Pulmonary cannonball metastasis and renal cell carcinoma
(Source: QJM)
Source: QJM - August 22, 2022 Category: Internal Medicine Source Type: research

Livedo racemosa in lymphocytic vasculitis
Learning points for cliniciansLivedo racemosa is characterized by a striking violaceous net-like pattern of erythema of the skin. A skin biopsy should be of an adequate size and depth and include the centre of the ring. This centre is important in order to sample the feeding artery and detect any relevant vascular pathology. (Source: QJM)
Source: QJM - August 19, 2022 Category: Internal Medicine Source Type: research

V-neck sign in dermatomyositis
Shanghai Municipal Health Commission10.13039/10001795020204Y0255 (Source: QJM)
Source: QJM - August 19, 2022 Category: Internal Medicine Source Type: research

Bilateral ptosis caused by patent foramen ovale-associated stroke
A 39-year-old woman presented with sudden onset bilateral ptosis and binocular diplopia for 3 days. The double vision was horizontal and most prominent when she was looking to the left side. The severity of symptoms does not vary over the day. She denied vertigo, headache, ocular pain, limb weakness, paresthesia, alcohol usage and botulinum toxin injection. Past medical history and family history were unremarkable. Neurological examination revealed bilateral ptosis, limited adduction in the right eye and normal pupils (Figure  1A). Other cranial nerves, extremity strength, coordination and sensory tests were intact. Deep ...
Source: QJM - August 16, 2022 Category: Internal Medicine Source Type: research

‘Black turbinates’ in COVID-associated sino-nasal mucormycosis
A 56-year-old male with acute-onset fever was diagnosed with coronavirus disease 2019 (COVID-19) pneumonitis on the basis of reverse transcriptase-polymerase chain reaction test and High resolution computed tomography findings revealed a score of 12/25). The blood parameters showed leukocytosis with a total leukocyte count of 17  × 103/mm3. Neutrophil count was 14.2  × 103/mm3 [83.8%] and lymphocyte count was 1.1  × 103/mm3 [6.5%]. Serum C-reactive protein was elevated (45  mg/dl). The glycosylated haemoglobin level was 11.9%, and the random blood sugar value was 194 mg/dl. Renal functions were within no...
Source: QJM - August 12, 2022 Category: Internal Medicine Source Type: research

Cutaneous larva migrans
A 41-year-old man with a background history of peptic ulcer disease was admitted with acute gastroenteritis. This settled with intravenous fluid and supportive treatment. Admission blood investigations showed mild eosinophilia (28% and 3.3 × 109/ml absolute count). He reported a history of pruritus over the lower and inner thighs. On examination, he had two healing wounds over the posterior aspect of the right thigh and one on the medial aspect of the right thigh (Figure  1a and b). Interestingly, there were also serpiginous scabs leading to two of the lesions. On inquiry, he frequently enters the jungles and had last en...
Source: QJM - August 12, 2022 Category: Internal Medicine Source Type: research

Extreme iatrogenesis
Learning points for cliniciansIatrogenic harm, which is often drug-induced and preventable, is involved in a substantial percentage of hospital admissions and general practice visits.Corticosteroids are notorious in the number, variety and impact of their potential adverse effects, here reported in a single patient.Congestive heart failure due to dilated cardiomyopathy due to iatrogenic Cushing syndrome is rarely encountered. (Source: QJM)
Source: QJM - August 12, 2022 Category: Internal Medicine Source Type: research

Eosinophilic myocarditis complicated by right ventricular outflow tract thrombus
Learning points for cliniciansEosinophilic myocarditis processes three stages including the earliest necrotic stage, the intermediate thrombotic stage and the late fibrotic stage. The classic echocardiographic findings include endomyocardial thickening, ventricular thrombus and posterior mitral leaflet involvement eosinophils. Furthermore, cardiac magnetic resonance delayed gadolinium enhancement imaging is capable of detecting myocardial fibrosis and inflammation. Herein, we reported a case of acute right heart failure and the right ventricular outflow tract obstruction, which was caused by eosinophilic myocarditis compli...
Source: QJM - August 11, 2022 Category: Internal Medicine Source Type: research

Long-term health outcomes of early menarche in women: an umbrella review
ConclusionWe found varied levels of evidence for the association between early menarche and the development of subsequent health problems. Our results recommend that physicians should pay attention to these associations, as early menarche can be a potential indicator of metabolic disorders and female-specific cancer and cause death in women. (Source: QJM)
Source: QJM - August 4, 2022 Category: Internal Medicine Source Type: research

U-shaped association between dietary thiamine intake and new-onset diabetes: a nationwide cohort study
ConclusionOur results suggested that there was a U-shape association between dietary thiamine intake and new-onset diabetes in general Chinese adults, with a minimal risk at 0.75 –1.10 mg/day. (Source: QJM)
Source: QJM - July 27, 2022 Category: Internal Medicine Source Type: research

Disparity in female and Asian representation amongst cardiology journal editorial boards members: a call for empowerment
ConclusionThis study highlights the female and Asian ethnic underrepresentation in academic roles in cardiology journal editorial boards. Further analysis is needed for other ethnicities, while the community pushes towards gender-balanced and ethnic diversity across editorial boards. (Source: QJM)
Source: QJM - July 22, 2022 Category: Internal Medicine Source Type: research

Prevention of suicidal behavior in diabetes: the role of primary care
AbstractStudies in different countries suggest that the rates of suicide ideation, attempts and death are increased in patients with diabetes in comparison to the general population. Suicidal behavior in patients with diabetes is a significant but underappreciated problem. Elevated suicide risk in individuals with diabetes may be related to comorbid psychiatric disorders, particularly depression. Considerable evidence suggests a bidirectional relationship between diabetes and depression: individuals with diabetes are at elevated risk of developing depression and patients with depression are more likely to develop diabetes....
Source: QJM - July 21, 2022 Category: Internal Medicine Source Type: research

What was the participation of Latin authors in TOP journals in internal medicine during 2021? A brief bibliometric analysis
In the field of medical scientific research and publication, there are few Latin American countries whose production is remarkable, although not comparable to that of high-income countries. The lack of investment for innovation is recognized as the main cause. Despite this, there are Latin authors who are making their contribution to the scientific heritage with high-quality studies.1 But how much participation do Latin authors have in research published by TOP internal medicine journals? Answering this question is part of the actions to achieve the current goals set by academic medicine regarding scientific development of...
Source: QJM - July 7, 2022 Category: Internal Medicine Source Type: research

Associations of a family history of lupus with the risks of lupus and major psychiatric disorders in first-degree relatives
ConclusionsThe FDRs of patients with SLE had higher risks of SLE, MDD, ADHD, OCD and bipolar disorder than the controls. (Source: QJM)
Source: QJM - June 27, 2022 Category: Internal Medicine Source Type: research

The diagnosis of central retinal artery occlusion after mRNA-SARS-CoV-2 vaccination
We read with interest the Case Report entitled ‘Combined central retinal artery and vein occlusion shortly after mRNA-SARS-CoV-2 vaccination’.1 However, we doubt about the underlying diagnosis accounting for the unilateral complete visual loss down to no light perception. (Source: QJM)
Source: QJM - January 28, 2022 Category: Internal Medicine Source Type: research