroke... more
Infective endocarditis complicated with heart failure
Infective Endocarditis (IE) is a clinical entity with high morbidity and mortality despite advances in diagnosis and medical and surgical treatment alternatives. Globally, the prevalence is estimated... more
Original Article
Incidence and predisposing factors of extra-articular manifestations in contemporary rheumatoid arthritis
Rheumatoid arthritis (RA) is the most prevalent of the chronic inflammatory joint diseases, with gradual destruction of joints and an increased risk of co-morbidity, predominantly cardiovascular... more
Consecutive or selectively included high bleeding risk patients in the MASTER DAPT screening log and trial
Screening logs have the potential to appraise the actual prevalence and distribution of predefined patient subsets, avoiding selection biases, which are inevitably and potentially present in... more
Iron deficiency and all-cause mortality after myocardial infarction
Iron is an essential element required for normal mitochondrial function [1,2] oxygen transport, synthesis of proteins and nucleic acids, and normal immune system function. Although iron is... more
Serum IL-6 level trajectory for predicting the effectiveness and safety of tocilizumab in the treatment of refractory Takayasu arteritis
Takayasu arteritis (TAK) is a chronic systemic granulomatous vasculitis that mainly affects aorta and its major branches in young women [1]. The inflammatory damage of arteries can develop... more
Cardio-protective effects of statins in patients undergoing anthracycline-based chemotherapy: An updated meta-analysis of randomized controlled trials
Cancer and cardiovascular disease are two leading causes of mortality worldwide, and cancer survivors have an increased cardiovascular risk due to shared risk factors with cardiovascular disease and... more
Prognostic value of 18 FDG-PET at diagnosis and follow-up in giant cell arteritis: An observational restrospective study
To evaluate the ability of 18FDG PET/CT, at diagnosis of giant cell arteritis (GCA) and during follow-up, to predict occurrence of relapse in large-vessel GCA (LV-GCA).
Prognostic impact of hypertension grading
Notwithstanding the continuous relation between blood pressure (BP) and the risk of cardiovascular disease [1,2], Guidelines generally grade hypertension in untreated subjects by arbitrary categories... more
Prognostic value of cognitive impairment, assessed by the Clock Drawing Test, in emergency department patients presenting with non-specific complaints
Cognitive impairment (CI) is common among older patients presenting to the emergency department (ED) [1–6]. Up to 40% of older ED patients have some degree of CI at presentation, particularly due to... more
Relation of plasma neuropeptide-Y with myocardial function and infarct severity in acute ST-elevation myocardial infarction
Acute myocardial infarction is associated with high levels of cardiac sympathetic stimulation [1], which is strongly related to poor outcome [2]. Prolongation of this sympathetic drive leads to the... more
The interplay between subclinical hypothyroidism and poor sleep quality: A systematic review
Sleep and the hypothalamic-pituitary-thyroid (HPT) axis show a mutual interdependence in normal physiological functioning [1]. While the interconnection between overt hypo- and hyperthyroidism and... more
Practice Guidelines
2024 European Society of Hypertension clinical practice guidelines for the management of arterial hypertension
The European Society of Hypertension (ESH) reported in 2023 its current Guidelines for the management of arterial hypertension [1]. Following their aim to summarize the best available evidence for... more
Review Article
What should I eat today? Evidence, guidelines, dietary patterns and consumer's behavior
The modern science of nutrition, starting from its origins more than one century and a half ago, initially has been strictly confined to the concepts of dietary requirements. These included energy... more
Single-pill combination for treatment of hypertension: Just a matter of practicality or is there a real clinical benefit?
Cardiovascular disease (CVD) represents the leading cause of morbidity and mortality worldwide resulting in approximately one third of all deaths globally [1,2]. Despite significant advances in... more