Internal Medicine Alert
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An Update to the Management of Atrial Fibrillation
This focused update to the 2014 guidelines for the management of atrial fibrillation (AF) includes revisions to anticoagulation recommendations and the role of catheter ablation of AF in patients with heart failure.
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Are the Changes Acute?
Imagine the ECG in the figure was obtained from a previously healthy, middle-aged man who presented to an ambulatory clinic for “indigestion.” How might one interpret the ECG?
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Caplacizumab-yhdp for Injection (Cablivi)
Caplacizumab-yhdp is indicated for the treatment of acquired thrombotic thrombocytopenic purpura in combination with plasma exchange and immunosuppressive therapy.
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Homeless Population Requires Hepatitis A Vaccination
A multistate outbreak of hepatitis A virus (HAV) infection in the homeless and/or drug-using population has prompted the United States Advisory Committee on Immunization Practices to add “homelessness” as an indication for HAV vaccination. This is in addition to existing indications for HAV vaccination of men who have sex with men and illicit drug users (with the exception of marijuana use).
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Combination Drug Therapy for Hypertension
A large regional database study from Italy revealed that initial combination therapy for newly diagnosed hypertension results in fewer major adverse cardiovascular events at one year compared to monotherapy.
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Clinical Outcomes After Oral Anticoagulant-Associated Intracerebral Hematoma
In this meta-analysis of multiple observational studies, clinical outcomes after oral anticoagulant-associated intracerebral hematoma were similar for those associated with vitamin K antagonists or the new class of direct oral anticoagulants.
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Apolipoprotein E and CSF Levels in Men and Women With Alzheimer’s Disease
Apolipoprotein E epsilon 4 (APOE4) genotype, the stronger genetic risk factor for late-onset Alzheimer’s disease, negatively affects cerebrospinal levels of tau protein in a sex-dependent manner, whereby the effect of APOE4 is stronger in women than men.
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Revefenacin Oral Inhalation (Yupelri)
Revefenacin should be used to help patients with COPD.
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Antipsychotics Do Not Shorten the Duration of ICU Delirium
In this randomized, placebo-controlled trial, neither haloperidol nor ziprasidone altered the duration of delirium when compared to placebo.
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PCSK9 Inhibitors in Acute Coronary Syndrome Patients
Compared to adding placebo, using the proprotein convertase subtilisin/kexin type 9 inhibitor alirocumab in post-acute coronary syndrome patients on maximally tolerated, high-intensity statins with low-density lipoprotein (LDL) cholesterol levels higher than 70 mg/dL lowered LDL and reduced the number of major adverse cardiac events.