November 2025
38 ArticlesNo Section
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
Clinical Insights
New perspectives on heart-brain interactions: Is it time to classify cardio-neurological syndromes?
The interplay between heart and brain is bi-directional, complex and profound. Each system influences the other in health as well as in disease, when dysfunction in one organ has broad and as yet... more
Commentary
Post-extubation high-flow nasal cannula (HFNC) therapy with a ROX index-based strategy: A real step forward in weaning?
Extubation, along with the entire process of weaning from invasive mechanical ventilation (IMV), represents a key phase in the management of the critically ill patient, as it significantly impacts... more
Navigating the pitfalls of pulmonary function testing in chronic lung allograft dysfunction and chronic pulmonary graft-versus-host disease
Chronic lung allograft dysfunction (CLAD) and pulmonary chronic graft-versus-host disease (Pc-GVHD) represent the major late non-infectious pulmonary complications following lung and allogeneic... more
Molecular echoes of CPAP: Tracking hypoxia-sensitive non-coding RNAs in obstructive sleep apnea
Obstructive sleep apnea (OSA) is a common and increasingly recognized disorder with complex systemic implications [1]. Beyond intermittent hypoxia and sleep fragmentation, OSA has been linked to... more
Standard acute myocardial infarction without standard modifiable risk factors
The identification of risk factors for cardiovascular diseases (CVD) using longitudinal cohort studies has been a major advance in medicine during the second half of the past century and, stimulating... more
Editorial
Point-of-care ultrasonography (POCUS): a substantial help for the internists with some caveats
Prior to the introduction of the point-of-care-ultrasonography (POCUS) in clinical practice, internists relied on the stethoscope and physical examination to guide patient management. Largely used by... more
Internal Medicine Flashcard
A man with fever, retinal artery occlusion, atrioventricular block and bilateral renal masses
A 61-year-old man with a history of recurrent otitis and recent evaluation for submandibular salivary gland enlargement presented with sudden vision loss in the left eye. He also reported fever and... more
Progressive nodules in bilateral lower extremities
A 58-year-old female patient presented with asymptomatic nodules that had been on her lower legs for 10 years. The nodules appeared spontaneously without any discernible cause and progressively... more
Recurrent bilateral infrapatellar subcutaneous nodules: what is the diagnosis?
A 32-year-old Hispanic man presented with a one-month history of bilateral infrapatellar tender erythematous subcutaneous nodules (Fig. 1, a and b), accompanied by dysesthesias in the same area and... more
Letter to the Editor
Not all immunosuppression is equal: Implications for post-discharge outcomes in community-acquired pneumonia − Authors’ reply
Dear Editor,
Annual chest computed tomography in multimorbid COPD: is universal screening clinically feasible?
Dear Editor,
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,
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
Cardiac outcomes in hypertrophic cardiomyopathy treated with beta-blockers or verapamil
In hypertrophic cardiomyopathy (HCM), beta-blockers (BBs) and non-dihydropyridine calcium channel blockers (particularly verapamil) are both used to manage symptoms such as dyspnea, chest pain, and... more
Effect of resmetirom on lipid profile and adiponectin levels
Resmetirom, a novel liver-targeted selective thyroid hormone receptor-beta (THR-β) agonist, has shown positive effects for the treatment of dyslipidemia and other metabolic disorders, including non-... more
Doctor on board: Ethical, legal, and practical reflections on responding to in-flight medical emergencies
To the Editor,
Mapping the clinical trial landscape of gut microbiota modulation in neurodegenerative diseases
Neurodegenerative diseases, such as Alzheimer's disease (AD), Parkinson's disease (PD), and multiple sclerosis (MS), are increasingly recognized as major contributors to the global burden of disease... more
Association of serum potassium time in target range with all-cause and cardiovascular mortality in HFrEF patients
Dyskalemia is relatively common in heart failure with reduced ejection fraction (HFrEF). Both hypokalemia and hyperkalemia exhibit U-shaped associations with adverse outcomes in HFrEF, including... more
Extended anticoagulation therapy on clinical outcomes in patients with gastrointestinal cancer and isolated distal deep vein thrombosis: Insights from the ONCO DVT Study
The current guidelines have recommended prolonged anticoagulation therapy with direct oral anticoagulants (DOACs) as a potential treatment option for patients with cancer-associated venous... more
Cancer treatment-associated hypomagnesemia: Analysis from a large pharmacovigilance database
Hypomagnesemia is common among patients with cancer, and can lead to increased morbidity and mortality as well as discontinuation of potentially life-saving treatments. Hypomagnesemia may occur due... more
Substantial variety in point of care ultrasound training across EFIM
Dear Editor,
Original Article
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
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
Deterioration of renal function is delayed in patients with atrial fibrillation treated with direct oral anticoagulants compared to vitamin K antagonists: systematic review and meta-analysis
The use of anticoagulants has been linked to anticoagulant-related nephropathy (ARN), a condition initially reported in patients treated with warfarin [1]. However, cases have also been documented in... more
Point of care ultrasound (POCUS) applications in the ambulatory internal medicine setting: A scoping review
Point of care ultrasound (POCUS) is an increasingly recognized tool in internal medicine, with evidence supporting its use largely derived in the inpatient setting. We endeavored to provide an... more
Modulation of hypoxia-sensitive non-coding RNAs following continuous positive airway pressure therapy in obstructive sleep apnea in peripheral blood
Obstructive sleep apnea (OSA) is a chronic clinical condition characterized by recurrent apnea or hypopnea during sleep, leading to intermittent hypoxemia, arousal, and sleep fragmentation. OSA... more
Incidence and prevalence of systemic lupus erythematosus across Italian referral centers and its clinical burden in terms of disease severity, treatment and hospitalization: The ESCULAPIO study
Systemic Lupus Erythematosus (SLE) is a multifaceted systemic autoimmune disorder distinguished by a diverse array of clinical manifestations that can potentially impact any organ or system in the... more
Survival effect of early high-flow nasal oxygen after the extubation of patients in the intensive care unit
Spontaneous awakening trial (SAT) and spontaneous breathing trial (SBT) protocols for mechanically ventilated patients in the intensive care unit (ICU) have been shown to reduce the duration of... more
Review Article
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
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
Effect of sodium-glucose cotransporter-2 inhibitors on skeletal muscle
Sodium-Glucose Cotransporter-2 inhibitors (SGLT2i) are increasingly prescribed for diabetic and nondiabetic patients with and without heart failure (HF) or renal insufficiency [1]. SGLT2i reduce... more
Point of care ultrasound: focus on evidence for a critical appraisal
The term point of care ultrasound (POCUS) refers to a sonographic examination directly performed at the patient’s bedside, ideally by the treating physician, to interpret and integrate images into... more