Internal Medicine Alert
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More Reports of Severe Group A Streptococcal Infection
Around the world, rates of severe illness caused by group A Streptococcus are rising. Possible explanations for the increase include immunity-altering, post-pandemic changes in exposure to respiratory pathogens and the emergence of new pathogenic M strains of Streptococcus.
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Steroids and Pneumonia — So Meta?
In a multicenter, randomized, placebo-controlled trial, hydrocortisone lowered mortality rates among patients with severe community-acquired pneumonia.
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Using Doxycycline as Postexposure Prophylaxis to Prevent Bacterial Sexually Transmitted Infections
In an open-label, randomized study involving men who have sex with men and transgender women, using doxycycline within 72 hours of condomless sex was associated with a two-thirds reduction in the incidence of bacterial sexually transmitted infections vs. those who received standard care.
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COVID-19 Vaccine, 2023-2024 Formula (Comirnaty, Spikevax)
The newest vaccines target XBB.1.5, which is no longer the dominant circulating variant, but they offer protection against XBB.1.16 and more distant variants (e.g., EG.5.1, FL.1.1.1, and BA.2.86).
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Is the Irregularity a Problem?
Interpreting ECGs without the benefit of any history always is challenging. Such is the case with the figure in this article, which manifests significant irregularity.
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Nonhormonal Treatment for Menopausal Vasomotor Symptoms: A Phase III Study of Fezolinetant
More than 500 women with moderate to severe menopausal vasomotor symptoms received either 45 mg of fezolinetant, 30 mg fezolinetant, or placebo. Both fezolinetant doses significantly reduced the frequency and severity of menopausal symptoms at four and 12 weeks of treatment vs. placebo.
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Oral Penicillin Challenge vs. Skin Testing: Diagnosing Low-Risk Patients with Reported Penicillin Allergy
In a comparison of direct oral penicillin challenge in low-risk patients to skin testing followed by oral challenge, researchers reported no significant differences. Direct oral penicillin challenge appears to be a safe and effective way to delabel a penicillin allergy.
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Researchers Report on the Efficacy of the Subcutaneous Implantable Cardioverter-Defibrillator
An FDA-mandated post-approval study of the subcutaneous cardioverter-defibrillator system in a real-world population revealed excellent safety and efficacy over five years.
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Timing of Anticoagulation Administration Following Atrial Fibrillation-Associated Stroke
A prospective, blinded, randomized study of early vs. later administration of oral anticoagulation after ischemic stroke in patients with atrial fibrillation calibrated by cerebral imaging showed no significant difference in 30-day outcomes.
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Glyceryl Trinitrate Topical Gel (Eroxon)
Eroxon can be recommended to treat adult men (age 18 years and older) with erectile dysfunction.