Internal Medicine Alert – March 15, 2020
March 15, 2020
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Heart Failure-Exacerbating Medications
In a large, diverse cohort of Medicare patients hospitalized for heart failure exacerbations, almost half were on medications known to exacerbate heart failure; more than one-third were on these agents at discharge.
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Optimal Antithrombic Therapy After PCI for Atrial Fibrillation Patients
In three subgroups of coronary artery disease patients with atrial fibrillation, apixaban plus a P2Y12 inhibitor provided superior safety and similar efficacy outcomes as treatment with warfarin, aspirin, or both for six months.
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The Safety and Effectiveness of Pyrethroid Insecticides as the Battle Against Mosquitoes Continues
There is a statistical association between a urine test suggestive of exposure to pyrethroid insecticides and increased mortality over the subsequent 14 years.
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Peanut (Arachis hypogaea) Allergen Powder-dnfp (Palforzia)
This is the first FDA-approved oral immunotherapy for desensitizing peanut allergy in children to help reduce the risk of allergic reactions.
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A ‘Normal’ Initial ECG?
The ECG in the figure was obtained from a 30-year-old man who was admitted to the hospital to “rule out myocardial infarction.” His symptoms of chest discomfort were thought to be atypical and unlikely to be due to a cardiac etiology. His initial ECG (not shown) was interpreted as normal. Evaluation, including serial troponins and stress testing, were deemed normal. Before sending the patient home, the ECG in the figure was obtained.