October 2025
No Section
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,
Diagnostic contribution of minor salivary glands biopsy in clinical practice
Dear Editor,
Beyond the Guidelines
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
Stroke prevention in atrial fibrillation patients with end-stage renal disease: how far from Ithaca after a long Odyssey?
Atrial fibrillation (AF) and chronic kidney disease (CKD) are closely interlinked clinical entities that frequently coexist [1–3] . CKD predisposes to AF through structural, inflammatory and... more
Commentary
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
Addressing polymorbidity in chronic obstructive pulmonary disease: an opportunity to improve outcomes
Comorbid diseases are a common feature of chronic obstructive pulmonary disease (COPD), with most deaths among COPD patients from diseases other than chronic respiratory disease [1,2]. The importance... 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
When the discovery of a biomarker stimulates basic interdisciplinary work on disease’s biology and pathophysiology
The paper by Aimo et al. [1] reported in the current issue of the European Journal of Internal Medicine highlights a significant increase in the gamma-glutamyltransferase enzyme (GGT) in patients... 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
Hijacked medical journals rank first via search engine optimization and threaten academic integrity
The rise of questionable journals poses a significant threat to academic integrity, resulting in substantial waste of institutional and university resources. This commentary analysis focuses on six... more
Artificial intelligence in ECG interpretation: Promise and pitfalls of AI in modern medicine
The integration of artificial intelligence (AI) into cardiovascular diagnostics, particularly through electrocardiogram (ECG) analysis, represents one of the most promising frontiers in contemporary... more
Senolytic drugs to slow down aging: The Fountain of Youth, revisited
Aging leads to progressive organ dysfunction, and many chronic degenerative diseases are characterized by accelerated aging of organs and apparatus. Thus, disentangling the effects of aging and age-... more
Uric acid and heart failure with mildly reduced ejection fraction (HFmrEF): one more step
Uric acid (UA) is the terminal product of purine catabolism and arises from both endogenous nucleic acid turnover and exogenous intake—particularly from diets rich in animal protein and fructose [1... more
Corrigendum
Corrigendum to “Telemedicine in Internal Medicine: a statement by the European Federation of Internal Medicine” [European Journal of Internal Medicine 112C (2023) 138-139]
The authors regret that the author names were listed incorrectly in the manuscript, resulting in the author forenames and surnames becoming reversed. The correct presentation of the authorship is as... 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
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
Smoking-induced “Scleroderma-like Pattern” and digital clubbing in a young adult
A 24-year-old man with a 10-year history of heavy cigarette smoking (approximately 20 cigarettes per day) was evaluated for recurrent episodes of cold-induced hand erythema and bilateral digital... 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
Fever and eye swelling in a teenager
A 16-year-old male with a history of atopic dermatitis presented to his primary care clinic after 7 d of nasal discharge and obstruction, followed by fever and periorbital swelling, which resulted in... more
Atypical and fatal presentation of acute liver failure
A 44-year-old female presented to the emergency department with fever (38 °C) and general malaise three days after an elective hysterectomy for bleeding uterine fibroids. The procedure was... more
Invited Review Article
Senolytic therapies for cardiovascular aging: tackling fibrosis and metabolic dysfunction
Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality worldwide, with its prevalence rising sharply with age [1,2]. Cellular senescence has emerged as a pivotal... more
Letter to the 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
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,
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
Annual chest computed tomography in multimorbid COPD: is universal screening clinically feasible?
Dear Editor,
Not all immunosuppression is equal: Implications for post-discharge outcomes in community-acquired pneumonia − Authors’ reply
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
Aortic valve calcification as a novel risk marker for kidney function deterioration: insights from the MESA study
Dear Editor,
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
Unaddressed limitations in triglyceride management among CHD patients: A call for methodological rigor
We have carefully reviewed the article by Ilay Shani and Avishay Elis, “The Approach to Triglyceride Levels in Patients with Coronary Heart Disease,” and commend the authors for their comprehensive... 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
Unmeasured burdens in nonagenarian ICU survivors: A cohort-based perspective
I read with interest the recent study by Weller and colleagues on excess mortality in ICU patients aged 90 years and older. Their use of relative survival provides instructive information about... 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
Classification of coronary syndromes: Need for refinement?
In addition to providing a common language, and thus facilitating communication among professionals, medical classifications aim to incorporate clinical and pathophysiological elements that help... 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
Efficacy and safety of beta-blockers in patients with comorbid chronic obstructive pulmonary disease and cardiovascular disease
To the editor: Chronic Obstructive Pulmonary Disease (COPD) and cardiovascular disease (CVD) often co-occur, presenting complex management challenges due to concerns over the effects of beta-blockers... more
Substantial variety in point of care ultrasound training across EFIM
Dear Editor,
Addressing unmet needs in the use of SGLT2 inhibitors in critical and acute care setting
Despite mounting evidence of benefit in acute heart failure (AHF), acute myocardial infarction (AMI), arrhythmias, and even intensive care settings, there remains a significant lack of clear guidance... more
Role of 12-lead electrocardiogram for identifying very low mortality risk patients with non-hypotensive acute pulmonary embolism
Pulmonary embolism (PE) is the third leading cause of cardiovascular mortality and a significant global health issue [1]. The simplified Pulmonary Embolism Severity Index (sPESI) is a practical tool... more
Real-world glucose-lowering strategies for managing glucocorticoid-induced diabetes in non-intensive hospital settings
A prolonged administration of glucocorticoids (GCs) can lead to side effects such as glucocorticoid-induced diabetes (GC-DM), a form of secondary diabetes, namely drug- or chemical-induced diabetes [... more
Gastroenteritis caused by Shiga-toxigenic Escherichia coli. Are antibiotics always prohibited in this disease?
Dear Editor-in-Chief and editorial team,
Validation of different acute kidney injury scores in patients undergoing transcatheter aortic valve implantation
Contrast-associated acute kidney injury (CA-AKI) remains one of the most relevant procedural complications in patients undergoing transcatheter aortic valve implantation (TAVI). Beyond contrast dye... more
Unmasking atrial cardiomyopathy in middle-aged patients with AF: A call for early detection
Atrial cardiomyopathy (AtCM) has emerged as a critical clinical entity in recent years, encompassing structural, architectural, electrical, and functional abnormalities in the atria [1]. Atrial... more
Nonarteritic anterior ischemic optic neuropathy and glucagon-like peptide-1 receptor agonists: Evaluating a potential association
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used for type 2 diabetes mellitus (T2DM) and obesity due to their efficacy in glycemic control, weight reduction, and... more
The role of the hospitalist in Europe: results by EFIM multimorbidity working group survey
The increasing prevalence of chronic diseases has led to a population with a higher level of care complexity. Multimorbidity (MM) has emerged as the most prevalent patient profile in both outpatient... more
Genotype-phenotype correlations and resistance to colchicine in a familial Mediterranean fever cohort in southwestern Spain
Familial Mediterranean Fever (FMF) is the most frequent autoinflammatory disease, characterized by recurrent episodes of fever, abdominal pain, arthritis, and rash. It primarily affects people in the... more
Abrupt fluoroquinolone-associated suicides: a SONAR report from North America, Europe, Australia, and Asia
One billion doses of fluoroquinolone (FQ) antibiotics have been administered since 1987. In 1998, the German Pharmaceutical Regulatory Agency received “a few” suicide reports that occurred shortly... more
Trends in cardiovascular disease-related mortality among adults with sleep apnea in the United States from 1999-2020
Cardiovascular disease-related mortality in adults with comorbid sleep apnea in the United States from 1999 to 2020.
Original Article
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 of 115 patients
IgG4-related disease (IgG4-RD) is a systemic fibroinflammatory condition with marked clinical heterogeneity [1]. Common manifestations include autoimmune pancreatitis and cholangitis, orbital... more
Non cardiovascular comorbidities in Heart Failure. An updated position paper from the Heart Failure Working Group of the Italian Society of Cardiology (SIC)
Heart Failure (HF) affects more than 64 million people worldwide[1]. While the incidence of HF has stabilized, its prevalence is increasing due to the ageing of the population, improvements in the... 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
A person-centred clinical approach to the multimorbid patient with COPD
Multimorbidity, the coexistence of multiple non-communicable diseases in an individual, is a growing concern, especially in an aging population [1]. Patients with chronic obstructive pulmonary... 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
Prognostic impact of uric acid levels in heart failure with mildly reduced ejection fraction: Insights from a large retrospective registry
Elevated uric acid (UA) levels represent an established risk factor for cardiovascular morbidity and mortality [1–3]. Numerous investigations have demonstrated an association between increased UA and... 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
Sex-related differences in the management and outcome of intubated adults with community-acquired pneumonia in Europe: A multicentre study
Sex and gender are increasingly recognized determinants in the epidemiology, clinical presentation, management, response to treatment, and prognosis of chronic and acute diseases [1]. Sex refers to... 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
Neurologic and psychiatric disorders following correction of profound hyponatremia - A cohort study
Hyponatremia, defined as a serum sodium concentration <135 mmol/L, is the most common electrolyte imbalance, seen in 15–20 % of all acute hospital admissions [1]. Women, elderly, and individuals... 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
Prognostic value of N-terminal prohormone B-type natriuretic peptide modified by renal function in patients with acute heart failure
Heart failure (HF), as the final phase of various cardiovascular disorders, imposes a formidable global healthcare challenge due to its diverse morbidity and high rate of mortality [1]. HF and kidney... more
Determinants of time to first palliative care consultation in hospitalized patients with advanced or terminal illness – A retrospective analysis
The Yentl Syndrome, a term coined by Dr. Bernadine Healy in 1991, refers to the phenomenon that women are less likely to receive accurate diagnosis and treatment because their symptoms do not align... more
Gamma-glutamyltransferase independently predicts mortality and heart failure hospitalization in cardiac transthyretin amyloidosis
Transthyretin cardiac amyloidosis (ATTR-CA) is an infiltrative cardiomyopathy caused by extracellular deposition of misfolded transthyretin (TTR) fibrils within the myocardium, leading to progressive... more
Long-term secondary prevention with colchicine in patients with CAD: an updated systematic review and meta-analysis
Randomized clinical trials (RCTs) for the prevention of vascular events in patients with coronary artery disease (CAD) over the past decade have clearly demonstrated that colchicine is able to reduce... more
Review Article
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
Optimizing PCSK9 inhibitor therapy: Understanding and managing suboptimal LDL-C response in clinical practice
Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality globally[1]. Elevated levels of low-density lipoprotein cholesterol (LDL-C) are a well-recognized... 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
When inflammatory bowel disease meets pregnancy
Inflammatory bowel disease (IBD) is a group of chronic and relapsing inflammatory conditions of the gastrointestinal tract with two major forms: Crohn’s disease (CD) (affecting any segment of the... 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
Artificial intelligence and the electrocardiogram: A modern renaissance
The electrocardiogram (ECG) is a fundamental, non-invasive diagnostic tool in cardiology, widely accessible and crucial for assessing the heart's electrical and structural conditions [1].... more