Internal Medicine Alert
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Statins After an MI: Does it Happen?
Following hospital discharge for a heart attack, the majority of Medicare patients do not get recommended high-intensity statin therapy.
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Clinical Briefs
Ambulatory BP Monitoring, A New Oral Treatment for Hyperkalemia: Patiromer, Obesity Leads to Overdiagnosis of Airflow Obstruction
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Strengthen the Feet to Treat Plantar Fasciitis
SYNOPSIS: A strength training exercise improved self-reported 3-month outcomes in treating plantar fasciitis compared with inserts and stretching.
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Effects of Coenzyme Q10 in Chronic Heart Failure Patients
SYNOPSIS: Treatment with coenzyme Q10 in addition to standard therapy for patients with moderate to severe HF is safe, well tolerated, and associated with a reduction in symptoms and major adverse cardiovascular events.
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Is BMI Good Enough to Measure Visceral Adiposity?
SYNOPSIS: A large international study found frequent discordance between body mass index (BMI) and waist circumference (WC), driven by the substantial variability in visceral adiposity. Within each BMI category, patients with the highest WC were more likely to have higher cardiometabolic risk.
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Alternating Morphology Every-other-beat
Interpretation: The underlying rhythm in this simultaneously recorded 3-lead tracing is a narrow-complex tachycardia.
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Internal Medicine [ALERT]
The United States Preventive Services Task Force (USPSTF) gave a level B recommendation in support of annual low-dose computed tomography (LDCT) to screen for lung cancer in appropriate risk groups. The USPSTF decision was largely based on the National Lung Screening Trial (NLST), a mega-trial (n = 53,454) in the United States that randomized subjects to annual LDCT or chest X-ray. The primary endpoint of the study was lung cancer mortality, and all-cause mortality was a secondary endpoint. Inclusion criteria included at least a 30-pack/year history of smoking (if stopped within 15 years), ability and willingness to complete follow-up for abnormal findings, and absence of problematic comorbidities that might otherwise compromise long-term survival.
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Human Papillomavirus 9-valent Vaccine, Recombinant (Gardasil® 9)
The FDA has approved a 9-valent human papillomavirus (HPV) vaccine. The new vaccine covers five more types of HPV than the previous vaccine and protects against 90% of the HPV strains that cause cervical cancer.1 The new vaccine is marketed by Merck as Gardasil®9.
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Liraglutide Preserves Beta Cell Function — Well, Kind of…
SYNOPSIS: Fifty-one patients with type 2 diabetes of 2.6 +/- 1.9 years duration and an A1C of 6.8 % completed 4 weeks of intensive insulin therapy in order to eliminate glucose toxicity which is injurious to pancreatic beta cells. Thereafter, patients were randomized to receive daily subcutaneous liraglutide or an equivalent volume of placebo. Serial assessments of beta-cell function following oral glucose tolerance testing was performed at 12 week intervals for 48 weeks. Patients using liraglutide noted a rebust enhancement of beta cell function which was sustained over the course of the trial, yet lost within two weeks after stopping treatment.
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Clinical Briefs
The Heavy Emotional Costs of Rosacea, Treatment Choices Among the PDE5 Inhibitors, and Screening Asymptomatic Diabetics with CT angiography