November 2015

29 Articles

Internal Medicine Flashcard

Aspiration, quadriplegia, incontinence

19 November 2015
Author(s): Shing Ching, San Ming Yu

A 64-year-old woman with hypertension and dyslipidemia was admitted for non-specific dizziness for 2days. Initial physical examination was unremarkable except a palpable bladder. Urinary... more

Unilateral pulmonary edema in acute coronary syndrome: A sinister sign

18 November 2015
Author(s): Hardik Doshi, Ramzi El Accaoui

A 75 year-old man with no significant prior medical history was transferred to our hospital for emergent management of inferior ST-elevation myocardial infarction. He had presented to a regional... more

A woman with recurrent chest pain and ST-segment elevation

17 November 2015
Author(s): Hesham R. Omar, Devanand Mangar, Enrico M. Camporesi

A 32-year-old female presents with recurrent episodes of unprovoked chest pain associated with inferior ST-segment elevation and reciprocal ST-segment depression. Coronary angiography during one of... more

Groove sign

13 November 2015
Author(s): Pablo Demelo-Rodríguez, Norberto Ortego-Centeno, Jose Luis Callejas-Rubio

A 72-year-old man with a history of arterial hypertension, diabetes mellitus and hypercholesterolemia presented to our outpatient clinic with a 6-month history of induration in both forearms and... more

A man with breast discharge and headache.

11 November 2015
Author(s): Abhishek Maiti, Avash Das, Sudip Chatterjee

A 44year old previously healthy man presented with gradual onset of discharge of whitish liquid from the nipples and a dull headache for last three years. The patient reported progressive erectile... more

A 28-year-old man with syncope, hypotension, and lethargy

11 November 2015
Author(s): Sreyasi Bhattacharya, Avash Das, Abhishek Maiti

A 28-year-old previously healthy man presented to the emergency department after an episode of syncope. He also complained of vomiting and diffuse abdominal pain for the past 1day and sore throat for... more

Chilaiditi's sign

11 November 2015
Author(s): Abraham M. Ittyachen, Mariam Eapen, Rajesh Kumar

A 79-year old male with a history of diabetes mellitus and systemic hypertension was admitted with cough and fever through the out-patient department of our hospital. In spite of his advanced age he... more

A cause for craniocervical pain

10 November 2015
Author(s): João Madaleno, António Fernandes, Nuno Silva

An 82-year-old woman presented with craniocervical pain exacerbated by rotation of head with several months. Her physical examination yielded no unusual results except for local tenderness in the... more

Letter to the Editor

Thalassemia and acute coronary syndromes

30 November 2015
Author(s): Beuy Joob, Viroj Wiwanitkit

The recent report on “risk of coronary artery disease in transfusion-naïve thalassemia populations [1]” is very interesting. In fact, thalassemia is a common congenital inherited hemoglobin disorder... more

Extra-pulmonary manifestations associated with pneumonia in adults

24 November 2015
Author(s): Yasuhiro Kawai, Naoyuki Miyashita, Tadashi Kato, Niro Okimoto, Mitsuo Narita

Mycoplasma pneumoniae is a well-recognized respiratory pathogen principally affecting children and younger adults. This organism is also responsible for producing a wide spectrum of extra-pulmonary... more

Cruising between Scylla and Charybdis … Just a hope?

17 November 2015
Author(s): Carlo Gelmetti

I have read with interest the recent paper written by Macchi and Pavan1 concerning the problems about the quality of medical care at the time of economic crisis. I acknowledge that the efforts for “... more

Producing evidence in support of disinvestment: The experience of the Tuscany region in Italy

9 November 2015
Author(s): Andrea Messori, Sabrina Trippoli, Valeria Fadda, Dario Maratea

In this journal, Macchi and Pavan [1] have described how, in Italy, a research hospital can be managed at the times of a global economic crisis and have pointed out that, as a matter of fact,... more

Does acromegaly suffice to explain the origin of Pulcinella? A novel interpretation

6 November 2015
Author(s): Emanuele Armocida, Thomas Böni, Frank J. Rühli, Francesco M. Galassi

Pulcinella, mainly known in the English-speaking world as Mr Punch (Fig. 1), is a character from the Italian Commedia dell'Arte, whose origins can be traced back to protagonists of Roman Atellan... more

Original Article

Chronic diseases and geriatric syndromes: The different weight of comorbidity

28 November 2015
Author(s): Davide L. Vetrano, Andrea D. Foebel, Alessandra Marengoni, Vincenzo Brandi, Agnese Collamati, George A. Heckman, John Hirdes, Roberto Bernabei, Graziano Onder

Comorbidity is a relevant health determinant in older adults. Co-occurrence of several diseases and other age-associated conditions generates new clinical phenotypes (geriatric syndromes [GS] as... more

Clinical findings of bacteremic septic arthritis according to the site of acquisition: The overlap between health care-related and community- and nosocomial-acquired cases

27 November 2015
Author(s): Oscar Murillo, Joan Gomez-Junyent, Imma Grau, Alba Ribera, Celina Cabrera, Salvador Pedrero, Fe Tubau, Joan M. Nolla, Javier Ariza, Roman Pallares

The site of acquisition of infection may have a major impact on outcome. The health care-related (HCR) environment has recently come under scrutiny. In a group of patients with bacteremic septic... more

Effectiveness of a Geriatric Care Model for frail older adults in primary care: Results from a stepped wedge cluster randomized trial

17 November 2015
Author(s): Emiel O. Hoogendijk, Henriëtte E. van der Horst, Peter M. van de Ven, Jos W.R. Twisk, Dorly J.H. Deeg, Dinnus H.M. Frijters, Karen M. van Leeuwen, Jos P.C.M. van Campen, Giel Nijpels, Aaltje P.D. Jansen, Hein P.J. van Hout

Primary care-based comprehensive care programs have the potential to improve outcomes in frail older adults. We evaluated the impact of the Geriatric Care Model (GCM) on the quality of life of... more

D-dimer and histamine in early stage bacteremia: A prospective controlled cohort study

13 November 2015
Author(s): Michael Schwameis, Margarete Maria Steiner, Christian Schoergenhofer, Heimo Lagler, Nina Buchtele, Petra Jilma-Stohlawetz, Thomas Boehm, Bernd Jilma

Plasma histamine levels and D-dimer predict disease severity and mortality in advanced septic shock. We hypothesized that increased plasma histamine levels parallel coagulation activation and yield... more

Management of patients with type 2 diabetes and multiple chronic conditions: A Delphi consensus of the Spanish Society of Internal Medicine

13 November 2015
Author(s): Javier Ena, Ricardo Gómez-Huelgas, Demetrio Sánchez-Fuentes, Miguel Camafort-Babkowsk, Francesc Formiga, Alfredo Michán-Doña, Emilio Casariego, the Working Group of Diabetes and Obesity of Spanish Society of Internal Medicine

To develop consensus-based recommendations for the management of chronic complex patients with type 2 diabetes mellitus using a two round Delphi technique.

Spring season birth is associated with higher emergency department admission for acute allergic reactions

12 November 2015
Author(s): Gianfranco Cervellin, Fabio Schirosa, Ruggero Buonocore, Antonio Nouvenne, Loris Borghi, Tiziana Meschi, Giuseppe Lippi

Acute allergic reactions are important causes of emergency department (ED) admission, imposing a significant clinical and organizational burden. Since the season of birth is linked with early... more

Cholesterol absorption and synthesis markers in Portuguese hypercholesterolemic adults: A cross-sectional study

11 November 2015
Author(s): Isabel Andrade, Lèlita Santos, Fernando Ramos

The dynamics of cholesterol homeostasis and the development of cardiovascular disease (CVD) are complex and multifactorial, to which adds individual variability in the proportion of cholesterol from... more

The syndrome of inappropriate antidiuretic hormone secretion: Distribution and characterization according to etiologies

9 November 2015
Author(s): Daniel Shepshelovich, Chiya Leibovitch, Alina Klein, Shirit Zoldan, Gai Milo, Tzippy Shochat, Benaya Rozen-zvi, Anat Gafter-Gvili, Meir Lahav

To determine the distribution of etiologies for the syndrome of inappropriate antidiuretic hormone secretion (SIADH) in hospitalized patients and to characterize patients according to the different... more

Prolonged length of stay in hospitalized internal medicine patients

9 November 2015
Author(s): Raquel Barba, Javier Marco, Jesús Canora, Susana Plaza, Sara Nistal Juncos, Juan Hinojosa, Manuel Mendez Bailon, Antonio Zapatero

Targeting patients with prolonged hospitalizations may represent an effective strategy for reducing average hospital length of stay (LOS). Objective: We sought to characterize predictors of prolonged... more

The effect of smoking on carotid intima–media thickness progression rate and rate of lumen diameter reduction

5 November 2015
Author(s): Kristina Hansen, Gerd Östling, Margaretha Persson, Peter M. Nilsson, Olle Melander, Gunnar Engström, Bo Hedblad, Maria Rosvall

The purpose of the study was to investigate the long-term associations between smoking habits, environmental tobacco smoke exposure (ETS), carotid intima–media thickness (IMT) progression rate, and... more

Cardiovascular outcomes and conventional risk factors in non-diabetic adult patients with GH deficiency: A long-term retrospective cohort study

5 November 2015
Author(s): Cesare de Gregorio, Giuseppe Andò, Salvatore Cannavò, Oana Ruxandra Cotta, Olimpia Trio, Maurizio Cusmà Piccione, Francesco Trimarchi, Lorenzo Curtò

To investigate the association between cardiovascular (CV) risk factors and cumulative CV events in patients with growth hormone deficiency (GHD) receiving GH replacement therapy (GHRT).

Clinical assessment of endothelial function in patients with rheumatoid arthritis: A meta-analysis of literature studies

4 November 2015
Author(s): Matteo Nicola Dario Di Minno, Pasquale Ambrosino, Roberta Lupoli, Alessandro Di Minno, Marco Tasso, Rosario Peluso, Elena Tremoli

Several studies reported an increased cardiovascular (CV) morbidity and mortality in patients with rheumatoid arthritis (RA). Flow-mediated (FMD) and nitrate-mediated dilation (NMD) are considered... more

Development of a new disease severity scoring system for patients with non-transfusion-dependent thalassemia

3 November 2015
Author(s): M. Domenica Cappellini, John B. Porter, Khaled M. Musallam, Antonis Kattamis, Vip Viprakasit, Renzo Galanello, Ali T. Taher

Patients with non-transfusion-dependent thalassemia (NTDT) present with a spectrum of disease severities. Since there are multiple pathophysiologies in such patients, tailoring treatment remains... more

Effect of salt intake on blood pressure in patients receiving antihypertensive therapy: Shimane CoHRE Study

2 November 2015
Author(s): Tomoko Ito, Miwako Takeda, Tsuyoshi Hamano, Tsunetaka Kijima, Masayuki Yamasaki, Minoru Isomura, Shozo Yano, Kuninori Shiwaku, Toru Nabika

Salt intake is recognized as an important risk factor for hypertension in the general population. On the other hand, the availability of various classes of antihypertensive drugs means that it is... more

Review Article

Association between particulate air pollution and venous thromboembolism: A systematic literature review

27 November 2015
Author(s): Massimo Franchini, Carlo Mengoli, Mario Cruciani, Carlo Bonfanti, Pier Mannuccio Mannucci

Air pollution is a leading global problem for public health. A number of ambient pollutants have been involved, including carbon monoxide (CO), nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3... more

Efficacy and safety of haloperidol for in-hospital delirium prevention and treatment: A systematic review of current evidence

6 November 2015
Author(s): E.J.M. Schrijver, K. de Graaf, O.J. de Vries, A.B. Maier, P.W.B. Nanayakkara

Haloperidol is generally considered the drug of choice for in-hospital delirium management. We conducted a systematic review to evaluate the evidence for the efficacy and safety of haloperidol for... more


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