July 2019

25 Articles

No Section

Cytopenia induced by low-dose methotrexate: An analysis of 433 cases from the French pharmacovigilance database

23 July 2019
Author(s): Sophie Lalevée, Bénédicte Lebrun-Vignes, Corinne Simon, Delphine Laugier, Laurence Fardet, the French Network of Regional Centres of Pharmacovigilance

Up to 5% of individuals exposed to low-dose methotrexate (MTX) (i.e., ≤30 mg/week) may develop cytopenia. However, MTX-induced cytopenia have been poorly described.


Role of ultrasound in the diagnosis of tuberculosis

25 July 2019
Author(s): Maria Teresa Giordani, Tom Heller

Tuberculosis (TB) is one of the most important infectious diseases affecting a sobering 10 million people worldwide per year and causing 1.6 million deaths annually [1]. The large majority of cases... more


Screening for atrial fibrillation: Need for an integrated, structured approach

30 July 2019
Author(s): Giuseppe Boriani, Marco Proietti

Atrial fibrillation (AF) is a very common disease, particularly in the elderly, and the number of affected patients has been predicted to increase in the next decades [1,2]. The existence of a link... more

North America anticoagulation forum guidance on reversal of direct oral anticoagulants

22 July 2019
Author(s): William Gansheng Shi, Mark Crowther

The direct oral anticoagulants (DOACs) (apixaban, rivaroxaban, betrixaban, edoxaban and dabigatran) have gradually replaced vitamin K antagonists (VKAs) as the mainstay anticoagulation therapy.... more

Continued evolution of hospital medicine

4 July 2019
Author(s): Geno J. Merli, Catriona McDonald Harrop

On August 15, 1996 in the New England Journal of Medicine, R.M. Wachter and L. Goldman anticipated the rapid growth of a new group of physicians and coined the term “hospitalist”. These inpatient... more

Internal Medicine Flashcard

A young man with orange hands

30 July 2019
Author(s): Stefan Matei Constantinescu, Johann Morelle

A 26-year-old Caucasian man with previous history of medullary sponge kidney (also known as Cacchi-Ricci disease) presented to the outpatient clinic for routine follow-up. While his kidney disease... more

Unusual bleeding

26 July 2019
Author(s): Paul Vincent Quentric, Gaétan Sauvêtre

A 15-year-old woman presented to the department for recurrent otorrhagia (panel A), bleeding from the nipples, bleeding from the forehead (panel B), bleeding from the navel (panel C) and epistaxis (... more

Pigmentation on the oral mucosa, hands, and feet

25 July 2019
Author(s): Ziwei Wang, Jin Li, Hong Fang, Jianjun Qiao

A 56-year-old female presented to the dermatology clinic with pigmentation on the lips, gums and tongue for 5 years. The amout and range of lesions gradually increased. The patient denied having... more

Elderly patient of Crohn's disease with dementia and edematous red plaques on dorsum of hands

24 July 2019
Author(s): Amit Dalla, Sheetanshu Kumar, Dipankar De

An elderly man sought dermatology consultation for gradually progressive, mildly itchy, photosensitive rash on dorsum of hands for a month. Apart from the skin lesions, he also complained of... more

Letter to the Editor

Is serum neutrophil gelatinase-associated lipocalin a useful marker in acute pancreatitis?

30 July 2019
Author(s): David Ojalvo, Emrah Erkan Mazi, Mine Kara, Fatih Borlu

Acute pancreatitis (AP) is the reversible inflammation of pancreas. Annually from 4.9 to 35 cases per 100,000 of AP is reported. About one-fourth of patients with AP, develop severe acute... more

Lung ultrasonography in pulmonary tuberculosis: Integrating chest radiology?

30 July 2019
Author(s): Antonio Mirijello, Salvatore De Cosmo, Marco Sperandeo

We read with interest the article by Montuori et al. evaluating the role of lung ultrasonography (LUS) in pulmonary tuberculosis (PTB). Authors conclude that “chest ultrasonography may be a promising... more

Is it possible to quickly identify acutely unwell patients who can be safely managed as outpatients? The need for a “Universal Safe to Discharge Score”

24 July 2019
Author(s): John Kellett, Christian H. Nickel, Niclas Skyttberg, Mikkel Brabrand

If scores or algorithms were developed that quickly identified patients who are bound to have 100% survival, if even only for a few days, more patients could be safely discharged from emergency... more

HIV-Tuberculosis co-infection: A growing public health issue and the need for guidelines development

19 July 2019
Author(s): Lefkothea Zacharopoulou, Christos Tsagkaris

Tuberculosis (TB) is the main cause of death amongst human immunodeficiency virus (HIV)-infected individuals worldwide, while 14 million people are estimated to be dually infected [1]. In Europe only... more

Predictors of mortality of bloodstream infections among internal medicine patients: Mind the complexity of the septic population!

17 July 2019
Author(s): Alberto Tosoni, Giovanni Addolorato, Antonio Gasbarrini, Salvatore De Cosmo, Antonio Mirijello, on behalf of the Internal Medicine Sepsis Study Group

We read with great interest the article by Papadimitriou-Olivgeris and colleagues [1] aiming to evaluate the predictors of mortality among internal medicine patients with bloodstream infections (BSIs... more

Looking for safety but overlooking efficacy: Non-inferiority trials of anti-diabetics

16 July 2019
Author(s): Vittorio Bertele', Rita Banzi, Chiara Gerardi, Silvio Garattini

Testing new interventions against placebo when effective treatments are already available is considered unethical [1] and dangerous for patients [2], so testing non-inferiority which aims at... more

Infective endocarditis in patients with cardiac implantable electronic devices: Impact of comorbidities on outcome

4 July 2019
Author(s): Igor Diemberger, Stefano Lorenzetti, Marco Vitolo, Giuseppe Boriani

We read with interest the paper by Armiñanzasa et al., recently published in the European Journal of Internal Medicine [1]. The authors provided an important analysis of a large, prospectively... more

Original Article

Occurrence of atrial fibrillation in pacemaker patients and its association with sleep apnea and heart rate variability

26 July 2019
Author(s): Andrea Mazza, Maria Grazia Bendini, Sergio Valsecchi, Mariolina Lovecchio, Massimo Leggio, Raffaele De Cristofaro, Giuseppe Boriani

Sleep apnea (SA) is a risk factor for atrial fibrillation (AF) occurrence. Sympathovagal imbalance is a mechanism that predisposes to the development of AF and that occurs in SA. Some pacemakers can... more

Acute heart failure and adverse events associated with the presence of renal dysfunction and hyperkalaemia. EAHFE- renal dysfunction and hyperkalaemia

20 July 2019
Author(s): Javier Jacob, Lluis Llauger, Pablo Herrero-Puente, Francisco Javier Martín-Sánchez, Pere Llorens, Alex Roset, Victor Gil, Marta Fuentes, Francisco Javier Lucas-Imbernón, Òscar Miró, ICASEMES-Research Group, Cristina Gil, Héctor Alonso, Enrique Pérez-Llantada, Guillermo Llopis-García, Maria Carmen Santos-Matallana, María Luisa Docavo Barrenechea-Moxó, Lucía Salgado-Pérez, Rosa Escoda, Carolina Xipell, Carolina Sánchez, Josep María Gaytan, María José Pérez-Durá, Eva Salvo, José Pavón, Antonio Noval, José Manuel Torres, María Luisa López-Grima, Amparo Valero, María Ángeles Juan, Alfons Aguirre, Maria Angels Pedragosa, Silvia Mínguez-Masó, María Isabel Alonso, Francisco Ruiz, José Miguel Franco, Ana Belén Mecina, Josep Tost, Marta Berenguer, Ruxandra Donea, Susana Sánchez-Ramón, Virginia Carbajosa-Rodríguez, Pascual Piñera, José Andrés Sánchez-Nicolás, Raquel Torres Garate, Aitor Alquézar-Arbé, Miguel Alberto Rizzi, Sergio Herrera, Alex Roset, Irene Cabello, Antonio Haro, Fernando Richard, José María Álvarez-Perez, María Pilar López-Diez, Joaquín Vázquez-Álvarez, Belén Prieto-García, María García García, Marta Sánchez González, Patricia Javaloyes, Víctor Marquina, Inmaculada Jiménez, Néstor Hernández, Benjamín Brouzet, Begoña Espinosa, Juan Antonio Andueza, Rodolfo Romero, Martín Ruíz, Roberto Calvache, María Teresa Lorca Serralta, Luis Ernesto Calderón Jave, Beatriz Amores Arriaga, Beatriz Sierra Bergua, Enrique Martín Mojarro, Brigitte Silvana Alarcón Jiménez, Lisette Travería Bécquer, Guillermo Burillo, Lluís Llauger García, Gerard Corominas LaSalle, Carmen Agüera Urbano, Ana Belén García Soto, Elisa Delgado Padial, Ester Soy Ferrer, José Manuel Garrido, Francisco Javier Lucas-Imbernón, Rut Gaya, Carlos Bibiano, María Mir, Beatriz Rodríguez, José Luis Carballo, Esther Rodríguez-Adrada, Belén Rodríguez Miranda

To study the outcomes of patients with acute heart failure (AHF) presenting renal dysfunction (RD) or hyperkalaemia (Hk) alone or in combination.

Long term prognosis of acute pulmonary embolism

17 July 2019
Author(s): I. Guerreiro, H. Magalhães, S. Coelho, A. Ribeiro, S. Ferreira, E. Araújo, P. Bettencourt, P. Lourenço

Acute pulmonary embolism (PE) can be fatal if left untreated. Long-term prognosis of acute PE in the 21st century has not been fully reported. We aimed to determine the long-term prognosis of... more

Prevalence of atrial fibrillation and stroke risk assessment based on telemedicine screening tools in a primary healthcare setting

15 July 2019
Author(s): Eraldo Ribeiro Ferreira Leão de Moraes, Cláudio Cirenza, Renato D. Lopes, Antônio Carlos Carvalho, Patricia O. Guimaraes, Alfredo Augusto Eyer Rodrigues, Angelo Amato Vincenzo de Paola

Worldwide atrial fibrillation (AF) prevalence varies between 0.1% and 4.0%, and has been increasing. Little is known about the prevalence of AF in Brazil. Our objective was to estimate the prevalence... more

Associations between early handoffs, length of stay and complications in internal medicine wards: A retrospective study

13 July 2019
Author(s): Christophe Fehlmann, Martine Louis Simonet, Jean-Luc Reny, Jérôme Stirnemann, Katherine Blondon

In US healthcare system, handoffs are associated with an increase in medical error and in hospital length of stay. In non-US healthcare systems, this phenomenon has not been well studied. We studied... more

The cost-effectiveness of omega-3 polyunsaturated fatty acids – The Australian healthcare perspective

6 July 2019
Author(s): Lan Gao, Marj Moodie, Shu-Chuen Li

To examine the cost-effectiveness of a triglyceride lowering medication–icosapent ethyl added on to statin from Australian healthcare system perspective.

Rituximab-induced serum sickness is more frequent in autoimmune diseases as compared to hematological malignancies: A French nationwide study

3 July 2019
Author(s): Guillaume Bayer, Marie-Sara Agier, Bertrand Lioger, Marion Lepelley, Marie Zenut, Mary-Christine Lanoue, François Maillot, Annie-Pierre Jonville-Bera

Rituximab induced serum sickness (RISS) is a rare delayed hypersensitivity reaction. The aim of this study was to describe the epidemiological and clinical characteristics of the RISS cases reported... more

Review Article

Cardiac amyloidosis: An underdiagnosed/underappreciated disease

30 July 2019
Author(s): Antonis S. Manolis, Antonis A. Manolis, Theodora A. Manolis, Helen Melita

Cardiac amyloidosis or amyloid cardiomyopathy (ACM), commonly resulting from extracellular deposition of amyloid fibrils consisted of misfolded immunoglobulin light chain (AL) or transthyretin (TTR)... more

Blood eosinophils as biomarkers of therapeutic response to chronic obstructive pulmonary disease: Still work in progress

12 July 2019
Author(s): Salvatore Fuschillo, Antonio Molino, Cristiana Stellato, Andrea Motta, Mauro Maniscalco

Disease phenotyping is a key step towards an increasingly personalized approach to chronic obstructive pulmonary disease (COPD), leading to a more precise assessment, treatment and definition of... more


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