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Internal Medicine

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  • Doxycycline Reduces the Risk of C. difficile Infection in Patients Treated for CAP

    In a retrospective study from the VA, doxycycline was associated with a lower risk of C. difficile infection compared to azithromycin in hospitalized patients with community-acquired pneumonia.

  • What Are Those T Waves?

    The patient whose ECG appears in the figure presented to an ambulatory care clinic for chest pain. Is the patient likely to have hyperkalemia?

  • Iloprost Injection (Aurlumyn)

    The U.S. Food and Drug Administration has approved iloprost for the treatment of severe frostbite to reduce the risk of amputation of fingers or toes. Iloprost, a synthetic analog of prostaglandin, initially was approved in 2004 for the treatment of pulmonary arterial hypertension. For that indication, it was given a priority review, accelerated approval, breakthrough therapy, and orphan drug designations. Iloprost for the frostbite indication is distributed by Eicos Sciences as Aurlumyn.

  • Empowered Relief vs. CBT vs. Health Education for Low Back Pain

    This randomized clinical trial involving adults with chronic low back pain demonstrates that a single session of a pain management class, when compared to a full course of cognitive behavioral therapy, yields noninferior (clinically on par) outcomes in pain catastrophizing and several other measures at the three-month follow-up.

  • Rates of Ad Hoc PCI Higher for Multivessel and Left Main Diseases

    In this retrospective analysis of patients from the New York state percutaneous coronary intervention (PCI) and coronary artery bypass grafting databases, ad hoc PCI was performed frequently among patients with left main and multivessel disease. Also, variability in ad hoc PCI use among hospitals and physicians for these populations was high.

  • How Safe Is Cannabis for the Heart?

    A nationwide Danish study of new prescriptions for medical cannabis for chronic pain compared to control patients has found that the 180-day incidence of atrial fibrillation/flutter is two-fold higher, but the absolute number of arrhythmias is small.

  • Omalizumab Injection (Xolair)

    The U.S. Food and Drug Administration has approved the first medication to help reduce allergic reactions, including anaphylaxis, that may occur after accidental exposure to multiple foods. Omalizumab is a recombinant humanized IgG1k monoclonal antibody that selectively binds to immunoglobulin E (IgE) lowering free serum IgE levels.

  • Is Cannabis Abuse During Pregnancy Associated with Poor Neonatal Outcomes?

    Cannabis use disorder is associated with small but significant increased risks measured in multiple neonatal outcomes.

  • Neuropeptides in Patients with Restless Legs Syndrome

    The diurnal onset of restless legs syndrome (RLS) has been replicated in a mouse model using central instillation of the main melanocortin agonist, α-MSH, which stimulates excessive locomotion and grooming in rodents as well as a state of hyperalgesia. The actions of β-endorphin (β-EDP) oppose those of α-MSH, since β-EDP promotes passivity and analgesia. In this study, these prohormones were measured in plasma and cerebrospinal fluid in patients with RLS and compared to controls. Patients with RLS had elevated levels of α-MSH and lower levels of β-EDP compared to the control group.

  • Effect of Atrial Fibrillation Catheter Ablation on Psychological Well-Being

    A randomized trial of catheter ablation vs. medical therapy for atrial fibrillation (AF) patients has shown that anxiety and depression scores are significantly reduced by catheter ablation and are associated with decreases in AF burden and improved physical symptoms.