October 2026
Beyond the Guidelines
Sex and gender in the era of personalized medicine: beyond one-size-fits-all
Medicine has traditionally relied on standardized diagnostic and therapeutic protocols perceived as universal and neutral. However, this presumed neutrality reflects a structural bias in the... more
Clinical Insights
Carbapenem-resistant Acinetobacter baumannii pneumonia: Treatment challenges
Carbapenem-resistant Acinetobacter baumannii (A. baumannii) (CRAB) is a cause of ventilator-associated pneumonia (VAP) that can be devastating. Suggested approaches are based on literature review,... more
Commentary
Breaking LDL-cholesterol inertia after myocardial infarction: from discharge prescription to closed-loop care
Acute myocardial infarction is both an emergency and the beginning of a prolonged period of exceptionally high recurrent cardiovascular risk. Few components of secondary prevention are supported by... more
A step toward precision screening for occult cancer after venous thromboembolism
Venous thromboembolism (VTE) has long been recognized as one of the earliest clinical manifestations of an underlying malignancy. More than 160 years after Trousseau first recognized the association... more
Subclinical atrial fibrillation in patients treated with Bruton’s tyrosine kinase inhibitors: ‘Much ado about nothing or phantom menace’
Bruton's tyrosine kinase inhibitors (BTKis) have reshaped the therapeutic landscape of B cell malignancies, significantly improving survival outcomes [1]. However, cardiovascular side effects,... more
Hyperuricemia and prevention of cardiometabolic disease: Unexplored is not unexpected
For decades, the management of hyperuricemia has been largely driven by the occurrence of gout. Outside the context of crystal-induced disease, asymptomatic hyperuricemia has traditionally been... more
Ideas and Opinions
Why rare uninformative findings appear highly specific
Sensitivity and specificity remain the dominant metrics for evaluating diagnostic tests in clinical epidemiology, and the Spin and Snout mnemonic—“specific findings rule disease in, sensitive... more
Internal Medicine Flashcard
A Woman with Progressive Skin Ulceration
A 62-year-old woman with heavy alcohol use developed difficulty walking and reduced oral intake over two weeks, followed by altered consciousness, disorientation, hallucinations, and watery diarrhea... more
Chronic hyperkeratotic and pustular cutaneous lesions of the hand
A 49-year-old Algerian woman, was referred for evaluation of cutaneous lesions evolving for four years suggestive of chronic infection. His medical history was relevant for diabetes mellitus... more
Letter to the Editor
Reconsidering the interpretation of prescribing shifts and treatment response in the AMBI-RA study. Authors’ reply
We read with great interest the letter by Huang M. et al. [1] on the AMBI-RA study by our group [2], and we are grateful for their comments which permit to better elucidate the significance of our... more
First UK report of Imlifidase-enabled deceased donor kidney transplantation in highly sensitised recipients
Dear Editor
Revisiting the link between left atrial enlargement and cerebrovascular events: The need for a multiparametric approach
Dear Editor,
Reflections on left atrial enlargement. Authors’ reply
Dear Editor,
From biological discovery to clinical translation: depot-specific adipose tissue miRNA profiling in gastrointestinal cancer
Dear Editor
Left atrial enlargement without atrial fibrillation: a warning signal rather than a treatment target
Dear Editor,
Does T90 reflect OSA-specific hypoxic burden or underlying pulmonary disease? Author's reply
Dear Editor,
Twelve-year trends in sex and age of patients with COPD and chronic respiratory failure undergoing pulmonary rehabilitation
Dear Editor,
Does T90 reflect OSA-specific hypoxic burden or underlying pulmonary disease?
To the Editor,
Reconsidering the interpretation of prescribing shifts and treatment response in the AMBI-RA study
We read with great interest the AMBI-RA study by Bertola et al. [1], which examined changes in b/tsDMARD prescribing and short-term treatment outcomes after regulatory restrictions on Janus kinase... more
Paroxysmal atrial fibrillation and bleeding: Pattern, prescription, or both? A call for aspirin-informed analyses in COMBINE-AF
Ntaios and colleagues report an exceptional individual patient-level analysis from COMBINE-AF (n = 71,466), providing unusually precise estimates of outcome gradients between paroxysmal atrial... more
Rethinking renal protection in patients with heart failure and reduced ejection fraction
We read with great interest the review titled “Renal protection in heart failure with reduced ejection fraction: not all that glitters is gold” by Elisa Russo and colleagues, published in your... more
Dialysis, but not severe renal dysfunction, is associated with excess bleeding in venous thromboembolism: Insights from a nationwide registry
Venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE), is a common and potentially fatal complication in patients with chronic kidney disease (CKD), including... more
Clinical applicability considerations for depot-specific miRNA profiling in gastrointestinal cancer
Dear Editor,
Serological and clinical features in patients with anti‐centromere antibody positivity
Dear Editor,
Refining cerebrovascular risk in left atrial enlargement: integrating CKM framework and atrial cardiomyopathy phenotyping
We read with great interest the article “Left atrial enlargement and 1-year cerebrovascular events in subjects without atrial fibrillation: A prospective cohort study” by Clerici et al. [1]. The... more
SGLT2 inhibitors for acute heart failure: Efficacy established, but for whom and when?
Dear editor,
Beyond survival: nuances in the robustness of SGLT2 inhibitor evidence for HFpEF
We read with great interest the article by Zuin et al., which provides a rigorous evaluation of the robustness of randomized controlled trial (RCT) evidence for sodium-glucose co-transporter 2... more
From structure to function: A commentary on left atrial enlargement and cerebrovascular events and the potential value of left atrial strain
I read with great interest the article by Clerici and colleagues titled "Left atrial enlargement and 1-year cerebrovascular events in subjects without atrial fibrillation: A prospective cohort study... more
Original Article
Long-term mortality in patients admitted acutely for chronic liver disease in England: A national cohort study
Mortality of CLD patients after a FEA in England is exceptionally high, with marked differences according to sociodemographic characteristics, aetiology, disease severity, and geographic region.... more
Unlocking the benefits of allopurinol: the role of timely initiation and adherence in cardiovascular and renal outcomes in hyperuricemia
Hyperuricemia (HU) is a prevalent chronic metabolic condition characterized by elevated serum uric acid (SUA) levels [1]. The accumulation of monosodium urate crystals in joint and extra-articular... more
Diagnostic and therapeutic inertia for LDL cholesterol management of consecutively verified patients with acute myocardial infarction
The effective management of low-density lipoprotein cholesterol (LDL-C) after acute myocardial infarction (AMI) is a cornerstone of secondary prevention in contemporary cardiovascular care [1–5].... more
Asymptomatic atrial fibrillation in patients treated with BTK inhibitors in hematologic malignancies: a systematic review and metanalysis
Atrial fibrillation (AF) is a frequent complication of Bruton’s tyrosine kinase inhibitor (BTKi) therapy, yet the proportion of asymptomatic AF events in this setting remains poorly defined.
Development and external validation of an international score to predict cancer 1 year after venous thromboembolism
Routine cancer screening is not recommended after venous thromboembolism (VTE), but improved risk stratification may support tailored strategies.
Epicardial fat enhances prediction of exercise-induced hypertension and ventricular arrhythmias in asymptomatic normotensive individuals
Exercise stress testing is commonly used to evaluate the cardiovascular response to exercise and to identify coronary artery abnormalities and arrhythmias. The normal physiological response to... more
Discharge medical treatment implementation and predictors of a successful decongestion in patients with acute heart failure: first data from the BRING-UP 3 Heart Failure Study
Current discharge management of acute heart failure patients and clinical predictors of successful decongestion in a large Italian network of cardiology sites.AF, atrial fibrillation; BMI, body mass... more
Infectious complications of ANCA-associated vasculitis: Description and associated outcome
ANCA-associated vasculitis (AAV) are a systemic autoimmune disease that primarily affect small vessels, according to the Chapel Hill classification [1] and cause necrotizing vasculitis and result... more
Hypertension and blood pressure profiles in patients with acute intermittent porphyria: a prospective case-control study
Acute intermittent porphyria (AIP), a rare disorder of heme biosynthesis, may manifest with neurovisceral crises affecting autonomic regulation. This study aimed to assess blood pressure (BP) pattern... more
Practice Guidelines
Identification and management of sarcopenia in patients with multimorbidity: An EFIM critically appraised and adapted guideline
Sarcopenia is highly prevalent among adults with multimorbidity and contributes substantially to frailty, disability, prolonged hospitalization, and mortality. International guidelines offer robust... more
Review Article
Testosterone therapy in chronic kidney disease patients: an underutilized resource
Testosterone deficiency is highly prevalent in men with chronic kidney disease (CKD), affecting 30–70% of patients depending on disease stage and diagnostic criteria. Despite its frequency and... more
Retinal microcirculation as a window to coronary artery disease
Coronary artery disease includes obstructive epicardial stenosis and ischemia with non-obstructive coronary arteries driven by microvascular dysfunction. Population screening is limited by the... more
Healthcare sustainability and the planetary crisis: A solution orientation
The climate crisis is an escalating public health emergency that demands urgent, systemic action from the healthcare sector. This article presents a solution-oriented framework for integrating... more
Linking the exposome to frailty: pathways, mechanisms, clinical implications, and prevention
Frailty is a state of heightened vulnerability arising from multisystem decline, in which minor stressors can precipitate disproportionate deterioration in function and health. It predicts falls,... more