Internal Medicine Alert
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Does CPAP Improve the Sex Lives of People With Obstructive Sleep Apnea?
Among men using CPAP, prior noncontrolled case series have suggested an improvement in sexual function, albeit primarily among subjects who reported prior sexual difficulties. Although hormonal effects have been implicated in obstructive sleep apnea, no one has confirmed that low testosterone is a consequence of sleep-disordered breathing or that testosterone can rise with the use of CPAP. However, factors that clearly can improve with CPAP, such as weight gain and poor sleep quality, have shown a definite relationship to testosterone levels.
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LDL Cholesterol: How Low Do We Go?
A meta-analysis of 29 cholesterol-lowering outcome studies with baseline average low-density lipoprotein (LDL) cholesterol levels ≤ 70 mg/dL showed consistent major adverse cardiovascular event risk reductions down to average LDL levels of 21 mg/dL without any increase in adverse events.
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Primary Headaches: Look, Listen, and Diagnose Rather Than Image
The diagnosis of primary headache disorders by a computerized and clinical paradigm can predict a baseline prevalence of intracranial abnormalities on brain imaging. Some historical “red flags” in children with headaches, including morning headaches and occipital pain, are not associated with increased intracranial abnormalities.
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Prophylactic Antibiotics for Acute Aspiration
Researchers compared outcomes in patients with aspiration pneumonitis who received prophylactic antibiotics during the first two days after macroaspiration to patients who received only supportive care during this time. Among 200 patients meeting the acute aspiration pneumonitis case definition, antimicrobial prophylaxis was not associated with improvement in mortality.
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Infections Associated With Travel to the United States
Infectious illness is common in travelers from other countries visiting the United States. Skin and soft tissue infections, respiratory infections, and gastrointestinal illness are most likely, but specific geographic illnesses such as Lyme disease also occur.
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Identify 4 Major Findings in New-onset Chest Pain Patient
The ECG in the figure was obtained from a patient with new-onset chest pain. He was hemodynamically stable at the time the tracing was obtained. In addition to the artifact that is most pronounced in the lateral chest leads, there are four major findings. Admittedly, two findings are subtle. How many findings can you identify?
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Human Papillomavirus Vaccine (Gardasil 9)
The FDA has approved a supplemental application to expand the indication for human papillomavirus 9-valent vaccine (HPV-9) to include men and women 27-45 years of age.
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Who Really Needs Intensive Blood Pressure Control?
A patient baseline characteristics level analysis of the SPRINT and ACCORD trials resulted in the creation of a simple algorithm for identifying high-risk patients who experienced fewer major cardiac events without increased serious adverse events from intensive blood pressure therapy.
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Neighborhood Socioeconomic Status Associated With Infection Risk, But Not Sepsis
Based on a large, national, prospective cohort study, lower neighborhood socioeconomic status was associated with a higher incidence of hospitalizations for infection (but not sepsis) at presentation.
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Is There a Connection Between Vitamin D and Fracture Prevention?
After conducting an extensive investigation, researchers did not find that vitamin D prevents falls or fractures.