Internal Medicine Alert – November 30, 2023

How Many Steps a Day Will Improve Patients’ Longevity?

A systematic review and meta-analysis of studies of the association of step counts and cadence with all-cause mortality and cardiovascular events showed the benefits in these outcomes are statistically significant, at about 2,600 steps/day and peak at about 8,000 steps/day. Also, faster step cadence augments these benefits.

Do We Overdiagnose Breast Cancer in Women 70 Years and Older?

Overdiagnosis of breast cancer from mammography is common in women age 70 years and older and increases with age. The use of mammography in women older than age 70 years does not reduce breast cancer deaths.

Which Coronary Artery Calcium Score Signifies the Need for Secondary Prevention?

A large registry study of individuals without known cardiovascular disease but with known coronary artery computed tomography calcium scores showed those with an Agatston score higher than 300 are at risk of experiencing major cardiac events similar to patients with known cardiovascular disease over five years.

Shigella: The New Superbug?

Five percent of Shigella isolates in the United States in 2022 were extensively drug-resistant.

Brain Atrophy and Type 1 Diabetes

In a long-term longitudinal study of people with type 1 diabetes, excessive brain atrophy and cognitive dysfunction were noted compared to healthy controls. The investigators calculated that type 1 diabetes resulted in six years of accelerated brain aging and brain atrophy that was separate and distinct from Alzheimer’s disease.

Zilucoplan Injection (Zilbrysq)

The U.S. Food and Drug Administration has approved a once-daily subcutaneously administered drug for the treatment of generalized myasthenia gravis in adult patients who are anti-acetylcholine receptor antibody positive. Zilucoplan is macrocyclic peptide that inhibits the cleavage of complement 5 (C5) to C5a and C5b.