Internal Medicine
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Blastomycosis (But Not That Blastomycosis) in the Western United States
Blastomycosis occurs in western Canada and in the United States well outside the known endemic area, but it is due to Blastomyces helicus, not Blastomyces dermatitidis.
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Optimal Treatment of Vivax Malaria
In glucose-6-phosphate-dehydrogenase-sufficient individuals in Southeast Asia, combined treatment with chloroquine and primaquine provides much more lasting relief from vivax malaria than either chloroquine alone or artesunate.
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Finding a Consensus on ARDS Diagnostics and Determining a Relationship to Hospital Mortality
Critical care physicians reviewed more than 700 mechanically ventilated patients with acute hypoxemia and reached a consensus on the presence of acute respiratory distress syndrome (ARDS) in 15% of patients and nonconsensus on the presence of ARDS in an additional 14% of cases. Hospital mortality was not different between these cohorts (37% and 35%, respectively).
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Preventive Tactics and Management of Acute Kidney Injury in the ICU
Acute kidney injury (AKI) is a sudden decline in renal function due to nephron dysfunction and/or damage that results in nitrogenous waste product accumulation and acid-base, electrolyte, and fluid disturbances. It is estimated to occur in 16-67% of critically ill patients admitted to the ICU. Common inciting causes include major surgery, iatrogenic interventions, and sepsis. Advanced age and comorbidities increase kidney susceptibility to various exposures and insults. Severe AKI requiring renal replacement therapy (RRT) is associated with a 10-fold increase in mortality and increases length of stay an average of 5.7 days. Preventive tactics and RRT remain the cornerstones of AKI management in critically ill patients.
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Identify 4 Major Findings in New-onset Chest Pain Patient
The ECG in the figure was obtained from a patient with new-onset chest pain. He was hemodynamically stable at the time the tracing was obtained. In addition to the artifact that is most pronounced in the lateral chest leads, there are four major findings. Admittedly, two findings are subtle. How many findings can you identify?
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Human Papillomavirus Vaccine (Gardasil 9)
The FDA has approved a supplemental application to expand the indication for human papillomavirus 9-valent vaccine (HPV-9) to include men and women 27-45 years of age.
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Who Really Needs Intensive Blood Pressure Control?
A patient baseline characteristics level analysis of the SPRINT and ACCORD trials resulted in the creation of a simple algorithm for identifying high-risk patients who experienced fewer major cardiac events without increased serious adverse events from intensive blood pressure therapy.
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Neighborhood Socioeconomic Status Associated With Infection Risk, But Not Sepsis
Based on a large, national, prospective cohort study, lower neighborhood socioeconomic status was associated with a higher incidence of hospitalizations for infection (but not sepsis) at presentation.
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Is There a Connection Between Vitamin D and Fracture Prevention?
After conducting an extensive investigation, researchers did not find that vitamin D prevents falls or fractures.
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Exercise Improves Physical Function in Patients With Knee Osteoarthritis
Tailored exercise therapy can improve physical functioning in patients with knee osteoarthritis and comorbid conditions.