Internal Medicine Alert – May 15, 2023
May 15, 2023
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Viral Exposure and the Risk of Developing Neurodegenerative Disease
In two national European biobanks, researchers identified and replicated 22 pairs of viral exposures associated with a higher risk of neurodegenerative diseases.
Is It Safe and Effective to Use Low-Dose Opioids Long Term to Treat Refractory RLS?
A review of two-year longitudinal data regarding efficacy and dose stability in refractory restless legs syndrome (RLS) patients treated with low-dose opioids shows that patients do not escalate their opiate dosage and that there is clinical and therapeutic stability in treating RLS with this therapeutic regimen.
Does One Negative Troponin Measurement Rule Out Acute Coronary Syndrome?
Using a common clinical chest pain algorithm plus a point-of-care troponin measurement for low-risk patients, researchers reported significantly lower healthcare costs. Also, this approach did not seem to result in more major adverse cardiovascular events.
Unexpected Low Voltage on an ECG
A registry study of hypertrophic cardiomyopathy (HCM) patients and elite athletes in Italy revealed low voltage on ECG is not uncommon in HCM and may be a marker for more left ventricular scarring on cardiac imaging — and a poor prognosis.
Rezafungin Injection (Rezzayo)
Rezafungin can be prescribed to treat candidemia and invasive candidiasis in patients age 18 years or older with limited or no alternative options.
Stroke and a Wide QRS
The ECG in the figure is from an older man who presented with an acute stroke. He denied chest pain. Why is there QRS widening? What might be the clinical implications?