Primary Care/Hospitalist
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Follow-up Blood Cultures in Gram-negative Bacteremia — Don’t Order Them
Not only does ordering routine follow-up blood cultures in patients with GNR bacteremia seldom produce helpful information, but common false-positive results can lead to longer length of stay, additional inappropriate antibiotic therapy, and increased healthcare costs.
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Clinical Briefs
In this section: Finding the prescription for the best diet, treating severe acute pain in the ED, and reducing falls among older patients.
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Ertugliflozin Tablets (Steglatro)
Ertugliflozin is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus.
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The Incidence of Dementia May Be Declining
In community-dwelling people from Bronx County, New York, there was a sharp decrease in dementia incidence in those born after mid-1929, which could not be readily explained by changes in the prevalence of cardiovascular diseases, higher education, or increased racial/ethnic diversity.
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CT Calcium Score vs. Stress Testing
A subgroup analysis of the PROMISE trial showed that CT coronary calcium scores in symptomatic patients at low to intermediate risk for coronary artery disease are more sensitive but less specific for major adverse cardiac events over a two-year follow-up period than stress testing. Consequently, both approaches exhibited similar but modest discriminatory ability.
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Hold the Hormones — At Least for Chronic Condition Prevention
The U.S. Preventive Services Task Force reissued a statement on hormone replacement therapy for the prevention of chronic conditions that reiterates its D recommendation from 2012. It recommends physicians do not prescribe hormone replacement therapy (HRT) to prevent medical conditions, but leave the question of using HRT for treatment of menopausal symptoms unanswered.
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How Many Conduction Defects?
The ECG and long lead II rhythm strip in the figure with the article was obtained from a 58-year-old man who was admitted to the hospital with chest pain and weakness. How would you interpret the tracing? How many different types of conduction disturbances can you identify?
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Clinical Briefs
In this section: using diuretics in heart failure patients; sexual dysfunction in patients with diabetes; and treating subtle gastrointestinal symptoms.
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Buprenorphine Extended-release Injection (Sublocade)
Buprenorphine extended-release injection is indicated for the treatment of moderate-to-severe opioid use disorder in patients who have initiated treatment with a transmucosal buprenorphine-containing product, followed by dose adjustment for a minimum of seven days.
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Travelers Unaware of the Need for Pre-travel Vaccinations
Outbreaks of measles continue to occur in the United States, mostly because of imported cases. More than half of these occur as the result of inadequately vaccinated returning U.S. travelers who acquire measles infection abroad.