July 2018
25 ArticlesNo Section
A 74-year-old woman with acute chest pain
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
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
Heart of ice
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
Right eyelid droop
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
A calcified cyst in the liver
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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
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)
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
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.