Italian Journal of Medicine <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> 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="" 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> A practical approach for a comprehensive evaluation and management of diabetes mellitus <p>Diabetes mellitus (DM) is a very common disease, encountered in nearly one third of patients admitted to Internal Medicine Units. The discharge from the hospital is a crucial moment for patients with chronic and complex diseases such as DM and also for the caregiver. After hospital admission, therapeutic modifications with respect to usual therapy might have occurred, and shift to insulin therapy during admission occurs in the majority of patients. Therefore, treatment with insulin needs education of the patient and/or the caregiver for the correct drug administration and treatment of related side effects, mainly hypoglycemia. We believe that a very practical and mnemonic approach can help the clinician in the management of the delicate phase of hospital discharge of the diabetic patient.</p> Filippo Pieralli Andrea Crociani Cristina Bazzini ##submission.copyrightStatement## 2019-03-06 2019-03-06 13 1 68 72 10.4081/itjm.2019.1014 Challenging diagnoses of toxocariasis: a report of two cases <p>The present study illustrates two cases of <em>Toxocara canis</em> infection: a 77-year-old man presenting with bilateral uveitis, sepsis, and non-convulsive status epilepticus (patient A); and a 63-year-old woman with a history of treated breast cancer, presenting with sight loss and paralysis of the right eye, neurological symptoms, pulmonary embolism, pneumonia, and a post traumatic vertebral fracture (patient B). Both diagnoses were challenging because the acute comorbidities withdrew the attention from the actual cause of the disease, and in one case the steroid treatment possibly affected the laboratory indexes. The lack of response to antibiotics and the involvement of specific organs and districts suggested parasitic infection. Indeed, immunoblot assay revealed the presence of specific <em>T. canis </em>immunoglobulin G antibodies. Both patients improved with albendazole 800 mg/die (400 mg ×2) for 28 days; the neurological state normalized, while sight and eye motility remained impaired. Overall, the findings from these two toxocariasis cases indicate that the occurrence of severe neurological symptoms associated with ocular involvement should generate suspicion of parasitic infection rather than leading to differential diagnosis of common presentations such as bacterial and viral infections or autoimmune diseases.</p> Maria Luisa Gastaldello Marcello Bigliocca Mauro Campanini ##submission.copyrightStatement## 2019-03-06 2019-03-06 13 1 59 63 10.4081/itjm.2019.1056 Acute dyspnea in Emergency Department: point of care ultrasound in the diagnosis of atrial sarcoma <p>We describe a rare case of a 65-year-old patient presented to Emergency Department for acute dyspnea. Traditional diagnostic work-up was done and the emergency physician promptly performed a bedside point-of-care ultrasound. A giant mass in the left atrium was detected with impairing of mitral valve function. The patient was then sent to cardiac surgery department with a final diagnosis of high-grade cardiac sarcoma.</p> Maria Immacolata Arnone Giampiero Foccillo Federica De Pisapia Giuliano De Stefano Giovanni Albano Maria Viviana Carlino Alfonso Sforza Enrico Giuseppe Ruggiero Costantino Mancusi ##submission.copyrightStatement## 2019-03-06 2019-03-06 13 1 45 47 10.4081/itjm.2019.1081