European Journal of Internal Medicine

February 2018

No Section

Factors reducing omalizumab response in severe asthma

3 February 2018
Author(s): B. Sposato, M. Scalese, M. Milanese, S. Masieri, C. Cavaliere, M. Latorre, N. Scichilone, A. Matucci, A. Vultaggio, A. Ricci, A. Cresti, P. Santus, A. Perrella, P.L. Paggiaro

Despite adding Omalizumab to conventional therapy, several severe asthmatics still show poor disease control. We investigated the factors that may affect a reduced Omalizumab response in a large... more

Prospective analysis of safety and efficacy of medical cannabis in large unselected population of patients with cancer

1 March 2018
Author(s): Lihi Bar-Lev Schleider, Raphael Mechoulam, Violeta Lederman, Mario Hilou, Ori Lencovsky, Oded Betzalel, Liat Shbiro, Victor Novack

Cancer is a major public health problem as the leading cause of death. Palliative treatment aimed to alleviate pain and nausea in patients with advanced disease is a cornerstone of oncology. In 2007... more

Ethical issues in medical cannabis use

1 March 2018
Author(s): Iftach Sagy, Tal Peleg-Sagy, Leonid Barski, Lior Zeller, Alan Jotkowitz

The increasing use of medical cannabis (MC) in the past decade raises several ethical considerations for the clinician. Regulatory issues stem from a gap between MC registration and certification in... more

Are there ways to improve the citations of a scientific paper?

3 February 2018
Author(s): E. Bartoli

The expansion of scientific publications makes more difficult the mining of relevant information necessary for a productive appraisal of authors' work, scientific interaction and exchange. Papers... more

Vasodilators in acute heart failure - evidence based on new studies

24 February 2018
Author(s): André M. Travessa, L. Menezes Falcão

Acute heart failure (AHF) contributes largely to the worldwide burden of heart failure (HF) and is associated with high mortality, poor prognosis and high rehospitalization rate. The pharmacologic... more

Recurrent and persistent pneumonia

2 February 2018
Author(s): Hiromichi Hara, Kazuyoshi Kuwano, Shohei Mori

A 60-year-old man presented to our department for investigation of pulmonary opacity detected by Chest Computed Tomography (CT) at medical checkup. He had no clinical symptoms. Chest CT revealed a... more

Predicting resistant etiology in hospitalized patients with blood cultures positive for Gram-negative bacilli

6 February 2018
Author(s): Marco Falcone, Giusy Tiseo, Francesco Dentali, Micaela La Regina, Emanuela Foglia, Maurizia Gambacorta, Elisabetta Garagiola, Giorgio Bonardi, Pierangelo Clerici, Fabrizio Colombo, Alessio Farcomeni, Ercole Concia, Salvatore Corrao, Mauro Campanini, Antonino Mazzone

To develop a risk-scoring tool to predict multidrug-resistant (MDR) etiology in patients with bloodstream infections (BSI) caused by Gram-negative bacilli (GNB).

Editorial

Medical cannabis: What physicians need to know?

1 March 2018
Author(s): Victor Novack

The current issue of European Journal of Internal Medicine is dedicated to the topic of cannabis derived products use in contemporary pharmacopeia. Despite hundreds of years of experience with... more

How to win space in medical journals: Bits and tips

10 February 2018
Author(s): Pier Mannuccio Mannucci

I chose to convey to the readership a few words not only on the achievements of the European Journal of Internal Medicine and the strategies implemented by me and the other editors for the disposal... more

Comprehensive geriatric assessment: Benefits and limitations

19 February 2018
Author(s): Katie Palmer, Graziano Onder

The traditional disease-oriented model of medicine focuses on the theory that organ- or system-based pathologies cause disease and, thus, treatment is focused on eliminating the underlying pathology... more

Internal Medicine Flashcard

Purple urine bag syndrome

26 February 2018
Author(s): Jean-Philippe Le Mouel, Mathurin Fumery

An 86-year-old woman, with history of metastatic pancreatic cancer, presented with asthenia, abdominal pain and weight loss. Few days after hospitalization, purple urine were observed in the... more

A young female with cyanosis and clubbing

27 February 2018
Author(s): Praveen K. Gupta, Raja J. Selvaraj

A 21 year old female, deaf-mute since birth, presented with a history of exertional dyspnea since 8 years. On auscultation, she had a single, loud second heart sound and no murmurs. Fig. 1 is a... more

Letter to the Editor

Unexpected trends in hospital standardized mortality indicate a novel cause

22 February 2018
Author(s): Rodney P. Jones

Physicians will be aware of alternating periods of management jubilation and witch-hunting relating to changes in hospital mortality, which may then result in needless clinical audit [1].

Violence against doctors: A pandemic in the making

3 February 2018
Author(s): Kanjaksha Ghosh

“No physician, however conscientious or careful can tell what day or hour he may not be the object of some undeserved attack, malicious accusation, black mail or suit for damages…”‘Assaults upon... more

The role of echocardiography as a risk-stratification tool in infective endocarditis

26 February 2018
Author(s): Lourdes Vicent, Hugo González Saldivar, Patricia Muñoz, Emilio Bouza, Manuel Martínez-Sellés

We would like to thank the interest in our paper “Prognostic implications of a negative echocardiography in patients with infective endocarditis” [1]. Our aim was to address the impact of... more

Evolution of bendopnea during admission in patients with decompensated heart failure

26 February 2018
Author(s): Ramón Baeza-Trinidad, Jose Daniel Mosquera-Lozano, Marta Gómez-Del Mazo, Irene Ariño-Pérez de Zabalza

The presence of bendopnea (lack of air that occurs during the first 30 s while bending forward) in the population with heart failure (HF), both stable (ambulatory) and decompensated (hospitalized)... more

The Internal Medicine and Assessment of Gender Differences in Europe (IMAGINE): The new European Federation of Internal Medicine initiative on sex and gender medicine

5 February 2018
Author(s): Alberto M. Marra, Ewelina Biskup, Valeria Raparelli, On behalf of The IMAGINE working group

The evidence that women and men are different is arguably as old as human life, yet basic research studies are performed exclusively in male animals and women are largely excluded from clinical... more

Impact of revascularization procedures on Doppler parameters in patients with atherosclerotic renal artery stenosis

5 February 2018
Author(s): Biagio Barbano, Antonietta Gigante, Marco Proietti, Edoardo Rosato, Rosario Cianci

Atherosclerotic renal artery stenosis (ARAS) represents 1% to 2% of all cases of secondary hypertension in the general population, rising up to 5.8%in patients ≥65 years old [1].

Artificial intelligence in internal medicine: Between science and pseudoscience

7 February 2018
Author(s): Henri-Corto Stoeklé, Philippe Charlier, Christian Hervé, Jean-François Deleuze, Guillaume Vogt

When faced with new, complex phenomena, humans frantically seek to predict their impact on the individual and society. The more complex the phenomenon, the more difficult it is to understand rapidly... more

Hospital mortality scores are unduly influenced by changes in the number of admissions

10 February 2018
Author(s): Rodney P. Jones, Rodney Jones

Any hospital doctor will point out that length of stay (LOS) is a far better indicator of patient acuity than diagnosis. So why do hospital doctors continue to be harassed over supposed changes in... more

Shortening antibiotic duration for community acquired pneumonia

14 February 2018
Author(s): Luis Melo, Susana Oliveira

For the last 20 years multi-resistant strains have changed the paradigm of in-hospital antibiotic prescription, forcing physicians to prescribe more broad-spectrum antibiotics. This selective... more

Significance of macro creatine kinase in admitted patients

15 February 2018
Author(s): Ami Schattner, Ina Dubin

High molecular mass forms have been reported for many serum enzymes measured in clinical laboratories. They are described as either type-1 (a normal enzyme complexed with an immunoglobulin by an... more

Molecular imaging should have played a role

17 February 2018
Author(s): Oscar M.P. Jolobe

In their account of the prognostic implications of negative echocardiography in infective endocarditis (IE) the authors made the observation that “molecular imaging may have provided additional... more

Lyme borreliosis and depressive symptoms in patients aged 65 years and older referred to a tertiary Lyme centre

20 February 2018
Author(s): Tizza P. Zomer, Thomas van Bemmel, Barbara van Munster, Barend van Kooten, Yolande M. Vermeeren

Little is known on Lyme borreliosis (LB) in patients aged ≥65 years. To optimize management of older patients referred to a tertiary Lyme centre, characteristics of older patients need to be assessed... more

Narrative Review

Cannabinoids and cancer pain: A new hope or a false dawn?

1 March 2018
Author(s): Matthew R.D. Brown, W. Paul Farquhar-Smith

The endocannabinoid system is involved in many areas of physiological function and homeostasis. Cannabinoid receptors are expressed in the peripheral and central nervous system and on immune cells,... more

Original Article

A proposed Oxford classification-based clinicopathological nomogram for predicting short-term renal outcomes in IgA nephropathy after acute kidney injury

3 February 2018
Author(s): Ling Zhang, Xiaodong Zhuang, Xinxue Liao

This study aimed to investigate the effect of acute kidney injury (AKI) on the progression of renal disease and to develop a clinico-pathological nomogram to predict the renal outcome of IgA... more

Geriatrician-performed comprehensive geriatric care in older adults referred to an outpatient community rehabilitation unit: A randomized controlled trial

3 February 2018
Author(s): Dmitri Zintchouk, Merete Gregersen, Torsten Lauritzen, Else Marie Damsgaard

Older adults make increasing demands on all sectors of the healthcare system. We investigated the effect of geriatrician-performed comprehensive geriatric care (CGC) in older adults referred to an... more

Epidemiological characteristics, safety and efficacy of medical cannabis in the elderly

2 February 2018
Author(s): Ran Abuhasira, Lihi Bar-Lev Schleider, Raphael Mechoulam, Victor Novack

There is a substantial growth in the use of medical cannabis in recent years and with the aging of the population, medical cannabis is increasingly used by the elderly. We aimed to assess the... more

Risk factors for the development of incident atrial fibrillation in patients with cardiac implantable electronic devices

26 February 2018
Author(s): Kazuo Miyazawa, Yusuke Kondo, Miyo Nakano, María Asunción Esteve-Pastor, José Miguel Rivera-Caravaca, Keitaro Senoo, Yoshio Kobayashi, Gregory Y.H. Lip

Cardiac implantable electronic devices (CIEDs) can detect atrial fibrillation (AF) early and accurately. Risk factors for the development of new-onset AF in patients with CIEDs remains uncertain.

Differential diagnosis of unexplained falls in dementia: Results of “Syncope & Dementia” registry

2 February 2018
Author(s): Enrico Mossello, Alice Ceccofiglio, Martina Rafanelli, Angela Riccardi, Chiara Mussi, Giuseppe Bellelli, Franco Nicosia, Mario Bo, Daniela Riccio, Anna Maria Martone, Assunta Langellotto, Elisabetta Tonon, Gabriele Noro, Pasquale Abete, Andrea Ungar

Dementia patients have an increased risk of fall, and some of them might suffer from undiagnosed syncope. The present analysis aimed at identifying predictors of differential diagnosis between... more

Prognostic implications of a negative echocardiography in patients with infective endocarditis

4 February 2018
Author(s): Lourdes Vicent, Hugo González Saldivar, Emilio Bouza, Patricia Muñoz, Gregorio Cuerpo, Aristides de Alarcón, Bárbara Vidal, Manuel Cobo, Miguel Ángel Goenaga, Fernando Carrasco-Chinchilla, Miguel Montejo, Juan Gálvez-Acebal, Carmen Hidalgo-Tenorio, David Vinuesa-García, Manuel Martínez-Sellés, GAMES investigators (Appendix 1)

Echocardiography plays an important role in infective endocarditis (IE) diagnosis according with the modified Duke criteria. We evaluated the implications of a positive echocardiography in the... more

Association of non-immediate drug hypersensitivity with drug exposure: A case control analysis of spontaneous reports from a Tunisian pharmacovigilance database

4 February 2018
Author(s): Amel Chaabane, Najeh Ben Fadhel, Zohra Chadli, Haifa Ben Romdhane, Nadia Ben Fredj, Naceur A. Boughattas, Karim Aouam

To assess delayed-type cutaneous reactions (DTCRs) related to drugs, using a case-control approach to qualify drug risks.

Impaired renal function is associated with adverse outcomes in patients with chest pain discharged from internal medicine wards

5 February 2018
Author(s): Guy Topaz, Wesal Gharra, Alon Eisen, Alon Y. Hershko, Lotan Shilo, Gil Beeri, Yona Kitay-Cohen, David Pereg

Assessment of chest pain is one of the most common reasons for hospital admissions in internal medicine wards. However, little is known regarding predictors for poor prognosis in patients discharged... more

Pleural effusions in acute decompensated heart failure: Prevalence and prognostic implications

7 February 2018
Author(s): José Luis Morales-Rull, Silvia Bielsa, Alicia Conde-Martel, Oscar Aramburu-Bodas, Pau Llàcer, Miguel Angel Quesada, Iván Suárez-Pedreira, Luis Manzano, Manuel Montero-Pérez Barquero, José M. Porcel, RICA Investigators group

The incidence of pleural effusions (PEs) in acute decompensated heart failure (ADHF) is not well established. We aimed to determine their prevalence, clinical characteristics and prognostic... more

The use of cerebral imaging for investigating delirium aetiology

7 February 2018
Author(s): Zina Hijazi, Peter Lange, Rosie Watson, Andrea B. Maier

This study aims to investigate the frequency and patterns of use of cerebral imaging in delirium and to describe pathological changes associated with delirium using computed tomography (CT) and... more

Newer glomerular filtration rate estimating equations for the full age spectrum based on serum creatinine and cystatin C in predicting mortality in patients with ischemic stroke

9 February 2018
Author(s): Tanja Hojs Fabjan, Meta Penko, Radovan Hojs

Renal dysfunction is associated with increased risk of mortality. The novel Full Age Spectrum (FAS) equations estimating the glomerular filtration rate (GFR) based on serum creatinine (FAScrea) and... more

Postoperative pneumonia among patients with and without COPD in Spain from 2001 to 2015

13 February 2018
Author(s): Javier de Miguel-Díez, Ana López-de-Andrés, Valentín Hernández-Barrera, Isabel Jiménez-Trujillo, Manuel Méndez-Bailón, José María de Miguel-Yanes, Rodrigo Jiménez-García

To describe and compare incidence, characteristics and outcomes of postoperative pneumonia among patients with or without COPD.

External validation of a decision tree early warning score using only laboratory data: A retrospective review of prospectively collected data

14 February 2018
Author(s): Tara E. Holm Atkins, Malin C. Öhman, Mikkel Brabrand

Early warning scores (EWS) have been developed to identify the degree of illness severity among acutely ill patients. One system, The Laboratory Decision Tree Early Warning Score (LDT-EWS) is wholly... more

Declining prevalence and increasing awareness of HCV infection in Italy: A population-based survey in five metropolitan areas

20 February 2018
Author(s): Angelo Andriulli, Tommaso Stroffolini, Andrea Mariano, Maria Rosa Valvano, Ignazio Grattagliano, Antonio Massimo Ippolito, Adriano Grossi, Giuseppina Brancaccio, Christian Coco, Maurizio Russello, Antonina Smedile, Elisa Petrini, Silvia Martini, Giovanni Battista Gaeta, Mario Rizzetto

In metropolitan areas in Italy, HCV is prevalent in elderly, reflecting a cohort effect determined by modalities of viral transmission no longer operative. The impact of the infection will further... more

A new standardized data collection system for interdisciplinary thyroid cancer management: Thyroid COBRA

21 February 2018
Author(s): Luca Tagliaferri, Carlo Gobitti, Giuseppe Ferdinando Colloca, Luca Boldrini, Eleonora Farina, Carlo Furlan, Fabiola Paiar, Federica Vianello, Michela Basso, Lorenzo Cerizza, Fabio Monari, Gabriele Simontacchi, Maria Antonietta Gambacorta, Jacopo Lenkowicz, Nicola Dinapoli, Vito Lanzotti, Renzo Mazzarotto, Elvio Russi, Monica Mangoni

The big data approach offers a powerful alternative to Evidence-based medicine. This approach could guide cancer management thanks to machine learning application to large-scale data. Aim of the... more

Review Article

The role of gut microbiota in Clostridium difficile infection

7 February 2018
Author(s): Michael Samarkos, Elpida Mastrogianni, Olga Kampouropoulou

Clostridium difficile infection has emerged as a major health problem. Because it is a spore-forming microorganism, C. difficile is difficult to eradicate and recurrences of the infection are... more