August 2021

28 Articles

No Section

Lung ultrasound in COVID-19: Insights from the frontline and research experiences

12 June 2021
Author(s): Chiara Cogliati, Frank Bosch, Yale Tung-Chen, Nick Smallwood, Juan Torres-Macho

Coronavirus disease 19 (COVID-19) has become a global threat. Its clinical course is different from other common illnesses and mortality remains high [1]. It is a challenge for clinicians to provide... more

Age and comorbidities are crucial predictors of mortality in severe obstructive sleep apnoea syndrome

9 May 2021
Author(s): Domenico Scrutinio, Pietro Guida, Maria Aliani, Giorgio Castellana, Patrizia Guido, Mauro Carone

Obstructive sleep apnoea syndrome (OSAS) is a highly prevalent disorder caused by the collapse of the upper airway during sleep [1]. In a USA nationwide study, 6.6% of 77.8 million individuals aged... more


Consumer-led screening for atrial fibrillation: What is the next step?

10 June 2021
Author(s): Georges H. MAIRESSE, Hein Heidbüchel

Atrial fibrillation (AF) is increasingly prevalent in the general population and is associated with significant morbidity and mortality. Opportunistic screening for AF is now a class I indication in... more

Maintenance immunosuppressive therapy in autoimmune hepatitis: To stop or not to stop, that is the question.

20 May 2021
Author(s): Mark F.J. Stolk, Aad P. van den Berg, Karel J. van Erpecum

Autoimmune hepatitis (AIH) is a rare and challenging disease. Its presentation ranges from mildly elevated transaminases to jaundice with decompensated liver disease. Blood tests often reveal... more

Internal Medicine Flashcard

Pulsatile neck veins and hepatomegaly, and icterus in an elderly female

29 June 2021
Author(s): Bhupinder Singh, Ankita Soni, Bishav Mohan

A 60-year-old male presented with complaints of deepening jaundice of 3-weeks duration. It was not accompanied by pyrexia, abdominal pain, or malaise. The patient gave a history of hot flushing. On... more

A young man with abdominal pain and intestinal distension

28 June 2021
Author(s): Andrea Malzner, Pius Steiner, Martin Windpessl

A 20-year old man of Balkan descent presented to the emergency department with abdominal pain and constipation of several days‘ duration. On clinical examination, he was afebrile and normotensive.... more

An old-age farmer with chronic dyspnea

23 June 2021
Author(s): Mohsen Shafiepour, Aryan Mohamadi Nezhad, Behnam Dalfardi

A 94-year-old man, known case of chronic lymphocytic leukemia and chronic lung disease, presented to the Emergency Department with aggravation of his chronic dyspnea and non-productive cough since... more

Spontaneous pneumothorax in a patient with skin lesions

3 June 2021
Author(s): Horacio Matías Castro, Martin Pablo Fullana

A 23- year- old man, presented to the emergency department with sudden dyspnea, without another symptom. On examination he had hypoxemia, and abolished breath sounds in the right lung. Skin... more

Invited commentary

Updating a simple clinical score predicting incident atrial fibrillation: The C2HEST score or more (mC2HEST)?

21 June 2021
Author(s): Jacopo Francesco Imberti, Giuseppe Boriani, Gregory Y.H. Lip

Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide but the actual incidence and prevalence of AF may be underestimated because approximately 40% of patients are asymptomatic and... more

Letter to the Editor

Mask-off policy in the shadow of emerging variants of SARS-COV-2

18 June 2021
Author(s): Abdolrazagh Hashemi Shahraki, Majid Vahed, Mehdi Mirsaeidi

From the beginning of the pandemic, several variants of SARS-CoV-2 have been identified with the significant capability of transmission rate relative to the wild-type virus. These emerging variants,... more

Blood pressure increase after Pfizer/BioNTech SARS-CoV-2 vaccine

15 June 2021
Author(s): Martina Zappa, Paolo Verdecchia, Antonio Spanevello, Dina Visca, Fabio Angeli

Although various strategies modify the transition from infection to life-threatening forms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), vaccines remain highly effective measures... more

Etiologies of Polyclonal Hypergammaglobulinemia: A scoping review

11 June 2021
Author(s): Clément BEUVON, Mickaël MARTIN, Chloé BAILLOU, Pascal ROBLOT, Mathieu PUYADE

Dear Editor,

Anakinra or tocilizumab for prevention of COVID-19 death? A big dilemma

5 June 2021
Author(s): Dimitrios Patoulias, Athina Dimosiari, Theodoros Michailidis

We have read with great interest the meta-analysis of observational studies performed by Pasin and colleagues [1] published in the European Journal of Internal Medicine, assessing the efficacy of... more

Use of hydroxychloroquine to control immune response and hypercoagulability in patients with primary antiphospholipid syndrome

4 June 2021
Author(s): Sabrina Saraiva-Mangolin, Camila de Oliveira Vaz, Thays Ruiz, Bruna Moraes Mazetto, Fernanda Andrade Orsi

Dear Editor,

Is troponin testing rather underestimated in clinic practice? Evidence from emergency medical admissions: Authors response

3 June 2021
Author(s): Richard Conway, Bernard Silke

We thank A. Watanabe for his comments on our article, “Is there excessive troponin testing in clinical practice? Evidence from emergency medical admissions” and his suggestions [1,2].

The debated issue of direct oral anticoagulants correct dosing: When even the reviewer is confused

2 June 2021
Author(s): Andrea Rubboli, Dan Atar

While the rejection of a paper submitted to a journal is an inevitable event in the activity of a researcher and must be accepted, sometimes the motivations for such rejection appear questionable or... more

Gender distribution in boards of internal medicine societies

31 May 2021
Author(s): Basil Ryser, Svenja Ravioli, Gregor Lindner

Women account for approximately 75% of the health-sector workforce worldwide [1]. In 2017 43% [2] of physicians in Organization for Economic Development and Co-operation (OECD) countries were women.... more

Is the troponin testing rather underestimated in clinical practice? Evidence from emergency medical admissions

28 May 2021
Author(s): Atsuyuki Watanabe

The novel findings reported by Conway R and colleagues in the current issue of European Journal of Internal Medicine, entitled “Is there excessive troponin testing in clinical practice? Evidence from... more

Original Article

Risk of stroke in CYP2C19 LoF polymorphism carrier coronary artery disease patients undergoing clopidogrel therapy: An ethnicity-based updated meta-analysis

3 June 2021
Author(s): Sarah Jafrin, Nura Ershad Naznin, Md. Sharif Reza, Md. Abdul Aziz, Mohammad Safiqul Islam

Stroke is one of the major causes of morbidity and disability in the elderly peoples, with a global prevalence of 104.2 million people in 2017. According to global statistics, Central and East Asia,... more

Minimal portosystemic encephalopathy: A new nosological entity in patients with hereditary haemorrhagic telangiectasia

18 May 2021
Author(s): Michele Barone, Patrizia Suppressa, Maria Teresa Viggiani, Gennaro Mariano Lenato, Arnaldo Scardapane, Luigi Chiumarulo, Nicola Ambrosini, Alfredo Di Leo, Carlo Sabbà

Hepatic encephalopathy (HE) is a potentially reversible disorder characterized by neuropsychiatric abnormalities and motor disturbances ranging from mild alterations of cognitive and motor functions... more

A model based on routine liver tests can reliably exclude intrahepatic cholestasis of pregnancy

10 May 2021
Author(s): Inbar Lifshitz, Geffen Kleinstern, Ori Rottenstreich, Shay Porat, Joshua I. Rosenbloom, Doron Kabiri, Moshe Rottenstreich, Yosef Ezra, Oren Shibolet, Rifaat Safadi, Amihai Rottenstreich

Intrahepatic cholestasis of pregnancy (ICP) is the most common liver disease in pregnancy [1,2]. It usually manifests in the late second or third trimesters of pregnancy and is characterized by... more

Refining age stratum of the C2HEST score for predicting incident atrial fibrillation in a hospital-based Chinese population

10 May 2021
Author(s): Yan-Guang Li, Jin Bai, Gongbu Zhou, Juan Li, Yi Wei, Lijie Sun, Lingyun Zu, Shuwang Liu

The incidence of atrial fibrillation (AF) increases with age and accumulating comorbidities, conferring significant risks of ischemic stroke [1], heart failure (HF) [2], and mortality [3,4].... more

Inhaled antibiotics for treatment of adults with non-cystic fibrosis bronchiectasis: A systematic review and meta-analysis

1 May 2021
Author(s): Sofia Tejada, Laura Campogiani, Candela Solé-Lleonart, Aroa Gómez, Miguel Gallego, Monserrat Vendrell, Joan B. Soriano, Jordi Rello

Non-cystic fibrosis bronchiectasis (NCFB) is a chronic, progressive respiratory disease characterized by permanent and abnormal dilation of the bronchial walls, mucociliary dysfunction, mucus... more

Prevalence, determinants and practical implications of inappropriate hospitalizations in older subjects: A prospective observational study

1 May 2021
Author(s): Gianluca Isaia, Enrico Brunetti, Roberto Presta, Bianca Salone, Giulia Carignano, Matteo Sappa, Gianfranco Fonte, Silvio Raspo, Giuseppe Lauria, Franco Riccardini, Enrico Lupia, Mario Bo

Over the last decades, along with the aging of the population, an increase in the demand for medical services has been observed in developed countries. Older people are more prone to illnesses, often... more

Drug withdrawal in patients with autoimmune hepatitis in long-term histological remission: A prospective observational study

14 April 2021
Author(s): Floris F. van den Brand, Romée J.A.L.M. Snijders, Ynto S. de Boer, Bart J. Verwer, Carin M.J. van Nieuwkerk, Elisabeth Bloemena, Sjoerd D. Kuiken, Joost P.H. Drenth, Gerd Bouma

Recommendations for drug withdrawal in patients with autoimmune hepatitis (AIH) in longstanding remission are conflicting and rely on retrospective data. We prospectively investigated the predictive... more

Review Article

Sarcopenia measurement in research and clinical practice

5 July 2021
Author(s): Elsa Dent, Jean Woo, David Scott, Emiel O. Hoogendijk

Sarcopenia is defined as an accelerated loss of skeletal muscle mass associated with decreased functional capacity [1–3]. The disease can range in severity from very mild to severe, preventing an... more

Combining New Classes of Drugs for HFrEF: from Trials to Clinical Practice

2 June 2021
Author(s): Gianfranco Sinagra, Linda Pagura, Davide Stolfo, Enrico Fabris, Gianluigi Savarese, Claudio Rapezzi, Roberto Ferrari, Marco Merlo

Standard of care for heart failure (HF) with reduced ejection fraction (HFrEF) combines inhibition of the renin-angiotensin-aldosterone system (RAAS) and blockade of the sympathetic system. Evidences... more


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