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La malattia da reflusso gastroesofageo nell’ambulatorio di Medicina Interna: quale gestione medica nel 2021? 内科门诊的胃食管反流病:2021年的医疗管理是什么?
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-30 DOI: 10.4081/itjm.q.2021.3
Giancarlo Parisi
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不可用
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引用次数: 0
Abstract Book of the XXVI Congresso Nazionale della Società Scientifica FADOI, 2-4 ottobre 2021 2021年10月2日至4日,法多伊科学协会第26届全国大会摘要书
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-27 DOI: 10.4081/itjm.2021.s1
D. Manfellotto
Abstract Book of the XXVI Congresso Nazionale della Società Scientifica FADOI, 2-4 ottobre 2021.
科学学会第二十六届全国代表大会摘要,FADOI,2021年10月2-4日。
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引用次数: 0
DRESS syndrome (drug rash with eosinophilia and systemic symptoms): sometimes, not all signs are there DRESS综合征(药物性皮疹伴嗜酸性粒细胞增多和全身症状):有时,并非所有症状都有
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-24 DOI: 10.4081/itjm.2021.1475
Fábio Murteira, Pedro Oliveira, J. Miranda, A. Moreira, Margarida Correira
DRESS syndrome is a rare and potentially fatal multisystemic reaction that occurs two to six weeks after exposure to certain drugs. It is characterized by fever, eosinophilia, and skin rash. Case of a 37-year-old man, black, with gout (started allopurinol 4 weeks before). He arrived at the Emergency Room complaining of headache, fever, abdominal pain, and scattered maculopapular skin lesions. The conducted study showed elevated transaminases and C-reactive protein, hepatomegaly, and peri-hepatic adenomegalies. Allopurinol was stopped, but throughout hospitalization, liver, renal and neurological dysfunctions (with meningoencephalitis) worsened; it also appeared eosinophilia. A skin biopsy was performed, the possibility of DRESS syndrome was assumed, and methylprednisolone 2 mg/kg/day was started, with progressive improvement. The skin biopsy was compatible with DRESS. The described case reveals some peculiarities. Among the most relevant arethe late onset of eosinophilia and the difficulty in evaluating the rash due to the patient's skin tone and neurological manifestations (rare).
DRESS综合征是一种罕见且可能致命的多系统反应,发生在接触某些药物后2至6周。它的特点是发热、嗜酸性粒细胞增多和皮疹。37岁男性,黑人,痛风(4周前开始使用别嘌呤醇)。他来到急诊室,主诉头痛、发烧、腹痛和分散的黄斑丘疹性皮肤病变。所进行的研究显示转氨酶和c反应蛋白升高,肝肿大和肝周围腺肿大。停用别嘌呤醇,但在整个住院期间,肝、肾和神经功能障碍(伴有脑膜脑炎)恶化;它还出现嗜酸性粒细胞增多。进行皮肤活检,假设有DRESS综合征的可能性,并开始使用甲基强的松龙2mg /kg/天,病情逐渐好转。皮肤活检符合DRESS。所描述的案例揭示了一些特点。其中最相关的是嗜酸性粒细胞的晚发性和由于患者的肤色和神经系统表现而难以评估皮疹(罕见)。
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引用次数: 1
Lesson learned by COVID-19 outbreak: multilevel triage strategies in patients admitted to the emergency room in southern Italy COVID-19疫情的教训:意大利南部急诊室收治患者的多级分诊策略
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-24 DOI: 10.4081/itjm.2021.1445
P. Di Micco, M. Imparato, M. Iannuzzo, A. Fontanella
After identifying a novel disease inducing a severe acute respiratory syndrome-related to coronavirus 2 (SARS-CoV-2) for epidemic pneumonia in China, the diffusion of infection is ongoing around the world, and Italy has been the second country in which an epidemic has been demonstrated. Clinical features of this infection may be summarized in viral pneumonia that SARS or acute respiratory distress syndrome (ARDS) may complicate. For this reason, this epidemic has been considerably more aggressive than the previous epidemic of SARS and Middle-East respiratory syndrome. Coronavirus disease 2019 (COVID-19) showed an easy diffusion from human to human and also showed to be more contagious than other viruses. So human contact should be avoided at the emergency room and for inpatients too. The Triage should be adapted to these new features in order to speed up procedures for the care of infected patients at high risk of morbidity and mortality for SARS and ARDS and for traditional access to the emergency room. Based on our experiences, this flow chart has been designed with a multi-level triage in which patients have been divided for admission to the emergency room into patients with fever/respiratory symptoms and patients without feverrespiratory symptoms, to improve medical performances while treating COVID-19. This organized, multilevel triage permitted a good selection of patients admitted to the emergency room during the epidemic of COVID-19 in Southern Italy.
在中国发现了一种导致冠状病毒2型相关严重急性呼吸系统综合征(SARS-CoV-2)的新型疾病后,感染正在全球范围内扩散,意大利是第二个被证实发生疫情的国家。这种感染的临床特征可以概括为病毒性肺炎,SARS或急性呼吸窘迫综合征(ARDS)可能使其复杂化。因此,这次流行病比以前的SARS和中东呼吸系统综合症流行病更具侵略性。2019冠状病毒病(COVID-19)表现出容易在人与人之间传播,并且比其他病毒更具传染性。因此,在急诊室和住院病人也应避免人类接触。分诊法应适应这些新特点,以加快对SARS和ARDS发病率和死亡率高的感染患者的护理程序,并加快传统的急诊室就诊程序。根据我们的经验,我们设计了多层分类流程图,将患者分为发烧/呼吸道症状患者和无发烧/呼吸道症状患者,以便在治疗COVID-19的同时提高医疗绩效。这种有组织的多层次分诊使得在意大利南部COVID-19流行期间能够很好地选择进入急诊室的患者。
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引用次数: 0
The side effects of the COVID-19 pandemic on key public health elements - How the global emergency has changed the acute management of myocardial infarction and stroke, the network of cancer care, and assistance to frail individuals 2019冠状病毒病大流行对关键公共卫生要素的副作用——全球紧急情况如何改变心肌梗死和中风的急性管理、癌症护理网络以及对体弱者的援助
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-24 DOI: 10.4081/itjm.2021.1462
G. Cioni, Jessica Canini
The coronavirus disease 2019 (COVID-19) pandemic is a primary health problem globally. In particular, it has caused troubles even to the advanced health systems of Western countrieswho attempted to limit the spread of the infection and manage patients with severe respiratory distress. However, this sudden contingency has had a much higher cost if we also consider the cost of suspending ordinary clinical care or delays in the emergency pathways of non-COVID-19 patients. Furthermore, the policies applied to contain the contagion have exacerbated the socio-economic disparities of the population and isolated fragile patients, making them subject to clinical relapses or aggravation of chronic diseases. For this reason, the various specialist centers have equipped themselves to guarantee an effective therapeutic path. In this brief review, we have outlined some consequent repercussions on the management of acute and chronic cardiovascular and neurovascular diseases and on oncological treatment. In particular, we have described the effects of the current health reorganization on some acute and time-dependent diseases, such as stroke and acute coronary syndromes, in which therapeutic delay is potentially disabling or fatal. Furthermore, we have focused on cancer treatments, whose essential cornerstones are early screening and follow-up. Finally, the suffering of the local health network has led to a lack of continuity of care in fragile patients, such as psychiatric, marginalized, or multiple comorbid patients.
2019冠状病毒病(新冠肺炎)大流行是全球主要的健康问题。特别是,它甚至给西方国家的先进卫生系统带来了麻烦,这些国家试图限制感染的传播并管理严重呼吸窘迫的患者。然而,如果我们还考虑到暂停普通临床护理或延迟非COVID-19患者的应急途径的成本,这种突发事件的成本要高得多。此外,为遏制传染病而采取的政策加剧了人口的社会经济差距,孤立了脆弱的患者,使他们容易出现临床复发或慢性病加重。出于这个原因,各个专科中心都配备了设备,以保证有效的治疗途径。在这篇简短的综述中,我们概述了对急性和慢性心血管和神经血管疾病的管理以及肿瘤学治疗的一些影响。特别是,我们已经描述了当前健康重组对一些急性和时间依赖性疾病的影响,如中风和急性冠状动脉综合征,在这些疾病中,治疗延迟可能会致残或致命。此外,我们专注于癌症治疗,其基本基石是早期筛查和随访。最后,当地卫生网络的痛苦导致脆弱患者缺乏连续性的护理,如精神病患者、边缘化患者或多种共病患者。
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引用次数: 0
From sciatica pain to a complex diagnosis: a case of pyomyositis and chronic lymphocytic leukemia 从坐骨神经痛到复杂诊断:一例化脓性肌炎和慢性淋巴细胞白血病
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-24 DOI: 10.4081/itjm.2021.1386
Ottavia Magnani, Matteo Caiti, E. Cenni, P. Moscatelli
We described a case of a 50-year-old man who presented severe low back and leg pain that quickly evolved in severe septic shock. Clinical workouts led us to diagnose a rare condition as pyomyositis because of the identification of Staphylococcus aureus septicemia and multiple muscle collections. Although this rare condition rarely occurs in temperate climates, its prevalence recently increased and is often associated with an immunocompromised condition. In this case, the investigation of an immunological impairment revealed an underlying chronic lymphocytic leukemia/small cell non-Hodgkin lymphoma.
我们描述了一个50岁的男性病例,他表现出严重的下背部和腿部疼痛,并迅速演变为严重的感染性休克。临床训练使我们诊断出一种罕见的情况,即化脓性肌炎,因为我们发现了金黄色葡萄球菌败血症和多处肌肉聚集。尽管这种罕见的疾病很少发生在温带气候中,但其流行率最近有所上升,通常与免疫功能低下的疾病有关。在这种情况下,对免疫损伤的调查揭示了潜在的慢性淋巴细胞白血病/小细胞非霍奇金淋巴瘤。
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引用次数: 0
Gender differences in COVID-19 patients: a regional survey among physicians of Internal Medicine Wards 新冠肺炎患者的性别差异:内科医师的区域调查
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-24 DOI: 10.4081/itjm.2021.1443
T. Ciarambino, A. Ilardi, O. V. Giannico, A. Maffettone, F. Ciaburri, V. D. Paoli, A. Fontanella, P. Tirelli, C. Bologna, F. Gallucci, M. Visconti, D. Caruso, M. Amitrano, M. Giordano, M. D’avino
Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) has infected millions of individuals around the World. Hypertension (HT), chronic heart disease (CHD), and diabetes mellitus (DM), particularly in the elderly, increase susceptibility to SARS-CoV-2 infection. However, conflicting results [such as coronavirus 2019 (COVID-19) disease vulnerability, case fatality, etc.] have been reported about the response to infection and COVID-19 outcomes in men and women. Therefore, understanding predictors of Intensive Care Unit (ICU) admission might help future planning and management of the disease. We conducted a multicenter survey about COVID-19 involving internists from Internal Medicine Wards. This survey indirectly allowed us to analyze the information of 2400 patients hospitalized in 35 wards of Internal Medicine of the Campania Region between July and October 2020. Our investigation has detected that the infection is more frequent in males, and the number of male patients hospitalized in ICU is also higher than females, with a large proportion of hypertensive patients. Extensive prospective studies are required to confirm this finding and explore the mechanisms for which hypertensive males are exposed to a higher proportion of admission to ICU and higher case fatality rates.
严重急性呼吸系统综合征相关冠状病毒2型已感染全球数百万人。高血压(HT)、慢性心脏病(CHD)和糖尿病(DM),尤其是老年人,增加了对严重急性呼吸系统综合征冠状病毒2型感染的易感性。然而,关于男性和女性对感染和新冠肺炎结果的反应,有报道称存在相互矛盾的结果[如2019冠状病毒病(新冠肺炎)的疾病脆弱性、病死率等]。因此,了解重症监护室(ICU)入院的预测因素可能有助于疾病的未来规划和管理。我们进行了一项关于新冠肺炎的多中心调查,涉及内科病房的内科医师。这项调查间接地使我们能够分析2020年7月至10月期间在坎帕尼亚地区35个内科病房住院的2400名患者的信息。我们的调查发现,感染在男性中更为常见,在ICU住院的男性患者数量也高于女性,其中高血压患者占很大比例。需要进行广泛的前瞻性研究来证实这一发现,并探索高血压男性进入重症监护室的比例更高和病死率更高的机制。
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引用次数: 1
Nurse coaching improves healthy conditions: an integrative review of the literature 护士指导改善健康状况:文献综述
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-24 DOI: 10.4081/itjm.2021.1297
E. Vitale, F. Germini
Coaching has become a popular strategy in a complex environment. Nurses who incorporate coaching into their professional practice broaden their skills and opportunities in the entire spectrum of health, wellness, and healing. The aim was to illustrate and compare coaching models and to address their relevance in health promotion. A literature review from 2010 to 2019, retrieved from MEDLINE, reference tracking, and consultation of academic networks, has led to peer-reviewed articles on coaching models for health promotion. A total of 70 articles were found, 45 of which were excluded because too generic and not specific to the clinical nursing field. Finally, only 15 articles that well respected the inclusion criteria have been selected. The implementation of coaching can be seen in several health care fields, especially in nursing, to enhance health by empowering individuals.
在复杂的环境中,辅导已经成为一种流行的策略。将辅导融入专业实践的护士拓宽了他们在健康、身心健康和康复方面的技能和机会。目的是说明和比较教练模式,并解决其在健康促进中的相关性。从MEDLINE、参考文献追踪和学术网络咨询中检索到的2010年至2019年的文献综述,导致了关于健康促进指导模式的同行评审文章。共发现70篇文章,其中45篇被排除在外,原因是过于笼统,不适合临床护理领域。最后,只有15篇完全符合入选标准的文章被选中。教练的实施可以在几个医疗保健领域看到,特别是在护理领域,通过赋予个人权力来增强健康。
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引用次数: 1
Meta-analysis of pharmacist-led and pharmacist-physician intervention on blood pressure control 药剂师主导和药师干预血压控制的Meta分析
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-24 DOI: 10.4081/itjm.2021.1463
M. Memişoğlu, Y. Çelik
Effective intervention is a significant component in the improvement of blood pressure control and patient adherence. Blood pressure control includes different self-monitoring techniques, mobile health monitoring, or healthcare professionals’ interventions. This study aims to compare, analyze, and interpret the effectiveness of pharmacist-physician collaboration and pharmacist- led interventions. Meta-analysis was performed using MEDLINE via PubMed, EMBASE, EBSCO, Web of Science, Scopus, and the Cochrane Library databases between 2008-2018. Of the 51 relevant systematic reviews identified, 15 were of sufficient quality and included in the data synthesis. The breakdown of the 15 included 7 (n=2026) pharmacist and 8 pharmacist-physician interventions (n=2361). The impact of pharmacist-physician collaboration and pharmacist-led interventions on Systolic Blood Pressure was –8.22 (–11.01; –5.42) (P<0.01) and –7.68 (–9.30; –6.06) (P=0.35), respectively. On the other hand, similar correlation for Diastolic Blood Pressure for the impact of pharmacist-physician collaboration and pharmacist-led interventions was –3.55 (–4.54; –2.55) (P=0.49) and –2.58 (–3.76; –1.39) (P=0.24), respectively. These results suggest that both interventions are effective for blood pressure control. However, when two meta-analyses were compared, it was found that pharmacist-physician collaboration was more effective than pharmacist-led interventions. This finding highlights the importance of multidisciplinary approaches during blood pressure control procedures. When a holistic view is considered; especially cost-effectiveness, future studies must be diversified to encompass a broader context and impact analysis.
有效的干预是改善血压控制和患者依从性的重要组成部分。血压控制包括不同的自我监测技术、移动健康监测或医疗保健专业人员的干预措施。本研究旨在比较、分析和解释药剂师-医生合作和药剂师主导的干预措施的有效性。2008-2018年间,通过PubMed、EMBASE、EBSCO、Web of Science、Scopus和Cochrane Library数据库使用MEDLINE进行荟萃分析。在确定的51项相关系统审查中,有15项质量足够,已纳入数据综合。15项干预措施的细分包括7项(n=2026)药剂师和8项药剂师-医生干预措施(n=2361)。药剂师-医生合作和药剂师主导的干预措施对收缩压的影响分别为-8.22(-11.01;-5.42)(P<0.01)和-7.68(-9.30;-6.06)(P=0.35)。另一方面,舒张压与药剂师-医生合作和药剂师主导的干预措施影响的相似相关性分别为-3.55(-4.54;-2.55)(P=0.49)和-2.58(-3.76;-1.39)(P=0.24)。这些结果表明,这两种干预措施对控制血压都是有效的。然而,当比较两项荟萃分析时,发现药剂师与医生的合作比药剂师主导的干预更有效。这一发现突出了多学科方法在血压控制过程中的重要性。当考虑整体观点时;特别是成本效益,未来的研究必须多样化,以涵盖更广泛的背景和影响分析。
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引用次数: 1
Cerebral microbleeds after COVID-19 infection: an Italian case report COVID-19感染后脑微出血:意大利1例报告
IF 0.4 Q3 MEDICINE, GENERAL & INTERNAL Pub Date : 2021-09-24 DOI: 10.4081/itjm.2021.1466
F. Manelli, M. Cotelli, G. Lodoli, S. Bonetti, M. Turla
Not available
不可用
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引用次数: 1
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Italian Journal of Medicine
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