December 2025
126 ArticlesNo Section
The changing landscape of heart failure: translating management into the modern era
Heart failure (HF) is a complex clinical syndrome associated with high morbidity and mortality, accounting for approximately 2 % of total healthcare expenditures. Despite advances in pharmacological... more
From networks of data to networks of care in clinical medicine: this is not artificial intelligence
The increasing availability of clinical, omic, and imaging data in clinical medicine opens unprecedented opportunities to uncover hidden patterns and mechanistic insights into disease. Available... more
Survival effect of early high-flow nasal oxygen after extubation: Statistical, methodological, and ethical concerns
We read with great interest the article by Ishihara et al. evaluating the survival impact of early high-flow nasal oxygen (HFNO) following extubation in intensive care patients [1] Although the... more
Optimising the Caravaggio score: developing a more universally applicable and comprehensive venous thromboembolism risk stratification tool. Author’s reply
Dear Editor, we thank Wang et al. for their suggestions on potential matters to optimize the Caravaggio score [1]. The recently published Caravaggio score was aimed to stratify the risk of recurrence... more
Serum transthyretin in ATTR-CM: A pragmatic biomarker edging toward prime time
Over the last decade, transthyretin amyloid cardiomyopathy (ATTR-CM) has shifted toward earlier recognition and routine use of disease-modifying therapy, heightening the need for biomarkers that are... more
Renal outcomes following anticoagulation in atrial fibrillation: urgent need for randomized evidence
We read with interest the well-written meta-analysis by Adamou et al. [1], focused on studies of atrial fibrillation (AF) patients, investigating the comparative effect of direct oral anticoagulants... more
Optimising the Caravaggio score: developing a more universally applicable and comprehensive venous thromboembolism risk stratification tool
Dear Editor,
Beyond the Guidelines
Exporting integration: The southern European internist in the age of specialization
If fragmentation is today’s common clinical hazard, the question is which model of Internal Medicine is built to resist it.
Managing invasive fungal infections in critical illness: reflections on recent American Thoracic Society recommendations
The global burden of invasive fungal diseases (IFDs) continues to increase, particularly among critically ill patients, where mortality remains high —reaching up to 70 %— despite major advances in... more
Repositioning beta-blocker therapy after acute myocardial infarction
Beta-blockers have long been prescribed for secondary prevention in patients with acute myocardial infarction (MI) after clinical trials performed in the 1980′s demonstrated that their use provided... more
Clinical Insights
Advances in syncope: Recent evidence and clinical implications
The purpose of this article is the synthesis of the most relevant advances in syncope research over the last decade, bridging current practice with future directions across settings of care (... more
Commentary
A call to action: Bridging glucose monitoring and treatment gaps in inpatient diabetes care
Diabetes mellitus remains a major global health challenge, increasing clinical, social, and economic burdens on individuals and healthcare systems. In nearly every region of the world, the rising... more
The challenges of anemia management in cardiorenal disease
Chronic kidney disease (CKD) and heart failure (HF) are two highly prevalent chronic conditions that together contribute substantially to the global burden of disease. The coexistence of HF and CKD... more
Tezepelumab for severe asthma – an “all round” player
Many patients with severe asthma who were historically dependent on oral corticosteroids (OCS) for disease control have now entered a new era. Initiation of OCS has become an uncommon event, and many... more
Air pollution: A new avenue for a population-level approach to tackle metabolic dysfunction-associated steatotic liver disease (MASLD)?
In this issue of the European Journal of Internal Medicine, Di Ciaula et al [1] provide new insights into metabolic dysfunction-associated steatotic liver disease (MASLD) by looking into the... more
Perspective on Epicardial Adipose tissue
In this issue of the European Journal of Internal Medicine, Calcaterra et al. wrote one of the most comprehensive reviews of Epicardial Adipose Tissue (EAT) [1]. In contrast to past dithyrambic EAT... more
From words to biomarkers: Why PEth should enter clinical practice when assessing the risk of venous thromboembolism
Alcohol consumption remains one of the most pervasive and modifiable risk factors influencing global health. Its dualistic nature—protective in moderation, harmful in excess—has long fascinated... more
Prevention of venous thromboembolism in critically ill patients: current state and future perspectives
Venous thromboembolic disease (VTE) is a major complication of intensive care, responsible for significant morbidity and mortality. It remains a constant challenge for clinicians because of the... more
Venous thromboembolism provoked by transient risk factors in women: Towards improved personalized risk assessment
The occurrence of venous thromboembolism (VTE) in young women is a scenario frequently encountered in clinical practice. In this population, a VTE event is often associated with provoking risk... more
Treatment target of blood pressure: Changes in evidence-based guidelines and impact of measurement conditions
Although exceptions exist, the general prognostic benefit of antihypertensive drug treatment is definite. With the accumulation of relevant evidence, the target blood pressure level of... more
Editorial
Management of patients without obstructive coronary arteries and suspected microvascular angina: Is it time for a paradigm shift?
Up to 50 per cent of patients undergoing coronary angiography for suspected angina with evidence or not of myocardial ischemia have non-obstructed coronary arteries [1], a condition which is... more
Internal Medicine Flashcard
A 74-year-old man with skin thickening and ulcers
A 74-year-old man with hypertension, type 2 diabetes (HbA1c 12 %), and chronic kidney disease (KDIGO IIb) presented to the dermatology emergency department with an eight-month history of progressive... more
Recurrent vomiting
A 28-year-old male was referred to the Gastroenterology Department for a 6-year history of recurrent vomiting, occurring 2–3 times daily and exacerbating to >10 episodes per day following cold... more
Woman with progressed gait instability
An 81-year-old woman presented with progressed gait instability for several months. She had a temperature of about 37.5 °C. The initial neurological examination revealed unsteadiness on the finger-... more
Xanthelasma, arcus senilis, and supravalvular aortic stenosis
A 28-year-old female presented with 12 months of progressive dyspnea and 6 months of exertional angina, now limiting daily activities. On examination (Fig. 1; Panel A), she had xanthelasma, arcus... more
Bilateral ocular motility impairment
An 82-year-old man was referred to the Diagnostic Imaging Center with progressive bilateral ocular motility impairment and diplopia, which had gradually worsened over the past three months, with... more
Ataxia, dysarthria and brainstem lesions in an elderly patient: a diagnostic challenge
A 75-year-old Hispanic man presented with a 3-year history of frequent falls conditioned by gait instability and generalized weakness. His symptoms progressed with worsening of gait imbalance,... more
Invited Review Article
Contemporary management of advanced chronic kidney disease: An evidence-based review
Chronic kidney disease (CKD) is a growing global health burden, affecting over 850 million people worldwide and contributing substantially to cardiovascular morbidity, premature mortality, and... more
Letter to the Editor
Critical considerations on uric acid in HFmrEF: from biomarker to metabolic integrator
To the editor,
Advancing beyond multimodality: integrating quantitative imaging biomarkers into the clinical workflow of cardiac amyloidosis
We read with great interest the comprehensive narrative review by Sinigiani et al. titled "Multimodality imaging for cardiac amyloidosis: clinical applications and future directions" published in the... more
Methodological considerations for interpreting the association between central systolic blood pressure and brain health. Author’s reply
Dear Editor,
West Nile virus infection: New guitars in town for the internal medicine community
Dear Editor,
Clinical implications of the U-shaped association between body mass index and atrial tachyarrhythmia recurrence after paroxysmal atrial fibrillation ablation
We read with great interest the article by Liao et al., which reported that both underweight and obese patients are at increased risk of atrial tachyarrhythmia (ATa) recurrence after catheter... more
Addressing gaps in inpatient diabetes management: A call for integrated multidisciplinary approaches
We commend Porth et al. for their timely and insightful study, "Gaps in Glycaemic Monitoring and Underuse of Cardioprotective Glucose-lowering Agents," which elucidates critical deficiencies in... more
Tirzepatide as adjunct to insulin for the treatment of type 1 diabetes
Based on the latest published data, global prevalence of type 1 diabetes (T1D) was 8.4 million individuals in 2021, with 18 % of them being younger than 20 years, 64 % aged 20–59 years and 19 % aged... more
Optimization and clinical applicability of monitoring strategies: further exploration of the monitoring of transient new-onset atrial fibrillation recurrence
We read with great interest the study by McIntyre et al. on the monitoring time and recurrence detection rate of transient new-onset atrial fibrillation (AF) [1]. The study provides valuable... more
Direct oral anticoagulant dose optimization in cancer-associated thrombosis: Current evidence and implications for extended therapy
Cancer-associated thrombosis (CAT) remains a leading cause of morbidity and mortality. Important risk factors in this population include chemotherapy, hormonal therapies, indwelling catheters or... more
Inpatient diabetes management in Europe: The limits of a single-day snapshot
We read with great interest the article by Porth et al. [1], titled "Gaps in Glycaemic Monitoring and Underuse of Cardioprotective Glucose-lowering Agents: Challenges of inpatient diabetes care... more
Body weight extremes and recurrence risk after ablation of paroxysmal atrial fibrillation
We read with great interest the recent article by Liao et al., entitled “Both underweight and obese patients are prone to relapse after ablation of paroxysmal atrial fibrillation” [1]. The authors... more
Antibiotic use in hospitalized older adults according to WHO AWaRe classification: data from the REPOSI register
Antimicrobial resistance is a growing global concern and represents a major threat to public health [1]. In response, many countries have implemented guidelines aimed at promoting the rational use of... more
Physical activity in systemic vasculitis
Dear Editor,
Cardiovascular siRNA therapeutics: A global clinical trial landscape analysis
Dear Editor
Bronchoscopy, ventilator dose and outcomes in severe CAP: reading the sex signal
We read with great interest the analysis conducted by Garin et al. regarding sex-related differences in adults intubated for severe community-acquired pneumonia within the EU VAP CAP platform, which... more
Beyond the algorithm: The human interface of medicine
“You should stand at the right side of the patient’s bed.” [1]
Cognitive impairment in familiar hypercholesterolemia: How much is vascular and how much is confounding? Author's reply
We sincerely thank Messina et al. for their thoughtful and valuable comments regarding our study. We fully acknowledge the importance of the points raised and appreciate their contribution to the... more
Bridging the gap: Phenotype-specific considerations for rituximab therapy in IgG4-related disease
We were pleased to read the recent article by Goni et al., entitled “Effectiveness and safety of rituximab across the four phenotypes of IgG4-related disease: a European multi-center cohort study of... more
Age, sex and DNAR: Re-evaluating the excess-mortality paradox in nonagenarian ICU patients. Author’s reply
Dear Editor,
Mepolizumab improves health-related quality of life in patients with hypereosinophilic syndrome
Hypereosinophilic syndrome (HES) is a rare, heterogeneous disorder, characterised by high eosinophil levels (≥1500 cells/µL) and eosinophilic inflammation leading to multiorgan dysfunction and damage... more
Considerations on socioeconomic and hormonal factors in sex- and gender-specific risk of metabolic syndrome
We read with great interest the article by Alipour et al. entitled “Role of sex and gender-related variables in development of metabolic syndrome” published in the European Journal of Internal... more
Heart failure with preserved ejection fraction in older inpatients: Where diagnostic algorithms meet geriatric reality
Heart failure with preserved ejection fraction (HFpEF) represents a growing and increasingly prevalent phenotype of heart failure (HF) in older adults, yet its recognition in routine clinical... more
Beyond binary Sex: Hormonal and physiological determinants of VTE outcomes
Dear Editor,
Anifrolumab for refractory dermatomyositis: Experience from a Spanish cohort
Dermatomyositis (DM) frequently remains active despite glucocorticoids and conventional immunosuppressants. A type I interferon (IFN-I) gene-expression signature across skin, muscle, and blood... more
Left ventricular remodeling in IgA nephropathy — clinical applicability and lessons from real-world practice
I read with great interest the study by Jin[1], which examines the prognostic implications of distinct left ventricular (LV) geometric patterns in patients with biopsy-proven IgA nephropathy (IgAN).... more
Managing psoriasis in patients with lupus: A complex challenge
Psoriasis is a common, chronic, and relapsing scaly erythematous skin disease, occurring worldwide at any age, with no clear gender predilection. It shows a bimodal age distribution, with incidence... more
Activation state of peripheral T lymphocytes predicts response to abatacept in patients with IgG4-related disease
Dear Editor,
Cognitive impairment and vascular injury in familial hypercholesterolemia: Looking beyond the association
We read with great interest the article by Sabrina Scilletta et al. published in the European Journal of Internal Medicine, which explored the relationship between cognitive function and subclinical... more
Methodological considerations for interpreting the association between central systolic blood pressure and brain health
We read with great interest the recent article by Yu et al. (2025) [1] in the European Journal of Internal Medicine, which investigated the association between central systolic blood pressure (cSBP... more
Utility of following morning body weight in patients with hyponatremia due to chronic SIAD
In patients with chronic hyponatremia, SNa must be maintained above 134 mEq/l to minimize associated morbidity [1].
Traceability of point-of-care ultrasound: The PACS integration process in a tertiary hospital
Point-of-Care Ultrasound (POCUS) has become established as an essential diagnostic and therapeutic tool in Internal Medicine, Emergency Medicine, Geriatrics, and other care settings. It allows... more
Tezepelumab in severe asthma: Strengthening real-world evidence and addressing unresolved clinical questions
We were pleased to read the recent article by Poto et al. entitled “Effectiveness of tezepelumab in severe asthma: A multicenter real-world study,” published in the European Journal of Internal... more
Meta-analysis of the relationship between internal microplastic and health outcomes
Dear editor,
Understanding the threat of West Nile virus infection. Comment on prevention and therapy
We read with interest the article from Gallo et al., which provides a clear and structured overview of the West Nile virus (WNV), particularly valuable for clinicians unfamiliar with its clinical... more
Authors of individual participant data meta-analyses must honor trialists’ commitments to trial participants: a case study
The need to respect the trial participants’ willingness regarding the secondary use of their data to conduct research such as meta-analyses has been recently discussed [1]. The best approach is to... more
Cognitive impairment in familiar hypercholesterolemia: how much is vascular and how much is confounding?
Dear editor,
Severe acute refractory hyperkalaemia associated with liposomal amphotericin B infusion
Dear editor,
Bolus or continuous for AHF? Lessons from DIUR-AHF. Author's reply
On behalf of the DIUR-AHF investigators, we thank Zhai and Sun for the attention on our research [1] and for the interesting comments provided in their letter to the editor, published in the present... more
Pharma’s subtle conditioning in clinical medicine
The relationship between physicians and the pharmaceutical industry continues to provoke debate, often framed around conflicts of interest and the potential for undue influence on prescribing... more
Association between sPESI score and 90-day hospital readmissions in patients with acute pulmonary embolism
Pulmonary embolism (PE) is a leading cause of cardiovascular morbidity and mortality, with 10–30 % of patients dying within one month of diagnosis [1]. Early risk stratification can aid clinicians in... more
Association of prevalence of hypertension and its subtypes with short-term weight change
Obesity is a well-established risk factor for hypertension, and produces various hemodynamic abnormalities that may impact hypertension subtypes [1]. From 2011 to 2020, obesity prevalence in the US... more
Age, sex and DNAR: Re-evaluating the excess-mortality paradox in nonagenarian ICU patients
We read with interest Weller and colleagues’ elegant demonstration that chronological age alone is not associated with excess mortality among nonagenarian ICU patients [1]. Their use of relative-... more
Beyond eligibility – the relevance of individualized heart failure therapy across specialties
We read with interest the article by Gencher et al., investigating specialty-related differences in the implementation of guideline-directed medical therapy (GDMT) for patients hospitalized with... more
Aetiology of inflammatory abdominal aortic aneurysms influences prognosis
Abdominal aortic aneurysms (AAA) affect approximately 5 % of male over the age of 65 [1]. Among these, 5 % to 10 % are classified as inflammatory AAA (IAAA) [2]. A wide range of underlying... more
Bolus or continuous for AHF? lessons from DIUR-AHF
With keen interest, we have read the DIUR-AHF study published by Palazzuoli et al. [1], which provides important real-world evidence on loop diuretic strategies in acute heart failure (AHF). The... more
Association of social isolation with excess mortality risk and life expectancy in people with prediabetes and diabetes
Diabetes affects 589 million adults globally and significantly increases mortality risk by 1.6- to 2-fold, with an additional 1.1 billion people estimated to have early-stage glucose metabolism... more
Potassium instability and prognosis in acute heart failure: Practice-oriented reflections
We read with interest the article, “Association between serum potassium variability during admission for decompensated heart failure and outcomes,” published in the European Journal of Internal... more
Critical considerations on sTREM2 as a biomarker for early MASH in women with severe obesity
We commend Mahmoudian et al. for their insightful study investigating soluble TREM2 (sTREM2) as a noninvasive biomarker for early metabolic dysfunction-associated steatohepatitis (MASH) in women with... more
Phosphatidylethanol and venous thromboembolism risk – clinical implications and future directions
I read with great interest the prospective study by Johansson et al. [1] published in the European Journal of Internal Medicine, which investigates the association between phosphatidylethanol (PEth)... more
Optimizing potassium control in hospitalized heart failure patients: Unanswered questions and future perspectives
We read with great interest the recent article by Suzuki et al., recently published in the European Journal of Internal Medicine [1]. The authors address an important and often overlooked aspect of... more
PFKP, EP300, and VCAN as causal drivers of migraine: Integrating genetics and epigenetics through mendelian randomization
Dear Editor,
Not just the level – the importance of potassium stability in patients with heart failure
We read with great interest the manuscript by Suzuki et al. investigating the prognostic impact of changes of serum potassium levels during index hospitalization in a large cohort of 1280 patients... more
DOACs vs. VKAs for renal protection: An established superiority gives rise to a new clinical paradox
I commend Adamou and colleagues for their important meta-analysis, which reinforces the established superiority of direct oral anticoagulants (DOACs) over vitamin K antagonists (VKAs) for preserving... more
Original Article
Fractional exhaled nitric oxide in acute exacerbations of chronic obstructive pulmonary disease: A meta-analysis with meta-regressions
Fractional exhaled nitric oxide (FeNO) has emerged as a useful tool for monitoring airway inflammation in chronic obstructive pulmonary disease (COPD) patients. We designed a systematic review and... more
Robustness of randomized controlled trial evidence for SGLT2 inhibitors in heart failure with preserved and mildly reduced ejection fraction
Sodium–glucose co-transporter 2 inhibitors (SGLT2i) have emerged as a fundamental therapy for patients with heart failure with preserved ejection fraction (HFpEF), a population that has historically... more
Effects of calcium channel blockers on GDMT prescription and outcomes according to ejection fraction: IN-HF real world data
Dihydropyridine calcium channel blockers (DHP-CCB) are widely used in heart failure (HF), despite the lack of data regarding their safety, especially in patients with reduced ejection fraction (HFrEF... more
Gaps in Glycaemic Monitoring and Underuse of Cardioprotective Glucose-lowering Agents: Challenges of inpatient diabetes care identified by EFIM’s Diabesity Day Survey 2024
People with diabetes and people with obesity have an increased risk of hospitalisation, tend to have longer hospital stays, and have higher mortality when hospitalised (1–3). Diabetes management... more
Both underweight and obese patients are prone to relapse after ablation of paroxysmal atrial fibrillation
Being overweight has been associated with arrhythmia recurrence after atrial fibrillation (AF) ablation, but the optimal threshold to identify high risk patients has not been well established.... more
Association between long-term exposure to PM10 and metabolic dysfunction-associated steatotic liver disease (MASLD) in subjects with disturbed metabolic homeostasis and genotypes at risk
Poor information exists on the role of air pollutants as possible predictors of liver fat over-storage in subjects with increased clinical and genetic risk for MASLD.
Evaluation of the concordance between clinical diagnosis and biopsy in cutaneous vasculitis
Cutaneous vasculitis poses a diagnostic challenge due to its variable presentations and overlap with other dermatologic conditions. Although biopsy is essential for confirmation, the concordance... more
Left ventricular remodeling in IgA nephropathy: Prognostic implications and clinical correlations
The determinants and prognosis of left ventricular (LV) geometric remodeling remain uncharacterized in immunoglobulin A nephropathy (IgAN). We investigated the (1) clinicopathological correlates of... more
Monitoring time-to-detection of recurrent atrial fibrillation in patients with transient new-onset atrial fibrillation detected initially during hospitalization for noncardiac surgery or medical illness
Approximately one-third-of patients with transient new-onset atrial fibrillation (AF) during hospitalization for noncardiac surgery or medical illness will have recurrent AF within 1 year when... more
Endothelin-1 as dual marker for renal function decline and associated cardiovascular complications in patients with chronic kidney disease
Cardiovascular (CV) complications are the leading cause of death in patients with chronic kidney disease (CKD). Endothelin-1 (ET-1), a potent vasoconstrictor involved in both renal and vascular... more
Prognostic role of TAPSE/PASP ratio among older patients with acute heart failure and preserved ejection fraction
Right ventricular (RV)-pulmonary circulation (PC) uncoupling is associated with poor outcome in patients with Heart Failure with Preserved Ejection Fraction (HFpEF). Tricuspid annular plane systolic... more
Cardiovascular-kidney-metabolic domains and impact on antithrombotic treatment, integrated care and clinical outcomes in patients with atrial fibrillation: results from a prospective European registry
Cardiovascular, kidney, and metabolic (CKM) conditions frequently coexist with atrial fibrillation (AF), but their impact in AF population remains poorly characterized.
Non-cardiac surgeries in adults with congenital heart disease -influence of complexity of disease and estimated risk of surgery on adverse events
To provide information on adults with congenital heart disease (ACHD) undergoing non-cardiac surgeries (NCS), specific risk compared non-ACHD, independent risk factors for adverse outcome and... more
Short and long term effects of a two-week transcutaneous vagus nerve stimulation in hyperadrenergic postural orthostatic tachycardia syndrome: a proof-of-concept trial
autonomic nervous system
Effectiveness of tezepelumab in severe asthma: A multicenter real-world study
Severe asthma is a complex, heterogeneous disease that remains a major therapeutic challenge. Despite several biologics targeting type 2 (T2) inflammation, some patients remain uncontrolled,... more
Prognostic impact of left ventricular dilatation in heart failure with mildly reduced ejection fraction
This study investigated the prognostic value of left ventricular (LV) dilatation in patients with heart failure with mildly reduced ejection fraction (HFmrEF).
Evaluation of cognitive profile and subclinical vascular damage in subjects with genetically confirmed familial hypercholesterolemia
Familial hypercholesterolemia (FH) is a genetic lipid disorder characterized by lifelong exposure to high levels of LDL cholesterol (LDL-C), which promotes the progression of atherosclerosis and... more
The Implementation of the Acute Basic Palliation Concept in Newly introduced Hospital Departments: An Explorative Observational Study of Non-Specialized Palliative Patients Discharged to Die at Home in Denmark
Palliative Care (PC) is a key component of patient-centred healthcare, focusing on relieving the symptoms, pain, dignity and stress of patients with serious, life-limiting conditions. A widely... more
Sex differences in venous thromboembolism outcomes: findings from the GARFIELD-VTE registry
Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is a major cause of morbidity and mortality [1] VTE is linked to several risk factors, including age,... more
Impact of a Checklist-Based Strategy for Cardiac Amyloidosis Screening on Diagnosis Rates in Heart Failure Patients (CHECKAMIC Study)
Amyloidosis is a storage disease caused by the extracellular deposition of fibers derived from structural alterations of unstable proteins, which after folding and aggregation are finally deposited... more
An exploratory model for short-term risk stratification in intermediate-high-risk pulmonary embolism running head: The STAMP score
Patients with acute pulmonary embolism (PE) characterized by hemodynamic stability, evidence of right ventricular (RV) dysfunction (RVD), positive cardiac biomarkers and high simplified pulmonary... more
Effectiveness and safety of rituximab across the four phenotypes of IgG4-related disease: a European multi-center cohort study
IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory condition with marked clinical heterogeneity [1]. Common manifestations include autoimmune pancreatitis and cholangitis, orbital... more
Long term fluid volume fluctuations and mortality in kidney failure patients on long term hemodialysis treatment
The prognosis of patients kidney failure (KF) patients on long term hemodialysis treatment is one of the most severe among chronic diseases, and only modest progress has been made over the last... more
Bleeding risk on rivaroxaban versus apixaban in older patients with venous thromboembolism: a nationwide observational register-based study
During primary treatment, apixaban was associated with a lower risk of major bleeding than rivaroxaban without a corresponding increase in recurrent PE risk. During secondary treatment, no difference... more
Venous thromboembolism associated with infections: a systematic review and meta-analysis
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), has long been a significant cause of severe disease and death. At the same time, its etiology is... more
A prospective study of the association between phosphatidylethanol concentration and risk of first-ever venous thromboembolism
Venous thromboembolism (VTE) is a common term for deep vein thrombosis (DVT) and pulmonary embolism. The overall incidence rate of VTE in adults is 1–2 per 1000 person-years and has increased... more
Transthyretin serum levels and clinical outcomes in patients with transthyretin amyloid cardiomyopathy
Over the last decade, significant advances have been made regarding the knowledge of the biological bases, diagnosis and treatment of transthyretin amyloid cardiomyopathy (ATTR-CM), which currently... more
Whether an optimal strategy exists for VTE prevention in critically ill patients: Insights from guidelines and randomized controlled trials
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a significant concern in critically ill patients. Effective prevention is vital due to its high... more
Performance of enhanced liver fibrosis test and indirect serum fibrosis markers for exclusion of advanced liver fibrosis in alpha-1 antitrypsin deficiency
Alpha-1 antitrypsin deficiency (AATD) is a hereditary condition caused by mutations in the SERPINA1 gene, encoding alpha-1 antitrypsin (AAT), an important antiprotease in the lungs that is primarily... more
Baseline risk and outcome benefit from intensive blood pressure targeting. A systematic review
The definition of blood pressure (BP) targets in treated hypertensive patients remains controversial. Some Guidelines recommend an ideal systolic BP target of <140 mmHg, with different targets... more
Venous thromboembolism associated with weak transient risk factors in young women: risk of late recurrence. An international cohort study
After a first episode of venous thromboembolism (VTE) treated according to the guidelines, the risk of thrombotic recurrence must be assessed in order to guide medical treatment. The clinical risk... more
Review Article
The neuro-cardiac axis in epilepsy
Epilepsy is one of the major noncommunicable neurological disorders (the other comprising migraine, Alzheimer disease/other dementias, Parkinson’s disease, motor neuron diseases, multiple sclerosis,... more
The evolving landscape of screening, management and treatment strategies of aortic stenosis in ATTR amyloidosis
Transthyretin amyloid cardiomyopathy (ATTR-CM) and aortic stenosis (AS) frequently coexist in elderly patients, particularly men, creating a complex clinical scenario with overlapping symptoms and... more
Cardiovascular Risk Assessment: Practical Tips for the Internal Medicine Specialist
Cardiovascular diseases remain the leading cause of mortality worldwide, and they also represent a significant burden in terms of health care expenditure, equipment use, therapeutic interventions and... more
Frailty measurement in research and clinical practice: An updated review
Frailty is a highly prevalent geriatric condition, affecting between 12–24% of older adults globally. It remains a major cause of morbidity and mortality in older adults. Incorporating frailty... more
Drug-induced rise in serum creatinine: cystatin C to the rescue? Evidence, pitfalls and knowledge gaps
Serum creatinine (SCr) concentration is a cheap biomarker of kidney function measured globally millions of times every day. It is part of the KDIGO definitions of both chronic kidney disease and... more
Multidisciplinary strategies and new technologies in the management of sarcoidosis
Sarcoidosis exemplifies the complexity of modern internal medicine, requiring comprehensive, system-based management. The disease is characterized by non-caseating granulomas and can affect virtually... more
Multimodality imaging for cardiac amyloidosis: clinical applications and future directions
Systemic amyloidosis are a group of disorders characterized by the extracellular deposition of misfolded protein fibrils [1]. When the heart is involved, the condition is referred to as cardiac... more
ANCA-associated vasculitis and interstitial lung disease: challenges and open questions
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic inflammatory disorder that primarily affects small blood vessels, often involving vital organs such as the... more
Crystal clear – Part II: the role of uric acid in cardiorenal disease
Building on the foundational mechanistic and epidemiological knowledge from Part I, this second part of the review further unpacks the cardiovascular implications of abnormalities in serum levels of... more
Anemia in cardiorenal disease: From pathogenesis to treatment
Chronic kidney disease (CKD) is a highly prevalent, and progressive comorbidity that affects >10 % of the population worldwide [1–2]. Heart failure (HF) is also a common, disabling, and deadly... more
Earlier Prediction of Cardiovascular Risk with Epicardial Fat Assessment
Obesity is no longer considered a cosmetic problem. The World Health Organisation (WHO) and the European Parliament, as well as many international medical and scientific societies, have recognised... more
Fever and inflammation of unknown origin in the 21st century
Fever of unknown origin (FUO) and inflammation of unknown origin (IUO) are among the most complex and challenging clinical syndromes in Internal Medicine. Internists, by virtue of their broad... more
Charting the future of AL amyloidosis: Diagnostic advancements, prognostic insights, and therapeutic challenges
Light-chain (AL) amyloidosis is a form of plasma cell dyscrasias characterized by deposition of misfolded monoclonal immunoglobulin light chain-derived amyloid fibrils, resulting in abnormal... more
Crystal clear – part I: The role of uric acid in cardiorenal disease
Uric acid (UA), the terminal product of purine catabolism in humans, arises from both endogenous nucleic acid turnover and exogenous sources—particularly diets rich in animal protein and fructose.... more