Internal Medicine Alert
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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.
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Reconsidering Aspirin Therapy for Elderly Patients
A post-hoc analysis of the ASPREE trial revealed that in presumably healthy elderly subjects, taking low-dose aspirin daily over three years was associated with a significant drop in hemoglobin and ferritin levels vs. placebo, even when patients with major bleeding events were excluded.
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Comparing Sequelae After Hospitalization with COVID-19, Influenza, or Sepsis
The incidence of most selected new-onset medical conditions did not significantly differ among those who had been hospitalized with COVID-19, influenza, or sepsis.
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Treating Psychotic Symptoms Among Alzheimer’s Disease Patients
In a meta-analysis of several large treatment trials of patients with Alzheimer’s disease, Parkinson’s disease, and dementia with Lewy bodies, cholinesterase inhibitors demonstrated a small but statistically significant benefit in alleviating psychotic symptoms.
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The Degree of Pyuria Can Help Determine Urinary Tract Infection in Elderly Women
Elderly women with a urinary tract infection recorded a higher median number of urinary leukocytes compared to uninfected controls, including those with asymptomatic bacteriuria. For 264 leukocytes/µL, the sensitivity and specificity of microscopy were 88%. Using the standard pyuria threshold of 10 leukocytes/µL gave a specificity of 36% and a sensitivity of 100%.
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Zuranolone Capsules (Zurzuvae)
Zuranolone can be prescribed to treat postpartum depression.
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Syncope and Complete AV Block?
The rhythm strip shown in the figure was recorded from a patient with syncope. It was interpreted as consistent with complete AV block. Do you agree with that interpretation?