Clinical
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Does One Negative Troponin Measurement Rule Out Acute Coronary Syndrome?
Using a common clinical chest pain algorithm plus a point-of-care troponin measurement for low-risk patients, researchers reported significantly lower healthcare costs. Also, this approach did not seem to result in more major adverse cardiovascular events.
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Unexpected Low Voltage on an ECG
A registry study of hypertrophic cardiomyopathy (HCM) patients and elite athletes in Italy revealed low voltage on ECG is not uncommon in HCM and may be a marker for more left ventricular scarring on cardiac imaging — and a poor prognosis.
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Stroke and a Wide QRS
The ECG in the figure is from an older man who presented with an acute stroke. He denied chest pain. Why is there QRS widening? What might be the clinical implications?
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Neurologists Try to Predict Cognitive Impairment Earlier
Researchers used easy memory tests among healthy participants to determine who might be more likely to need closer monitoring.
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Sitting, Standing, and Walking: The Effect on Cardiometabolic Markers
This meta-analysis explores the effects of interrupting sitting with either light-intensity walking or standing and finds that light-intensity walking is associated with the most significant impact on several markers of cardiometabolic health.
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More Steps Mean Better Cardiovascular Health for Older Americans
In a meta-analysis, researchers found walking 6,000 to 9,000 steps daily lowered the risk of cardiovascular disease by 40% to 50% vs. walking 2,000 steps daily.
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Limiting Meal Size and Caloric Intake May Be More Beneficial Than Time-Restricted Eating
Researchers found monitoring total caloric intake may be more effective for losing weight than intermittent fasting.
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Subcutaneous IVIG for Treatment of Myasthenia Gravis
A Phase II trial comparing subcutaneous (SC) administration of pooled immunoglobulin to intravenous (IV) administration of immunoglobulin in 23 patients with seropositive myasthenia gravis demonstrated a stable course after transition from IV to SC.
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Inclusion Body Myositis: Variability and Clinical Subsets
Inclusion body myositis (IBM) is a progressive myopathy characterized by prominent finger flexor and quadriceps involvement. Black patients with IBM have more prominent proximal weakness, in addition to finger flexion and quadriceps weakness. Female patients have less prominent finger flexion and quadriceps weakness and slower progression, whereas younger patients had a greater delay in diagnosis. There are variability and distinct clinical subsets among IBM patients, which can have implications in terms of timely diagnosis and possibly response to treatments.
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The Neural Pathways of Pain Treatment Response in Small-Fiber Neuropathy
Pain in peripheral neuropathy, referred to as neuropathic pain, is thought to result from overexpression of pain receptors, regeneration of hypersensitive nerve sprouts, and denervation hypersensitivity of neurons in the sensory ganglia. Additionally, activation of the pain pathways appears to induce secondary structural and functional changes in the brain that contribute to pain perception, persistence, and response.