RESUMO
Context: Sodium-glucose co-transporter 2 inhibitors (SGLT2-I) are a new class of oral antidiabetic drugs. Objective: Side effects of drugs are frequently encountered with increasing use in clinical practice. Design/Subjects and Methods: We present a case with an unidentified body odor that has not been described yet in the literature as an adverse effect of SGLT2-I. Results: A 49-year-old female patient with Type 2 DM was applied to our clinic for routine control. She had been receiving sitagliptin/metformin 50/1000 mg b.i.d. Her fasting plasma glucose was 160 mg/dL and HbA1c was 8%. Empagliflozin 10 mg/day was added to therapy. The patient noticed that two weeks after starting empagliflozin treatment, she began to smell herself and felt a bad/foul odor was released from her body. The patient associated these complaints with the new drug(empagliflozin) stopped two weeks ago. She also stated that all these complaints had disappeared one week after stopping the medication and there were no complaints at the moment. Conclusions: Here we report an unidentified body odor as a potential empagliflozin-associated adverse event. There was a close temporal relationship between empagliflozin intake and the development and the occurrence of the described odor.
RESUMO
Point-of-care ultrasound (POCUS) is increasingly used to assess medical patients. It has many uses in daily clinical practice, including improved diagnostic timeliness and accuracy, and providing information about a patient's prognosis and follow-up. It has been integrated into numerous specialities, but remains relatively undefined in internal medicine training programs. Ultrasonography is a useful tool in the standard clinical practice of internists in numerous clinical scenarios (Emergency Department, hospital ward, general and specific consultations, and home care). Although POCUS has been recently included in the European curriculum of internal medicine, there are differences between European internists in its use, ranging from not at all to well structured educational programs. The use of POCUS needs to be widespread in internal medicine departments, and to accomplish this we must encourage structured training. This document details the consensus-based recommendations by the European Federation of Internal Medicine (EFIM) Ultrasound working group. We establish POCUS core competencies and clinical settings for internists in a symptom-based approach. We also propose training requirements, providing a framework for training programs at a national level.
