European Journal of Internal Medicine
Peer review in medical journals: Beyond quality of reports towards transparency and public scrutiny of the process
Published medical research influences health care providers and policy makers, guides patient management, and is based on the peer review process. Peer review should prevent publication of unreliable... more
Frailty is a geriatric condition characterized by increased vulnerability, resulting from aging-associated declines in reserves and function across multiple physiologic systems, such that the ability... more
Internal Medicine Flashcard
A 60-year-old-woman presented to the emergency department with a six-hour history of severe left pectoral chest pain radiating to left shoulder associated with shortness of breath. She noted that... more
A 49-year-old man, who works as a farmer in rural Colombia, consulted in the emergency department with a clinical picture of 5months history of frontal and occipital headache, associated with... more
Letter to the Editor
We read the article published by Sansanayudh et al. with great interest . The authors report the association between mean platelet volume (MPV) and cardiovascular risk factors. This is a cross-... more
An abnormal peak of mortality attributed to an unusually persisting heat wave (HW) has been recorded throughout Italy by the National Institute of Statistics (ISTAT) during the summer of 2015 .
I read with great interest the paper by Hsu et al. , a study in patients with gout showing increased risk of organic and psychogenic erectile dysfunction (ED) by using large samples. The authors... more
We recently read with interest the correspondences between Hampson and Weaver  and Kao . In particular, Kao has mentioned several advantages of using the National Health Insurance (NHI) data in... more
We much appreciate these comments . Based on the recommendation, we did the new analyses of medical treatment on gout. Comparing them to the gouty patients without using anti-gout drugs, the... more
Rome has been always a centre of civilization and art, since the antiquity.
We very appreciate these valuable comments for the National Health Insurance Research Database (NHIRD) in Taiwan [1,2]: The NHIRD covers a highly representative sample of Taiwan's general population... more
Is ACE–inhibitors cough a difficult diagnosis? 1100 general practitioners replies from four countries
Angiotensin-converting enzyme inhibitors (ACEI) are widely used in the management of hypertension, heart failure, myocardial infarction, renal failure, and kidney diseases. ACEI produced a 10%... more
A previous epidemiological study reported that males have higher prevalence rates of a diagnosis and severity of obstructive sleep apnea syndrome (OSAS) than females, with a ratio of 2:1 to 3:1 .... more
The influence of the stroke suffered by Leonardo on his last paintings. A pioneer of psychoanalysis?
Leonardo da Vinci (Vinci 1452–Amboise 1519) represents the ideal man of the Italian Renaissance .
Since the times of Roman Empire knowledge sharply increased when the communication among human beings has been accelerated; thus, the inventors of roots and bridges paved the way for more rapid... more
A strong need for improving the education of physicians on glucocorticoid replacement treatment in adrenal insufficiency: An interdisciplinary and multicentre evaluation
Adrenal insufficiency (AI) is a rare disease with an estimated prevalence of less than 300 per million . AI can either be the result of destruction of the adrenal glands (primary AI), or of... more
In the western and eastern civilization, rudimental hospitals were built since the antiquity . There has been always a close relationship between religion and medicine. In Greece, sick people... more
Letters to the Editor
Unfortunately throughout history there have been wide variations in the way death has been handled by the medical profession in different times and places, and even today within the same hospital... more
Risk stratification using D-dimers in patients presenting to the emergency department with nonspecific complaints
Patients with nonspecific complaints (NSC) such as generalized weakness present frequently to acute care settings. These patients are at risk of adverse health outcomes. The aim of our study was to... more
Mutation detection rates associated with specific selection criteria for BRCA1/2 testing in 1854 high-risk families: A monocentric Italian study
BRCA mutation screening is frequently offered on the basis of the fulfillment of empirical selection criteria, thought to be indicative of a genetic predisposition to breast/ovarian cancer (BrCa/OvCa... more
Fever emerged to be common as part of the FD clinical spectrum and it significantly contributed to the diagnostic delay encountered with this rare disease. Furthermore, our retrospective analysis... more
Levothyroxine treatment restored the decreased circulating fibroblast growth factor 21 levels in patients with hypothyroidism
Fibroblast growth factor 21 (FGF21) is an important endogenous regulator of energy metabolism. Thyroid hormone has been shown to regulate hepatic FGF21 expression in rodents. The goal of this study... more
Polymorphic variants of the HSD11B1 gene may be involved in adverse metabolic effects of glucocorticoid replacement therapy in Addison's disease
Increased frequency of glucose intolerance, dyslipidaemia, and obesity has been reported in subjects treated for adrenocortical failure (Addison's disease, AD). Glucocorticoid substitution is... more
Autoimmune gastritis may be associated with other organ-specific autoimmune disorders, but the prevalence of this association is not entirely quantified. The aims of this study were to investigate... more
Comparing the contributions of smoking and obesity to the risk of myocardial infarction (MI) can help prioritize behavioral modifications. The objective of this study was to determine the relative... more
Handgrip strength is inversely and independently associated with multimorbidity among older women: Results from the KORA-Age study
Data on the association between handgrip strength and multimorbidity (MMB) are missing.
Relationships of iron metabolism with insulin resistance and glucose levels in young and healthy adults
Several biomarkers within the iron metabolism pathway have been related to the occurrence of diabetes mellitus, but underlying mechanisms are unknown. The aim of our study was to investigate the... more
Comparison of low-normal and high-normal IGF-1 target levels during growth hormone replacement therapy: A randomized clinical trial in adult growth hormone deficiency
Current guidelines state that the goals of growth hormone (GH) therapy in adults should be an appropriate clinical response, avoidance of side effects, and an IGF-1 value within the age-adjusted... more
Short-term amiodarone treatment for atrial fibrillation after catheter ablation induces a transient thyroid dysfunction: Results from the placebo-controlled, randomized AMIO-CAT trial
Amiodarone is known to affect the thyroid, but little is known about thyroid recovery after short-term amiodarone treatment.
Randomized clinical trial comparing ten day concomitant and sequential therapies for Helicobacter pylori eradication in a high clarithromycin resistance area
Currently only a few studies compare sequential and concomitant non-bismuth Helicobacter pylori therapies referring to high antibiotic resistance populations.
Impact of long-term gastric acid suppression on spontaneous bacterial peritonitis in patients with advanced decompensated liver cirrhosis
Recent studies have presented conflicting results on the association between gastric acid suppression and spontaneous bacterial peritonitis (SBP). The long-term effects of gastric acid suppression on... more
Obesity is an independent risk factor for developing flu-related complications.
For many years pregnancy has been contraindicated in patients with SLE, particularly when kidney involvement was present. Today, pregnancy is no longer considered impossible in women with lupus. Yet... more
Obesity is a chronic disease that is increasingly prevalent around the world and is a well-recognized risk factor for type 2 diabetes and hypertension, leading causes of end-stage renal disease (ESRD... more