February 2024
30 ArticlesClinical Insights
Global burden of new-onset hypertension associated with severe acute respiratory syndrome coronavirus 2 infection
To date, over 770 million confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and approximately 6.9 million deaths related to coronavirus disease 2019 (COVID-19... more
Commentary
Non-adherence to chronic treatments: A commitment for Internal Medicine specialists
Adherence to treatment poses two challenges. First, identifying patients who are non-compliant to treatments. Secondly, improving adherence. The issue of adherence has been addressed in this issue of... more
Will the manipulation of the gut microbiota be effective for the treatment of metabolic diseases?
The gut microbiota is a complex ecosystem of microorganisms, including bacteria, viruses, fungi and other microbes, that colonize our gastrointestinal tract. These microorganisms play a fundamental... more
Confused at a higher level, once more? Implications of asymptomatic vs. symptomatic, and clinical vs. subclinial atrial fibrillation
About 20 years ago, the definition of atrial fibrillation (AF) seemed to be a very straight forward one: An irregularly irregular heart rhythm, with no discernible P-waves and, ideally, detectable... more
Oral anticoagulants in patients with atrial fibrillation and end-stage renal disease: Walking the tightrope between thromboembolic and bleeding risk
Atrial fibrillation (AF) and chronic kidney disease (CKD) have a complex relationship, with each condition reciprocally influencing the other [1–3]. The strong, independent, and graded relationship... more
Internal Medicine Flashcard
Persistent rash associated with multiple pulmonary nodules
A male individual aged 39 hailing from a remote island in Japan was directed to the general hospital due to a chest skin rash that persisted for 6 months. The patient denied experiencing any fever or... more
Severe hand deformities in an undertreated condition
A 79-year-old man presented to the clinic with pain, severe deformities and functional impotence in his hands and feet (Fig. 1A and B). At the age of 59 he had a first episode of knee arthritis,... more
Letter to the Editor
Serological biomarkers at hospital admission and hospitalization treatments are not related to the development of post-COVID dyspnea
Dear Editor
Congenital anomalies of inferior vena cava
We present a descriptive, single-centre study of congenital anomalies of the inferior vena cava (IVC) detected over 46 months, from September 2019 to July 2023 (double IVC, left-sided IVC,... more
Extra respiratory comorbidities in adult patients with cystic fibrosis
Dear Editor,
No evidence of a “July Effect” on mortality
There exists an apocryphal adage to avoid going to hospital in July (or August in the UK), attributing a temporal increase in risk due to inexperienced house staff [1]. This phenomenon has been... more
Clinical characteristics of left ventricular thrombus and the use of anticoagulants in patients with dilated cardiomyopathy and sinus rhythm
Dear Editor,
Late administration of glucarpidase in methotrexate intoxication: Do we have more time than we thought?
Methotrexate (MTX) is a drug interfering with the metabolism of folic acid suitable, at different dosages, for treating neoplastic and rheumatic diseases. It is characterized by a narrow therapeutic... more
Medical specialties in Europe: The less the better?
Dear Editor,
Effects of moderate caffeine intake in athletes
Caffeine intake increases the risk of premature atrial contractions (PACs) and premature ventricular contractions (PVCs) because of its sympathomimetic effects via dopamine and norepinephrine [1–3].... more
Non-invasive high-frequency oscillatory ventilation for carbon dioxide clearance in a hypercapnic lung model of chronic obstructive pulmonary disease and healthy subjects
Dear editor,
CHEDDAR score versus YEARS algorithm for suspected pulmonary embolism in SARS-CoV-2-infected patients: A comparison of two strategies
Patients with clinically suspected pulmonary embolism (PE) should be managed according to standardized flowcharts. These flowcharts include validated algorithms to determine pretest probability, d-... more
Original Article
Asymptomatic vs. symptomatic atrial fibrillation: Clinical outcomes in heart failure patients
Atrial fibrillation (AF) is the most common arrhythmia worldwide, afflicting patients’ prognosis and symptoms. The European Heart Rhythm Association (EHRA) proposed the EHRA score for grading the... more
New genetic drivers in hemorrhagic hereditary telangiectasia
Hereditary hemorrhagic telangiectasia (HHT) or Rendu–Osler–Weber syndrome (ORPHA:774) is a rare autosomal dominant vascular disease characterized by the presence of telangiectases and larger vascular... more
Abatacept in usual and in non-specific interstitial pneumonia associated with rheumatoid arthritis
Interstitial lung disease (ILD) is a severe and frequent extraarticular manifestation of rheumatoid arthritis (RA). A higher mortality rate in patients with RA-ILD in comparison with those without... more
Efficacy and safety of direct oral anticoagulants vs vitamin K antagonists in patients with atrial fibrillation and end-stage renal disease on hemodialysis: A systematic review and meta-analysis
The prevalence of atrial fibrillation (AF) in individuals with end stage renal disease (ESRD) who are on chronic hemodialysis is increasing, exceeding that of the general population and resulting in... more
Renin‐angiotensin-aldosterone system inhibitors and mortality risk in elderly patients with atrial fibrillation. Insights from the nationwide START registry
The estimated prevalence of atrial fibrillation (AF) in the general population is about 1–4% and rises according to aging [1]. Cardiovascular comorbidities are utmost prevalent in patients with AF,... more
Novel potassium binders to optimize RAASi therapy in heart failure: A systematic review and meta-analysis
Heart failure (HF) is a major cause of cardiovascular (CV) mortality and morbidity, resulting in more than one million hospitalizations per year. In patients affected by HF with reduced ejection... more
Infarct severity and outcomes in ST-elevation myocardial infarction patients without standard modifiable risk factors – A multicenter cardiac magnetic resonance study
Ischemic heart disease remains a leading contributor to the burden of cardiovascular disease with 1.8 million annual deaths in Europe [1]. The annual incidence of hospital admissions for acute... more
Value of inflammatory response and oxidative damage in the diagnosis of infections in severe alcoholic hepatitis
Alcohol is one of the most consumed substances in the world. Among the organic lesions produced by alcohol consumption, liver disease has been the most studied and documented. Alcohol use disorder is... more
Impact of antimicrobial stewardship in organisms causing nosocomial infection among COVID-19 critically ill adults
Since the firsts reports of a novel viral respiratory illness emerged in December 2019 in Hubei province, China [1], the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has infected... more
Immunosuppressive therapy and oral anticoagulation in kidney transplant recipients: Direct oral anticoagulants versus vitamin-k antagonists
Kidney transplant recipients (KRTs), have an increased risk of atrial fibrillation that has an incidence of about 7% in the first 3 years after transplantation 1. Moreover, the risk of thromboembolic... more
Review Article
From non-adherence to adherence: Can innovative solutions resolve a longstanding problem?
“Non-adherence is a rare deviation of poorly educated patients who do not take their diseases seriously enough”. “Non-adherence is entirely a patient's fault”. “Non-adherence is not a responsibility... more
Gut microbes in metabolic disturbances. Promising role for therapeutic manipulations?
A complex polymicrobial ecology exists in the human gut at the interface of internal and external environment [1]. These microbes grow within the mucin layer, as an essential component of the gut... more
The role of adherence in patients with chronic diseases
In the long-term management of chronic diseases, adherence and persistence to prescribed medications are continuous challenges in order to obtain all the potential benefits of drug therapies.... more