May 9, 2025
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A way to motivate older persons to exercise

Jan Willem Elte, The Netherlands Physical exercise is often recommended to older persons but it is not always easy to motivate them. A recent randomized clinical trial (in JAMA) investigated whether older persons who talked with peers about their exercise program (interpersonal strategy) were able to increase and sustain physical activity levels better than those who focused on self-motivation by setting fitness goals (intrapersonal strategy). Low physical activity among older adults is linked with disability, increased weight, difficulty in managing chronic conditions, increased falls and related injuries. Exercise may help. Yet fewer than 16 % of older adults meet the recommended guidelines (150 minutes of moderate aerobic activity and two muscle-strenghtening sessions per week). More than 300 participants aged 70 years and older who did not meet physical activity guidelines were given a wearable fitness tracker and an exercise program and randomly divided in four groups: One using intrapersonal behavior change strategies Another using interpersonal strategies A group combining both intra- and interpersonal strategies A control group that received neither intervention For eight weeks, all participants exercised in meetups and discussed their progress in their groups, afterwards they were left on their own devices and monitored for the remainder of […]
March 21, 2025
Daniel Sereni receives his EFIM 2025 Life Achievement Award in Clinical Medicine

FDIME activities during ECIM 2025, March 5 – 8 in Florence

FDIME activities during ECIM 2025, March 5 – 8 in Florence During the European Congress of Internal Medicine (ECIM) in Florence the Foundation for the development of Internal Medicine in Europe (FDIME) was involved in a variety of activities. Already during the opening session there was a remarkable and joyful event: Prof Daniel Sereni, President of the FDIME received the EFIM 2025 Life Achievement Award in Clinical Medicine. A very honorful, prestigious and only once yearly reached out award. And this is well deserved! Daniel Sereni receives his EFIM 2025 Life Achievement Award in Clinical Medicine All FDIME Board members present (Daniel Sereni, Runolfur Palsson, Lorenzo Dagna, Chris Davidson, Nica Cappellini and Jan Willem Elte) gave presentations and/or acted as chairpersons of sessions or were members of a jury. Ramon Pujol was present during the EFIM-FDIME and the award sessions through Zoom. Ricardo Gomez Huelgas became a FDIME Board member during the annual GA/Board meeting. Before the congress most FDIME Board members looked at and rated numerous abstracts. For the fourth time there was a combined FDIME/EFIM patient session on Friday March 6, mainly organized by members of the FDIME Management Team and chaired by Daniel Sereni and Ricardo Gomez […]
March 20, 2025
Systemic Lupus Erythematosus (SLE)

Systemic Lupus Erythematosus (SLE)

From: Salud (About Health) PABLO PÉREZ MARTÍNEZ, JOSÉ MANUEL RAMOS RINCÓN, ANA MAESTRE PEIRÓ Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease, which is characterized by a dysregulation of the immune system. It results in  loss of tolerance to one’s own antigens, so that the body recognizes them wrongly as foreign, producing an attack on the different organs and tissues by antibodies (autoantibodies). Prevalence rates generally range from 20 to 70 cases per 100,000 people, with more frequent prevalence in young women between 20 and 40 years of age. Its origin is unknown, but it is believed that there is an interrelationship between genetic and environmental factors. Genetically, an association has been found with certain HLAs such as B8, DR3, DQW2, C4AQ0. In addition to genetic factors, environmental factors such as infections (Epstein-Barr virus) or exposure to xenobiotics (UV light or tobacco) appear to be related to the development of the disease. These genetic and environmental factors will culminate in the production of autoantibodies and immune complexes. The main autoantibodies present in SLE are antinuclear antibodies (ANA), a marker that identifies patients at risk of developing or having this disease, as well as others such as anti-DNA or […]
December 19, 2024
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Life’s essentials 8

Recently the AHA (American Heart Association) reported a study on the Life’s Essential 8 (LE 8) and its association with both life expectancy and health span free of chronic diseases such as cardiovascular disease (cvd), cancer, diabetes and dementia. Ths study was performed in the UK and included more than 135,000 adults with a mean age of 55. The study was published in JAMA Internal Medicine (Wang et al. JAMA Intern Med. 2023;183(4):340-349. doi:10.1001/jamainternmed.2023.0015) and summarized in Medscape. The AHA Essential Life’s Essential 8 score includes: Not smoking; Regular physical activity; Healthy weight; Healthy diet; Healthy sleep (defined as an average of 7-9 hours nightly); Blood pressure in a healthy range; Blood glucose in a healthy range; and LDL (bad) cholesterol in a healthy range. In a large cohort study of 135199 adults from the UK Biobank researchers investigated the association of cardiovascular (cv) health levels (as estimated by  the AHA Essential Life’s Essential 8 score) with life expectancy free of major disease. The study population was divided into three groups: those with low, moderate and high LE 8 scores, indicating low, moderate and high cv health. The average life expectancy free of chronic disease was estimated (at age 50) to […]
November 7, 2024
Osteoporosis

Osteoporosis

From: Salud (About Health) PABLO PÉREZ MARTÍNEZ, JOSÉ MANUEL RAMOS RINCÓN, ANA MAESTRE PEIRÓ Osteoporosis is a disease that affects the bones, making them more fragile, so that they break  more easily and are less resistant to blows. It is estimated that osteoporosis affects 5.6% of the total European population aged over 50 years (22.1% of women and 6.6% of men). The number of new fragility fractures in Europe was estimated at 4.3 million per year. Osteoporosis does not manifest itself with any symptoms until fractures appear. Most people find out they have osteoporosis after they break a bone. The bones that are most often fractured are the vertebrae, hip, and wrist. Fractures can lead to chronic pain, disability, or even death, occasionally. Osteoporosis is diagnosed by quantifying bone mineral density that can be measured with densitometry, making it possible to predict the risk of fracture in patients without any broken bones. Established osteoporosis is defined as the presence of one or more fragility fractures (spontaneous, without a previous direct blow). Some risk factors for osteoporosis are older age, menopause, a family history of hip fracture, or having had a previous fracture from a minor blow, especially after the age […]
September 17, 2024
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Reduction of dietary sodium is as beneficial as starting a first line antihypertensive agent

Jan Willem Elte, The Netherlands Recently published results of a prospective crossover trial show that a low-salt diet for just a week provided a reduction in systolic blood pressure of about 6 mm as compared with those with a normal diet (daily intake approximately 4.5 gr) and 8 mm versus the group with high-sodium diet. The trial involved 213 individuals, aged 50 – 75 years, with or without hypertension. A high-sodium regimen (approximately 2200 mg sodium added to usual diet) was compared with a low-sodium regimen (approximately 500 mg daily in total) both during one week. Average 24-hour ambulatory systolic and diastolic pressure and pulse pressure were measured. Among the 213 participants who completed both high- and low-sodium diet visits, the median age was 61 years, 65% were female and 64% black. The low-sodium diet lowered systolic blood pressure in nearly 75% of individuals compared with the high-sodium diet group. So the effects obtained in one week were impressive and consistent in all subgroups (sex, age, race and BMI), including those with or without hypertension or those with antihypertensive medication. In diabetes patients (21 % of the study population) the reduction in blood pressure was even more impressive, close to […]
July 31, 2024
Polypharmacy and deprescribing

Do you take too many pills? Should you ask your doctor for deprescription?

Polypharmacy and deprescribing Polypharmacy is an increasing problem in a population, which gets older, is more obese and affected with more diabetes and subsequently cardiovascular problems (see earlier news item). In this short report polypharmacy is the excessive or unnessary use of medications. The polypill is one solution, predescribing is another one. Polypharmacy has several possible consequences: Adverse drug effects such as nausea, confusion, bleeding Drug-drug interactions , when a medication changes the effect of other medications taken together Medication nonadherence Deceased mobility and falls Increased health care use, including visits to a clinic, an emergency department or hospitalization Higher costs both out-of-pocket and for the community How can the risk of polypharmacy be decreased: Bring an up-to-date list of prescriptions and over-the-counter medications or take all medication bottles to each medical appointment and also report if you take dietary supplements, they may interact. Talk with a doctor or pharmacist before starting any over-the-counter medications or dietary supplements to be taken on a regular basis. When a new medication is recommended, ask the doctor or pharmacist how long you should expect to take it. Talk with a doctor or pharmacist if you are taking a medication longer than planned, to […]
July 9, 2024
Acute Low Back Pain

Acute Low Back Pain. What is it? What can be done?

Daniel Sereni, France 1. What is the cause of acute Low Back Pain (Backache)? Ninety percent of adults experience at least one episode of backache during their life. In most cases the lumbar pain is acute and resolves in less than one or two days. It may be provoked by an effort or an unusual and brisk movement; but it can also appear suddenly without evident reason. Pain can be intense with a sensation of burning aggravated by bending or walking. Acute Lumbar Pain is not the consequence of any anomaly of the vertebrae or of the vertebral disk. Pain is triggered by a sudden strain in the muscles and ligaments around the intervertebral disk. As the disk is richly innervated this situation results in an acute pain. 2. Is it necessary to visit a doctor? To have x-rays? Low back Pain may be very painful, but it does not mean that it is dangerous. In an adult in general good health the backache will resolve in a few hours or days. There is no need to visit a doctor; x -rays will not show anything relevant and should not be performed.  Yet there are some situations when a call to […]
May 15, 2024
“Long colds” do exist and share characteristics with long covid

“Long colds” do exist and share characteristics with long covid

Jan Willem Elte, The Netherlands For many years we know that patients may continue to have complaints long after an acute infection (mostly viral) has vanished. New research now sheds light on some of the problems associated with the post viral syndrome. Until now no good explanation for these lasting complaints has been found and also no cure. Well-known viral infection diseases such as influenza, Q-fever, Epstein-Barr virus and mononucleosis infectiosa (M.Pfeiffer) have resulted in long-lasting periods of complaints, described as post-viral disease. Nowadays these complaints have been taken together and called myalgic encephalomyelitis (ME) or chronic fatigue syndrome (CFS). ME/MFS is a complex, chronic condition influenced by multiple factors and it received its name because despite extensive research no definitive cause or tools with which to diagnose it are available. The condition results in debilitating symptoms with extreme fatigue, unfreshing sleep, difficulty in recovering from exertion, cognitive dysfunction and immune system abnormalities. It may last for years with little or no improvement. Moreover, these complaints are quite frequent and are non-specific. Infections may just be one of the causes and indeed after certain infections some persons experience durable symptoms.  Since the start of the Covid-19 pandemic, infection with SARS-CoV-2 […]