Italian Journal of Medicine 2019-02-21T18:26:34+01:00 Paola Granata Open Journal Systems <p>The <strong>Italian Journal of Medicine (ITJM)</strong> is the official journal of FADOI, the Federation of Associations of Hospital Doctors on Internal Medicine and focus to describe the complex and variable situations confronted by Internists in daily practice. ITJM aims to promote excellence in the practice of internal medicine in hospitals and to disseminate the results of clinical research in internal medicine departments. The journal also contributes to the updating of hospital internists on general topics concerning public health, including ethical, legal, economical and health policy issues. The <strong>Italian Journal of Medicine (ITJM)</strong> is a quarterly peer-reviewed journal aiming to publish highest-quality material covering original basic and clinical research on all aspects of internal medicine. The Journal includes original clinical research papers, reviews, case reports and specific sections dedicated to clinical pharmacology, chronic diseases, health management. The Italian Journal of Medicine is currently indexed in <a title="Scopus" href="" target="_blank" rel="noopener">Scopus</a> and <a title="DOAJ" href="" target="_blank" rel="noopener">DOAJ</a> since September 2009.</p> <p>This journal does not apply the article processing charge&nbsp;to Authors as it is supported by institutional funds.</p> An unusual cause of eosinophilic pleural effusion and migrating biliary stenosis: Strongyloides stercoralis infection in a young immunocompetent man 2019-02-20T15:29:35+01:00 Elisa Paolucci Eva Tonveronachi Chiara Praticò Maria Cristina Zani Maria Cristina Paonessa Michele Maria Domenico Imperatore Beniamino Praticò <p>We present the case of a 33 year-old Italian man who came to our attention for epigastralgia associated with polyserositis (pleural and pericardial and peritoneal effusion with the involvement of the Douglas excavation), in the absence of a significant medical history. Laboratory analysis revealed exudative eosinophilic pleural effusion; serial imaging techniques showed a transient stenosis of the right hepatic duct and a subsequent stenosis of the left hepatic duct. After several negative sierological investigations, a positive antistrongyloides IgG antibodies titre rose suspicions of Strongyloides infection, which was confirmed by positive stool sample for parasite. Ivermectin-therapy was started and the patient’s fully recovered.</p> 2019-02-20T11:37:19+01:00 ##submission.copyrightStatement## Interpretation of electrocardiogram in an ultra-marathon athlete: a case report 2019-02-21T18:26:32+01:00 Antonio Villa Pietro Vandoni Isabella Riva Claudio Moro Luisa Chiappa Carlo Valena Mario Macchiarulo <p>The electrocardiogram (ECG) of athletes, especially in those that are endurance-trained, frequently shows some alterations; however, abnormalities of athlete’s ECG may be an expression of an underlying heart disease, which carries a risk of sudden death during sport. It is important that ECG abnormalities are correctly distinguished. We report a case of an ultramarathon athlete who arrived in Emergency Department, after a 100 kilometres race, showing ECG alterations that required further investigations to rule out a cardiac disease. ECG trace showed anterior repolarization abnormalities with ST-segment elevation in V1 to V3 leads. He was admitted in the Cardiology Department and underwent a coronary study that was normal. A cardiac magnetic resonance was also performed. The final diagnosis was athlete’s heart.</p> 2019-01-03T15:36:25+01:00 ##submission.copyrightStatement## Anticoagulation in the early phase of non-valvular atrial fibrillation-related acute ischemic stroke: where do we stand? 2019-02-21T18:26:34+01:00 Luca Masotti Elisa Grifoni Alessandro Dei Vieri Vannucchi Federico Moroni Grazia Panigada Stefano Spolveri Giancarlo Landini <p>The balance between the risk of early stroke recurrence and haemorrhagiic transformation represents the cornerstone of practical management of non valvular atrial fibrillation (NVAF)-related acute ischemic stroke (AIS). Patients who receive antithrombotic therapy as secondary prevention in the early phase of NVAF-related AIS have a better prognosis compared with patients who do not receive antithrombotic treatment. Recently, the RAF study showed that the best efficacy/safety profile was associated with anticoagulation started between 4 and 14 days from stroke onset. Based on the RAF study, the 2018 American Heart Association/American Stroke Association (AHA/ASA) guidelines suggest to start anticoagulants between 4 and 14 days from stroke onset with a class of recommendation IIa. Strong evidence for the use of direct oral anticoagulants (DOACs) in the early phase of NVAF-related AIS is lacking, because this kind of patients were excluded from phase III randomized clinical trials (RCT) and ad hoc RCTs are ongoing. However, the real life evidence suggests that early starting time of DOACs in patients with NVAF-related AIS is safe and associated with low recurrence risk and all-cause mortality. In the present review the Authors provide an update on anticoagulation in the early phase of NVAF-related AIS with focus on DOACs.</p> 2019-01-03T13:49:39+01:00 ##submission.copyrightStatement##