Internal Medicine
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Is it Guillain-Barré or Acute-onset CIDP?
Acute inflammatory demyelinating polyneuropathy and acute-onset chronic inflammatory demyelinating polyneuropathy (CIDP) may present with identical clinical pictures and can be differentiated only with the passage of time. CIDP will have a slower course of progression and may involve relapses.
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Telemedicine Improves Outcomes in Heart Failure
In patients with chronic heart failure, adding a remote patient management program to usual care was associated with improvement in unplanned cardiovascular hospitalization or death.
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Total Arterial Revascularization: Where Is It?
The results of a long-term follow-up study of matched pairs of patients undergoing surgical coronary artery revascularization showed that total arterial graft usage significantly reduced all-cause mortality vs. left internal mammary artery plus saphenous vein grafts.
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VEST: A Positively Negative Clinical Trial
In a randomized trial of the wearable cardioverter-defibrillator prescribed to patients with left ventricular dysfunction after acute myocardial infarction, overall compliance rates were low. The authors observed no significant improvement in arrhythmic death rates; yet, overall mortality was lower.
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LDL Cholesterol: How Low Do We Go?
A meta-analysis of 29 cholesterol-lowering outcome studies with baseline average low-density lipoprotein (LDL) cholesterol levels ≤ 70 mg/dL showed consistent major adverse cardiovascular event risk reductions down to average LDL levels of 21 mg/dL without any increase in adverse events.
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MitraClip Scores Big Win in COAPT
The largest trial to date of MitraClip in highly selected patients with congestive heart failure and functional mitral regurgitation revealed significant reductions in heart failure hospitalization and two-year mortality.
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Infectious Disease Alert Updates
Tuberculosis Transmission From NAAT-negative Patients; Worldwide Rabies Risk: Dogs; Patients Need to Rethink the ‘Quality’ in Healthcare
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Plazomicin (Zemdri)
Plazomicin is an aminoglycoside recently approved by the Food and Drug Administration for treating complicated urinary tract infections.
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Here Comes the Sun — And Here Comes Coccidioidomycosis
Another occupational outbreak of coccidioidomycosis in solar farm workers in an endemic area points to the continued risk and the difficulty of preventing such occurrences.
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In Patients Who Self-catheterize, Antibiotic Prophylaxis Prevents UTIs but Increases Antibiotic Resistance
A randomized, open-label, superiority trial found that daily antibiotic prophylaxis for patients who use clean, intermittent self-catheterization reduced symptomatic urinary tract infections by 48% over a 12-month period. Antibiotic resistance became prevalent in urinary isolates from the group receiving prophylaxis compared to controls.