European Journal of Internal Medicine

March 2018

No Section

A young man with acute onset epigastric pain after the ingestion of Japanese sushi

1 March 2018
Author(s): Yusaku Kajihara

A 32-year-old man presented to the author's hospital with a 1-day history of acute onset epigastric pain after the ingestion of Japanese sushi (bite-sized pieces of cold cooked rice topped with fish... more

A case-mix classification system for explaining healthcare costs using administrative data in Italy

4 March 2018
Author(s): Maria Chiara Corti, Francesco Avossa, Elena Schievano, Pietro Gallina, Eliana Ferroni, Natalia Alba, Matilde Dotto, Cristina Basso, Silvia Tiozzo Netti, Ugo Fedeli, Domenico Mantoan

The Italian National Health Service (NHS) provides universal coverage to all citizens, granting primary and hospital care with a copayment system for outpatient and drug services. Financing of Local... more

Natriuretic peptide B plasma concentration increases in the first 12 h of pulmonary edema recovery

17 March 2018
Author(s): Francesca Susini, Emilio Assanelli, Elisabetta Doria, Marco Morpurgo, Denise Brusoni, Alice Bonomi, Simone Barbieri, Angelo Cabiati, Laura Salvini, Roberta Chiodelli, Monica Loguercio, Alessandro Galli, Piergiuseppe Agostoni

According to guidelines, single determination of B-type Natriuretic peptide (BNP) should be used for distinguishing between cardiac and non-cardiac acute dyspnea at the emergency room. BNP... more

Implementation of thyroid function tests algorithms by clinical laboratories: A four-year experience of good clinical and diagnostic practice in a tertiary hospital in Greece

28 March 2018
Author(s): George Notas, Marilena Kampa, Niki Malliaraki, Maria Petrodaskalaki, Stathis Papavasileiou, Elias Castanas

Thyroid Function Tests (TFTs) are among the most commontly ordered tests. Significant overuse of TFTs can occur when instead of using a single TSH test to screen for thyroid disease a full panel (TSH... more

Case Report

An elderly woman with progressive odynophagia, epigastralgia and nausea

1 March 2018
Author(s): Yusaku Kajihara

An 84-year-old woman presented to the author's hospital with a 5-day history of progressive odynophagia, epigastralgia and nausea. These symptoms developed 3 days after taking an alendronate oral... more

Internal Medicine Flashcard

Middle-aged man with symmetrical lesions in his throat

1 March 2018
Author(s): Mayumi Imahashi, Yoshiyuki Yokomaku

A 51-year-old man infected with HIV for more than 10 years visited our HIV clinic due to lesions in his throat. He had a CD4 T-cell count of >500 cells per μl and a HIV-RNA viral load of

Dementia, cardiomyopathy and pseudo-obstruction in a 63-year-old female

1 March 2018
Author(s): A. Garrahy, A. Agha

A 63-year-old female was referred with a history of progressive functional decline after being found in a state of poor self-care at home. She had a history of anorexia, lethargy, abdominal... more

An unusual esophageal endoscopic appearance

3 March 2018
Author(s): Jean-Philippe Le Mouel, Mathurin Fumery, Richard Delcenserie

A 44-year-old man, with medical history of chronic alcoholic intoxication and smoking, presented with suspicion of infected pancreatic necrosis, 5 weeks after severe acute alcoholic pancreatitis. The... more

Violaceous papules on the legs of an elderly Mediterranean man

8 March 2018
Author(s): Sydney E. Liang, Tracey N. Liebman

A 71-year-old Italian man with a remote history of multiple myeloma presented with dark spots on his bilateral legs and feet. The lesions had been present for many months and were not painful or... more

Letter to the Editor

Autonomic dysfunction and cardiovascular risk in patients with atherosclerotic renal artery stenosis: A pilot study

7 March 2018
Author(s): Antonietta Gigante, Viviana Zingaretti, Marco Proietti, Edoardo Rosato, Rosario Cianci, HRV Study Group

Atherosclerotic renal artery stenosis (ARAS) is a secondary cause of hypertension, with prevalence ranging from 1% to 5% in hypertensive patients. ARAS is associated with ischemic nephropathy,... more

Experimentation of 2.0 telemedicine in elderly patients with chronic heart failure: A study prospective in 175 patients

7 March 2018
Author(s): E. Andrès, S. Talha, M. Hajjam, J. Hajjam, S. Ervé, A. Hajjam

Heart failure is thus responsible for more than 100,000 hospitalizations per year in France [1]. It accounts for 5% of all hospitalizations and is the main cause of hospitalization among elderly... more

Association of obesity, sleep apnea and hypothalamic inflammation: Novel possibilities of research

6 March 2018
Author(s): Vinícius Dokkedal-Silva, José Carlos Fernandes Galduróz, Sergio Tufik, Monica Levy Andersen

Sleep apnea and obesity problems are two health concerns that are commonly seen together [1]. Both are increasing trends in the general population worldwide, and when associated, both are capable of... more

Diagnosing catheter-associated urinary tract infection: Still a matter of concern

8 March 2018
Author(s): Queralt Jordano, Miriam Molina, Eva Acosta, Mariona Xercavins, Alejandro de la Sierra

Treatment of bacteriuria in the absence of symptoms is not indicated, taking into account the potential complications of therapy, including the increasing incidence of Clostridium difficile infection... more

Admissions for certain conditions show explosive growth in England following a sudden and unexpected increase in deaths

15 March 2018
Author(s): Rodney P. Jones

Physicians will be aware that workload seems to be inexplicably higher at sometimes than others. Interestingly, almost half of a person's entire lifetime utilization of acute inpatient care occurs in... more

Brucellosis infection increasing in Southern China

15 March 2018
Author(s): Weili Kong

Brucellosis is the most common zoonotic disease mainly caused by Brucella melitensis infection (biovars 1 and 3) which posed a threat to animal and public health [1]. Brucellosis symptoms include... more

Heterogeneity among splanchnic vein thrombosis associated with myeloproliferative neoplasms

20 March 2018
Author(s): Daniele Cattaneo, Umberto Gianelli, Paola Bianchi, Agostino Cortelezzi, Alessandra Iurlo

In BCR-ABL1-negative myeloproliferative neoplasms (MPNs) thrombo-hemorrhagic complications represent the most common cause of morbidity and mortality. In particular, the reported overall incidence of... more

You can keep your shirt on: A physician's auscultating s(k)in

20 March 2018
Author(s): L.S. van Galen, P.P.P. Bos

It is known that when physicians fall ill they often find it hard to consult their colleagues. We tend to wait too long and the interaction is not always smooth due to projected expectations and... more

Use of degludec insulin in chronic complex patients

22 March 2018
Author(s): J. Carretero Gómez, J.P. Miramontes González, J.M. Varela Aguilar, J. Ena, J.C. Arévalo Lorido, Diabetes and Obesity Working Group of Spanish Society of Internal Medicine

Diabetes mellitus has emerged as an important global public concern, affecting 422 million adults. In addition, it is expected that diabetes will become the 7th leading cause of death by 2030 [1].... more

Narrative Review

Accounting for frailty when treating chronic diseases

8 March 2018
Author(s): Graziano Onder, Davide L. Vetrano, Alessandra Marengoni, J. Simon Bell, Kristina Johnell, Katie Palmer, Optimising Pharmacotherapy through Pharmacoepidemiology Network (OPPEN)

Chronic diseases are considered to be major determinants of frailty and it could be hypothesized that their treatment may counteract the development of frailty. However, the hypothesis that intensive... more

Original Article

Association between blood eosinophil count with asthma hospital readmissions

4 March 2018
Author(s): Francisco-Javier Gonzalez-Barcala, Maria-Esther San-Jose, Juan-José Nieto-Fontarigo, Jose-Martín Carreira, Uxio Calvo-Alvarez, Maria-Jesus Cruz, David Facal, Maria-Teresa Garcia-Sanz, Luis Valdes-Cuadrado, Francisco-Javier Salgado

The presence of eosinophils in asthma inflammation is a relevant factor in the pathophysiology of the disease, however the relationship between the blood eosinophil count (BEC) with asthma severity... more

Antipsychotic drugs and the risk of recurrent venous thromboembolism: A prospective cohort study

13 March 2018
Author(s): L.M. Mollard, R. Le Mao, C. Tromeur, E. Le Moigne, M. Gouillou, B. Pan-Petesch, A. Delluc, F. Couturaud, K. Lacut

Numerous studies have suggested that antipsychotic drugs are associated with an increased risk for a first episode of venous thromboembolism (VTE). However, after anticoagulation discontinuation, the... more

Synergistic effect of oral corticosteroids use on risk of hepatocellular carcinoma in high risk populations

16 March 2018
Author(s): Shih-Wei Lai, Cheng-Li Lin, Kuan-Fu Liao

Little evidence is available on the relationship between oral corticosteroids use and hepatocellular carcinoma. The objective of this study was to investigate whether oral corticosteroids use... more

Effects on short term outcome of non-invasive ventilation use in the emergency department to treat patients with acute heart failure: A propensity score-based analysis of the EAHFE Registry

22 March 2018
Author(s): Òscar Miró, Gemma Martínez, Josep Masip, Víctor Gil, Francisco Javier Martín-Sánchez, Pere Llorens, Pablo Herrero-Puente, Carolina Sánchez, Fernando Richard, Javier Lucas-Invernón, José Manuel Garrido, Alexandre Mebazaa, José Ríos, W. Frank Peacock, Judd E. Hollander, Javier Jacob, on behalf of the ICA-SEMES Research Group Researchers

To assess the effects of non-invasive ventilation (NIV) in emergency department (ED) patients with acute heart failure (AHF) on short term outcomes.

Model for End-Stage Liver Disease Excluding INR (MELD-XI) score is associated with hemodynamic impairment and predicts mortality in critically ill patients

22 March 2018
Author(s): Bernhard Wernly, Michael Lichtenauer, Namkje Vellinga, Christiaan Boerma, Can Ince, Malte Kelm, Christian Jung

We aimed (i) to evaluate Model for End-stage Liver Disease excluding INR (MELD-XI) score for prediction of mortality in a cohort of critically ill patients and (ii) to investigate associations of... more

Fatty liver index is associated to pulse wave velocity in healthy subjects: Data from the Brisighella Heart Study

24 March 2018
Author(s): Arrigo F.G. Cicero, Stefano Gitto, Federica Fogacci, Martina Rosticci, Marina Giovannini, Sergio D'Addato, Pietro Andreone, Claudio Borghi, for the Brisighella Heart Study Group Medical and Surgical Sciences Dept., University of Bologna

Non-Alcoholic Fatty Liver Disease (NAFLD) is associated to increased risk of cardiovascular disease. Our aim was to evaluate association of indexes of fatty liver with arterial stiffness (AS).