Clinical
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Outpatient CAP Treatment in Adults: Narrower Spectrum Therapy Is Better Tolerated
Examination of a large database led to the conclusion that treatment of community-acquired pneumonia in outpatients with narrower-spectrum agents (macrolides or doxycycline) was associated with similar clinical outcomes but with a lower incidence of adverse effects when compared to broader-spectrum therapy.
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Wildfire Smoke Exposure Is a Risk Factor for Dementia
In this large, open cohort study based on electronic health record data from 2009 to 2019 of dementia-free people older than 60 years of age, exposure to wildfire smoke resulted in an increased incidence of dementia later in life.
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Psychiatric Comorbidities in Persons with Epilepsy
In this systematic review and meta-analysis, the prevalence of most psychiatric disorders was significantly higher in persons with epilepsy than in those without epilepsy. These findings show the high burden of psychiatric comorbidities in persons with epilepsy and underscore the importance of appropriately identifying and treating psychiatric comorbidities in epilepsy patients.
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Patterns of Brain Atrophy in Memory Disorders
In this multicenter, memory clinic-based cohort targeting earliest at-risk states for dementia of Alzheimer’s type, limbic-predominant and hippocampus-sparing atrophy subtypes were identified. Limbic-predominant atrophy was linked to worse cognitive outcomes over time, including in individuals who were asymptomatic or only had subjective memory symptoms at the time of baseline imaging.
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Examination and Imaging Correlates of Visual Symptoms in Mild TBI
This study highlights measurable visual and structural changes in patients with mild traumatic brain injury (mTBI). Findings include convergence insufficiency, reduced contrast sensitivity, and occipital cortex changes, despite normal standard imaging and visual field tests. Machine learning discerned mTBI from controls with 72% accuracy, suggesting advanced diagnostics can uncover subtle abnormalities.
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Monotruncular (Monomelic) CIDP
In this study, the authors describe the clinical, electrophysiological, and radiological features of patients with multifocal chronic inflammatory demyelinating polyneuropathy (CIDP) that presented with monotruncular (monomelic) onset.
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From Exhaustion to Empowerment: Combating Physician Burnout in Healthcare
Medicine always has been demanding, both emotionally and intellectually. Yet, primary care providers have found deep purpose in their work. However, the modern practice of medicine brings new challenges, such as administrative burdens, financial strain, and large patient loads, contributing to widespread burnout. This paper examines burnout in the primary care provider and its related consequences and offers practical strategies for supporting provider well-being.
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Cardioprotective Therapy Initiation in Chemotherapy Patients
An international study of patients undergoing cancer chemotherapy or left chest radiation therapy showed that those who showed isolated reductions in echocardiography left ventricular global longitudinal strain but not ejection fraction during follow-up who were randomized to neurohormonal therapy vs. usual care showed better preservation of 12-month cardiac magnetic resonance-determined ejection fraction.
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Prognostic Value of Stress Echocardiography
A UK National Health Service database study of stress echocardiography has shown the degree of ischemia accurately predicts the risk of future cardiovascular events over five years. The same study also showed that a negative test in patients without a history of cardiac disease identifies patients with no more than the expected background risk of an event for patients in this demographic for five years.
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EARLY TAVR Study Reports a Win for TAVR in Asymptomatic Severe AS
In this multicenter, randomized trial comparing transcatheter aortic valve replacement (TAVR) with active surveillance in patients with asymptomatic severe aortic stenosis (AS), early TAVR showed an advantage regarding the composite endpoint of death, stroke, or unplanned hospitalization for cardiovascular causes. This result was driven primarily from the progression to severe symptomatic AS among the surveillance group, with no significant difference in mortality.