Internal Medicine Alert
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Heart Failure-Exacerbating Medications
In a large, diverse cohort of Medicare patients hospitalized for heart failure exacerbations, almost half were on medications known to exacerbate heart failure; more than one-third were on these agents at discharge.
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Icosapent Ethyl Capsules (Vascepa)
Icosapent is the first drug approved to reduce the risk of cardiovascular events in patients with established cardiovascular disease and hypertriglyceridemia on maximally tolerated statin therapy.
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CNS Agents Emerge as Frontrunners in FDA-Approved Treatments for Low Libido in Women
Low libido is the most common sexual complaint, affecting up to 38.7% of women, with up to 12.3% also reporting significant distress associated with this condition. Debate continues about how female desire disorders are characterized, diagnosed, and treated.
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The Risk of Endocarditis With Bacteremia
Interrogation of the Danish National Patient Registry revealed bacteremia due to Enterococcus faecalis was most likely to be associated with infective endocarditis; thus, echocardiography is warranted in these patients.
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Fever of Unknown Origin Due to Cat Scratch Disease
Disseminated cat scratch disease may present as a fever of unknown origin.
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Longer Antibiotic Courses for Pneumonia Do Not Improve Outcomes, Do Cause More Adverse Effects
Excess antibiotic therapy did not improve mortality or morbidity outcomes, although each additional antibiotic day was associated with 3% increased odds of antibiotic-associated adverse drug events.
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Can One Be Certain About the Rhythm Diagnosis?
The 12-lead ECG and long lead II rhythm strip in the figure was obtained from a patient who was hemodynamically stable. What is the rhythm in the figure? Why can one be virtually certain what the rhythm diagnosis is before attempting a vagal maneuver or using medication?
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Ubrogepant Tablets (Ubrelvy)
Ubrogepant is indicated for the acute treatment of migraine with or without aura in adults.
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Prognosis in Small Fiber Neuropathy
Small fiber neuropathy is a common disorder that causes chronic pain, but rarely progresses to disability or more severe neurological disorders. Management of the pain continues to be the major treatment challenge.
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Colonization With Clostridioides difficile Frequently Leads to a Misdiagnosis of Healthcare-Associated Infection
A prospective cohort study from a single institution revealed 27% of patients diagnosed with healthcare-associated Clostridioides difficile infection were colonized with the same isolate on admission.