Internal Medicine Alert
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Is There AV Block?
The long lead II rhythm strip in the figure was recorded at the standard 25 mm/second speed. This tracing was obtained from a middle-aged woman who presented to an outpatient clinic with noncardiac chest pain. How would one interpret this rhythm? Are there signs of AV block? Is it apparent if there is a cardiac problem?
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Esketamine Nasal Spray (Spravato) CIII
Esketamine, in conjunction with an oral antidepressant, is indicated for the amelioration of treatment-resistant depression in adults.
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Witness Observations in Diagnosing Transient Loss of Consciousness
Investigators found that adding witness-reported observations to patient demographics and patient-reported symptoms improved the diagnostic accuracy between epilepsy, syncope, and psychogenic nonepileptic seizures.
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Medication First? Ablation First? Either Way, Make Weight Loss a Priority
Weight loss management and aggressive risk factor modification associated with slowing or even reversal of atrial fibrillation progression.
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Behavioral Interventions in Adults for Weight Loss or Weight Loss Maintenance
The U.S. Preventive Services Task Force evaluated the risks and benefits of interventions for weight loss and weight loss maintenance to prevent complications from obesity. Panelists found a moderate net benefit from weight loss-intensive behavioral interventions.
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PrabotulinumtoxinA-xvfs Injection (Jeuveau)
PrabotulinumtoxinA-xvfs is indicated for temporary improvement in the appearance of moderate to severe glabellar lines associated with corrugator and/or procerus muscle activity in adults.
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Ripples From Original WHI Study Results Continue: Is This Appropriate?
Recommendations for menopausal hormone therapy were widely publicized and adopted following the original publication of the results of the Women’s Health Initiative, affecting both initiation and continuation of estrogen therapy through at least 2013.
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Dual Antiplatelet Therapy With Cilostazol for Secondary Stroke Prevention (LB3)
In a recent trial, patients treated with dual antiplatelet therapy combining cilostazol with either aspirin or clopidogrel were at a lower risk of ischemic stroke recurrence and at a similar risk of significant bleeding compared to patients treated with aspirin or clopidogrel alone.
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IV to Oral Conversion of Antibiotic Therapy for Bacteremia Due to Enterobacteriaceae
Oral step-down antibiotic therapy (IV to oral conversion) is safe and effective in patients with bloodstream infection due to Enterobacteriaceae.
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Rethinking the Prophylactic Use of Proton Pump Inhibitors in the ICU
The authors of this multicenter, blinded, randomized trial found that among critically ill adults at risk for gastrointestinal (GI) bleeding, fewer patients in the pantoprazole group exhibited clinically important GI bleeding compared to placebo, although mortality at 90 days was similar in both groups.