March 2024

64 Articles

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The prophylaxis of venous thromboembolism in medical patients: If you do it, do it right

16 December 2023
Author(s): Claudio Cimminiello

The study by Le Gal et al. [1] published in this issue of European Journal of Internal Medicine, offers the starting point for a series of remarks on the prophylaxis of venous thromboembolism (VTE)... more

Asymptomatic hyperuricemia and cardiovascular mortality: A matter of mechanisms?

9 December 2023
Author(s): Roberto Pontremoli, Maria Carla Ghinatti, Cecilia Barnini

Chronic hyperuricemia may result from increased purine catabolism through endogenous and/or dietary sources including fructose, alcohol, and purine-rich foods like certain meats and seafood [1]. In... more

Impact of rehabilitation treatment during the acute phase of SARS-CoV-2 infection

2 December 2023
Author(s): Ugo Paliani, Andrea Cardona, Alessio Gili, Maria Laura Di Meo, Maria La Penna

The coronavirus disease 2019 (COVID-19) pandemic had major repercussions on the health status of the general population, with significant health-related economic and social consequences [1]. A long... more

Beyond the Guidelines

Rationale of treatment recommendations in the 2023 ESH hypertension guidelines

11 January 2024
Author(s): Giuseppe Mancia, Mattias Brunström, Michel Burnier, Guido Grassi, Andrzej Januszewicz, Maria Lorenza Muiesan, Konstantinos Tsioufis, Sverre E. Kjeldsen, Reinhold Kreutz

We thank Drs. Verdecchia, Grossmann and Whelton for their interest and comments on the 2023 Guidelines on Hypertension of the European Society of Hypertension (ESH) [1]. The points they raise are... more

Clinical Insights

Interventions targeting LGBTQIA+ populations to advance health equity

18 January 2024
Author(s): Lia Ginaldi, Massimo De Martinis

The role of the physician is not limited to the provision of clinical care, but must also extend to identifying barriers to accessing care that patients encounter. As doctors we are called and must... more

Colchicine and cardiovascular prevention

3 January 2024
Author(s): Alessia Alunno, Francesco Carubbi, Claudio Ferri

“Scientia semper incerta est, expedit ut iudicium suspendat”Attributable to Marcus Tullius Cicer (106 b.C. – 43 b.C.)

Differences and similarities in interatrial shunts management

10 December 2023
Author(s): Gianluca Rigatelli, Marco Zuin

The most common types of interatrial communications are represented by the ostium secundum, ostium primum and sinus venosus defects. Specifically, the ostium secundum atrial septal defects (ASD)... more


Harnessing machine learning for the early prediction of ventilator-associated pneumonia: A leap towards precision in critical care

22 January 2024
Author(s): J.M. Garcia-Alamino, R. Pirracchio

The potential of medical applications of Artificial Intelligence (AI)/ Machine Learning (ML) has generated growing interest in recent years as AI/ML is anticipated to significantly influence not only... more

Beyond sex and gender: Call for an intersectional feminist approach in biomedical research

6 January 2024
Author(s): Jeanne M. Barbier, Joëlle Schwarz

In recent years, a growing focus on the theme of gender has emerged in biomedical research. Inclusion of sex and gender dimensions is crucial to conduct “rigorous, reproducible and responsible... more

A pulmonary perspective on current challenges in connective tissue diseases

15 December 2023
Author(s): Louis Jouanjan, Daiana Stolz, Björn C. Frye

Connective tissue diseases (CTD) are systemic diseases and as such can affect any organ. Why then should we focus on the lungs in particular, now more than ever? And why do we need a review on... more

Long COVID autonomic syndrome: Improved understanding through translational research

5 December 2023
Author(s): James Quinn

SARS-CoV-2 descended on humanity in 2020 as an acute virus causing millions of excess deaths and suffering [1]. Early research into antibody use, antivirals and the development of vaccines lead to... more

Electrocardiogram to guide early discharge in hemodynamically stable pulmonary embolism patients

27 November 2023
Author(s): Marco Zuin, Loris Roncon

The current European Society of Cardiology guidelines (ESC) on the management of patients with acute pulmonary embolism (PE) recommend a risk adapted management for therapy and discharge [1].... more

When the responsibility for a crime is shared between several actors. The case of hypertensive heart failure with preserved ejection fraction

27 November 2023
Author(s): Stefano Coiro, Paolo Verdecchia, Fabio Angeli

The current issue of the Journal hosts an important Review Article authored by leaders in Hypertension research [1]. The title of the Review may leave the mind open to the hope that at least one of... more

Ideas and Opinions

Trial sequential analysis methodology for interpreting meta-analytical findings

2 January 2024
Author(s): Antonio Greco, Davide Capodanno

In evidence-based medicine, systematic reviews and meta-analyses lie on top of the hierarchy of evidence [1]. This holds true also in the field of cardiovascular medicine, with meta-analyses often... more

Urgent and emergency care in europe: Time for a rational network?

28 November 2023
Author(s): Livio Garattini, Marco Badinella Martini, Alessandro Nobili

Spanning from helicopters and ambulances to hospital intensive care units, emergency and urgent care are required for respectively life-threatening and non-life-threatening sudden needs that require... more

Internal Medicine Flashcard

Unexpected myocardium: Benign finding or pathological debut?

4 January 2024
Author(s): Liliana Estefania Ramos Villalobos, Amayrani Nayle Romero Muñoz

A 24-year-old male without cardiovascular risk factors or family history, presented with a ten-day history of recurrent angina pectoris, accompanied by diaphoresis, dyspnea and nausea. Physical... more

Recurrent generalized rounded plaques

11 December 2023
Author(s): Emilio Berna-Rico, Jorge Naharro-Rodriguez, Emilio Garcia-Mouronte

A 40-year-old man attended to the emergency department with a one-day history of generalized painful lesions. He was on tramadol for a clavicle fracture. Six hours before the appearance of the... more

A keloid-like tumour

5 December 2023
Author(s): Juan Carlos Cataño, Nicolas Londoño

A 37-year-old male with no relevant past medical history, had a 5-year work history as a farmer in the Colombian Amazon River area, and presented with a 2-year history of a nodular, hyperpigmented... more

An unusual cause of ischemic stroke

2 December 2023
Author(s): Yusaku Kajihara

A 60-year-old Japanese woman had a history of ischemic stroke. She had no risk factors including a history of transient ischemic attack (TIA), hypertension, myocardial infarction, atrial fibrillation... more

Letter to the Editor

Strengthening insights into sleep duration and chronic diseases: A call for comprehensive consideration of family history, socioeconomic factors, dietary patterns, and age dynamics

18 January 2024
Author(s): Javeria Saeed, Muhammad Uneeb Ullah, Wardah Saeed

We read the article by Yaoling Wang et al. [1] with great interest. We extend our heartfelt gratitude to the authors for their thorough and careful examination of this crucial subject, which merits... more

The role of novel nicotine-containing products on SARS-CoV-2 infection and COVID-19 progression

5 January 2024
Author(s): Marco Scala, Alessandra Lugo, Giansanto Mosconi, Antonella Zambon, Anna Odone, Luc Smits, Silvano Gallus

A relatively low smoking prevalence was observed among COronaVIrus Disease 19 (COVID-19) patients [1]. Some researchers, whose link to the tobacco industry cannot be ruled out in some cases [2],... more

JAK2-V617F-mutated myeloproliferative neoplasms: A cannot be missed cause of symptomatic postoperative epidural hematoma after lumber spine surgery

3 January 2024
Author(s): Zhiquan Yang, Yun Yang, Yingguang Wu, Dayong Peng, Changjun Chen

We read with great interest the article by Gregoire Stalder published in the European Journal of Internal Medicine [1]. We appreciate the authors’ great work. Compared with their findings that... more

Effect of tirzepatide on blood pressure levels in overweight/obese individuals without diabetes

26 December 2023
Author(s): Dimitrios Patoulias, Djordje S. Popovic, Theocharis Koufakis, Konstantinos Stavropoulos, Michael Doumas

Tirzepatide is a novel dual gastric inhibitory polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor co-agonist recently approved for the treatment of type 2 diabetes (T2D) and obesity. It... more

Risk factors and complications associated with superficial venous thrombosis

20 December 2023
Author(s): Alejandro Díez Vidal, Javier Gómez López, María Angélica Rivera Núñez, Ana María Martínez Virto, Yale Tung Chen

I am writing to shed light on the critical and multifaceted issue of superficial venous thrombosis (SVT), a condition which is evolving from its perceived benign nature to one that is potentially... more

Early intervention is important when administering glucarpidase for methotrexate intoxication

15 December 2023
Author(s): L.R. Bettini, C. Rizzari

Giuseppe Miceli and colleagues describe in a letter recently published in the European Journal of Internal Medicine [1] the case of a patient with methotrexate intoxication who received treatment... more

“Exploring sarcoidosis systemic treatment: Patient factors and therapeutic strategies. Author's reply”

15 December 2023
Author(s): Raúl Fernández-Ramón, Santos Castañeda, Ricardo Blanco

We appreciate Rahman et al.’s interest and positive comments [1] in relation to our article published in the European Journal of Internal Medicine [2]. In this regard, we would like to make some... more

Elevated cardiac biomarkers in relatively healthy U.S. adults

11 December 2023
Author(s): Sophie E. Claudel, Insa M. Schmidt, Deepa M. Gopal, Ashish Verma

Cardiovascular disease (CVD) is the leading cause of death in the United States [1]. Prevention of CVD events often relies on early identification of higher risk individuals based on known CVD risk... more

Prognosis of hospitalized patients during different pandemic waves in Greece: Omicron innocent until proven guilty?

8 December 2023
Author(s): Ioannis El. Michelakis, Aristeidis E. Boukouris, Anastasia Komodromou, Stefania Foteinou, Maria Dafni

The coronavirus disease 2019 (COVID-19) pandemic had a tremendous impact on almost all aspects of life. More than 776 million confirmed cases of COVID-19 globally have resulted in 7 million deaths,... more

Novel technique of measuring diaphragm thickness using computed tomography and its potential for predicting prognosis of pneumonia

5 December 2023
Author(s): Masashi Yamamoto, Yoshiro Maezawa, Mayumi Shoji, Koutaro Yokote, Minoru Takemoto

The diaphragm is an essential skeletal muscle responsible for respiration [1]. However, the significance of measuring its muscle mass and function remains largely unexplored. In particular, it is... more

The medical history taking in elderly patients from Hippocrates to the Health Care Information Technology age

3 December 2023
Author(s): Paolo Dionigi Rossi, Simona Ciccone

The reorganization of the healthcare system in the last decades has dramatically reduced the time available for medical examination, so collecting medical history can be particularly challenging for... more

Association of incident cardiovascular events with unilateral low ankle-brachial index and bilateral low ankle-brachial index

20 November 2023
Author(s): Song Zhao, Chong Xu, Jing Xiong, Yawei Xu, Yi Zhang

The ankle-brachial index (ABI) represents a dependable approach to the early detection of lower extremity peripheral arterial disease, rendering it a valuable vascular marker for cardiovascular (CV)... more

Pyrin-associated autoinflammatory disease with p.Thr577Ala MEFV somatic mutation

17 November 2023
Author(s): Alexandre Terré, Flora Magnotti, Jean-Maxime Piot, Guilaine Boursier, Sophie Georgin-Lavialle

Familial Mediterranean fever (FMF) is the most common monogenic autoinflammatory disease worldwide. FMF is classically a recessive disease due to mutations in exon 10 of the MEFV gene and affects... more

Novel antidiabetics for the primary prevention of cardiopulmonary diseases

17 November 2023
Author(s): Mei Qiu, Limin Zhao, Xiangqi Kong, Xiaoqing Quan, Xiehui Chen

Glucagon-like peptide 1 receptor agonists (GLP1RAs) have been recommended for preventing cardiorenal events in patients with type 2 diabetes (T2D) [1], and sodium-glucose cotransporter-2 inhibitors (... more

Phenotyping pleural effusion in patients hospitalized in Internal Medicine wards with decompensated heart failure

16 November 2023
Author(s): Arianna Bartoli, Mattia Donadoni, Elisa Ceriani, Chiara Cogliati, DRY-OFF study group, A.L. Fracanzani, G. Pisano, G. Gambassi, G. De Matteis, S. Perlini, T. Perrone, M.L. Muiesan, M. Salvetti, F. Leidi, F. Ferrara, C. Sabbà, P. Suppressa, N. Montano, J. Peta, E. Fiorelli, 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]. Congestion represents a key clinical feature... more

Visualizing diagnostic “hotspots” in a tertiary hospital

15 November 2023
Author(s): Masashi Yokose, Yukinori Harada, Taro Shimizu

The Current healthcare system in the tertiary hospital has become highly specialized to focus on patients’ organ-specific problems, and patients expect to receive such specialized care [1]. On the... more

Chronic heart failure: An appropriate clinical context to search for GH deficiency?

10 November 2023
Author(s): Antonio Cittadini, Mariarosaria De Luca, Luigi Saccà

Until the beginning of the 90′s, it was commonly thought that adult-onset Growth Hormone Deficiency (GHD) did not bear any clinical relevance. Since then, several studies have systematically... more

Non-pharmacological home remedies used by primary care patients

3 November 2023
Author(s): Neria E. Winkler, Paul Sebo, Dagmar M. Haller, Hubert Maisonneuve, Home Remedies Research Collaboration

Non-pharmacological home remedies (NPHRs) have been used for generations, yet there is limited evidence on their conditions of use, effectiveness, and safety profile in high-income countries. However... more

Usefulness of multi-organ point-of-care ultrasound as a complement to the diagnostic process in an Internal Medicine outpatient clinic

2 November 2023
Author(s): Borja González-Muñoz, Carlos Oñoro-López, Alejandro Díez-Vidal, María-Angustias Quesada-Simón, Yale Tung-Chen

Point-of-care ultrasound (POCUS) has experienced a great development in the last decade. As it was initially used in emergencies, it accelerated the diagnosis process and improved the diagnostic... more

Original Article

Event rates and risk factors for venous thromboembolism and major bleeding in a population of hospitalized adult patients with acute medical illness receiving enoxaparin thromboprophylaxis

29 November 2023
Author(s): Grégoire Le Gal, Giancarlo Agnelli, Harald Darius, Susan R Kahn, Tarek Owaidah, Ana Thereza Rocha, Zhenguo Zhai, Irfan Khan, Yasmina Djoudi, Ekaterina Ponomareva, Alexander T. Cohen

Venous Thromboembolism (VTE) related morbidity in patients hospitalized with acute medical illness may account for over 50 % of the overall burden of VTE. [1–7] Several randomized controlled trials (... more

Early prediction of ventilator-associated pneumonia with machine learning models: A systematic review and meta-analysis of prediction model performance✰

17 November 2023
Author(s): Tuomas Frondelius, Irina Atkova, Jouko Miettunen, Jordi Rello, Gillian Vesty, Han Shi Jocelyn Chew, Miia Jansson

Although lifesaving, mechanical ventilation predisposes patients to ventilator-associated pneumonia (VAP), which is the most serious respiratory infection, occurring in 23.5–39.3 % (12.2 to 22.4... more

How to recognize pulmonary embolism in syncope patients: A simple rule

8 November 2023
Author(s): Francesca Gianni, Mattia Bonzi, Alessandro Jachetti, Monica Solbiati, Giulia Dreon, Giorgio Colombo, Giulia Colombo, Antonio Russo, Ludovico Furlan, Giovanni Casazza, Giorgio Costantino

Pulmonary embolism (PE) is a known and potentially serious cause of syncope but the prevalence of PE in patients presenting with syncope remains unclear. In particular, while PE is reported as a rare... more

Direct oral anticoagulants are associated with lower risk of dementia in patients with atrial fibrillation

31 October 2023
Author(s): Dimitrios Sagris, George Ntaios, Benjamin J.R Buckley, Stephanie L Harrison, Paula Underhill, Deirdre A. Lane, Gregory Y.H. Lip

Both atrial fibrillation (AF) and dementia have evolved into silent epidemics which convey significant health-related, societal and financial burden. The number of patients with AF are expected to... more

Long-term cardiovascular events, graft failure, and mortality in kidney transplant recipients

28 October 2023
Author(s): Charlotte Andersson, Ditte Hansen, Søren Schwartz Sørensen, Martina McGrath, Finnian R. McCausland, Christian Torp-Pedersen, Morten Schou, Lars Køber, Marc A Pfeffer

Kidney transplant recipients are at increased risks of cardiovascular events, but contemporary risk estimates are sparse. Using the Danish nationwide administrative databases, we quantified 1- and 5-... more

Prevalence, predictors and outcomes of physician care left undone in acute care hospitals across six European countries during COVID-19: A cross-sectional study

28 October 2023
Author(s): Simon Dello, Luk Bruyneel, Dorothea Kohnen, Hans De Witte, Wilmar B. Schaufeli, Matthew D. Mchugh, Linda H. Aiken, Walter Sermeus, Magnet4Europe consortium

Healthcare is becoming increasingly complex [1]. The COVID-19 pandemic arose, in many countries, in a context of prolonged underinvestment, with reduced staffing levels relative to need and poor... more

Anticoagulation in atrial fibrillation. A large real-world update

23 October 2023
Author(s): Mario Bo, Stefano Fumagalli, Luca Degli Esposti, Valentina Perrone, Melania Dovizio, Daniela Poli, Rossella Marcucci, Paolo Verdecchia, Gianpaolo Reboldi, Gregory Y.H. Lip, Andrea Ungar, Alessandro Boccanelli, Carlo Fumagalli, Niccolò Marchionni, Italian Society of Geriatric Cardiology (SICGe)

Oral anticoagulant treatment (OAT) is strongly recommended for the prevention of ischemic stroke or systemic embolism in patients with non-valvular atrial fibrillation (NVAF) and additive risk... more

Glycemic control and prescription profiles in internal medicine inpatients: The role of frailty

21 October 2023
Author(s): Jose Carlos Arévalo Lorido, Juana Carretero Gomez, Patricia Vazquez Rodriguez, Ricardo Gómez Huelgas, Carmen Marín Silvente, Fernando Javier Sánchez Lora, Elena Isaba Ares, Anna Pardo i Pelegrín, Onán Pérez Hernández, Javier Ena

The number of adults over 65 years of age with diabetes mellitus (DM) is increasing worldwide and is estimated to reach 26.7 million by 2050 [1]. Accordingly, hospital admissions for adults over 65... more

One-year outcomes following a hypertensive urgency or emergency

21 October 2023
Author(s): Christos Fragoulis, Dimitrios Polyzos, Andreas Mavroudis, Panagiotis-Anastasios Tsioufis, Alexandros Kasiakogias, Ioannis Leontsinis, Emmanouil Mantzouranis, Theodoros Kalos, Athanasios Sakalidis, John Ntalakouras, Ioannis Andrikou, Kyriakos Dimitriadis, Dimitris Konstantinidis, Costas Thomopoulos, Konstantinos Tsioufis

Hypertensive urgencies (HU) or emergencies (HE) are characterized by a variable clinical presentation in patients with acute blood pressure (BP) increase to levels > 180/110 mmHg. According to the... more

Crohn´s disease is an independent risk factor for liver fibrosis in patients with inflammatory bowel disease and non-alcoholic fatty liver disease

21 October 2023
Author(s): Samuel J. Martínez-Domínguez, Sandra García-Mateo, Carla J. Gargallo-Puyuelo, Beatriz Gallego Llera, Engy Refaie, Pilar Callau, Carolina Mendi, Pedro M. Baptista, María Hernández Ainsa, María Teresa Arroyo-Villarino, Julia López de la Cruz, Javier Martínez-García, Erika Alfambra, Miguel Ángel Simón Marco, Javier Ampuero, Fernando Gomollón

Inflammatory Bowel Diseases (IBD) are chronic inflammatory pathologies that mainly affect gastrointestinal tract, including Crohn´s Disease (CD), Ulcerative Colitis (UC) and Indeterminate Colitis (IC... more

Hyperuricaemia-associated all-cause mortality risk effect is increased by non-impaired kidney function – Is renal hyperuricaemia less dangerous?

17 October 2023
Author(s): Janis Timsans, Jenni Emilia Kauppi, Anne Mirjam Kerola, Tiina Maarit Lehto, Hannu Juhani Kautiainen, Markku Jaakko Kauppi

Elevated serum uric acid (SUA) level, i.e., hyperuricaemia, is independently associated with all-cause mortality as well as with several cause-specific types of mortality [1–9]. It has been... more

Role of sex and gender-related variables in development of metabolic syndrome: A prospective cohort study

17 October 2023
Author(s): Pouria Alipour, Zahra Azizi, Valeria Raparelli, Colleen M. Norris, Alexandra Kautzky-Willer, Karolina Kublickiene, Maria Trinidad Herrero, Khaled El Emam, Peter Vollenweider, Martin Preisig, Carole Clair, Louise Pilote

Metabolic syndrome (MetS), defined as clustering of abdominal obesity, insulin resistance, dyslipidemia, and elevated blood pressure, is strongly associated with cardiovascular related mortality and... more

Systolic blood pressure is associated with abnormal alterations in brain cortical structure: Evidence from a Mendelian randomization study

16 October 2023
Author(s): Ziliang Ye, Qing Zeng, Limeng Ning, Wanzhong Huang, Qiang Su

Hypertension, a prevailing global health concern, has long been recognized as a critical risk factor for cerebrovascular diseases [1–3] and cognitive impairment [4–6]. It is characterized by... more

Chronic inflammatory diseases increase the risk of post-thrombotic syndrome: A prospective cohort study

16 October 2023
Author(s): Aaron F.J. Iding, Thibaut M.P. Limpens, Hugo ten Cate, Arina J. ten Cate-Hoek

Clinical management of patients with deep vein thrombosis (DVT) is centered around their risk of recurrent venous thromboembolism (VTE) and post-thrombotic syndrome (PTS) [1]. In both conditions,... more

Effects of the implementation of the dynamic silver code in the emergency department

13 October 2023
Author(s): Mauro Di Bari, Antonella Giordano, Ilaria Giannini, Daniela Balzi, Francesco Tonarelli, Enrico Benvenuti, Germana Ruggiano, Giancarlo Landini, Jeff D Williamson, Justin K Brooten, Giulia Carreras

Older patients represent an increasing share of Emergency Department (ED) visitors worldwide [1]. Because of their complex medical and social problems, older patients in the ED require longer... more

Uncovering a dose-response relationship between positive fecal immunochemical test (FIT) and all-cause, cardiovascular and cancer-related mortality

28 September 2023
Author(s): Chi Pang Wen, Min Kuang Tsai, June Han Lee, Hung Yi Chiou, Christopher Wen, Ta-Wei David Chu, Chien Hua Chen

The introduction of the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening has brought significant advantages over the previous guaiac fecal occult blood test (gFOBT), particularly... more

Legionella pneumonia in hospitalized adults with respiratory failure: Quinolones or macrolides?

18 September 2023
Author(s): Alfonsina Ruiz-Spinelli, Jordi Rello

Legionellosis represents an important public health problem throughout the world, although it is considered as an underdiagnosed and underreported disease. Morbidity and mortality remain high, as... more

Impact of bronchoalveolar lavage on the management of immunocompromised hosts

16 September 2023
Author(s): Kathleen Jahn, Meropi Karakioulaki, Desiree M. Schumann, Hans H. Hirsch, Karoline Leuzinger, Leticia Grize, Stefano Aliberti, Giovanni Sotgiu, Michael Tamm, Daiana Stolz

BAL leads to changes in management in the majority of immunosuppressed patients. There is a high prevalence of multimicrobial infections and respiratory viral infections in immunocompromised patients... more

Prognostic significance of quantitative electrocardiographic parameters in patients with non-high-risk pulmonary embolism

5 September 2023
Author(s): Xin-Xin Yan, Hong-Da Zhang, Fu-Hua Peng, Lei Ding, Li-Jie Mi, Ai-Kai Zhang, Lu Hua, Min Tang

Acute pulmonary embolism (PE), a common acute cardiovascular disease, has an annual incidence of 39∼120 cases per 100 000 population [1,2]. The incidence is increasing because of global population... more

The Long-COVID autonomic syndrome in hospitalized patients: A one-year prospective cohort study

29 August 2023
Author(s): Stefano Rigo, Franca Barbic, Kareem Khalaf, Andrea Bisoglio, Margherita Pani, Maura Minonzio, Luca Rinaldi, Michele Ciccarelli, Maria Grazia Bordoni, Paolo Verzeletti, Fabio Badilini, Stefanos Bonovas, Daniele Piovani, Dana Shiffer, Raffaello Furlan

A growing body of evidence [1–6] suggests that some patients who survive an acute SARS-CoV-2 viral infection (COVID-19) may experience persistent symptoms for months, resulting in a clinical syndrome... more

Review Article

Whipple's disease: A rare disease that can be spotted by many doctors

16 December 2023
Author(s): Alessandro Cappellini, Paolo Minerba, Stiliano Maimaris, Federico Biagi

Whipple's disease (WD) is a chronic, systemic, relapsing infection theoretically capable of affecting any organ, but primarily affects the joints, the mucosa of the small intestine, and the central... more

The diagnostic approach and management of hypertension in the emergency department

11 December 2023
Author(s): AJ Manolis, MS Kallistratos, M Koutsaki, M Doumas, L.E. Poulimenos, J Parissis, E Polyzogopoulou, A Pittaras, ML Muiesan, G Mancia

Cardiovascular disease is the leading cause of death worldwide, and hypertension is the main cardiovascular risk factor. Despite the increased use of antihypertensive medications, the prevalence of... more

Non-conventional immunomodulation in the management of sepsis

31 October 2023
Author(s): M.A. Slim, O. Turgman, L.A. van Vught, T. van der Poll, W.J. Wiersinga

Sepsis remains a critical global health issue, demanding novel therapeutic strategies. Traditional immunomodulation treatments such as corticosteroids, specific modifiers of cytokines, complement or... more

The current best drug treatment for hypertensive heart failure with preserved ejection fraction

20 October 2023
Author(s): Aurora Rist, Kaja Sevre, Kristian Wachtell, Richard B. Devereux, Gerard P. Aurigemma, Otto A. Smiseth, Sverre E. Kjeldsen, Stevo Julius, Bertram Pitt, Michel Burnier, Reinhold Kreutz, Suzanne Oparil, Giuseppe Mancia, Faiez Zannad

Heart failure (HF) affects 2.4 % of the American population and is expected to rise to 3 % by 2030 [1]. The prognosis of HF remains poor, with 5-year mortality above 50 % [2,3]. The fact that ACEIs... more

Residual cardiovascular risk: When should we treat it?

14 October 2023
Author(s): Francisco Gomez-Delgado, Manuel Raya-Cruz, Niki Katsiki, Javier Delgado-Lista, Pablo Perez-Martinez

Cardiovascular disease (CVD) remains a major health problem worldwide and especially in the European Union (EU) with an incidence of 12.7 million new CVD cases per year, 2.2 million deaths in females... more

Respiratory involvement in connective tissue diseases

14 October 2023
Author(s): Panagiota Xanthouli, Ishan Echampati, Hanns-Martin Lorenz, Claus Peter Heussel, Nicola Benjamin

Rheumatology is a special area of internal medicine engaged with the diagnosis and care of rheumatic, autoimmune and auto-inflammatory diseases (ARD) involving not only the muscles and the bones but... more


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