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Internal Medicine Alert

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  • Safety and Tolerability of Inclisiran

    A pooled analysis of seven relatively short-term ORION studies of inclisiran vs. placebo for lowering low-density lipoprotein cholesterol that assessed safety and tolerability for up to six years showed that inclisiran has similar rates of adverse events, excluding injection site reactions, as placebo treatment and is associated with fewer major adverse cardiovascular events.

  • A Comparison of Acute Migraine Therapies Using Big Data

    In a big data-driven observational study that compared 3 million treated migraine attacks captured from a migraine diary smartphone app, triptans were found to be the most efficacious treatment class. Among the triptans, eletriptan had the highest rate of success. Consistent with clinical practice and recent consensus statements, the success of triptans was followed by ergots and antiemetics.

  • Nitrates in Food Reduce Cardiovascular Risk

    Dietary nitrates, such as in beetroot juice, improve the cardiovascular risk profile, lowering blood pressure and enhancing endothelial function.

  • Is Brain Impairment Following COVID-19 Hospitalization Worse Than for Other Severe Illnesses?

    The authors of this prospective cohort study with matched controls found that long-term brain health following severe COVID-19 hospitalization was impaired but was similar to hospitalization from other severe diseases.

  • Iptacopan Capsules (Fabhalta)

    The U.S. Food and Drug Administration has approved the first oral drug to treat paroxysmal nocturnal hemoglobinuria (PNH). Iptacopan is a first-in-class oral selective inhibitor of complement factor B (C3 pathway). It is distributed by Novartis Pharmaceutical Corporation as Fabhalta.

  • Metformin Use Is Associated with Decreased Diabetes-Associated Dementia

    In two recent cohort studies, metformin use was found to decrease the risk of developing dementia in older adults with type 2 diabetes mellitus.

  • Risk Factors for Atrial Fibrillation

    A United Kingdom Biobank study of new onset atrial fibrillation (AF) has shown strong associations with hypertension and obesity at all ages and acute illnesses/surgery in older individuals. Genetics was less important, but in those at low genetic risk, obesity and hypertension were strong predictors of AF.

  • Do Patients with Heart Failure Feel Better on Dapagliflozin?

    An analysis of the DETERMINE studies of dapagliflozin vs. placebo in patients with heart failure showed some improvement in self-reported symptoms in those with reduced ejection fraction on dapagliflozin but not in the six-minute walk test. No improvements in symptoms or physical activity levels were found in those with preserved ejection fraction on dapagliflozin.

  • H. pylori Infection – A Potential Modifiable Risk Factor of Alzheimer’s Dementia

    A large nested case-control cohort study of subjects aged 50 years and older found that clinically apparent Helicobacter pylori infection is associated with a moderately increased risk of developing Alzheimer’s disease.

  • What Kind of Artifact?

    To emphasize the importance of recognizing the clinical finding shown in the figure, no history is given. The two most helpful leads for interpretation of these unusual ECG findings are lead I and lead V3. How would you interpret this tracing?