October 2016
35 ArticlesNo Section
Association between acute kidney injury and risk of Parkinson disease
Worldwide, the incidence of acute kidney injury (AKI) has been increasing. However, information on the long-term incidence of Parkinson disease (PD) in patients with AKI has not been reported.
Internal Medicine Flashcard
A 77-year-old man with fever and night sweats
A 77-year-old man presented to the emergency department with five days of episodic fevers, rigors, and night sweats. He described malaise and low appetite. There was no weight loss, headache, neck... more
T wave alternans: An ominous marker for malignant cardiac arrhythmias
60yr old lady presented with increasing dyspnoea. She had history of anterior myocardial infarction 4yrs. ago. Her admission EKG revealed a peculiar abnormality during repolarisation.
Large subcutaneous tumor of the left shoulder
A 66-year-old, otherwise healthy man presented to our clinic with a large tumor on the left shoulder. The patient reported that the lesion had initially been a small, firm nodule that appeared six... more
Prolonged P wave with biphasic morphology in the inferior leads
A 68-year-old woman was admitted to the hospital with fever, progressive dyspnea, and cough productive of white sputum. The patient's history included type 2 diabetes mellitus, hypertension, and... more
Isolated hand weakness
A 63-year old man, with a past medical history of hypertension and dyslipidemia, presented with a one-day history of isolated left-hand weakness of sudden onset. Neurological examination revealed a... more
A rare cause of intractable diarrhea
An 81-year old man was admitted to an Internal Medicine Division because of severe watery diarrhea lasting 8months, unresponsive to fasting and to a gluten-free diet. Since the onset of symptoms he... more
Hypotension with scrotal and penile ecchymoses
A 61-year-old man with a history of end stage renal disease (requiring intermittent hemodialysis) presented to the hospital with hypotension, tachycardia and decreased level of consciousness. A... more
Acute kidney injury: Finding a needle in a haystack
An 80-year-old woman with a history of venous thromboembolism and ischemic stroke was admitted with headache and confusion. Examination revealed fever and an altered mental status, but was otherwise... more
Did we do something wrong?
A 64-year-old male was brought to the hospital for evaluation of weight loss, inability to eat, and coughing with copious oral secretions. He had a history of squamous cell carcinoma of the right... more
Letter to the Editor
The Italian plan of the chronicity: Where is the internist?
The Italian Health Minister recently elaborated the “national plan of the chronicity”, a document which governs the care and the protection of the patients suffering from chronic diseases [1]. The... more
Use of non-steroidal anti-inflammatory drugs and analgesics in a cohort of hospitalized elderly patients: Results from the REPOSI study
Pain in the elderly is associated with substantial disability stemming from reduced mobility, avoidance of activity, falls, depression, anxiety, sleep impairment and isolation [1–3]. Pharmacological... more
Association between anthropometric indices and hyperuricemia in rural area of China: Methodological issues
We read with great interest the currently published manuscript written by Zhang N et al. [1] entitled “A Body Shape Index and Body Roundness Index: Two new body indices for detecting association... more
Use of the citizen's electronic health record by doctors and patients in a mature application throughout a district of the national health system of Italy
In the Unified and Universal Health Systems of Western Europe countries and Brazil, the Electronic Health Record (EHR) is an important item within the e-health national agendas for strengthening the... more
Leonardo teaching anatomy and psychology to Raffaello and Michelangelo
Leonardo, Raffaello and Michelangelo were the promoters of a new form of art; a universal art, above the horizons of the imagination itself. They materialized in images a superior art, where dreams... more
Effects of granulocyte-colony stimulating factor (G-CSF) on stem cell mobilization in patients with liver failure
Acute liver failure (ALF) as well as acute-on-chronic liver failure (ACLF) in patients with pre-existing chronic liver disease are defined by rapid deterioration of liver function in association with... more
Impact of antiretroviral therapy on mid-and-long term survival among people living with HIV/AIDS in Guangxi, Southern China — A cohort study
The study included 10,726 people living with HIV/AIDS, of which 5735 (53.6%) individuals had initiated cART and 4991 (46.4%) who were therapy-naïve between 2010 and 2014. Of all patients, the median... more
Imported filariasis in Europe: A series of 31 cases from Metropolitan France
Filariases are diseases caused by parasitic roundworms (nematodes) called filariae [1]. Main infections are onchocerciasis, loiasis and lymphatic filariasis. All are arthropod-borne infections, and... more
PCSK9 inhibitors: A new era in stroke prevention?
In an interesting paper Milionis et al. [1], aimed to investigate the effect of Proprotein Convertase Subtilisin Kexin 9 (PCSK9) inhibition on stroke risk in a meta-analysis involving data from... more
Splenomegaly and the JAK2 V617F mutation
The classical Philadelphia chromosome-negative myeloproliferative neoplasms (MPN) comprise the clinically and pathologically related polycythemia vera (PV), essential thrombocythemia (ET) and primary... more
Seasonal variations of incident primary immune thrombocytopenia in adults: An ecological study
Thus far, only two studies have investigated seasonal variations of primary immune thrombocytopenia (ITP) incidence in children. Results have shown a temporally correlated increase in ITP incidence... more
Letters to the Editor
Long delay to onset of ACE inhibitors-induced cough: Reason of difficult diagnosis in primary care?
Angiotensin converting enzyme inhibitors (ACEI) were first introduced in 1981. They are widely used in the field of hypertension, heart failure and kidney dysfunction. In general, ACEI are effective... more
Inadequate reporting of enrolled patient and study site characteristics, and inter-study site differences in randomized controlled trials: A systematic review in six leading medicine journals
Randomized controlled trials (RCTs) are the gold standard in assessing the efficacy of any kind of healthcare intervention. A clear, complete, and transparent reporting of the design, conduct, and... more
Narrative Review
Community-acquired pneumonia in adults: Highlighting missed opportunities for vaccination
Pneumococcal pneumonia remains a clear unmet medical need for adults worldwide. Despite advances in vaccine technology, vaccination coverage remains low, putting many people at risk of significant... more
Original Article
The efficacy advantage of evolocumab (AMG 145) dosed at 140mg every 2weeks versus 420mg every 4weeks in patients with hypercholesterolemia: Evidence from a meta-analysis
Evolocumab (AMG 145), a PCSK9 inhibitor, has been shown to decrease low-density lipoprotein cholesterol (LDL-C) levels. Doses of 140mg administered every 2weeks (Q2W) and 420mg administered every... more
Behçet's disease and FMF: Two sides of the same coin or just an association? A cross-sectional study
Familial Mediterranean fever (FMF) is a genetic disease, characterized by attacks of fever, arthritis, serositis and pain. Behçet's disease (BD) is an inflammatory disorder with a genetic basis,... more
The quality of the reported sample size calculations in randomized controlled trials indexed in PubMed
There are limited data on the quality of reporting of information essential for replication of the calculation as well as the accuracy of the sample size calculation. We examine the current quality... more
CRONIGAL: Prognostic index for chronic patients after hospital admission
We have followed patients admitted to a Polypathology and Advanced Age Unit for two years in order to identify the variables that best define the mortality prognosis at medium-term (1–2years) for... more
Chronic obstructive pulmonary disease is associated with increased recurrent peptic ulcer bleeding risk
The association between chronic obstructive pulmonary disease (COPD) and the risk of recurrent peptic ulcer bleeding (PUB) remains unclear. In this study, we compared the risk of recurrent PUB... more
Comprehensive evaluation of cardiac involvement in eosinophilic granulomatosis with polyangiitis (EGPA) with cardiac magnetic resonance
Eosinophilic granulomatosis with polyangiitis (EGPA) is a systemic necrotizing vasculitis characterized by hypereosinophilia. EGPA typically develops in three clinical phases, beginning with asthma,... more
Impaired flow-mediated dilation in hospitalized patients with community-acquired pneumonia
Community-acquired pneumonia (CAP) is complicated by cardiovascular events as myocardial infarction and stroke but the underlying mechanism is still unclear. We hypothesized that endothelial... more
Simultaneous control of glycemic, blood pressure, and lipid significantly reduce the risk of renal progression in diabetes patients
Hyperglycemic, hypertension, and lipid abnormalities are risk factors for diabetic kidney disease However, no study has discussed the association of the simultaneous control of glycemic, blood... more
CHA2DS2-VASc score and clinical outcomes of patients with acute coronary syndrome
The CHA2DS2-VASc score has been recommended for the assessment of thromboembolic risk in patients with atrial fibrillation.
Review Article
The appropriate use of proton pump inhibitors (PPIs): Need for a reappraisal
The advent of powerful acid-suppressive drugs, such as proton pump inhibitors (PPIs), has revolutionized the management of acid-related diseases and has minimized the role of surgery. The major and... more
Shared decision making and the internist
In this narrative review, we locate within the tradition of great diagnosticians in internal medicine, a fundamental development in patient-centered care: shared decision making (SDM). In this way,... more