Internal Medicine Alert – June 15, 2003

June 15, 2003

• Effects of a New Aldosterone Blocker in Patients with Myocardial Infarction

  The addition of eplerenone to optimal medical therapy reduces morbidity and mortality among patients with acute myocardial infarction complicated by left ventricular dysfunction and heart failure.

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• Postinfectious Irritable Bowel Syndrome

  Some patients seem to develop chronic irritable bowel syndrome following an episode of gastroenteritis, possibly based on excessive mucosal serotonin release.

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• Smokescreen: Your Tax Dollars at Work

  Direct-to-consumer marketing of helical computed tomography (CT) screening for older adult smokers is not advisable.

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• Pharmacology Update: Gemifloxacin Tablets (Factive — Gensoft Pharmaceuticals)

  Another fluoroquinolone has been added to the list of antibacterial agents for respiratory tract infections. Gemifloxacin is a broad-spectrum agent that is highly active against the most common respiratory pathogens, including penicillin and macrolide resistant Streptococcus pneumoniae.

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• Clinical Briefs

  Impaired Fasting Glucose vs Impaired Glucose Tolerance; Risk Stratification in Long-QT Syndrome; EBCT, Motivation, Behavioral Change, and Cardiovascular Risk Profile

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• ECG Review: RBBB — and Something Else?

  The ECG in the Figure was obtained from a 41-year-old woman with chest pain of suspected cardiac etiology. The tracing shows complete RBBB (right bundle branch block). How many additional ECG findings of potential concern can you identify that may be relevant in view of this patients clinical history?

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• Pharmacology Watch: Pneumococcal Vaccine Ineffective at CAP Prevention

  Pneumococcal Vaccine Ineffective at CAP Prevention; Flu Vaccine Limits Hospitalization; Verapamil Not Up To Competition; International Companies Unite Against SARS; New FDA Comissioner Brings Controversy; Janssen: Dear Doctor Letter for Risperidone

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