Acute Renal Infarction After a Bilateral Aortic-Iliac Stent Thrombosis.

A renal infarction occurs when kidney's arterial blood supply is compromised, causing parenchymal necrosis and loss of function. It is a relatively uncommon complication and its treatment is time-dependent. We present a case where a female patient with a history of bilateral aortic-iliac stenting over 10 years before presented with chest pain, palpitations, and dyspnea associated with hypertension.

From Carbon Monoxide Poisoning to Myocardial Infarction.

Myocardial injury is a known complication following acute carbon monoxide (CO) poisoning, yet there is little literature on this subject. Here, we present the case of a 56-year-old man admitted to the emergency room with severe CO poisoning. The electrocardiogram (ECG) at admission revealed an ST-segment elevation in leads II, III, and aVF, with an elevated troponin-T level.

A Palliative Care Approach to Amyotrophic Lateral Sclerosis.

Introduction: Amyotrophic lateral sclerosis (ALS) is a degenerative disease characterized by motor dysfunction. Currently, treatment options are limited and management is based mostly on symptom control and quality of life optimization, so palliative care plays a fundamental role. Our objective was to characterize the ALS population in Madeira Island that was referenced and/or followed by a palliative care unit over a five-year period.

Creutzfeldt-Jakob Disease: A Rare Case of Dementia.

Prion diseases are rare neurodegenerative diseases that have a rapid evolution. Creutzfeldt-Jakob disease (CJD) is the most common and its sporadic form the most frequent. Definitive diagnosis is only obtained through autopsy, and there are currently no available treatments.

A Case Report on Metamizole-Induced Agranulocytosis: Is the Benefit Worth the Risk?

Metamizole is a drug with analgesic and antipyretic properties widely available in Portugal. Its use is highly controversial because of the risk of agranulocytosis, a rare but serious adverse event. A 70-year-old female patient with a recent history of treatment with metamizole for post-surgery fever and pain presented to the ED with sustained fever, diarrhea, and painful mouth ulcers.

Subacute Invasive Pulmonary Aspergillosis (IPA) Is a Challenging Diagnosis.

Aspergillus is a ubiquitous fungus whose clinical manifestations and prognosis after infection depend on the host's immune status. The disease can have an insidious course, making it a challenging diagnosis that should be considered in patients with risk factors. We report the case of a 78-year-old man with a known history of asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome and idiopathic pulmonary fibrosis on long-term therapy with high-dose oral corticosteroids, hypertension, dyslipidemia, type 2 diabetes, and hypo coagulated atrial fibrillation.

A Rare Case of Intravenous Amiodarone Toxicity.

Amiodarone is a highly effective treatment for life-threatening supraventricular and ventricular arrhythmias, namely in the setting of acutely decompensated heart failure. However, it could be associated with several serious adverse effects both in long-term oral therapy and in short-term use of intravenous (IV) preparation, including shock and liver injury. We report an unusual case of life-threatening refractory hypotension associated with acute hepatitis and renal failure a few hours after initiation of IV amiodarone.

Predicting Prognosis in Internal Medicine: A Short and Long-Term Mortality Comparison Analysis.

Introduction The marked increase in life expectancy seen in Portugal in the last five decades led to a change in the profile of patients being most commonly admitted in internal medicine wards. In deciding the best care for these patients, prognostication models are needed in order to reduce readmissions, mortality, and adequate care. We aimed to study short and long-term mortality and predictors of all-cause mortality, independently of cause admission, of patients admitted in an internal medicine ward.

Severe Acute Respiratory Syndrome Coronavirus 2 Antibodies Among Healthcare Workers After Vaccine Administration in an Intensive Care Unit.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-19) emerged in China in December 2019. Healthcare workers (HCWs) are one of the high-risk groups of infection and knowledge of the seroprevalence of SARS-CoV-2 antibodies among this class is very important, not only to understand the spread of COVID-19 among health institutions but also to assess the success of public health interventions. The objective of this prospective study was to determine the seroprevalence of COVID-19 immunoglobulin G (IgG) antibodies after vaccine administration and assess the symptomatology associated with the number of IgG antibodies.

Left Atrial Appendage Occlusion: A Therapeutic Option in a Patient With Atrial Fibrillation and Hereditary Hemorrhagic Telangiectasia.

Hereditary hemorrhagic telangiectasia (HHT) is a predominantly inherited disorder of blood vessel structure, characterized by mucocutaneous telangiectasias, multiple arteriovenous malformations, and frequent epistaxis. A 67-year-old female with atrial fibrillation and high thromboembolic risk (CHADs2Vasc2: 4) with renal arterial thrombosis started oral anticoagulation (OAC). The patient had multiple episodes of heavy nasal and gastrointestinal bleeding (requiring multiple blood transfusions) such that OAC had to be interrupted, and a complementary investigation led to the diagnosis of HHT.

Drug-Induced Liver Injury Caused by Amoxicillin/Clavulanate.

Drug-induced liver injury (DILI) has a relatively low incidence, and as it is a diagnosis of exclusion, it can become quite a challenge for the clinician. Amoxicillin/clavulanate continues to be one of the most prescribed antibiotics and only rarely causes liver injury. We report a case of DILI associated with this antibiotic to bring attention to a rare side effect of a very commonly prescribed drug.