October 2022

30 Articles

Clinical Insights

Structural evolution of severe acute respiratory syndrome coronavirus 2: Implications for adhesivity to angiotensin-converting enzyme 2 receptors and vaccines

11 August 2022
Author(s): Martina Zappa, Paolo Verdecchia, Antonio Spanevello, Fabio Angeli

The Omicron BA.5 variant currently accounts for the majority of cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (https://covid.cdc.gov/covid-data-tracker/#variant-... more


Ultrafiltration in decompensated heart failure: Is time to look forward?

16 August 2022
Author(s): Gianfranco Sinagra, Enrico Fabris

Heart failure (HF) is a chronic condition resulting in more than 1 million hospitalizations annually in both the United States and Europe [1]. Because the natural history of HF is characterised by... more

Assessment of cardiovascular risk with C-reactive protein in rheumatoid arthritis patients

13 August 2022
Author(s): Rita Queirós, Fernando Salvador

Over the past decades, it has become increasingly accepted that the risk of cardiovascular (CV) morbidity and mortality is noticeably augmented in rheumatoid arthritis (RA) patients [1]. When... more

Internal Medicine Flashcard

Dorsal pigmentation of tongue

12 August 2022
Author(s): Takeshi Onda, Kamichika Hayashi, Masayuki Takano

A 56-year-old male patient with diabetes presented with black discolouration of the tongue 7 days after extraction of two mandibular molars (Fig. 1). Prophylactic oral amoxicillin 750 mg was started... more

Generalized erythematous scaly rash after glucocorticoids

10 August 2022
Author(s): Miguel Sogbe, Andrés Blanco-Di Matteo, José Luis Del Pozo

A 65-years-old woman with a medical history of idiopathic thrombocytopenic purpura and psoriasis in treatment with topical glucocorticoids presented with a three-month history of burning, generalized... more

Interstitial pneumonia with subpleural sparing and weight loss

13 July 2022
Author(s): Federico Vanoni, Andrea Caccioppo, Fabrizio Elia

A 36-years-old man from West Africa was admitted to our ED with respiratory failure and a 15 days history of fatigue and peevish cough. He reported watery diarrhea and a 30 kg weight loss in the last... more

Malar rash with pancytopenia

4 July 2022
Author(s): Hiroshi Hori, Takahiko Fukuchi, Hitoshi Sugawara

A 35-year-old Japanese man presented with a four-month history of persistent flushing and persistent high fever (≥38 °C) for the past several weeks.

Letter to the Editor

Non-invasive respiratory supports on inspiratory effort in COVID-19: How and when is it matter of selection? Author's reply.

1 September 2022
Author(s): Gioacchino Schifino, Maria Laura Vega, Lara Pisani, Stefano Nava

Dear Editor,

Non-invasive respiratory supports on inspiratory effort in Covid-19: how and when is it matter of selection?

21 August 2022
Author(s): Martina Flora, Mariano Mollica, Giuseppe Fiorentino, Antonio M. Esquinas

Dear editor,

COVID-19 mRNA vaccination in patients with previous myocarditis

17 July 2022
Author(s): Maurizio Pieroni, Michele Ciabatti, Elisa Saletti, Emanuele D'Aniello, Leonardo Bolognese, on-behalf-of-the-COVID-Vaccine-in-myocarditis-study-group

Dear Editor,

The impact of co-working with an Internist in a high-speciality division of cardiology in a third-level centre. Experience with a new organization model

5 July 2022
Author(s): Valentina Scheggi, Lorenzo Righi, Guia Moschi, Maria Teresa Mechi, Niccolò Marchionni

Despite remarkable international differences, most European health care systems rely on a primary care, a secondary care and more specialized or tertiary institutions, which often focus mainly on one... more

Sodium-glucose cotransporter 2 inhibitors reduce cardiovascular events in acute heart failure. A real-world analysis

27 June 2022
Author(s): Raquel López-Vilella, Víctor Donoso Trenado, Borja Guerrero Cervera, Ignacio Sánchez-Lázaro, Luis Almenar Bonet

Since the recent past, sodium-glucose cotransporter type 2 inhibitors (SGLT2i) have been recommended as mainstay therapy for patients with chronic heart failure (HF) and reduced ejection fraction (... more

Serum and urine angiopoietin-like protein 4 levels correlate with different degrees of dislipidemea and proteinuria in patients with primary nephrotic syndrome

24 June 2022
Author(s): Yue Li, Huajie Liu, Jingzhi Wang, Wangqiu Gong, Xia Gao

Primary nephrotic syndrome (PNS) is characterized by massive proteinuria, hypoproteinemia, edema and hyperlipidemia. Angiopoietin like protein 4 (ANGPTL4) is a secretory glycoprotein and belongs to... more

Supine vs prone position in mild to moderate COVID-19 pneumonia: The impact of proning on computed tomography findings

16 June 2022
Author(s): S Piciucchi, ML Garo, S Tomassetti, C Ravaglia, V Poletti

Dear Editor,

Blood pressure increase during hospitalization for COVID-19

15 June 2022
Author(s): Fabio Angeli, Martina Zappa, Federico Mattia Oliva, Antonio Spanevello, Paolo Verdecchia

The first report of a rise in blood pressure (BP) associated with vaccination for coronavirus disease 2019 (COVID-19) was provided by Meylan et al. [1]. These authors published a series of subjects... more

Effects of statins on clinical outcomes in hospitalized patients with COVID-19

8 June 2022
Author(s): Paulo Ricardo Martins-Filho, José Augusto Soares Barreto-Filho, Antônio Carlos Sobral Sousa

Statins are lipid-lowering drugs that have been evaluated as a potential treatment for COVID-19 due to their pleiotropic effects, including anti-inflammatory, immunomodulatory, antioxidant,... more

Systemic diseases associated with a diagnosis of achalasia: A case-control study with the All of Us research program

1 June 2022
Author(s): Erik Almazan, Gayane Yenokyan, Kenneth Ng

Esophageal achalasia is an idiopathic disorder characterized by degeneration of neurons in the myenteric plexus of the esophagus [1]. Enteric neuropathies, primary and secondary, have been proposed... more

Original Article

Physicians’ responsibility toward environmental degradation and climate change: A position paper of the European Federation of Internal Medicine

31 August 2022
Author(s): Luís Campos, J. Vasco Barreto, Stefano Bassetti, Monica Bivol, Amie Burbridge, Pietro Castellino, João Araújo Correia, Mine Durusu-Tanriöver, Carmen Fierbinteanu-Braticevici, Thomas Hanslik, Zbigniew Heleniak, Radovan Hojs, Leonid Lazebnic, Maria Mylona, Matthias Raspe, João Queirós e Melo, Filomena Pietrantonio, Reinold Gans, Runólfur Pálsson, Nicola Montano, Ricardo Gómez-Huelgas, Dror Dicker

The 2021 Assessment of the United Nations Intergovernmental Panel on Climate Change (IPCC) was the sixth in a series of reports of the latest scientific and socioeconomic data on climate change [1].... more

Varicella-Zoster virus reactivation following severe acute respiratory syndrome coronavirus 2 vaccination or infection: New insights

31 July 2022
Author(s): Raquel Martinez-Reviejo, Sofia Tejada, Ganiyat A.R. Adebanjo, Camilla Chello, Miriam C. Machado, Francesca R. Parisella, Magda Campins, Antonella Tammaro, Jordi Rello

Coronavirus disease-2019 (COVID-19) is caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. The systemic manifestations of COVID-19 comprise respiratory,... more

A machine learning approach to characterize patients with asthma exacerbation attending an acute care setting

31 July 2022
Author(s): Maria D'Amato, Pasquale Ambrosino, Francesca Simioli, Sarah Adamo, Anna Agnese Stanziola, Giovanni D'Addio, Antonio Molino, Mauro Maniscalco

Asthma is a respiratory disease with a wide spectrum of clinical presentations. The prevalence in adults is 8.2% and 9.4% in children in the European Union [1]. Severe asthma is a clinical condition... more

Host response dysregulations amongst adults hospitalized by influenza A H1N1 virus pneumonia: A prospective multicenter cohort study

30 July 2022
Author(s): Blanca Valenzuela-Méndez, Francisco Valenzuela-Sánchez, Juan Francisco Rodríguez-Gutiérrez, Rafael Bohollo-de-Austria, Ángel Estella, Pilar Martínez-García, María Ángela González-García, Grant Waterer, Jordi Rello

The influenza virus affects the respiratory tract through direct damage, or indirectly through the inflammatory response. While the inflammatory and immune response produced after influenza infection... more

Nutritional status in patients with hepatocellular carcinoma: Potential relevance for clinical outcome

26 July 2022
Author(s): Anne M. van Dijk, Bart J.P. Coppens, Maartje A. van Beers, Alexandra S. Bruins Slot, Carina J.R. Verstraete, Joep de Bruijne, Frank P. Vleggaar, Karel J. van Erpecum


Different profiles of advanced heart failure among patients with and without diabetes mellitus. Findings from the EPICTER study

22 July 2022
Author(s): José Carlos Arévalo Lorido, Juana Carretero Gómez, Miriam Romero Correa, Jesus Recio Iglesias, Teresa Choucino Fernández, Rosa Jordana Camajuncosa, Margarita Carrera Izquierdo, Carlos Jiménez Guardiola, Lucía Fuentes Pardo, Esther Piniella Ruiz, Francesc Formiga, Prado Salamanca Bautista

Heart failure (HF), the representative end-stage of most heart diseases, has a heterogeneous course that makes it difficult to know with certainty whether a patient is in the advanced stage of the... more

C-reactive protein and 10-year cardiovascular risk in rheumatoid arthritis

9 July 2022
Author(s): Gian Luca Erre, Fabio Cacciapaglia, Garifallia Sakellariou, Andreina Manfredi, Elena Bartoloni, Ombretta Viapiana, Marco Fornaro, Alberto Cauli, Arduino Aleksander Mangoni, Richard John Woodman, Bianca Lucia Palermo, Elisa Gremese, Giacomo Cafaro, Valeria Nucera, Caterina Vacchi, Francesca Romana Spinelli, Fabiola Atzeni, Matteo Piga, “Cardiovascular, Obesity and Rheumatic Disease Study (CORDIS) Group” of the Italian Society of Rheumatology (SIR)

Rheumatoid arthritis (RA) is associated with an increased risk of cardiovascular disease compared with the general population [1]. The increased risk of cardiovascular disease in patients with RA is... more

Safety and efficacy of ultrafiltration versus diuretics in patients with decompensated heart failure: A systematic review and meta-analysis

27 May 2022
Author(s): Waqas Ullah, Muhammad Khawar Sana, Hamza Usman Mustafa, Harigopal Sandhyavenu, Alexander Hajduczok, Tanveer Mir, David L. Fischman, Mahek Shah, Yevgeniy Brailovsky, Indranee N. Rajapreyar

Acute decompensated heart failure, a constellation of dyspnea, edema, and fatigue due to volume overload, accounts for the high healthcare costs, projected to increase from $21 billion in 2012 to $70... more

Review Article

Monkeypox infection: An update for the practicing physician

20 August 2022
Author(s): Fabian Patauner, Raffaella Gallo, Emanuele Durante-Mangoni

As of August 5, 2022, >26,000 cases of monkeypox have been diagnosed worldwide and the steep increase of cases has spurred renewed concern about the risk for another viral pandemic. In this... more

Sudden death in young athletes: Is it preventable?

17 June 2022
Author(s): Pietro Amedeo Modesti, Giancarlo Casolo, Iacopo Olivotto, Alessio Pellegrino

Sudden deaths in athletes (SDA) are rare but devastating events, with huge social impact and vast echo in the media. Elite athletes are contemporary icons epitomizing health and success, promoting... more

Adult-onset type 1 diabetes: A changing perspective

16 June 2022
Author(s): J Burahmah, D Zheng, RD Leslie

Diabetes represents a disease state, irrespective of the presence of clinical symptoms, determined by raised glucose or HbA1c levels. Diabetes has surged in prevalence in recent years, whether type 1... more

Epidemiology of portal vein thrombosis in liver cirrhosis: A systematic review and meta-analysis

7 June 2022
Author(s): Jiahui Pan, Le Wang, Fangbo Gao, Yang An, Yue Yin, Xiaozhong Guo, Filipe Gaio Nery, Eric M. Yoshida, Xingshun Qi

Liver cirrhosis is the 11th most common cause of death worldwide [1]. The number of deaths from liver cirrhosis increased from 899,000 in 1990 to 1,320,000 in 2017, constituting 2.4% of total deaths... more


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