Italian Journal of Medicine最新文献

{"title":"Characteristics, comorbidities and laboratory measures associated with disease severity and poor prognosis in young and elderly patients with COVID-19 admitted to medical wards in Emilia-Romagna region, Italy: a multicentre retrospective study","authors":"S. Fiorino, A. Carusi, Alessandro Zappi, Fabio Tateo, L. Peruzzo, Melissa Zanardi, Francesco Savelli, G. Di Marzio, Silvia Cesaretti, F. Dazzani, R. Francesconi, P. Leandri, G. Tortorici, Susanna Vicari, D. Melucci, F. Lari","doi":"10.4081/itjm.2023.1608","DOIUrl":"https://doi.org/10.4081/itjm.2023.1608","url":null,"abstract":"Background and Objectives. A relatively small number of studies have investigated the characteristics, comorbidities and laboratory measures associated with prognosis in patients with COVID-19, admitted to Internal Medicine Units (IMU) in Italy. Therefore, we performed a retrospective multicentre study to identify baseline features, predisposing to severe disease and poor outcomes, in adult individuals with SARS-CoV-2 infection, hospitalized in 5 IMUs in the Emilia-Romagna region (Italy). Materials and Methods. We included 129 consecutive patients (male 75, median age 68 years) from 1st March 2020 to 31st October 2021. Patients’ baseline characteristics, comorbidities, laboratory measures, and outcomes were collected. Results. At admission, the factors significantly associated with a higher risk of in-hospital mortality included: age (median 68 vs. 83 years in survived vs. dead patients, P=0.000), diabetes [Odds Ratio (OR) 4.00, P=0.016], chronic obstructive pulmonary disease (OR 4.60, P=0.022), cancer (OR 5.81, P=0.021), acute- (OR 9.88, P=0.000) and chronic-renal failure (OR 6.76, P=0.004). During the study period, 16 individuals died (12.4%), all over 70 years old. In deceased vs. non-deceased patients were detected: i) more elevated white blood cells and neutrophils-counts and lower lymphocytes count; ii) higher levels of total/direct bilirubin, creatinine, C-reactive-protein, lactate-dehydrogenase, ferritin, but only a slight Interleukin-6 increase; iii) a trend of lower vitamin D values. Conclusions. We proposed a new I index, a modified form of the Age-Adjusted Charlson Comorbidity Index, by considering pO2/FiO2 ratio, to better characterize the severity of COVID-19. Furthermore, we critically discuss our results with the current assumption which considers COVID-19 as a pathological condition associated with cytokine storm.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46576543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antimicrobial stewardship: un imperativo per il futuro","authors":"C. Santini, M. Giusti","doi":"10.4081/itjm.q.2023.2","DOIUrl":"https://doi.org/10.4081/itjm.q.2023.2","url":null,"abstract":"\u0000Principi generali di antimicrobial stewardshipS. Tedeschi\u0000L’interpretazione dell’antibiogrammaE. Carretto\u0000La terapia antibiotica empirica della sepsiP. Bocchi, P.G. Giuri, M. Gianfreda, S. Detrenis\u0000Il trattamento delle infezioni delle vie urinarieB. Laface, C. Moressa, E. Palaghita, G. Palamà, B. Marchisio, P. Colagrande, M. Giusti\u0000Approccio clinico alle polmoniti battericheM. Galassi, S. Fiorino, F. Lari\u0000Le infezioni di cute e tessuti molliS. Spiezia, C. Santini\u0000Infezioni fungine in Medicina InternaA. Milia, L. Corbo, F. Pieralli","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45665620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The experience of COVID-19 ward’s patients: a narrative medicine approach","authors":"P. Pisanu, Daniela Lucchetti, Dario Lucchetti, Nicolò Contu, V. Saraceni","doi":"10.4081/itjm.2023.1602","DOIUrl":"https://doi.org/10.4081/itjm.2023.1602","url":null,"abstract":"Narrative Medicine approach has increased in popularity in the medical context as an effective model to approach their patients’ experiences of illness with more understanding and compassion, offering fresh opportunities for empathic, respectful, and nourishing medical care. The goal of our work has been to study the overall experience of COVID-19 patients, putting the personal dimension at the center of the dialogue and the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Firstly, we considered their reaction to the consequences of the Lockdown, then we asked if they were fearful of potentially being infected, and finally, we asked about their illness and arrival at the hospital, having little to no information about their future. The interdisciplinary intersection between neuropsychology, micro-sociology of health, and physical and rehabilitative medicine has made it possible for us to report the following experience, providing new insights on the pre-existent doctorpatient relationship and the importance of hospitalization stories, for humane and effective medical practice.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47716189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A rare cause of recurrent syncope: chemodectoma of left carotid","authors":"Claudia Arturo, L. D'Alessandro, M. R. Poggiano, G. Orefice, Antonietta Longobardo, M. Liguori, C. Arcamone, A. Di Scala, Ciro di Gennaro, P. Di Micco","doi":"10.4081/itjm.2023.1585","DOIUrl":"https://doi.org/10.4081/itjm.2023.1585","url":null,"abstract":"Syncope is a frequent cause of access to emergency departments. Recurrent syncope may be associated with a transient lock of consciousness. When neurological or cardiological common causes of syncope are excluded, rare causes of syncope, such as solid carotid tumors, should be considered. In this study, we report a rare case of left carotid chemodectoma in a patient with frequent access to the emergency room for syncope in which a thorough differential diagnosis has been performed.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70231176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adult-onset Still’s disease with secondary macrophage activation syndrome: a case report","authors":"G. Nicoletti, Antonio Bonelli, Rocco Clemente, Simona Ciuffreda, Gaetano Dentamaro, Agata Tiziana La Masa, Vito Lascaro, P. Santarcangelo","doi":"10.4081/itjm.2023.1595","DOIUrl":"https://doi.org/10.4081/itjm.2023.1595","url":null,"abstract":"We describe a case of adult-onset Still’s disease (AOSD) with secondary macrophage activation syndrome. AOSD is a rare disease with unknown origin. Rarely it’s complicated by secondary macrophage activation syndrome, which is a life-threatening disorder. Because the diagnosis of AOSD is essential for exclusion and complications are life-threatening, it is mandatory for a prompt and extensive diagnostic workup and treatment.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41560396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FADOI survey on chronic kidney disease and anaemia in internal medicine departments of Italian hospitals","authors":"P. Bocchi, A. Montagnani, Michele Meschi, F. Pomero, P. Piccolo, A. Valerio, G. Gussoni, D. Manfellotto, F. Dentali, Chronic Kidney Disease and Anaemia In Internal Medicine (CKD-AIM) FADOI Study Group","doi":"10.4081/itjm.2023.1605","DOIUrl":"https://doi.org/10.4081/itjm.2023.1605","url":null,"abstract":"The presence of anaemia in patients with chronic kidney disease (CKD) is associated with decreased quality of life, along with increased morbidity, mortality, and hospitalization rates. This, in turn, affects healthcare costs and the utilization of medical resources. The mechanisms involved in anaemia of CKD are diverse and complex. They include reduced production of endogenous erythropoietin (EPO), absolute and/or functional iron deficiency (due to inflammation leading to elevated levels of hepcidin), the diminished response of the bone marrow to EPO due to uraemic toxins, the shortened lifespan of red blood cells (RBC), and deficiencies in vitamin B12 or folic acid. [...]","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48352279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nattokinase historical sketch on experimental and clinical evidence","authors":"P. Di Micco, F. F. Bernardi, G. Camporese, Mario Biglietto, A. Perrella, T. Ciarambino, V. Russo, E. Imbalzano","doi":"10.4081/itjm.2023.1583","DOIUrl":"https://doi.org/10.4081/itjm.2023.1583","url":null,"abstract":"Nattokinase (NK) is a protease derived from food used mainly in the Japanese diet that has several properties. The main activity is related to improving fibrinolytic activities. Other activities have been demonstrated in the regulation of blood pressure by the action toward angiotensin proteases and in the antiplatelet activities. NK can be given orally and reaches its maximal concentration after 12 hours. In addition, an antithrombotic activity based on various NK activities has been proposed. First, increased fibrinolytic activity increases thrombus dissolution and/or the formation of atherosclerotic plaques; second, its enhanced antiplatelet action adds to clot dissolution. All activities have been studied in animals and humans in vitro and in vivo. Relevant adverse effects of NK therapy have not been described, however clinical experience is restricted to case series and volunteers and is not based on clinical studies, thus clinical trials are required to confirm.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48581755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Results of an observational retrospective multicenter study: “Campania INternal medicine - the Clinical INternist for heart failure”","authors":"F. Gallucci, Emiliana Marrone, Roberto Nappi, Maurizio Renis, M. Coppola, T. Ciarambino, Daniele D'Ambrosio, A. Maffettone, M. D’avino, Cin Cin For HF Group Researchers","doi":"10.4081/itjm.2023.1594","DOIUrl":"https://doi.org/10.4081/itjm.2023.1594","url":null,"abstract":"Introduction. The Campania population is characterized by a high incidence and prevalence of heart failure (HF). The aim of this study is to describe the clinical epidemiology, comorbidities, and treatments in HF patients admitted to Internal Medicine Wards (IMW) in Campania. Materials and Methods. It is a retrospective, regional, multicentric, observational study including patients admitted to 15 IMW in Campania, with an HF diagnosis, over a period of three consecutive months. Results. We identified 427 patients, stratified by ejection fraction (EF) category (127 EF≤40%; 216 EF 41-49%; 84 EF≥50%). In comparison with HFpEF subjects, patients with HFrEF were younger (74 years vs. 9 years), more commonly male (67% vs. 32%), and more likely to have an ischaemic aetiology (45% vs. 25%). The most used drugs at the time of hospitalization and after were Diuretics (80.3/93.5%), BBs (69.6/92.6%), and Statins (52.1/63.7%), with statistically significant pre-/post- differences (P≤0.05). Conclusions. EF is more likely to be non-preserved in younger males and in patients with CAD etiology. Hospitalization influences in a statistically significant way the change or adjustment of therapy for almost all drugs.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49619728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Abstract book of the XXVIII Congresso Nazionale della Società Scientifica FADOI, 6-8 maggio 2023","authors":"Fadoi Scientific Committee","doi":"10.4081/itjm.2023.s1","DOIUrl":"https://doi.org/10.4081/itjm.2023.s1","url":null,"abstract":"Abstract book of the XXVIII Congresso Nazionale della Società Scientifica FADOI, 6-8 maggio 2023.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46366715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The prevalence of anemia in patients with malignant tumors: a hospital based cross sectional study","authors":"Dafalla O. Abuidris, O. Abdelbagi, Reem Altayeb, Hiba Elrashid Yagoub, Osama Al-Wutayd, I. Adam, M. Alorini","doi":"10.4081/itjm.2023.1571","DOIUrl":"https://doi.org/10.4081/itjm.2023.1571","url":null,"abstract":"Cancer is a worldwide health problem, and anemia is one of its manifestations. There are no published data on anemia among patients with cancer in Sudan. The current study aimed to investigate the prevalence of anemia among patients with malignant tumors in central Sudan. The medical records of patients with malignant tumors admitted to the National Cancer Institute, University of Gezira, Sudan, from March to December 2020 were reviewed. Among the 471 patients enrolled in the study, 292 (62.0%) were female. The median (interquartile range, IQR) age was 55 (45-66) years. Breast cancer (109, 23.1%), colorectal/anorectal (88, 18.7%), head and neck (83, 17.6%), female genital tract (70, 14.9%), and prostate (35, 7.4%) cancer were the main cancers observed in this study. The median (IQR) hemoglobin was 11.9 (10.5-13.0) g/dl and 237 (50.3%) patients had anemia. The prevalence of anemia ranged from 31.2% in breast cancer patients to 82.9% in those with prostate cancer. Compared with males (120/292, 41.1%), females (117/179, 65.4%) had a significantly higher prevalence of anemia (P<0.001). The median (IQR) age of the patients with anemia was significantly higher than that of those without anemia (57.0 years vs. 51.5 years, respectively; P=0.003). Half the patients with malignant tumors had anemia. Anemia was more common among female patients and elderly patients.","PeriodicalId":43715,"journal":{"name":"Italian Journal of Medicine","volume":" ","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44255189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}