March 2023

29 Articles


Antimicrobial stewardship at the emergency department: Dead bugs do not mutate!

19 January 2023
Author(s): Jordi Rello, José Artur Paiva

Detecting organisms in blood is a key determinant in sepsis management [1] and in optimizing antimicrobial use in hospitalized patients [2]. Conway et al. [3] reported that blood cultures were... more

Ideas and Opinions

General health check-ups: To check or not to check? A question of choosing wisely

4 January 2023
Author(s): Omar Kherad, Antonio Vaz Carneiro, On behalf of Choosing wisely working group of the European Federation of Internal Medicine

In high-income countries, regular general health check-ups are part of the fabric of the health care systems. The hidden concept of general health check-ups, promoted for more than a century, is to... more

Internal Medicine Flashcard

Peculiar form of rapidly progressive pneumonia in healthy man

25 December 2022
Author(s): Valeria Bellelli, Gabriella De Girolamo, Giovanni Talerico

A healthy 53–years-old male presented to ED with fever and arthralgia for two days. On admission the patient was alert, oriented, febrile; thoracic exam revealed crackles in left basal area. Blood... more

A plaque on the right retropharyngeal wall

24 December 2022
Author(s): Yu-Kun Zhao, Jing-Fa Lu, Di-Qing Luo

A 25-year-old unmarried man was referred because of 1-week history of mildly sore throat, without association of systemic symptoms. He had an oral sex with a man 3 weeks before his presentation. His-... more

Dyspnea with chylothorax: Importance of examining the nails

23 December 2022
Author(s): Maud Pichon, Ines Zaraa, Françoise Le Pimpec-Barthes

A previously healthy 53-year-old man presented to our department with 2 months of dyspnea. Lung examination revealed a left-sided pleural effusion confirmed on the chest radiograph (Fig. 1A) and CT... more

Letter to the Editor

Which events to consider in the study of venous thromboses in pancreatic cancer patients? Authors' reply

17 January 2023
Author(s): Silvia García Adrián, Vanessa Pachón Olmos, Purificación Martínez del Prado, Andrés J. Muñoz Martín

We appreciate the comments made by Debourdeau et al. [1] regarding our recent publication “Incidence, risk factors, and evolution of venous thromboembolic events in patients diagnosed with pancreatic... more

Prognostic value of positive blood cultures and culture results on outcomes in emergency medical admissions

17 December 2022
Author(s): Richard Conway, Declan G. Byrne, Deirdre O'Riordan, Bernard Silke

Blood cultures are commonly performed in emergency medical admissions but the extent to which they improve established prognostic algorithms has been infrequently studied [1]. We report on a large... more

Trend in the proportion of subjects with SARS-CoV-2 infection without COVID-19 specific symptoms among patients admitted to a COVID-19 referral hospital

5 December 2022
Author(s): Andrea Giacomelli, Anna Lisa Ridolfo, Letizia Oreni, Giuliano Rizzardini, Spinello Antinori, COVID-Sacco Study group

The clinical and epidemiological characteristics of COVID-19 gradually changed during different waves [1]. The highly transmissible omicron variant that has globally dominated during 2022 has led to... more

Which events to consider in the study of venous thromboses in pancreatic cancer patients?

25 November 2022
Author(s): Philippe Debourdeau, Simon Launay, Malika Chaouche

The incidence of Venous Thromboembolism (VTE) in patients with pancreatic cancer is high, especially in individuals with locally advanced or metastatic disease treated with chemotherapy, as outlined... more

Non-infectious gastrointestinal manifestations of Good syndrome

19 November 2022
Author(s): Chen Wang, Yiyun Shi

Good syndrome is a rare adult-onset immunodeficiency syndrome, typically characterized by thymoma and hypogammaglobulinemia. Its clinical manifestations are highly variable, and concurrent non-... more

The effects of different types of resistance training in patients with coronary artery disease

18 November 2022
Author(s): Tim Kambic, Vedran Hadžić, Mitja Lainscak

Exercise-based cardiac rehabilitation in patients with coronary artery disease (CAD) reduces all-cause mortality, reinfarction and revascularisation rates, and rehospitalizations for cardiovascular... more

Safety and efficacy of interleukin-1 antagonists in hospitalized patients with COVID-19

15 November 2022
Author(s): Athina Dimosiari, Dimitrios Patoulias, Ioannis Pantazopoulos, Epaminondas Zakynthinos, Demosthenes Makris

the ongoing pandemic of coronavirus disease-2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection still represents a major public health concern. Severe COVID-... more

Discordance in perception of disease severity between patient and physicians

13 November 2022
Author(s): Valencia Long, Xer Min Nicole Lau, Clara Xinyi Ng, Phillip Phan, Ci En Ellie Choi

Dear Editor,

Impact of chronic lung disease on long-term clinical outcomes in patients with venous thromboembolism: From the COMMAND VTE registry

5 November 2022
Author(s): Shinya Ikeda, Yugo Yamashita, Takeshi Morimoto, Koh Ono, Takeshi Kimura, COMMAND VTE Registry Investigators

Chronic lung disease (CLD), such as asthma, chronic obstructive pulmonary disease (COPD), and restrictive lung diseases, has been reported to be a moderate risk factor for the development of venous... more

Fostering the intersection between primary care and hospital: hints from a survey and the PRIME (PRIMary care-hospital Embedding) project

3 November 2022
Author(s): Marco Montagna, Nuccia Morici, Tobias Tritschler, Patrizia Rovere Querini

great debate is ongoing in Italy and in other countries about the challenges faced by primary care, among which its reduced efficacy and lack of workforce turnover [1–3]. Some even envisage “the end... more

Prognostic value of clusterin/apolipoprotein J in patients with reperfused ST-segment elevation myocardial infarction

28 October 2022
Author(s): Shiru Zhang, Yundi Jiao, Yang Hou, Zhijun Sun, Zhaoqing Sun

Dear Editor,

The management of erythrocytosis during testosterone therapy: A practical approach

28 October 2022
Author(s): Milou C. Madsen, Marielle J. Wondergem, Elfi B. Conemans, Abel Thijs, Martin den Heijer

Testosterone is the primary sex hormone and anabolic steroid in men. It is a widely used drug which is used by males as an anabolic–androgenic steroid but it is also the cornerstone in treatment of... more

Original Article

Patterns of immunosuppressive drug use during pregnancy in women with systemic vasculitis: A nationwide population-based cohort study

24 January 2023
Author(s): Camille Mettler, Nathanael Beeker, Mathis Collier, Véronique Le Guern, Benjamin Terrier, Laurent Chouchana

Systemic vasculitis are characterized by inflammation of the vessel wall, classified according to clinical, biological and histological criteria [1]. Systemic vasculitis can be severe and even life-... more

Competences of internal medicine specialists for the management of patients with multimorbidity. EFIM multimorbidity working group position paper

17 January 2023
Author(s): M Bernabeu-Wittel, O Para, J Voicehovska, R Gómez-Huelgas, J Václavík, E Battegay, M Holecki, B.C. van Munster, EFIM Multimorbidity Working Group

By 2060, the number of Europeans above age 65 is projected to increase from 88 to 153 million [1]. In consequence, the true challenge for European health care systems is to prepare for this... more

Active fluid de-resuscitation in critically ill patients with septic shock: A systematic review and meta-analysis

11 January 2023
Author(s): Anna S. Messmer, Tatjana Dill, Martin Müller, Carmen A. Pfortmueller

Adequate initial fluid resuscitation

Is the steady-state concentration, duration of action, or molecular weight of GLP-1RA associated with cardiovascular and renal outcomes in type 2 diabetes?

9 January 2023
Author(s): Shuzhen Bai, Chu Lin, Ruoyang Jiao, Xiaoling Cai, Suiyuan Hu, Fang Lv, Wenjia Yang, Xingyun Zhu, Linong Ji

Patients with type 2 diabetes (T2D) suffer from a higher risk of cardiovascular events and renal events, which are strongly associated with morality [1–3]. The novel anti-hyperglycemic agent,... more

Associations of relative fat mass, a new index of adiposity, with type-2 diabetes in the general population

3 January 2023
Author(s): Navin Suthahar, Kan Wang, Victor W. Zwartkruis, Stephan J.L. Bakker, Silvio E. Inzucchi, Laura M.G. Meems, Tim R. Eijgenraam, Fariba Ahmadizar, Eric G. Sijbrands, Ron T. Gansevoort, Lyanne M. Kieneker, Dirk J. van Veldhuisen, Maryam Kavousi, Rudolf A. de Boer

Associations of adiposity measures with incident type-2 diabetes in the total population and across multiple age categories. Adiposity indices were standardized sex specifically. Abbreviations: RFM,... more

Impact of adherence to EULAR quality indicators on the quality of life of patients with systemic lupus erythematosus

28 December 2022
Author(s): Nadim Taheri, Arthur Mageau, Marie-Paule Chauveheid, Antoine Dossier, Fatima Farhi, Celine Mendes, Thomas Papo, Tiphaine Goulenok, Karim Sacre

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease with a wide range of manifestations affecting health-related quality of life [1]. In recent years recommendations have been... more

The effect of sex inequality on solid organ transplantation: A systematic review and meta-analysis

28 December 2022
Author(s): Sofia Tejada, Raquel Martinez-Reviejo, Taísa A. Nogueira, Aroa Gómez, Teresa Pont, Xuelian Liao, Zheng Zhang, Oriol Manuel, Jordi Rello

Solid organ transplantation (SOT) is the preferred treatment option for patients with end-stage diseases [1]. The prognosis of these patients is influenced by many factors such as infection [2],... more

Cardiovascular outcomes and mortality after incident ischaemic stroke in patients with a recent cancer history

21 December 2022
Author(s): Ralph K. Akyea, Barbara Iyen, Georgios Georgiopoulos, Joe Kai, Nadeem Qureshi, George Ntaios

Evidence from previous studies suggests a relationship between ischaemic stroke and cancer such that 1 in 10 patients with ischaemic stroke has been shown to have comorbid cancer [1–3]. The most... more

Role of anti-tumor necrosis factor-alpha agents in treatment of sarcoidosis: A meta-analysis

14 December 2022
Author(s): Malihe Rezaee, Moein Zangiabadian, Amirali Soheili, Tess Moore Calcagno, Maryam Rahmannia, Roshan Dinparastisaleh, Mohammad J. Nasiri, Mehdi Mirsaeidi

Sarcoidosis is a chronic multisystem inflammatory disorder characterized by noncaseating granulomas. The exact etiology and underlying mechanisms of sarcoidosis have not been fully elucidated. It is... more

Review Article

How low should blood pressure be in patients with chronic coronary and cerebrovascular diseases

9 January 2023
Author(s): A.J. Manolis, M.S. Kallistratos, M. Camafort, A. Coca

Cardiovascular disease (CVD) represents the leading cause of morbidity and mortality worldwide. More than 18 million deaths are attributed to CVD in 2019 while the global trends for disability-... more

The spike effect of acute respiratory syndrome coronavirus 2 and coronavirus disease 2019 vaccines on blood pressure

12 December 2022
Author(s): Fabio Angeli, Martina Zappa, Gianpaolo Reboldi, Giorgio Gentile, Monica Trapasso, Antonio Spanevello, Paolo Verdecchia

Data accrued over the last 2 years reported that specific comorbidities are associated with increased risk of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and worse... more

Reshaping care in the aftermath of the pandemic. Implications for cardiology health systems

30 November 2022
Author(s): Antonio Jordan-Rios, Vincenzo Nuzzi, Daniel I Bromage, Theresa McDonagh, Gianfranco Sinagra, Antonio Cannata

Since the COVID-19 pandemic commenced more than two years ago, it has taken the lives of more than six million people around the globe [1]. In parallel with high mortality rates, health care delivery... more


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