February 2020

30 Articles


A half-century of developments in the field of antithrombotics–A tribute to Jack Hirsh

25 February 2020
Author(s): Henri Bounameaux, Arnaud Perrier

Nobody could be more qualified than Jack Hirsh [1] to comment five decades of progress in the field of antithrombotic therapy, as he did in an authoritative review in the December issue of this... more

2019 ESC guidelines on pulmonary embolism: Novelties and unanswered questions

19 February 2020
Author(s): Stavros Konstantinides

The European Society of Cardiology (ESC) Guidelines for the diagnosis and management of acute pulmonary embolism (PE), developed in collaboration with the European Respiratory Society (ERS), were... more

Death from, with, and without pulmonary embolism

9 February 2020
Author(s): Stefano Barco, Tim Sebastian

Sudden death can be the initial presentation of pulmonary embolism and early fatality is substantial among patients who present with haemodynamic instability [1,2]. Death from pulmonary embolism,... more


The guidelines they are a changin’

22 February 2020
Author(s): Heloni M. Dave, Alok A. Khorana

The association of cancer with a clinical hypercoagulable state has been known for over 140 years but continues to be an important clinical problem. Despite rapid changes in cancer treatments, venous... more

Impact of mobile intensive care units on STEMI delays and outcomes–Is it simply a matter of time?

5 February 2020
Author(s): Stefano Coiro, Claudio Cavallini

Ischemic heart disease (IHD) remains the leading cause of death worldwide [1], regardless of the income level of the country [2]. Mortality trends for IHD slowly but progressively declined over the... more

Internal Medicine Flashcard

A mysterious lesion on the chest X-Ray

28 February 2020
Author(s): Kalyan Mansukhbhai Shekhda

A 87 year old Lady presented to her General Practitioner with gradual onset and rapidly progressive shortness of breath and right sided chest pain. Observations in the GP surgery were within normal... more

Rapidly progressive gangrene on the scrotum

27 February 2020
Author(s): Yayu Hu, Xiangchuan Su, Xiangen Chen

A 35-year-old man presented at our hospital with high fever (up to 39.7 °C), and progressive edema and pain of the scrotal and perineal region for 7 days. He had received intravenous levofloxacin at... more

Joint pain, black urine… and a heart murmur

21 February 2020
Author(s): Alejandro Morales Ortega, Carmen Cristóbal Varela, Santiago Serrano Fiz

A 64-year-old man, with history of hypertension and hypercholesterolemia, presented with chronic polyarthralgias and backache. He had brown-colored deposits in sclera and blueish pigmentation in... more

Beware of the dog

20 February 2020
Author(s): Tommaso Lupia, Valentina Libanore, Francesco Giuseppe De Rosa

A 24-years old male complained new-onset urinary retention during a return flight from a 1-month trip to Thailand, needed to be urgently catheterized. His past medical history was unremarkable. He is... more

Letter to the Editor

Atrial fibrillation in patients with inflammatory bowel disease: A systematic review and meta-analysis

29 February 2020
Author(s): Marco Zuin, Giovanni Zuliani, Gianluca Rigatelli, Giuseppe Del Favero, Loris Roncon

Systematic review and meta-analysis

The impact of proton pump inhibitors on levothyroxine absorption: The good, the bad and the ugly

21 February 2020
Author(s): Yuli Guzman-Prado, Roberto Vita, Ondrej Samson

Levothyroxine (LT4) and proton pump inhibitors (PPI) are two of the most prescribed drugs particularly in elderly population [1,2]. As they are frequently co-ingested, the effect on levothyroxine... more

Key decision-making around hospitalization in patients with acute heart failure

20 February 2020
Author(s): Òscar Miró, Víctor Gil, Pere Llorens

We appreciate the commentary of Moliner and Comin-Colet [1] regarding our previously published article in the EUROPEAN JOURNAL OF INTERNAL MEDICINE. In our study, the LORHCA study, we tested the... more

Time-based clinical and functional achievements in real-life HF patients on ARNI treatment

20 February 2020
Author(s): Cesare de Gregorio, Giulia Laterra, Vittoria Vaccaro, Roberto Bitto, Giuseppe Dattilo

The prevalence of chronic heart failure (CHF) in the general population is gradually increasing mainly due to prolonged life expectancy of the general population and effective interventional and... more

Could Duplex carotid ultrasound be useful in the assessment of volume status and fluid responsiveness?

20 February 2020
Author(s): Nicola Parenti, Luca Bastiani, Carmela Palazzi, Katrianna Urrea, Mauro Silingardi

Although the ultrasound assessment of inferior vena cava diameters and their respiratory variations have been suggested as a tool for fluid management, recent reports do not confirm its validity in... more

THE role of metabolic syndrome in blood pressure control and pulse wave velocity progression over a 3.5 years in treated hypertensive PATIENTS.

18 February 2020
Author(s): A. Maloberti, R.M. Bruno, R. Facchetti, G. Grassi, S. Taddei, L. Ghiadoni, C. Giannattasio

Metabolic Syndrome (MS) is a cluster of elevated Blood Pressure (BP) and glucose, lipids alterations (elevated triglycerides or low HDL-cholesterol) and abdominal obesity that has been associated... more

Antibiotic treatment in patients that present with solely non-specific symptoms and positive serology at a Lyme centre

16 February 2020
Author(s): Gerine Nijman, Barend van Kooten, Yolande M Vermeeren, Babette C van Hees, Tizza P Zomer

Lyme Borreliosis (LB) is a tick-borne disease caused by Borrelia burgdorferi sensu lato (s.l.). Patients present with several specific manifestations, of which an erythema migrans (EM) occurs most... more

Annual screening of comorbidities for people living with HIV in a single day hospitalization: A one-year experience

8 February 2020
Author(s): Martin Michaud, Lucie Bidouze, Sophie Ancellin, Florian Catros, Francis Gaches

The HIV-infected population faces more comorbidities than the general population, with increased incidence of viral hepatitis, renal disease, cardiovascular diseases, osteoporosis and malignancies [1... more

Comprehensive heart failure assessment: A challenge to modify the course of heart failure. Author's reply

8 February 2020
Author(s): Michele Correale, Stefania Paolillo, Gaetano Ruocco, Alberto Palazzuoli, Savina Nodari, from Italian Society of Cardiology (SIC) Working Group on Heart Failure

We read with great interest the article by JF Martín-Sánchez [1] commenting on our article "Comorbidities in chronic heart failure: An update from Italian Society of Cardiology (SIC) Working Group on... more

Prognostic significance of the modified Barthel index in elderly patients with diffuse large B-cell lymphoma

7 February 2020
Author(s): Shinji Ogura, Tomonori Nakazato

The modified Barthel index (mBI) is widely used to measure performance in activities in daily living (ADL), especially in elderly patients [1]. It consists of the following 10 items: feeding,... more

In stroke patients, lower LDL-cholesterol is actually better

6 February 2020
Author(s): Luis Castilla-Guerra, Jose Antonio Perez de Leon, María del Carmen Fernandez-Moreno

Internists often treat patients with dyslipidemia or atherosclerotic cardiovascular disease (ASCVD); however, there remain questions regarding what degree of reduction in low density lipoprotein... more

More research and clinical attention is needed on nutrition to prevent influenza incidence and mortality

6 February 2020
Author(s): Luke Curtis

I read with interest your 12/24/19 Papadimitriou paper on factors affecting influenza mortality in a Swiss hospital [1]. One factor that I found especially interesting was the huge influence on... more

Thrombocytopenia in primary antiphospholipid syndrome, a marker of high-risk patients?

5 February 2020
Author(s): Cécile M. Yelnik, Yann Nguyen, Véronique Le Guern, Eric Hachulla, Marc Lambert

As recently written by Cruz and coll., antiphospholipid antibodies (aPL) are frequently found in immune thrombocytopenia (ITP) and are not associated with specific clinical feature [1]. Similarly,... more

Giant cell arteritis incidence in La Reunion island, a particularly cosmopolite region of south hemisphere

31 January 2020
Author(s): Quentin Richier, Thylbert Deltombe, Aurélie Foucher, Céline Roussin, Loic Raffray

Giant cell arteritis (GCA) is classified as a large vessel vasculitis according to the Chapel Hill nomenclature [1]. GCA is present worldwide but the reported incidence rates are highly variable... more

Comparison between arterial and peripheral-venous blood gases analysis in patients with dyspnoea and/or suspected acute respiratory failure

Author(s): Jerneja Golub, Mario Gorenjak, Eva Žuran Pilinger, Amadeus Lešnik, Andrej Markota

Withdrawal of blood for arterial blood gases analysis (ABGA) has formed the mainstay of treatment in patients with dyspnoea and suspected acute respiratory failure for the past 50 years [1]. The... more

Original Article

Computed tomography assessment of evolution of interstitial lung disease in systemic sclerosis: Comparison of two scoring systems

20 February 2020
Author(s): Fausto Salaffi, Marina Carotti, Marika Tardella, Marco Di Carlo, Paolo Fraticelli, Colomba Fischetti, Andrea Giovagnoni, Armando Gabrielli

Systemic sclerosis (SSc) is a connective tissue disease characterized by extensive skin fibrosis and abnormalities in large and small vessels. Although cutaneous manifestations are the most frequent... more

Clinical outcomes and need for intensive care after non-ST-segment-elevation myocardial infarction

20 February 2020
Author(s): Patrícia O. Guimarães, Márcio C. Sampaio, Felipe L. Malafaia, Renato D. Lopes, Alexander C. Fanaroff, Pedro G.M. de Barros e Silva, Tiago Mendonça dos Santos, Mariana Y. Okada, Amanda R.E. Mouallem, Miguel da S. Diniz, Juliano V. Custódio, José C.T. Garcia, Valter Furlan

The decision on whether non-ST-segment elevation myocardial infarction (NSTEMI) patients should be admitted to intensive care units (ICU) takes into account clinical presentation, hemodynamic status... more

Why optional inferior vena cava filters are not always retrieved? A real world 19 years experience in a Swiss tertiary care university hospital.

13 February 2020
Author(s): Giacomo Buso, Adriano Alatri, Luca Calanca, Marco Fresa, Salah-Dine Qanadli, Raffaele Pesavento, Lucia Mazzolai

Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is a serious and potentially fatal disease, with an estimated annual incidence of 104–183 per 100,000... more

Review Article

Inhalation therapy devices for the treatment of obstructive lung diseases: the history of inhalers towards the ideal inhaler

26 February 2020
Author(s): Claudio Sorino, Stefano Negri, Antonio Spanevello, Dina Visca, Nicola Scichilone

When a drug is administered orally, intravenously or intramuscularly, it enters the blood stream and it can reach most organs and tissues including the airways.

NAFLD and autoimmune hepatitis: Do not judge a book by its cover

9 February 2020
Author(s): George N. Dalekos, Nikolaos K. Gatselis, Kalliopi Zachou, George K. Koukoulis

Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome and is defined by the accumulation of fat in > 5% of hepatocytes at the histological level or by... more

Treat-to-target in systemic lupus erythematosus: Where are we?

1 February 2020
Author(s): Roberto Ríos-Garcés, Gerard Espinosa, Ronald van Vollenhoven, Ricard Cervera

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by affecting predominantly woman of childbearing age in a chronic, relapsing-remitting course. It is also notable for its... more


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