Internal Medicine
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Is it Normal Aging or Chronic Kidney Disease?
Current clinical guidelines for the diagnosis of chronic kidney disease resulted in more than half of adults > 70 years of age having chronic kidney disease. Should these guidelines change to require age calibration for diagnosis and classification of chronic kidney disease?
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ECG Review: Why are aVR Waveforms Positive?
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Clinical Briefs
In this section: Are annual physicals worth it?; breakfast might be the most important meal of the day; and evaluating the total knee replacement. -
Insulin Degludec Injection (Tresiba)
Insulin degludec provides an alternative to insulin glargine and insulin detemir as long-acting human insulin analogs.
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Beta-blocker Dose More Important Than Heart Rate in Systolic Heart Failure
In chronic heart failure with reduced ejection fraction, titrating beta-blocker doses may confer a greater benefit than reducing heart rate.
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Using Procalcitonin to Differentiate Bacterial from Viral Meningitis
A meta-analysis based on nine studies found an elevated serum procalcitonin to be an accurate test for differentiating bacterial from viral meningitis in adults.
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Risk of New Onset Diabetes When Blood Pressure Becomes Elevated Over the Usual Measurement
An increase of 20 mmHg in systolic blood pressure was associated with a 58% higher risk of new-onset diabetes mellitus, whereas an increase of 10 mmHg in diastolic blood pressure was associated with a 52% higher risk of developing new-onset diabetes mellitus.
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Beta-blocker Dose More Important Than Heart Rate in Systolic Heart Failure
Beta-blockers reduce both morbidity and mortality in chronic heart failure with reduced ejection fraction.
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Acetaminophen for Fever in the ICU
SYNOPSIS: Seven hundred ICU patients with fever and known or suspected infection were randomly assigned to receive acetaminophen 1 g IV or placebo every 6 hours until ICU discharge, resolution of fever, cessation of antimicrobial therapy, or death. Early administration of acetaminophen did not affect number of ICU-free days.
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Clostridium difficile Infection — Back to the Future
SYNOPSIS: This study provides strong evidence that the diagnosis of Clostridium difficile infection (as opposed to colonization) should be made on the basis of evidence of toxin production, not the mere presence of the organism as detected by glutamate dehydrogenase testing or the presence of toxin genes.