Internal Medicine Alert – April 15, 2019

April 15, 2019

• Behavioral Interventions in Adults for Weight Loss or Weight Loss Maintenance

  The U.S. Preventive Services Task Force evaluated the risks and benefits of interventions for weight loss and weight loss maintenance to prevent complications from obesity. Panelists found a moderate net benefit from weight loss-intensive behavioral interventions.

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• Medication First? Ablation First? Either Way, Make Weight Loss a Priority

  Weight loss management and aggressive risk factor modification associated with slowing or even reversal of atrial fibrillation progression.

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• Witness Observations in Diagnosing Transient Loss of Consciousness

  Investigators found that adding witness-reported observations to patient demographics and patient-reported symptoms improved the diagnostic accuracy between epilepsy, syncope, and psychogenic nonepileptic seizures.

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• Esketamine Nasal Spray (Spravato) CIII

  Esketamine, in conjunction with an oral antidepressant, is indicated for the amelioration of treatment-resistant depression in adults.

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• Is There AV Block?

  The long lead II rhythm strip in the figure was recorded at the standard 25 mm/second speed. This tracing was obtained from a middle-aged woman who presented to an outpatient clinic with noncardiac chest pain. How would one interpret this rhythm? Are there signs of AV block? Is it apparent if there is a cardiac problem?

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