 
          Internal Medicine Alert – July 15, 2008
July 15, 2008
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            Long-Term Cognitive Decline and Coronary Artery Bypass Surgery (CABG)Enthusiasm for coronary artery bypass grafting (CABG) as an intervention for cardiovascular disease has been tempered by concerns about postoperative cognitive decline.
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            Meta-analysis: Sequential Therapy Appears Superior to Standard Therapy for Helicobacter pylori Infection in Patients Naïve to TreatmentStandard eradication therapy for H. pylori in the U.S. has involved use of a proton pump inhibitor (PPI) plus clarithromycin and either amoxicillin or an imidazole (metronidazole).
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            Value of Homocysteine-lowering Folic-Acid/ vitamin B Therapy in Cardiovascular Prevention-Have We Been Wrong Again?After 7.3 years of treatment and follow-up, a combination pill of folic acid, vitamin B6 and vitamin B12 did not reduce a combined endpoint of total cardiovascular events among high-risk women despite significant homocysteine lowering.
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            Duloxetine Delayed-Release Capsules (Cymbalta®)Duloxetine is the first serotonin norepinephrine reuptake inhibitor (SNRI) to be approved for the treatment of fibromyalgia.
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            Clinical Briefs by Louis Kuritzky, MDThere have been no major therapeutic steps added for the management of acute gouty arthritis (AGA) for over 30 years.
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            ECG Review: A Scooped ST TachycardiaThe 12-lead ECG and lead II rhythm strip in the Figure were obtained from a 83-year old woman who presented with rapid heart rate. She was on no antiarrhythmic medications. How would you interpret her ECG?
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            Pharmacology WatchShingles vaccine added to CDC list of vaccines for adults 60 and older; CDC recommends Tdap for postpartum women; new study suggests sequential therapy with antibiotics for H. pylori may be more effective than standard therapy; FDA Actions.
