Internal Medicine
RSSArticles
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Mefloquine: Still Effective and Still Safe for Malaria Chemoprophylaxis
Mefloquine is known as an effective agent for malaria chemoprophylaxis. However, concerns about serious adverse effects have limited its use. Now, a careful review of data suggests that fatal outcomes related to mefloquine prophylaxis are very rare.
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MRSA Infections May Lead to Prolonged Impairment of Lymphatic Vessel Function
In the first study to investigate the potential interactions between bacterial infections and lymphatic function, researchers found that methicillin-resistant Staphylococcus aureus toxins killed muscle cells critical to the pumping of lymph fluid and led to prolonged lymphatic dysfunction months after the bacteria had been cleared.
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Prolonged vs. Short Duration Infusion of Beta-lactam Antibiotics: The Verdict Is In
When compared to shorter infusion duration, prolonged infusion of anti-pseudomonal β-lactam antibiotics was associated with reduced mortality.
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Stroke Risk in Atrial Fibrillation: A Moving Target?
An investigation of patients in a national database with atrial fibrillation and no comorbidities and not on aspirin or anticoagulants showed that the clinical features that make up the CHA2DS2-VASc score change over time and can increase a patient’s risk for stroke, which could affect therapy decisions.
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Physical Activity and Death in CAD Patients
An observational study of leisure time physical activity (LTPA) assessed at baseline and two years later in stable coronary artery disease patients, who then were followed for about five more years, showed that LTPA at baseline, at two years, and if it went from zero at baseline to some at two years was associated with lower rates of cardiac death compared to inactive patients.
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Accurately Diagnosing Aortic Dissection
A prospective study of patients with suspected acute aortic syndromes showed that a clinical risk score plus D-dimer testing carried a positive predictive value of 99.7% and a 0.3% incidence of false-negative studies. The authors recommended that this approach become the standard method for triage to imaging in patients with suspected acute aortic syndromes.
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What’s the Best Technique to Measure Low-flow, Low-gradient Aortic Stenosis?
In patients with low-flow, low-gradient aortic stenosis, current guideline-based criteria for identifying true severe aortic stenosis did not predict aortic stenosis severity or survival. Calculation of the projected aortic valve area at a normal transvalvular flow rate more accurately identifies true severe aortic stenosis and is a stronger predictor of outcomes.
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CASTLE-AF Supports Catheter Ablation for Atrial Fibrillation in Patients with Heart Failure
Catheter ablation for atrial fibrillation in relatively young men with cardiomyopathy and heart failure is associated with a substantial reduction in arrhythmia burden, improvement in ejection fraction, and reduction in heart failure hospitalizations and mortality compared to medical therapy.
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Clinical Briefs
In this section: tackling insomnia with cognitive behavioral therapy; navigating the spurious claims of internet-advertised products; and updated guidelines regarding hypertension treatment.
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Ozenoxacin Cream 1% (Xepi)
Ozenoxacin is indicated for the topical treatment of impetigo due to S. aureus and S. pyogenes in adult patients and pediatric patients ≥ 2 months of age.