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The latest updates on the COVID-19 pandemic from the European Medicines Agency (EMA) are available, see preferred links.

MESSAGE FROM THE PRESIDENT

29 April 2021

Although the situation of Covid 19 pandemic is now improving in most European countries, the FDIME will not stop its efforts in providing information on this disease to the public. Our next Newsletters will focus on explaining why vaccination is a fundamental weapon against the virus. They will also contain updated data permitting to evaluate the benefit- risk ratio of different types of vaccines and anti-viral treatments.

In this context the goal of FDIME is to help the public by giving unbiased, objective and easy to understand information from international experts.
I wish to express my gratitude to the panel of European internists for their dedication to write our monthly Newsletters.

Prof Daniel Sereni

Did you know? (what are internists and what are they actually doing)

  • Internists are experts in diagnosing, treating and caring for adult patients.
  • They often serve as medical consultants to physicians in other specialties.
  • In some countries internists may specialize in general primary care of adults (for instance in Switzerland); they can also take additional training and “subspecialize” in such areas as endocrinology, hematology/oncology, immunology. Cardiology, pulmonology, gastroenterology and reumatology ususally are independent subspecialties.
  • What is internal medicine? (European definition):
    The specialty of internal medicine covers a wide range of conditions affecting the internal organs of the body. Although some diseases specifically affect individual organs, the majority of common diseases may affect many internal organs of the body. The internist must then be trained to recognise and manage a broad range of diseases and, with the aging population, many patients with chronic and multiple disorders.

Dance of the porcupines:

A view into the rapid development of covid-19 vaccines
from around the world

Missing diagnoses during the Covid-19 pandemic:
a year in review

Hector Pifarré i Arolas, Josep Vidal-Alaball, Joan Gil et al. Evidence that the Covid-19 pandemic has disrupted regular health care service considerably. This is an important problem that may be seen as a fourth wave.
See link: https://www.mdpi.com/1660-4601/18/10/5335#

Abstracts FDIME Grant winners

Moulis (France, 2017): The prevalence of thrombocytopenia (too few platelets) and thrombocytosis (too many platelets) and the association with hospital admission and mortality.

Platelets are involved in clot formation. However, they have multiple effects. Notably, they are involved in immune system regulation, participating in the control of infections, and may complicate auto-immune diseases and cancers. Abnormal platelet count (thrombocytopenia and thrombocytosis) reflect disease severity in many condition and therefore can be used as a biomarker of disease severity in patients acutely admitted to hospital for medical conditions.

Arvaniti (Greece, 2018): Epigenetics (changes in genes expression) in autoimmune liver diseases (ALDs)

In our research we studied complex chemical processes and genetic (DNA) changes in blood cells (B and T lymphocytes) in patients with autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC). A relationship between changes in these chemical processes with disease activity was found, probably explaining part of the pathogenesis of the diseases and opening new ways for treatment strategies.

Lanzillotta (Italy, 2020): Towards treatment optimization in autoimmune pancreatitis (AIP).

Autoimmune pancreatitis (AIP) is a rare form of inflammation of the pancreas. It carries a higher risk for metabolic and infectious complications, related to glycaemic derangements and biliary strictures or immunosuppressive treatment, respectively. Moreover, AIP is prone to relapse, requiring multiple courses of glucocorticoids that might exacerbate diabetes. Yet, to date there are only scant data on predictors of disease relapse, while data related to risk factors for long-term metabolic and infectious complications are absent.

My project aims at retrospectively identifying baseline disease-related or treatment-related features that are related to long-term outcomes (in terms of disease activity and infectious and metabolic complications). Once recognized, these putative predictors will be tested and employed in a prospective fashion, and ultimately will provide a huge step forward to a more tailored treatment approach.

FDIME Research Grant Award 2019 ECIM 2021
(March 19, 2021)

During the virtual ECIM 2021 the recipient of the FDIME Research Grant 2019 has presented his achievements.

After a short introduction on the aims and activities of FDIME Daniel Sereni, (FDIME President) announced the 2019 winner Francois Rodrigues, resident internal medicine in Paris, who wanted to spend time in Leeds at the Institute of Rheumatic and Musculoskeletal Research to build a collaboration between two institutes. The period of investigations was intended to be from January up to October 2020.

The research is about a rare familial inflammatory disease. The aim of the project is to better understand the way inflammatory cells are stimulated ; this could lead to the finding of therapeutic targets.

Below you can read more details for doctors and scientists and of course also for other interested readers.

The initial project was on courier transfer of blood samples of patients with TNF receptor associated periodic syndrome (TRAPS). He learned several laboratory techniques, but before the first patient arrived both laboratories in Paris and Leeds were close because of Covid 19. He resumed his work in September 2020 with a new project: Multiple cell isolation (neutrophils, B cells, T cells, monocytes) from whole blood of patients with UBA1 mutations, RNA sequence compared with Sanger sequencing somatic mutation with different impacts according to cell lines using FACS. And then again the FACS facilities were closed. In between some more techniques were learned. The question was: Is metabolism different between white type HEK cells and HEK cells transfected with TRAPS variants? This has not yet been confirmed now, but the collaboration between the Paris and Leeds institutes will be resumed at due time.

FDIME Research Grant Award Ceremony

FDIME Research Grant
Award Ceremony

FDIME Best Research Abstracts Awards ECIM 2021 (March 20, 2021)

During the virtual ECIM 2021 three abstracts were awarded as FDIME best research abstracts. A jury consisting of Jan Willem Elte (FDIME Secretary General), Ramon Pujol (FDIME Vice President), Nicola Montana (Past EFIM President and FDIME Board member) and Runolfur Palsson (Past-past EFIM President and FDIME Board member) made the definitive selection.

The following three abstracts received the awards:

  1. 76 IMPAIRED HOST ANTIVIRAL TH1 AND CD8 RESPONSE IN HIGHLY INFLAMMATORY SARS-COV-2 PATIENTS
    Dr Janine Rupp from Austria
    The T cell composition, activation and proliferation in patients with severe (n=8) or critical (n=12) Covid 19 and matched healthy controls ( 2 per Covid patient) were assessed.
    Beside lymphopenia several abnormal Th cell patterns were identified and also CD4+ and CD8+ cells amongst others differed from healthy controls suggesting active anti-viral T cell defense.
    Conclusion: the data suggest that SARS-CoV-2 induced CRS ( cytokine release syndrome) may impair viral clearance by blunting the antiviral T-cell response.
  2. 115 EFFICACY OF CDSS IN IMPROVING ANTI-RESORPTIVE BONE PROTECTIVE THERAPY AMONGST ORTHOGERIATRIC INPATIENTS: A COMPARISON STUDY
    Dr Lata Bhandary from Ireland
    Subject of the study was to compare the proportion of patients commenced on ABPT ( anti-resorptive bone protective therapy) following the introduction of a clinical decision support system (CDDS) to support appropriate ABPT prescribimg by non-specialists.
    An orthogeriatric patient cohort before (2019) and after (2020) was studied. In 2019 31 % (55/178) did not receive orthogeriatric specialist input and only 27 % (15 of 55) had ABPT. In 2020 17 % (32/185) did not receive specialist input, however, 44 % (14/32) were commenced on ABPT.
    Overall more patients were prescribed ABPT in 2020 (78 %) than in 2019 (55 %).
    Conclusion: a CDDS improves ABPT prescribing and may reduce specialist appointments, long-term mortality and future health costs.
  3. 1072 GLUTEN-SPECIFIC CD4+ T CELLS EXPRESS A DISTINCT SET OF MARKERS AFTER GLUTEN CHALLENGE THAT CORRELATE WELL ON THE TRANSCRIPTOMIC AND PHENOTYPIC LEVEL
    Dr Stephanie Zühlke from Norway
    After a 3-day gluten challenge in CeD (Coeliac Disease) blood was sampled after 6 days. A clear increase in gut-homing gluten-specific effector-memory (CD4) T cells were observed in all 6 patients. Transcriptome analysis revealed 94 DE genes coding for cell surface markers, phenotypically similar with gluten-specific T-cells. So the gluten-specific cells from blood after gluten challenge may serve as an alternative outcome measure in clinical drug trials.
    In short: gluten-specific CD4+ T cells express a distinct set of markers after gluten challenge.
LIVE Awards Ceremony

FDIME Awards Ceremony

Bursaries & Grants Available in 2020-2021

EUROPEAN SCHOOL OF INTERNAL MEDICINE (ESIM)

Björkliden, Sweden, 14 – 18 February 2022

http://www.esim2022.org

FDIME offers Bursaries to support Young Internists from low-income EFIM member countries to attend the next ESIM, hosted by the Swedish Society of Internal Medicine.
Arrival: Sunday 13 February 2022.
Departure: Saturday 19 February 2022.
Course dates: Monday 14th February (09.00 hr) to Friday 18th February 2022 (16.45 hr).
Venue: Hotel Fjället, Bjorkiden, Sweden.
Airport: Stockholm.
Bursary Application closing date: 15.12.2021.
For further details, download:
ESIM Bursary Information & Requirements
ESIM Bursary Application Form Summer 2020

FDIME-EFIM 16th CLINICAL RESEARCH SEMINAR

Paris, 25 – 27 October 2021

Young Internists from EFIM member countries who are interested to upgrade their existing clinical research skills may apply for a place at the Clinical Research Seminar.

FDIME will provide funding for economy-rate travel and 3 nights hotel stay in Paris for 15 selected candidates.

Upload your current CV with your online application. Closing date 15.08.2021
For further details, download:
CRS Announcement
CRS Schedule
CRS Application form
Or contact the FDIME Administrator email contact@fdime.org

FDIME RESEARCH GRANTS IN 2021

The Foundation for the Development of Internal Medicine in Europe (FDIME) is offering Research Grants to Young Internists (up to age 38 yrs) to study in.

Research projects including all fields of General Internal Medicine, particularly polymorbidity and other common I.M. conditions.

For further details, download:
Internal Medicine Grant Announcement
Internal Medicine Grant Application Form – closing date 15th July 2021

For further information:
Contact the FDIME Administrator email: contact@fdime.org

EUROPEAN SCHOOL OF INTERNAL MEDICINE (ESIM)

El Escorial, Madrid, Spain, Postponed

http://www.esim2020.org

FDIME offers Bursaries to support Young Internists from low-income EFIM member countries to attend the next ESIM, hosted by the Spanish Society of Internal Medicine.
Arrival: Sunday 14 June 2020.
Departure: Saturday 20 June 2020.
Course dates: Monday 15 June (09.00 hr) to Friday 19 June 2020 (17.30 hr).
Venue: Real Centro Universitario, El Escorial-María Cristina, El Escorial, Madrid, Spain.
Airport: Barajas Madrid.
Bursary Application closing date: 31.03.2020.
For further details, download:
ESIM Bursary Information & Requirements
ESIM Bursary Application Form Summer 2020