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What Kind of Bundle Branch Block?

Assuming QRS widening in a supraventricular rhythm is not the result of hyperkalemia or other toxicity, and assuming the patient has not been diagnosed with Wolff-Parkinson-White syndrome, classification of 12-lead ECG conduction disturbances can be simplified into one of three basic categories. The tracing in the figure illustrates this concept.

Donislecel-jujn Allogenic Pancreatic Islet Cellular Suspension (Lantidra)

Lantidra can be prescribed to adults with type 1 diabetes who cannot approach target HbA1c levels because of current repeated episodes of severe hyperglycemia despite intensive diabetes management and education.

Report from the 2023 American Diabetes Association Scientific Sessions

At the 2023 American Diabetes Association Scientific Sessions, experts presented key updates, advances, and best practices for patient care. A selection of presentations relevant to the internal medicine and primary care community is presented here.

Disease-Modifying Therapy After Natalizumab Discontinuation in Patients with Relapsing Multiple Sclerosis

In this retrospective cohort study, the investigators found that, when compared to fingolimod and dimethyl fumarate, ocrelizumab use was associated with significantly lower annualized relapse rate and treatment discontinuation. There were no significant differences in outcomes between fingolimod and dimethyl fumarate use. Ocrelizumab use was associated with a lower rate of disability accumulation when compared to fingolimod.

Treatment of Psychotic Symptoms in Alzheimer’s Disease

In a meta-analysis of several large treatment trials of patients with Alzheimer’s disease, Parkinson’s disease, and dementia with Lewy bodies, cholinesterase inhibitors demonstrated a small but statistically significant benefit in reducing psychotic symptoms.

Antidepressants for Chronic Pain: Do They Work?

Antidepressant medications have been widely used for treating a variety of chronic pain disorders but strong evidence to support their efficacy is lacking. Some patients may respond, but available data do not help us to determine which agents may be helpful in a specific type of chronic pain condition.

Celery Seed-Derived Compound: A Legitimate Neuroprotectant for Acute Ischemic Stroke?

A Phase III double-blind, placebo-controlled, randomized controlled trial suggests that early administration of DL-3-n-butylphthalide, when given adjunctively to thrombolysis or endovascular therapy, improves functional outcomes in patients with acute ischemic stroke. Statistically significant results of well-designed analyses are tantalizing, but confidence in the findings is tempered by a lack of generalizability, an unclear mechanism of action, and trial design irregularities.

Brain Atrophy and Type 1 Diabetes

In a long-term longitudinal study of people with type 1 diabetes, excessive brain atrophy and cognitive dysfunction were noted compared to healthy controls. The investigators calculated that type 1 diabetes resulted in six years of accelerated brain aging and brain atrophy that was separate and distinct from Alzheimer’s disease.

Reconsidering Aspirin Therapy for Elderly Patients

A post-hoc analysis of the ASPREE trial revealed that in presumably healthy elderly subjects, taking low-dose aspirin daily over three years was associated with a significant drop in hemoglobin and ferritin levels vs. placebo, even when patients with major bleeding events were excluded.

Can Physical Activity Thwart the Negative Cardiometabolic Effects of Obesity?

Compared to normal-weight workers, overweight or obese employees in Spain exhibited a higher prevalence of risk factors for cardiovascular disease, which can be partially mitigated by regular exercise.