July 2016
30 ArticlesInternal Medicine Flashcard
Syncope with transient diffuse T-wave inversions
A 64year old African-American male with a history of hypertension and tobacco abuse presented after collapsing at home. The patient was watching television but then lost consciousness and was woken... more
Letter to the Editor
Are we really tackling the "evidence-based medicine issue" in Alzheimer's disease?
Age-related medical conditions are increasingly becoming a research priority given the relevant burden for healthcare systems and the projected demographic changes occurring in our societies.... more
Broadband access, housing and car ownership as deprivation predictors of the emergency medical admission
The rate at which emergency medical conditions present is dependent on social deprivation; an eightfold difference in the annual incidence rate from 5/1000 to 40/1000 may occur [1]. The explanation... more
Experience pays off! Endocrine centres are essential in the care of patients with adrenal insufficiency
Patients with adrenal insufficiency (AI) require continuous glucocorticoid (GC) replacement treatment to restore well-being and to prevent life-threatening complications. Knowledge of symptoms of... more
Homocysteine in nonalcoholic steatohepatitis: A reply
We read with interest the letter-to-the-Editor of Leach et al. [1], commenting on our [2–4] and their [5] previous works and considerations. We hereby highlight some considerations raised by Leach et... more
“The sins of the fathers will be visited upon the children”: Congenital syphilis and leg braces pictorial depiction in eighteenth century Britain
Treponema pallidum pallidum, the agent of venereal syphilis, is transmitted by sexual contact and can be spread across the placental barrier. The congenital form can occur at any stage of maternal... more
Ethical limits to biomedical publications?
Out of the political implications of the recent editorial signed by editors (not scholars!) in the Lancet about the Israelo-Palestinian conflict, one may ask if some ethical limits exist to... more
The secret of the questions: medical interview in 21st century
Despite the progress in diagnosis and disease management achieved over the last 20years, the role of anamnesis in routine clinical practice has drastically changed [1]. In fact, both the... more
Obesity or smoking: Which factor contributes more to the incidence of myocardial infarction? Authors' Reply
The authors thank Shiri for his questions and concerns [1] and appreciate the opportunity to respond to them. The primary concern was that the study population may be sicker than the general Israeli... more
Ulcerative colitis: A scientometric approach to the global research output and network
Ulcerative colitis (UC) is the most common type of inflammatory bowel disease worldwide [1]. Despite decades of scientific work there are many aspects of uncertainty leading to an ongoing interest in... more
Letters to the Editor
A survey among hospital specialists and pharmacists about biosimilars
Biological medicines are essential for many acute and chronic conditions [1]. A biosimilar is a version similar to an authorized original biological product with clinical comparability that must be... more
Obesity is a risk factor for asthma in women but not in men among elder people in China
Obesity and asthma are important health issues and a positive association between them has been reported [1–3]. However, the reports were mainly based on school-age children and there are few reports... more
Parenteral routes for opioid administration in cancer pain management
Oral opioid administration is preferable in most cancer patients with pain. However, while the oral route is not available for different reasons, an alternative route of administration is often... more
Risk of osteonecrosis in patients with systemic lupus erythematosus: A nationwide population-based study
The occurrence of osteonecrosis (ON) in patients with systemic lupus erythematosus (SLE) was first quantified by Dubois et al. [1] in 1960, in their report describing ON in 11 out of 400 SLE patients... more
Addressing exploitation of poor clinical trial participants in North America and the European Union
One of the cornerstones of ethical research is to protect participants from exploitation [1]. Exploitation occurs when investigators, sponsors or others take unfair advantage of participants by... more
Falling in the elderly; a clarification of results
Upon reading the article “Falling in the elderly: Do statistical models matter for performance criteria of fall prediction? Results from two large population-based studies”, which was recently... more
Narrative Review
Aging of the endocrine system and its potential impact on sarcopenia
Sarcopenia, occurring as a primary consequence of aging, is a progressive generalized decline of skeletal muscle mass, strength and function. The pathophysiology of sarcopenia is complex and... more
Original Article
Prevalence and predictors of hyperprolactinemia in subclinical hypothyroidism
Hyperprolactinemia has been reported in 0–57% of primary hypothyroidism. Data on hyperprolactinemia in subclinical hypothyroidism (ScH) is scant and inconsistent. This study aimed to determine the... more
Early eradication has a lower risk of peptic ulcer bleeding in Helicobacter pylori-infected chronic kidney disease patients
End stage renal disease (ESRD) contributes to a higher mortality rate in peptic ulcer bleeding (PUB) patients. A crucial question is whether early Helicobacter pylori (H. pylori) eradication therapy... more
Pre-hospital alarm activation for STEMI patients undergoing primary percutaneous coronary intervention in the era of transradial procedures
Transradial access (TRA) improves outcome compared with trans-femoral access for the management of patients with acute coronary syndromes. In this setting, it is unknown whether the activation of a... more
Randomized comparison between the invasive and conservative strategies in comorbid elderly patients with non-ST elevation myocardial infarction
Comorbid elderly patients with non-ST-elevation myocardial infarction (non-STEMI) are underrepresented in randomized trials and undergo fewer cardiac catheterizations according to registries. Our aim... more
Diagnostic performances of M-protein tests according to the clinical presentations of kidney disease
Screening for monoclonal immunoglobulin (MIg) is critical in patients with kidney disease.
Severity of coronary artery disease is an independent risk factor for decline in kidney function
Chronic kidney disease (CKD) and cardiovascular disease are closely interrelated and the presence of one condition synergistically affects the prognosis of the other, in a negative manner. There are... more
Endostatin in chronic kidney disease: Associations with inflammation, vascular abnormalities, cardiovascular events and survival
Endostatin, generated from collagen XVIII, and endorepellin, possess dual activity as modifiers of both angiogenesis and endothelial cell autophagy. Plasma endostatin levels are elevated in a large... more
A new definition of health? An open letter of autochthonous peoples and medical anthropologists to the WHO
Currently, for many practitioners (hospital and liberals) and researchers (including public health), the WHO definition of health is outdated: first it seems more utopian than pragmatic; then, it... more
Vitamin K and non-vitamin K antagonists oral anticoagulants for non-valvular atrial fibrillation in real-life
Current guidelines recommend vitamin K antagonists (VKAs) or non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention in patients with non-valvular atrial fibrillation (AF).
Determinants of thromboxane biosynthesis in patients with moderate to severe chronic kidney disease
Mechanisms of accelerated atherothrombosis in patients with chronic kidney disease (CKD) are only partly characterized. The aims of this study were to evaluate the extent of thromboxane (TX)-... more
Three year functional changes and long-term mortality hazard in community-dwelling older men
Low levels of physical function have been associated with higher mortality hazard in older persons. However, few studies have investigated the association between functional changes and subsequent... more
Review Article
The role of sodium intake in nephrolithiasis: epidemiology, pathogenesis, and future directions
The prevalence of nephrolithiasis has doubled over the last decade and the incidence in females now approaches that of males. Since dietary salt is lithogenic, a purported mechanism common to both... more
Candidemia and invasive candidiasis in adults: A narrative review
Candidemia and invasive candidiasis are major causes of morbidity and mortality, and their incidence is increasing because of the growing complexity of patients. Five species of Candida (Candida... more