Internal Medicine
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Preventing Recurrent UTI with Probiotics
About half of women experience urinary tract infection (UTI) during their lifetime, and around 20% to 25% will experience recurrent UTI (defined as three or more UTIs in a 12-month period or two UTIs in a six-month period). Those with two UTIs in a six-month period have a 50% chance of a third UTI. Repeated courses of antibacterials distort both intestinal and vaginal flora, further increasing the risk of urinary infection.
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Inavolisib Tablets (Itovebi)
The U.S. Food and Drug Administration (FDA) has approved inavolisib, a phosphatidylinositol 3-kinase (PI3K) inhibitor, for the treatment of advanced hormone receptor-positive, human epidermal growth factor receptor 2 (HER2)-negative breast cancer with a PIK3CA mutation. Inavolisib was granted a priority review and Breakthrough Therapy Designation.
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Long-Term Proton Pump Inhibitor Use and the Risk of Colorectal Cancer
A large retrospective cohort study demonstrated that long-term use of proton pump inhibitors is associated with an increased risk of developing colorectal adenocarcinoma.
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How Does the 12-Lead Help?
You are given the electrocardiogram (ECG) in the figure without the benefit of any history. How would you interpret this tracing? How does the 12-lead ECG help with interpretation of the rhythm?
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Xanomeline and Trospium Chloride Capsules (Cobenfy)
The U.S. Food and Drug Administration has approved the first-in-class muscarinic agonist and antagonists for the treatment of schizophrenia in adults. This is the first antipsychotic drug approved in decades and is unique in that it targets cholinergic receptors — unlike traditional agents, which target dopamine receptors.
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A New Technique for Predicting Outcomes in Asymptomatic AS
An international study of patients with moderate or asymptomatic severe aortic stenosis has demonstrated that increased amounts of left ventricular fibrosis, as measured by cardiac magnetic resonance imaging, is associated with worse outcomes.
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Antithrombotic Treatment for Atrial Fibrillation After Acute Coronary Events
An analysis of the AUGUSTUS trial comparing a P2Y12 inhibitor plus four combinations of double or triple therapy with apixaban, aspirin, and a vitamin K antagonist in patients with atrial fibrillation and a recent acute coronary event or percutaneous coronary intervention has shown that a P2Y12 inhibitor plus apixaban exhibited the lowest rate of major adverse events and major bleeding events.
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Screening for Atrial Fibrillation in Older Adults
A two-week ambulatory electrocardiogram monitor in a large group of individuals 70 years of age or older with no history of atrial fibrillation (AF) showed a very low incidence of AF (4.4%), almost all of which was paroxysmal. In less than 2% of the subjects did it represent ≥ 2% of the monitoring time. However, some patients had hours of AF, raising a concern for thromboembolic risk.
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A New Drug for Heart Failure with Preserved Ejection Fraction?
The addition of the nonsteroidal mineralocorticoid receptor antagonist finerenone to standard therapy reduced the incidence of recurrent heart failure and death compared to placebo in patients with heart failure and mildly reduced or preserved left ventricular ejection fraction and was generally well tolerated.
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Early Bird or Night Owl: Who’s Mentally Sharper?
A large cross-sectional analysis of adults aged 53-86 years found that people with normal sleep durations while being “night owls” often scored higher on cognitive tests than “early bird” types.