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An Updated Review on Metabolic Regulation in the Alzheimer’s Brain: Type 3 Diabetes?
Diabetes is a strong risk factor for the development of Alzheimer's disease (AD) given the mitochondrial, vascular, and inflammatory modalities that contribute to its progression. Therefore, it is vital to understand the pathophysiology of these two diseases as they relate to insulin resistance and mitochondrial dysfunction. Exposing a metabolic relationship between these diseases can provide further understanding of metabolic health and how treatment of insulin resistance can decrease disease burden.
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Does Ascending Aorta Size Predict Dissection?
A large Australian database study has shown that, because of the much larger number of patients without severe aortic dilatation, almost all fatal dissections occur in individuals with non-severely dilated aortas — the so-called aortic paradox.
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Chlorthalidone vs. Hydrochlorothiazide for Hypertension
A subgroup analysis of those with prior myocardial infarction or ischemic stroke in the Diuretic Comparison Project for the treatment of hypertension has found that this higher-risk group experiences fewer major adverse cardiovascular events while taking chlorthalidone compared to hydrochlorothiazide, but at the expense of more hypokalemia.
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CVD Risk from Ketogenic Diets
A recent analysis of the UK Biobank data found that subjects on a low-carbohydrate, high-fat diet had higher levels of low-density lipoprotein cholesterol and apolipoprotein B, and an increase in incident major adverse cardiovascular events over a 12-year follow-up than subjects on a standard diet.
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Risk of Atherosclerotic Coronary Artery Disease in Autoimmune Disorders
A large Danish registry study of patients with autoimmune disease referred for coronary computed tomography angiography compared to those without autoimmune disease has shown that autoimmune disease increases the incidence of atherosclerotic events and that the event rate is influenced by traditional atherosclerotic disease risk factors. These results support aggressive risk factor management in patients with autoimmune disease.
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The Role of Pulmonary Hypertension in the Decision to Intervene in Degenerative Mitral Regurgitation
A retrospective observational study of patients with degenerative mitral valve regurgitation has shown that Doppler echocardiographic-determined elevated pulmonary artery systolic pressure is related to mortality independent of the severity of mitral regurgitation, and that this excess mortality can be attenuated by mitral valve surgery.
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How Do the Rhythm and 12-Lead Go Together?
The patient whose electrocardiogram (ECG) is shown presented for care because of chest pain. Looking at this ECG, can you determine why?
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Imetelstat Injection (Rytelo)
The U.S. Food and Drug Administration has approved a first-in-class telomerase inhibitor for the treatment of myelodysplastic syndrome with transfusion-dependent anemia.
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Being Mindful of COVID’s Effects on Cognitive Decline
A large observational study finds objective evidence of lingering cognitive deficits associated with past COVID-19 infection, particularly in patients infected early in the pandemic, those hospitalized, or those with prolonged illness duration.
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Summer Travel: News Clinicians (and Their Patients) Can Use
The pandemic has waned. Summer vacation has arrived. Airports are crowded. Planes are full. New science can guide us as we and our patients travel this season.