Internal Medicine Alert
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Another Step in the Journey to Combat Diagnostic Errors in Hospitalized Patients
Diagnostic errors in hospitalized patients who died or were transferred to the intensive care unit were common in this large retrospective, multicenter trial and frequently associated with patient harm. Problems with clinical assessment and ordering and interpreting tests were the most prevalent diagnostic process faults, with sepsis the diagnosis most associated with diagnostic error.
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Increased Risk of Morbidity with Prolonged Use of PPIs Without an Indication Post-ICU
In previously critically ill adults, the use of a proton pump inhibitor without an indication for more than eight weeks increased morbidity and mortality.
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The Burden of Clostridioides difficile Infection
This article outlines the clinical, social, and economic burden of Clostridioides difficile infection (CDI) in the United States and its shifting epidemiology.
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Inappropriate Diagnosis of Pneumonia Is Common in Hospitalized Patients
A cohort study that included 48 hospitals in Michigan found that 12% of patients treated for community-acquired pneumonia were diagnosed inappropriately. Older age, dementia, and presenting with acute change in mental status increased the risk for misdiagnosis.
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Which Is the Key Lead?
The patient whose ECG appears in the figure is a middle-aged man who presented to the emergency department with new chest pain. Should the cath lab be activated?
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Cefepime and Enmetazobactam Injection (Exblifep)
The U.S. Food and Drug Administration has approved the combination of cefepime and enmetazobactam (FPE) for the treatment of complicated urinary tract infections. Cefepime-enmetazobactam was granted a priority review and a five-year marketing exclusivity as part of the Generating Antibiotic Incentive Now (GAIN) Act incentivizing development of new anti-infectives. FPE is distributed by Allecra Therapeutics SAS as Exblifep.
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Comparing Early vs. Late-Onset MS
A recent retrospective study, combining data from a United Kingdom patient registry with a United Kingdom neuropathology tissue bank, showed that late-onset multiple sclerosis (MS), referring to disease onset after age 50 years, is linked with increased disability and quicker progression compared to MS onset at a younger age, and has distinct pathological features.
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Timing of Biomarker Changes in Alzheimer’s Disease
In a longitudinal multicenter, nested case-control study of cognitive normal participants from China, the time courses of key Alzheimer’s disease biomarkers were identified during the 20 years preceding clinical diagnosis of sporadic Alzheimer’s disease.
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Better Outcomes for Acute Stroke Patients Who Arrive Rapidly at Endovascular-Capable Centers
The SELECT2 trial was structured to identify which patients with large ischemic strokes would benefit from endovascular thrombectomy and analyzed the effect of direct arrival at a thrombectomy-capable center compared to transfer from a primary stroke center.
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Meningococcal Disease Is on the Rise
The number of cases of infection with Neisseria meningitidis is increasing in the United States. The majority of presentations are with bacteremia; meningitis is infrequent.