Italian Journal of Medicine https://www.italjmed.org/index.php/ijm <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="https://www.scopus.com/sourceid/19600165300?origin=sbrowse" target="_blank" rel="noopener">Scopus</a> and <a title="DOAJ" href="https://doaj.org/toc/1877-9352" 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> PAGEPress Scientific Publications, Pavia, Italy en-US Italian Journal of Medicine 1877-9344 <p><strong>PAGEPress</strong> has chosen to apply the&nbsp;<a href="http://creativecommons.org/licenses/by-nc/4.0/" target="_blank" rel="noopener"><strong>Creative Commons Attribution NonCommercial 4.0 International License</strong></a>&nbsp;(CC BY-NC 4.0) to all manuscripts to be published.<br><br> An Open Access Publication is one that meets the following two conditions:</p> <ol> <li>the author(s) and copyright holder(s) grant(s) to all users a free, irrevocable, worldwide, perpetual right of access to, and a license to copy, use, distribute, transmit and display the work publicly and to make and distribute derivative works, in any digital medium for any responsible purpose, subject to proper attribution of authorship, as well as the right to make small numbers of printed copies for their personal use.</li> <li>a complete version of the work and all supplemental materials, including a copy of the permission as stated above, in a suitable standard electronic format is deposited immediately upon initial publication in at least one online repository that is supported by an academic institution, scholarly society, government agency, or other well-established organization that seeks to enable open access, unrestricted distribution, interoperability, and long-term archiving.</li> </ol> <p>Authors who publish with this journal agree to the following terms:</p> <ol> <li>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</li> <li>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</li> <li>Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.</li> </ol> Interpretation of electrocardiogram in an ultra-marathon athlete: a case report https://www.italjmed.org/index.php/ijm/article/view/itjm.2019.1074 <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> Antonio Villa Pietro Vandoni Isabella Riva Claudio Moro Luisa Chiappa Carlo Valena Mario Macchiarulo ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-01-03 2019-01-03 12 4 10.4081/itjm.2019.1074 Anticoagulation in the early phase of non-valvular atrial fibrillation-related acute ischemic stroke: where do we stand? https://www.italjmed.org/index.php/ijm/article/view/itjm.2019.1111 <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> Luca Masotti Elisa Grifoni Alessandro Dei Vieri Vannucchi Federico Moroni Grazia Panigada Stefano Spolveri Giancarlo Landini ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2019-01-03 2019-01-03 12 4 10.4081/itjm.2019.1111 Malattie croniche da ricercare attivamente e mettere in trattamento nel paziente anziano multimorbido al momento della dimissione da un reparto di Medicina Interna a seguito di un ricovero per insufficienza respiratoria acuta attribuita a riacutizzazione di BPCO https://www.italjmed.org/index.php/ijm/article/view/itjm.q.2018.7 <p class="titolo"><img src="/public/site/images/pgranata/intro.jpg" alt=""></p> <p class="titolo"><strong>Introduzione</strong><br><em>P. Gnerre, L.M. Fabbri, C. Nozzoli</em></p> <p><img src="/public/site/images/pgranata/rass.jpg" alt=""></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento dello scompenso cardiaco</strong><br><em>P. Gnerre</em></p> <p class="titolo"><strong>BPCO e cardiopatia ischemica</strong><br><em>G. Vescovo</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento della fibrillazione atriale</strong><br><em>D. Panuccio</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento dell’ipertensione arteriosa</strong><br><em>M. D’Avino, G. Caruso</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento di malattie croniche respiratorie concomitanti</strong><br><em>C. Nozzoli, L.M. Fabbri</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento delle dislipidemie</strong><br><em>G. Imperiale</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento del diabete</strong><br><em>F. Costanzo, L. Magnani</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento del rischio tromboembolico</strong><br><em>F. Dentali</em></p> <p class="titolo"><strong>BPCO e arteriopatia</strong><br><em>E. Maduli, E. Zoppis</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi della vasculopatia cerebrale e delle malattie neurologiche degenerative nel paziente con BPCO</strong><br><em>I. Cova, S. Pomati, L. Pantoni</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento delle tireopatie</strong><br><em>M. Grandi, C. Sacchetti, S. Pederzoli</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento dell’osteoporosi</strong><br><em>P. Leandri, A. Cenni, S. Fiorino, G. Belmonte, R. Nardi</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento di eventuali malattie croniche renali</strong><br><em>D. Manfellotto</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento di eventuali epatopatie croniche</strong><br><em>L. Fontanella</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi, valutazione di gravità e trattamento di eventuali malattie infiammatorie croniche dell’intestino</strong><br><em>A. Lonardo, S. Lugari</em></p> <p class="titolo"><strong>Criteri minimi per la diagnosi di fragilità, disabilità e multimorbilità ed interventi generali per tutti i pazienti anziani multimorbidi (vaccinazioni, attività fisica/intellettiva, dieta, ecc.)</strong><br><em>R. Antonelli Incalzi, C. Pedone</em></p> <p class="titolo"><strong>La politerapia del paziente anziano con comorbilità: problematiche in causa</strong><br><em>F. Tangianu, R. Nardi, G. Pinna, A. Sacchetta, M. Campanini</em></p> <p class="titolo"><strong>Esami di laboratorio essenziali per l’inquadramento del paziente anziano multimorbido</strong><br><em>M. Pelloso, F. Tosato, M. Plebani</em></p> <p><img src="/public/site/images/pgranata/appendix.jpg" alt=""></p> <p class="titolo"><strong>Schemi riassuntivi</strong></p> Guest Editors: L.M. Fabbri C. Nozzoli ##submission.copyrightStatement## http://creativecommons.org/licenses/by-nc/4.0 2018-12-21 2018-12-21 12 4 1 97 10.4081/itjm.q.2018.7