Internal Medicine Alert

• Gabapentin vs. Duloxetine vs. Falls in Older Adults

  This retrospective study examining fall risk among older adults taking gabapentin compared to duloxetine finds gabapentin users exhibit a markedly lower risk of fall-related visits at six months (hazard ratio = 0.52) yet finds no difference in the incidence of severe falls.

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• Determinants of Long-Term Outcome After Concussion

  This cohort study of U.S. veterans found that mild traumatic brain injuries occurring alongside psychological trauma are associated with long-term post-concussive symptoms and disability. The authors postulate that the traumatic context contributes to the development of post-traumatic stress disorder, which may in turn potentiate long-term sequelae.

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• Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation

  An integrated nationwide medical and pharmacy claims database analysis of patients with new atrial fibrillation undergoing catheter ablation as first-line therapy has shown that 17% of patients required repeat ablation for recurrent atrial fibrillation despite the frequent use of antiarrhythmic drugs.

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• Ten-Year Outcomes of the SCOT-HEART Study

  The 10-year follow-up of the SCOT-HEART Study of new-onset chest pain patients randomized to standard care vs. the addition of coronary computed tomography angiography (CTA) has shown that coronary heart disease-related death, myocardial infarction, and other adverse cardiovascular outcomes are reduced with CTA use, perhaps because preventive therapy is increased.

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• Apomorphine Hydrochloride Injection (Onapgo)

  The U.S. Food and Drug Administration has approved apomorphine as a constant subcutaneous infusion for the treatment of advanced Parkinson’s disease with persistent motor fluctuations. It is the second subcutaneous infusion for this indication following foscarbidopa/foslevodopa (as Vyalev).

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