October 2024

109 Articles

Clinical Insights

Oropouche virus infection: What internal medicine physicians should know

9 August 2024
Author(s): Lorenzo Bertolino, Fabian Patauner, Emanuele Durante-Mangoni

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Internal medicine in the 21st century: Back to the future

2 August 2024
Author(s): Ricardo Gómez-Huelgas, George N. Dalekos, Dror Dicker, Nicola Montano

Healthcare systems face multiple challenges arising from demographic factors (population aging) and epidemiological factors (rise of chronic diseases and patients with multimorbidity) as well as... more

Commentary

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

Putting frailty at the forefront of hypertension management in the elderly

26 September 2024
Author(s): Giacomo Buso, Claudia Agabiti-Rosei, Maria Lorenza Muiesan

In a progressively aging world, the concept of frailty is becoming increasingly relevant. Frailty is a dynamic, age-related biological syndrome with multifactorial causes leading to impaired... more

A potential novel stratification model to predict cardiovascular disease in patients with metabolic dysfunction-associated steatotic liver disease

14 September 2024
Author(s): Thomas Bülow Pedersen, Martin Bødtker Mortensen, Henning Grønbæk

Steatotic Liver Disease (SLD) is defined as excessive built-up of fat in the liver (>5 %) diagnosed by imaging or a liver biopsy [1]. Recently, a novel term metabolic dysfunction-associated... more

Cannabis is probably not the best choice for weight reduction

6 September 2024
Author(s): Ran Abuhasira

The field of medical cannabis has made significant advancements in recent years from both research and clinical perspectives [1]. These developments were driven by substantial shifts in public... more

Deprescribing in reflex syncope

29 August 2024
Author(s): Alessandra Fusco, Monica Solbiati, Giorgio Costantino

Reflex syncope is generally considered a benign condition. It is due to a reflex response (parasympathetic enhancement and decreased sympathetic tone) to several stimuli (e.g. micturition, defecation... more

Optimal timing of antibiotic administration in septic patients: The need to reformulate this question

20 August 2024
Author(s): Ángel Estella, Jordi Rello

Sepsis represents the most severe clinical manifestation of infectious diseases. Despite advances in understanding this pathology, recent global data document an estimated incidence of 48.9 million... more

It is time to get all the job done: For patients’ sake

17 August 2024
Author(s): Angelo Avogaro

Guidelines prioritize cardiovascular (CV) prevention by controlling all risk factors: this is a commitment for every healthcare professional following patients with type 2 diabetes. Not doing so... more

Unmasking eosinophilic granulomatosis with polyangiitis (EGPA)

10 August 2024
Author(s): Luca Moroni, Gabriele Gallina, Lorenzo Dagna

Eosinophilic granulomatosis with polyangiitis (EGPA) remains a challenging diagnosis due to its rarity and heterogeneous presentation. The article by Solans-Laqué et al. represents a significant step... more

Navigating the bleeding risk dilemma in patients with atrial fibrillation on therapy with direct-acting oral anticoagulants: Comparing the HAS-BLED vs. DOAC Score

27 July 2024
Author(s): Eva Soler-Espejo, José Miguel Rivera-Caravaca

Oral anticoagulation (OAC) is pivotal in preventing stroke in atrial fibrillation (AF), but its use poses inherent risks, notably an increased susceptibility to bleeding, especially in clinically... more

Internal Medicine Flashcard

A man with large periumbilical masses

3 September 2024
Author(s): Dimitrios Patoulias, Konstantinos Stavropoulos, Theocharis Koufakis

A 82-year old man presented to the Outpatient Department due to difficult-to-treat type 2 diabetes mellitus (T2DM), initially diagnosed 15 years ago. His rest medical history included coronary artery... more

A peculiar cause of dysphagia

24 July 2024
Author(s): Pinar Kucukdagli, Ozlem Yilmaz, Gulistan Bahat

An 82-year-old man with middle stage Alzheimer's dementia presented to the emergency clinic with poor general condition, productive cough, sputum, wheezing, and falling. He was found on the floor by... more

Diagnostic challenge of hemoptysis in a hemodialysis patient

23 July 2024
Author(s): Fullana Martin, Aliaga Leandro, Verni Giuliana

A 60-year-old male with a history of chronic kidney disease (CKD) diagnosed 3 years ago, on thrice-weekly hemodialysis, presented to the emergency department with a one-month history of hemoptysis... more

Man with progressed cognitive impairment

23 July 2024
Author(s): Jia-Qi Chen, Wei-Nv Fan

A 69-year-old man presented to the neurology department with progressed cognitive impairment for two years. He had medical history of diabetes but without remarkable family history of dementia. On... more

Invited Review Article

Managing and discharging COPD patients hospitalized because of an exacerbation of respiratory symptoms: An opportunity to improve outcomes

5 September 2024
Author(s): Alvar Agusti, Bartolome R. Celli, Leonardo Fabbri, Claus Vogelmeier

Many patients with chronic obstructive pulmonary disease (COPD) develop episodes of exacerbation of respiratory symptoms (ECOPD) that may require hospitalization (H-ECOPD). Long-term prognosis during... more

Advances in the pathophysiology, diagnosis and management of chronic diarrhoea from bile acid malabsorption: a systematic review

27 July 2024
Author(s): Agostino Di Ciaula, Mohamad Khalil, Gyorgy Baffy, Piero Portincasa

Excessive biosynthesis or secretion of bile acids (BAs) and their malabsorption (BAM) in the terminal ileum or the colon [1] generates chronic diarrhoea (cholorrhea). This symptom depends on a... 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

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

2 October 2024
Author(s): Paschalis Karakasis, Dimitrios Patoulias, Ieva Ruža, Alberto Maria Marra, Ricardo Gómez-Huelgas

Dear Editor,

Co-management hospitalist services for neurosurgery. Where are we?

27 September 2024
Author(s): Ombretta Para, Joel Byju Valuparampil, Alberto Parenti, Carlo Nozzoli, Alessandro Della Puppa

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

26 September 2024
Author(s): Wanyi Lin, Chenhan Jia, Hanlin Yin, Liangjing Lu

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

20 September 2024
Author(s): Marco Vincenzo Lenti, Carmine Frenna, Alice Silvia Brera, Catherine Klersy, Gino Roberto Corazza, SMAC Study group

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

18 September 2024
Author(s): S.S.A. Simon, A.M.C. van Vliet, L. Vogt, G. Lindner, R.H.G. Olde Engberink

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?

12 September 2024
Author(s): Brandon Stretton, Joshua Kovoor, Edmund Tse, Guy Maddern, Stephen Bacchi, Study group investigators

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

11 September 2024
Author(s): Anna Litwińska-Kmiecik, Kamil Mrówczyński

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

6 September 2024
Author(s): Ourania S. Kotsiou, Nikolaos D. Karakousis, Dimitrios Papagiannnis, Garyfallia Perlepe, Konstantinos I. Gourgoulianis

Dear Editor,

Predictive performance of hepatocellular carcinoma risk scores in chronic hepatitis C patients with advanced fibrosis after achieving sustained virological response: Insights from European Association for the study of the Liver Policy recommendations

4 September 2024
Author(s): Riham Soliman, James Lok, Saima Ajaz, Kosh Agarwal, María Guerra

Current European guidelines recommend hepatocellular carcinoma (HCC) surveillance in patients with an annual HCC risk of 1.5% or higher comprising serial ultrasound imaging ± alpha fetoprotein (AFP)... more

Oh no, all we needed was monkeypox!

3 September 2024
Author(s): Giuseppe Lippi

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

2 September 2024
Author(s): Hong Li, Yun Peng, Xixi Wan, Jiming Cai

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

29 August 2024
Author(s): José Guilherme Assis

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

24 August 2024
Author(s): César Fernández-de-las-Peñas, Gema Díaz-Gil, Antonio Gil-Crujera, Stella M. Gómez-Sánchez, Silvia Ambite-Quesada

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?

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

The prediction of alterations in plasma sodium levels in acutely ill patients should be more comprehensive

15 August 2024
Author(s): Milosz J. Jaguszewski, Michal Pruc, Lukasz Szarpak

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

Antimicrobial therapy and patient management for severe Legionnaires’ pneumonia

13 August 2024
Author(s): Jordi Rello, Joan Sabater-Riera

Legionellosis (LD) becomes a major public health problem, predominantly presenting as Pontiac fever or pneumonia with predominance of Legionella pneumophila (Lp) throughout the world, as reported in... more

Immune heterogeneity associated with disease severity and activity in eosinophilic granulomatosis with polyangiitis patients

10 August 2024
Author(s): Lijuan Hua, Mengyao Guo, Wenxue Bai, Dongyuan Wang, Min Xie

Dear Editor,

Challenges in using the clock drawing test for prognosis prediction in patients with non-specific complaints

9 August 2024
Author(s): Hiroshi Ito

Espejo and colleagues, using data from a prospective cross-sectional study, discovered that patients visiting the emergency department with non-specific complaints who had poor results on the Clock... more

Inhaled corticosteroids in severe COPD patients with cardiovascular diseases. Authors’ reply

7 August 2024
Author(s): Alberto Papi, Giacomo Forini, Mauro Maniscalco, Maria Aliani, Leonardo M Fabbri

We thank Pruc and Szarpak [1] for their interest in our article [2]. They address several questions, nicely summarised in the last sentence of their letter, “future research should focus on the... 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

Quinolones or macrolides for adults with Legionnaires’ disease and respiratory failure?

29 July 2024
Author(s): Lorna Pairman, Stephen T. Chambers

We recently read the systematic review entitled “Legionella pneumonia in hospitalized adults with respiratory failure: Quinolones or macrolides?” by Ruiz-Spinelli A, and Rello J published in the... more

Long-term inhaled corticosteroid treatment in patients with chronic obstructive lung disease, cardiovascular disease, and recent hospitalization for exacerbation

29 July 2024
Author(s): Michal Pruc, Lukasz Szarpak

The article “Long-term inhaled corticosteroid treatment in patients with chronic obstructive pulmonary disease, cardiovascular disease, and recent hospitalization for exacerbation: A pragmatic... 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

Precision medicine in COPD: A possible contribution of vitamin D?

22 July 2024
Author(s): Gianluca Azzellino, Lia Ginaldi, Massimo De Martinis

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

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

How do we diagnose Miyoshi Muscular Dystrophy in the absence of symptoms?

17 July 2024
Author(s): Özge Sönmez, Uğur Kimyon, Mehmet Çopur, İbrahim Ataş, Işıl Bavunoğlu

Elevated liver enzyme is a common incidental laboratory finding. Evaluating such problems particularly in asymptomatic patients might be challenging. Alterations in liver enzymes are not enterily... 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

Insights into recurrence of hypertriglyceridemia-associated acute pancreatitis: Methodological challenges

9 July 2024
Author(s): Sehrish Gaho, Raja Ram Khenhrani, Amna Afaque

We read the article by Ling Ding et al. with great interest [1]. We would like to commend the authors for their comprehensive study, which found that hypertriglyceridemia-associated acute... 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,

Predictive performance of HAS-BLED, ORBIT, ABC, and DOAC scores for major bleeding in atrial fibrillation patients on DOACs

4 July 2024
Author(s): Shan Zeng, Wengen Zhu, Siyu Guo, Hong Hong

Atrial fibrillation (AF) is the most common type of irregular heartbeat in clinical practice. It has been found to increase the risk of ischemic stroke by 5 times. To mitigate this risk, oral... more

Risk of psoriatic arthritis development with interleukin-17 inhibitors compared to tumour necrosis factor inhibitors

22 June 2024
Author(s): Po-Cheng Shih, An-Ping Huo, Pui-Ying Leong, James Cheng Chung Wei

Psoriatic arthritis (PsA) is one of the most important comorbidities in patients with psoriasis (PsO), with approximately one third of PsO patients developing arthritis over their whole lifetime [1... more

Direct oral anticoagulants or vitamin K antagonists in adult patients with congenital heart disease?

21 June 2024
Author(s): Paschalis Karakasis, George Giannakoulas, Panagiotis Theofilis, Dimitrios Patoulias, Nikolaos Fragakis

Dear Editor,

Divergent views on prescription adherence: A qualitative comparison of perspectives from the patient, pharmacist, and physician triad

20 June 2024
Author(s): Anjali Bundele, Hui Wen Lim, Amartya Mukhopadhyay, Phillip H. Phan, Jennifer Sumner

Up to 70 % of patients fail to follow prescribed regimens [1], resulting in detrimental health and economic consequences. While existing adherence research often focuses on either the traditional... more

Myocardial infarction in foreign-born individuals in the total population of Sweden

17 June 2024
Author(s): Per Wändell, Xinjun Li, Axel C Carlsson, Jan Sundquist, Kristina Sundquist

Cardiovascular diseases (CVD) are still frequent globally with a high mortality rate, even if the incidence has decreased since the 1980s in Europe, especially in Northern Europe [1], including a... more

Beneficial effects of early low-dose methylprednisolone with long-term treatment in ARDS

15 June 2024
Author(s): Haiming Hu, Shuting Wei, Jiayin Huang, Lokesh Sharma, De Chang

Since the concept of acute respiratory distress syndrome (ARDS) was first proposed by Ashbaugh in 1967 [1], it has been refined several times for better reflect the phenotype in recent decades. The... more

Cardiovascular outcome with SGLT2i and GLP1RA

7 June 2024
Author(s): Soo Lim, Minji Sohn, Michael A. Nauck

Dear editor,

Clostridioides difficile infection as a potential trigger for Familial Mediterranean Fever attacks and fecal transplantation as a rescue

7 June 2024
Author(s): Sophie Georgin-Lavialle, Marion Delplanque, Claude Bachmeyer, Léa Savey, Harry Sokol, FMF Clostridium Study Group

Sir,

Definition of an algorithm to identify patients with sickle-cell disease in the French National Health Database

31 May 2024
Author(s): Ondine Walter, Pierre Cougoul, Yoann Zadro, Guillaume Moulis, Margaux Lafaurie

Sickle cell disease (SCD) is the most frequent inherited disease with monogenic transmission (300,000 newborns per year in the world) [1]. SCD is due to a mutation on both alleles of the gene coding... more

Navigating the challenges: Would onboarding bootcamps enhance comfort and wellbeing of residents in medicine?

28 May 2024
Author(s): Jonathan Assouly, Margaret Hayes, Blaise Debien, Camille Roubille, Boris Jung

Medical interns (first-year residents) and residents (second-to fourth-year residents) in France are junior medical staff in charge of overseeing up to 200 medicine beds during night shifts, with no... more

Dual tobacco smoking, electronic cigarette use and COVID-19 outcomes

27 May 2024
Author(s): Tahlia Grammatopoulos, Ellana Yeoh, Nouhad El-Haddad, Kristin Carson-Chahhoud, Freddy Sitas

We congratulate Scala and colleagues on the publication of their paper on electronic cigarette (e-cigarette) use and Coronavirus Disease 2019 (COVID-19) outcomes [1]. Scala et al. focused on e-... more

Survival analysis of diabetes cardiovascular outcome trials using reconstructed Kaplan-Meier curves

25 May 2024
Author(s): Marko Skelin, Bruna Perkov-Stipičin, Marko Lucijanić, Eugen Javor, Ivan Krečak

The management of type 2 diabetes mellitus (T2DM) has witnessed a treatment paradigm in the light of recent cardiovascular outcomes trials (CVOTs) which have placed more emphasis on cardiovascular... more

Multi-organ abnormalities assessed by a single MRI scan in individuals with blood cancer

24 May 2024
Author(s): Sophie Reed, Michele Pansini, Charlie Diamond, Amitava Banerjee, Helena Thomaides Brears, Onima Chowdhury

During the COVID-19 pandemic individuals with all blood cancers were classified as clinically vulnerable and at high risk of complications and death. Our study sought to determine if individuals with... more

The association between long-acting muscarinic antagonist-based therapy and the risk of urinary tract infection in patients with chronic obstructive pulmonary disease

24 May 2024
Author(s): Ping Li, Jianjun Luo, Jun Chen, Yongchun Shen, Fuqiang Wen

Chronic obstructive pulmonary disease (COPD) is a common respiratory disease featuring persistent respiratory symptoms and progressive airflow limitation. Long-acting muscarinic antagonists (LAMAs)... more

Self-publishing in the history of medicine: The paradoxical case of Edward Jenner's science-changing monograph (1798)

13 May 2024
Author(s): Francesco M. Galassi, Elena Varotto, Domenico Ribatti

According to the Cambridge Dictionary, self-publishing is regarded as the act of arranging or paying for one's ‘own book to be published, rather than having it done by a publisher’ [1]. Whether it be... more

Original Article

A large language model-based clinical decision support system for syncope recognition in the emergency department: A framework for clinical workflow integration

28 September 2024
Author(s): Alessandro Giaj Levra, Mauro Gatti, Roberto Mene, Dana Shiffer, Giorgio Costantino, Monica Solbiati, Raffaello Furlan, Franca Dipaola

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

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

The impact of the COVID-19 Pandemic on hypertension phenotypes (ESH ABPM COVID-19 study)

10 September 2024
Author(s): Aleksandra Ostrowska, Wiktoria Wojciechowska, Marek Rajzer, Thomas Weber, Michael Bursztyn, Alexandre Persu, George Stergiou, Grzegorz Kiełbasa, Marzena Chrostowska, Michaelis Doumas, Gianfranco Parati, Grzegorz Bilo, Guido Grassi, Giuseppe Mancia, Andrzej Januszewicz, Reinhold Kreutz, ESH ABPM COVID-19 Study Investigators

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

9 September 2024
Author(s): Valentine Mismetti, Francis Couturaud, Olivier Sanchez, Raquel Morillo, Edouard Ollier, Carmen Rodriguez, Pierre-Marie Roy, Pedro Ruiz-Artacho, Frédéric Gagnadoux, Raphael Le-Mao, Eva Tabernero, Michel Nonent, Jeannot Schmidt, Laurent Bertoletti, David Jimenez

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

Distinct biophysiological effects of Ramadan fasting and traditional intermittent fasting on markers of body fat storage. A real-life study

26 August 2024
Author(s): Mohamad Khalil, Hala Abdallah, Nour Jaber, Gabriella Garruti, Agostino Di Ciaula, Piero Portincasa

Obesity is a metabolic disease characterized by fat over-storage in multiple districts. The continuous increase of the obesity epidemic makes mandatory innovative interventions and new guidelines to... 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

Prediction of plasma sodium changes in the acutely ill patients: the potential role of tissue sodium content

2 August 2024
Author(s): S.S.A. Simon, A.M.C. van Vliet, L. Vogt, J.J. Oppelaar, G. Lindner, R.H.G. Olde Engberink

Dysnatremias, disorders of plasma sodium concentration ([Na+]), are frequently encountered in daily clinical practice and pose a diagnostic and therapeutic challenge for many clinicians[1]. Rapid... 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

Intra-abdominal infection and sepsis in immunocompromised intensive care unit patients: Disease expression, microbial aetiology, and clinical outcomes

29 July 2024
Author(s): José-Artur Paiva, Jordi Rello, Christian Eckmann, Massimo Antonelli, Kostoula Arvaniti, Despoina Koulenti, Georgios Papathanakos, George Dimopoulos, Mieke Deschepper, Stijn Blot, Abdominal Sepsis Study (AbSeS) group for the Trials Group of the European Society of Intensive Care Medicine

Sepsis-related multiple organ dysfunction is fundamentally driven by the host response to infection, rather than by the direct effect of the microorganism. This was accepted in the consensus... more

Native skeletal muscle T1-time on cardiac magnetic resonance: A predictor of outcome in patients with heart failure with preserved ejection fraction

23 July 2024
Author(s): Christina Kronberger, Katharina Mascherbauer, Robin Willixhofer, Franz Duca, René Rettl, Christina Binder-Rodriguez, Michael Poledniczek, Nikita Ermolaev, Carolina Donà, Matthias Koschutnik, Christian Nitsche, Luciana Camuz Ligios, Dietrich Beitzke, Roza Badr Eslam, Jutta Bergler-Klein, Johannes Kastner, Andreas A. Kammerlander

Heart failure (HF) with preserved ejection fraction (HFpEF) is a major public health problem that is associated with a high morbidity and mortality [1] leading to an excess in hospitalizations and... more

Door-to-antibiotic time and mortality in patients with sepsis: Systematic review and meta-analysis

20 July 2024
Author(s): Ling Yan Leung, Hsi-Lan Huang, Kevin KC Hung, Chi Yan Leung, Cherry CY Lam, Ronson SL Lo, Chun Yu Yeung, Peter Joseph Tsoi, Michael Lai, Mikkel Brabrand, Joseph H Walline, Colin A Graham

Timely administration of antibiotics is one of the most important interventions in sepsis management to improve patient outcomes and reduce mortality. However, the impact on mortality of the early... 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

Plasma levels of myeloperoxidase and resistin independently predict mortality in dialysis patients

16 July 2024
Author(s): Luca Liberale, Claudia Torino, Patrizia Pizzini, Sabrina Mezzatesta, Graziella D'Arrigo, Mercedes Gori, Federico Carbone, Elisa Schiavetta, Valeria Cugno, Mara Cabri, Cosimo Sgura, Elia Maioli, Danielle Mbarga, Gianluca Rubini, Amedeo Tirandi, Davide Ramoni, Francesca Mallamaci, Giovanni Tripepi, Carmine Zoccali, Fabrizio Montecucco

Dialysis is a vital treatment for patients with kidney failure on dialysis (KF). Yet, it associates with a high risk of death mainly due to both cardiovascular (CV) and non-CV causes [1,2]. Indeed,... more

A machine learning algorithm for stratification of risk of cardiovascular disease in metabolic dysfunction-associated steatotic liver disease

16 July 2024
Author(s): Naoki Shibata, Yasuhiro Morita, Takanori Ito, Yasunori Kanzaki, Naoki Watanabe, Naoki Yoshioka, Yoshihito Arao, Satoshi Yasuda, Yuichi Koshiyama, Hidenori Toyoda, Itsuro Morishima

Steatotic liver disease (SLD) has emerged as a prevalent and significant condition that contributes to the rising burden of liver diseases worldwide [1]. Given the increasing prevalence of SLD, it is... more

Associations of cannabis use and body mass index–The Coronary Artery Risk Development in Young Adults (CARDIA) study

9 July 2024
Author(s): Julian Jakob, Fiona Schwerdtel, Steve Sidney, Nicolas Rodondi, Mark J. Pletcher, Jared P. Reis, Ranganath Muniyappa, Carole Clair, Kali Tal, Michael P. Bancks, Jamal S. Rana, Tinh-Hai Collet, Reto Auer

In the US in 2020, 18 % of the population reported use of cannabis in the past year. Use among middle and older-aged people is rising [1,2]; from 2016 to 2018 the percentage of US adults ≥55 years... more

Long-term inhaled corticosteroid treatment in patients with chronic obstructive pulmonary disease, cardiovascular disease, and a recent hospitalised exacerbation: The ICSLIFE pragmatic, randomised controlled study

8 July 2024
Author(s): Alberto Papi, Giacomo Forini, Mauro Maniscalco, Elena Bargagli, Claudia Crimi, Pierachille Santus, Antonio Molino, Valeria Bandiera, Federico Baraldi, Silvestro Ennio D'Anna, Mauro Carone, Maurizio Marvisi, Corrado Pelaia, Giulia Scioscia, Vincenzo Patella, Maria Aliani, Leonardo M Fabbri, ICSLIFE Study Group

Patients with chronic obstructive pulmonary disease (COPD) are typically older [1], and have multiple comorbidities, including heart failure, ischaemic heart disease, and arrhythmias [2–5]. The... more

Performance of HAS-BLED and DOAC scores to predict major bleeding events in atrial fibrillation patients treated with direct oral anticoagulants: A report from a prospective European observational registry

4 July 2024
Author(s): Davide Antonio Mei, Jacopo Francesco Imberti, Niccolò Bonini, Giulio Francesco Romiti, Bernadette Corica, Marco Proietti, Marco Vitolo, Gregory Y.H. Lip, Giuseppe Boriani

Atrial fibrillation (AF) is the most common arrhythmia worldwide and it is associated with a 3–5-fold higher risk of stroke [1]. This risk has been significantly reduced after the introduction of... more

Metabolic health and genetic predisposition in inflammatory bowel disease: Insights from a prospective cohort study

2 July 2024
Author(s): Ningning Mi, Qiangsheng He, Yuyao Liu, Yingmei Li, Ying Li, Yingjie Wu, Man Yang, Yingya Zhao, Peng Xie, Wenjing Li, Siqin Wu, Zijun Li, Danni Wang, Xiwen Qin, Jinqiu Yuan, Pingguang Lei, Jian Qi, Bin Xia

Inflammatory bowel disease (IBD), encompassing Crohn's disease (CD) and ulcerative colitis (UC), is a chronic inflammatory disease of the gastrointestinal tract driven by an inappropriate and... more

Effectiveness Of Tocilizumab In Aortitis And Aneurysms Associated With Giant Cell Arteritis

22 June 2024
Author(s): Adrián Martín-Gutiérrez, Javier Loricera, Javier Narváez, Vicente Aldasoro, Olga Maiz, Paloma Vela, Susana Romero-Yuste, Eugenio de Miguel, Eva Galíndez-Agirregoikoa, Jesús C. Fernández-López, Iván Ferraz-Amaro, Julio Sánchez-Martín, Patricia Moya, Cristina Campos, Fernando López-Gutiérrez, Santos Castañeda, Ricardo Blanco, Tocilizumab in Giant Cell Arteritis Spanish Collaborative Group

Giant Cell Arteritis (GCA) is a vasculitis involving the large and medium vessels, especially the extracranial branches of the carotid arteries, and particularly, the temporal artery. Arterial wall... more

Red flags for clinical suspicion of eosinophilic granulomatosis with polyangiitis (EGPA)

15 June 2024
Author(s): R. Solans-Laqué, I. Rúa-Figueroa, M. Blanco Aparicio, I. García Moguel, R. Blanco, F. Pérez Grimaldi, A. Noblejas Mozo, M. Labrador Horrillo, J.M. Álvaro-Gracia, C. Domingo Ribas, G. Espigol-Frigolé, F. Sánchez-Toril López, F.M. Ortiz Sanjuán, E. Arismendi, M.C. Cid

Eosinophilic granulomatosis with polyangiitis (EGPA), formerly known as Churg-Strauss syndrome [1], is a systemic vasculitis classified as an anti-neutrophil cytoplasm antibody (ANCA)-associated... more

Beta-cell function and glucose metabolism in patients with chronic pancreatitis

12 June 2024
Author(s): Gea Ciccarelli, Gianfranco Di Giuseppe, Laura Soldovieri, Giuseppe Quero, Enrico Celestino Nista, Michela Brunetti, Francesca Cinti, Simona Moffa, Umberto Capece, Vincenzo Tondolo, Andrea Mari, Antonio Gasbarrini, Alfredo Pontecorvi, Sergio Alfieri, Andrea Giaccari, Teresa Mezza

Diabetes of the exocrine pancreas (DEP), - also defined as pancreatic, pancreatogenic, or type 3c diabetes - arises from the structural or functional loss of insulin secretion secondary to exocrine... more

Diagnosis of acute aortic syndromes with ultrasound and d-dimer: the PROFUNDUS study

12 June 2024
Author(s): Fulvio Morello, Paolo Bima, Matteo Castelli, Elisa Capretti, Alexandre de Matos Soeiro, Alessandro Cipriano, Giorgio Costantino, Simone Vanni, Bernd A. Leidel, Beat A. Kaufmann, Adi Osman, Marcello Candelli, Nicolò Capsoni, Wilhelm Behringer, Marialessia Capuano, Giovanni Ascione, Tatiana de Carvalho Andreucci Torres Leal, Lorenzo Ghiadoni, Emanuele Pivetta, Stefano Grifoni, Enrico Lupia, Peiman Nazerian, PROFUNDUS Study Investigators

Acute aortic syndromes (AASs), including aortic dissection (AD), intramural aortic haematoma (IMH) and penetrating aortic ulcer (PAU), affect 5–7/100,000 individuals/year [1]. They are time-dependent... more

A group-based intervention for diabetes-related emotional distress among emerging adults with type 1 diabetes: A pilot study

8 June 2024
Author(s): Anne-Sofie Kortegaard, Rikke B. Rokkjær, Hanne Marie H. Harboe, Sten Lund, Anette Andersen, Mette Bohl

Emerging adulthood is a critical period with increased risk of acute and chronic health complications, psychological problems, and psychosocial issues for emerging adults with type 1 diabetes (T1D) [... more

Relationship between degree of risk factor control and all-cause mortality in individuals with type 2 diabetes: A prospective cohort study

5 June 2024
Author(s): Monia Garofolo, Giuseppe Penno, Anna Solini, Emanuela Orsi, Martina Vitale, Veronica Resi, Enzo Bonora, Cecilia Fondelli, Roberto Trevisan, Monica Vedovato, Antonio Nicolucci, Giuseppe Pugliese, Renal Insufficiency And Cardiovascular Events (RIACE) Study Group

Risk of death is approximately twice higher in people with diabetes than in those without, mainly though not exclusively due to an increased risk of cardiovascular disease (CVD) [1]. However, death... more

Association between socioeconomic and psychosocial factors with use of interventional and surgical treatments and outcomes in patients with myocardial infarction – Inpatient data of the largest European health care system

4 June 2024
Author(s): Omar Hahad, Lukas Hobohm, Sadeer Al-Kindi, Volker H. Schmitt, Fawad Kazemi-Asrar, Donya Gilan, Katja Petrowski, Tommaso Gori, Philipp Wild, Klaus Lieb, Andreas Daiber, Philipp Lurz, Thomas Münzel, Karsten Keller

Myocardial infarction (MI) remains a leading contributor for morbidity and mortality worldwide [1,2]. While the medical progress regarding diagnostic and therapeutic approaches has improved outcomes... more

Targets for deprescribing in patients with hypertension and reflex syncope

24 May 2024
Author(s): Antonella Groppelli, Giulia Rivasi, Artur Fedorowski, Frederik de Lange, Vincenzo Russo, Roberto Maggi, Marco Capacci, Sara Nawaz, Angelo Comune, Andrea Ungar, Gianfranco Parati, Michele Brignole

In hypertensive patients with reflex syncope, detection of transient hypotension as possible trigger mechanism of syncope may prompt deprescribing of hypotensive medications to counteract the risk of... more

Early palliative care program in idiopathic pulmonary fibrosis patients favors at-home and hospice deaths, reduces unplanned medical visits, and prolongs survival: A pilot study

23 May 2024
Author(s): Ilaria Bassi, Stefania Pastorello, Aldo Guerrieri, Gilda Giancotti, Anna Maria Cuomo, Chiara Rizzelli, Maria Coppola, Danila Valenti, Stefano Nava

Idiopathic Pulmonary Fibrosis (IPF) is a relentlessly progressive fibrotic interstitial lung disease (ILD) with an unfavourable prognosis1. The median survival is 3 to 5 years form the time of... more

Comparison of different frailty instruments for prediction of functional decline in older hypertensive outpatients (HYPER-FRAIL pilot study 2)

18 May 2024
Author(s): Giulia Rivasi, Ludovica Ceolin, Giada Turrin, Virginia Tortù, Maria Flora D'Andria, Marco Capacci, Giuseppe Dario Testa, Sara Montali, Francesco Tonarelli, Enrico Brunetti, Mario Bo, Roman Romero-Ortuno, Enrico Mossello, Andrea Ungar

Frailty is a geriatric syndrome characterized by a cumulative decline in multiple body systems, which results in the reduction of individuals’ physiological functional reserve with increased... more

Evolution and outcomes of aortic dilations in giant cell arteritis

5 April 2024
Author(s): Sophie Gallou, Christian Agard, Anael Dumont, Samuel Deshayes, Jonathan Boutemy, Gwénola Maigné, Nicolas Martin Silva, Alexandre Nguyen, Rémi Philip, Olivier Espitia, Achille Aouba, Hubert de Boysson

Giant cell arteritis (GCA) is a systemic vasculitis that typically affects large and medium vessels in patients over 50 years of age [1–3]. In addition to the cephalic presentation mainly explained... more

Review Article

Gliflozines use in heart failure patients. Focus on renal actions and overview of clinical experience

21 September 2024
Author(s): Edoardo Gronda, Massimo Iacoviello, Arduino Arduini, Manuela Benvenuto, Domenico Gabrielli, Mario Bonomini, Luigi Tavazzi

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

The clinical relevance of the reversal of coronary atherosclerotic plaque

20 August 2024
Author(s): Arturo Cesaro, Vincenzo Acerbo, Ciro Indolfi, Pasquale Perrone Filardi, Paolo Calabrò

Despite tremendous progress in study of the pathophysiological mechanisms underlying atherosclerosis and the subsequent development of innovative preventive therapies, atherosclerotic cardiovascular... more

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

Pulmonary hypertension associated to left heart disease: Phenotypes and treatment

1 August 2024
Author(s): Rosalinda Madonna, Filippo Biondi, Sandra Ghelardoni, Alberto D'Alleva, Stefano Quarta, Marika Massaro

According to the last updated ESC guidelines 2022, the term Pulmonary Hypertension (PH) describes a clinical condition characterised haemodynamically by the presence of mean pulmonary artery pressure... more

Exploring Cardiovascular Risk Factors and Atherosclerosis in Rheumatoid Arthritis

23 July 2024
Author(s): Alexandros A. Drosos, Aliki A. Venetsanopoulou, Eleftherios Pelechas, Paraskevi V. Voulgari

Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the synovium of the joints, leading to joint destruction and bone damage. It affects 0, 5–1 % of the general population,... 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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