March 2022

56 Articles

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Convalescent plasma for COVID-19. TSUNAMI is not the final word

6 January 2022
Author(s): Massimo Franchini, Daniele Focosi, Arturo Casadevall, Michael J. Joyner, Cesare Perotti

We read with interest the paper by Menichetti and colleagues recently published in the European Journal of Internal Medicine, which allows us to make some considerations [1].

An unusual cause of colitis

5 January 2022
Author(s): Yusaku Kajihara

An 81-year-old Japanese woman presented to the author's department with acute abdominal pain and nausea. Laboratory evaluation showed a white-cell count of 13,270 cells/mm3 (Reference range, 3500–... more


5 January 2022
Author(s): Shuhei Takeyama, Nobuya Abe, Tatsuya Atsumi

A 30-year-old woman manifested fatigue and high fever. She was diagnosed with antiphospholipid antibodies positive-systemic lupus erythematosus (SLE), but she had never demonstrated any serious organ... more

The age-adjusted D-dimer cutoff level to rule out pulmonary embolism in patients with syncope

21 December 2021
Author(s): Eyal Fuchs, Emilia Hardak, Anat Keren-Politansky, Ron Hoffman, Inna Tzoran

Syncope is one of the most common main complaints, requiring emergency department (ED) evaluations, and among the most insidious and life-threatening conditions that are attributed to pulmonary... more

Real-life data on the impact of successful downstaging in patients with hepatocellular carcinoma: A Dutch Multicenter Study

21 December 2021
Author(s): Annelotte G.C. Broekhoven, Marta Fiocco, Dave Sprengers, R. Bart Takkenberg, Suzanne van Meer, Karel J. van Erpecum, Dewkoemar Ramsoekh, Hein W. Verspaget, Mark C. Burgmans, Susanne Osanto, Andrzej G. Baranski, Bart van Hoek, Minneke J. Coenraad

Hepatocellular Carcinoma

The relevance of nutritional and metabolic derangements in COVID-19 patients

20 December 2021
Author(s): Alessio Molfino, Giovanni Imbimbo, Maurizio Muscaritoli

Dear Editor,

Correlation of non-invasive oxygenation parameters with paO2/FiO2 ratio in patients with COVID-19 associated ARDS

20 December 2021
Author(s): Giacomo Zaccagnini, Andrea Berni, Filippo Pieralli

COVID-19 associated ARDS (CARDS) is defined as a new-onset respiratory failure with bilateral, non-cardiogenic pulmonary infiltrates, and a paO2/FiO2 ratio (P/F) ≤ 300 mmHg is the most severe... more

Factors associated with persistence of symptoms 1 year after COVID-19: A longitudinal, prospective phone-based interview follow-up cohort study

5 December 2021
Author(s): Carlo Fumagalli, Chiara Zocchi, Luigi Tassetti, Maria Vittoria Silverii, Carla Amato, Luca Livi, Lorenzo Giovannoni, Federica Verrillo, Alessandro Bartoloni, Rossella Marcucci, Federico Lavorini, Stefano Fumagalli, Andrea Ungar, Iacopo Olivotto, Laura Rasero, Francesco Fattirolli, Niccoló Marchionni, AOU Careggi COVID-19 Follow-up study Group

Since the beginning of the SARS-CoV-2 pandemic and its disease (COVID-19), over 200 million cases of infection and 4.37 million deaths have been reported world-wide [1,2]. While the most common acute... more

Short term blood pressure alterations in recently COVID-19 vaccinated patients

28 November 2021
Author(s): Elias Sanidas, Theoharis Anastasiou, Dimitrios Papadopoulos, Maria Velliou, Marina Mantzourani

The global medical community supports that vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is crucial for reaching the herd immunity threshold needed to curb the... more

Procedural myocardial infarction and major myocardial injury after percutaneous coronary interventions in chronic coronary syndrome: Is the fog really waning?

18 November 2021
Author(s): Stefano De Servi, Antonio Landi

Procedural myocardial infarction (MI) is among the components of major endpoints of several trials evaluating the effects of different treatment strategies, intracoronary devices and/or drugs in... more

Glucagon-like peptide-1 receptor agonists and sodium−glucose cotransporter 2 inhibitors for cardiovascular and renal protection: A treatment approach far beyond their glucose-lowering effect

16 November 2021
Author(s): Ricardo Gómez-Huelgas, Jaime Sanz-Cánovas, Lidia Cobos-Palacios, Almudena López-Sampalo, Luis M. Pérez-Belmonte

Type 2 diabetes (T2D) is a major risk factor for cardiovascular disease (CVD) [1]. The presence of CVD has been described as the main cause of death among individuals with T2D and is associated with... more

Representativity of women and racial/ethnic minorities in randomized clinical trials on bempedoic acid: Positive efforts and lacking data

13 November 2021
Author(s): Federica Fogacci, Davide Gori, Arrigo F.G. Cicero

Even though today there is recognition of the need to proportionally include in clinical trials and prospectively evaluate women and racial minorities through all phases of drug development, in... more

Learning in times of stress: Lessons from COVID-19 that will last throughout this century

11 November 2021
Author(s): Paula Jiménez-Fonseca, Ramón Salazar, Vicent Valentí, Alberto Carmona-Bayonas, Giancarlo Agnelli

Systems tend toward inertia until an external pressure pushes them toward change; thus, a situation of crisis such as the COVID-19 pandemic represents an opportunity for technological innovation. The... more

Mobile stroke unit is not a stroke unit

11 November 2021
Author(s): Stefano Ricci, Danilo Toni, Mauro Silvestrini

Dear Editor,

Hematuria and subsequent long-term risk of end-stage kidney disease: A Danish population-based cohort study

11 November 2021
Author(s): Kristine Fogh, Søren Viborg Vestergaard, Christian Fynbo Christiansen, Lars Pedersen, Dorothea Nitsch, Mette Nørgaard

Hematuria is a frequent incidental clinical finding and may be a symptom of pre-existing underlying benign or malignant urinary tract or kidney disease. However, in patients with no apparent... more

Anakinra in COVID-19: A step closer to the cure

10 November 2021
Author(s): Fotios Barkas, Eirini Christaki, Evangelos Liberopoulos, Maria Kosmidou, Haralampos Milionis

Acute respiratory distress syndrome and cytokine release syndrome are the major complications of coronavirus disease 2019 (COVID-19) associated with increased mortality risk [1]. Apart from... more

A year later

Anticoagulant therapy for COVID-19: What we have learned and what are the unanswered questions?

10 November 2021
Author(s): Dimitrios Giannis, James D. Douketis, Alex C. Spyropoulos

Venous thromboembolism (VTE), which comprises deep vein thrombosis (DVT) and pulmonary embolism (PE), and arterial thromboembolism (ATE), which includes myocardial infarction, ischemic stroke,... more

Beyond the Guidelines

Pulmonary embolism – An EFIM guideline critical appraisal and adaptation for practicing clinicians

11 December 2021
Author(s): Cecilia Becattini, Valentin A. Kokorin, Wiktoria Lesniak, Ignacio Marin-Leon, Francisco J. Medrano, Laura Morbidoni, Alberto M. Marra, Ewelina Biskup, Antoni Riera-Mestre, Dror Dicker

Pulmonary embolism (PE) is the third most common cardiovascular disease with an incidence of 100–200 cases per 100,000 population per year. Moreover, the incidence rates of PE have been increasing... more

The 2021 ESC guidelines on cardiovascular prevention: Whether the ends justify the means

22 November 2021
Author(s): Claudio Cimminiello, Charalambos Vlachopulos, Marco De Carlo

In chapter XVIII of "The Prince", the Florentine political theorist Niccolò Machiavelli wrote “in the actions of all men, and especially of princes, which it is not prudent to challenge, one judges... more

Clinical Insights

Does early systemic sclerosis really exist?

27 December 2021
Author(s): Andrés González-García, José Luis Callejas-Rubio

Systemic sclerosis (SSc) is an autoimmune systemic disease of unknown origin, characterized by sclerosis of the skin and internal organs associated with endothelial dysfunction, immune dysregulation... more


Pregnancy-related venous thromboembolism: Progress but questions remain

1 February 2022
Author(s): Shannon M. Bates

The care of pregnant persons at risk for or with known or suspected venous thromboembolism (VTE) has many challenges; including specialized content knowledge, a limited high-quality evidence base... more

Gender distribution in boards of internal medicine societies and paper authorship: Networking is the key to success

8 January 2022
Author(s): Francesca Rubulotta, Cristina Santonocito, Giorgia Rubulotta

Networking is about building long-term relationships as well as a good reputation over time. Active professional networking is vital to career growth as it involves meeting people who you can support... more

The effect of telemedicine in heart failure based on frailty phenotypes

16 December 2021
Author(s): A Driscoll, S Cartledge

Heart failure (HF) is a disease of the elderly. In people aged>65years, it is the most common cause of rehospitalisations [1]. Nearly half of the patients diagnosed with HF will be frail (44.5%,... more

Rheumatoid arthritis patients “al nostro cuore”

13 December 2021
Author(s): José A. Gómez-Puerta, Raimon Sanmartí

Rheumatoid arthritis (RA) constitutes one of the main inflammatory chronic diseases which can lead to important disability and an inflammatory burden including a higher risk of cardiovascular (CV)... more

Nephrotoxicity: A growing problem or an exaggerated fear with unpredictable dimensions?

25 November 2021
Author(s): Neriman Sıla Koç, Mustafa Arici

Nephrotoxicity is not only a simple matter of a sudden rise in creatinine followed by a return to normal. In many cases, this scenario may be seen without any permanent damage, but in others an acute... more

Concise report

Off-label use of biologics for the treatment of refractory and/or relapsing granulomatosis with polyangiitis

26 October 2021
Author(s): C. Mettler, CA. Durel, P. Guilpain, B. Bonnotte, F. Cohen-Aubart, M. Hamidou, JC. Lega, V. Le Guern, F. Lifermann, V. Poindron, G. Pugnet, A. Servettaz, X. Puéchal, L. Guillevin, B. Terrier, French Vasculitis Study Group

Granulomatosis with polyangiitis (GPA) is an antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAVs), characterized by granulomatous necrotizing vasculitis of small vessels [1].... more

Internal Medicine Flashcard

Abdominal aortic aneurysm and gas in the kidney in a diabetes patient

10 January 2022
Author(s): Yueming Liu, Mian Ren, Yicheng Huang

A 65-year-old man was admitted to our emergency department with a 12-day history of nausea and a progressive backache, and an 8-day history of dysuria with low-grade fever. He had been diagnosed with... more

Acute abdominal pain following esophagogastroduodenoscopy

7 January 2022
Author(s): Takashi Oshima, Hiroyuki Yano, Mitsuyo Kinjo

A 48-year-old man developed abdominal pain and vomiting twelve hours after esophagogastroduodenoscopy. He had lost 4.4 kg while being treated for a gluteal muscle abscess two months prior, and then... more

Segmental anhidrosis and heat intolerance

7 January 2022
Author(s): Valentin Lacombe, Christian Le Clec'h

A 62 year-old woman with no previous medical history presented to the Dermatology department with sweating disorders for several years. She described segmental hyperhidrosis and hyperemia while... more

Darier's sign

6 January 2022
Author(s): Ivan Krečak, Ivana Karaman, Sanja Jakelić

A 38-year-old Caucasian male presented with a ten-year history of back pains, dyspepsia and allergic rhinitis and conjunctivitis treated with non-steroidal antirheumatic drugs and on-demand... more

Letter to the Editor

COVID-19 infection survivors and the risk of depression and anxiety symptoms: A nationwide study of adults in the United States

11 January 2022
Author(s): Jagdish Khubchandani, James H. Price, Sushil Sharma, Michael J. Wiblishauser, Fern J. Webb

Recently, media reports and scientific publications have started highlighting the long-term sequalae of COVID-19 infections. A wide variety of persistent symptoms such as respiratory distress, cough... more

Return to work after hospitalisation for COVID-19 infection

9 January 2022
Author(s): Orlando Hürlimann, Pierre Decavel, Jean-Marie Annoni, Marco Mancinetti

Dear Editor

SARS-CoV-2 antibody response eight months after vaccination with mRNA vaccines. Influence of prior SARS-CoV-2 exposure

4 January 2022
Author(s): Jesús Fernando García-Cruces-Méndez, Luis Corral-Gudino, María Piedad Del-Amo-Merino, José María Eiros-Bouza, Marta Domínguez-Gil González

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) appeared in late 2019. Since then, SARS-CoV-2 spread worldwide and led to a health crisis due to coronavirus disease (COVID-19). To... more

Colchicine for the prevention of COVID-19 “hard” outcomes: All that glitters is not gold

24 November 2021
Author(s): Dimitrios Patoulias, Christodoulos Papadopoulos, Asterios Karagiannis, Michael Doumas

In a paper recently published in the European Journal of Internal Medicine, Schattner provided a thorough and in-depth review regarding the multiple, pleiotropic effects of colchicine, also... more

Trends and outcomes of opioid-related cardiac arrest in a contemporary US population

16 November 2021
Author(s): Senada S. Malik, Wilbert S. Aronow, Alexandros Briasoulis

Opioid abuse is a worldwide public health issue, and deaths related to opioid abuse are increasing. We aimed to investigate trends, predictors, and outcomes of cardiac arrest in patients with opioid... more

Colchicine for COVID-19: Hype or hope?

12 November 2021
Author(s): Chia Siang Kow, Dinesh Sangarran Ramachandram, Syed Shahzad Hasan

We appreciate the efforts of Schattner [1] to summarize the evidence from randomized controlled trials regarding the efficacy and safety of colchicine for various emerging indications, which included... more

Gender gap in authorship: a study of 44,000 articles published in 100 high-impact general medical journals

28 September 2021
Author(s): Paul Sebo, Carole Clair

Dear Editor, the profile of the medical profession has changed dramatically in recent decades, with an increasing proportion of women physicians [1]. However, the gender gap in academic medicine... more

Original Article

The Birmingham and Black Country cohort of Venous Thromboembolism (BBC-VTE) registry: Rationale, design and preliminary results

22 January 2022
Author(s): Alexander Sanders, Wahbi K. El-Bouri, Gregory Y.H. Lip, *BBC-VTE investigators

Venous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pulmonary embolism (PE) is a severe condition which causes significant morbidity and mortality in hospitalised patients as... more

Real world comparison of spironolactone and eplerenone in patients with heart failure

6 January 2022
Author(s): Patricia Pardo-Martínez, Eduardo Barge-Caballero, Alberto Bouzas-Mosquera, Gonzalo Barge-Caballero, David Couto-Mallón, María J. Paniagua-Martín, Marta Sagastagoitia-Fornie, Óscar Prada-Delgado, Javier Muñiz, Luis Almenar-Bonet, José M. Vázquez-Rodríguez, María G. Crespo-Leiro

Mineralocorticoid receptor antagonists (MRA) play a central role in the therapeutic scheme recommended for patients with heart failure and reduced left ventricular ejection fraction (HFrEF). Three... more

Outcome of SARS CoV-2 inpatients treated with convalescent plasma: One-year of data from the Veneto region (Italy) Registry

27 December 2021
Author(s): Giustina De Silvestro, Piero Marson, Massimo La Raja, Anna Maria Cattelan, Gabriella Guarnieri, Jacopo Monticelli, Ivo Tiberio, Andrea Vianello, Giorgio Gandini, Gianluca Gessoni, Francesco Fiorin, Corrado Sardella, Laura Astolfi, Mario Saia, Veneto Hospitals

Convalescent plasma (CP) has been used worldwide to counteract the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)[1]. Since April 2020, it has also been utilised in the treatment of... more

Renal outcomes associated with glucose-lowering agents: Systematic review and meta-analysis of randomized outcome trials

22 December 2021
Author(s): Konstantina Chalmoukou, Dimitris Polyzos, Eleni Manta, Fotis Tatakis, Dimitris Konstantinidis, Costas Thomopoulos, Tsioufis Costas

Large-scale cardiovascular outcome trials and meta-analyses of new antihyperglycemic agents in patients with type 2 diabetes mellitus (DM) demonstrated that these new agents reduce cardiovascular... more

Interstitial pneumonia with autoimmune features: Evaluation of connective tissue disease incidence during follow-up

22 December 2021
Author(s): Paul Decker, Vincent Sobanski, Thomas Moulinet, David Launay, Eric Hachulla, Victor Valentin, Benoit Godbert, Sabine Revuz, Anne Guillaumot, Emmanuel Gomez, François Chabot, Lidwine Wémeau, Roland Jaussaud

Interstitial lung diseases (ILD) are a heterogenous group of diseases characterized by diffuse abnormal deposition of collagen matrices in the pulmonary parenchyma [1,2]. Interstitial lung diseases (... more

Phenotyping congestion in patients with acutely decompensated heart failure with preserved and reduced ejection fraction: The Decongestion duRing therapY for acute decOmpensated heart failure in HFpEF vs HFrEF- DRY-OFF study

26 November 2021
Author(s): C Cogliati, E Ceriani, G Gambassi, G De Matteis, S Perlini, T Perrone, ML Muiesan, M Salvetti, F Leidi, F Ferrara, C Sabbà, P Suppressa, A Fracanzani, N Montano, E Fiorelli, G Tripepi, M Gori, A Pitino, A Pietrangelo

Acute decompensation of heart failure (ADHF) is the most common reason for hospitalization in patients above the age of 65 years in Western countries [1]. It imposes a significant burden both on... more

Neutrophil count, lymphocyte count and neutrophil-to-lymphocyte ratio in relation to response to adjunctive dexamethasone treatment in community-acquired pneumonia

12 November 2021
Author(s): Esther Wittermans, Ewoudt MW van de Garde, G Paul Voorn, Arnoud F Aldenkamp, Rob Janssen, Jan C Grutters, Willem Jan W Bos, Santeon-CAP study group

The cornerstones of community-acquired pneumonia (CAP) treatment are early diagnosis and timely initiation of appropriate antibiotic treatment [1]. Despite advances in antibiotic treatment, CAP... more

Left ventricular global longitudinal strain in secondary hypertension: A meta-analysis of echocardiographic studies

26 October 2021
Author(s): Marijana Tadic, Carla Sala, Stefano Carugo, Giuseppe Mancia, Guido Grassi, Cesare Cuspidi

Secondary hypertension defines a wide range of clinical conditions in which the increase in blood pressure (BP) is due, unlike primary hypertension, to an identifiable cause [1]. Although definition... more

Association between air temperature, air pollution and hospital admissions for pulmonary embolism and venous thrombosis in Italy

23 October 2021
Author(s): Chiara Di Blasi, Matteo Renzi, Paola Michelozzi, Francesca de’ Donato, Matteo Scortichini, Marina Davoli, Francesco Forastiere, Pier Mannuccio Mannucci, Massimo Stafoggia

Cardiovascular diseases (CVD) are the leading cause of death in the world [1], as well as in Europe and Italy [2], accounting for more than 1.8 million deaths (36% of total) every year. It has been... more

Risk factors for community-onset pneumonia caused by drug-resistant pathogens: A prospective cohort study

18 October 2021
Author(s): J. Vasco Barreto, Cláudia Camila Dias, Teresa Cardoso

It is presumed that 70% of Community-Acquired Pneumonias (CAP) are caused by bacteria [1], but, in clinical practice, microbial etiology remains unknown in at least 60% of the cases [2]. One of the... more

Estimated 10-year cardiovascular risk in a large Italian cohort of rheumatoid arthritis patients: Data from the Cardiovascular Obesity and Rheumatic DISease (CORDIS) Study Group

14 October 2021
Author(s): Fabio Cacciapaglia, Francesca Romana Spinelli, Matteo Piga, Gian Luca Erre, Garifallia Sakellariou, Andreina Manfredi, Ombretta Viapiana, Marco Fornaro, Sergio Colella, Alberto Floris, Arduino Aleksander Mangoni, Floriana Castagna, Caterina Vacchi, Giovanni Orsolini, Serena Bugatti, Giacomo Cafaro, Alberto Cauli, Elisa Gremese, Fabiola Atzeni, Elena Bartoloni

Rheumatoid Arthritis (RA) is a chronic, systemic inflammatory disease characterized by a relatively high risk of atherosclerotic cardiovascular (CV) events. Notably, such risk has been reported to be... more

Effectiveness of telemedicine in patients with heart failure according to frailty phenotypes: Insights from the iCOR randomised controlled trial

13 October 2021
Author(s): Sergi Yun, Cristina Enjuanes, Esther Calero-Molina, Encarnación Hidalgo, Núria José, Elena Calvo, José María Verdú-Rotellar, Paloma Garcimartín, David Chivite, Francesc Formiga, Santiago Jiménez-Marrero, Alberto Garay, Lídia Alcoberro, Pedro Moliner, Xavier Corbella, Josep Comín-Colet

Heart failure (HF) is a worldwide global healthcare problem due to its high prevalence, incidence and associated mortality and morbidity [1,2]. Moreover, HF is associated with impaired health-related... more

Review Article

Venous thromboembolism during pregnancy and postpartum period

20 December 2021
Author(s): Syed Bukhari, Shumail Fatima, Amr F. Barakat, Annemarie E. Fogerty, Ido Weinberg, Islam Y. Elgendy

The maternal mortality rates in the United States (US) remain the highest among developed countries, and continue to rise (1). Cardiovascular diseases are the leading etiology of maternal deaths in... more

Drug-induced liver injury: Pathogenesis, epidemiology, clinical features, and practical management

9 November 2021
Author(s): HK Björnsson, ES Björnsson

Drug-induced liver injury (DILI), an injury to the liver or biliary system associated with intake of hepatotoxic drugs, is the most common cause of acute liver failure in the Western world [1,2]. A... more

The impact of nutrition and lifestyle modification on health

17 October 2021
Author(s): Lèlita Santos

According to the World Health Organization (WHO), Noncommunicable Diseases (NCDs), heart disease, stroke, diabetes, obesity, metabolic syndrome, chronic obstructive pulmonary disease, and some types... more

Colchicine – new horizons for an ancient drug. Review based on the highest hierarchy of evidence

14 October 2021
Author(s): Ami Schattner

Colchicine is a tricyclic alkaloid with anti-inflammatory properties extracted from the herbaceous Colchicum autumnale plant and first isolated and synthesized in the 19th century [1]. It is one of... more

Toxic nephropathy: Adverse renal effects caused by drugs

1 October 2021
Author(s): Robert J. Unwin

This is a brief overview of toxic nephropathy, which is an increasingly recognised problem with the continual introduction of new drugs and novel drug modalities, especially in oncology, and the... more


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