August 2016

45 Articles

No Section

Blood cultures in the evaluation of uncomplicated cellulitis

12 August 2016
Author(s): Sophie Bauer, Carole E. Aubert, Mischa Richli, Christian Chuard

The frequency of bacteremia and the array of microorganisms involved in cellulitis vary greatly among studies. Although current guidelines do not recommend routine blood culture in uncomplicated... more


The old open question of marijuana and healthcare: Flares from NANHES

30 August 2016
Author(s): P. Santus, D. Radovanovic

The issue about marijuana use and health problems is an old question that has been actual for many years. If, on one hand, the medical interest towards the use of marijuana has been related to its... more

Internal Medicine Flashcard

A man with abdominal pain and skin pigmentation

30 August 2016
Author(s): Sylvia Aide Martínez-Cabriales, Emmanuel I. González-Moreno, Jorge Ocampo-Candiani

A 52-year-old man presented to the Emergency department because of 1-week history of nausea and abdominal pain. The patient referred generalized muscle pain, fatigue, hyporexia and 13kg weight loss... more

A rare cause of syncope in a young female

26 August 2016
Author(s): Jim X. Liu, Anjali A. Satoskar, Konstantinos Dean Boudoulas

A 39year-old female with one-week history of chills, night sweats and myalgias presented after a syncopal episode. Physical examination was unremarkable and electrocardiogram showed normal sinus... more

A warning sign

20 August 2016
Author(s): Sandeep Patri, Soji Joseph, Yashwant Agrawal

A 64year old man presented with atypical chest pain of 6h duration. Physical examination showed tachycardia and an irregularly irregular pulse. Initial EKG showed atrial fibrillation with rapid... more

A young woman with oligomenorrohea and dysphagia

20 August 2016
Author(s): Arijit Singha, Dibakar Biswas, Manojkumar Patil

A 35-year-old house wife attended our clinic with oligomenorrhea for the last three months. She also complained of diffuse body ache, joint pain and decreased bowel movements. Very often she... more

Photoallergic contact dermatitis

18 August 2016
Author(s): Germana Consuegra Romero, Beatriz Castro Gutiérrez, Marcos A. González López

A previously healthy 42-year-old man presented with a 2-day history of an intensely pruritic erythematous well-demarcated plaque on his right anterior ankle (Fig. 1a) and ipsilateral foot dorsum (Fig... more

A woman with dizziness, headache and epigastric discomfort

18 August 2016
Author(s): Shing Ching, Chiu Sun Yue

A woman in her 70s presented to the emergency department with 4h of dizziness, headache and epigastric discomfort. Her only medical history was hypertension. The blood pressure was 89/45mmHg, pulse... more

Joint effusion as an indication of a lung disease

18 August 2016
Author(s): Frank Timo Beil, Michael Amling, Wolfgang Ruether

A 64-year-old man suffered of long-standing joint effusions of both knees. Preceding cortisone injections had not led to a decline of effusions. Microbiological analysis of joint aspirate showed no... more

Hyperpigmented hand lesion – A woodland's souvenir

16 August 2016
Author(s): Jameson Loyal, Joseph C. Pierson

A 27-year-old healthy, Caucasian woman was referred to the dermatology clinic with a 1.5×1.5cm uniformly, hyperpigmented, light brown patch with irregular borders on her right palmar hand (Fig. 1A)... more

A case of leukocytosis with hepatosplenomegaly

15 August 2016
Author(s): Melissa N. Yan, Abhishek Maiti, Jane S. Mathews

A 51-year-old man with hypertension presented with left upper quadrant (LUQ) pain, fatigue, and 10kg weight loss over 6months. He had no fever or lymphadenopathy. Physical examination was significant... more

A painful skin lesion

11 August 2016
Author(s): Keren Cohen-Hagai, Andy Kotliroff, Sydney Benchetrit

A 64-year-old man with a history of arterial hypertension; diabetes mellitus; chronic kidney disease stage V; dilated, non-ischemic cardiomyopathy; status post-aortic valve replacement, was treated... more

Rice bodies in the wrist joint

3 August 2016
Author(s): Helmi Sulaiman, Nadia Atiya, Kai Weng Loi, Kee Peng Ng

A 71-year-old-female with HIV since 2005, presented to us in the clinic with a lesion on the dorsal aspect of her right wrist, which she had for the past 3years. Her latest CD4 count in November was... more

Chronic pruritic, hyperkeratotic eruption on the feet of a patient with end-stage renal disease

2 August 2016
Author(s): R. Gillihan, R. Fischer, D. Liu

A 43year old male with end-stage renal disease on hemodialysis, peripheral vascular disease, and MRSA bacteremia presented to dermatology as an inpatient consult for a nine-month history of a... more

Letter to the Editor

External validation of the modified Ottawa score for risk stratification of recurrent cancer-associated thrombosis

31 August 2016
Author(s): Nolwenn Astruc, Jean-Christophe Ianotto, Jean-Philippe Metges, Karine Lacut, Aurélien Delluc

Venous thromboembolism (VTE) and cancer are two major public health issues that are closely linked. Cancer is part of the major risk factors for VTE and it is estimated that up to 20% of cancer... more

Uncertainty about the evidence on untargeted antifungal treatment

30 August 2016
Author(s): Cortegiani Andrea, Russotto Vincenzo, Raineri Santi Maurizio, Gregoretti Cesare, Giarratano Antonino

We read with great interest the narrative review by Antinori et al. about candidaemia and invasive candidiasis in adults [1]. We focused our attention on the description of main results from three... more

Is oral anticoagulation needed in patients with atrial fibrillation and stent implantation at low–moderate risk of stroke?

27 August 2016
Author(s): Laurent Fauchier, Juan M. Ruiz-Nodar, Mariano Valdés, Denis Angoulvant, Gregory Y.H. Lip, Francisco Marín

Thromboprophylaxis for patients with coronary artery disease and atrial fibrillation (AF) is problematic when there is a low or moderate risk of stroke (CHADS2 score=0 or 1), particularly when... more

Non-conventional treatments within the Italian healthcare system. Epistemological and ethical issues

26 August 2016
Author(s): Sara Patuzzo, Rosagemma Ciliberti

In the past, the so-called “non-conventional treatments” were relegated to “medical charlatans”, regarded as nothing more than magicians and sorcerers, and looked down on arrogantly by the medical... more

Should women with endometriosis be screened for coronary artery disease?

26 August 2016
Author(s): Marco Zuin, Gianluca Rigatelli, Giancarlo Stellin, Giuseppe Faggian, Loris Roncon

Recent studied have suggested that endometriosis (EM) in linked to systemic chronic inflammation, atherogenic lipid profile and oxidative stress [1]. As well known, all these risk factors play a key... more

Beta blockers and intravenous roentgen contrast materials: Which risks do exist?

13 August 2016
Author(s): Ingrid Boehm, John Morelli, Knud Nairz, Patricia Silva Hasembank Keller, Johannes T. Heverhagen

Currently, beta blockers (e.g. metoprolol, atenolol, bisoprolol, esmolol, nebivolol, propranolol, pindolol) are broadly used to treat diseases like hypertension, tachycardia, cardiac arrhythmia,... more

Is the French clinical trials regulation discriminatory?

9 August 2016
Author(s): Rafael Dal-Ré, David Wendler

Current clinical trial regulations across most Western countries take a similar approach to participants who lack access to healthcare services: they ignore them. These individuals are at increased... more

Internal medicine network: Is it a newsworthy idea?

4 August 2016
Author(s): Filomena Pietrantonio, Emilio Scotti

According to a recent study on medical discharge records (SDO) [1] in Italy, internal medicine today takes in charge mainly elderly patients affected by complex diseases in phase of exacerbation. The... more

Marijuana users do not have increased healthcare utilization: A National Health and Nutrition Examination Survey (NHANES) study

4 August 2016
Author(s): Sanjay Bhandari, Cecilia J. Hillard, Thangam Venkatesan

Nearly half (49%) of Americans say that they have tried marijuana [1]. Although increased legalization of marijuana has led to its widespread use, there is a paucity of data on healthcare utilization... more

“From father to son”: Early onset gout in Guidobaldo I da Montefeltro, Duke of Urbino (1472–1508)

4 August 2016
Author(s): R. Bianucci, A. Perciaccante, O. Appenzeller

Named the “Disease of the Kings”, gout (podagra) is one of the oldest diseases reported in medical literature and has modern clinical relevance due to its impact on morbidity and premature mortality... more

The beneficial effect of acute phase increase in serum ferritin

1 August 2016
Author(s): Jecko Thachil

It is well-known that serum ferritin levels increase as an acute phase reactant. In patients who have infections or inflammatory states, the levels of ferritin can go up several-fold. However, what... more

Letters to the Editor

Nutritional risk screening 2002 should be used in hospitalized patients with chronic obstructive pulmonary disease with respiratory failure to determine prognosis: A validation on a large Chinese cohort

30 August 2016
Author(s): Ruiqi Chen, Lu Xing, Chao You

Hospitalized patients with chronic obstructive pulmonary disease (COPD) with respiratory failure are susceptible to nutritional risks due to the increasing energy expenditure [1], and nutritional... more

Narrative Review

The complex interface between economy and healthcare: An introductory overview for clinicians

28 August 2016
Author(s): Federica Liliana Ottolini, Laura Buggio, Edgardo Somigliana, Paolo Vercellini

In a period of generalized economic crisis, it seems particularly appropriate to try to manage a continuing growing sector such as healthcare in the best possible way. The crucial aim of optimization... more

Management and monitoring recommendations for the use of eliglustat in adults with type 1 Gaucher disease in Europe

10 August 2016
Author(s): Nadia Belmatoug, Maja Di Rocco, Cristina Fraga, Pilar Giraldo, Derralynn Hughes, Elena Lukina, Pierre Maison-Blanche, Martin Merkel, Claus Niederau, Ursula Plӧckinger, Johan Richter, Thomas M. Stulnig, Stephan vom Dahl, Timothy M. Cox

In Gaucher disease, diminished activity of the lysosomal enzyme, acid β-glucosidase, leads to accumulation of glucosylceramides and related substrates, primarily in the spleen, liver, and bone marrow... more

Frailty and sarcopenia: From theory to clinical implementation and public health relevance

1 August 2016
Author(s): Matteo Cesari, Alessandro Nobili, Giovanni Vitale

The sustainability of healthcare systems is threatened by the increasing (absolute and relative) number of older persons referring to clinical services. Such global phenomenon is questioning the... more


Tribute to Prof. Ugo Carcassi (1921–2016)

14 August 2016
Author(s): Jan Willem F. Elte, Christopher Davidson

It was with great sadness that the Federation heard that Prof. Ugo Carcassi died peacefully in Cagliari on May 16th 2016 at the age of 94. His distinguished academic and scientific career in Internal... more

Original Article

Trimethylamine-N-oxide (TMAO) predicts fatal outcomes in community-acquired pneumonia patients without evident coronary artery disease

24 August 2016
Author(s): Manuel Ottiger, Manuela Nickler, Christian Steuer, Jonas Odermatt, Andreas Huber, Mirjam Christ-Crain, Christoph Henzen, Claus Hoess, Robert Thomann, Werner Zimmerli, Beat Mueller, Philipp Schuetz

The pro-atherosclerotic metabolite trimethylamine-N-oxide (TMAO) is a risk factor for incident cardiovascular events and a potentially modifiable mediator of chronic inflammation through broad-... more

Epidemiology and outcome of candidemia in internal medicine wards: A regional study in Italy

20 August 2016
Author(s): Sara Tedeschi, Fabio Tumietto, Maddalena Giannella, Michele Bartoletti, Francesco Cristini, Giorgio Cioni, Simone Ambretti, Edoardo Carretto, Vittorio Sambri, Mario Sarti, Pierluigi Viale, Emilia Romagna Candida Network

More than one-third of candidemia episodes occur in Internal Medicine Wards (IMWs) but only few studies have focused on this setting and specific data about epidemiology, clinical characteristics and... more

Serum lipoprotein(a) level as long-term predictor of cardiovascular mortality in a large sample of subjects in primary cardiovascular prevention: data from the Brisighella Heart Study

20 August 2016
Author(s): Federica Fogacci, Arrigo Francesco Giuseppe Cicero, Sergio D'Addato, Laura D'Agostini, Martina Rosticci, Marina Giovannini, Enrico Bertagnin, Claudio Borghi, on behalf of the Brisighella Heart Study Group

High lipoprotein(a) [Lp(a)] levels have been re-evaluated as an independent risk factor for atherosclerotic vascular diseases.

Metabolic syndrome, obesity, and the risk of cancer development

18 August 2016
Author(s): Rafael Bitzur, Ronen Brenner, Elad Maor, Maayan Antebi, Tomer Ziv-Baran, Shlomo Segev, Yechezkel Sidi, Shaye Kivity

Metabolic syndrome and its components are severe global health issues that are increasing in frequency as the prevalence of obesity increases. Various studies have established a correlation between... more

Time patterns in mortality after an emergency medical admission; relationship to weekday or weekend admission

18 August 2016
Author(s): Richard Conway, Sean Cournane, Declan Byrne, Deirdre O'Riordan, Bernard Silke

The aim of this study was to detail the time profile and frequency distribution of mortality following an emergency admission and to compare these for weekday and weekend admissions.

Hyponatremia, all-cause mortality, and risk of cancer diagnoses in the primary care setting: A large population study

13 August 2016
Author(s): Christian Selmer, Jesper Clausager Madsen, Christian Torp-Pedersen, Gunnar Hilmar Gislason, Jens Faber

Hyponatremia has been associated with increased all-cause mortality in hospitalized individuals. In this study we examine the risk of all-cause mortality in primary care subjects with hyponatremia,... more

Renal transplant among type 1 and type 2 diabetes patients in Spain: A population-based study from 2002 to 2013

9 August 2016
Author(s): Ana López-de-Andrés, José M. de Miguel-Yanes, Valentín Hernández-Barrera, Manuel Méndez-Bailón, Montserrat González-Pascual, Javier de Miguel-Díez, Miguel A. Salinero-Fort, Napoleón Pérez-Farinós, Isabel Jiménez-Trujillo, Rodrigo Jiménez-García

RTx rates were higher and increased over time at a higher rate among T2DM patients. Mortality decreased over time in all groups. Diabetes does not predict mortality during admission for RTx.

The Minimum Basic Data Set (MBDS) as a tool for cancer epidemiological surveillance

5 August 2016
Author(s): Pablo Fernández-Navarro, Gonzalo López-Abente, Carmen Salido-Campos, José Miguel Sanz-Anquela

This work aims to evaluate the Minimum Basic Data Set (MBDS) as a data source in the detection of malignant tumors and explore its usefulness as a tool for epidemiological surveillance of cancer.

Long-term clinical outcome of elderly patients with acute coronary syndrome treated with early percutaneous coronary intervention: Insights from the BASE ACS randomized controlled trial

4 August 2016
Author(s): Wail Nammas, Adam de Belder, Matti Niemelä, Jussi Sia, Hannu Romppanen, Mika Laine, Pasi P. Karjalainen

The BASE ACS trial demonstrated an outcome of titanium–nitride–oxide-coated bioactive stents (BAS) that was non-inferior to everolimus-eluting stents (EES) in patients presenting with acute coronary... more

High serum uric acid is associated to poorly controlled blood pressure and higher arterial stiffness in hypertensive subjects

3 August 2016
Author(s): Arrigo F.G. Cicero, Martina Rosticci, Federica Fogacci, Elisa Grandi, Sergio D'Addato, Claudio Borghi, on behalf of the Brisighella Heart Study Group

Serum uric acid (SUA) has been associated to incident hypertension and increased risk of cardiovascular diseases.

Venous thromboembolism in centenarians: Findings from the RIETE registry

2 August 2016
Author(s): Beatriz Lacruz, Gregorio Tiberio, Manuel Jesús Núñez, Luciano López-Jiménez, Antoni Riera-Mestre, Eros Tiraferri, Peter Verhamme, Lucia Mazzolai, José González, Manuel Monreal, for the RIETE Investigators

The balance between the efficacy and safety of anticoagulant therapy in patients aged ≥100years receiving anticoagulant therapy for venous thromboembolism (VTE) is uncertain.

MEDical wards Invasive Candidiasis ALgorithms (MEDICAL): Consensus proposal for management

2 August 2016
Author(s): Luigia Scudeller, Matteo Bassetti, Ercole Concia, Salvatore Corrao, Francesco Cristini, Francesco Giuseppe De Rosa, Valerio Del Bono, Emanuele Durante-Mangoni, Marco Falcone, Francesco Menichetti, Carlo Tascini, Mario Tumbarello, Mario Venditti, Pierluigi Viale, Claudio Viscoli, Antonino Mazzone, on behalf of the MEDICAL group, Società Italiana di Terapia Antinfettiva (SITA),, Federazione delle Associazioni dei Dirigenti Ospedalieri Internisti (FADOI)

A majority of invasive Candida infections occur in medical wards; however, evidence for management in this setting is scarce and based primarily on the intensive care or surgical setting. On behalf... more

Validation of PROFUND prognostic index over a four-year follow-up period

1 August 2016
Author(s): M. Bernabeu-Wittel, L. Moreno-Gaviño, M. Ollero-Baturone, B. Barón-Franco, J. Díez-Manglano, C. Rivas-Cobas, J. Murcia-Zaragoza, C. Ramos-Cantos, A. Fernández-Moyano, on behalf of the PROFUND researchers

The PROFUND index stratifies accurately the 12-month mortality risk of polypathological patients (PPs), but its fitness over a longer follow-up period remains unknown. We aimed to explore the... more

Review Article

The p-value: A clinician's disease?

26 August 2016
Author(s): F.R. Rosendaal

It is remarkable that in the interpretation of scientific evidence, be it as reviewer for a medical journal or as reader, clinicians appear to be the ones most impressed by p-values and statistical... more

Brain-kidney cross-talk: Definition and emerging evidence

13 August 2016
Author(s): Baris Afsar, Alan A. Sag, Can Ege Yalcin, Eren Kaya, Dimitrie Siriopol, David Goldsmith, Adrian Covic, Mehmet Kanbay

Cross-talk is broadly defined as endogenous homeostatic signaling between vital organs such as the heart, kidneys and brain. Kidney–brain cross-talk remains an area with excitingly few publications... more


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