Internal Medicine
RSSArticles
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COVID-19 Vaccine Update
There are dozens of vaccine candidates undergoing investigation in human and animal trials. Only a few have reached Phase III testing. This is a closer look at those.
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Gut Microbiome in Patients at Risk for Parkinson’s Disease
Certain risk factors and prodromal markers of Parkinson’s disease (PD), such as constipation and rapid eye movement sleep behavior disorder, are associated with specific bacterial compositions of the gut. However, the value of gut microbiome data to predict the risk of PD development needs further investigation.
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Auditory Startle Response as a Predictor of Recovery from Coma
Preserved habituation of the auditory startle response, performed bedside, indicates intact cortical structures and cortico-cortical white matter tract connections. Preservation of this reaction in patients with unresponsive wakefulness can help distinguish the vegetative state from minimally conscious state and may even predict eventual awakening.
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Oral Calcitonin Gene-Related Peptide Antagonist for Migraine Prevention
Atogepant, an oral calcitonin gene-related peptide antagonist, was shown to be effective and safe for migraine prevention.
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Antibiotic Use in COVID-19 Patients
Fifty-seven percent of patients with COVID-19 infection treated at 38 hospitals in Michigan received early empiric antibiotics, although researchers documented community-onset bacterial coinfection in only 3.5%.
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Data: Cardiovascular Disease, Other Problems Go Unchecked During COVID-19 Pandemic
The use of telemedicine surged from almost nothing to 35% between April and June 2020, but the number of in-person primary care consultations dropped by more than 21% when compared with the volume of such encounters during the second quarter from previous years.
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Recurrent Stroke After Embolic Stroke of Undetermined Source
Twenty percent to 40% of ischemic strokes are classified as cryptogenic, meaning a specific cause cannot be identified. A subset of those have been classified by some investigators as embolic stroke of undetermined source. However, this remains a controversial category and classification.
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Can Anticoagulant Strategies Reduce Covert Brain Infarcts in Patients with Cardiovascular Disease?
Covert brain infarcts are detected on magnetic resonance imaging studies in the aging brain in about 10% of people at age 65 years, increasing to 25% at age 80 years. Most patients who develop dementia have a combination of multiple small infarcts, plus amyloid deposition. Prevention of covert infarcts is a strategy to mitigate the frequency and severity of late-life dementia.
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Carotid Endarterectomy vs. Medical Therapy in Patients with Asymptomatic Carotid Stenosis
Multiple randomized clinical trials have demonstrated that carotid endarterectomy is beneficial in patients who have symptomatic carotid stenosis, and currently, that is the recommendation for such patients. However, in the intervening years, advances in medical therapy, as well as significant improvement in the management of blood pressure, diabetes, diet, and exercise, have been shown to reduce stroke rate. Therefore, it is currently controversial whether carotid endarterectomy is still beneficial in asymptomatic patients with carotid artery stenosis compared to current medical management.
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Tranexamic Acid and Outcomes in Patients with Moderate or Severe TBI
In this randomized, placebo-controlled trial using tranexamic acid to treat patients with moderate or severe traumatic brain injury within two hours of injury, there was no significant difference between treatment groups in either mortality or functional recovery at six months.