European journal of internal medicine
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Eur. J. Intern. Med. · Dec 2021
Meta AnalysisHydroxichloroquine for COVID-19 infection: Do we have a final word after one year?
The results presently available from randomised clinical trials and their meta-analysis indicate that Hydroxychloroquine is not associated in COVID-19 patients with either decreased mortality or clinical worsening. Thus, the use of Hydroxychloroquine in COVID-19 patients cannot at present be encouraged. However, the hypothesis that Hydroxychloroquine might have a beneficial role in subgroups of patients at low risk and/or when used at low dosage (≤ 400 mg/day) deserves to be tested in large, well designed randomised clinical trials.
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Eur. J. Intern. Med. · Dec 2021
ReviewPopular procedures without evidence of benefit: A case study of percutaneous coronary intervention for stable coronary artery disease.
Despite limited benefit, percutaneous coronary intervention (PCI) remains a common procedure that is often performed for uncertain or inappropriate indications in patients with stable coronary artery disease (CAD). PCI cases per capita have increased year-over-year in most European countries, and many have higher rates than the U. S. ⋯ This article reviews the evidence on use of PCI in stable CAD. Specifically, we analyzed randomized control trials, systematic reviews, appropriate use criteria, and professional society guidelines that examine the risks and benefits of PCI compared to OMT. We then highlight utilization patterns as well as interventions that better align current practice with evidence-based care.
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Eur. J. Intern. Med. · Dec 2021
Multicenter StudyExamination of the relationship between emergency department presentations and population mortality: a multicenter analysis of emergency department presentations during the COVID-19 pandemic.
In the spring of 2020, Italy experienced a significant reduction in the number of emergency department (ED) presentations during the first wave of the COVID-19 pandemic. If ED access has an impact on patients' prognosis, such a reduction in ED presentations would be expected to correlate with a parallel increase in the mortality rate of the corresponding population. The aim of the present study was to evaluate the impact of reduced ED presentations on the all-cause mortality of the general population. ⋯ Taking into account the increase in mortality due to SARS-CoV-2, reductions in ED access did not seem to affect death rates. If this finding will be confirmed, ED organization and access would need to be reconsidered.
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Eur. J. Intern. Med. · Dec 2021
Diagnostic yield of endoscopy in irritable bowel syndrome: A nationwide prevalence study 1987-2016.
Symptoms of irritable bowel syndrome (IBS) are common reasons for endoscopic procedures. We examined the yield of colonoscopy and upper endoscopy in IBS for several organic diseases. ⋯ The diagnostic yield of upper endoscopy and colonoscopy for organic disease is low in patients with a first-time diagnosis of IBS, though increases with age.