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  1. Article ; Online: Pulmonary Complications in a Patient with Common Variable Hypogammaglobulinemia

    Paolo Ghiringhelli / Fabrizio Foieni / Girolamo Sala / Alessandro Diana / Beatrice Valvo / Mariella Ciola / Michele Zaza / Roberto Bertolini / Cinzia Simoni / Lorenzo Bellintani / Andrea Agostinelli / Federica Macchi / Sara Limbiati / Michela Provisione

    Clinical Management Issues, Vol 17, Iss

    2023  Volume 1

    Abstract: Common variable immunodeficiency (CVID) is a rare disorder characterized by primary antibody deficiency leading to hypogammaglobulinemia and increased risk of infections. Pulmonary hypertension (PH) is an unusual complication of CVID and may be ... ...

    Abstract Common variable immunodeficiency (CVID) is a rare disorder characterized by primary antibody deficiency leading to hypogammaglobulinemia and increased risk of infections. Pulmonary hypertension (PH) is an unusual complication of CVID and may be associated with chronic hypoxemic respiratory failure. We described the case of a 47-year-old female patient hospitalized with worsening dyspnea, which had emerged about 10 days before and was associated with productive cough. 26 years before, she was diagnosed with common variable hypogammaglobulinemia, that was treated with intravenous immunoglobulin infusions for at least 20 years. She had suffered from recurrent secondary infections of the respiratory tract with inveterate bronchiectasis, pulmonary hypertension, and chronic respiratory failure. This case suggests that Internal Medicine wards, due to their global vision of the patient, are well suited to manage subjects with serious, complex, and genetically determined pathologies.
    Keywords common variable hypogammaglobulinemia ; respiratory failure ; pulmonary hypertension ; Medicine (General) ; R5-920
    Language English
    Publishing date 2023-01-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  2. Article ; Online: [Fever of Unknown Origin in a Patient Administered With Bacillus Calmette-Guérin (BCG) to Treat Urothelial Vesical Carcinoma in Situ]

    Paolo Ghiringhelli / Federica Macchi / Mariella Ciola / Girolamo Sala / Beatrice Valvo / Andrea Agostinelli / Lorenzo Bellintani / Gaetano Emanuele Rizzo / Michela Provisione / Michela Zaza / Alessandro Diana / Maurizio Ferrarese

    Clinical Management Issues, Vol 17, Iss

    2023  Volume 1

    Abstract: Koch’s Bacillus bovis (Mycobacterium bovis) was made avirulent by special culture conditions, i.e., 230 passages on medium containing potatoes treated with bile salts. It has been used mainly to prevent tuberculosis. The vaccine was named after the ... ...

    Abstract Koch’s Bacillus bovis (Mycobacterium bovis) was made avirulent by special culture conditions, i.e., 230 passages on medium containing potatoes treated with bile salts. It has been used mainly to prevent tuberculosis. The vaccine was named after the bacteriologist Albert Calmette and the veterinarian Camille Guérin, i.e., Bacillus Calmette-Guérin (BCG). These researchers worked at the Pasteur Institute in Lille and launched the vaccine in 1921. Recently, BCG was used also for its non-specific immunostimulant action. Intravesical administration of BCG is an adjunctive therapy for the treatment of bladder cancer, which does not invade the muscle wall. We will discuss the clinical case of a patient who had fever of unknown origin for about 2 months and was resistant to treatment with multiple lines of antibiotics.
    Keywords bcg ; urothelial carcinoma ; fever ; mycobacterium bovis ; Medicine (General) ; R5-920
    Subject code 616
    Language English
    Publishing date 2023-07-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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  3. Article ; Online: [A rare case of sepsis from Citrobacter koseri in adults]

    Matteo Pistoia / Mariella Ciola / Girolamo Sala / Fabrizio Foieni / Andrea Agostinelli / Beatrice Valvo / Lorenzo Bellintani / Paolo Ghiringhelli

    Clinical Management Issues, Vol 15, Iss

    2021  Volume 1

    Abstract: We describe the case of a 53-year-old man, recently diagnosed with decompensated type II diabetes mellitus, admitted to our Department for fever, asthenia, and detection of multiple lung abscesses and pulmonary embolism at chest tomography. His clinical ... ...

    Abstract We describe the case of a 53-year-old man, recently diagnosed with decompensated type II diabetes mellitus, admitted to our Department for fever, asthenia, and detection of multiple lung abscesses and pulmonary embolism at chest tomography. His clinical history revealed just a recent orthopedic surgery of osteosynthesis on the left wrist with normal clinical and instrumental post-surgical evolution. Empirical antibiotic therapy with piperacillin/tazobactam and clindamycin was initiated. During hospital stay, swelling and functional impotence in the right knee occurred. They were investigated by arthrocentesis and magnetic resonance, and diagnosed as septic arthritis. Blood culture performed at admission tested positive for Citrobacter koseri on several samples where meropenem was added according to antibiogram. On the other hand, the cultures of bronchoaspirate, pulmonary fine needle aspiration, and arthrocentesis were negative. Antibiotic therapy was administered up to two weeks after discharge and radiological and physical features progressively improved.
    Keywords citrobacter koseri ; septic arthritis ; fever ; Medicine (General) ; R5-920
    Subject code 610
    Language English
    Publishing date 2021-06-01T00:00:00Z
    Publisher SEEd
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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    Inter-library loan at ZB MED

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  4. Article ; Online: Clinical complexity and hospital admissions in the December holiday period.

    Marco Vincenzo Lenti / Catherine Klersy / Alice Silvia Brera / Valeria Musella / Irene Benedetti / Lucia Padovini / Mariella Ciola / Gabriele Croce / Alessia Ballesio / Maria Fortunata Gorgone / Giampiera Bertolino / Antonio Di Sabatino / Gino Roberto Corazza

    PLoS ONE, Vol 15, Iss 6, p e

    2020  Volume 0234112

    Abstract: Background Christmas and New Year's holidays are risk factors for hospitalization, but the causes of this "holiday effect" are uncertain. In particular, clinical complexity (CC) has never been assessed in this setting. We therefore sought to determine ... ...

    Abstract Background Christmas and New Year's holidays are risk factors for hospitalization, but the causes of this "holiday effect" are uncertain. In particular, clinical complexity (CC) has never been assessed in this setting. We therefore sought to determine whether patients admitted to the hospital during the December holiday period had greater CC compared to those admitted during a contiguous non-holiday period. Methods This is a prospective, longitudinal study conducted in an academic ward of internal medicine in 2017-2019. Overall, 227 consecutive adult patients were enrolled, including 106 cases (mean age 79.4±12.8 years, 55 females; 15 December-15 January) and 121 controls (mean age 74.3±16.6 years, 56 females; 16 January-16 February). Demographic characteristics, CC, length of stay, and early mortality rate were assessed. Logistic regression analyses for the evaluation of independent correlates of being a holiday case were computed. Results Cases displayed greater CC (17.7±5.5 vs 15.2±5.9; p = 0.001), with greater impact of socioeconomic (3.51±1.7 vs 2.9±1.7; p = 0.012) and behavioral (2.36±1.6 vs 1.9±1.8; p = 0.01) CC components. Cases were also significantly frailer according to the Edmonton Frail Scale (8.0±2.8 vs 6.4±3.1; p<0.001), whilst having similar disease burden, as measured by the CIRS comorbidity index. Age (OR 1.02; p = 0.039), low income (OR 1.97, 95% CI 1.10-3.55; p = 0.023), and total CC (OR 1.06; p = 0.014) independently correlated with the cases. Also, cases showed a longer length of stay (median 15.5 vs 11 days; p = 0.0016) and higher in-hospital (12 vs 4 events; p = 0.021) and 30-day (14 vs 6 events; p = 0.035) mortality. Conclusions Patients hospitalized during the December holiday period had worse health outcomes, and this could be attributable to the grater CC, especially related to socioeconomic (social deprivation, low income) and behavioral factors (inappropriate diet). The evaluation of all CC components could potentially represent a useful tool for a more rational resource ...
    Keywords Medicine ; R ; Science ; Q
    Subject code 360
    Language English
    Publishing date 2020-01-01T00:00:00Z
    Publisher Public Library of Science (PLoS)
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

    Full text online

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    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

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