European journal of internal medicine
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Eur. J. Intern. Med. · Jun 2008
ReviewEarly repolarization syndrome and Brugada syndrome: is there any linkage?
Early repolarization syndrome (ERS) is characterized by the presence, in most cases in mid-to-lateral precordial leads, of a J wave on the downsloping portion of the QRS complex, followed by an elevation of the ST-segment with upward concavity. ERS is considered a benign electrocardiographic pattern of ventricular repolarization and, thus far, clinical interest in this syndrome has been confined to its differential diagnosis from myocardial infarction and pericarditis. ⋯ Although clinical findings seem to differentiate the two syndromes, similarities between BS and ERS in terms of response to heart rate, pharmacologic agents, and neuromodulation could suggest a linkage in their pathophysiological mechanism. The authors review the clinical and experimental data in order to test this hypothesis.
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Eur. J. Intern. Med. · May 2008
Admission characteristics predicting longer length of stay among elderly patients hospitalized for decompensated heart failure.
Acutely decompensated heart failure (HF) has become the leading cause of hospitalization for people aged 65 or older. Hospital length of stay (LOS) is a key determinant of higher hospitals costs. The aim of our study is to identify the admission characteristics that predict a longer LOS for elderly patients admitted for an acute exacerbation of HF. ⋯ In elderly patients admitted for decompensated HF, the female gender and a worse functional class at the time of admission were associated with a longer subsequent LOS.
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Eur. J. Intern. Med. · May 2008
Case ReportsStridor secondary to hypocalcemia in the elderly: an unusual presentation.
Though hypocalcemic stridor is a well-recognized pediatric emergency, it has rarely been reported in the elderly, and hypocalcemia of nutritional origin presenting with stridor in this group has not previously been reported. We report an elderly patient who presented with stridor and intermittent sudden airway obstruction resulting from laryngospasm secondary to hypocalcemia of nutritional origin and we present a brief review of this life-threatening complication of hypocalcemia.
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Obesity, one of the most prevalent health problems in the Western world, is a chronic and progressive condition. Therefore, as with other chronic diseases, patients with obesity require lifelong treatment. Long-term efficacy and effectiveness of obesity treatments is notoriously poor. ⋯ Health professionals need to take care to identify, acknowledge and address these barriers where possible to increase patient success as well as compliance and adherence with treatments. Failure to do so may further undermine the sense of failure, low self esteem and self efficacy already common among obese individuals. Addressing treatment barriers can save resources and increase the prospect of long-term success.
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Eur. J. Intern. Med. · Mar 2008
ReviewProposal for a multidisciplinary approach to the patient with morbid obesity: the St. Franciscus Hospital morbid obesity program.
Morbid obesity is a serious disease as it is accompanied by substantial co-morbidity and mortality. The prevalence is increasing to an alarming extent, in Europe as well as in the United States. In the past few decades, bariatric surgery has developed and gained importance. ⋯ The importance of a standardized protocol, the use of selection criteria, and a multidisciplinary approach have been stressed but not yet described in detail. Therefore, in this article, the multidisciplinary approach and the treatment protocol that have been applied in our hospital for more than 20 years are set out in a detailed manner. The application of a strict protocol may help to select and follow-up motivated patients and to organize multidisciplinary research activities.