European journal of internal medicine
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Eur. J. Intern. Med. · Nov 2004
Nesidioblastosis associated with hyperinsulinemic hypoglycemia in adults: review of the literature.
Nesidioblastosis is a term that was first introduced by Laidlaw in 1938 to define the diffuse proliferation of pancreatic islet cells budding from ductal epithelium. First described in neonates, it is widely recognized to be the primary cause of persistent hyperinsulinemic hypoglycemia in infants. In adults, insulinoma accounts for most cases of hyperinsulinemic hypoglycemia. ⋯ This article provides a guide for the diagnosis of organic hyperinsulinism and indicates when nesidioblastosis should be suspected. New diagnostic methods and treatment options for this rare disease are proposed. We also present a review of all reported cases of adult nesidioblastosis in the last 22 years.
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Eur. J. Intern. Med. · Jun 2004
The predictive value of white blood cell count on the success of primary percutaneous intervention of the left anterior descending artery in patients admitted with acute anterior wall myocardial infarction.
Background: Epidemiological studies have shown correlations between the white blood cell (WBC) count and the risk of acute myocardial infarction (AMI) and stroke. The risk of AMI is four times as great in patients with WBC counts in the high-normal range (>9000/microl) as it is in those in the low-normal range (<6000/microl). A high WBC count also predicts a greater risk of re-infarction and in-hospital death. ⋯ Multiple logistic dregression analysis demonstrated that low ejection fraction (p=0.01) and high WBC counts (p=0.04) were correlated with failure of angioplasty and referral for an emergency CABG. WBC counts were positively correlated with heart rate (p=0.005), platelet count (p=0.0006), and Hg level (p=0.001). Conclusions: These data suggest that measuring WBC count on admission to the catheterization laboratory for primary angioplasty provides clinically important prognostic information.
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Respiratory viral infections, also known as the common cold, are the most common infections in humans. Despite their benign nature, they are a major cause of morbidity and mortality on a worldwide basis. Several viruses have been associated with such illness, of which rhinovirus is the most common. ⋯ Therefore, antiviral treatment alone may not be able to prevent these events. The optimal use of such agents also requires earlier initiation; therefore, it is important to develop accurate and rapid diagnostic techniques for respiratory viruses. Before any reliable and effective treatment is available, symptomatic therapies may remain the only possible choice of management.
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Eur. J. Intern. Med. · Feb 2004
Acute pancreatitis complicating intrabiliary rupture of liver hydatid cyst.
Acute pancreatitis is a rare complication of hydatidosis, and the successful use of endoscopic sphincterotomy in the treatment of pancreatitis complicating ruptured hydatid cyst has been very rarely reported. We report here a case of a 50-year-old man, known to have hydatid cyst of the liver, who presented with upper abdominal pain. ⋯ At endoscopic retrograde cholangiopancreatography (ERCP) the common bile duct was dilated. A sphincterotomy was performed and a mucoid structure was extracted, after which the patient made an uneventful recovery.
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Eur. J. Intern. Med. · Nov 2003
Acute, painful, and swollen testicle as the presenting feature in polyarteritis nodosa.
A 74-year-old man presented with spiking fever, myalgias, and a painful left testicle. A diagnosis of polyarteritis nodosa (PAN) was made. Corticosteroids, in combination with cyclophosphamide, induced clinical remission.