Internal Medicine
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Possible Aerosol Spread of SARS-CoV-2 in an Apartment Building
Although not definitive, evidence is consistent with aerosol spread of SARS-CoV-2 in an apartment building as a result of transport through the drainage system to apartments directly above.
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A Novel Rifabutin-Containing Combination Regimen Eradicates H. pylori Infection
Researchers found a significantly higher eradication rate for H. pylori with a 14-day regimen of rifabutin, amoxicillin, and omeprazole compared to 14 days of amoxicillin and omeprazole.
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Race Correction in Clinical Calculations: Is It Time to Reconsider?
Many clinical calculators use race as a predictive variable to assess risk for outcomes. Although most tools assume a genetic disposition for these outcomes, other factors, such as health disparities and other potential confounders, are more likely to be the underlying reasons for any race-related differences in outcomes.
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More Is Not Better with Vitamin D Supplementation
A recent study revealed vitamin D levels higher than normal from high-dose supplementation are harmful to bone health.
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Prophylactic PCI for Vulnerable Plaques
In this proof-of-concept trial, treatment of non-flow limiting vulnerable plaque by PCI with bioabsorbable stents resulted in no significant difference in lesion-related events compared with optimal medical therapy, but there was a trend toward less angina driven revascularization in the stented group.
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Are Anti-Inflammatory Drugs Useful in Malignant Pericardial Effusion?
Researchers studied patients with malignant pericardial effusion treated with pericardiocentesis and then anti-inflammatory agents if signs of adhesions or constriction were observed in post-drainage echocardiograms. Compared to NSAIDs and steroids, the authors found colchicine administration for 60 days reduced the rate of subsequent all-cause mortality and recurrent pericardial effusion.
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Using Sacubitril/Valsartan to Treat Heart Failure with Preserved Ejection Fraction
An analysis of renal outcomes in the PARAGON-HF trial revealed sacubitril/valsartan slows progression of kidney disease in patients with heart failure with preserved ejection fraction compared to valsartan alone.
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The Effect of Age on Cholesterol-Lowering Therapy
Investigators analyzed data on the effect of age on cardiovascular (CV) outcomes and LDL cholesterol-lowering by alirocumab vs. placebo in recent acute coronary syndrome patients. They found alirocumab can lower the rate of CV events regardless of age — and produce increasing absolute benefit with age.
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Another Affirmation for Rhythm Control in Atrial Fibrillation
A rhythm control strategy implemented less than one year after atrial fibrillation diagnosis was associated with significant reduction in adverse cardiovascular outcomes when compared to usual care.
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Is There Right Ventricular Strain or Acute Pulmonary Embolism?
The ECG in the figure was obtained from a middle-age woman who presented with new dyspnea. Is the T wave inversion in the inferior leads a reflection of right ventricular “strain” from acute pulmonary embolism? If not, what else might cause these ECG findings?