November 2025
No Section
Optimising the Caravaggio score: developing a more universally applicable and comprehensive venous thromboembolism risk stratification tool. Author’s reply
Dear Editor, we thank Wang et al. for their suggestions on potential matters to optimize the Caravaggio score [1]. The recently published Caravaggio score was aimed to stratify the risk of recurrence... more
Serum transthyretin in ATTR-CM: A pragmatic biomarker edging toward prime time
Over the last decade, transthyretin amyloid cardiomyopathy (ATTR-CM) has shifted toward earlier recognition and routine use of disease-modifying therapy, heightening the need for biomarkers that are... more
Differences in indications, contraindications, and prescribing patterns for heart failure between specialties: the VancOuver CoastAL Acute Heart Failure (VOCAL-AHF) registry
Heart failure (HF) is a major public health challenge affecting over 64 million adults worldwide and a leading cause of hospitalization [1]. Despite therapeutic advances, the prognosis remains poor,... more
Renal outcomes following anticoagulation in atrial fibrillation: urgent need for randomized evidence
We read with interest the well-written meta-analysis by Adamou et al. [1], focused on studies of atrial fibrillation (AF) patients, investigating the comparative effect of direct oral anticoagulants... more
Optimising the Caravaggio score: developing a more universally applicable and comprehensive venous thromboembolism risk stratification tool
Dear Editor,
Beyond the Guidelines
Managing invasive fungal infections in critical illness: reflections on recent American Thoracic Society recommendations
The global burden of invasive fungal diseases (IFDs) continues to increase, particularly among critically ill patients, where mortality remains high —reaching up to 70 %— despite major advances in... more
Repositioning beta-blocker therapy after acute myocardial infarction
Beta-blockers have long been prescribed for secondary prevention in patients with acute myocardial infarction (MI) after clinical trials performed in the 1980′s demonstrated that their use provided... more
Clinical Insights
New perspectives on heart-brain interactions: Is it time to classify cardio-neurological syndromes?
The interplay between heart and brain is bi-directional, complex and profound. Each system influences the other in health as well as in disease, when dysfunction in one organ has broad and as yet... more
Commentary
Air pollution: A new avenue for a population-level approach to tackle metabolic dysfunction-associated steatotic liver disease (MASLD)?
In this issue of the European Journal of Internal Medicine, Di Ciaula et al [1] provide new insights into metabolic dysfunction-associated steatotic liver disease (MASLD) by looking into the... more
Perspective on Epicardial Adipose tissue
In this issue of the European Journal of Internal Medicine, Calcaterra et al. wrote one of the most comprehensive reviews of Epicardial Adipose Tissue (EAT) [1]. In contrast to past dithyrambic EAT... more
From words to biomarkers: Why PEth should enter clinical practice when assessing the risk of venous thromboembolism
Alcohol consumption remains one of the most pervasive and modifiable risk factors influencing global health. Its dualistic nature—protective in moderation, harmful in excess—has long fascinated... more
Prevention of venous thromboembolism in critically ill patients: current state and future perspectives
Venous thromboembolic disease (VTE) is a major complication of intensive care, responsible for significant morbidity and mortality. It remains a constant challenge for clinicians because of the... more
Venous thromboembolism provoked by transient risk factors in women: Towards improved personalized risk assessment
The occurrence of venous thromboembolism (VTE) in young women is a scenario frequently encountered in clinical practice. In this population, a VTE event is often associated with provoking risk... more
Treatment target of blood pressure: Changes in evidence-based guidelines and impact of measurement conditions
Although exceptions exist, the general prognostic benefit of antihypertensive drug treatment is definite. With the accumulation of relevant evidence, the target blood pressure level of... more
Post-extubation high-flow nasal cannula (HFNC) therapy with a ROX index-based strategy: A real step forward in weaning?
Extubation, along with the entire process of weaning from invasive mechanical ventilation (IMV), represents a key phase in the management of the critically ill patient, as it significantly impacts... more
Navigating the pitfalls of pulmonary function testing in chronic lung allograft dysfunction and chronic pulmonary graft-versus-host disease
Chronic lung allograft dysfunction (CLAD) and pulmonary chronic graft-versus-host disease (Pc-GVHD) represent the major late non-infectious pulmonary complications following lung and allogeneic... more
Molecular echoes of CPAP: Tracking hypoxia-sensitive non-coding RNAs in obstructive sleep apnea
Obstructive sleep apnea (OSA) is a common and increasingly recognized disorder with complex systemic implications [1]. Beyond intermittent hypoxia and sleep fragmentation, OSA has been linked to... more
Standard acute myocardial infarction without standard modifiable risk factors
The identification of risk factors for cardiovascular diseases (CVD) using longitudinal cohort studies has been a major advance in medicine during the second half of the past century and, stimulating... more
Editorial
Point-of-care ultrasonography (POCUS): a substantial help for the internists with some caveats
Prior to the introduction of the point-of-care-ultrasonography (POCUS) in clinical practice, internists relied on the stethoscope and physical examination to guide patient management. Largely used by... more
Internal Medicine Flashcard
Recurrent vomiting
A 28-year-old male was referred to the Gastroenterology Department for a 6-year history of recurrent vomiting, occurring 2–3 times daily and exacerbating to >10 episodes per day following cold... more
Woman with progressed gait instability
An 81-year-old woman presented with progressed gait instability for several months. She had a temperature of about 37.5 °C. The initial neurological examination revealed unsteadiness on the finger-... more
Xanthelasma, arcus senilis, and supravalvular aortic stenosis
A 28-year-old female presented with 12 months of progressive dyspnea and 6 months of exertional angina, now limiting daily activities. On examination (Fig. 1; Panel A), she had xanthelasma, arcus... more
Bilateral ocular motility impairment
An 82-year-old man was referred to the Diagnostic Imaging Center with progressive bilateral ocular motility impairment and diplopia, which had gradually worsened over the past three months, with... more
Ataxia, dysarthria and brainstem lesions in an elderly patient: a diagnostic challenge
A 75-year-old Hispanic man presented with a 3-year history of frequent falls conditioned by gait instability and generalized weakness. His symptoms progressed with worsening of gait imbalance,... more
A man with fever, retinal artery occlusion, atrioventricular block and bilateral renal masses
A 61-year-old man with a history of recurrent otitis and recent evaluation for submandibular salivary gland enlargement presented with sudden vision loss in the left eye. He also reported fever and... more
Progressive nodules in bilateral lower extremities
A 58-year-old female patient presented with asymptomatic nodules that had been on her lower legs for 10 years. The nodules appeared spontaneously without any discernible cause and progressively... more
Recurrent bilateral infrapatellar subcutaneous nodules: what is the diagnosis?
A 32-year-old Hispanic man presented with a one-month history of bilateral infrapatellar tender erythematous subcutaneous nodules (Fig. 1, a and b), accompanied by dysesthesias in the same area and... more
Invited Review Article
Contemporary management of advanced chronic kidney disease: An evidence-based review
Chronic kidney disease (CKD) is a growing global health burden, affecting over 850 million people worldwide and contributing substantially to cardiovascular morbidity, premature mortality, and... more
Letter to the Editor
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
Managing psoriasis in patients with lupus: A complex challenge
Psoriasis is a common, chronic, and relapsing scaly erythematous skin disease, occurring worldwide at any age, with no clear gender predilection. It shows a bimodal age distribution, with incidence... more
Activation state of peripheral T lymphocytes predicts response to abatacept in patients with IgG4-related disease
Dear Editor,
Cognitive impairment and vascular injury in familial hypercholesterolemia: Looking beyond the association
We read with great interest the article by Sabrina Scilletta et al. published in the European Journal of Internal Medicine, which explored the relationship between cognitive function and subclinical... more
Methodological considerations for interpreting the association between central systolic blood pressure and brain health
We read with great interest the recent article by Yu et al. (2025) [1] in the European Journal of Internal Medicine, which investigated the association between central systolic blood pressure (cSBP... more
Utility of following morning body weight in patients with hyponatremia due to chronic SIAD
In patients with chronic hyponatremia, SNa must be maintained above 134 mEq/l to minimize associated morbidity [1].
Traceability of point-of-care ultrasound: The PACS integration process in a tertiary hospital
Point-of-Care Ultrasound (POCUS) has become established as an essential diagnostic and therapeutic tool in Internal Medicine, Emergency Medicine, Geriatrics, and other care settings. It allows... more
Tezepelumab in severe asthma: Strengthening real-world evidence and addressing unresolved clinical questions
We were pleased to read the recent article by Poto et al. entitled “Effectiveness of tezepelumab in severe asthma: A multicenter real-world study,” published in the European Journal of Internal... more
Meta-analysis of the relationship between internal microplastic and health outcomes
Dear editor,
Authors of individual participant data meta-analyses must honor trialists’ commitments to trial participants: a case study
The need to respect the trial participants’ willingness regarding the secondary use of their data to conduct research such as meta-analyses has been recently discussed [1]. The best approach is to... more
Cognitive impairment in familiar hypercholesterolemia: how much is vascular and how much is confounding?
Dear editor,
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
Severe acute refractory hyperkalaemia associated with liposomal amphotericin B infusion
Dear editor,
Bolus or continuous for AHF? Lessons from DIUR-AHF. Author's reply
On behalf of the DIUR-AHF investigators, we thank Zhai and Sun for the attention on our research [1] and for the interesting comments provided in their letter to the editor, published in the present... more
Pharma’s subtle conditioning in clinical medicine
The relationship between physicians and the pharmaceutical industry continues to provoke debate, often framed around conflicts of interest and the potential for undue influence on prescribing... more
Not all immunosuppression is equal: Implications for post-discharge outcomes in community-acquired pneumonia − Authors’ reply
Dear Editor,
Annual chest computed tomography in multimorbid COPD: is universal screening clinically feasible?
Dear Editor,
Association between sPESI score and 90-day hospital readmissions in patients with acute pulmonary embolism
Pulmonary embolism (PE) is a leading cause of cardiovascular morbidity and mortality, with 10–30 % of patients dying within one month of diagnosis [1]. Early risk stratification can aid clinicians in... more
Association of prevalence of hypertension and its subtypes with short-term weight change
Obesity is a well-established risk factor for hypertension, and produces various hemodynamic abnormalities that may impact hypertension subtypes [1]. From 2011 to 2020, obesity prevalence in the US... more
Sodium-glucose cotransporter 2 inhibitors may increase iron availability with beneficial effects on erythropoiesis and cardiovascular mortality in patients with type 2 diabetes mellitus. Author’s Reply
We appreciate the authors’ thoughtful letter and their emphasis on the growing body of evidence linking sodium-glucose cotransporter 2 inhibitors (SGLT2is) treatment to enhanced erythropoiesis and... more
Annual chest computed tomography in multimorbid COPD: Is universal screening clinically feasible? Author's reply
Dear Editor,
Age, sex and DNAR: Re-evaluating the excess-mortality paradox in nonagenarian ICU patients
We read with interest Weller and colleagues’ elegant demonstration that chronological age alone is not associated with excess mortality among nonagenarian ICU patients [1]. Their use of relative-... more
Beyond eligibility – the relevance of individualized heart failure therapy across specialties
We read with interest the article by Gencher et al., investigating specialty-related differences in the implementation of guideline-directed medical therapy (GDMT) for patients hospitalized with... more
Not all immunosuppression is equal: Implications for post-discharge outcomes in community-acquired pneumonia
We appreciate the authors’ important contribution on post-discharge outcomes in community-acquired pneumonia (CAP)[1]. One key concern lies in the treatment of “immunosuppression” as a unitary... more
Sodium-glucose cotransporter 2 inhibitors may increase iron availability with beneficial effects on erythropoiesis and cardiovascular mortality in patients with type 2 diabetes mellitus
In their recent review, Cannarella et al. describe a number of advantages of sodium-glucose cotransporter 2 inhibitors (SGLT2is) beyond simple glycemic control, including important cardio-renal... more
Aetiology of inflammatory abdominal aortic aneurysms influences prognosis
Abdominal aortic aneurysms (AAA) affect approximately 5 % of male over the age of 65 [1]. Among these, 5 % to 10 % are classified as inflammatory AAA (IAAA) [2]. A wide range of underlying... more
Bolus or continuous for AHF? lessons from DIUR-AHF
With keen interest, we have read the DIUR-AHF study published by Palazzuoli et al. [1], which provides important real-world evidence on loop diuretic strategies in acute heart failure (AHF). The... more
Association of social isolation with excess mortality risk and life expectancy in people with prediabetes and diabetes
Diabetes affects 589 million adults globally and significantly increases mortality risk by 1.6- to 2-fold, with an additional 1.1 billion people estimated to have early-stage glucose metabolism... more
Potassium instability and prognosis in acute heart failure: Practice-oriented reflections
We read with interest the article, “Association between serum potassium variability during admission for decompensated heart failure and outcomes,” published in the European Journal of Internal... more
Critical considerations on sTREM2 as a biomarker for early MASH in women with severe obesity
We commend Mahmoudian et al. for their insightful study investigating soluble TREM2 (sTREM2) as a noninvasive biomarker for early metabolic dysfunction-associated steatohepatitis (MASH) in women with... more
Phosphatidylethanol and venous thromboembolism risk – clinical implications and future directions
I read with great interest the prospective study by Johansson et al. [1] published in the European Journal of Internal Medicine, which investigates the association between phosphatidylethanol (PEth)... more
Optimizing potassium control in hospitalized heart failure patients: Unanswered questions and future perspectives
We read with great interest the recent article by Suzuki et al., recently published in the European Journal of Internal Medicine [1]. The authors address an important and often overlooked aspect of... more
PFKP, EP300, and VCAN as causal drivers of migraine: Integrating genetics and epigenetics through mendelian randomization
Dear Editor,
Not just the level – the importance of potassium stability in patients with heart failure
We read with great interest the manuscript by Suzuki et al. investigating the prognostic impact of changes of serum potassium levels during index hospitalization in a large cohort of 1280 patients... more
Cardiac outcomes in hypertrophic cardiomyopathy treated with beta-blockers or verapamil
In hypertrophic cardiomyopathy (HCM), beta-blockers (BBs) and non-dihydropyridine calcium channel blockers (particularly verapamil) are both used to manage symptoms such as dyspnea, chest pain, and... more
Effect of resmetirom on lipid profile and adiponectin levels
Resmetirom, a novel liver-targeted selective thyroid hormone receptor-beta (THR-β) agonist, has shown positive effects for the treatment of dyslipidemia and other metabolic disorders, including non-... more
Doctor on board: Ethical, legal, and practical reflections on responding to in-flight medical emergencies
To the Editor,
DOACs vs. VKAs for renal protection: An established superiority gives rise to a new clinical paradox
I commend Adamou and colleagues for their important meta-analysis, which reinforces the established superiority of direct oral anticoagulants (DOACs) over vitamin K antagonists (VKAs) for preserving... more
Mapping the clinical trial landscape of gut microbiota modulation in neurodegenerative diseases
Neurodegenerative diseases, such as Alzheimer's disease (AD), Parkinson's disease (PD), and multiple sclerosis (MS), are increasingly recognized as major contributors to the global burden of disease... more
Association of serum potassium time in target range with all-cause and cardiovascular mortality in HFrEF patients
Dyskalemia is relatively common in heart failure with reduced ejection fraction (HFrEF). Both hypokalemia and hyperkalemia exhibit U-shaped associations with adverse outcomes in HFrEF, including... more
Extended anticoagulation therapy on clinical outcomes in patients with gastrointestinal cancer and isolated distal deep vein thrombosis: Insights from the ONCO DVT Study
The current guidelines have recommended prolonged anticoagulation therapy with direct oral anticoagulants (DOACs) as a potential treatment option for patients with cancer-associated venous... more
Cancer treatment-associated hypomagnesemia: Analysis from a large pharmacovigilance database
Hypomagnesemia is common among patients with cancer, and can lead to increased morbidity and mortality as well as discontinuation of potentially life-saving treatments. Hypomagnesemia may occur due... more
Substantial variety in point of care ultrasound training across EFIM
Dear Editor,
Original Article
Gaps in Glycaemic Monitoring and Underuse of Cardioprotective Glucose-lowering Agents: Challenges of inpatient diabetes care identified by EFIM’s Diabesity Day Survey 2024
People with diabetes and people with obesity have an increased risk of hospitalisation, tend to have longer hospital stays, and have higher mortality when hospitalised (1–3). Diabetes management... more
Both underweight and obese patients are prone to relapse after ablation of paroxysmal atrial fibrillation
Being overweight has been associated with arrhythmia recurrence after atrial fibrillation (AF) ablation, but the optimal threshold to identify high risk patients has not been well established.... more
Association between long-term exposure to PM10 and metabolic dysfunction-associated steatotic liver disease (MASLD) in subjects with disturbed metabolic homeostasis and genotypes at risk
Poor information exists on the role of air pollutants as possible predictors of liver fat over-storage in subjects with increased clinical and genetic risk for MASLD.
Evaluation of the concordance between clinical diagnosis and biopsy in cutaneous vasculitis
Cutaneous vasculitis poses a diagnostic challenge due to its variable presentations and overlap with other dermatologic conditions. Although biopsy is essential for confirmation, the concordance... more
Left ventricular remodeling in IgA nephropathy: Prognostic implications and clinical correlations
The determinants and prognosis of left ventricular (LV) geometric remodeling remain uncharacterized in immunoglobulin A nephropathy (IgAN). We investigated the (1) clinicopathological correlates of... more
Monitoring time-to-detection of recurrent atrial fibrillation in patients with transient new-onset atrial fibrillation detected initially during hospitalization for noncardiac surgery or medical illness
Approximately one-third-of patients with transient new-onset atrial fibrillation (AF) during hospitalization for noncardiac surgery or medical illness will have recurrent AF within 1 year when... more
Endothelin-1 as dual marker for renal function decline and associated cardiovascular complications in patients with chronic kidney disease
Cardiovascular (CV) complications are the leading cause of death in patients with chronic kidney disease (CKD). Endothelin-1 (ET-1), a potent vasoconstrictor involved in both renal and vascular... more
Prognostic role of TAPSE/PASP ratio among older patients with acute heart failure and preserved ejection fraction
Right ventricular (RV)-pulmonary circulation (PC) uncoupling is associated with poor outcome in patients with Heart Failure with Preserved Ejection Fraction (HFpEF). Tricuspid annular plane systolic... more
Cardiovascular-kidney-metabolic domains and impact on antithrombotic treatment, integrated care and clinical outcomes in patients with atrial fibrillation: results from a prospective European registry
Cardiovascular, kidney, and metabolic (CKM) conditions frequently coexist with atrial fibrillation (AF), but their impact in AF population remains poorly characterized.
Effectiveness of tezepelumab in severe asthma: A multicenter real-world study
Severe asthma is a complex, heterogeneous disease that remains a major therapeutic challenge. Despite several biologics targeting type 2 (T2) inflammation, some patients remain uncontrolled,... more
Non-cardiac surgeries in adults with congenital heart disease -influence of complexity of disease and estimated risk of surgery on adverse events
To provide information on adults with congenital heart disease (ACHD) undergoing non-cardiac surgeries (NCS), specific risk compared non-ACHD, independent risk factors for adverse outcome and... more
Short and long term effects of a two-week transcutaneous vagus nerve stimulation in hyperadrenergic postural orthostatic tachycardia syndrome: a proof-of-concept trial
autonomic nervous system
Prognostic impact of left ventricular dilatation in heart failure with mildly reduced ejection fraction
This study investigated the prognostic value of left ventricular (LV) dilatation in patients with heart failure with mildly reduced ejection fraction (HFmrEF).
Evaluation of cognitive profile and subclinical vascular damage in subjects with genetically confirmed familial hypercholesterolemia
Familial hypercholesterolemia (FH) is a genetic lipid disorder characterized by lifelong exposure to high levels of LDL cholesterol (LDL-C), which promotes the progression of atherosclerosis and... more
The Implementation of the Acute Basic Palliation Concept in Newly introduced Hospital Departments: An Explorative Observational Study of Non-Specialized Palliative Patients Discharged to Die at Home in Denmark
Palliative Care (PC) is a key component of patient-centred healthcare, focusing on relieving the symptoms, pain, dignity and stress of patients with serious, life-limiting conditions. A widely... more
Sex differences in venous thromboembolism outcomes: findings from the GARFIELD-VTE registry
Venous thromboembolism (VTE), including pulmonary embolism (PE) and deep vein thrombosis (DVT), is a major cause of morbidity and mortality [1] VTE is linked to several risk factors, including age,... more
Impact of a Checklist-Based Strategy for Cardiac Amyloidosis Screening on Diagnosis Rates in Heart Failure Patients (CHECKAMIC Study)
Amyloidosis is a storage disease caused by the extracellular deposition of fibers derived from structural alterations of unstable proteins, which after folding and aggregation are finally deposited... more
An exploratory model for short-term risk stratification in intermediate-high-risk pulmonary embolism running head: The STAMP score
Patients with acute pulmonary embolism (PE) characterized by hemodynamic stability, evidence of right ventricular (RV) dysfunction (RVD), positive cardiac biomarkers and high simplified pulmonary... more
Effectiveness and safety of rituximab across the four phenotypes of IgG4-related disease: a European multi-center cohort study
IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory condition with marked clinical heterogeneity [1]. Common manifestations include autoimmune pancreatitis and cholangitis, orbital... more
Long term fluid volume fluctuations and mortality in kidney failure patients on long term hemodialysis treatment
The prognosis of patients kidney failure (KF) patients on long term hemodialysis treatment is one of the most severe among chronic diseases, and only modest progress has been made over the last... more
Bleeding risk on rivaroxaban versus apixaban in older patients with venous thromboembolism: a nationwide observational register-based study
During primary treatment, apixaban was associated with a lower risk of major bleeding than rivaroxaban without a corresponding increase in recurrent PE risk. During secondary treatment, no difference... more
Venous thromboembolism associated with infections: a systematic review and meta-analysis
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), has long been a significant cause of severe disease and death. At the same time, its etiology is... more
A prospective study of the association between phosphatidylethanol concentration and risk of first-ever venous thromboembolism
Venous thromboembolism (VTE) is a common term for deep vein thrombosis (DVT) and pulmonary embolism. The overall incidence rate of VTE in adults is 1–2 per 1000 person-years and has increased... more
Transthyretin serum levels and clinical outcomes in patients with transthyretin amyloid cardiomyopathy
Over the last decade, significant advances have been made regarding the knowledge of the biological bases, diagnosis and treatment of transthyretin amyloid cardiomyopathy (ATTR-CM), which currently... more
Cluster analysis for clinical, radiological, and histopathological profiling in chronic pulmonary graft-versus-host disease
Chronic pulmonary graft-versus-host disease (Pc-GVHD) is a non-infectious complication of allogeneic hematopoietic stem cell transplantation (HSCT), typically presenting >100 days post-... more
sTREM2 evaluation in women with metabolic dysfunction-associated steatotic liver disease: Advancing diagnostic approaches for early MASH
Metabolic dysfunction-associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD) [1], is an emerging public health concern affecting approximately 32.4... more
Whether an optimal strategy exists for VTE prevention in critically ill patients: Insights from guidelines and randomized controlled trials
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a significant concern in critically ill patients. Effective prevention is vital due to its high... more
Performance of enhanced liver fibrosis test and indirect serum fibrosis markers for exclusion of advanced liver fibrosis in alpha-1 antitrypsin deficiency
Alpha-1 antitrypsin deficiency (AATD) is a hereditary condition caused by mutations in the SERPINA1 gene, encoding alpha-1 antitrypsin (AAT), an important antiprotease in the lungs that is primarily... more
Baseline risk and outcome benefit from intensive blood pressure targeting. A systematic review
The definition of blood pressure (BP) targets in treated hypertensive patients remains controversial. Some Guidelines recommend an ideal systolic BP target of <140 mmHg, with different targets... more
Association between serum potassium variability during hospitalization and clinical outcomes in patients with heart failure
Serum potassium levels are tightly regulated within a narrow physiological range, typically 3.5–5.0 mEq/L [1]. Potassium homeostasis involves maintaining a concentration gradient between... more
Clinical characteristics and outcomes of patients with acute myocardial Infarction without standard modifiable risk factors (SMuRFs)
The etiology as well as the prevalence of acute myocardial infarction (AMI) in patients without history of standard modifiable risk factors (SMuRFs) remains unclear, especially in European... more
Venous thromboembolism associated with weak transient risk factors in young women: risk of late recurrence. An international cohort study
After a first episode of venous thromboembolism (VTE) treated according to the guidelines, the risk of thrombotic recurrence must be assessed in order to guide medical treatment. The clinical risk... more
Deterioration of renal function is delayed in patients with atrial fibrillation treated with direct oral anticoagulants compared to vitamin K antagonists: systematic review and meta-analysis
The use of anticoagulants has been linked to anticoagulant-related nephropathy (ARN), a condition initially reported in patients treated with warfarin [1]. However, cases have also been documented in... more
Point of care ultrasound (POCUS) applications in the ambulatory internal medicine setting: A scoping review
Point of care ultrasound (POCUS) is an increasingly recognized tool in internal medicine, with evidence supporting its use largely derived in the inpatient setting. We endeavored to provide an... more
Modulation of hypoxia-sensitive non-coding RNAs following continuous positive airway pressure therapy in obstructive sleep apnea in peripheral blood
Obstructive sleep apnea (OSA) is a chronic clinical condition characterized by recurrent apnea or hypopnea during sleep, leading to intermittent hypoxemia, arousal, and sleep fragmentation. OSA... more
Incidence and prevalence of systemic lupus erythematosus across Italian referral centers and its clinical burden in terms of disease severity, treatment and hospitalization: The ESCULAPIO study
Systemic Lupus Erythematosus (SLE) is a multifaceted systemic autoimmune disorder distinguished by a diverse array of clinical manifestations that can potentially impact any organ or system in the... more
Survival effect of early high-flow nasal oxygen after the extubation of patients in the intensive care unit
Spontaneous awakening trial (SAT) and spontaneous breathing trial (SBT) protocols for mechanically ventilated patients in the intensive care unit (ICU) have been shown to reduce the duration of... more
Review Article
Multidisciplinary strategies and new technologies in the management of sarcoidosis
Sarcoidosis exemplifies the complexity of modern internal medicine, requiring comprehensive, system-based management. The disease is characterized by non-caseating granulomas and can affect virtually... more
Multimodality imaging for cardiac amyloidosis: clinical applications and future directions
Systemic amyloidosis are a group of disorders characterized by the extracellular deposition of misfolded protein fibrils [1]. When the heart is involved, the condition is referred to as cardiac... more
ANCA-associated vasculitis and interstitial lung disease: challenges and open questions
Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a systemic inflammatory disorder that primarily affects small blood vessels, often involving vital organs such as the... more
Crystal clear – Part II: the role of uric acid in cardiorenal disease
Building on the foundational mechanistic and epidemiological knowledge from Part I, this second part of the review further unpacks the cardiovascular implications of abnormalities in serum levels of... more
Anemia in cardiorenal disease: From pathogenesis to treatment
Chronic kidney disease (CKD) is a highly prevalent, and progressive comorbidity that affects >10 % of the population worldwide [1–2]. Heart failure (HF) is also a common, disabling, and deadly... more
T follicular helper cells (TFH): From physiological to pathological aging
Human longevity has increased worldwide, partly due to medical improvements, better sanitation and easier access to clean water [1]. As the population ages, age-related diseases are leading to... more
The role of the senescence-associated secretory phenotype in cardiovascular disease among the elderly
Aging is a major independent risk factor for cardiovascular disease (CVD), the leading cause of death worldwide, particularly in older adults [1,2]. With global population aging, the burden of age-... more
Earlier Prediction of Cardiovascular Risk with Epicardial Fat Assessment
Obesity is no longer considered a cosmetic problem. The World Health Organisation (WHO) and the European Parliament, as well as many international medical and scientific societies, have recognised... more
Fever and inflammation of unknown origin in the 21st century
Fever of unknown origin (FUO) and inflammation of unknown origin (IUO) are among the most complex and challenging clinical syndromes in Internal Medicine. Internists, by virtue of their broad... more
Management of asymptomatic patients with abnormal liver function tests
Liver function tests (LFTs) are regularly included in screening blood panels, making them among the most frequently requested laboratory tests in clinical practice [1–3]. Their widespread use and... more
Charting the future of AL amyloidosis: Diagnostic advancements, prognostic insights, and therapeutic challenges
Light-chain (AL) amyloidosis is a form of plasma cell dyscrasias characterized by deposition of misfolded monoclonal immunoglobulin light chain-derived amyloid fibrils, resulting in abnormal... more
Crystal clear – part I: The role of uric acid in cardiorenal disease
Uric acid (UA), the terminal product of purine catabolism in humans, arises from both endogenous nucleic acid turnover and exogenous sources—particularly diets rich in animal protein and fructose.... more
Effect of sodium-glucose cotransporter-2 inhibitors on skeletal muscle
Sodium-Glucose Cotransporter-2 inhibitors (SGLT2i) are increasingly prescribed for diabetic and nondiabetic patients with and without heart failure (HF) or renal insufficiency [1]. SGLT2i reduce... more
Point of care ultrasound: focus on evidence for a critical appraisal
The term point of care ultrasound (POCUS) refers to a sonographic examination directly performed at the patient’s bedside, ideally by the treating physician, to interpret and integrate images into... more