Internal Medicine Alert – November 30, 2025

Early vs. Late Catheter Ablation for Atrial Fibrillation in Older Patients

An observational study from China in older patients with persistent atrial fibrillation (AF) has shown that an earlier diagnosis to catheter ablation time of ≤ 12 months compared to > 12 months is associated with lower rates of AF recurrence and adverse cardiovascular outcomes.

Spironolactone for the Treatment of Acne Vulgaris

In this meta-analysis of 563 patients from five randomized controlled trials, objective assessment of acne improvement was higher in the spironolactone group compared to the placebo group (odds ratio, 6.59; 95% confidence interval, 3.50-12.43).

Detection of Atrial Fibrillation in Cryptogenic Stroke

The ANTARCTICA study is a pooled meta-analysis from multiple prospective studies of patients with ischemic stroke of varying etiologies, where loop monitoring was performed for atrial fibrillation detection. The groups were divided into cryptogenic stroke/transient ischemic attack or non-cryptogenic stroke/non-stroke. Both groups demonstrated an unadjusted rate of atrial fibrillation of about 30%.

Fleas, Typhus, and Texas

Cases of flea-borne typhus are dramatically increasing in Texas.

Ambulatory Glucose Monitoring a Risk for Bloodborne Pathogens

A report of acute hepatitis B virus infection in a skilled nursing facility diabetes patient in North Carolina prompted an investigation for potential exposures and assessment of infection prevention practices in the facility.

Elinzanetant Capsules (Lynkuet)

The U.S. Food and Drug Administration has approved elinzanetant, a second non-hormonal neurokinin receptor antagonist, following fezolinetant (Veozah), for the treatment of vasomotor symptoms associated with menopause. Elinzanetant is distributed by Bayer HealthCare Pharmaceuticals, Inc., as Lynkuet.