Internal Medicine Alert
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CT Calcium Score vs. Stress Testing
A subgroup analysis of the PROMISE trial showed that CT coronary calcium scores in symptomatic patients at low to intermediate risk for coronary artery disease are more sensitive but less specific for major adverse cardiac events over a two-year follow-up period than stress testing. Consequently, both approaches exhibited similar but modest discriminatory ability.
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Hold the Hormones — At Least for Chronic Condition Prevention
The U.S. Preventive Services Task Force reissued a statement on hormone replacement therapy for the prevention of chronic conditions that reiterates its D recommendation from 2012. It recommends physicians do not prescribe hormone replacement therapy (HRT) to prevent medical conditions, but leave the question of using HRT for treatment of menopausal symptoms unanswered.
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How Many Conduction Defects?
The ECG and long lead II rhythm strip in the figure with the article was obtained from a 58-year-old man who was admitted to the hospital with chest pain and weakness. How would you interpret the tracing? How many different types of conduction disturbances can you identify?
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Clinical Briefs
In this section: using diuretics in heart failure patients; sexual dysfunction in patients with diabetes; and treating subtle gastrointestinal symptoms.
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Buprenorphine Extended-release Injection (Sublocade)
Buprenorphine extended-release injection is indicated for the treatment of moderate-to-severe opioid use disorder in patients who have initiated treatment with a transmucosal buprenorphine-containing product, followed by dose adjustment for a minimum of seven days.
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Travelers Unaware of the Need for Pre-travel Vaccinations
Outbreaks of measles continue to occur in the United States, mostly because of imported cases. More than half of these occur as the result of inadequately vaccinated returning U.S. travelers who acquire measles infection abroad.
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Newer Guidelines for Influenza Testing This Season
The California Department of Public Health and the CDC have recommended that, regardless of the results of prior rapid influenza testing, empiric therapy with a neuraminidase inhibitor should be administered promptly to patients hospitalized with influenza-like illness or suspected influenza.
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L-methylfolate for Bipolar Disorder
L-methylfolate improves some symptoms in major depression in people with type 1 bipolar disorder.
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Studies Find Cognitive Decline Reversible, Even if Patients Are ApoE4 Positive
Insulin resistance is associated with cognitive decline and Alzheimer’s disease. Patients who are positive for the apolipoprotein E4 gene are at increased risk for Alzheimer’s disease. This risk may be reversed by treating insulin resistance.
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Clinical Briefs
In this section: considering cardiorespiratory fitness and mortality; searching for answers on knee osteoarthritis; and comprehensive treatment for atopic dermatitis.