December 2023
30 ArticlesClinical Insights
Newer COVID-19 vaccines: Still lights and shadows?
Coronavirus Disease 2019 (COVID-19) vaccines are continuing to protect people from death, hospitalization, and severe clinical manifestations caused by severe acute respiratory syndrome coronavirus 2... more
Commentary
Geographical and ethnoracial differences in venous thromboembolism and anticoagulation: An expanding horizon
Venous thromboembolism (VTE) carries a long-term risk of recurrence. Anticoagulation is administered with the aim of both treating the index VTE (initial management [first 5-21 days of diagnosis] and... more
What changed after the 2022 guidelines for pulmonary hypertension?
The 2022 European Society of Cardiology (ESC)/European Respiratory Society (ERS) Pulmonary Hypertension (PH) Guidelines have been reviewed by Mona Lichtblau et al., and the most important changes... more
Why the grass isn't always greener on the machine learning side
In their article on predicting mortality in pulmonary embolism (PE) patients, El-Bouri and colleagues developed a prediction model to improve upon two existing pulmonary embolism scores, sPESI and... more
The fatty liver as testimonial of systemic diseases. Further evidence from rheumatoid arthritis and confirmation for a leading role of internal medicine
Fat over-storage in the liver, in particular non-alcoholic fatty liver disease (NAFLD), has become the most frequent chronic liver disease worldwide [1]. At a global level, steatotic liver disease... more
Internal Medicine Flashcard
Sudden onset of left hemiplegia
A 65-year-old male presented with sudden onset of left hemiplegia for four hours, he was confused, blood pressure 158/109 mmHg, slightly delayed response, dysarthria, the muscle strength was 4/5 in... more
Respiratory failure following upper gastrointestinal endoscopy: A rare and unanticipated outcome to look out for
A 67-year-old male patient was admitted to the Emergency Department with a one-week history of hematemesis and melaena. He was known to have liver cirrhosis secondary to alcoholic liver disease. Upon... more
Letter to the Editor
Cost-effectiveness analysis of ritonavir boosted nirmatrelvir for adult outpatients with mild to moderate COVID-19 in a European health system
After the coronavirus disease 2019 (COVID-19) emergency, there has been a search for antiviral drugs able to cure or ameliorate COVID-19 symptoms. In hospitalized patients requiring respiratory... more
Causes of death in nursing home residents during the pandemic
Worldwide there are no official statistics on mortality in nursing homes (NH) during the pandemic. In 2020, deaths among NH residents in Europe accounted for 37–66 % of all COVID-19-related deaths [1... more
Chronic liver disease-related mortality during the COVID-19 pandemic
Chronic liver disease (CLD) is a major global health concern, accounting for approximately 2 million deaths annually worldwide [1]. Despite the advances in managing CLD over the past decade, CLD-... more
Interleukin-6 inhibition for the treatment of IgG4 related vasculitis
Dear Editor
Comparison of cardiovascular risk in co-existent primary aldosteronism and obstructive sleep apnea with neither or either alone in hypertension
Dear Editor,
Performance of multi-biomarker panels based on urinary N-terminal osteopontin for prediction of diabetic kidney disease in patients with diabetes mellitus
Diabetic kidney disease (DKD), defined as chronic kidney disease (CKD) attributed to diabetes mellitus (DM), is the leading cause of end-stage renal disease (ESRD) and is associated with increased... more
Extreme anemia (hemoglobin < 5 G/DL) at the emergency department
Dear Editor,
Exploring sarcoidosis systemic treatment: Patient factors and therapeutic strategies
Dear Editor,
Long-term efficacy and safety of secukinumab in patients with psoriatic arthritis
Psoriatic arthritis (PsA) is a chronic inflammatory autoimmune disease that can adversely affect functional capabilities, if left untreated, leading to irreparable damage to joint spaces [1].... more
Dosing of iodixanol for predicting acute kidney injury in patients undergoing elective percutaneous coronary intervention
A dose of iodinated contrast over the maximum allowable contrast dose (MACD) of 300 mL has been considered as a major factor leading to acute kidney injury (AKI) [1]. However, we found that the... more
Original Article
Anticoagulation strategies and long-term recurrence in patients with venous thromboembolism in the era of direct oral anticoagulants
Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is a major health problem all over the world [1]. VTE has a long-term risk of recurrence, and the... more
Haemoglobin levels as a predictor for the occurrence of future cardiovascular events in adults–Sex-dependent results from the EPIC trial
Anemia, defined by the World Health Organization (WHO) as hemoglobin (HGB) levels
Elevated levels of IL-6 in IgA nephropathy patients are induced by an epigenetically driven mechanism modulated by viral and bacterial RNA
Immunoglobulin A nephropathy (IgAN), also known as Berger's disease, is the most frequent primary glomerulonephritis characterized by the presence of IgA immune complexes in the glomeruli [1]. It... more
Clinical features and immune mechanisms directly linked to the altered liver function in patients with rheumatoid arthritis
Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that mainly affects the synovial membrane, cartilage, and bone tissue, and is associated with progressive disability, systemic... more
Performance of admission pathways within acute medicine services: Analysis from the Society for Acute Medicine Benchmarking Audit 2022 and comparison with performance 2019 - 2021
Healthcare services are under huge strain, with rising Emergency Department (ED) attendances, increased waiting times for ED assessment and increasing pressures within inpatient services in acute... more
Relationships between education and non-alcoholic fatty liver disease
Affecting up to 30% of the adult population in western countries, non-alcoholic fatty liver disease (NAFLD) is a worldwide public health problem [1,2]. Because 5% of individuals with NAFLD suffer... more
Short-term prognosis of changes in plasma potassium following an episode of hyperkalaemia in patients with chronic heart failure
Chronic heart failure (HF) is an increasing problem in public healthcare and is associated with considerable morbidity and mortality [1]. HF affects approximately 23 million people worldwide,... more
Non-eligibility for pivotal HFpEF/HFmrEF outcome trials and mortality in a contemporary heart failure cohort
Heart failure with preserved (HFpEF) and mildly reduced ejection fraction (HFmrEF) account for more than half of all heart failure decompensations [1]. Patients are exposed to a high risk of... more
Predicting acute and long-term mortality in a cohort of pulmonary embolism patients using machine learning
Venous thromboembolism (VTE), including both pulmonary embolism (PE) and deep vein thrombosis (DVT), is a severe condition that causes significant mortality and morbidity in the acute phase, with a... more
Review Article
Atrial cardiomyopathy: An entity of emerging interest in the clinical setting
Since 1995, the concept of atrial cardiomyopathy (ACM) has been associated with myocardial fibrosis. Despite a consensus document in 2016, ACM's definition primarily relies on histopathological... more
A novel risk factor for malignancy: Albuminuria
Cancer is a global health concern with 23.6 million new cases globally in 2019, a 26.2 % increase from 2010 [1]. It is the second leading cause of death in adults after cardiovascular diseases,... more
What changed after the 2022 guidelines for pulmonary hypertension?
With an estimated prevalence of around 1%, pulmonary hypertension (PH) presents a relevant burden worldwide. The revised European Society of Cardiology (ESC) /European Respiratory Society (ERS)... more
Cannabidiol's impact on drug-metabolization
Cannabis and cannabis-derived substances are worldwide the most frequently consumed psychopharmaceuticals [1]. Over the past decade, attitudes toward the recreational and medicinal use of cannabis... more