July 2018

25 Articles

No Section

A 74-year-old woman with acute chest pain

10 July 2018
Author(s): Takeshi Kondo

A 74-year-old woman presented to our emergency department with acute chest pain. She had been diagnosed with depression two years earlier, for which she was taking antidepressants. Chest radiograph... more

Internal Medicine Flashcard

A jelly belly: An unusual cause of ascites

15 July 2018
Author(s): Christodoulos Dolapsakis, Andreas Panagopoulos

A 77-year-old man presented with a two-month history of increasing abdominal girth, weight loss and early satiety. Physical examination revealed a distended, nontender abdomen with dullness on... more

Right eyelid droop

10 July 2018
Author(s): Justin B. Hellman, Lily Koo Lin

A 59 year-old female with history of hemithyroidectomy for a benign lesion presented with 1 year of drooping of the right eyelid and anhidrosis of the right side of her face. She denied neck pain or... more

Heart of ice

10 July 2018
Author(s): Fabrizio Elia, Michela Chiarlo, Andrea Verhovez

A 41-year-old man was found unresponsive at home. On arrival, the air Ambulance team reported Glasgow Coma Scale 5 (E1V1M3), myosis, afinalistic movements and cold skin (28 °C). Blood glucose levels... more

A calcified cyst in the liver

7 July 2018
Author(s): Chia-Hung Shen, Chun-Han Liao, Te-Chun Shen

Chest radiography performed during the general health check-up of a 60-year-old herdsman revealed a round, calcified lesion in the right upper quarter of the abdomen (Fig. 1a). The patient did not... more

Letter to the Editor

Epidemiological and clinical characteristics of imported malaria in adults in Milan, Italy, 2010–2015

28 July 2018
Author(s): Spinello Antinori, Maria Napolitano, Romualdo Grande, Simone Passerini, Anna Lisa Ridolfo, on behalf of Malaria study group, Laura Galimberti, Letizia Oreni, Sara Schinaia, Laura Milazzo, Massimo Galli, Mario Corbellino, Maria Rita Gismondo, Nadia Zanchetta, Laura Cordier, Giuliano Rizzardini

Malaria is the most common and lethal parasitic disease worldwide with an estimated 216 million of cases and 445,000 deaths in 2016 [1]. In Europe, where malaria has been eradicated, there were over... more

Major hemorrhages in patients treated with oral anticoagulants: choice of management in the emergency room

18 July 2018
Author(s): Christian Folli, Chiara Casiraghi, Simon Braham, Angelo Rovellini, Valter Monzani

Millions of people are treated with antithrombotic drugs and major hemorrhages are the most threatening consequence. When this study was performed the prevalence in the general population of people... more

Therapeutic role of monoclonal antibodies in Migraine: A new paradigm

18 July 2018
Author(s): Kumar Ashish, Mohammed Faisaluddin, Dhrubajyoti Bandyopadhyay, Kartik Dhaduk, Anupam Baral

Migraine continues to be the 6th most disabling illness with extremely incapacitating neurological symptoms affecting approximately 39 millions of US population. Besides its chronic illness, migraine... more

Fluoroquinolone-associated suicide

18 July 2018
Author(s): Anuhya Kommalapati, Sara Wallam, Sri Harsha Tella, Zaina P. Qureshi, Charles L. Bennett

Suicide is a huge global health problem and is the tenth leading cause of death in the United States. Several case reports have raised concerns that exposure to fluoroquinolones (FQs) may increase... more

Short- and long-term prognostic role of diastolic blood pressure in intermediate-high risk patients with acute pulmonary embolism

17 July 2018
Author(s): Marco Zuin, Gianluca Rigatelli, Pietro Zonzin, Franco Casazza, Loris Roncon

In patients with acute pulmonary embolism (PE), both the prognostic stratification and reperfusion treatment are mainly based on the hemodynamic profile at admission, which is assessed using the... more

Multimorbidity and polypharmacy among elderly people followed in general practices in Germany

17 July 2018
Author(s): Karel Kostev, Louis Jacob

Multimorbidity, defined as the presence of two or more chronic conditions, has been a growing health problem globally, especially in recent decades [1]. Polypharmacy, which is often defined as the... more

Funding is not enough

15 July 2018
Author(s): Silvio Garattini, Vittorio Bertele'

We welcome the European Commission's proposal to invest €100 billion on research in the Horizon Europe programme from 2021 to 2027 [1,2]. We hope the detailed proposals for each policy area will... more

Trajectories of survival in patients with nonspecific complaints

10 July 2018
Author(s): Alexandra Malinovska, Christian H. Nickel, Roland Bingisser

Patients presenting to acute care settings with nonspecific complaints (NSCs) are at high risk of adverse outcomes [1, 2] and pose diagnostic and prognostic challenges [3]. The majority of these... more

Symptoms of alcohol abuse: The first warning sign of cancer development risk

6 July 2018
Author(s): M. Bifulco, M. Citro, M. Abate

Balance disorders, irascibility and facial redness are the most common signs of alcohol abuse that usually disappear within twenty-four hours and therefore are generally underestimated, but that don'... more

Narrative Review

Cardiovascular disease risk unmasked by pregnancy complications

25 July 2018
Author(s): Rosie Jasper, Kimberly Skelding

Pregnancy related complications indicate a propensity for atherosclerotic disease. Epidemiologic data demonstrate early onset cardiovascular disease in women with a history of pregnancy loss, preterm... more

Transcatheter aortic valve implantation: Update in 2018

4 July 2018
Author(s): Nils Perrin, Angela Frei, Stephane Noble

During the last 15 years, transcatheter aortic valve implantation (TAVI) has gained wide acceptance with good reproducible clinical and safety outcomes. Today, TAVI has not only overtaken... more

Narrative Review Article

Prediabetes and macrovascular disease: Review of the association, influence on outcome and effect of treatment

11 July 2018
Author(s): W. Kleinherenbrink, E. Osei, H.M. den Hertog, A.A.M. Zandbergen

Prediabetes is an intermediate metabolic state between normal glucose metabolism and diabetes mellitus. Patients with prediabetes have an increased risk (of up to 70%) of developing type 2 diabetes.... more

Original Article

Blood urea nitrogen has additive value beyond estimated glomerular filtration rate for prediction of long-term mortality in patients with acute myocardial infarction

30 July 2018
Author(s): Bernhard Richter, Patrick Sulzgruber, Lorenz Koller, Matthias Steininger, Feras El-Hamid, David J. Rothgerber, Stefan Forster, Georg Goliasch, Benjamin I. Silbert, Elias L. Meyer, Christian Hengstenberg, Johann Wojta, Alexander Niessner

Blood urea nitrogen (BUN) has been shown to independently predict short- and intermediate-term outcomes in patients with acute myocardial infarction (AMI). We aimed to assess the additive predictive... more

Tocilizumab as an add-on therapy to glucocorticoids during the first 3 months of treatment of Giant cell arteritis: A prospective study

24 July 2018
Author(s): Maxime Samson, Hervé Devilliers, Kim Heang Ly, François Maurier, Boris Bienvenu, Benjamin Terrier, Pierre Charles, Loïc Guillevin, Jean-François Besancenot, Eric Liozon, Anne Laure Fauchais, Romaric Loffroy, Christine Binquet, Sylvain Audia, Raphaèle Seror, Xavier Mariette, Bernard Bonnotte

The aim of this study was to evaluate tocilizumab (TCZ) as an add-on therapy to glucocorticoids (GC) during the first 3 months of treatment of giant cell arteritis (GCA).

Impaired fasting glucose is associated with lower glomerular filtration rate decline among men but not women –a large cohort study from Israel

18 July 2018
Author(s): Idan Goldberg, Eytan Cohen, Elad Goldberg, Tzippy Shochat, Ilan Krause

Early stages of diabetes are associated with an increased glomerular filtration rate (GFR). Little is known, however, about the change in GFR among patients with impaired fasting glucose (IFG). We... more

Prognostic significance of high free T4 and low free T3 levels in non-thyroidal illness syndrome

17 July 2018
Author(s): Hayriye Esra Ataoğlu, Süleyman Ahbab, Mustafa Kemal Serez, Mehmet Yamak, Derya Kayaş, Esra Turan Canbaz, Faik Çetin, Şaban Seçmeler, Fuat Şar, Mustafa Yenigün

Non-thyroidal illness syndrome is characterized by decreased serum free T3 (FT3) level and associates with long term mortality. Serum free T4 (FT4) may affect on mortality with FT3 in course of... more

A one-year risk score to predict all-cause mortality in hypertensive inpatients

11 July 2018
Author(s): Ana María Martínez-Díaz, Antonio Palazón-Bru, David Manuel Folgado-de la Rosa, Dolores Ramírez-Prado, Miguel Navarro-Juan, Natalia Pérez-Ramírez, Vicente Francisco Gil-Guillén

The aim of this study was to construct and internally validate a scoring system to estimate the probability of death in hypertensive inpatients. Existing predictive models do not meet all the... more

The association between bowel obstruction and the management of cholelithiasis and cholecystitis in elderly patients: A population-based cohort study

9 July 2018
Author(s): Yen-Chun Peng, Cheng-Li Lin, Hong-Zen Yeh, Chi-Sen Chang, Chia-Hung Kao

This study aimed to evaluate the risk of bowel events among elderly patients treated using only PTGBD (Percutaneous Gallbladder Drainage), or a cholecystectomy on its own, or PTGBD combined with a... more

Clostridium difficile infection in hospitalized patients with COPD in Spain (2001–2015)

2 July 2018
Author(s): Javier de Miguel-Díez, Ana López-de-Andrés, María D. Esteban-Vasallo, Valentín Hernández-Barrera, José M. de Miguel-Yanes, Manuel Méndez-Bailón, Rodrigo Jiménez-García

The objectives of this study were to examine incidence and in-hospital outcomes of Clostridium difficile infection (CDI) among patients with COPD, to compare clinical variables among COPD patients... more

Review Article

The added value of health indicators to mortality predictions in old age: A systematic review

15 July 2018
Author(s): Sasmita Kusumastuti, Maarten Pieter Rozing, Rikke Lund, Erik Lykke Mortensen, Rudi G.J. Westendorp

Numerous risk prediction models use indicators of health to predict mortality in old age. The added value to mortality predictions based on demographic variables is unknown.

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