Internal Medicine Alert
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How Safe Is Cannabis for the Heart?
A nationwide Danish study of new prescriptions for medical cannabis for chronic pain compared to control patients has found that the 180-day incidence of atrial fibrillation/flutter is two-fold higher, but the absolute number of arrhythmias is small.
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Omalizumab Injection (Xolair)
The U.S. Food and Drug Administration has approved the first medication to help reduce allergic reactions, including anaphylaxis, that may occur after accidental exposure to multiple foods. Omalizumab is a recombinant humanized IgG1k monoclonal antibody that selectively binds to immunoglobulin E (IgE) lowering free serum IgE levels.
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Is Cannabis Abuse During Pregnancy Associated with Poor Neonatal Outcomes?
Cannabis use disorder is associated with small but significant increased risks measured in multiple neonatal outcomes.
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Neuropeptides in Patients with Restless Legs Syndrome
The diurnal onset of restless legs syndrome (RLS) has been replicated in a mouse model using central instillation of the main melanocortin agonist, α-MSH, which stimulates excessive locomotion and grooming in rodents as well as a state of hyperalgesia. The actions of β-endorphin (β-EDP) oppose those of α-MSH, since β-EDP promotes passivity and analgesia. In this study, these prohormones were measured in plasma and cerebrospinal fluid in patients with RLS and compared to controls. Patients with RLS had elevated levels of α-MSH and lower levels of β-EDP compared to the control group.
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Effect of Atrial Fibrillation Catheter Ablation on Psychological Well-Being
A randomized trial of catheter ablation vs. medical therapy for atrial fibrillation (AF) patients has shown that anxiety and depression scores are significantly reduced by catheter ablation and are associated with decreases in AF burden and improved physical symptoms.
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Identifying Risk Factors for Young-Onset Dementia
In this large, population-based prospective cohort study, the investigators identified 15 risk factors that have strong associations with young-onset dementia. Modifications of these risk factors might delay the onset of, or prevent the development of, young-onset dementia.
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Bigeminy and What Else?
The medical providers in this case were concerned the cause of the bigeminal rhythm in the figure below was sinoatrial block. Do you agree? Are there other things to be concerned about?
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Bempedoic Acid (Nexletol) and Bempedoic Acid and Ezetimibe (Nexlizet)
The U.S. Food and Drug Administration is expected to update the indications for bempedoic acid and bempedoic acid/ezetimibe. Esperion has submitted clinical evidence in the form of Cholesterol Lowering via Bempedoic Acid an ACL-inhibiting Regimen (CLEAR) that demonstrated that bempedoic acid was associated with a lower risk of major adverse cardiovascular events compared to placebo. Bempedoic acid and bempedoic acid/ezetimibe are distributed by Esperion as Nexletol and Nexlizet, respectively.
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Is Screening First-Degree Relatives of Cardiomyopathy Patients Worthwhile?
An observational study of screening first-degree relatives of patients with dilated cardiomyopathy revealed 14% will show either dilated left ventricles, low left ventricular function, or both. These findings are more common if the relatives have been diagnosed with hypertension or are obese, but their frequency is not altered by sex or race.
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Long-Term Antiplatelet Therapy After PCI
The five-year follow-up of patients randomized to clopidogrel vs. aspirin monotherapy beyond one year after percutaneous coronary intervention has shown that clopidogrel is noninferior, but not superior, to aspirin for preventing the combined endpoint of adverse cardiovascular or major bleeding events.