Internal Medicine Alert
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What Can Be Said With LBBB?
The ECG in the figure was obtained from a patient with new-onset chest pain. It was interpreted as showing complete left bundle branch block (LBBB). Thus, the provider reasoned that “it is impossible to tell if anything acute is going on because there is LBBB.” Do you agree with that assessment?
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Clinical Briefs
In this section: Managing postprandial glucose excursions in diabetic patients, strategies for improving long-term outcomes for obesity patients, and effectively treating Crohn's disease.
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Vancomycin HCl for Oral Solution (Firvanq)
Vancomycin oral solution is indicated for adults and pediatric patients < 18 years of age for Clostridium difficile-associated diarrhea and enterocolitis caused by Staphylococcus aureus (including methicillin-resistant strains).
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Aerobic Exercise and Cognitive Impairment
Progressive aerobic exercise training appears to be a low-risk and effective intervention for improving cognitive function in community-dwelling adults with mild subcortical ischemic vascular cognitive impairment.
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Type 2 Diabetes Is Reversible
Type 2 diabetes is reversible (or can be put in remission) in a primary care practice through an intense low-carbohydrate weight management program.
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Clinical Briefs
In this section: tackling insomnia with cognitive behavioral therapy; navigating the spurious claims of internet-advertised products; and updated guidelines regarding hypertension treatment.
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Ozenoxacin Cream 1% (Xepi)
Ozenoxacin is indicated for the topical treatment of impetigo due to S. aureus and S. pyogenes in adult patients and pediatric patients ≥ 2 months of age.
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Updated Recommendations for Prevention of Hepatitis B Virus Infection
Fresh recommendations for prevention of hepatitis B virus infection focus on testing and management of newborns.
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Functional Imaging Studies in Parkinson’s Disease
A meta-analysis of 142 studies demonstrated that functional imaging studies in Parkinson’s disease using tracers for aromatic acid decarboxylase showed smaller defects compared to those using tracers targeting dopamine transport and VMAT2. Symptom severity correlated linearly with dopamine neuron loss as determined by these imaging studies.
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A Closer Look at the Effects of NSAIDs on Blood Pressure
An ambulatory blood pressure monitoring substudy of the PRECISION trial showed that ibuprofen use significantly increased mean 24-hour systolic blood pressure compared to celecoxib. Further, naproxen produced intermediate results despite equivalent pain relief in patients with arthritis.