December 2025
34 ArticlesNo Section
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
Beyond the Guidelines
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
Commentary
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
Internal Medicine Flashcard
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
Letter to the Editor
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,
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
Severe acute refractory hyperkalaemia associated with liposomal amphotericin B infusion
Dear editor,
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
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
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
PFKP, EP300, and VCAN as causal drivers of migraine: Integrating genetics and epigenetics through mendelian randomization
Dear Editor,
Original Article
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
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
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
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