Novel biomarkers to assess the risk for acute coronary syndrome: beyond troponins
AbstractCurrent diagnostic biomarkers for ACS are mainly represented by troponin I and troponin T. Dosing of these two molecules often leads to false positive results, since their plasma levels can increase in several different systemic settings. Therefore, identification of new markers able to detect patients with acute coronary syndromes is an emerging priority. On this view, many studies have been performed on different microRNAs, mitochondrial peptides, inflammatory cytokines and adhesion molecules with very promising results. Besides their introduction in screening programs, further studies are now needed in the acute...
Source: Internal and Emergency Medicine - July 3, 2020 Category: Emergency Medicine Source Type: research

COVID-19 and elderly: beyond the respiratory drama
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - July 3, 2020 Category: Emergency Medicine Source Type: research

A COVID-19 patient with seven consecutive false-negative rRT-PCR results from sputum specimens
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - July 2, 2020 Category: Emergency Medicine Source Type: research

Practical implications of the 2019 Nobel Prize in Physiology or Medicine: from molecular adaptation to hypoxia to novel anti-anemic drugs in the clinic
AbstractThe 2019 Nobel Prize for Medicine or Physiology was assigned to three prestigious physician-scientists, Gregg L. Semenza, William G. Kaelin, and Peter J. Ratcliffe, who clarified the molecular mechanisms of hypoxia adaptation. This viewpoint traces their fundamental findings, which have paved the way for the development of innovative drugs for a wide range of common diseases, including cancer and anemia. (Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - July 2, 2020 Category: Emergency Medicine Source Type: research

Modification of the HEART pathway by adding coronary computed tomography angiography for patients suspected of acute coronary syndrome in the emergency department
AbstractThe HEART (history, ECG, age, risk factors, troponin) pathway (HP) was developed for identifying low-risk patients for early discharge among patients presenting with chest pain to the emergency department (ED). We investigated whether adding coronary computed tomography angiography (CCTA) results to selected patients could improve the diagnostic accuracy of the HP. Patients suspected of acute coronary syndrome who had undergone CCTA were included. The HP was modified by adding CCTA results of stenosis of any major epicardial coronary arteries to patients either with 0 –3 points and a positive troponin test or...
Source: Internal and Emergency Medicine - July 2, 2020 Category: Emergency Medicine Source Type: research

Benefit of dual antithrombotic therapy with direct oral anticoagulants in patients with atrial fibrillation undergoing percutaneous coronary intervention: a systematic review and metaanalysis of randomized clinical trials
AbstractAntithrombotic treatment in patients with atrial fibrillation undergoing percutaneous coronary intervention is still debated. We conducted a meta-analysis of recent randomized controlled trials to evaluate the benefit of different antithrombotic strategies. Data were analyzed between May and September 2019. Efficacy outcomes were trial-defined major adverse cardiovascular events (MACE); its individual components; stent thrombosis. Safety outcomes were trial-defined primary bleeding outcome; TIMI and ISTH major bleeding; clinically relevant non-major bleeding; intracranial hemorrhage. Differences in outcomes among g...
Source: Internal and Emergency Medicine - July 2, 2020 Category: Emergency Medicine Source Type: research

Bilateral lower limb weakness: a cerebrovascular consequence of covid-19 or a complication associated with it?
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - July 2, 2020 Category: Emergency Medicine Source Type: research

Which preoperative screening tool should be applied to older patients undergoing elective surgery to predict short-term postoperative outcomes? Lessons from systematic reviews, meta-analyses and guidelines
ConclusionMultiple tools were associated with poor short-term postoperative outcomes in older elective surgical patients. No single superior tool could be identified. Frailty, cognitive and/or functional tools were most frequently utilized. (Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - July 1, 2020 Category: Emergency Medicine Source Type: research

Pulmonary embolism and screening for concomitant proximal deep vein thrombosis in noncritically ill hospitalized patients with coronavirus disease 2019
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 26, 2020 Category: Emergency Medicine Source Type: research

Potential role of incretins in diabetes and COVID-19 infection: a hypothesis worth exploring
AbstractPatients with diabetes mellitus have been reported to be at a high risk of complications from SARS-CoV2 virus infection (COVID-19). In type 2 diabetes, there is a change in immune system cells, which shift from an anti-inflammatory to a predominantly pro-inflammatory pattern. This altered immune profile may induce important clinical consequences, including increased susceptibility to lung infections; and enhanced local inflammatory response. Furthermore, dipeptidyl peptidase 4 (DPP4) enzyme is highly expressed in the lung, and that it may have additional actions besides its effects on glucose metabolism, which migh...
Source: Internal and Emergency Medicine - June 26, 2020 Category: Emergency Medicine Source Type: research

COVID-19: a clinical and organizational crisis
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 23, 2020 Category: Emergency Medicine Source Type: research

Short vs long-course antibiotic therapy in pyelonephritis: a comparison of systematic reviews and guidelines for the SIMI choosing wisely campaign
ConclusionsShort-course antibiotic treatment is at least as effective as longer courses for both microbiological and clinical success in the treatment of acute uncomplicated pyelonephritis. (Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 21, 2020 Category: Emergency Medicine Source Type: research

The SARS-CoV-2 receptor, ACE-2, is expressed on many different cell types: implications for ACE-inhibitor- and angiotensin II receptor blocker-based cardiovascular therapies: comment
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 20, 2020 Category: Emergency Medicine Source Type: research

Lack of utility of CK-MB in combination with troponin I for the diagnosis of acute coronary syndrome
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 20, 2020 Category: Emergency Medicine Source Type: research

An unusual cause of large bowel perforation: ingestion of a clam valve
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 19, 2020 Category: Emergency Medicine Source Type: research

Low ADAMTS 13 plasma levels are predictors of mortality in COVID-19 patients
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 18, 2020 Category: Emergency Medicine Source Type: research

A rare case of prothrombin time prolongation
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 17, 2020 Category: Emergency Medicine Source Type: research

Paralytic ileus after planned abdominal surgery in a patient on treatment with erenumab
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 17, 2020 Category: Emergency Medicine Source Type: research

What is the prevalence of frequent attendance to emergency departments and what is the impact on emergency department utilisation? A systematic review and meta-analysis
AbstractPatients who frequently attend to emergency departments are a varying group and have complex health care needs. This systematic review and meta-analysis aimed to determine  the prevalence of patients who have frequent attendance to emergency departments. A systematic review was performed in line with PRISMA guidelines. A database search was conducted, and studies were included in the final review if they analysed a population of frequent attendance. Meta-analysis was performed only on population-based studies to estimate prevalence. The search yielded 2922 nonduplicate publications, of which 27 were included i...
Source: Internal and Emergency Medicine - June 15, 2020 Category: Emergency Medicine Source Type: research

Clopidogrel versus ticagrelor in high-bleeding risk patients presenting with acute coronary syndromes: insights from the multicenter START-ANTIPLATELET registry
AbstractOptimal dual antiplatelet therapy (DAPT) strategy in high-bleeding risk (HBR) patients presenting with acute coronary syndrome remains debated. We sought to investigate the use of clopidogrel versus ticagrelor in HBR patients with acute coronary syndrome and their impact on ischemic and bleeding events at 1  year. In the START-ANTIPLATELET registry (NCT02219984), consecutive patients with ≥ 1 HBR criteria were stratified by DAPT type in clopidogrel versus ticagrelor groups. The primary endpoint was net adverse clinical endpoints (NACE), defined as a composite of all-cause death, myocardial infarct io...
Source: Internal and Emergency Medicine - June 15, 2020 Category: Emergency Medicine Source Type: research

Association between sleep disordered breathing, neurocognitive impairment and diastolic function in acute heart failure patients: an insight after the vulnerable phase of the hospitalization
AbstractSleep disordered breathing (SDB) and neurocognitive impairment (NI) are a typical feature of HF (heart failure), especially with preserved ejection fraction (HFpEF). So far, very few data exist regarding changes in the severity of SDB, the degree of NI, and the diastolic function in acute HF (AHF) patients and during follow up. In a population of 24 AHF patients (12 with reduced ejection fraction-HFrEF- and 12 HFpEF) with SDB a complete echocardiogram, a set of NI tests, and a polysomnography were performed in the acute phase and after 90  days. A control group of 12 non-HF patients hospitalized for other card...
Source: Internal and Emergency Medicine - June 15, 2020 Category: Emergency Medicine Source Type: research

Cognitive impairment in patients hospitalized for congestive heart failure: data from the RICA Registry
The objective of this study is to determine the prevalence of cognitive impairment (CogI) in patients hospitalized for congestive heart failure, and the influence of CogI on mortality and hospital readmission. This is a multicenter cohort study of patients hospitalized for congestive heart failure enrolled in the RICA registry. The patients were divided into 3 groups according to their Short Portable Mental Status Questionnaire score: 0 –3 errors (no CogI or mild CogI), 4–7 (moderate CogI) and 8–10 (severe CogI). A total of 3845 patients with a mean (SD) age of 79 (8.6) years were included; 2038 (53%) wer...
Source: Internal and Emergency Medicine - June 15, 2020 Category: Emergency Medicine Source Type: research

The Euro Heart Survey and EURObservational Research Programme (EORP) in atrial fibrillation registries: contribution to epidemiology, clinical management and therapy of atrial fibrillation patients over the last 20  years
AbstractManagement of atrial fibrillation (AF) may be challenging in clinical practice. Given the complexity of AF patients and the continuous advances in AF clinical management, there is a need for standardized programmes aimed at collecting so-called ‘real-world clinical practice data’ regarding the epidemiology, diagnostic/therapeutic/management practices and assessing adherence to guidelines. Over the past 20 years, the number of registries and surveys based on real-world AF patients has been dramatically increased. In Europe, based on th e Euro Heart Survey (EHS) and the EURObservational Research Prog...
Source: Internal and Emergency Medicine - June 15, 2020 Category: Emergency Medicine Source Type: research

No clear beneficial effects of beta-blockers for heart failure with preserved ejection fraction to improve prognostic outcomes in elderly patients with sinus rhythm
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 11, 2020 Category: Emergency Medicine Source Type: research

Safety and effectiveness of biosimilar of Rituximab CT-P10 in the treatment of cryoglobulinemic vasculitis: the MARBLe study (Mixed cryoglobulinemiA Rituximab BiosimiLar)
AbstractRituximab (RTX) represents a milestone in the treatment of mixed cryoglobulinemic vasculitis (MCV). Despite usually well-tolerated, RTX may induce different types of adverse drug reactions, including exacerbation of vasculitis. Recently, RTX biosimilar CT-P10 has been approved in Europe for the treatment of rheumatoid arthritis, but no data are available about effectiveness and safety of CT-P10 in the treatment of MCV. In this multicenter open-label study, we analyzed the safety of CT-P10 in patients with MCV treated in first-line or after a shift by RTX originator. Fifty-one consecutive MCV patients (females/males...
Source: Internal and Emergency Medicine - June 10, 2020 Category: Emergency Medicine Source Type: research

Chagas disease in Italy: updated estimates
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 9, 2020 Category: Emergency Medicine Source Type: research

Treat all COVID 19-positive patients, but do not forget those negative with chronic diseases
AbstractThe outbreak of coronavirus disease 2019 (COVID-19) has distressed our working practice. Infectious disease specialists, pneumologists and intensivists were not enough to face the enormous amount of patients that needed hospital care; therefore, many doctors have been recruited from other medical specialties trying to take care of as many patients as possible. The ‘call to duty’ of such doctors for urgent COVID-19 cases, however, diverted the attention from the care of patients with chronic conditions, which might have been neglected or undervalued. In this extremely difficult time, the standard of care...
Source: Internal and Emergency Medicine - June 9, 2020 Category: Emergency Medicine Source Type: research

Systematic review of the prevalence of current smoking among hospitalized COVID-19 patients in China: could nicotine be a therapeutic option?: Comment
AbstractThis is a comment on the low prevalence of smokers in hospitalized COVID-19 patients, citing the possible role of squamous cell metaplasia, which is commonly associated with smokers. (Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 8, 2020 Category: Emergency Medicine Source Type: research

Emergency Department and Out-of-Hospital Emergency System (112 —AREU 118) integrated response to Coronavirus Disease 2019 in a Northern Italy centre
AbstractSince December 2019, the world has been facing the life-threatening disease, named Coronavirus disease-19 (COVID-19), recognized as a pandemic by the World Health Organization. The response of the Emergency Medicine network, integrating “out-of-hospital” and “hospital” activation, is crucial whenever the health system has to face a medical emergency, being caused by natural or human-derived disasters as well as by a rapidly spreading epidemic outbreak. We here report the Pavia Emergency Medicine network response to the COVI D-19 outbreak. The “out-of-hospital” response was analys...
Source: Internal and Emergency Medicine - June 8, 2020 Category: Emergency Medicine Source Type: research

Managing anticoagulation in the COVID-19 era between lockdown and reopening phases
AbstractPatients on anticoagulant treatment are constantly increasing, with an estimated prevalence in Italy of 2% of the total population. The recent spreadout of the COVID-19 pandemic requires a re-organization of Anticoagulation Clinics to prevent person-to-person viral diffusion and continue to offer the highest possible quality of assistance to patients. In this paper, based on the Italian Federation of Anticoagulation Clinics statements, we offer some advice aimed at improving patient care during COVID-19 pandemic, with particular regard to the lockdown and reopening periods. We give practical guidance regarding the ...
Source: Internal and Emergency Medicine - June 8, 2020 Category: Emergency Medicine Source Type: research

The burden of thrombotic complications in critically ill patients with COVID-19: charting the uncharted
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - June 5, 2020 Category: Emergency Medicine Source Type: research

Hydroxychloroquine and azithromycin as a treatment of COVID-19
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - May 30, 2020 Category: Emergency Medicine Source Type: research

HLA-B*51 allelic and carrier frequency in Kazakhstan: insights into Beh çet’s disease prevalence in Central Asia
AbstractBeh çet’s disease (BD) is a systemic vasculitis whose prevalence varies according to the ethnicity. HLA-B*51 is a well-known genetic factor predisposing to BD: populations with higher HLA-B*51 allelic frequencies are also those with a greater disease prevalence, as occurs in the Silk Road countries. However, the BD prevalence is unknown in many countries, including Kazakhstan and, in general, Central Asia, despite the location on or near the Silk Road. Due to the lack of clinical studies from this area, we analyzed the bone marrow donors registry in Kazakhstan, in order to assess the HLA-B*51 a llelic ...
Source: Internal and Emergency Medicine - May 30, 2020 Category: Emergency Medicine Source Type: research

Clinical features of 1487 COVID-19 patients with outpatient management in the Greater Paris: the COVID-call study
AbstractClinical features of COVID-19 have been mostly described in hospitalized patients with and without ICU admission. Yet, up to 80% of patients are managed in an outpatient setting. This population is poorly documented. In France, health authorities recommend outpatient management of patients presenting mild-to-moderate COVID-19 symptoms. The aim of this study was to describe their clinical characteristics. The study took place in an emergency medical dispatching center located in the Greater Paris region. Patients included in this survey met confirmed COVID-19 infection criteria according to the WHO definition. We in...
Source: Internal and Emergency Medicine - May 30, 2020 Category: Emergency Medicine Source Type: research

A deep vein thrombosis in a young man
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - May 29, 2020 Category: Emergency Medicine Source Type: research

Providing evidence on the ongoing health care workers ’ mask debate
AbstractThe scarcity of facemasks, particularly N95 respirators, combined with the lack of solid data to address the suitability of each mask type for adequate health care worker (HCW) protection have caused turmoil among HCWs. Current recommendations suggest mask usage solely during HCW contact with Covid-19 patients, namely plain medical mask for low-risk contacts and N95 for aerosol generating procedures. The distinction regarding the escalation of mask complexity depending on contact type is nevertheless based on plausible theoretical assumptions rather than hard evidence of a clear benefit. Conversely, we suggest that...
Source: Internal and Emergency Medicine - May 29, 2020 Category: Emergency Medicine Source Type: research

When internal and emergency medicine speak to each other: organization in the time of COVID
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - May 29, 2020 Category: Emergency Medicine Source Type: research

Plasma from donors recovered from the new Coronavirus 2019 as therapy for critical patients with COVID-19 (COVID-19 plasma study): a multicentre study protocol
AbstractSince the end of 2019, a new coronavirus strain has been reported in the Chinese province of Wuhan, indicated as 2019-nCoV or SARS-CoV-2. In February 2020, the first case of transmission on Italian soil was reported. On March 09, 2020, at the time of protocol design, the Italian Ministry of Health reported 10,149 people who had contracted the virus; of these, 8514 were positive, of which 5038 were hospitalized with symptoms (59.2%) and 877 in intensive care (10.3%), while the remaining 2599 were in home isolation; 631 were deceased (6.2%) and 1004 healed (9.9%). To date there are no studies in the literature that d...
Source: Internal and Emergency Medicine - May 28, 2020 Category: Emergency Medicine Source Type: research

Potential new treatment strategies for COVID-19: is there a role for bromhexine as add-on therapy?
AbstractOf huge importance now is to provide a fast, cost-effective, safe, and immediately available pharmaceutical solution to curb the rapid global spread of SARS-CoV-2. Recent publications on SARS-CoV-2 have brought attention to the possible benefit of chloroquine in the treatment of patients infected by SARS-CoV-2. Whether chloroquine can treat SARS-CoV-2 alone and also work as a prophylactic is doubtful. An effective prophylactic medication to prevent viral entry has to contain, at least, either a protease inhibitor or a competitive virus ACE2-binding inhibitor. Using bromhexine at a dosage that selectively inhibits T...
Source: Internal and Emergency Medicine - May 26, 2020 Category: Emergency Medicine Source Type: research

Management of acute pulmonary embolism 2019: what is new in the updated European guidelines?
AbstractPulmonary embolism (PE) is the third most frequent acute cardiovascular syndrome. Annual PE incidence and PE-related mortality rates rise exponentially with age, and consequently, the disease burden imposed by PE on the society continues to rise as the population ages worldwide. Recently published landmark trials provided the basis for new or changed recommendations included in the 2019 update of the European Society of Cardiology Guidelines (developed in cooperation with the European Respiratory Society). Refinements in diagnostic algorithms were proposed and validated, increasing the specificity of pre-test clini...
Source: Internal and Emergency Medicine - May 26, 2020 Category: Emergency Medicine Source Type: research

Design and rationale of a randomized, placebo-controlled trial on the efficacy and safety of sulodexide for extended treatment in elderly patients after a first venous thromboembolism
AbstractHow to prevent recurrences after a first venous thromboembolic (VTE) event in elderly patients is still an open issue, especially because of the high bleeding risk of anticoagulation in these patients. The placebo-controlled “Jason” study aims at assessing the efficacy and safety for secondary VTE prevention in elderly patients of oral Sulodexide (Vessel®) administration, a mixture of glycosaminoglycans (Alfasigma, Bologna, Italy) which proved effective against recurrences in a general population (SURVET study) without major bleeding (MB) complications. 1450 patients, aged  ≥ 75&nbs...
Source: Internal and Emergency Medicine - May 25, 2020 Category: Emergency Medicine Source Type: research

Subclinical liver fibrosis in patients with idiopathic pulmonary fibrosis
AbstractData on the presence of subclinical fibrosis across multiple organs in patients with idiopathic lung fibrosis (IPF) are lacking. Our study aimed at investigating through hepatic transient elastography (HTE) the prevalence and clinical impact of subclinical liver fibrosis in a cohort of patients with IPF. Patients referred to the Centre for Rare Lung Disease of the University Hospital of Modena (Italy) from March 2012 to February 2013 with established diagnosis of IPF and without a documented history of liver diseases were consecutively enrolled and underwent HTE. Based on hepatic stiffness status as assessed throug...
Source: Internal and Emergency Medicine - May 25, 2020 Category: Emergency Medicine Source Type: research

The predictive value of the HEART and GRACE scores for major adverse cardiac events in patients with acute chest pain
This study investigated the application of these scores in predicting the short-term risk of a major adverse cardiac event (MACE) in patients with chest. A total of 509 patients were analyzed. All patients were followed up for 30  days after visiting our emergency department. At 30 days post-admission, the primary outcome (MACE) was recorded in 92 patients (18.1%), 88 (95.6%) of whom had experienced an acute myocardial infarction. Thirty-seven (40.2%) of the patients with a MACE underwent percutaneous coronary intervention and six patients (6.5%) died. The HEART and GRACE scores were both significantly higher in ...
Source: Internal and Emergency Medicine - May 25, 2020 Category: Emergency Medicine Source Type: research

Google trends and COVID-19 in Italy: could we brace for impact?
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - May 25, 2020 Category: Emergency Medicine Source Type: research

Does this patient have COVID-19? A practical guide for the internist
AbstractCoronavirus disease 2019 (COVID-19) is currently causing a pandemic and will likely persist in endemic form in the foreseeable future. Physicians need to correctly approach this new disease, often representing a challenge in terms of differential diagnosis. Although COVID-19 lacks specific signs and symptoms, we believe internists should develop specific skills to recognize the disease, learning its ‘semeiotic’. In this review article, we summarize the key clinical features that may guide in differentiating a COVID-19 case, requiring specific testing, from upper respiratory and/or influenza-like illness...
Source: Internal and Emergency Medicine - May 23, 2020 Category: Emergency Medicine Source Type: research

Altered clot formation and lysis are associated with increased fibrinolytic activity in ascites in patients with advanced cirrhosis
AbstractAnalysis of coagulation disorders and assessment of rebalanced hemostasis with the use of traditional coagulation assays is challenging in cirrhotic patients. Therefore, alternative tests are under investigation for the evaluation of coagulopathy in this specific setting. Aim of this study was to analyze the modifications of clot structure and function in cirrhotic patients with different degrees of severity. Cirrhotic patients referred to our Unit were consecutively enrolled. Global test measurements, including clot and lysis assays, clot lysis time, and determination of other fibrinolytic parameters, were perform...
Source: Internal and Emergency Medicine - May 22, 2020 Category: Emergency Medicine Source Type: research

Ethics in the age of COVID-19
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - May 21, 2020 Category: Emergency Medicine Source Type: research

Switch from oral anticoagulants to parenteral heparin in SARS-CoV-2 hospitalized patients: comment
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - May 21, 2020 Category: Emergency Medicine Source Type: research

Postoperative atrial fibrillation is related to a worse outcome in patients undergoing surgery for hip fracture
AbstractFew information exist about incidence and prognostic significance of postoperative atrial fibrillation (POAF) in patients undergoing hip fracture surgery. In the period comprised between January 2012 and December 2016, we evaluated 3129 patients referred for hip fracture. At hospital admission 277 were in permanent atrial fibrillation and were excluded from the study. POAF was defined as symptomatic or asymptomatic AF of duration  >  10 min occurring during hospitalization after hip surgery. In-hospital and 1-year outcomes of POAF patients were compared to that of an age- and sex-matched hip f...
Source: Internal and Emergency Medicine - May 21, 2020 Category: Emergency Medicine Source Type: research

Another old man with fever and confusion
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - May 21, 2020 Category: Emergency Medicine Source Type: research