January 2025

35 Articles

Beyond the Guidelines

Elevated blood pressure and hypertension in older persons: A comment on the recent ESC guidelines

23 October 2024
Author(s): Giulia Rivasi, Enrico Brunetti, Roberto Presta, Niccolò Marchionni, Giovambattista Desideri, Mario Bo, Italian Society of Geriatric Cardiology (SICGe)

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

The assessment, interpretation and implementation of lung ultrasound examinations in Heart Failure: Current evidence and gaps in knowledge

17 October 2024
Author(s): Alberto Palazzuoli, Matteo Beltrami, Nicolas Girerd, Anna Maw, Gaetano Ruocco, Elke Platz

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

14 October 2024
Author(s): Raffaele Antonelli-Incalzi, Camillo Marra

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

“Obesity management in the older age, new understanding for old challenges”

7 November 2024
Author(s): Dror Dicker, Nursel Çalık Başaran, Volkan Demirhan Yumuk

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

Linking functional capacity and heart failure outcomes: Easy assessment, major implications

9 October 2024
Author(s): Maria Perotto, Enrico Fabris, Gianfranco Sinagra

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

7 October 2024
Author(s): Cy R. Wilkins, Jeffrey I. Zwicker

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

1 October 2024
Author(s): Giuseppe Barilaro, Ricard Cervera

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

Two recent European guidelines on hypertension

27 October 2024
Author(s): Paolo Verdecchia, Fabio Angeli, Giacomo Pucci, Giovanni de Simone, Gianpaolo Reboldi

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 tiny green lesion mimicking a big problem

15 October 2024
Author(s): Luis Gorospe, Rosa Mariela Mirambeaux-Villalona, Paola Arrieta

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

14 October 2024
Author(s): María Ezquerra-Marigómez, Mercedes Misiego, Javier Riancho

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

1 November 2024
Author(s): Meltem Koca, Laurence J Dobbie, Andreea Ciudin, Meltem Halil

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

Pharmacotherapy for older people with obesity

18 June 2024
Author(s): Luke D. Boyle, Feray Akbas, Dilek Yazıcı, Barbara M. McGowan, Volkan Yumuk

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

Compassion in medicine: Are we failing our future doctors?

21 August 2024
Author(s): Daniela Martins-Mendes

Dear editor,

Empagliflozin controls cirrhotic refractory ascites along with improvement of natriuresis and circulatory, cardiac, and renal function: A pilot study

20 August 2024
Author(s): Georgios Kalambokis, Ilias Tsiakas, Sebastien Filippas-Ntekouan, Maria Christaki, Haralampos Milionis

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

20 August 2024
Author(s): Pasquale Mone, Valentina Trimarco, Maria Morgante, Bruno Trimarco, Gaetano Santulli

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

Atrial fibrillation-related mortality trends among adults with comorbid chronic obstructive pulmonary disease in the United States from 1999 to 2020

6 August 2024
Author(s): Usama Qamar, Waleed Qamar, Siddharth Agarwal

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

31 July 2024
Author(s): Luis E. Simental-Mendía, Mario Simental-Mendía, Laura Jazel Barragán-Zúñiga, Litzy Navarro-Tinoco

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

31 July 2024
Author(s): Hui Li, Qin Guo, Shufen Zhou, Chengshan Guo

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?

24 July 2024
Author(s): Livio Garattini, Marco Badinella Martini, Antonino Mazzone

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

Sudden death in congenitally corrected transposition of the great vessels

19 July 2024
Author(s): Antonis A. Manolis, Theodora A. Manolis, Antonis S. Manolis

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

16 July 2024
Author(s): Marco Vincenzo Lenti, Emanuela Miceli, Shamim Joudaki, Antonella Gentile, Antonio Di Sabatino, Autoimmune Gastritis Team

Dear Editor,

Sodium–Glucose Co-transporter 2 Inhibitors treatment improve pancreatic β-cells function and insulin resistance in patients with Type 2 diabetes

12 July 2024
Author(s): Fang-Hong Shi, Li Xu, Long Shen, Min-Jia Cao, Hao Li

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?

8 July 2024
Author(s): Paschalis Karakasis, Dimitrios Patoulias, Nikolaos Fragakis, María Rosa Bernal-López, Ricardo Gómez-Huelgas

Dear Editor,

Original Article

Carotid plaque offsets sex-related differences in cardiovascular risk of young hypertensive patients

17 September 2024
Author(s): Costantino Mancusi, Christian Basile, Eva Gerdts, Ilaria Fucile, Maria Virginia Manzi, Maria Lembo, Daniela Pacella, Giuseppe Giugliano, Grazia Canciello, Raffaele Piccolo, Alessandra Spinelli, Carmine Morisco, Nicola De Luca, Bruno Trimarco, Giovanni de Simone, Eduardo Bossone, Raffaele Izzo, Maria Angela Losi, Giovanni Esposito

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

16 September 2024
Author(s): Chiara M.A. Cefalo, Alessia Riccio, Teresa Vanessa Fiorentino, Elena Succurro, Maria Perticone, Angela Sciacqua, Francesco Andreozzi, Giorgio Sesti

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

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)

20 August 2024
Author(s): Manuel Sánchez Cánovas, Javier López Robles, Evdochia Adoamnei, Diego Cacho Lavin, Carmen Diaz Pedroche, Eva Coma Salvans, Teresa Quintanar Verduguez, Francisco José García Verdejo, Mónica Cejuela Solís, Silvia García Adrián, Berta Obispo Portero, Alberto Garrido Fernández, Carmen Salvador Coloma, María Purificación Martínez del Prado, Jaime Mendiola, Andres J. Muñoz Martín

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

14 August 2024
Author(s): Martina Orlandi, Silvia Bellando-Randone, Rossella De Angelis, Clodoveo Ferri, Dilia Giuggioli, Fabio Cacciapaglia, Luca Magnani, Giovanna Cuomo, Antonietta Gigante, Veronica Codullo, Corrado Campochiaro, Alarico Ariani, Rosario Foti, Serena Guiducci, Marco Matucci-Cerinic, Cosimo Bruni, SPRING-SIR (Systemic Sclerosis PRogression INvestiGation group of the Italian Society of Rheumatology) coworkers

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

11 August 2024
Author(s): Mike Du, Francesco Dernie, Martí Català, Antonella Delmestri, Wai Yi Man, James T. Brash, Hanne van Ballegooijen, Núria Mercadé-Besora, Talita Duarte-Salles, Miguel-Angel Mayer, Angela Leis, Juan Manuel Ramírez-Anguita, Romain Griffier, Guillaume Verdy, Albert Prats-Uribe, Alexandra Pacurariu, Daniel R. Morales, Roberto De Lisa, Sara Galluzzo, Gunter F. Egger, Daniel Prieto-Alhambra, Eng Hooi Tan

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

10 August 2024
Author(s): Giuseppina Tiziana Russo, Annalisa Giandalia, Giuseppe Lucisano, Maria Chiara Rossi, Pamela Piscitelli, Roberto Pontremoli, Francesca Viazzi, Alberto Rocca, Valeria Manicardi, Graziano Di Cianni, Riccardo Candido, Antonio Nicolucci, Salvatore De Cosmo, AMD Annals Study Group

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

7 August 2024
Author(s): Vincenzo Russo, Moiz Tariq, Erika Parente, Angelo Comune, Anna Rago, Andrea Antonio Papa, Gerardo Nigro, Michele Brignole

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

7 August 2024
Author(s): Camilla Cirelli, Raul Limonta, Greta Carioli, Emilia D'Elia, Pietro Ameri, Riccardo Maria Inciardi, Arianna Ghirardi, Luca Fazzini, Ferdinando Perra, Ginevra Rizzola, Erika Chiesa, Laura Tomasoni, Roberta Montisci, Antonello Gavazzi, Michele Senni, Mauro Gori

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

31 July 2024
Author(s): Domenico Scrutinio, Pietro Guida, Andrea Passantino

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

18 July 2024
Author(s): Tobias Schupp, Alexander Schmitt, Felix Lau, Marielen Reinhardt, Noah Abel, Mohammad Abumayyaleh, Mohamed Ayoub, Kambis Mashayekhi, Muharrem Akin, Jonas Rusnak, Kathrin Weidner, Ibrahim Akin, Michael Behnes

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

Review Article

Diet and physical exercise in elderly people with obesity: The state of the art

18 August 2024
Author(s): Francesca Battista, Silvia Bettini, Ludovica Verde, Luca Busetto, Luigi Barrea, Giovanna Muscogiuri

“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

30 March 2024
Author(s): Nursel Çalık Başaran, Dana Marcoviciu, Dror Dicker

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

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