Internal Medicine Alert
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An ECG in Disguise?
The electrocardiogram (ECG) in the figure was recorded from an older man following a bradycardic and hypotensive episode. What ECG diagnosis is suggested by this tracing?
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Epinephrine Nasal Spray (Neffy)
The U.S. Food and Drug Administration has approved epinephrine nasal spray for the emergency treatment of allergic reactions, including anaphylaxis. It was granted a fast-track designation and will be distributed by ARS Pharmaceuticals as Neffy.
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Indications for Reduced-Dose Direct Oral Anticoagulants
A subgroup analysis of the ENGAGE-AF TIMI 48 study of edoxaban 60 mg/day vs. 30 mg/day compared to warfarin in patients with atrial fibrillation of the group 80 years of age or older has shown that 30 mg/day results in less major bleeding without a concomitant increase in stroke risk compared to 60 mg/day or warfarin.
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Anchoring Alzheimer’s Disease Along an Amyloid Timeline
In 601 individuals from Wisconsin-based cohorts with amyloid-beta and tau positron emission tomography scans, the magnitude and topographical spread of tau pathology increased with longer duration of amyloid-beta positivity, and the cognitive decline was steepest in those with the longest duration of amyloid-beta positivity and elevated entorhinal tau.
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Sweating for Sleep: Examining Evening Exercise and its Effects on Sleep Duration
This small, randomized crossover trial demonstrates that short, repetitive bouts of early evening exercise lead to an increase in total sleep time compared to prolonged sitting.
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Sofpironium Topical Gel (Sofdra)
The U.S. Food and Drug Administration has approved a second topical anticholinergic product for the treatment of hyperhidrosis.
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Enlargement of Choroid Plexus in Subacute COVID-19 Patients
The choroid plexus is a network of capillaries whose main role involves facilitating cerebrospinal fluid production and the exchange of nutrients and waste products between the central nervous system and the bloodstream. Immune cells are present near the choroid plexus. Enlargement of the choroid plexus has been noted in patients with multiple sclerosis.
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Chlorthalidone vs. Hydrochlorothiazide for Hypertension
A subgroup analysis of those with prior myocardial infarction or ischemic stroke in the Diuretic Comparison Project for the treatment of hypertension has found that this higher-risk group experiences fewer major adverse cardiovascular events while taking chlorthalidone compared to hydrochlorothiazide, but at the expense of more hypokalemia.
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TB Screening Dismayingly Low in Those at Risk
Screening for latent tuberculosis (TB) infection in persons at risk is woefully lax in our country — and yet, reactivation TB is such an eminently preventable disease.
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Is It Past Time to Change Dietary Guidelines for Alcohol Use?
Analysis reveals that previous studies demonstrating the health benefits of moderate alcohol drinking were of low quality and that the relatively few published studies meeting the minimal quality criteria to avoid this problem do not show significantly lower mortality risk for moderate alcohol drinkers.