Internal Medicine Alert
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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.
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Dyeing to Death: Examining the Risks of Red 40 and High-Fat Diets
This study exploring colorectal cancer development reveals that Allura Red AC (Red 40), a synthetic dye prevalent in many American diets, causes significant deoxyribonucleic acid damage and colonic inflammation in mice, especially when combined with a high-fat diet.
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Vitamin D and Marine n-3 Fatty Acids Reduce Autoimmune Diseases
Continued use of vitamin D3 and n-3 fatty acids reduced the incidence of autoimmune diseases such as psoriasis.
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Birch Triterpenes Topical Gel (Oleogel-S10) (Filsuvez)
The U.S. Food and Drug Administration has approved a treatment for wounds associated with junctional epidermolysis bullosa and dystrophic epidermolysis bullosa not specific to a particular mutation. Birch triterpene is a botanical drug substance composed of a mixture of pentacyclic triterpenes (e.g., botulin, lupeol, betulinic acid, erythrodiol, and oleanolic acid) formulated as a topical gel.
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Buprenorphine May Be an Effective Alternative to Full Opioids for Pain in the ICU
In a small, single-center, retrospective, propensity-matched cohort study examining enteral oxycodone vs. sublingual buprenorphine in a critically ill population, pain control was equivalent, indicating that sublingual buprenorphine may be an effective and appropriate alternative.
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Long-Term Follow-Up Confirms Efficacy of Invasive Strategy in Very Old Patients with Non-ST-Elevation ACS
In this long-term analysis of patients in the After Eighty Study, with a mean age of 85 years and non-ST-elevation acute coronary syndrome, an invasive strategy showed a reduction in a composite endpoint of major adverse cardiovascular events and was associated with a significant improvement in event-free survival compared with a conservative approach.
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Cumulative Number of Head Strikes Contributes to the Development of CTE
A recent study evaluated the connection between head impact and chronic traumatic encephalopathy (CTE) in male athletes and found that the total number and severity of head impacts throughout life better predicted CTE than the number of symptomatic concussions.