Bilateral ovarian teratoma presenting with a clinical picture of acute abdomen

We describe the case of a 30-year-old patient with bilateral mature cystic teratoma (MCT) of the ovaries. The patient had been complaining of mild abdominal pain for several months that had suddenly become severe. Early diagnosis at the emergency room was acute appendicitis, but definitive diagnosis was bilateral ovarian teratoma. We therefore recommend considering ovarian teratomas in the differential diagnosis of acute abdomen in young women in an emergency care setting

Circadian blood pressure rhythm and intimal-medial thickness changes in non-dipper normotensive patients

We investigated 25 non-dipper normotensive vs 25 dipper normotensive patients. The aim of our study was to evaluate carotid intimal-medial thickness (IMT) in the two groups. At the admission patients underwent anamnesis and general examination, blood sampling for lipid profile measurement, glycemia, homocysteine, ambulatory blood pressure measurement to assess the circadian blood pressure profile, and Doppler ultrasound to measure carotid intimal-medial thickness (IMT). Our results showed that IMT is significantly higher in the non-dipper group (P&lt;0.006) vs dippers. Non-dipper status has been recognized in several studies a condition with increased risk for target organ damage in hypertensive and normotensive subjects. However, to our knowledge, a possible relationship between IMT and normotensive non-dipper patients has not yet clearly investigated. Our study instead has clearly demonstrated a significant relationship between IMT and the non-dipper status.</p

Using INTERCheck® to Evaluate the Incidence of Adverse Events and Drug–Drug Interactions in Out- and Inpatients Exposed to Polypharmacy

Background: Polypharmacy exposes patients with comorbidities (particularly elderly patients) to an increased risk of drug-specific adverse events and drug–drug interactions. These adverse events could be avoided with the use of a computerized prescription support system in the primary care setting. The INTERCheck® software is a prescription support system developed with the aim of balancing the risks and benefits of polytherapy and examining drug–drug interactions. Objectives: This observational study used the INTERCheck® software to evaluate the incidence of adverse events and of drug–drug interactions in outpatients and inpatients receiving multiple medications. Methods: Patients were randomly enrolled from the outpatient department (n = 98) and internal medicine ward (n = 46) of S. Andrea Hospital of Rome. Polypharmacological treatment was analyzed using INTERCheck® software, and the prevalence of risk indicators and adverse events was compared between the two groups. Results: Polypharmacy (use of five or more drugs) applied to all except three cases among outpatients and one case among inpatients. A significant positive correlation was found between the number of medications and the INTERCheck® score (ρ = 0.67; p &lt; 0.000001), and a significant negative correlation was found between the drug-related anticholinergic burden and cognitive impairment (r = −&nbsp;0.30 p = 0.01). Based on the INTERCheck® analysis, inpatients had a higher score for class D (contraindicated drug combination should be avoided) than did outpatients (p = 0.01). The potential class D drug–drug interactions were associated with adverse events that caused hospitalization (χ2 = 7.428, p = 0.01). Conclusions: INTERCheck® analysis indicated that inpatients had a high risk of drug–drug interactions and a high percentage of related adverse drug events. Further prospective studies are necessary to evaluate whether the INTERCheck® software may help reduce polypharmacy-related adverse events when used in a primary care setting and thus potentially avoid related hospitalization and severe complications such as physical and cognitive decline

Using INTERCheck® to Evaluate the Incidence of Adverse Events and Drug–Drug Interactions in Out- and Inpatients Exposed to Polypharmacy

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