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Electrolyte Disorders as Triggers for Takotsubo Cardiomyopathy
Get PDFA 56-year-old woman presented with cognitive impairment, confusion and slowed speech, muscle cramps and peripheral paraesthesia
preceded by vomiting. Blood tests revealed severe hypokalaemia, hyponatremia, hypomagnesemia and hypocalcaemia. Following a diagnosis
of Takotsubo cardiomyopathy based on ultrasonography, the patient was treated with electrolyte supplementation and recovered within
48h. When heart failure is suspected, electrolyte abnormalities should be carefully ruled out as they can affect cardiac function
Paesaggio sacro e architettura cristiana nella prefettura di Nagasaki
No full textIl volume apre una riflessione interculturale sul riconoscimento internazionale del cristianesimo nascosto, un’eredità che dal XVI secolo ha unito l’Occidente con l’Estremo Oriente. Nel ripercorrere le tappe fondamentali di questo patrimonio, in prima istanza, vengono analizzati alcuni dei significativi fatti storici che hanno determinato l’incontro–scontro tra la comunità giapponese e i missionari occidentali, per poi proseguire con un più dettagliato riesame finalizzato a illustrare il patrimonio costruito e a indagare il paesaggio sacro, dimostrando l'importanza della valorizzazione di quegli aspetti intangibili che hanno reso davvero unica e straordinaria questa eredità culturale, simbolo, oggi più che mai, di un proficuo dialogo tra Oriente e Occidente
Preliminary Report on the 2015 Field Season of the American Excavations at Morgantina: Contrada Agnese Project (CAP)
Get PDFIn its third season, the Contrada Agnese Project (CAP) continued archaeological investigations in the remains of a building, located near the western margins of the ancient urban center of Morgantina. In 2015, excavations opened a larger portion of the so-called Southeast Building, extending from the trenches opened during the 2014 season. These investigations yielded evidence from construction trenches and sub-floor fills that now allow a preliminary dating of the building’s phases. The building appears to have had a short life, having been built and abandoned within fewer than 75 years, beginning around the middle of the third century BCE. New architectural features were revealed by the 2015 excavations, including columns composed of terracotta drums and a small oven set in the corner of a central room, indications of monumental decoration and food production, respectively. This combination of monumentality and small-scale production leads excavators to identify the building as a modest house, but further excavations will be needed to fully characterize its form and function
Giant-cell Arteritis of the Ovarian Arteries: A Rare Manifestation of a Common Disease
Get PDFWe describe a 58-year-old woman presenting with headache and an elevated erythrocyte sedimentation rate (ESR), who was diagnosed with and successfully treated for giant-cell arteritis (GCA). Seven months after the end of treatment, ovarian GCA was incidentally found after ovariectomy for a simple cyst. GCA of extracranial vessels like the ovarian arteries is rare. Nevertheless, we stress that extracranial GCA should be considered in patients older than 50 years with an elevated ESR, even if a temporal artery biopsy is negative or specific symptoms are absent. Moreover, we discuss the importance of imaging techniques when GCA of the extracranial large vessels is suspected
The ‘SILENT Alarm’: When History Taking Reveals a Potentially Fatal Toxicity
Get PDFIntroduction: The combination of acute/sub-acute neurological and metabolic derangements should always raise the suspicion of toxicity,
either endogenous or exogenous. The adverse effects of psychiatric medications are especially difficult to determine since the psychiatric
background of patients is often inaccessible.
Clinical Presentation: A 66-year-old man presented to the emergency department with dysarthria and uncontrolled tremor, rapidly
deteriorating into a complex of severe neurological and metabolic derangements. Only after repeated attempts to take a thorough history
was lithium toxicity identified.
Conclusion: Thorough, comprehensive history taking, including chronic medications and their substitutes, is essential and lifesaving when
potentially lethal medications are involved
When a Diuretic Causes Pulmonary Oedema
Get PDFBackground: Hydrochlorothiazide (HCTZ) is one of the most popular drugs for the treatment of hypertension and heart failure. Most of its side effects are harmless and predictable, but some studies report a few life-threatening reactions to this drug, one of the most dangerous being acute pulmonary oedema.
Case Report: A 73-year-old woman was admitted to the Emergency Department with acute respiratory failure due to pulmonary oedema. Her past medical history included long-lasting hypertension with permanent atrial fibrillation and mitral stenosis. Her blood pressure control had been suboptimal, so her cardiologist had changed amlodipine to combination therapy with ramipril and HCTZ. However, 20 min after taking the new drug, the patient experienced fever, vomiting and diarrhoea immediately followed by acute onset of dyspnoea.
Conclusion: Since HCTZ is one of the most popular drugs for hypertension treatment and millions of patients take it every day, it is important to keep in mind both the common adverse reactions as well as the dangerous, although rare, ones
Primary Hepatic Diffuse Large B-cell Lymphoma Mimicking Acute Fulminant Hepatitis
Get PDFPrimary hepatic lymphoma (PHL) is a rare variant of non-Hodgkin's lymphoma. Diffuse hepatic involvement is uncommon and therefore presentation as progressive hepatitis or acute fulminant hepatic failure is rare. Acute onset of signs and symptoms can mimic a variety of infectious and inflammatory disorders, thus delaying the diagnosis. A high index of suspicion and liver biopsy early in the course of liver dysfunction may establish the diagnosis and allow rapid initiation of chemotherapy to prevent a fatal outcome. In this report, we describe a rare case of fulminant primary hepatic diffuse large B-cell lymphoma in a 55-year-old woman who died 2 weeks after admission, before the initiation of chemotherapy
Le migrazioni nei Paesi dell'Europa del Sud: realtà e discorso
Get PDFIn questo articolo esaminiamo alcune tendenze della ricerca sui flussi migratori che riguardano i Paesi
dell’Europa meridionale. Essi sono: l’immigrazione dai Paesi sviluppati, la cosiddetta nuova emigrazione
sudeuropea e il flusso persistente di migranti, rifugiati e richiedenti asilo dai Paesi del Sud del mondo.
Essi ricevono un trattamento assai differente nei dibattiti politici locali e nazionali, dominati dalla
preoccupazione per la ‘crisi’, ovvero l’insieme complesso di cambiamenti economici, sociali e politici
derivanti dalla globalizzazione neoliberista in corso. Oltre a discutere della letteratura scientifica più
recente relativa a questi argomenti, cercheremo di mostrare come questi flussi sono politicamente
costruiti per gli scopi delle classi dirigenti locali e nazionali. Allo stesso tempo, cercheremo di
evidenziare le relazioni tra queste tendenze e i cambiamenti generali che interessano i Paesi dell’Europa
meridionale
Investment in innovation for European recovery: a public policy priority
Get PDFThe 2008 crisis had severe consequences in Europe, especially for investment, including investments
in R&D and innovation. We argue that there are large scientific and technological opportunities that
could pave the way to a new stage of social development and economic growth, but they need
appropriate economic policies to be seized. A European recovery can come from developing and
exploiting these opportunities, but to do so requires a large public programme of investment in R&D
and innovation that attracts businesses to invest further. The European Union could play a crucial role
in this process by pursuing the ambitious goals outlined by the European Council in the Lisbon (2000)
and Barcelona (2002) summits, which unfortunately were abandoned as a consequence of the
economic crisis and the austerity measures. Powerful instruments, such as the Juncker investment
plan, and the proposed 2021-2027 Framework Programme Horizon Europe, can provide the right kind
of stimulus. A re-organization of the governance of the European innovation and competence building
through a proper Council at the EU level is essential
