Browse Clinical Articles by Topic

Arrhythmia Recurrence After Catheter Ablation of Atrial Fibrillation

An integrated nationwide medical and pharmacy claims database analysis of patients with new atrial fibrillation undergoing catheter ablation as first-line therapy has shown that 17% of patients required repeat ablation for recurrent atrial fibrillation despite the frequent use of antiarrhythmic drugs.

Ten-Year Outcomes of the SCOT-HEART Study

The 10-year follow-up of the SCOT-HEART Study of new-onset chest pain patients randomized to standard care vs. the addition of coronary computed tomography angiography (CTA) has shown that coronary heart disease-related death, myocardial infarction, and other adverse cardiovascular outcomes are reduced with CTA use, perhaps because preventive therapy is increased.

Apomorphine Hydrochloride Injection (Onapgo)

The U.S. Food and Drug Administration has approved apomorphine as a constant subcutaneous infusion for the treatment of advanced Parkinson’s disease with persistent motor fluctuations. It is the second subcutaneous infusion for this indication following foscarbidopa/foslevodopa (as Vyalev).

Determinants of Long-Term Outcome After Concussion

This cohort study of U.S. veterans found that mild traumatic brain injuries occurring alongside psychological trauma are associated with long-term post-concussive symptoms and disability. The authors postulate that the traumatic context contributes to the development of post-traumatic stress disorder, which may in turn potentiate long-term sequelae.

Gabapentin vs. Duloxetine vs. Falls in Older Adults

This retrospective study examining fall risk among older adults taking gabapentin compared to duloxetine finds gabapentin users exhibit a markedly lower risk of fall-related visits at six months (hazard ratio = 0.52) yet finds no difference in the incidence of severe falls.

Clinical Insights on Managing DPN and PAD in Patients with Diabetes

Given the significant prevalence of diabetes in the population, it is important for the primary care clinician to be familiar with the many types of neuropathies commonly affecting people living with diabetes. By far the most prevalent type is chronic diabetic peripheral sensorimotor neuropathy, affecting up to 50% of people with diabetes. Peripheral arterial disease (PAD) refers to partial or complete occlusion of peripheral vessels of the lower extremities. The underdiagnosis of PAD in the primary care setting may be a major issue because of many patients presenting without the typical claudication symptoms described in medical textbooks. The ability of primary care clinicians to diagnose PAD in asymptomatic patients still has a significant clinical effect because PAD acts as a marker for systemic atherosclerosis.

Clinical Consequences of Alzheimer’s and Lewy Body Co-Pathologies

This large study of patients with cognitive impairment-assessed cerebrospinal fluid biomarkers, positron emission tomography imaging, and cognitive tests showed that those with evidence of both Alzheimer’s and Lewy body pathologies had greater cognitive dysfunction and faster progression than those with either pathology alone.

Long-Term Efficacy of Ocrelizumab as First-Line Treatment for Relapsing-Remitting Multiple Sclerosis

Nine-year follow-up data from open-label extension of the Phase III clinical trials of ocrelizumab show that, although the efficacy of ocrelizumab was maintained throughout the duration of the study, patients who were treated with ocrelizumab from the beginning of the Phase III trials did better than the patients who were on subcutaneous (SC) interferon β-1a initially and were switched to ocrelizumab at the onset of the open-label extension period.

Small Fiber Neuropathy in Post-COVID Patients with Chronic Fatigue Syndrome

This study examines small fiber neuropathy (SFN) in post-COVID patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). While ME/CFS patients reported more SFN symptoms, objective testing showed limited diagnostic value beyond heat/cold detection differences.

Should Thrombolytic Drugs Be Added to Mechanical Thrombectomy in Acute Stroke?

Two recent trials from China studied the effect of post-thrombectomy, intra-arterial thrombolysis on neurological outcomes. One study used tenecteplase and the other used urokinase. Both studies showed a trend toward improvement that was not statistically significant, and there was an increase in brain hemorrhage. The benefit of adjunctive thrombolysis with mechanical thrombectomy is uncertain and requires more study.