A simple score with a limited number of non-invasive variables successfully predicted cardiac mortality in a real-life cohort of CHF patients. The use of this model in clinical practice identifies a subgroup of high-risk patients that should be closely managed.

Rapid intravenous hydration with sodium bicarbonate plus N-AC before contrast injection is effective and safe in the prevention of CIN in patients undergoing emergency PCI.

Use of pneumatic compression guided by MAP is safe and efficient, and it can significantly lower the incidence of radial artery occlusion.

Aims/hypothesis. This study analysed the relationship between congenital malformations (CM) and severity of gestational diabetes mellitus. Methods. A cohort of 2060 infants of mothers with gestational diabetes was studied. Universal screening and 3 rd Workshop-Conference criteria were used to diagnose gestational diabetes. The severity of diabetes was assessed on the basis of previous hyperglycaemia, blood glucose values in diagnostic OGTT, area under the glucose curve, gestational age and HbA 1 c at diagnosis, insulin requirements during pregnancy, and OGTT after delivery. Potentially confounding variables (age, pre-pregnancy BMI, smoking) were considered. The relationship of potential predictors with CM was analysed with several multivariate logistic regression analyses.Results. The rate of CM was 6% for minor and 3.8% for major malformations (1.4% heart, 0.8% renal/urinary, 0.7% skeletal, 0.3% hypospadias, 0.2% central nervous system, 0.2% cleft lip/palate, 0.1% digestive tract, 0.3% other). In the final models, forward logistic regression analysis identified pre-pregnancy BMI as the predictor of CM (area under receiver operating characteristic curve 0.616); in the backward analysis additional predictors were 1-h blood glucose in diagnostic OGTT and gestational age at diagnosis (area under receiver operating characteristic curve 0.646). Both BMI and severity of gestational diabetes were predictors of heart and minor CM, whereas BMI predicted renal/urinary CM and severity of diabetes predicted skeletal CM. Conclusions/interpretation. In these infants of mothers with gestational diabetes, severity of diabetes and pre-pregnancy BMI were predictors of CM, in accordance with the well-documented pathogenic role of BMI (in the general population) and hyperglycaemia (in diabetic pregnancy). BMI was the main predictor of more prevalent CM. [Diabetologia (2004) 47:509-514]

No abstract

Case ReportThyr otoxic periodic paralysis (TPP) is a rare complication of hyperthyroidism characterized by episodes of muscle weakness and hypokalemia. TPP is often not recognized at first attack due to a very low prevalence among the Caucasian population and usually mild symptoms of hyperthyroidism. We report a case of TPP due to Graves' disease in a Caucasian male, who presented with 4 paralytic episodes before the diagnosis was made. Case ReportA 37-year-old Caucasian man was admitted at the hospital for evaluation of episodic muscular weakness. He recalled four similar episodes in the previous 4 months, which started during sleep or post-exercise rest. Attacks consisted of flaccid muscle weakness that varied from mild proximal leg weakness to quadriparesis, involving mainly the lower-limbs. Three attacks resolved spontaneously over 2 to 8 hours. Hypokalemia (2.3 mEq/L) and mild hypomagnesemia (1.53 mg/dL) were documented in one episode and managed with administration of intravenous potassium chloride in the emergency department. In this attack, proximal flaccid quadriparesis 2/5 was observed, with normal reflexes and sensory examination. The electrocardiogram was normal.Two weeks later (between episodes) laboratory studies revealed normal renal and hepatic function, and the following results: serum sodium 143 mEq/L (136-145), potassium 3.6 mEq/L (3.50-5.10), calcium 9.03 mg/dL (8.27-9.80), albumin 34.5 g/L (34-48), urine sodium 77 mEq/L (25-150), urine potassium 93mEq/L (17-83). He had no significant personal or familial medical history and he was not taking any medication. He related weight loss, distal tremor, and heat Keywords: Hyperthyroidism; Hypokalemia; Thyrotoxic periodic paralysisWe describe a 37-year-old man with a 4-month history of episodic muscular weakness, involving mainly lower-limbs. Hypokalemia was documented in one episode and managed with intravenous potassium chloride. Hyperthyroidism was diagnosed 4 months after onset of attacks because of mild symptoms. The patient was subsequently diagnosed as having thyrotoxic periodic paralysis associated with Graves' disease. Treatment with propranolol and methimazol was initiated and one year later he remains euthyroid and symptom free. Thyrotoxic periodic paralysis is a rare disorder, especially among Caucasians, but it should always be considered in patients with acute paralysis and hypokalemia, and thyroid function should be evaluated.

The PREDIRCAM platform is technically ready for clinical evaluation. Training is required to use the platform and, in particular, for registration of dietary food intake.

Antithyroglobulin antibodies can interfere with the measurement of thyroglobulin yielding spuriously high or low levels depending on the method used. Interference is unrelated to the antibody concentration and can occur at very low concentrations. We report a patient in whom antithyroglobulin antibodies below the cut-off for positivity nearly led to an incorrect diagnosis of thyrotoxicosis factitia.