An "aubergine" in the heart: huge native mitral valve endocarditis caused by Streptococcus agalactiae.

Polymyalgia rheumatica and vertebral fractures: a 1-year pilot controlled study

No data exist about the possibility that vertebral fracture in PMR patients could be independent of steroid therapy. For this reason, we aimed to investigate this topic by a case cohort study with a 1-year follow-up for each patient. We selected ten consecutive patients who experienced vertebral fractures (VF-group) during the first month of 1-year follow-up period and without any other significant associated condition. As a control group we studied ten control patients, without vertebral fractures and with a follow-up of 1 year, randomly selected among a larger group of patients affected by polymyalgia rheumatica. The following data were analysed: eritrosedimention rate (ESR), visual analo…

An uncommon clinical picture: Wellens’ syndrome in a morbidly obese young man

A 39-year-old man presented to the emergency department (ED) of the ‘‘Paolo Giaccone’’ Academic Hospital, Palermo (Italy). He had anterior chest pain that did not radiate to the neck or arms. The patient came from home where the chest pain initiated. The patient was morbidly obese (BMI 54 kg/m). At the ED, the patient’s blood pressure was 120/80 mmHg, the serum troponin I concentration was 0.029 ng/ml (normal values \ 0.034, borderline 0.034–0.12), myoglobin 45 ng/ml (normal values \ 120). While experiencing chest pain, the patient underwent a standard 12 lead electrocardiogram (ECG) that was normal. An echocardiogram, also during the chest pain, excluded the presence of hypo-akinetic left …

Evidence-Based Practice Needs Stronger Prognostic Scores for the Prediction of Recurrent Stroke

To the Editor: The article by Weimer et al1 is of great interest for internists and neurologists that have to prognostically stratify patients with acute or subacute cerebrovascular disease based on risk scores. However, we have to comprehend the actual and pragmatic value of the study findings for clinical practice. We previously underscored the …