August 2025
36 ArticlesNo Section
Demographic features in patients with acute mountain sickness
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The Declaration of Helsinki protects clinical trial participants
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Commentary
Hyponatriemia and mortality: cause or surrogate marker?
Disorders of plasma sodium concentration subject cells to hypo- or hypertonic stress, potentially causing significant cellular dysfunction. The osmoregulatory system maintains plasma sodium within a... more
R202Q homozygosity in the MEFV gene may not be classified as classical FMF
In this issue of the European Journal of Internal Medicine, Sagris et al. explore the clinical relevance of the R202Q homozygous variant in the MEFV gene in a cohort of Greek patients displaying... more
Vitamin D supplements for prevention of diseases
Vitamin D supplementation is still a cause of considerable controversy. The recent articles of Cimminiello [1], Grant [2] and Cimminiello [3] on the effect of vitamin D supplementation on... more
Community-acquired pneumonia: The burden echoes well beyond discharge
There is an immense burden associated with pneumonia worldwide. The global incidence of lower respiratory tract infections (LRTI) is estimated to be well over 340 million cases annually with >2... more
Challenges in the diagnosis of coeliac disease in primary care: Serology, biopsy, and administrative data
Coeliac disease (CD) is a common, lifelong, immune-mediated condition characterised by villous atrophy resulting from the ingestion of dietary gluten [1], which leads to malabsorption and various... more
Editorial
Phenomena and noumena in nephrology: Beyond the illusion of precision in kidney function assessment
In his Critique of Pure Reason, Immanuel Kant famously distinguished between phenomena, the world as it appears to us, and noumena, the thing-in-itself, which eludes direct human comprehension.... more
Internal Medicine Flashcard
Inverted V sign
A 79-year-old woman visited with a 3-week history of tingling sensation of the tongue. Physical examination showed smooth back ground of tongue with scattered reddish lesions (Fig. 1A). Results of... more
Electrocardiographic changes associated with hypothermia
A 69-year-old Japanese man, who lived alone and was undergoing treatment for diabetes at another hospital was found unconscious in an unheated room at his residence in February 2025. He was... more
Black discoloration of the esophageal mucosa
A 66-year-old man with type 2 diabetes mellitus and chronic alcohol consumption presented to an acute care hospital with generalized fatigue, anorexia, and melena. On arrival, he was in hypovolemic... more
Letter to the Editor
Serum IL-18 in autoinflammatory diseases diagnosis: unresolved challenges
We read with great the article by Elhani et al. recently published in the European Journal of Internal Medicine [1]. This study attempts to establish the relationship between interleukin-18 (IL-18)... more
Clinical epidemiological characteristics of BRASH syndrome
BRASH syndrome—characterized by bradycardia, renal failure, atrioventricular (AV) nodal blockade, shock, and hyperkalemia—has recently been recognized as a distinct clinical entity. This syndrome is... more
Protected discharge and combined interventions: A viable path to reduce hospital readmissions
Hospital readmissions within 30 days continue to be a challenge for healthcare systems, particularly in the case of frail, elderly patients and those with chronic diseases. From international studies... more
Clinical trial landscape for pulmonary arterial hypertension targeted therapy: Beyond vasodilators
Pulmonary arterial hypertension (PAH) is a multifaceted and lethal disorder characterized by elevated pulmonary pressures and right ventricular failure, ultimately leading to premature death. With an... more
Thromboembolic and bleeding risks in patients on anticoagulation after noncardiac surgery for malignancy
Atrial fibrillation (AF) and pulmonary embolism/deep vein thrombosis (DVT), all of which have an indication for anticoagulation, are observed commonly in patients with malignancy, regardless of... more
Efficacy and safety of crinecerfont for the treatment of congenital adrenal hyperplasia
Congenital adrenal hyperplasia (CAH) is an autosomal recessive genetic disease that leads to an enzyme deficiency, the main consequence of which is the reduction in the production of cortisol and... more
Clinical factors associated with limited therapeutic implementation in patients with heart failure and reduced ejection fraction hospitalized in internal medicine wards
Heart failure (HF) affects over 56 million people globally and accounts for 1–2 % of all hospitalizations in the Western world [1]. Prevalence of HF rises with age, as patients over 70 years of age... more
Accuracy of glomerular filtration rate estimating equations in systemic sclerosis
Kidney involvement in Systemic Sclerosis (SSc) is primarily due to vasospasm induced by renal Raynaud's phenomenon, leading to hypoxia, impaired angiogenesis and microvascular dysfunction. Renal... more
Serum angiopoietin-like protein 4 levels correlate with hypertriglyceridemia and renal function decline in pediatric patients with lupus nephritis
Lupus nephritis (LN) is the most common complication of systemic lupus erythematosus (SLE), with up to 70 % of pediatric SLE patients experiencing kidney involvement, and LN also aggravates the... more
Atrial fibrillation ablation versus medical therapy in heart failure with preserved ejection fraction
Heart failure with preserved ejection fraction (HFpEF) is a multifaceted and increasingly prevalent clinical syndrome that presents significant challenges in both diagnosis and management. Its... more
Why did it take forty years to uncover long-term fluoroquinolone associated toxicities?
Since fluoroquinolones (FQs) were introduced in 1986, 1 billion courses have been administered [1]. Safety announcements have been disseminated since 2016 in the United States (US), European Union (... more
Diastolic blood pressure variability predicts adverse outcomes in stabilized acute heart failure patients
Blood pressure variability; heart failure; Cardiovascular outcome; Diastolic blood pressure
Original Article
Different loop diuretic dosing and administration in acute heart failure (DIUR-AHF): a multicenter prospective observational open-label study
Acute heart failure (AHF) is a clinical syndrome characterized by progressive or sudden and rapid onset of signs and symptoms of HF, related to hemodynamic and neurohormonal derangement [1,2]. AHF... more
Prevalence of malnutrition and its impact on clinical outcomes in internal medicine wards: The SIMI-NUTRO study
Screening for malnutrition is recommended for all hospitalized patients and can be performed using tools such NRS-2002, MUST, and MNA-SF. Patients at risk should undergo further evaluation for the... more
Recombinant human hyaluronidase-facilitated subcutaneous immunoglobulin (hf-SCIg) for inflammatory myositis: a multicenter retrospective real-world observational study
The spectrum of idiopathic inflammatory myositis (IIM) includes a heterogeneous group of diseases that share chronic inflammation of skeletal muscle, mainly characterized by proximal muscle weakness... more
Vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic (VEXAS) syndrome: A comprehensive review of cases across different ethnicities
Vacuoles, E1 enzyme, X-linked, Autoinflammatory, Somatic (VEXAS) syndrome is a recently described somatic autoinflammatory disease [1]. A genetic mutation in the UBA1 gene results in a deficiency of... more
Natural history of the severe subtype of MYH9-related disease (Epstein syndrome)
Congenital thrombocytopenia, giant platelets, and Döhle-like bodies in granulocytes characterize MYH9-related disease (MYH9-RD). Clinical manifestations include deafness, nephritis, and cataracts [1,... more
Metabolic dysfunction-associated steatotic liver disease (MASLD). Assessing metabolic dysfunction, cardiovascular risk factors, and lifestyle habits
Steatotic liver disease (SLD), a hallmark of metabolic dysfunction, is closely associated with atherosclerotic cardiovascular disease (ASCVD). This study investigated gender differences, metabolic... more
ICD-10-CM coding uncovers the gap between serological and clinically identified coeliac disease prevalence: A population-based study
Coeliac disease (CD) is one of the most common lifelong disorders and affects people of all ages worldwide [1]. A systematic review and meta-analysis reported that the global CD seroprevalence was 14... more
Burden and risk factors for 30-day readmission and mortality after CAP hospitalization: A population-based cohort study
Community-acquired pneumonia (CAP) is considered the world’s most fatal infectious disease and is associated with a fundamental burden in healthcare and society [1]. 30-day mortality ranges from <... more
Mortality and causes of death in patients hospitalized with hyponatremia – a propensity matched cohort study
Hyponatremia is the commonest electrolyte imbalance, affecting more than one in 10 patients admitted to hospital [1]. Women, elderly, and individuals with comorbid burdens are generally at greater... more
R202Q homozygosity of Mediterranean fever gene is associated with atypical clinical phenotype of familial Mediterranean fever
Autoinflammatory disorders represent a heterogenous group of genetic or acquired systemic diseases characterized by febrile episodes and chronic inflammation, due to dysregulation of innate immunity... more
Review Article
A holistic view of SGLT2 inhibitors: From cardio-renal management to cognitive and andrological aspects
Type 2 diabetes mellitus (T2DM) is a multifactorial disease associated with complications that significantly affect both survival and quality of life, including cardiovascular, renal, cognitive,... more
Cogan's syndrome. A comprehensive review
Cogan Syndrome (CS) is a rare systemic vasculitis affecting the inner ear and the eye with systemic manifestations described first in 1945 by David G. Cogan as a “syndrome of non-syphilitic... more
The medical ward round: evidence, pitfalls, and tips
Ward rounds are pivotal for patient-centered care and bedside teaching. In today’s hospitals, care is provided by multidisciplinary and multiprofessional teams. To conduct an effective and efficient... more