[What's new in internal medicine?]

Area of Science:

• Virology: Discovery of virophage, a mimivirus parasite, and association of Human Herpesvirus 8 (HHV-8) with a specific form of African diabetes.
• Cardiology & Thrombosis: Investigation into risk factors for arterial and venous thrombosis, including obesity, hypertension, and diabetes.
• Immunology & Rheumatology: Exploration of therapies for autoimmune disorders and inflammatory conditions.

Context:

• Oral estrogen therapy is linked to increased venous thromboembolism risk in postmenopausal women.
• Vitamin supplementation (folic acid, B6, B12) failed to reduce cardiovascular events in high-risk patients despite homocysteine lowering.
• Patients with venous thromboembolism face elevated long-term cardiovascular event risk.

Purpose:

• To review recent advancements in virology, thrombosis risk, and autoimmune disease treatment.
• To assess the effectiveness of various interventions, including vitamin supplementation, anticoagulation, and targeted immunotherapies.
• To evaluate risk stratification tools and treatment modalities for cardiovascular and autoimmune conditions.

Summary:

• The ApoB/ApoA1 ratio shows promise for estimating acute myocardial infarction risk across ethnicities.
• Subcutaneous methotrexate is more effective than oral administration for rheumatoid arthritis.
• Hydroxychloroquine inhibits antiphospholipid antibody binding, while anti-IL-5 and anti-IL-6 antibodies show efficacy in specific autoimmune conditions.
• Proteasome inhibitors and mesenchymal stem cells demonstrate potential for lupus-like disease and graft-versus-host disease.

Impact:

• Findings inform clinical practice regarding thrombosis prevention, cardiovascular risk assessment, and autoimmune disease management.
• Highlights the need for careful consideration of treatment efficacy, long-term toxicity, and patient-specific factors.
• Suggests potential new therapeutic avenues for challenging autoimmune and inflammatory conditions.
• Identified placebo effect of saline injections on immunocompetent cell activation.