Red cell distribution width and prognosis in acute heart failure: ready for prime time!
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - December 13, 2018 Category: Emergency Medicine Source Type: research

Primary stroke centers: are they worthy of an upgrade?
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - December 12, 2018 Category: Emergency Medicine Source Type: research

Prognostic value of sepsis-induced coagulation abnormalities: an early assessment in the emergency department
This report utilizes a portion of the data collected in a prospective study, with the aim to identify reliable biomarkers for an early sepsis diagnosis. In the period November 2011 –December 2016, we enrolled 268 patients, admitted to our High-Dependency Unit with a diagnosis severe sepsis/septic shock. Study-related blood samplings were performed at ED-HDU admission (T0), after 6 h (T6) and 24 h (T24): D-dimer, thrombin–antithrombin complex (TAT) and prothrombin fragmen t F1 + 2 levels were analyzed. The primary end-points were day-7 and in-hospital mortality. Day-7 mortality rate was 1...
Source: Internal and Emergency Medicine - December 7, 2018 Category: Emergency Medicine Source Type: research

Triggering agents and microbiome as environmental factors on Beh çet’s syndrome
AbstractEnvironmental and other triggering factors are suggested to cause the onset and the clinical relapses of Beh çet’s syndrome (BS), a multi-systemic inflammatory disorder. In this review, environmental factors are discussed according to their interactions with etiopathogenesis, immune response and disease activity. Stress is a common self-triggering factor for most BS patients. Stimuli such as some foods can activate oral ulcers, and may be linked to the histamine content of the food. Oral/skin trauma and menstruation associated with hormonal factors aggravate, whereas allergy/atopy seem to alleviate the...
Source: Internal and Emergency Medicine - December 6, 2018 Category: Emergency Medicine Source Type: research

A young male with progressive dyspnea: Ebstein ’s anomaly
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - December 6, 2018 Category: Emergency Medicine Source Type: research

An uncommon cause of acute flank pain: renal infarction
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - December 6, 2018 Category: Emergency Medicine Source Type: research

Chronic kidney disease in low-middle income populations: a call to action for screening and prevention
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - December 6, 2018 Category: Emergency Medicine Source Type: research

Retroperitoneal dedifferentiated liposarcoma
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - December 5, 2018 Category: Emergency Medicine Source Type: research

Correction to: Clinical impact of hospital malnutrition
In the original publication, article was published with a wrong title as ‘Risk, prevalence, and impact of hospital malnutrition in a Tertiary Care Referral University Hospital: a cross-sectional study’ and also one of the references has been omitted in the reference list. The correct article title should be read as ‘Clinical impact of hospital malnutrition’. (Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - December 5, 2018 Category: Emergency Medicine Source Type: research

A possible still role for colchicine in children with idiopathic recurrent acute pericarditis?
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - December 5, 2018 Category: Emergency Medicine Source Type: research

Central PRES (posterior reversible encephalopathy syndrome) in HELLP syndrome
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - December 5, 2018 Category: Emergency Medicine Source Type: research

An unusual cause of acute thoracic pain: left ventricular pseudoaneurysm
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 23, 2018 Category: Emergency Medicine Source Type: research

Hazelnut and cocoa spread improves flow-mediated dilatation in smokers
AbstractHazelnut and cocoa spread is an Italian product containing cocoa and hazelnut. Several epidemiological studies suggest that cocoa and hazelnuts cocoa exert beneficial cardiovascular effects. To investigate whether in smokers, hazelnut and cocoa spread elicits artery dilatation via down-regulation of oxidative stress. Flow-mediated dilatation (FMD), oxidative stress (as assessed by serum isoprostanes excretion, Nox2 activation and NO bioavailability) and antioxidant status [as assessed by vitamin E levels, plasma total polyphenols and H2O2 breaking down activity (HBA)] were studied in 20 smokers in a crossover, sing...
Source: Internal and Emergency Medicine - November 23, 2018 Category: Emergency Medicine Source Type: research

Bertolotti ’s syndrome: a transitional anatomic cause of low back pain
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 23, 2018 Category: Emergency Medicine Source Type: research

Antimicrobial stewardship in an Internal Medicine ward: effects on antibiotic consumption and on the use of carbapenems
AbstractAssessing the effects of an antimicrobial stewardship program (ASP) implemented in a 78-bed Internal Medicine ward of an Italian mid-sized acute care hospital of 296 beds (26,820  bed days/year in 2015 and 26,653 in 2016). The ASP, implemented in May 2016, included: (a) formulation and dissemination of local guidelines on empiric antibiotic therapy; (b) educational training; and (c) restrictive control on the use of carbapenems. We included in the study all the patients who had received at least one systemic antibiotic as empiric therapy and who were discharged in two comparable time periods (Oct–Nov 201...
Source: Internal and Emergency Medicine - November 23, 2018 Category: Emergency Medicine Source Type: research

Treatment of apixaban- and rivaroxaban-associated major bleeding using 4-factor prothrombin complex concentrate
AbstractThere is limited clinical experience with the use of coagulation concentrates to reverse the effect of direct oral anticoagulants. We assess the achievement of effective clinical hemostasis with the use of 4-factor prothrombin complex concentrate (PCC) in patients on apixaban or rivaroxaban presenting with major bleeding. A retrospective chart review was conducted at a tertiary referral medical center in the USA. We assess the achievement of clinical hemostasis using 4-factor PCC in patients on chronic apixaban or rivaroxaban therapy presenting with major bleeding. Clinical hemostasis was assessed by the Internatio...
Source: Internal and Emergency Medicine - November 9, 2018 Category: Emergency Medicine Source Type: research

A sticking sensation in the throat!
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 9, 2018 Category: Emergency Medicine Source Type: research

A sweet fever
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 8, 2018 Category: Emergency Medicine Source Type: research

Stevens –Johnson syndrome
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 8, 2018 Category: Emergency Medicine Source Type: research

 Antithrombotic therapy and intracranial bleeding in subjects with sporadic brain arteriovenous malformations: preliminary results from a retrospective study
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 7, 2018 Category: Emergency Medicine Source Type: research

Obstructive nephropathy: simple yet complicated!
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - November 1, 2018 Category: Emergency Medicine Source Type: research

Superior vena cava syndrome with concomitant upper extremity deep vein thrombosis
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 31, 2018 Category: Emergency Medicine Source Type: research

Non-invasive ventilation in COPD exacerbation: how and why
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 27, 2018 Category: Emergency Medicine Source Type: research

Chronic kidney disease and kidney health care status: the healthy life in Suriname (HeliSur) study
AbstractThe high cardiovascular risk burden in low- and middle-income countries is expected to lead to an explosive increase in chronic kidney disease (CKD). However, population data on CKD from these countries are scarce. Therefore, we assessed kidney health in Suriname. In the Healthy Life in Suriname (HeliSur) study, a random sample of the adult population, we collected data with standardized questionnaires, physical examination, and blood and urine samples analysed in a central laboratory. Prevalent CKD was graded with KDIGO guidelines. In addition, we assessed national data on prevalent renal replacement therapy (RRT)...
Source: Internal and Emergency Medicine - October 26, 2018 Category: Emergency Medicine Source Type: research

Long-term effectiveness and safety of switching from originator to biosimilar infliximab in patients with Beh çet’s disease
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 25, 2018 Category: Emergency Medicine Source Type: research

Risk factors associated with bacteremia correlated with mortality in patients with acute bacterial skin and skin structure infection
AbstractAcute bacterial skin and skin structure infections (ABSSSI) is a common cause of acute admissions worldwide, but the disease is not well understood epidemiologically with respect to factors that determine positive blood cultures or patient mortality. To understand the utility of blood cultures and the association between bacteremia and mortality in patients with ABSSSI, we conducted a retrospective study to investigate factors associated with positive blood cultures and mortality in patients with ABSSSI. A retrospective cohort study of hospitalized adult patients with ABSSSI was conducted in a tertiary hospital in ...
Source: Internal and Emergency Medicine - October 25, 2018 Category: Emergency Medicine Source Type: research

Potential drug –drug interactions in deceased inpatients
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 24, 2018 Category: Emergency Medicine Source Type: research

Artificial neural networks and risk stratification in emergency departments
AbstractEmergency departments are characterized by the need for quick diagnosis under pressure. To select the most appropriate treatment, a series of rules to support decision-making has been offered by scientific societies. The effectiveness of these rules affects the appropriateness of treatment and the hospitalization of patients. Analyzing a sample of 1844 patients and focusing on the decision to hospitalize a patient after a syncope event to prevent severe short-term outcomes, this work proposes a new algorithm based on neural networks. Artificial neural networks are a non-parametric technique with the well-known abil...
Source: Internal and Emergency Medicine - October 23, 2018 Category: Emergency Medicine Source Type: research

Symptom expression in advanced cancer patients admitted to hospice or home care with and without delirium
AbstractThe aim of this study is to investigate the relationship between delirium and symptom expression in advanced cancer patients admitted to palliative care services. This is a secondary analysis of a consecutive sample of advanced cancer patients who were admitted to home care and hospices, and prospectively assessed for a period of 10  months. The Edmonton Symptom Assessment Scale (ESAS) and the MDAS (Memorial Delirium Assessment Scale) were measured at admission (T0) and after seven days of home care or hospice care (T7). Of the eight hundred and forty-eight patients screened in the period, 585 were not conside...
Source: Internal and Emergency Medicine - October 17, 2018 Category: Emergency Medicine Source Type: research

Silybin and metabolic disorders
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 17, 2018 Category: Emergency Medicine Source Type: research

SIRS or qSOFA? Is that the question? Clinical and methodological observations from a meta-analysis and critical review on the prognostication of patients with suspected sepsis outside the ICU
AbstractThe purpose of the study was to assess the prognostic performances, in terms of in-hospital mortality, of the quick sequential organ failure assessment (qSOFA) score and the systemic inflammatory response syndrome (SIRS) criteria applied to patients with suspected infection outside the ICU, and to critically reappraise the results and the clinical impact of the SEPSIS-3 study and of the subsequent trials. We performed bivariate meta-analysis, evaluation of the Bayesian post-test probabilities of death, and computation of the unidentified deaths for every 1000 screened cases (UDS1000). The use of qSOFA for screening...
Source: Internal and Emergency Medicine - October 15, 2018 Category: Emergency Medicine Source Type: research

Sulphurous mud-bath therapy for treatment of chronic low back pain caused by lumbar spine osteoarthritis
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 13, 2018 Category: Emergency Medicine Source Type: research

Exploring the relationship between nonalcoholic fatty liver disease and pancreatic cancer by computed tomographic survey: comment
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 11, 2018 Category: Emergency Medicine Source Type: research

Central venous oxygen saturation is not predictive of early complications in cancer patients presenting to the emergency department
This study does not support the use of ScvO2 to risk stratify cancer patients presenting to the ED. (Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 10, 2018 Category: Emergency Medicine Source Type: research

Comparison of CHA 2 DS 2 -VASc and AHEAD scores for the prediction of incident dementia in patients hospitalized for heart failure: a nationwide cohort study
This study explores the use of the CHA2DS2-VASc and the AHEAD scores to predict incident dementia in patients with heart failure (HF) who need hospitalization. We used a large national database to study 387,595 adult patients hospitalized for HF from Taiwan. This registration cohort was followed to document the cumulative incidence of dementia. The area under the curve of receiver operating characteristics (AUROC) was used to evaluate the discriminative ability of CHA2DS2-VASc and AHEAD scores in predicting dementia, whereas the DeLong test was used to examine the difference between the predictive capacity. A higher CHA2DS...
Source: Internal and Emergency Medicine - October 10, 2018 Category: Emergency Medicine Source Type: research

Short- vs long-course antibiotic therapy for pneumonia: a comparison of systematic reviews and guidelines for the SIMI Choosing Wisely Campaign
AbstractReduction of the inappropriate use of antibiotics in clinical practice is one of the main goals of the Societ à Italiana di Medicina Interna (SIMI) choosing wisely campaign. We conducted a systematic review of secondary studies (systematic reviews and guidelines) to verify what evidence is available on the duration of antibiotic treatment in Pneumonia. A literature systematic search was performed to identi fy all systematic reviews and the three most cited and recent guidelines that address the duration of antibiotic therapy in pneumonia. Moreover, a meta-analysis of non-duplicate data from randomized contro...
Source: Internal and Emergency Medicine - October 8, 2018 Category: Emergency Medicine Source Type: research

Reducing carbapenem prescribing in high-use settings: it is possible, and it is good to talk
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 6, 2018 Category: Emergency Medicine Source Type: research

Immune thrombocytopenic purpura and infections
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 1, 2018 Category: Emergency Medicine Source Type: research

Position paper of the Italian Society of Internal Medicine (SIMI) on prophylaxis and treatment of venous thromboembolism in patients with cancer
AbstractCancer patients are at high risk of developing thrombotic events, including venous thromboembolism (VTE) [deep venous thrombosis (DVT)  and pulmonary embolism (PE)], and arterial thrombosis. DVT and PE represent the second leading cause of death in cancer patients; moreover, the development of thromboembolic events in cancer patients is linked to a greater need of hospitalization and frequency of side effects during treatment, in particular bleeding, and to an increased risk of recurrence during and following antithrombotic therapy. The thromboembolic risk may be different in different subgroups of cancer popu...
Source: Internal and Emergency Medicine - October 1, 2018 Category: Emergency Medicine Source Type: research

Red cell distribution width predicts mid-term prognosis in patients hospitalized with acute heart failure: the RDW in Acute Heart Failure (RE-AHF) study
AbstractThe aim of the study was to evaluate the prognostic role of red cell distribution width (RDW) in a broad population of patients hospitalized for acute heart failure (AHF). In a retrospective cohort observational study, 451 consecutive patients discharged for AHF were categorized in patients with low RDW ( ≤ 14.8%) and high RDW (>  14.8%). The rates of death from all causes or of hospital readmission for worsening heart failure and death were determined after a median follow-up of 18 months. The overall population has a median age of 80 years (IQR 72–85), 235 patients (52%) were m...
Source: Internal and Emergency Medicine - October 1, 2018 Category: Emergency Medicine Source Type: research

A simple treatment for a potentially life-threatening cause of malabsorption
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 1, 2018 Category: Emergency Medicine Source Type: research

Position paper of the Italian Society of Internal Medicine (SIMI) on prophylaxis and treatment of venous thromboembolism in patients with cancer
AbstractCancer patients are at high risk of developing thrombotic events, including venous thromboembolism (VTE) [deep venous thrombosis (DVT)  and pulmonary embolism (PE)], and arterial thrombosis. DVT and PE represent the second leading cause of death in cancer patients; moreover, the development of thromboembolic events in cancer patients is linked to a greater need of hospitalization and frequency of side effects during treatment, in particular bleeding, and to an increased risk of recurrence during and following antithrombotic therapy. The thromboembolic risk may be different in different subgroups of cancer popu...
Source: Internal and Emergency Medicine - October 1, 2018 Category: Emergency Medicine Source Type: research

Red cell distribution width predicts mid-term prognosis in patients hospitalized with acute heart failure: the RDW in Acute Heart Failure (RE-AHF) study
AbstractThe aim of the study was to evaluate the prognostic role of red cell distribution width (RDW) in a broad population of patients hospitalized for acute heart failure (AHF). In a retrospective cohort observational study, 451 consecutive patients discharged for AHF were categorized in patients with low RDW ( ≤ 14.8%) and high RDW (>  14.8%). The rates of death from all causes or of hospital readmission for worsening heart failure and death were determined after a median follow-up of 18 months. The overall population has a median age of 80 years (IQR 72–85), 235 patients (52%) were m...
Source: Internal and Emergency Medicine - October 1, 2018 Category: Emergency Medicine Source Type: research

A simple treatment for a potentially life-threatening cause of malabsorption
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - October 1, 2018 Category: Emergency Medicine Source Type: research

The pathogenetic mechanisms of cough in idiopathic pulmonary fibrosis
AbstractIdiopathic pulmonary fibrosis is a peripheral subpleural interstitial lung disorder limited to the lung not involving the airways. It has a poor prognosis (survival less than 5  years) and commonly an interstitial pneumonia radiological pattern. Patients complain of a chronic dry cough in 80% of cases. A cough is often the first symptom of this rare disease, preceding dyspnea by years, and is associated with a poor prognosis, high dyspnea scores and low FVC percentages. T he pathogenetic mechanisms leading to coughing in IPF are unclear. This review focuses on recent evidence of cough pathophysiology in this d...
Source: Internal and Emergency Medicine - September 29, 2018 Category: Emergency Medicine Source Type: research

Has time come for the use of direct oral anticoagulants in the extended prophylaxis of venous thromboembolism in acutely ill medical patients?
(Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - September 27, 2018 Category: Emergency Medicine Source Type: research

Management of hepatitis C virus infection in patients with chronic kidney disease: position statement of the joint committee of Italian association for the study of the liver (AISF), Italian society of internal medicine (SIMI), Italian society of infectious and tropical disease (SIMIT) and Italian society of nephrology (SIN)
AbstractHepatitis C virus (HCV) infection is now considered a systemic disease due to the occurrence of extra-hepatic manifestations. Among these, the renal involvement is frequent. HCV infection, in fact, is strongly associated with proteinuria and chronic kidney disease (CKD) and negatively affects the prognosis of renal patients. In the last few years, availability of more specific and effective drugs against HCV has dramatically changed the clinical course of this disease. These drugs may provide further advantages in the CKD population as a whole by reducing progression of renal disease, mortality rate and by increasi...
Source: Internal and Emergency Medicine - September 25, 2018 Category: Emergency Medicine Source Type: research

Risk of new-onset atrial fibrillation among heart, kidney and liver transplant recipients: insights from a national cohort study
This study demonstrates an increased incidence of AF a fter OT. Heightened awareness and clinician vigilance are warranted to facilitate early diagnosis and improved outcomes. (Source: Internal and Emergency Medicine)
Source: Internal and Emergency Medicine - September 25, 2018 Category: Emergency Medicine Source Type: research