Pharmacological Therapy Optimization for Heart Failure: A Practical Guide for the Internist.

Heart failure carries significant morbidity and mortality and affects a large population of patients cared for predominantly by primary care physicians. The complexity of managing heart failure patients is increasing as new therapies continue to emerge. This review outlines important clinical pearls and proposes strategies for optimization of medical therapy.

Ocular Sarcoidosis and Autoimmune Polyglandular Syndrome Type 2: A Case Report.

Purpose: to describe a clinical case of ocular sarcoidosis in a patient with Autoimmune Polyglandular Syndrome Type 2 (APS-2).

Methods: an 86-year-old female diagnosed with APS-2 was referred to our uveitis department with rapid visual loss in her left eye during a 3-month period. Her best-corrected visual acuity (BCVA) was counting fingers in her left eye (OS) and 20/40 in her right eye (OD).

Promoting Cardiac Rehabilitation in Acute Coronary Syndrome Patients: Quality Initiative Based on Education, Automated Referral, and Multidisciplinary Rounds.

Cardiac rehabilitation is a class 1 recommendation for acute coronary syndrome (ACS) patients according to the American College of Cardiology/American Heart Association. However, only 1 in 5 ACS patients are referred for cardiac rehabilitation nationally, and even fewer at our institution. We sought to improve the number of referrals to cardiac rehabilitation for post-ACS patients admitted to our inpatient cardiology service, and ultimately their participation in the program.

Gout in Pregnancy: A Rare Phenomenon.

Gout is a rare phenomenon in reproductive age women due to the uricosuric effects of estrogen. Furthermore, gout in pregnancy has been reported in only a scant number of case reports. We present the case of a 21-year-old gravida-4 para-3 female at four-weeks gestation presenting with acute polyarticular gout, complicated by Haemophilus influenzae sepsis and hyperemesis gravidarum.

Early manifestation of myocardial involvement in systemic sclerosis.

Introduction: Systemic sclerosis (SSc) is a systemic autoimmune disease involving multiple organs. We present a rare case of SSc in which clinical manifestations of cardiac fibrosis occurred early in the disease course.

Case Report: We report the case of a 40-year-old Caucasian man, previously diagnosed with SSc, who presented with decompensated heart failure.

A Challenging Diagnosis of Ascites: A Case Report of Peritoneal Tuberculosis.

Approximately 2 billion people, which is about one third of the world's population, are infected with tuberculosis (TB). Around 10% of infected people will develop active TB at one point in their lifetime. We present a rare case of a 68-year-old male who presented to the emergency department with a 2-week progressive dyspnea.

Epidemiology of Clostridium difficile infection in Portugal: Experience at a tertiary care hospital.

Background: Clostridium difficile is the main cause of healthcare-associated diarrhoea. Its incidence, severity and relapse rates increased over the past two decades.

Aim: To study epidemiologic characteristics and treatment of Clostridium difficile infection (CDI) and compare with a previous cohort from the same hospital.

[National Post Hospital Care Project and length of hospitalization of patients with stroke 2010-2011].

Introduction: The National Post Hospital Care Project was created to provide a continuity of care after hospitalization or to functionally dependent people. Currently there is a great difficulty in the integration of patients. The objective of this paper is to compare the impact of the referral to the Project versus being discharged home, in the length of stay of stroke patients between 2010 and 2011.

Predicting Acute Pancreatitis Severity: Comparison of Prognostic Scores.

Background: Acute pancreatitis has a broad clinical spectrum, from mild illness to multiple organ failure and death. Prognostic scores have been developed or adapted to predict disease severity. This study aimed to compare the prognostic scores according to sensitivity and specificity, receiver operating characteristic curves and area under the curve.