Deactivation of cardiac implantable electronic devices in palliative patients: When and how.

Cardiac implantable electronic devices have transformed medicine as they improve quality of life and prevent premature death. In palliative care settings, deactivation of these devices must be discussed, particularly at end-of-life. In terminally ill patients it is consensual to recommend implantable cardioverter defibrillator deactivation once shocks are frequent and painful.

Thrombocytopenia Induced by Clopidogrel: A Rare Adverse Effect.

Introduction: Immune thrombocytopenic purpura (ITP) can be induced by several drugs but there are few case reports of ITP induced by clopidogrel. Second-line treatment with thrombopoietin receptor agonists (TPO-RA) presents solid evidence and should be considered in patients in need of elective surgery who are poor responders to steroids.

Case Description: We report the case of a 79-year-old male who developed severe immune thrombocytopenic purpura after initiating treatment with clopidogrel.

Lumbar paraspinal intramuscular myxoma: A case report.

Background: With an estimated incidence of about 1 case/million patients, paravertebral intramuscular myxomas represent a rare cause of lumbar pain. Rather, they typically occur in the heart and in bone tissues.

Case Description: A 64-year-old female presented with a protracted course of nocturnal lumbar pain that radiated to the anterior aspect of the right thigh accompanied by numbness.

Increasing HIV early diagnosis by implementing an automated screening strategy in emergency departments.

Introduction: Late HIV diagnosis is associated with increased morbidity, mortality and risk of onward transmission. Increasing HIV early diagnosis is still a priority. In this observational study with historical control, we determined the impact of an opportunistic HIV screening strategy in the reduction of late diagnosis and missed opportunities for earlier diagnosis.

Impact of telemedicine on the management of heart failure patients during coronavirus disease 2019 pandemic.

Aims: Chronic heart failure (HF) is a major comorbidity accounting for an increased severity and mortality related to coronavirus disease 2019 (COVID-19). To reduce the risk of COVID-19 in HF patients, telemedicine has been encouraged.

Methods And Results: During the COVID-19 pandemic, telemedical management with mainly over-the-phone appointments became a major strategy of follow-up of our HF clinic patients.

A Case of Pancytopenia with Many Possible Causes: How Do You Tell Which is the Right One?

Unlabelled: Systemic lupus erythematosus (SLE) often presents with cytopenia(s); however, pancytopenia is found less commonly, requiring the consideration of possible aetiologies other than the primary disease. The authors describe the case of a female patient with a recent diagnosis of SLE admitted through the Emergency Department with fever of unknown origin and severe pancytopenia. She was medicated with prednisolone, hydroxychloroquine, azathioprine, amlodipine and sildenafil.

Palliative approach in acute neurological events: a five-year study.

Introduction: Acute neurological illness often results in severe disability. Five-year life expectancy is around 40%; half the survivors become completely dependent on outside help.

Objective: Evaluate the symptoms of patients admitted to a Hospital ward with a diagnosis of stroke, subarachnoid hemorrhage or subdural hematoma, and analyze the role of an In-Hospital Palliative Care Support Team.

Maternal mortality, marital status and bone mineral density in young women from the Coimbra identified skeletal collection.

In contemporary populations, pregnancy and lactation are usually followed by transient bone loss. The observation of reduced bone mass in young females from archaeological sites has sometimes been interpreted as an outcome of reproductive stress. In order to evaluate the overall effect of reproductive dynamics on bone mass in a historical skeletal sample, bone mineral density (BMD) at the proximal femur was assessed by dual-energy X-ray absorptiometry in 78 young women (17-39 years) from the Coimbra Identified Skeletal Collection.

Myasthenia Gravis Induced by Ipilimumab in a Patient With Metastatic Melanoma.

In daily clinical practice, there is a growing number of patients receiving new biological agents used in the treatment of malignancies. Ipilimumab is a fully humanized monoclonal antibody approved for patients with melanoma. It acts as an immune checkpoint inhibitor, binding and blocking cytotoxic T-lymphocyte antigen-4 in order to increase the antitumor immune response.

Pediatric chronic osteomyelitis in the outskirts of Al-Ushbuna (Carnide, Lisboa, Portugal).

The skeletal remains of seven individuals (five non-adults and two adults) were recovered during an archeological intervention in the township of Carnide (Lisbon, Portugal). Funerary anthropology strongly suggests that the sample is from the Medieval Islamic period (8th - 12th centuries AD). This report presents a case of chronic osteomyelitis in a non-adult individual.

Vestibular Migraine: Clinical Challenges and Opportunities for Multidisciplinarity.

Migraine and vertigo are two very prevalent conditions in general population. The coexistence of both in the same subject is a significant clinical challenge, since it is not always possible to understand whether they are causally related or associated by chance, requiring different diagnostic and therapeutic approaches. In this review we analyze and summarize the actual knowledge about vestibular migraine (VM), focusing on the new concepts proposed by the International Classification of Headache Disorders 3-beta and by the Bárány Society and also addressing the former concepts, which are still present in clinical practice.

Acute Pyelonephritis with Bacteremia Caused by Enterococcus hirae: A Rare Infection in Humans.

Enterococci are one of the usual residents of the microflora in humans. In the last decade this genus has been reported as the third most common cause of bacteremia. We present the case of a 78-year-old female who was admitted to the emergency room because of nausea, lipothymia, and weakness.