Internal Medicine Alert – June 15, 2025

Measles Outbreaks in the United States

Several measles outbreaks have been active in the United States, with more than 1,000 cases reported already in 2025. Most outbreaks begin as unvaccinated individuals in the United States come into contact with an infected individual who has recently arrived after international travel. Vaccination is effective, but current U.S. vaccine coverage rates are below the 95% rate considered necessary to provide herd immunity.

Looking Beyond LDL in Cardiovascular Risk Screening for Women

In a 30-year prospective study of nearly 28,000 initially healthy U.S. women, baseline levels of high-sensitivity C-reactive protein, low-density lipoprotein cholesterol or lipoprotein(a) independently and additively predicted major cardiovascular events.

TIA Is Associated with Accelerated Cognitive Decline

The study investigators looked at data from a prospective study of 30,239 Black and white community-dwelling persons aged 45 years or older with cognitive evaluations over the phone every other year until 2022. The researchers documented patients who had transient ischemic attack (TIA) or stroke, and demonstrated that persons who had TIA had a cognitive decline trajectory similar to those patients who had a definite diagnosis of stroke.

Nipocalimab-aahu Injection (Imaavy)

The U.S. Food and Drug Administration has approved a neonatal Fc-receptor (FcRn) blocker for the treatment of generalized myasthenia gravis. Nipocalimab-aahu is a recombinant human immunoglobulin G1 lambda monoclonal antibody directed at FcRn with high affinity and selectivity.

What Kind of Block?

The electrocardiogram in the figure was obtained from an older adult who presented for evaluation of syncope. What kind of atrioventricular (AV) block is present? Or is the rhythm something other than an AV block?