Internal Medicine Alert
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Searching for a Connection Between Silent Myocardial Infarction and Heart Failure
In a large community-based cohort, the development of silent myocardial infarction on ECG was associated with increased risk of future heart failure.
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Lower Blood Pressure Targets May Increase Mortality in Type 2 Diabetes Patients
Type 2 diabetic patients with systolic blood pressure < 120 mmHg experienced more cardiovascular events than patients with systolic blood pressure up to 140 mmHg.
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Identifying Common Traits Regarding Inappropriate Antibiotic Prescribing
In a retrospective cohort study of outpatient visits for upper respiratory infections that should not require antibiotics, researchers found several patient, practice, and provider characteristics associated with inappropriate antimicrobial prescribing. Notably, adult patients seen by an advanced practice provider were 15% more likely to receive an antimicrobial than those seen by a physician provider.
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Non-opioid vs. Opioid Medications for Chronic Back, Knee, or Hip Pain
In this small study, non-opioid therapy (primarily acetaminophen and nonsteroidal anti-inflammatory drugs) was as effective as opioid therapy for chronic musculoskeletal pain with fewer medication-related side effects.
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Clinical Briefs
In this section: treating obstructive sleep apnea; influenza and myocardial infarction; and a promising Zika treatment.
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Tildrakizumab-asmn Injection (Ilumya)
Tildrakizumab-asmn is indicated for the treatment of adults with moderate-to-severe plaque psoriasis who are candidates for systemic therapy or phototherapy.
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Pre-existing Health Determines Quality of Life, Physical Symptoms After ICU Discharge
The authors of this nested cohort study within a randomized, controlled trial of ICU survivors requiring > 48 hours of mechanical ventilation found that pre-existing comorbidity was the main determinant of long-term health-related quality of life.
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Hospital Ice Machines Contaminated With Bacteria
Requiring staff to cleanse their hands with alcohol hand gel prior to using an ice machine and directing housekeeping personnel to perform more frequent machine cleaning may improve situation.
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Mefloquine: Still Effective and Still Safe for Malaria Chemoprophylaxis
Mefloquine is known as an effective agent for malaria chemoprophylaxis. However, concerns about serious adverse effects have limited its use. Now, a careful review of data suggests that fatal outcomes related to mefloquine prophylaxis are very rare.
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What Form of AV Block?
The long lead II rhythm strip shown in the figure was obtained from a hemodynamically stable patient. The rhythm was diagnosed as showing second-degree AV block, Mobitz Type II. Do you agree with that assessment?