September 2025
36 ArticlesNo Section
Publisher's note
Within the publishing industry, article numbering has emerged as an easy and efficient way to cite journal articles. Article numbering has already been successfully rolled out to Elsevier's... more
Clinical Insights
From vectors to victims: understanding the threat of West Nile virus infection
Growing numbers of West Nile virus infection cases are sparking fears among citizens and health care providers in Europe. In this Clinical Insight, we provide Internal Medicine physicians with a... more
Commentary
Hypochloremia no longer a “Carneades” in heart failure
“Carneades! Who was he?” is the opening phrase of Chapter VIII in *The Betrothed* (*I Promessi Sposi*), the most significant Italian novel of the 19th century, written by Alessandro Manzoni. Whit... more
In the line of fire: Sleep well as the first step of care
Sleep is a fundamental biological process that is essential for human life. A substantial body of research has indicated a correlation between inadequate sleep and adverse health consequences... more
Oral semaglutide in HFpEF: Real-world evidence and causal considerations
Heart failure with preserved ejection fraction (HFpEF) represents a significant and growing public health burden, with obesity and type 2 diabetes (T2D) emerging as major predisposing factors [1].... more
Redrawing the map for corticosteroids in severe community-acquired pneumonia
Current guidelines give a positive recommendation for the use of corticosteroids in severe community-acquired pneumonia (CAP) [1,2]. This is largely based on positive results from one of two recently... more
Modern data on blood pressure distribution in European children and adolescents
Prevalence of hypertension in childhood is around 2–5 % [1,2] and it is progressively rising, particularly among adolescents from low-income countries [3]. Despite the solid evidence that... more
Editorial
“Limits to medicine” still needed after 50 years
“The medical establishment has become a major threat to health” [1]. This opening statement and main point of Ivan Illich’s book Limits to medicine (Medical Nemesis) is more urgent than ever – but... more
Internal Medicine Flashcard
Dropped fingers
A woman in her 60s presented with a one year history of a slowly-growing painful mass at the dorsal right wrist and sudden inability to actively lift her ring and little fingers without any trauma.... more
Constrictive pericarditis and tuberculosis: A second look
A 42-year-old man presented with cough and nocturnal sweats since 3 weeks. He was being treated for pulmonary and lymph node tuberculosis (TB) since 5 months, and had improved both clinically and... more
Progressive skin thickening in a young adult
A 22-year-old man was referred to the dermatology service for the appearance of thickening of the skin, predominantly on the hands, feet and face, accentuation of the folds of the forehead and... more
Invited Review Article
Lipoprotein (a): A new target for pharmacological research and an option for treatment
Lipoprotein(a) [Lp(a)] is increasingly recognised as a crucial and independent risk factor for atherosclerotic cardiovascular disease (ASCVD), calcific aortic valve stenosis (AVS), and possibly heart... more
Letter to the Editor
In ageing research the slope matters
We appreciate the thoughtful commentaries by Ye & Huang and Incalzi & Pedone regarding our study on relative survival in intensive care unit (ICU) patients aged 90 years and over [1–3].
Drug-induced hyponatremia in clinical care. Authors' reply
We extend our sincere gratitude to Ben Salem et al. for their letter commenting on the review “Drug-induced hyponatremia in clinical care” recently published [1,2].
Are ACE2 rs2285666 and TMPRSS2 rs12329760 polymorphisms a risk factor for the development of Post-COVID-19 condition?
Evidence on viral mechanisms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the agent causing the coronavirus disease, 2019 (COVID-19), suggests the involvement of several receptors... more
Drug-induced hyponatremia in clinical care
In their excellent literature review, Mannheimer B et al. do not include several drugs that may induce hyponatremia [1]. Various dopaminergic agents are associated with hyponatremia.
Hyponatremia and mortality: Marker of disease or modifiable risk? Rethinking causality in large-scale observational research. Authors’ reply
We would like to thank Xia et al. for their thorough evaluation of our recent work based on the Stockholm Sodium Cohort (SSC) [1,2], in which they raise several concerns, some of which are inherent... more
Disabling hearing loss in ischemic stroke: Prevalence, predictors, and prognostic implications
Growing evidence suggests that hearing loss may be an overlooked risk factor and consequence of ischemic stroke [1]. Several large-scale cohort analyses indicate that individuals with hearing loss... more
Hyponatremia and mortality: Marker of disease or modifiable risk? Rethinking causality in large-scale observational research
We read with great interest the article by Mannheimer et al. investigating mortality and causes of death in patients hospitalized with hyponatremia using a large propensity-matched cohort from the... more
Prognostic impact of bone scintigraphy in elderly patients with hypertrophic cardiomyopathy
Hypertrophic cardiomyopathy (HCM) is a heterogeneous condition that may result from sarcomeric mutations or infiltrative disorders such as transthyretin amyloid cardiomyopathy (ATTR-CM) [1].... more
Prevalence, awareness, and control of cardiovascular risk factors among specialists in cardiovascular field: A survey
Dear Editor,
Short term variability of peripheral blood eosinophil count in individuals with stable COPD
Chronic obstructive pulmonary disease (COPD) is typically considered a neutrophil-driven inflammatory disease [1], but some individuals, particularly those with frequent exacerbations, show... more
Cardiovascular safety and efficacy of intensive blood pressure control: how low should we go?
Dear Editor,
Excess risk or misestimated baseline? Reconsidering relative survival in the oldest ICU patients
We commend Weller et al. for their important and timely contribution, which provides a rigorous and impressively sized analysis of 1076 ICU patients aged 90 years and older, using relative survival... more
Original Article
Blood pressure values in healthy normal weight children and adolescents in eight European countries: auscultatory and oscillometric measurements
The importance of high blood pressure (BP) as a modifiable risk factor for early disability and death is well established [1]. Although the majority of adverse outcomes occur in adulthood, high BP is... more
Long-term quality of life after sleeve gastrectomy vs Roux-en-Y Gastric Bypass in patients with severe obesity: Results from the SleeveBypass multicentre randomised controlled trial
Obesity is a chronic condition and a worldwide problem that poses health risks, reduces quality of life (QoL), contributes to psychosocial issues and increases public healthcare costs [1]. While,... more
Efficacy and safety of once-daily oral semaglutide in patients with heart failure with preserved ejection fraction, type 2 diabetes and obesity: a real-world study
Heart failure with preserved ejection fraction (HFpEF) is a complex and multifactorial heart disease. It has become the most common type of heart failure (HF), which can be explained in part by its... more
Identification of risk factors for permanent visual loss in patients with giant cell arteritis
Giant cell arteritis (GCA) is the most common systemic vasculitis affecting older people in Western countries, being more prevalent in females [1–4]. Vascular inflammation predominantly affects the... more
Current epidemiology, risk factors and influence on prognosis of multidrug resistance in Klebsiella spp. bloodstream infection. Insights from a prospective cohort
Klebsiella spp. are the third most common cause of bloodstream infections, only after Escherichia coli and Staphylococcus aureus, both in the community and nosocomial infections [1]. Usually arising... more
Systemic markers of inflammation and immune activation in patients with obstructive sleep apnea and paroxysmal atrial fibrillation
Sleep apnea and AF are both associated with adverse cardiovascular outcomes [1,2]. Obstructive sleep apnea (OSA) is more prevalent in patients with atrial fibrillation (AF) than in patients with... more
The approach to triglyceride levels in patients with coronary heart disease
Hypercholesterolemia is one of the major modifiable cardiovascular risk factors, while current guidelines mark the low-density lipoprotein cholesterol (LDL-C) levels as the primary target of... more
Hypochloremia in chronic and acute heart failure scenarios: Prevalence and risk factors
Traditionally, sodium and potassium disorders have been considered the most relevant ionic disturbances in heart failure (HF)., [1] However, in recent years, hypochloremia has emerged as a critical... more
Latent class analysis identifies novel coeliac disease subgroups with distinctive clinical features: a multicentric study
Coeliac disease (CD) is a chronic, lifelong, immune-mediated disorder causing villous atrophy in genetically susceptible individuals upon the ingestion of gluten in the diet [1,2]. It has been... more
The effects of sleep improving interventions in medical hospital wards: the WEsleep study - A randomized clinical trial
Multiple studies indicate that sleep in hospitals is suboptimal.1,2 Disturbed and inadequate sleep occurs in 48 to 77 % of hospitalized patients.3,4 Sleep-disturbing factors in hospitals include... more
Review Article
The climate crisis in clinical practice: Addressing air pollution, heat, and microplastics
The climate crisis has evolved from a future threat into a present-day health emergency. Rising global temperatures, worsening air pollution, and frequent extreme weather events, all driven by... more
Impact of micro- and nanoplastics on gastrointestinal diseases: Recent advances
Plastics are light, durable, low-cost daily necessities used in packaging, medical treatment, electronics, and transportation [1]. Global plastic production has increased from less than two megatons... more