Sepsis in internal wards: results of an Italian multicenter prospective study

Sepsis is a frequent inflammatory disease with a high mortality and morbidity rate. Most of the data about epidemiology, management and prognosis of patients with sepsis came mainly from studies conducted within Intensive Care Units (ICUs). A consistent number of studies suggest that a proportion of patients with sepsis and severe sepsis are admitted to internal medicine units, and not transferred to an ICU. In this article, we presented the data of an Italian study, a multicenter study, evaluating consecutive patients, with an objective diagnosis of sepsis treated in internal medicine units

New oral anticoagulants: key messages for clinicians

New oral anticoagulants are an effective and safe alternative to vitamin K antagonists in many fields of clinical practice. The use of the direct inhibitors of activated Factor II (dabigatran) and activated Factor X (apixaban and rivaroxaban), both in patients with non-valvular atrial fibrillation (NVAF) and those with acute venous thromboembolism (VTE), is of great interest for internal medicine physicians. This paper aims to give practical guidance on management (starting therapy, follow up and bleeding complications) of patients treated with dabigatran, rivaroxaban or apixaban for NVAF or acute VTE providing practical tables concerning the phases of therapy, management of complications, drug interaction and dose adjustment if renal impairment occurs

A new series on diagnostic echographic cases and living brief reviews: a potentially useful tool for clinicians edited by FADOI

Sonography – similar to what happened almost two centuries ago with the introduction of stethoscopes – has completely changed patients’ clinical management in Internal Medicine. The availability of performant, sometimes even small-sized and cost-effective machines, has allowed doctors in Internal-Medicine units to perform bedside-ultrasound examinations alongside regular clinical ones. [...

Emergence of SARS-COV-2 Spike Protein Escape Mutation Q493R after Treatment for COVID-19

7noWe report in vivo selection of a severe acute respiratory syndrome coronavirus 2 spike mutation (Q493R) conferring simultaneous resistance to bamlanivimab and etesivimab. This mutation was isolated from a patient who had coronavirus disease and was treated with these drugs.openopenFocosi, Daniele; Novazzi, Federica; Genoni, Angelo; Dentali, Francesco; Gasperina, Daniela Dalla; Baj, Andreina; Maggi, FabrizioFocosi, Daniele; Novazzi, Federica; Genoni, Angelo; Dentali, Francesco; Gasperina, Daniela Dalla; Baj, Andreina; Maggi, Fabrizi

Statins, fibrates, and venous thromboembolism: a meta-analysis.

Aims The aim is to make a systematic review of the literature to assess the effect of lipid-lowering drugs on venous thromboembolism (VTE) occurrence. Methods and results MEDLINE and EMBASE databases were searched to identify studies that evaluated the effect of lipid-lowering drugs, in particular statins and fibrates, on VTE risk until April 2009. A scoring system was used to divide studies into two quality categories. Odds ratios (ORs) and 95% confidence intervals (CIs) were then calculated and pooled using a fixed and a random-effects model. Statistical heterogeneity was evaluated through the use of I2 statistics. Three randomized controlled trials (RCTs), three cohort, and eight case\u2013control studies were included in our systematic review, for a total of 863 805 patients. Statins use significantly reduced VTE risk [OR, 0.81; 95% CI, 0.66\u20130.99, random-effect model)]. There was a very high heterogeneity among the studies (I2 > 80%). The use of fibrates was associated with a significant increase in the risk of VTE (OR, 1.58; 95% CI, 1.23\u20132.02), without heterogeneity (I2 = 0%). Data on other lipid-lowering drugs were lacking. Conclusion This meta-analysis of available literature suggests that statins may lower the risk of VTE, whereas fibrates may increase this risk. Due to several methodological limitations, this conclusion should be considered with caution, and additional, specifically designed RCTs are warranted

Progetto FADOI “EUCLIDE”. Clinica, comunicazione, telemedicina e governance: le esperienze da COVID-19 per il futuro della Medicina Interna

Introduzione Dario Manfellotto, Francesco Dentali, Andrea Fontanella Materiali e Metodi Dario Manfellotto, Francesco Dentali, Andrea Fontanella Gestione clinica del paziente complesso con patologie cardiovascolari e comorbilità Giuseppe Campagna, Claudia Ferrigno, Franco Mastroianni Gestione clinica del paziente complesso con diabete e comorbilità Ada Maffettone, Ernesto De Menis, Maria Serena Fiore Cura e comunicazione: l’esperienza nella pandemia e le prospettive future Luigi Magnani, Lara Bellardita, Salvatore Lenti Gestione a distanza del paziente complesso: la medicina digitale Filippo Pieralli, Flavio Tangianu, Maria Gabriella Coppola Governance per la Medicina Interna Andrea Montagnani, Roberta Re, Ilario Stefani Considerazioni conclusive Dario Manfellotto, Francesco Dentali, Andrea Fontanell