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Is Weight Loss the Key to Heart Health?

The second trial of semaglutide in obese patients with heart failure and preserved left ventricular ejection fraction, this one in people with type 2 diabetes, also has shown significant improvements in symptoms and exercise function with significantly fewer adverse effects than placebo-treated patients.

It Is Never Too Late: A Systematic Review of Lifestyle Interventions for Cognitive Preservation in the Oldest-Old

This systematic review reveals the importance of a healthy diet rich in fruits and vegetables, along with regular leisure and physical activities, to maintain cognitive functioning in the oldest-old, individuals older than 80 years of age.

Disorders of Immunity Are a Risk Factor for Herpes Simplex Virus Encephalitis

The current study of herpes simplex virus (HSV) encephalitis demonstrated an association of encephalitis with preexisting autoimmune disease and/or exposure to immunosuppressive and immunomodulatory medications. The findings underscore the potential underestimation of antecedent immune-related dysregulation in HSV encephalitis cases to date.

Efgartigimod for Seronegative Myasthenia Gravis

In an uncontrolled, open-label series of patients with myasthenia gravis, double antibody-negative patients responded to immunosuppressive therapies in a similar manner as do those with antibodies to acetylcholine receptors (AChR) or muscle-specific tyrosine kinase. However, when treating myasthenia patients with a specific agent (efgartigimod) that blocks AChR antibodies at the level of endothelial cells, double antibody-negative patients do not respond as well.

Usefulness of the Physical Examination in the Concussed Patient

This article suggests that certain specific physical examination findings may be helpful in evaluating and monitoring patients with sports-related concussion using oculovestibular responses and balance tests.

Intensive Lifestyle Interventions May Prevent and Ameliorate the Symptoms of Alzheimer’s Disease

Recent clinical studies support the benefit of intensive lifestyle interventions, which should include a plant-based diet, exercise, stress management, and avoidance of smoking and alcohol, for the prevention of Alzheimer’s disease.

Non-Marine Envenomations in the United States

Envenomations can be caused by many different species, both marine and non-marine. The presentation can range from minor skin irritation to anaphylaxis, systemic illness, organ failure, and even death. Knowing which species are endemic to the area, and what the presentations of medically important envenomations will look like, can aid in recognition and timely treatment, especially when the bite or sting was unwitnessed. This article will give an overview of medically important non-marine envenomations in the United States, including their clinical manifestations, treatment, and disposition.

Cardioversion in Obese Patients

A multicenter, single-blind, randomized clinical trial of dual vs. single defibrillator shocks for cardioverting obese patients with atrial fibrillation showed that dual defibrillation was significantly more effective without any increase in adverse events.

Are Women with Atrial Fibrillation Still at Higher Risk of Ischemic Stroke?

A Finnish national database study of newly diagnosed atrial fibrillation from 2007-2018 has shown that the independent association of ischemic stroke risk with female sex initially was high but trended downward to nonsignificant at the end of the study. This has implications for the risk stratification of atrial fibrillation patients regarding oral anticoagulation therapy.

Insights from the Apixaban vs. Aspirin for Subclinical Atrial Fibrillation Trial

An analysis of the ARTESiA trial of apixaban vs. aspirin for stroke prevention in subclinical atrial fibrillation by CHA2DS2VASc score has shown that the benefits of apixaban outweigh the risk of major bleeding at scores > 4 and the opposite is true at scores < 4.