October 2017

32 Articles

No Section

Intox, detox, antidotes – Evidence based diagnosis and treatment of acute intoxications

30 October 2017
Author(s): Andreas Schaper, Martin Ebbecke

Aim of this review is to describe the role of clinical toxicology in the context of acute medicine. A special focus is put on antidotes and important aspects of diagnosis and therapy of acute... more

Clinical outcomes of elderly patients with bloodstream infections due to extended-spectrum β-lactamase–producing Enterobacteriaceae in an Italian Internal Medicine ward

28 October 2017
Author(s): Simone Meini, Raffaele Laureano, Carlo Tascini, Fabio Arena, Lucia Fani, Anna Frullini, Maria Teresa Passaleva, Anna Teresa Roberts, Dario Mannini, Francesco Sbrana, Andrea Ripoli, Gian Maria Rossolini

Infections caused by ESBL-producing Enterobacteriaceae (ESBL-EB) are a major health problem, but data regarding elderly patients is lacking.

Prognostic value of early warning scores in the emergency department (ED) and acute medical unit (AMU): A narrative review

7 October 2017
Author(s): R.S. Nannan Panday, T.C. Minderhoud, N. Alam, P.W.B. Nanayakkara

A wide array of early warning scores (EWS) have been developed and are used in different settings to detect which patients are at risk of deterioration. The aim of this review is to provide an... more

Technological aided assessment of the acutely ill patient – The case of postoperative complications

4 October 2017
Author(s): C. Haahr-Raunkjær, C.S. Meyhoff, H.B.D. Sørensen, R.M. Olsen, E.K. Aasvang

Surgical interventions come with complications and highly reported mortality after major surgery. The mortality may be a result of delayed detection of severe complications due to lower monitoring... more

The assessment of acute kidney injury in critically ill patients

2 October 2017
Author(s): Sebastjan Bevc, Robert Ekart, Radovan Hojs

Acute kidney injury (AKI) is common in critically ill patients and is associated with high morbidity and mortality. The availability of several biomarkers of kidney injury offers new tools for its... more

Internal Medicine Flashcard

Dilation of duodenum, stomach and esophagus in a patient with weight loss

5 October 2017
Author(s): Toyoaki Sawano, Yoshitaka Nishikawa, Akihiko Ozaki

A 37-year-old man with no significant medical history presented to our emergency department with abdominal pain and vomiting since the previous day. He had experienced dysphagia when eating solids... more

A young patient with back pain

5 October 2017
Author(s): Massimo Torreggiani, Vittoria Esposito, Ciro Esposito

A 25year-old Nigerian woman, was admitted because of a 7month lasting lumbar pain irradiated to the abdomen. She's been in Italy for 5months. Her medical history was mute except for a malaria... more

Letter to the Editor

Ultrasound versus stethoscope in internal medicine: Do not skip steps

24 October 2017
Author(s): Emmanuel Andrès, Raymond Gass

We read with interest the review by M.J Blans and F.H. Bosch entitled “Ultrasound in acute internal medicine; time to set a European standard?” published in the Journal [1]. We agree with the... more

Association between statin exposure and venous thromboembolism risk in cancer patients. Data from the EDITH case-control study

15 October 2017
Author(s): Claire De Moreuil, Raphaël Le Mao, Cécile Tromeur, Francis Couturaud, Karine Lacut, Aurélien Delluc

The occurrence of venous thromboembolism (VTE) in cancer patients is strongly associated with a poor cancer outcome irrespective of cancer stage [1]. Primary thromboprophylaxis with low-molecular... more

Superior safety of dual therapy with dabigatran and clopidogrel vs. triple therapy with warfarin, aspirin and clopidogrel in the RE-DUAL PCI trial: What is key, the strategy or the drug?

5 October 2017
Author(s): Andrea Rubboli

In line with the results of the PIONEER AF-PCI trial with rivaroxaban [1], those of the recent RE-DUAL PCI trial with dabigatran [2] further support the superior safety on bleeding events of dual... more

Quality of medication related information in discharge letters: A prospective cohort study

4 October 2017
Author(s): Elien B. Uitvlugt, Regina Suijker, Marjo J.A. Janssen, Carl E.H. Siegert, Fatma Karapinar-Çarkit

Transitions from one care setting to another is a well known risk factor for medication errors [1]. Inaccurate or delayed information transfer between settings could lead to serious harm to patients... more

Narrative Review

Obesity phenotypes and their paradoxical association with cardiovascular diseases

31 October 2017
Author(s): Alessandra Vecchié, Franco Dallegri, Federico Carbone, Aldo Bonaventura, Luca Liberale, Piero Portincasa, Gema Frühbeck, Fabrizio Montecucco

The pro-inflammatory state of the visceral adipose tissue (VAT) is supposed to accelerate cardiovascular (CV) and metabolic diseases in obese subjects. Some studies have recently reported an improved... more

Serology in autoimmune hepatitis: A clinical-practice approach

19 October 2017
Author(s): Benedetta Terziroli Beretta-Piccoli, Giorgina Mieli-Vergani, Diego Vergani

Serology is key to the diagnosis of autoimmune hepatitis (AIH). Clinicians need to be aware of which tests to request, how to interpret the laboratory reports, and be familiar with the laboratory... more

Recognising older frail patients near the end of life: What next?

6 October 2017
Author(s): Magnolia Cardona-Morrell, Ebony Lewis, Sanjay Suman, Cilla Haywood, Marcella Williams, Audrey-Anne Brousseau, Sally Greenaway, Ken Hillman, Elsa Dent

Frailty is a state of vulnerability resulting from cumulative decline in many physiological systems during a lifetime. It is progressive and considered largely irreversible, but its progression may... more

Ultrasound in acute internal medicine; time to set a European standard

4 October 2017
Author(s): Michael Justinus Blans, Frank Hendrik Bosch

Nowadays point-of-care ultrasound (POCUS) is considered indispensable for critical care and emergency physicians. POCUS is a noninvasive tool, can be done at the bedside, leads to instant diagnostic... more

Pioneers in pulmonary medicine

4 October 2017
Author(s): Shaylika Chauhan, Hassan Tariq, Yaseer Durrani, Yesenia Galan, Haris Rana, Arjun Madhavan

In the final year of the American Civil War, 1865, Chevalier Jackson was born on the 4th of November in Pittsburgh, Pennsylvania to a livestock raising family [1]. The depiction of his youth by his... more

Original Article

Epidemiology and risk factors for mortality in bloodstream infection by CP-Kp, ESBL-E, Candida and CDI: A single center retrospective study

30 October 2017
Author(s): Silvia Corcione, Roberto Angilletta, Stefania Raviolo, Claudia Filippini, Lucina Fossati, Giovanni Di Perri, Rossana Cavallo, Francesco Giuseppe De Rosa

The incidence of C. difficile infection (CDI) and of bloodstream infection (BSI) caused by Candida spp., ESBL-E-producing Enterobacteriaceae (ESBL-E) and carbapenemase-producing K. pneumoniae (CP-Kp... more

Comparing associations of different metabolic syndrome definitions with ischemic stroke in Chinese elderly population

29 October 2017
Author(s): Qian Liu, Yan-xun Li, Zhi-hao Hu, Xiao-yan Jiang, Shu-juan Li, Xiao-feng Wang

Studies have showed the associations between different definitions of metabolic syndrome (MetS) and risk of ischemic stroke were inconsistent. In this study, we compared associations of different... more

Epidemiological trends of deep venous thrombosis in HIV-infected subjects (1997–2013): A nationwide population-based study in Spain

25 October 2017
Author(s): Alejandro Alvaro-Meca, Pablo Ryan, Esther Martínez-Larrull, Dariela Micheloud, Juan Berenguer, Salvador Resino

Chronic infections may be a triggering factor as well as a risk factor of deep venous thrombosis (DVT). The purpose of this study was to analyze the epidemiological trends of hospital admissions... more

Glomerular filtration rate is associated with free triiodothyronine in euthyroid subjects: Comparison between various equations to estimate renal function and creatinine clearance

24 October 2017
Author(s): Josephine L.C. Anderson, Eke G. Gruppen, Lynnda van Tienhoven-Wind, Michele F. Eisenga, Hanne de Vries, Ron T. Gansevoort, Stephan J.L. Bakker, Robin P.F. Dullaart

Effects of variations in thyroid function within the euthyroid range on renal function are unclear. Cystatin C-based equations to estimate glomerular filtration rate (GFR) are currently advocated for... more

Systematically assessed symptoms as outcome predictors in emergency patients

23 October 2017
Author(s): R. Bingisser, M. Dietrich, R. Nieves Ortega, A. Malinovska, T. Bosia, C.H. Nickel

It is known that symptoms are predictive of mortality in “nonsurgical” emergency patients. It is unknown whether a prospective, systematic, and “unscreened” assessment of all symptoms is of any... more

Mild water restriction with or without urea for the longterm treatment of SIADH: Can urine osmolality help the choice?

7 October 2017
Author(s): G. Decaux, F. Gankam Kengne, B. Couturier, W. Musch, A. Soupart, F. Vandergheynst

Treatment options for chronic SIADH include water restriction (WR) and urea. The usefulness of urine osmolality to guide the choice of the treatment option is not clearly defined. We hypothesized... more

An acute hospital admission greatly increases one year mortality – Getting sick and ending up in hospital is bad for you: A multicentre retrospective cohort study

5 October 2017
Author(s): Marianne Fløjstrup, Daniel Pilsgaard Henriksen, Mikkel Brabrand

For most of the population a serious acute illness that require an emergency admission to hospital is a rare “once in a life time” event. This paper reports the one year mortality of patients... more

Using scores to identify patients at risk of short term mortality at arrival to the acute medical unit: A validation study of six existing scores

4 October 2017
Author(s): Mikkel Brabrand, Peter Hallas, Søren Nygaard Hansen, Kristian Møller Jensen, Janni Lynggård Bo Madsen, Stefan Posth

“Early warning scores” (EWS) have been developed to quantify levels of vital sign abnormality. However, many scores have not been validated. The aim of this study was to validate six scores that all... more

Age-specific and year of birth changes in hospital admissions during a period of unexplained higher deaths in England

4 October 2017
Author(s): Rodney P. Jones

Policy makers have assumed that increase in medical demands and costs are attributable to the increasing age of the population and the inability of health and social care to limit demand.

Screening of the frail patient in the emergency department: A systematic review

4 October 2017
Author(s): Rasmus Jørgensen, Mikkel Brabrand

Several frailty rating scales have been developed to detect and screen for the level of frailty. It is uncertain what diagnostic value screening of frailty level have in the emergency department.

Specific indications and clinical outcome in patients with subcutaneous ICD – A nationwide multicentre registry

1 October 2017
Author(s): Michael Sponder, Cesar Khazen, Wolfgang Dichtl, Lukas Fiedler, Deddo Mörtl, Alexander Teubl, Clemens Steinwender, Martin Martinek, Michael Nürnberg, Daniel Dalos, Johannes Kastner, Christoph Schukro

Subcutaneous implantable cardioverter-defibrillators (S-ICD) are an innovative and less invasive alternative to transvenous ICD (TV-ICD) in selected patients. We aimed to investigate the underlying... more

Reflections in Internal Medicine

The professional in the lead?

14 October 2017
Author(s): Wouter Bos

After graduating in economics and political sciences, I subsequently worked for Shell, became a member of parliament, party leader and Finance Minister, then took up consultancy and now am the CEO of... more

The dynamics of the emergency medical readmission — The underlying fundamentals

6 October 2017
Author(s): Declan Byrne, Deirdre O'Riordan, Richard Conway, Sean Cournane, Bernard Silke

Hospital readmissions are a perennial problem. We reviewed readmissions to one institution (2002–2015) and investigated their dynamics.

Review Article

Liver disease and heart failure: Back and forth

31 October 2017
Author(s): Michele Correale, Nicola Tarantino, Rossella Petrucci, Lucia Tricarico, Irma Laonigro, Matteo Di Biase, Natale Daniele Brunetti

In their clinical practice, physicians can face heart diseases (chronic or acute heart failure) affecting the liver and liver diseases affecting the heart. Systemic diseases can also affect both... more

Gut microbiota and obesity: Concepts relevant to clinical care

27 October 2017
Author(s): Maria Carlota Dao, Karine Clément

The composition and function of gut microbiota play a role in obesity and metabolic disease, yet the mechanisms have not been fully described. As new discoveries and advances in the field have... more

Special Article

Acute Oncology Care: A narrative review of the acute management of neutropenic sepsis and immune-related toxicities of checkpoint inhibitors

6 October 2017
Author(s): Thomas Knight, Shin Ahn, Terry W. Rice, Tim Cooksley

Cancer care has become increasingly specialized and advances in therapy have resulted in a larger number of patients receiving care. There has been a significant increase in the number of patients... more


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