January 2025
153 ArticlesNo Section
Hydroxychloroquine use in patients with primary immune thrombocytopenia and antiphospholipid antibodies
The prevalence of antiphospholipid antibodies (aPL) among patients with immune thrombocytopenia (ITP) is high, at 20 % or higher according to previous studies [1,2].
Beyond the Guidelines
Elevated blood pressure and hypertension in older persons: A comment on the recent ESC guidelines
The recently published European Society of Cardiology (ESC) Guidelines (GLs) for the management of elevated blood pressure (BP) and hypertension [1] introduced substantial changes in recommendations... more
Clinical Insights
Redefining giant cell arteritis: From current practices to future paradigms
The management of patients with giant cell arteritis (GCA), the most common vasculitis in adults, has undergone significant transformation over the past decade [1]. This shift has been primarily... more
The assessment, interpretation and implementation of lung ultrasound examinations in Heart Failure: Current evidence and gaps in knowledge
Pulmonary congestion is a common finding of volume overload or volume shift in heart failure (HF) and its detection is essential to facilitate timely therapy initiation or adjustment prior to frank... more
The screening of cognitive impairment in the emergency department: A valuable clinical and epidemiological goal
The screening of cognitive impairment is a critical and underestimated problem in the Emergency Department (ED). Overall, dementia remains unrecognized in more than a half of the Italian population,... more
Commentary
Sodium bicarbonate in metabolic acidosis: A never-ending story?
Is it useful to treat metabolic acidosis with bicarbonate or not? This question is still one of the hot topics that doctors deal with in their daily clinical practice, mainly due to the lack of clear... more
Pulmonary metastases and bleeding in the anticoagulated oncology patient with thrombosis: is the risk solely influenced by the location of distant disease?
The article by García-García V et al. [1], published in this issue of the European Journal of Internal Medicine,provides a valuable exploration of hemorrhagic complications in cancer-associated... more
Hypertension and heart failure: A dangerous relationship with clinical implications
Heart failure (HF) is currently classified into three categories, according to left ventricular (LV) ejection fraction (LVEF): HF with reduced ejection fraction (HFrEF; LVEF <40%), HF with mid-... more
Risk factors for community-acquired acute kidney injury: Challenges and perspectives
Acute kidney injury (AKI), even in its milder forms, significantly contributes to increased morbidity and mortality among both hospitalized and non-hospitalized individuals. However, AKI is now... more
Exploring predictors of pulmonary embolism in hospitalized patients with acute exacerbation of chronic obstructive pulmonary disease
In this issue of the European Journal of Internal Medicine, Mismetti et al. published an original article titled "Predictors of pulmonary embolism in chronic obstructive pulmonary diseases patients... more
Hypertension management: The lesson from the SARS-CoV-2 pandemic
Hypertension is a major risk factor for cardiovascular diseases and a major cause of premature death worldwide [1]. Its regular monitoring is crucial for reducing cardiovascular risk, since it is the... more
“Obesity management in the older age, new understanding for old challenges”
Obesity, a silent pandemic, is rapidly spreading across all age groups and populations worldwide. >1 billion individuals are expected to be living with obesity by 2030 [1]. Parallel to the obesity... more
The new ESC 2024 guidelines on the management of peripheral arterial and aortic diseases: Lights and shadows
The new guidelines on the management of peripheral arterial and aortic diseases have been released at the European Society of Cardiology (ESC) Annual Congress 2024 and published simultaneously [1].... more
Hyperhomocysteinaemia and MASLD: Causal relationship or spurious correlation?
Metabolic dysfunction-associated liver disease (MASLD) is the most common chronic liver disease worldwide and a leading cause of liver-related morbidity and mortality, affecting one-third-of the... more
Linking functional capacity and heart failure outcomes: Easy assessment, major implications
Heart failure (HF) is a global pandemic that affects nearly 60 million people worldwide. Despite continuous and significant advances in treatment, HF continues to be associated with poor prognosis... more
Realizing the scope of venous and arterial thrombosis in cyclin-dependent kinase 4/6 inhibitors in hormone positive breast cancer
In hormone positive, human epidermal growth factor receptor 2 (HER2)-negative advanced and metastatic breast cancer, the cyclin-dependent kinase (CDK) 4/6 inhibitors palbociclib, ribociclib and... more
Treatment of systemic lupus erythematosus in real life
The study by Du et al., published in this issue of the European Journal of Internal Medicine [1] adds significant information regarding the treatment patterns in systemic lupus erythematosus (SLE),... more
Editorial
A new era in optimization of anti-infective therapy: Current challenges and priorities
Managing infectious diseases is an ever increasing challenge keeping pace with rising antimicrobial resistance, emerging pathogens and changing treatment paradigms. In a changing world, COVID-19,... more
Two recent European guidelines on hypertension
During the past year, two influential Hypertension Guidelines from Europe have been released. The first, published in year 2023, was issued by the European Society of Hypertension [1]. The second,... more
Internal Medicine Flashcard
A 73-year-old man with purpura and fever
A 73-year-old man presented to our dermatology department with a four-week history of palpable purpura on the lower limbs. His medical history included a suspicion of polymyalgia rheumatica based on... more
An uncommon and unexpected cause of chest pain: When stockings become trauma
An 80-year-old woman presented to the emergency department (ED) with acute sternal pain that began after removing her compression stockings. Three days earlier, she experienced a similar episode... more
Female patient with telangiectasia, epistaxis and pulmonary arteriovenous malformation
A 55-years-old female patient was admitted to our clinic with a long-standing complaint of epistaxis. She had no medical history and was not taking any medications. Both her children had nosebleeds.... more
Generalized bullous fixed drug eruption
A 73-year-old female presented with a diffuse rash accompanied by itching for 3 days. She had taken levofloxacin orally for a cough one day before the rash developed. She had a 16-year history of... more
Esophagitis in an immunocompetent patient: A diagnostic challenge
A 65-year-old man with Parkinson's disease was admitted to hospital for continuous subcutaneous infusion of levodopa/carbidopa. On day 6 of hospitalization, he developed pharyngalgia, sensation of... more
Man with red eyes
A 71-year-old male presented to our hospital with vertigo. The supine roll test induced vertigo, leading to a diagnosis of left horizontal semicircular canal benign paroxysmal positional vertigo (... more
Coronary artery pulsatile ectasia and multiple occlusion in an adolescent male
An adolescent male was referred to our hospital due to dyspnea persisting for over a month. He has no previous medical illness and is not taking any medications. There was no history of smoking or... more
Hemiatrophy of the face and limb
A 64-year-old man presented to the Department of Neurology with recurrent head discomfort for over eight years and right-side facial and limb atrophy for five years. The head discomfort usually... more
A woman with unconsciousness and tachycardia after drug overdose.
A 44-year-old female was brought to our emergency department due to impaired consciousness. On arrival, her Glasgow Coma Scale score was 6. Her blood pressure was 102/60 mmHg, her heart rate was 132... more
A tiny green lesion mimicking a big problem
A 75-year-old smoker patient presented to our hospital with shortness of breath and mild hemoptysis. A chest radiograph demonstrated a suspicious left parahilar opacity (Fig. 1A). A thoracic computed... more
Reversible polyneuropathy with multiple hypochromic lesions, digital ulcers and onychodystrophy
A 40-year-old Brazilian woman with a medical history of a subclinical hypothyroidism came to our clinic because of progressive distal numbness, weakness and polyarthralgia. She denied fever nor... more
Invited Review Article
Behaviour therapy for obesity in older adults
Obesity is a major public health concern, with global data highlighting that 650 million adults are living with obesity and 1.9 billion adults are living with overweight [1]. Current epidemiological... more
Treat the patient, not the disease: The embolic stroke of undetermined source as an opportunity to optimize cardiovascular prevention in a holistic approach
“It is much more important to know what sort of patient has a disease than what sort of disease a patient has.”“The good physician treats the disease; the great physician treats the patient who has... more
Pharmacotherapy for older people with obesity
The prevalence of obesity continues to rise in Europe, particularly in adults aged between 60 and 74 years [1]. Despite this rising prevalence of obesity in older adults, use of medication for weight... more
Letter to the Editor
Trends in industry-sponsored research payments to internist principal investigators
In the United States, the Physician Payments Sunshine Act, passed by Congress as part of the 2010 Affordable Care Act, has brought greater transparency to financial relationships between industry and... more
Optimal BMI cutoff for lean MASLD/MetALD and adverse hepatic outcomes in East-Asian populations
Nonalcoholic fatty liver disease (NAFLD) is a primary contributor to hepatocellular carcinoma (HCC)/liver cirrhosis (LC), affecting ∼30 % of the global population. Its incidence is rising parallel to... more
Refining insights into rheumatoid arthritis-associated liver dysfunction: Opportunities for methodological advancements and clinical implications
We read with great interest the article by Arias-de la Rosa et al., published in the European Journal of Internal Medicine [1]. This study provides valuable evidence that patients with rheumatoid... more
Vaginal self-sampling for human papillomavirus to improve cervical cancer screening in patients with immune-mediated inflammatory diseases
Dear Editor,
Reevaluating hypoxia and cancer as determinants of prognosis in COPD and Takotsubo syndrome
Dear Editor,
Internists at the frontline of epidemic viral illnesses: From tiredness to preparedness
In the wake of the coronavirus disease 2019 (COVID-19) pandemic, who would reasonably declare that a time will ever come «to close the book on infectious diseases»? Indeed, new viral threats are... more
The evolving role of head up tilt test: New protocol and indications for optimizing the care of syncope patients
Dear Editor, we read with great interest the metanalysis by Guida et al. [1] about the diagnostic held of head up tilt test (HUTT) in patients with suspected vasovagal (VVS) syncope. The authors... more
Rituximab in Immune-mediated thrombotic thrombocytopenic purpura
Thrombotic thrombocytopenic purpura (TTP) is a rare and potentially fatal thrombotic microangiopathy, defined by a mechanical hemolytic anemia, severe thrombocytopenia, and visceral ischemia due to... more
Evaluating feature importance biases in logistic regression: Recommendations for Robust Statistical Methods. Author's reply
Dear Editor,
Associations of cardiovascular health and exercise capacity with moderate-to-vigorous physical activity prior to enrolment to cardiac rehabilitation in coronary artery disease patients
Exercise training is a core component of cardiac rehabilitation (CR) and is associated with improvement in (sub)maximal exercise capacity, quality of life, and a reduction in the risk of re-... more
Refining the understanding of cardiovascular risk following COPD exacerbations: Opportunities for stratified and multidisciplinary approaches
We have carefully reviewed the article by Calabria et al., published in the European Journal of Internal Medicine [1]. This study, based on a comprehensive database analysis, highlights the... more
Refining risk assessment for intra-abdominal infections in immunocompromised intensive care unit patients
The study by Paiva and colleagues [1] provides valuable insights into intra-abdominal infections (IAI) in immunocompromised intensive care unit (ICU) patients, highlighting similarities and... more
Analysis of “characteristics of familial mediterranean fever disease after 65 years of age”
I have read the article “Characteristics of Familial Mediterranean fever (FMF) after 65 years of age” with great interest. The study provides valuable insights into the clinical features and... more
The potential impact of educational attainment on NAFLD risk. Author's reply
We thank Ke-qian Chen et al. and the European Journal of Internal Medicine for the opportunity to engage in a constructive discussion about the relationship between educational attainment and non-... more
Revisiting the association between air pollution and peripheral artery disease: Evidence from mendelian randomization analysis
We read with great interest the article by Di Blasi et al., published in the European Journal of Internal Medicine [1]. This well-designed study provides significant evidence on the association... more
Hypertension – a global problem requiring a comprehensive approach
We read with great interest a recently published study by Rikuta Hamaya, Molin Wang, Ellen Hertzmark, et al. regarding modifiable lifestyle factors in the primordial prevention of hypertension [1].... more
Enhancing hypertension prevention research: Insights and opportunities for social work interventions. Author's reply
Dear Editor,
Risk for hospital-treated infections in dermatitis herpetiformis and coeliac disease
Dear Editor,
Risk of injurious falls in older people with atrial fibrillation
Dear editor,
Enhancing the understanding of hyperhomocysteinemia and MASLD: Addressing methodological limitations and future directions
To the editor:
Use of betablockers in post-myocardial infarction patients in a real-world setting
For many years, the main guidelines have been recommending the use of betablocker therapy in patients after myocardial infarction (MI) [1,2]. This recommendation entails a high class and grade for... more
Prognostic impact of different triggers in patients with Takotsubo syndrome and chronic obstructive pulmonary disease. Author's reply
We thank the authors for the interest in our study recently published in the journal [1]. In that, we focused specifically on patients with takotsubo syndrome (TTS) and chronic obstructive pulmonary... more
High-risk allogeneic stem cells transplantation in advanced age patients with uncontrolled sickle cell disease
Sickle cell disease (SCD) is a recessive monogenic disease where a single nucleotide mutation of the HBB gene, encoding the β-globin chain of hemoglobin (Hb), leads to the synthesis of HbS.... more
Measuring the risk of clinical adverse events (RISK ACE) by quantifying liver function: A patient-centric model
Identifying the patients with compensated advanced chronic liver disease (cACLD) who are at risk for clinical decompensation is a goal of clinical management [1]. Early detection of those at risk for... more
Clarifications and enhancements for cardiovascular risk study in metabolic dysfunction-associated steatotic liver disease
This study by Shibata et al. [1] investigated the risk of major adverse cardiac events (MACE) in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) and employed a... more
Extra-articular manifestations in rheumatoid arthritis: Incidence and predisposing factors
The research by Lotta Ljung et al. [1] offers valuable insights into extra-articular manifestations (ExRA) in rheumatoid arthritis (RA) yet has room for improvement. The questionnaire-based approach... more
Evaluating feature importance biases in logistic regression: Recommendations for robust statistical methods
Dear Editor,
Seasonality of diabetic ketoacidosis in hot climate
Diabetic ketoacidosis (DKA) is a life-threatening condition arising from an absolute or relative insulin deficiency, leading to hyperglycemia and ketone body accumulation in the blood with metabolic... more
Prognostic impact of different triggers in patients with Takotsubo syndrome and chronic obstructive pulmonary disease
We read with great interest a recently published study by Luca Arcari, Giacomo Tini, Michela Zuccanti, et al. regarding clinical characteristics and outcomes of Takotsubo syndrome (TTS) in patients... more
Diagnostic yield of head-up tilt testing in suspected vasovagal syncope
Vasovagal syncope (VVS) is the most frequent form of syncopal spells characterized by a reflex causing hypotension and often bradycardia, usually elicited by prolonged standing or exposure to... more
Validating ChatGPT's role in systematic reviews and meta-analyses: A case study on GLP-1 receptor agonists and all-cause mortality
Dear Editor,
Enhancing cardiovascular risk management in rheumatoid arthritis: From medication adherence to multidisciplinary interventions
We carefully read the article by Cacciapaglia et al. published in the European Journal of Internal Medicine [1]. This study reveals the suboptimal adherence to lipid-lowering therapy prescriptions in... more
Enhancing hypertension prevention research: Insights and opportunities for social work interventions
We read with great interest the recent article by Hamaya et al. published in the European Journal of Internal Medicine [1]. The Authors conducted a comprehensive analysis of the impact of lifestyle... more
GLP-1 receptor agonists for the treatment of obstructive sleep apnea and obesity
Obstructive sleep apnea (OSA) syndrome is a common disorder of repeated upper airway collapse during sleep, leading to recurrent hypoxia and hypercapnia [1]. Continuous positive airway pressure (CPAP... more
Switching from hospital centered to community based, person centered and integrated social health and care systems; Mission impossible or key objective?
Length of Stay (LOS) is a widely recorded metric used in hospital management and considered an important indicator of healthcare efficiency [1]. Despite its strategic value and one of the longest... more
Vaccination trends and recent therapeutics to encounter resurgence of monkeypox
The World Health Organization (WHO) declared a public health emergency of international concern (PHEIC) on the resurgence of monkeypox after the 2022–2023 epidemic, a zoonotic ailment with primary... more
Optimizing socioeconomic and psychosocial factor analysis in myocardial infarction outcomes
Dear Editor,
The potential impact of educational attainment on NAFLD risk
We read with great interest the article by Florian Koutny and his colleagues, recently published in the European Journal of Internal Medicine [1]. In this article, Florian Koutny and his colleagues... more
Refining metabolic health assessment in inflammatory bowel disease risk prediction
Mi et al.'s investigation [1], drawing upon the United Kingdom (UK) Biobank resource, delves into the interplay between metabolic health and genetic predisposition to inflammatory bowel disease (IBD... more
Characteristics of familial Mediterranean fever after 65 years of age
Dear Editor,
External factors affecting weight loss during intermittent fasting. Author's reply
Dear Editor,
Comparative safety and efficacy analysis of GLP-1 receptor agonists and SGLT-2 inhibitors among frail individuals with type 2 diabetes in the era of continuous population ageing
Dear Editor,
Co-management hospitalist services for neurosurgery. Where are we?
Dear Editor, the increase in the average age of the population and in the prevalence of chronic comorbidities has made healthcare extremely difficult and sometimes with difficult home management [1,2... more
Clinical significance of the anti-Nucleolar Organizer Region 90 antibodies (NOR90) in systemic sclerosis
We read with great interest the article by Dima et al. on the clinical significance of the anti-Nucleolar Organizer Region antibodies (NOR90) in systemic sclerosis (SSc) [1]. The authors conducted a... more
Factors associated to multiple chronic conditions in internal medicine patients
Dealing with patients with multiple chronic conditions (MCC) is certainly one of the most compelling healthcare challenges [1]. Most of the available data about MCC derive from large administrative... more
The prediction of alterations in plasma sodium levels in acutely ill patients should be more comprehensive. Author's reply
We thank Jaguszewski et al. [1] for their interest in our article [2] and their thoughtful comments.
FIB-4 score association with operative outcomes, truth or fibs?
In recent years, liver disease has become established as a significant predictor of poor perioperative outcomes [1]. Despite declining rates of hepatitis B and hepatitis C-related morbidity and... more
External factors affecting weight loss during intermittent fasting
we read with great interest a recently published study by Mohamad Khalil, Hala Abdallah, et al. regarding distinct biophysiological effects of Ramadan fasting and traditional intermittent fasting on... more
Diagnostic value of pleural calprotectin in differentiating complex parapneumonic effusions
Dear Editor,
Oh no, all we needed was monkeypox!
Four years after the spread of the coronavirus disease 2019 (COVID-19) pandemic, with a worldwide epidemiology largely under control thanks to widespread immunity against severe acute respiratory... more
A bibliometric analysis of awake prone positioning for non-intubated patients
The global coronavirus disease 2019 (COVID-19) pandemic led to severe medical, economic, and social challenges, including a critical shortage of mechanical ventilators and intensive care unit beds [1... more
Enhancing immunization strategies in heart failure: A call to action
Heart failure (HF) is a severe cardiovascular pathology with escalating prevalence and notable morbidity and mortality on a global scale. Addressing this condition presents an imperative, in order to... more
DNA methylation levels of the ACE2 promoter are not associated with symptoms-severity and related-disability in previously hospitalized COVID-19 survivors
The presence of long-lasting symptoms after suffering an acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has recently extensive attention in the last years. One of the first meta-... more
Compassion in medicine: Are we failing our future doctors?
Dear editor,
Empagliflozin controls cirrhotic refractory ascites along with improvement of natriuresis and circulatory, cardiac, and renal function: A pilot study
Ascites is the most common decompensating event in cirrhosis [1]. Its pathophysiology involves splanchnic arterial vasodilation and reduced effective arterial blood volume, which activate potent... more
Combining L-arginine and vitamin C improves physical frailty in hypertensive elders
Hypertension is one of the most common comorbidities which has been suggested to play a pivotal role in the transition to pre-frailty and physical frailty (hereafter called frailty), especially in... more
The prediction of alterations in plasma sodium levels in acutely ill patients should be more comprehensive
We read with great interest the article by Simon et al. entitled "Prediction of plasma sodium changes in the acutely ill patients: the potential role of tissue sodium content"[1]. The study focuses... more
Immune heterogeneity associated with disease severity and activity in eosinophilic granulomatosis with polyangiitis patients
Dear Editor,
Atrial fibrillation-related mortality trends among adults with comorbid chronic obstructive pulmonary disease in the United States from 1999 to 2020
Atrial fibrillation-related mortality in adults with comorbid chronic obstructive pulmonary disease in the United States from 1999 to 2020.
Effect of tirzepatide on leptin and adiponectin levels
In the field of innovative treatments for type 2 diabetes, tirzepatide emerges as a novel dual agonist of the glucose-dependent insulinotropic polypeptide (GIP) receptor and the glucagon-like peptide... more
Clinical trial landscape for immune thrombocytopenia: Progress and the long road ahead
Immune thrombocytopenia (ITP) has seen the development and evaluation of several breakthroughs in recent clinical trials [1-4]. The clinical trial landscape for ITP provides valuable insights into... more
Integrated care and lean management in internal medicine: An ideal mix for a functioning health system?
Many European health systems are still under pressure in the post pandemic period, mainly because of the long-term trend of ageing people requiring more and more health care. Therefore, a rational... more
Precision medicine in COPD: A possible contribution of vitamin D?
we read the interesting review by Gilda Varricchi and Remo Poto on the most innovative and recent therapeutic approaches for COPD [1].
Sudden death in congenitally corrected transposition of the great vessels
Transposition of the great arteries (TGA) comprises dextro-TGA and levo-TGA (L-TGA). In dextro-TGA, the aorta, arising from the right ventricle (RV), is positioned to the right of the pulmonary... more
Impact of an active case-finding strategy in autoimmune gastritis
Dear Editor,
Sodium–Glucose Co-transporter 2 Inhibitors treatment improve pancreatic β-cells function and insulin resistance in patients with Type 2 diabetes
Diabetes is a leading cause of death and disability [1]. Approximately, more than 1.31 billion people will have diabetes by 2050 [1,2]. Insulin resistance in target tissues and insufficient insulin... more
Glucagon-like peptide-1 receptor agonists and sodium-glucose cotransporter-2 inhibitors combination therapy versus monotherapy and major adverse cardiovascular events: Do the benefits add up?
Dear Editor,
Original Article
What is the impact of thiamine deficiency on cognitive function in patients with alcohol use disorder? – A systematic review
Cognitive impairments, frequently observed in Alcohol Use Disorder (AUD) patients, range from severe memory impairment with other cognitive functions relatively preserved seen in Korsakoff's Syndrome... more
Effects of population-based screening for atrial fibrillation on quality of life
Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with an increased risk of stroke, heart failure, and mortality [1]. Many cases of AF remain undetected due to no or... more
The impact of hypoalbuminemia on the long-term prognosis of patients with acute heart failure: The modifying role of carbohydrate antigen 125
The main novelty of the present study is:
Adverse effects of late sleep on physical health in a large cohort of community-dwelling adults
Human health is influenced by a myriad of factors, including genetics, environment, and behavior. One behavior that has received significant recent attention is the impact of sleep on human health.... more
Prevalence and impact of multidrug resistance in a cohort of patients admitted to emergency department for urinary tract-infections: The UTILY study, a prospective multicentre study
Urinary tract infections (UTIs) are among the most frequent bacterial infections both in community and healthcare settings [1]. The Global Burden of Diseases (GBD) has estimated an incidence of 0.4... more
The effect of a new thinking guidance of OPACCUS for shock on the 30-day mortality: A multicenter, prospective, observational, cohort study
Shock is the final common pathway before death and a constant focus of ICU physicians due to its high morbidity and mortality [1] (ranging from 27 % to 60 %) in critically ill patients. Recent... more
Effects of valsartan vs amlodipine and achieved lower blood pressure on the incidence of end-stage kidney disease: The VALUE Trial
There is a strong relationship between high blood pressure (BP) and the risk of developing chronic kidney disease (CKD) [1–8]. In people with CKD, a high BP is associated with a faster decline of... more
Length of hospital stay, delayed pneumonia diagnosis and post-discharge mortality. The Pneumonia in Italian Acute Care for Elderly units (PIACE)-SIGOT study
The ageing of populations in high-income countries has increased the number of vulnerable older persons requesting medical care, including care for acute and complex illnesses that warrant medical... more
Effect of continuous positive airway pressure on non-fatal stroke and paroxysmal atrial fibrillation recurrence in obstructive sleep apnoea elderly patients
Obstructive sleep apnoea (OSA) is a respiratory disorder characterised by repeated events of upper airway collapse leading to airflow limitation [1]. OSA is often under-recognised, and if untreated,... more
Exploring phenotypes to improve long-term mortality risk stratification in obstructive sleep apnea through a machine learning approach: an observational cohort study
Obstructive sleep apnea (OSA) is a highly prevalent [1] and heterogeneous sleep disorder [2], characterized by frequent collapses of the upper airway that induce intermittent hypoxia and sleep... more
Evaluations of metabolic and innate immunity profiles in subjects with familial hypercholesterolemia with or without subclinical atherosclerosis
Atherosclerosis is a chronic and progressive process promoted by several environmental and genetic factors [1,2]; among these, low-density lipoprotein cholesterol (LDL-C) has been recognized to have... more
Long-term follow-up of hereditary hemorrhagic telangiectasia patients without significant pulmonary right-to-left shunt at screening
Hereditary hemorrhagic telangiectasia (HHT) is a vascular genetic rare disease (ORPHA: 774) characterized by systemic telangiectases and larger vascular malformations [1]. HHT can be diagnosed using... more
Different impact of chronic kidney disease in older patients with heart failure according to frailty
Chronic kidney disease (CKD) affects up to 10 % of the general population, being one-third of these individuals over 65 years old [1]. A bidirectional interaction, has been described between CKD and... more
Association between long-term exposure to air pollution and incidence of peripheral artery disease: Evidence from a longitudinal study
Cardiovascular disease (CVD) is one the most frequent cause of death and disability globally, including Europe. CVD causes 3.9 million annual deaths in the European Union and the loss of 26 million... more
Comorbidity patterns and the risk of injurious falls in older people with atrial fibrillation: Findings from a Swedish nation-wide population-based study
Atrial fibrillation (AF) is the most common arrhythmia in the general population, increasing by 30 % over the last 20 years primarily as a result of the better diagnostics and ageing population [1],... more
Clinical characteristics and outcomes of Takotsubo syndrome in patients with chronic obstructive pulmonary disease
Takotsubo syndrome (TTS) is an acute heart failure syndrome characterized by a transient impairment of systolic function [1]. Adverse outcomes have been described both in the acute phase and, despite... more
Modifiable lifestyle factors in the primordial prevention of hypertension in three US cohorts
Hypertension is a leading cause of cardiovascular diseases (CVD). The prevalence has doubled from 1990 to 2019 [1] and now impacts almost half of the US adult population [2], and the condition... more
Adherence to the 2019 ESC/EAS guidelines for dyslipidaemia management in a large rheumatoid arthritis cohort: Data from the CORDIS Study Group of the Italian Society of Rheumatology
The evidence that several variables, including inflammation, autoimmunity and traditional cardiovascular (CV) risk factors, closely interact to enhance atherosclerotic risk burden in rheumatoid... more
Association of non-cardiac comorbidities and sex with long-term Re-hospitalization for heart failure
Heart failure (HF) is a complex clinical syndrome, the course of which is usually complicated by concomitant comorbidities [1–6]. However, in spite of this long-held notion, the impact of non-cardiac... more
Hyperhomocysteinemia is linked to MASLD
Arterial Hypertension
Clinically relevant bleeding according to location of metastases in cancer-associated thrombosis
Venous thromboembolism (VTE), comprising deep vein thrombosis (DVT) and pulmonary embolism (PE), is a frequent complication in patients with cancer [1]. It is estimated that 20–30 % of VTE cases are... more
Systolic blood pressure, a predictor of mortality and life expectancy following heart failure hospitalization, 2010–2023
Each year, over 1 million Americans are admitted to hospitals with heart failure (HF) as the primary discharge diagnosis [1]. Hospitalization for acute decompensated HF (ADHF) represents a critical... more
Association between trajectory of systolic blood pressure and outcomes in heart failure patients with preserved ejection fraction (HFpEF)
Heart failure with preserved ejection fraction (HFpEF) is a heterogeneous disease which accounts for 50 % of all heart failure [1–3]. Currently, treatment for HFpEF not only focuses on improving... more
TLR4 and TNF-α single nucleotide polymorphisms in patients with brucellosis: Association with infection complications
Brucellosis is a zoonotic infectious disease caused by Brucella spp, an intracellular facultative anaerobe Gram negative bacteria transmitted to humans by domestic (cattle, goats, sheep, swine, dogs... more
External validation of a prognostic score to identify low-risk outpatients with acute deep venous thrombosis in the lower limbs
Deep vein thrombosis (DVT) and pulmonary embolism (PE) stand as the primary manifestations of venous thromboembolism (VTE) [1-3]. Nonetheless, the absence of national surveillance systems for VTE... more
Hyperchloremic metabolic acidosis potentially benefiting sodium bicarbonate therapy: A multi-center cohort study
Metabolic acidosis is a type of acid-base imbalance that significantly impacts prognosis. It can be caused by poisoning, infections, surgeries, acute and chronic renal failure, diabetic ketosis, and... more
Prediction of left ventricular thrombus after myocardial infarction: a cardiac magnetic resonance-based prospective registry
Left ventricular thrombus (LVTh) is a rare but serious complication following ST-segment elevation myocardial infarction (STEMI) [1–4]. During the prethrombolytic era, LVTh was detected in up to 60%... more
Prospective study of risk factors for community-acquired acute kidney injury
Acute kidney injury (AKI) is a common condition, both in hospital and outpatient settings, and is associated with increased mortality, prolonged hospital stay, progressive chronic kidney disease (CKD... more
A large language model-based clinical decision support system for syncope recognition in the emergency department: A framework for clinical workflow integration
Syncope is a common presenting symptom in the emergency department (ED), [1,2] the management of which poses inherent challenges, starting from recognition. Crucial information is collected during... more
Carotid plaque offsets sex-related differences in cardiovascular risk of young hypertensive patients
Risk for cardiovascular disease (CVD), in particular risk for coronary artery disease and acute coronary syndrome, is lifelong higher in men than in women [1], although this difference is attenuated... more
Impaired insulin sensitivity measured by estimated glucose disposal rate is associated with decreased myocardial mechano-energetic efficiency in non-diabetic individuals
Atherosclerotic cardiovascular diseases encompassing coronary artery disease, and stroke, remain major causes of death worldwide regardless the substantial advances in the prevention and treatment of... more
The impact of the COVID-19 Pandemic on hypertension phenotypes (ESH ABPM COVID-19 study)
The COVID-19 pandemic had a significant impact on various aspects of public health. The imposed restrictions forced people to spend more time at home, which may have resulted in a decline in physical... more
Predictors of pulmonary embolism in chronic obstructive pulmonary diseases patients admitted for worsening respiratory symptoms: An individual participant data meta-analyses
Chronic obstructive pulmonary disease (COPD) is a widespread condition with significant morbidity and mortality [1,2]. It is one of the leading causes of death and is already expected to experience a... more
Thrombosis in breast cancer patients on cyclin-dependent kinase inhibitors: Survival impact and predictive factors - A study by the cancer and thrombosis group of the spanish society of medical oncology (SEOM)
TESEO registry data indicate that breast cancer ranks third in cases of cancer-associated thrombosis [1]. This cannot be solely attributed to the prevalence of malignant breast pathology, as a study... more
Towards a comprehensive approach to the management and prognosis of systemic sclerosis's patients: The role of comorbidities in the SPRING-SIR registry
In systemic sclerosis (SSc), widespread skin and visceral fibrosis are associated with poor outcome and increased mortality [1]. For this reason, SSc management remains a challenge due to clinical... more
Treatment of systemic lupus erythematosus: Analysis of treatment patterns in adult and paediatric patients across four European countries
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder of connective tissue with a highly variable clinical presentation, disease course and prognosis [1]. SLE is characterised by... more
Prevalence and clinical determinants of rapid eGFR decline among patients with newly diagnosed type 2 diabetes
Diabetic kidney disease (DKD) is the most common cause of end-stage kidney disease (ESKD) in the western world, accounting for more than 40 % of patients that require kidney replacement therapy [1].... more
Prevalence and clinical predictors of vasodepressor syncope during head up tilt test
Head-up tilt test (HUTT) is a useful diagnostic tool for patients with suspected reflex syncope after initial clinical assessment [1]. When using the Italian protocol, HUTT allows to confirm the... more
Prognostic role of gait speed in worsening heart failure
Heart failure (HF) is a progressive disease, affecting more than 60 million people worldwide [1]. Despite advances in treatment options, HF is associated with a high risk of mortality and morbidity.... more
Functional limitation predicts mortality in heart failure with preserved ejection fraction
Globally, more than 64 million people are affected by HF [1]. The estimated prevalence of HF is 1 % to 3 % in Europe and 2.1 % in the USA [2,3]. The estimated incidence is 1 to 4 cases per 1000... more
Distribution and prognostic impact of different heart failure etiologies in patients with heart failure with mildly reduced ejection fraction
As a result of ongoing demographic changes and an ageing population, the overall number of patients with heart failure (HF) has significantly increased. It is estimated that more than 60 million... more
Practice Guidelines
Treatment of hospitalized patient with hyperglycemia: An EFIM critically appraised and adapted guideline
Over the past decade, diabetes mellitus (DM) has emerged as a growing epidemic with an estimated global prevalence of 10.5 % (537 million people) in 2021, according to the International Diabetes... more
Review Article
Chronic obstructive pulmonary disease: A narrative synthesis of its hallmarks for palliative care clinicians
Chronic obstructive pulmonary disease (COPD) accounts for approximately 55 % of cases of respiratory diseases and is now the third cause of both death and morbidity worldwide [1]. Its prevalence is... more
Practical management of severe acute pancreatitis
Diagnosis of acute pancreatitis (AP) is based on the Revised Atlanta Classification[1] (Table 1) requiring at least two of three criteria: i) typical epigastric pain radiating to the back, ii) serum... more
Transforming organ donation and transplantation: Strategies for increasing donor participation and system efficiency
Organ transplantation stands as one of the most significant advancements in modern medicine, providing life-saving solutions for patients with end-stage organ failure [1]. From the first successful... more
Translating evidence into practice: Managing electrolyte imbalances and iron deficiency in heart failure
Heart failure (HF) is defined as a clinical syndrome with symptoms and/or signs caused by a structural and/or functional cardiac abnormality, corroborated by elevated natriuretic peptides and/or... more
New strategies for the treatment of hyperkalemia
Potassium (K+) is the most abundant cation in the body (50–75 mEq/L/kg body weight). Under physiological conditions, approximately 98 % of total body K+ is located in the intracellular space and only... more
Triglyceride glucose (TyG) index: A promising biomarker for diagnosis and treatment of different diseases
Insulin resistance (IR) is a metabolic condition in which insulin levels are elevated due to insensitivity to insulin and associated with elevated triglyceride levels. Hypertriglyceridemia leads to... more
Chronic obstructive pulmonary disease's eosinophilic phenotype: Clinical characteristics, biomarkers and biotherapy
COPD is a complex, heterogeneous, and chronic inflammatory disorder of the airways characterized by persistent and poorly reversible airflow limitation, along with significant respiratory symptoms... more
Gliflozines use in heart failure patients. Focus on renal actions and overview of clinical experience
In the past decades impressive progress in heart failure (HF) treatment has been achieved by adoption of therapeutic tools ranging from renin angiotensin system antagonists to beta blocking agents,... more
Diet and physical exercise in elderly people with obesity: The state of the art
“Obesity and ageing: two side of the same coin” in 2020 Tam et al. have summarised the complex pathophysiological interaction and mutual relationship between obesity and ageing in a comprehensive... more
Metabolic Bariatric surgery in People with Obesity aged ≥65 Years
The World Health Organization (WHO) estimated that 1.4 billion people in the world will be aged 60 years and older in 2030 and 2.1 billion by 2050, comprising 12–22 % of the global population [1].... more