February 2026
143 ArticlesNo Section
From algorithms to care: ten principles for responsible deployment of artificial intelligence in healthcare
Dear Editor,
Detection of left ventricular hypertrophy through ECG: diagnostic performance and comparison of ten ECG scores in different hypertrophic conditions
Different electrocardiographic (ECG) criteria were proposed to improve ECG-based detection of left ventricular hypertrophy (LVH), but external validation data are limited and their diagnostic... more
Multiperspective ultrasonography in COPD exacerbations: Insights into inspiratory muscle recruitment and clinical outcomes
We have read with considerable interest the recent investigation by Tabbì and colleagues elucidating inspiratory muscle activity through ultrasonographic assessment in patients with chronic... more
Corrigendum to “The changing landscape of Heart Failure: translating management into the modern era” [European Journal of Internal Medicine (2026) 106633]
The authors regret that in Figure 1 the name of the drug Sacubitril/Valsartan was incorrectly reported as sacubutril valsartan. This was a typographical error, and the figure has now been corrected... more
Critical considerations on uric acid in HFmrEF: from biomarker to metabolic integrator. Author's reply
Dear Editor,
Oral anticoagulant nonprescription at discharge in geriatric patients with atrial fibrillation and reduced expected survival
Oral anticoagulant therapy (OAC), with direct oral anticoagulants (DOACs) recommended over vitamin K antagonists (VKAs), is considered the standard of care for patients with atrial fibrillation (AF)... more
Corrigendum to “Natural history of the severe subtype of MYH9-related disease (Epstein syndrome)” [European Journal of Internal Medicine 138 (2025) 6354]
The authors regret that an error appeared in Fig. 1 of the published article. The panels for Deafness, Renal failure, and Proteinuria inadvertently displayed the Kaplan-Meier curves for the R702C/H... more
Is left ventricular hypertrophy a reliable predictor of renal and cardiac outcome in IgA nephropathy?
Cardiovascular disease (CVD) is the most important cause of adverse clinical outcome in chronic kidney disease (CKD), due to shared etiopathogenetic factors and common pathophysiological mechanisms [... more
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
Clinical Insights
Integrating the lungs and the nervous system: Redefining chronic obstructive pulmonary disease care
We read with great interest the article by Mannino et al., which offers a thoughtful and balanced discussion on the clinical relevance of comorbidities in chronic obstructive pulmonary disease (COPD... more
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
SGLT-2 inhibitors in heart failure with preserved and mildly reduced ejection fraction: a big step forward but still a long way to go
Heart failure with preserved ejection fraction (HFpEF) is a complex and multifactorial heart disease that traditionally has had no effective therapy options beyond congestive symptom’s control [1].... more
Hypertriglyceridemia-mediated acute pancreatitis: timely attention for an underdiagnosed and severe disease
In this issue of the European Journal of Internal Medicine a narrative review on hypertriglyceridemia-mediated acute pancreatitis (HTG-AP) is published by Subramanian et al. [1]. This well written... more
To dilate or not to dilate: the puzzle of phenotyping heart failure with mildly reduced ejection fraction
Heart failure (HF) is a significant global health concern burdened by an increasingly prevalent issue in both developed and developing countries [1]. It currently affects over 20 million people... more
Intensification of monitoring for improving detection of atrial fibrillation after a presumed “trigger- induced episode” due to potentially reversible factors: what tools and what implications for decision making?
Atrial fibrillation (AF) is an arrhythmia with an increasing epidemiological burden worldwide[1] even if its precise prevalence cannot be defined, since it is frequently asymptomatic, either in... more
Why we measure frailty: Aligning tools with use
Frailty has become an increasingly prominent topic of investigation, attracting substantial and growing attention within the scientific community. However, such rapid expansion of interest also... more
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
Editorial
A hierarchized proposal to integrate steatotic liver disease in cardiometabolic care: A new mindset to evaluate MASLD in Internal medicine
The introduction of direct-acting antivirals against hepatitis C virus (HCV) signaled the end of a major era in liver disease, while simultaneously opening new opportunities for medical research and... more
Internal Medicine Flashcard
Tongue atrophy following unexplained nausea, vomiting, and hiccups
A 45-year-old woman was admitted with aspiration pneumonia. She was found to have progressive dysphagia and severe dysarthria. Neurological examination showed a hypernasal voice, diminished gag... more
“Normally distended” bladder in an anuric hemodialysis patient
A 72-year-old man with end-stage kidney disease had been on maintenance hemodialysis for 18 years and was completely anuric. He presented with a two-week history of persistent low-grade fever (37 °C... more
Recurrent postprandial mandibular swelling with systemic symptoms: a diagnostic challenge
A 56-year-old woman with allergic rhinitis presented to the emergency department with severe lower abdominal pain and generalized wheals shortly after lunch. Blood tests and abdominal CT were... more
De Winter‐like electrocardiogram changes in the inferior leads
A 48-year-old man with an unremarkable medical history presented with two hours of persistent chest tightness and heartburn. His electrocardiogram (ECG) on arrival showed 1‑ to 3‑mm upsloping ST‑... more
Double halo sign, abdominal pain and purpura
A 66-year-old man was admitted to the internal medicine department with subacute abdominal pain and diarrhoea, resulting in a weight loss of 10 kg over three weeks. Shortly thereafter, he developed... more
Demyelinating or compressive myelopathy
A 29-year-old male presented with an eight-month history of progressive ambulation difficulty and a four-month history of urinary hesitancy. He reported no family history of neurological or... more
Perisplenic fibrosis
Case 1: A 35-year-old woman presented with diabetes insipidus diagnosed at the age of six years. Ten years after diagnosis, she presented with facial sinus infiltration, pleural thickening, long bone... more
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
Letter to the Editor
Timing and absolute benefit in updated colchicine meta-analysis for coronary artery disease. Author's reply
Dear Editor
Is there a clinical benefit of mechanical CPR in obesity?
We read with interest the article by Sujanyal et al. investigating the outcomes of LUCAS®-assisted versus manual cardiopulmonary resuscitation (CPR) in obese patients with in-hospital cardiac arrest... more
Unmeasured confounders in residual OSA: The roles of polypharmacy, loop gain, and weight trajectory
We read with interest the article by Vitacca et al. [1] In this retrospective cohort spanning ten years of cardiorespiratory monitoring (CRM), the authors assessed residual respiratory events (rAHI≥... more
Management of ANOCA and suspected microvascular angina: integration of plaque-directed and functional strategies
We read with interest the Ideas and Opinions article by De Servi and colleagues, who question the current emphasis on invasive coronary function testing (CFT) in patients with angina with no... more
Fractional exhaled nitric oxide in acute exacerbations of chronic obstructive pulmonary disease: Beyond pooled means to individual precision
We read with great interest the meta-analysis by Ambrosino and colleagues evaluating fractional exhaled nitric oxide (FeNO) in acute exacerbations of chronic obstructive pulmonary disease (AECOPD) [1... more
Reconsidering residual sleepiness and respiratory events in treated obstructive sleep apnea
We read with great interest the article by Vitacca and colleagues regarding the persistence of respiratory events and daytime sleepiness in patients treated for obstructive sleep apnea [1]. The study... more
Cerebral small vessel disease: a potential risk modifier for future guidelines on management of dyslipidaemias
Cerebral small vessel disease (cSVD) is a highly prevalent and prognostically relevant condition in older adults, yet it is not specifically addressed in current dyslipidaemia management guidelines.... more
TAPSE/PASP ratio in older HFpEF patients: Prognostic insights and geriatric challenges
We read with interest the article by De Matteis et al. on the prognostic role of the TAPSE/PASP ratio in older patients with HFpEF hospitalized for acute heart failure [1]. The authors show that RV-... more
Epicardial adipose tissue assessment for earlier cardiovascular risk prediction: from association to clinical utility
Calcaterra and colleagues provide a timely narrative review on epicardial adipose tissue (EAT) as an imaging marker of cardiometabolic risk and a potentially modifiable therapeutic target [1]. Yet... more
Use of continuous morphine infusions in end-of-life care in an internal medicine ward
The use of continuous opioid infusions at the end of life remains a clinically and ethically sensitive area in acute hospital practice[1,2]. International recommendations emphasize that opioids are... more
Optimizing cardiorenal protection in HFrEF: From pharmacological mechanisms to clinical implementation
We read with great interest the review article by Russo et al. titled [1]. The authors provided a comprehensive and timely overview of the "four pillars" of heart failure therapy—RAAS inhibitors,... more
Monitoring for atrial fibrillation recurrence following transient new-onset atrial fibrillation
We thank Yang and colleagues for their interest in our study on the time-to-detection of recurrent atrial fibrillation (AF) in patients with transient new-onset AF detected during hospitalization for... more
Comparison of primary prevention strategy guided by SCORE2 versus coronary artery calcium scoring in a non-diabetic population
Cardiovascular disease (CVD) remains the leading cause of death and disability worldwide [1]. The role of preventive medicine in reducing the burden of CVD tends to grow because prevention is better... more
Environmental PM10 exposure and MASLD: Challenges in translating gene–environment interactions into routine clinical care
We read with great interest the article by Di Ciaula et al. exploring the association between long-term PM10 exposure and metabolic dysfunction-associated steatotic liver disease (MASLD) in... more
Advancing beyond multimodality: integrating quantitative imaging biomarkers into the clinical workflow of cardiac amyloidosis. Author’s reply
We thank Jiang and colleagues for their interesting Letter [1] and for the generous attention dedicated to our review on multimodality imaging in cardiac amyloidosis (CA) [2]. We greatly appreciate... more
Challenges in defining difficult-to-treat rheumatoid arthritis in the elderly: Channeling bias, sarcopenia, and the age paradox. Author’s reply
Dear Editor,
Clinical incidents attended by the internal medicine on-call team at a tertiary care hospital
On-call duty is a cornerstone of hospital-based Internal Medicine, yet it remains one of the least quantified and most debated components of medical practice. Originally conceived to address... more
Survival outcomes with LUCAS-AssiSTED VS MANUal CPR in in-hospital cardiac arrest obese patients
Obesity has emerged as a global health challenge, contributing not only to chronic disease but also to poorer outcomes in acute, high-acuity situations such as cardiac arrest. In the in-hospital... more
Reassessing the safety signal: Dihydropyridine calcium channel blockers in the era of quadruple therapy for heart failure. Author's reply
We read with interest the letter by Wang et al [1] regarding our recently published paper on prescription patterns and outcomes associated with dihydropyridine calcium channel blockers (DHP-CCBs)... more
Methodological and generalizability considerations in the study of bleeding risk with rivaroxaban vs apixaban in older VTE patients
We read with great interest the nationwide register-based cohort study by Roupe et al., recently published in the European Journal of Internal Medicine [1]. The authors should be commended for... more
Timing and absolute benefit in updated colchicine meta-analysis for coronary artery disease
We read with interest the updated systematic review and meta-analysis by Boracchi and colleagues evaluating long-term secondary prevention with low-dose colchicine in patients with coronary artery... more
“One size does not fit all”: Personalized approach to define appropriate level of palliative care in newly diagnosed idiopathic pulmonary fibrosis patients
Idiopathic pulmonary fibrosis (IPF) is still a disease in which patients' clinical needs and the delivery of palliative care (PC) are mismatched. International societies recommend integrating PC for... more
Antiplatelet therapy in patients with stable coronary artery disease who require long-term oral anticoagulation
Coronary artery disease (CAD) and atrial fibrillation (AF) and frequently coexist, with overlapping cardiovascular risk factors [1]. Oral anticoagulants (OACs) are indicated for AF-related stroke... more
Refining cardio-kidney-metabolic phenotyping to strengthen interpretation and clinical translation in atrial fibrillation
We read with great interest the article by Mei and colleagues, who investigated cardiovascular-kidney-metabolic (CKM) domains in a large European cohort of patients with atrial fibrillation (AF) and... more
SGLT2 Inhibitors in musculoskeletal and connective tissue diseases: Is there a role?
Dear Editor,
Infections as a dynamic trigger for venous thromboembolism: toward clinically actionable risk stratification
Dear Editor,
Reconsidering the prognostic significance of fluid volume fluctuations in kidney failure
We read with great interest the recent study by Zoccali and colleagues regarding the association between long term fluid volume fluctuations and mortality in patients with kidney failure [1]. The... more
Quality-of-life outcomes after sleeve gastrectomy versus Roux-en-Y gastric bypass: looking beyond mean differences
We read with great interest the article by ’t Hart et al. reporting long-term quality of life (QoL) outcomes after sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) in the SleeveBypass... more
Recombinant hf-SCIg in inflammatory myositis: refining patient selection and outcome assessment
We read with great interest the article by Palermo et al. reporting a multicentre real-world experience with recombinant human hyaluronidase-facilitated subcutaneous immunoglobulin (hf-SCIg) for... more
Challenges in inpatient diabetes care: A single-day snapshot or a shot at the heart of the problem?
We read with great interest the thoughtful comments from Wang et al. [1] regarding our article, “Gaps in Glycaemic Monitoring and Underuse of Cardioprotective Glucose-Lowering Agents: Challenges of... more
Stratifying AF ablation recurrence risk: Limitations of BMI and optimized assessment strategies
We read with great interest the article by Liao et al. titled “Both underweight and obese patients are prone to relapse after ablation of paroxysmal atrial fibrillation” published in the European... more
Bronchoscopy, ventilator dose and outcomes in severe CAP: Reading the sex signal. Author's reply
Dear Editor
Most acute heart failure with preserved ejection fraction is not true HFpEF
Dear Editor,
The widening gap between point-of-care ultrasonography course participation and supervision resources
Dear Editor,
Heart failure with preserved ejection fraction in the elderly: Clinical, imaging, and biomarker profiles according to global longitudinal strain by cardiac magnetic resonance
Dear editor,
Bridging the gap: Phenotype-specific considerations for rituximab therapy in IgG4-related disease. Author's reply
We thank Li and Wang for their thoughtful appraisal of our study and for emphasizing the growing need for phenotype-individualized approaches in IgG4-related disease (IgG4-RD) [1,2]. Their comments... more
On the urgency of redefining endpoints and precision stratification in extended monitoring for atrial fibrillation
McIntyre et al. have made a significant contribution to the growing body of evidence supporting extended ambulatory electrocardiogram monitoring in patients with transient new-onset atrial... more
Enhancing the clinical relevance of BMI in atrial fibrillation ablation: A call for integrating body-composition and peri-left-atrial adipose tissue measures
Liao et al. report a multicentre analysis showing a U-shaped association between pre-ablation BMI and post-ablation atrial tachyarrhythmia recurrence in paroxysmal AF [1]. The work is timely and... more
Reassessing the safety signal: Dihydropyridine calcium channel blockers in the era of quadruple therapy for heart failure
Dear Editor,
The four ages of diagnosis: A physician’s journey through time
Dear Editor
Beyond ejection fraction: Small left ventricular volumes define a high-risk phenotype in acute heart failure with preserved ejection fraction
In patients with heart failure and reduced ejection fraction (HFrEF), larger indexed left ventricular volumes (iLVEDV) have been traditionally considered a surrogate of lower left ventricular... more
Communicating robustness and sex-specific benefit of SGLT2 inhibitors in HFpEF and HFmrEF
Dear Editor,
Challenges in defining difficult-to-treat rheumatoid arthritis in the elderly: Channeling bias, sarcopenia, and the age paradox
We read with great interest the recent original article by Jung et al., entitled “Difficult-to-treat rheumatoid arthritis among elderly patients from the KOBIO registry,” published in the European... more
Integrating sTREM2 into non-invasive pathways for early MASH in MASLD
We read with great interest the article by Mahmoudian et al., who evaluated soluble triggering receptor expressed on myeloid cells 2 (sTREM2) as a non-invasive biomarker for early metabolic... more
Beyond systemic biomarkers: Future directions in understanding the inflammatory nexus of obstructive sleep apnea and atrial fibrillation
We read with great interest the article by Hunt et al. entitled “Systemic markers of inflammation and immune activation in patients with obstructive sleep apnea and paroxysmal atrial fibrillation,”... more
Critical considerations on uric acid in HFmrEF: from biomarker to metabolic integrator
To the editor,
West Nile virus infection: New guitars in town for the internal medicine community
Dear 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,
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,
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
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,
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
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
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].
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,
Cognitive impairment in familiar hypercholesterolemia: how much is vascular and how much is confounding?
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
Original Article
Identifying distinct clinical phenotypes and outcomes in adult-onset IgA vasculitis using unsupervised clustering analysis
IgA vasculitis (IgAV) is a systemic vasculitis of the small vessels characterized by immune complexes including immunoglobulin A1 (IgA1) [1]. The clinical picture is a vascular purpura with or... more
Impact of chronic kidney disease on treatment implementation and prognosis of patients with heart failure: A large retrospective observational analysis from the Italian Network-Heart Failure (IN-HF) registry
In contemporary cohorts of stable heart failure (HF) outpatients, the prevalence of renal dysfunction varies upon definition, but may approach 70% [1]. Hemodynamic and metabolic alterations resulting... more
Incidence of major adverse cardiovascular events decreases with greater adherence to both Mediterranean and low-fat dietary patterns in secondary prevention patients: a randomized controlled trial
Diet plays a crucial role in lifestyle interventions for secondary cardiovascular prevention [1–5]. Recent guidelines for reducing cardiovascular risk in secondary prevention populations recommend,... more
Mechanistic insights into heart failure progression and therapeutic target discovery through plasma microRNA profiling: Findings from HOMAGE
Identifying early pathobiological mechanisms associated with the onset and progression of heart failure (HF) could guide development of preventive strategies.
Optimizing patient selection for patent foramen ovale closure after stroke: The CRISP-PFO score
Although patent foramen ovale (PFO) transcatheter closure lowers recurrent cryptogenic stroke (CS), identifying patients who benefit most remains challenging. We developed, validated and assessed the... more
Pre- and in-hospital lactate ratio as a predictor of mortality in severe diabetic ketoacidosis: a multicenter prospective cohort study
Lactate kinetics between prehospital and in-hospital measurements have been associated with prognosis in acute conditions. This study aimed to evaluate the prognostic value of the prehospital-to-... more
Adrenal insufficiency following systemic glucocorticoid therapy: a systematic review and meta-analysis
Adrenal insufficiency (AI) is a common complication following glucocorticoid (GC) therapy. However, reliable predictors of AI and GC regimens that mitigate this risk remain unclear. Previous... more
Inflammatory spectrum of frailty: Association between the systemic immune-inflammation index and frailty in liver transplant candidates
Frailty is common among patients with advanced chronic liver disease (AdvCLD), progressively impairing physical fitness as the disease worsens [1]. It is characterized by reduced physiological and... more
Left atrial appendage closure in patients with hereditary hemorrhagic telangiectasia and atrial fibrillation: a prospective study and systematic review
Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant vascular disease with a high risk of iron deficiency anemia secondary to epistaxis and gastrointestinal bleeding. Atrial... more
Growth differentiation factor-15 in patients presenting with acute chest pain: Diagnostic and prognostic utility
Each year, over 15 million patients present to the emergency department (ED) in North America and Europe with suspected acute myocardial infarction (AMI) [1,2]. Clinical practice guidelines highlight... more
Residual respiratory events and daytime sleepiness despite management of obstructive sleep apnoea with and without additional central apnoeas. A three-month follow-up study
Despite treatment, individuals with obstructive sleep apnoea (OSA) may still exhibit high apnoea and hypopnoea indices (AHI) and excessive daytime sleepiness (EDS). We recorded residual respiratory... more
Recent trends and future projections of atrial fibrillation epidemiology in a large european population
Atrial fibrillation (AF) is a major public health concern with a rising global epidemiological burden and marked regional variability. We analysed AF epidemiology, trends, and future projections in a... more
Risk of endocarditis in patients with bacteraemia by coagulase-negative staphylococci; a multicenter retrospective cohort
Infective endocarditis (IE) is a serious and under-recognized complication of coagulase-negative staphylococci (CoNS) bacteraemia. The aim was to identify predictors of IE in patients with CoNS... more
Association between interleukin-6, C-reactive protein and chronic kidney disease outcomes: A systematic review and meta-analysis
Chronic kidney disease (CKD) is a progressive disorder defined by structural or functional kidney abnormalities persisting for at least three months. According to KDIGO criteria, CKD is diagnosed by... more
Ultrasound-based evaluation of inspiratory muscle effort in patients with type 2 respiratory failure secondary to exacerbation of chronic obstructive pulmonary disease
Exacerbations of chronic obstructive pulmonary disease (ECOPD) are a major cause of acute hypercapnic respiratory failure. Diaphragmatic dysfunction is common, often accompanied by compensatory... more
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
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.
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).
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
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
Review Article
Precision medicine with pioneering RNAi therapeutics in ATTR amyloidosis: from bench to bedside
Transthyretin (ATTR) amyloidosis is a multisystem disease caused by misfolding and aggregation of the plasma protein transthyretin (TTR) into insoluble amyloid fibrils in various organs [1]. This... more
Detecting dementia symptoms in internal medicine settings: clinical red flags, frailty and intervention perspectives
This paper provides a comprehensive overview of dementia in internal medicine hospital settings, highlighting its clinical detection, key red flags and frailty factors, as well as intervention... more
Prevention and treatment of hypertriglyceridemia-mediated acute pancreatitis: A narrative review
Acute pancreatitis can result in death or serious consequences including chronic pancreatitis, diabetes mellitus, and organ failure. Causes of acute pancreatitis include gallstones, alcohol, and... more
Renal protection in heart failure with reduced ejection fraction: not all that glitters is gold
Chronic kidney disease (CKD) is prevalent among patients with chronic heart failure (CHF), largely due to shared risk factors such as hypertension, diabetes, and dyslipidemia. In patients with heart... more
Medical cannabis and the hype cycle: Clinical evidence and future directions
Medical cannabis has moved from a taboo subject to a mainstream clinical discussion over the past three decades. This review synthesizes the evidence and frames its progression using a Hype Cycle... more
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