Internal Medicine Alert
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Do Patients with Heart Failure Feel Better on Dapagliflozin?
An analysis of the DETERMINE studies of dapagliflozin vs. placebo in patients with heart failure showed some improvement in self-reported symptoms in those with reduced ejection fraction on dapagliflozin but not in the six-minute walk test. No improvements in symptoms or physical activity levels were found in those with preserved ejection fraction on dapagliflozin.
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H. pylori Infection – A Potential Modifiable Risk Factor of Alzheimer’s Dementia
A large nested case-control cohort study of subjects aged 50 years and older found that clinically apparent Helicobacter pylori infection is associated with a moderately increased risk of developing Alzheimer’s disease.
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What Kind of Artifact?
To emphasize the importance of recognizing the clinical finding shown in the figure, no history is given. The two most helpful leads for interpretation of these unusual ECG findings are lead I and lead V3. How would you interpret this tracing?
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Exagamglogene Autotemcel Suspension (Casgevy)
The U.S. Food and Drug Administration has approved the first treatment for sickle cell disease using CRISPR (clustered regularly interspaced short palindromic repeats)/Cas9 (CRISPR associated protein 9) genome editing technology.
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Acute Vertigo Caused by Herpes Zoster Oticus
Herpes zoster oticus (HZO) and vestibular neuritis (VN) can be difficult to distinguish, but treatments may be different. Magnetic resonance imaging may help by showing inflammatory lesions in the vestibular nuclei or the proximal portions of the eighth nerves in HZO, but not VN.
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Studying Patients at High Risk for Death in the ICU Can Give Them a Voice and Help Clinicians Understand Their Concerns
Using a multiple-source approach, this study showed that when given a voice, patients at high risk of dying in the intensive care unit express variable logistical, spiritual, physical, psychological, and existential concerns that clinicians should consider and address.
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Coronary CT Angiography in Patients with Type 2 MI
In an observational, single-center study of patients with type 2 myocardial infarction who underwent coronary computed tomography (CT) angiography, researchers reported fewer than half had a significant anatomic stenosis (50% or greater), but only 26% had a hemodynamically significant lesion by CT fractional flow reserve.
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Atorvastatin vs. Rosuvastatin in Patients with Coronary Artery Disease
A large trial of moderate doses of rosuvastatin vs. atorvastatin in patients with coronary artery disease has shown that both drugs are equivalent at reducing major adverse cardiovascular and cerebral events, but rosuvastatin is associated with higher rates of new-onset diabetes and cataract surgery.
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To Activate the Cath Lab?
The ECG in the figure was recorded on a patient with new chest pain that began one hour earlier. How would you interpret this ECG? Should the catheterization lab be activated, given the history and this ECG?
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Tirzepatide Injection (Zepbound)
The U.S. Food and Drug Administration has approved tirzepatide for chronic weight management. The drug previously was approved for the treatment of type 2 diabetes under the trade name Mounjaro.