Internal Medicine
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Dulaglutide Injection (Trulicity™)
The FDA has approved a third long-acting, once-weekly, glucagon-like peptide (GLP-1) receptor agonist for the treatment of type 2 diabetes mellitus, joining exenetide ER and albiglutide. Dulaglutide is made up of two identical human-based GLP-1 analogs linked to a modified human IgG4 Fc fragment. This makes the molecule resistant to degradation by DPP-4, slows absorption, reduces renal clearance, and extends the elimination half-life to approximately 5 days. Dulaglutide is marketed by Eli Lilly as Trulicity.
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Angiotensin Receptor Blockers for Hypertension
Angiotensin receptor blockers (ARBs) are often used as first-line therapy for the treatment of systemic hypertension because of their perceived efficacy and relatively low incidence of adverse effects.
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Colchicine for Recurrent Pericarditis
Although colchicine has been shown to be effective for the treatment of acute pericarditis and first recurrences, little information exists about its use in patients with multiple recurrences.
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Nerve Biopsy for Asymptomatic Vasculitic Neuropathy
Nerve biopsy is a safe and highly sensitive definitive diagnostic test for systemic vasculitis, even without symptoms of peripheral neuropathy, when electrodiagnostic tests indicate an axonal neuropathy.
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Migraine and Cognitive Dysfunction
During an attack of migraine without aura, patients may experience transient cognitive impairment, with predominant involvement of verbal processing speed, learning, and memory, due to reversible cortical dysfunction.
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RYR1-related Myopathies
Ryanodine receptor gene mutations are among the most common genetic disorders found in a variety of congenital myopathies, both mild and severe.
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A Modern Epidemiologic View of Status Epilepticus in the United States
In this retrospective review of mortality and hospitalization related to status epilepticus from 1999 to 2010, the authors found that overall mortality remained relatively stable, whereas the rate of related hospitalizations significantly increased, particularly in patients who were intubated and in whom status epilepticus was not the primary diagnosis.
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Infectious Disease Alert Updates
HPV on that Ultrasound Probe? and Saving Elephants from Herpesviruses
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Squirrels as the Source of a New Viral Cause of Encephalitis
Evidence indicates that a newly discovered bornavirus caused infection in squirrels and was transmitted from them to three humans who developed encephalitis and died.
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Scrub Typhus and the Brain
Scrub typhus infections involve the nervous system in a majority of cases and should be suspected in patients who live in, or are returning from, endemic regions with a compatible clinical syndrome.