May 2019

27 Articles

No Section

Spontaneous pneumomediastinum presententing as nasal voice

26 May 2019
Author(s): Asaf Miller, Tal Mann Ben Yehuda

We present a case of spontaneous pneumomediastinum in a person with hypoxemia and dyspnea caused by vigorous cough. The entity of spontaneous pneumomediastinum is unfamiliar and is considered rare.... more

A refractory bicytopenia in a pregnant woman

25 May 2019
Author(s): Mathieu Gerfaud-Valentin, Florence Chaudot, Pascal Seve

A 24-year-old woman was referred to our hospital for an anaemia with thrombocytopenia worsening since 3 months at 36 amenorrhoea weeks of her first pregnancy. She had no significant past medical... more

Predictors of mortality of bloodstream infections among internal medicine patients in a Swiss Hospital: Role of quick Sequential Organ Failure Assessment

22 May 2019
Author(s): Matthaios Papadimitriou-Olivgeris, Roxanni Psychogiou, Jonathan Garessus, Adeline De Camaret, Nicolas Fourre, Sujitha Kanagaratnam, Virginie Jecker, Charly Nusbaumer, Luce Bertaiola Monnerat, Alain Kocher, Vera Portillo, Hervé Duplain

Sepsis has been associated with high morbidity and mortality. The aims were to determine predictors of mortality among patients with bloodstream infections (BSIs) and to ascertain the role of quick... more

An unusual cause of ventricular tachycardia

17 May 2019
Author(s): Marco Zuin, Loris Roncon

A 64-year old male presented for chest pain. His medical history included arterial hypertension, diabetes and a familial history of sudden cardiac death. Four weeks before he received a surgical... more

Hereditary angioedema, emergency management of attacks by a call center

17 May 2019
Author(s): Nicolas Javaud, Adrien Altar, Olivier Fain, Paul-Georges Reuter, Michel Desmaizieres, Tomislav Petrovic, Aiham Ghazali, Isabelle Durand-zaleski, Laurence Bouillet, Eric Vicaut, David Launay, Ludovic Martin, Bernard Floccard, Anne Gompel, Alain Sobel, Isabelle Boccon-Gibod, Gisele Kanny, Frederic Lapostolle, Frederic Adnet

Hereditary angiœdema (HAE) is a rare autosomal dominant disease characterized by recurrent, unpredictable, potentially life-threatening swelling. Objective is to assess the management of the acute... more

Burning red hot feet

16 May 2019
Author(s): Vishal Thakur, Dipankar De

A man in his fifties presented with 1-year history of burning sensation and pain in both feet with dusky erythema on both dorsal feet and soles with no associated systemic complaint. Cutaneous... more

Clinical Insights

And now we have the AUGUSTUS … How will it impact on antithrombotic therapy in patients with atrial fibrillation undergoing percutaneous coronary intervention?

23 May 2019
Author(s): Andrea Rubboli

Optimal antithrombotic therapy in patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention with stent (PCI) should consist of both oral anticoagulation (OAC) and... more


Navigating the treacherous waters of antithrombotic therapies in patients with atrial fibrillation and coronary artery disease: Lessons from AUGUSTUS

23 May 2019
Author(s): Ralf E. Harskamp, John H. Alexander, Renato D. Lopes

Determining the optimal antithrombotic regimen to prevent ischemic events and bleeding presents a challenge to cardiologists in managing their patients with atrial fibrillation (AF) who experience an... more

Internal Medicine Flashcard

Multimodality imaging of aortopulmonary paraganglioma

23 May 2019
Author(s): Francesco Melillo, Roberto Spoladore, Alberto Margonato

A 72-years old woman was admitted to our department for a long lasting (3-hours) thoracic pain episode and increasing palpitations during the last month. At admission clinical examination was... more

Sparse pustules and tenosynovitis in a young man

17 May 2019
Author(s): Ignacio Torres-Navarro, Blanca de Unamuno-Bustos, Javier López-Davia

A man in his 37 s consulted about a two-day-history of pustules on his both hands (Fig. 1A-C) and his right elbow (Fig. 1D). He complained also about edema, polyarthralgia with asymmetric small joint... more

Letter to the Editor

Author's Reply: Issues regarding ambulatory blood pressure measurement in severely obese population: The guilty upper-arm' Item cover sheet has been updated accordingly

17 May 2019
Author(s): Anna Głuszewska, Barbara Gryglewska, Jerzy Gąsowski

Leblanc et al. are correct to note that using inappropriate cuff size and shape for blood pressure (BP) measurements, may lead to measurement error, especially in population of obese patients [1]. In... more

Pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension incidence in Latvia in 2018

14 May 2019
Author(s): Dana Kigitovica, Matiss Sablinskis, Kristaps Sablinskis, Ainars Rudzitis, Andris Skride

Pulmonary hypertension (PH) is a heterogeneous group of disorders that can be classified according to clinical, hemodynamic and pathological findings and the prognosis of each group differs... more

A robust tool for recording pharmacist's interventions in a low-resource setting

10 May 2019
Author(s): Timothy Rennie, Liisa Anguuo, Nicola Corkhill, Mwangana Mubita, Christian John Hunter

Yailian et al., [1] describe the medical and pharmaceutical staff perspectives of pharmacist's interventions in a clinical rheumatology setting in France. Interventions were classified according to a... more

Narrative Review

New oncologic emergencies: What is there to know about inmunotherapy and its potential side effects?

23 May 2019
Author(s): Arantzazu Barquín-García, Javier Molina-Cerrillo, Pilar Garrido, Daniel Garcia-Palos, Alfredo Carrato, Teresa Alonso-Gordoa

Over the last decade anticancer treatment has experienced encouraging changes. One of the latest developments is immunotherapy, which is increasingly becoming a mainstay for the treatment of these... more

Original Article

Associations between patient and system characteristics and MET review within 48 h of admission to a teaching hospital: A retrospective cohort study

30 May 2019
Author(s): Joshua Allen, Liliana Orellana, Daryl Jones, Julie Considine, Judy Currey

The Medical Emergency Team (MET) has enhanced the recognition and response to clinical deterioration in acute healthcare. However, patients reviewed by the MET are at increased risk of in-hospital... more

Delirium in patients with dementia and in children: Overlap of symptoms profile and possible role for future diagnosis

28 May 2019
Author(s): Alessandro Morandi, Jennifer L. Thompson, Giuseppe Bellelli, Elena Lucchi, Renato Turco, Simona Gentile, Marco Trabucchi, Alasdair MacLullich, David Meagher, E. Wesley Ely, Pratik Pandharipande, Heidi Smith

Delirium in the extremes of the age spectrum may show similarities in presentations, and these similarities may provide information to develop tools for the diagnosis of delirium superimposed on... more

CD5/CD20 expression on circulating B cells in HCV-related chronic hepatitis and mixed cryoglobulinemia

21 May 2019
Author(s): Sabino Russi, Alessandra Vincenti, Angela Vinella, Maria Addolorata Mariggiò, Fabio Pavone, Franco Dammacco, Gianfranco Lauletta

The role of CD5+ B cells in patients with HCV infection and HCV-related disorders, including mixed cryoglobulinemia (MC), has been addressed in previous reports with conflicting results. We... more

A quarter of admitted poisoned patients have a mild poisoning and require no treatment: An observational study

18 May 2019
Author(s): Laura Hondebrink, Saskia J. Rietjens, Dirk W. Donker, Claudine C. Hunault, Irma van den Hengel-Koot, Pauline M. Verputten, Irma de Vries, Karin A.H. Kaasjager, Douwe Dekker, Dylan W. de Lange

Poisoned patients are frequently admitted following Emergency Department (ED) presentation, while the necessity of such admissions is hardly investigated. We determined the proportion and... more

Body mass index as a driver of selection of biologic therapy in rheumatoid arthritis. Results from the US-CLARA study

18 May 2019
Author(s): Marco Di Carlo, Fausto Salaffi, Elisa Gremese, Florenzo Iannone, Giovanni Lapadula, Gianfranco Ferraccioli, on behalf of the GISEA Study Group

Body mass index (BMI) demonstrated to influence the clinical response to different drugs in rheumatoid arthritis (RA). The aim of this study was to investigate the role of BMI in the achievement of... more

Prognosis after pacemaker implantation in extreme elderly

13 May 2019
Author(s): Balla Cristina, Malagu’ Michele, Fabbian Fabio, Guarino Matteo, Zaraket Fatima, Brieda Alessandro, Smarrazzo Vittorio, Ferrari Roberto, Bertini Matteo

Significant comorbidities may limit the potential benefit of pacemaker (PM) implantation in extreme elderly. A short-term mortality risk prediction score, able to identify high-risk patients, may be... more

Drug–drug interactions involving CYP3A4 and p-glycoprotein in hospitalized elderly patients

10 May 2019
Author(s): Paolo Gallo, Antonio De Vincentis, Claudio Pedone, Alessandro Nobili, Mauro Tettamanti, Umberto Vespasiani Gentilucci, Antonio Picardi, Pier Mannuccio Mannucci, Raffaele Antonelli Incalzi, REPOSI Investigators

Polypharmacy is very common in older patients and may be associated with drug-drug interactions. Hepatic cytochrome P450 (notably 3A4 subtype, CYP3A4) is a key enzyme which metabolizes most drugs; P-... more

Effect of risk of malnutrition on 30-day mortality among older patients with acute heart failure in Emergency Departments

7 May 2019
Author(s): Francisco Javier Martín-Sánchez, Federico Cuesta Triana, Xavier Rossello, Rebeca Pardo García, Guillermo Llopis García, Francisca Caimari, María Teresa Vidán, Pedro Ruiz Artacho, Juan González del Castillo, Pere Llorens, Pablo Herrero, Javier Jacob, Víctor Gil, Cristina Fernández Pérez, Pedro Gil, Héctor Bueno, Òscar Miró, Pilar Matía Martín, Representing the members of the OAK Register Investigators, Esther Rodríguez Adrada, María Carmen Santos, Lucía Salgado, Berenice Nayla Brizzi, María Luisa Docavo, María del Mar Suárez-Cadenas, Carolina Xipell, Carolina Sánchez, Sira Aguiló, Josep María Gaytan, Alba Jerez, María José Pérez-Durá, Pablo Berrocal Gil, María Luisa López-Grima, Amparo Valero, Alfons Aguirre, Maria Àngels Pedragosa, Pascual Piñera, Paula LázaroAragues, José Andrés Sánchez Nicolás, Miguel Alberto Rizzi, Sergio Herrera Mateo, Aitor Alquezar, Alex Roset, Carles Ferrer, Ferrán Llopis, José María Álvarez Pérez, María Pilar López Diez, Fernando Richard, José María Fernández-Cañadas, José Manuel Carratalá, Patricia Javaloyes, Juan Antonio Andueza, José Antonio Sevillano Fernández, Rodolfo Romero, Marta Merlo Loranca, Virginia Álvarez Rodríguez, María Teresa Lorca, Luis Calderón, Ester Soy Ferrer, José Manuel Garrido, Enrique Martín Mojarro

Little is known about the prevalence and impact of risk of malnutrition on short-term mortality among seniors presenting with acute heart failure (AHF) in emergency setting. The objective was to... more

Plasma level of soluble urokinase plasminogen activator receptor (suPAR) predicts long-term mortality after first acute alcohol-induced pancreatitis

3 May 2019
Author(s): Anu Aronen, Janne Aittoniemi, Reetta Huttunen, Anssi Nikkola, Jussi Nikkola, Olli Limnell, Isto Nordback, Juhani Sand, Johanna Laukkarinen

Soluble urokinase plasminogen activator receptor (suPAR) is a biomarker associated with inflammatory and certain malignancies. Earlier we have shown that plasma suPAR (P-suPAR) predicts severity of... more

Predictive value of serum myostatin for the severity and clinical outcome of heart failure

2 May 2019
Author(s): Pingan Chen, Zhen Liu, Yishan Luo, Lushan Chen, Shaonan Li, Yizhi Pan, Xiaoming Lei, Daihong Wu, Dingli Xu

The exact relationship between serum myostatin and the severity and prognosis of chronic heart failure (CHF) is unclear. In this study, we investigated the association between serum myostatin and the... more

Intermediate-risk pulmonary embolism: Aiming to improve patient stratification

1 May 2019
Author(s): Roy Beigel, Israel Mazin, Orly Goitein, Romana Herscovici, Sharon Natanzon, Fernando Chernomordik, Sagit Ben-Zekry, Paul Fefer, Avishay Grupper, Shlomi Matetzky

Intermediate-risk pulmonary embolism (PE) patients present a therapeutic dilemma. While some are at risk for developing adverse events, possibly requiring escalation therapy, most will have a benign... more

Review Article

Management of iron deficiency in chronic heart failure: Practical considerations for clinical use and future directions

17 May 2019
Author(s): Maria Nikolaou, Christina Chrysohoou, Theodosis Anastasios Georgilas, Gregory Giamouzis, George Giannakoulas, Apostolos Karavidas, Christodoulos Papadopoulos, Sotirios Patsilinakos, Dimitrios Tziakas, John Parissis, for the Hellenic Iron Consensus Group

Heart Failure (HF) is a global pandemic with rapidly increasing prevalence. In an attempt to maintain patients well being, the therapeutic interest has expanded to the vicious cycles that confer to... more

Systematic review and meta-analysis of randomised controlled clinical trial evidence refutes relationship between pharmacotherapy with angiotensin-receptor blockers and an increased risk of cancer

3 May 2019
Author(s): Thomas Datzmann, Susanne Fuchs, Daniel Andree, Bernd Hohenstein, Jochen Schmitt, Christoph Schindler

The potential influence of angiotensin-receptor blockers (ARBs) on carcinogenesis is a much-debated topic. Both observational, as well as preclinical studies in rodent carcinogenic assays, suggest a... more


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