Browse Internal Medicine Alert Articles by Topic

Prognostic Value of Stress Echocardiography

A UK National Health Service database study of stress echocardiography has shown the degree of ischemia accurately predicts the risk of future cardiovascular events over five years. The same study also showed that a negative test in patients without a history of cardiac disease identifies patients with no more than the expected background risk of an event for patients in this demographic for five years.

Tirzepatide Injection (Zepbound) for Obstructive Sleep Apnea

The U.S. Food and Drug Administration has approved tirzepatide for the treatment of moderate-to-severe sleep apnea in adults with obesity.

Clostridioides difficile: Reduced Susceptibility to Vancomycin?

Many sites have been reluctant to prescribe fidaxomicin as the first-line agent, despite fairly robust evidence indicating its efficacy relative to vancomycin in preventing recurrences. We still cannot predict who will do well with vancomycin and which patients are likely to relapse or to do more poorly. The gradual emergence of Clostridioides difficile with reduced vancomycin susceptibility may contribute to adverse outcomes when using this agent.

Arrhythmias in the Holiday Heart Syndrome

A small study of continuous electrocardiogram and breath alcohol concentration in young volunteers during acute excessive alcohol consumption has shown that heart rate and ventricular premature beats increased during the drinking period. During recovery (six to 19 hours), significant arrhythmias such as atrial fibrillation occurred in 5% of the subjects. The observed changes in heart rate variability and breath alcohol concentration suggest that these effects are the result of increased sympathetic nervous system activity associated with excessive blood alcohol concentrations.

Reduced Control and Workplace Burnout

This cross-sectional study of more than 2,000 physicians from diverse healthcare organizations found that reduced control over specific aspects of practice — such as patient load, clinical hours, and overall workload — was significantly associated with not only higher levels of burnout, but also increased intentions to reduce clinical hours or leave practice altogether.

Unhurried Patient Care

Unhurried conversations during patient encounters can improve outcomes for patients and enhance career satisfaction of physicians. Specific communication strategies can foster unhurried conversations without adding undue time to clinical care.

Flank Pain and ‘Heartburn?’

The electrocardiogram (ECG) in the figure was obtained from a man in his 60s who presented to the emergency department for a suspected kidney stone. The patient also noted some intermittent heartburn in recent weeks. How would you interpret his ECG? Should you activate the cath lab?

Revumenib Tablets (Revuforj)

The U.S. Food and Drug Administration has approved the first menin inhibitor, revumenib, for the treatment of relapsing or refractory acute leukemia with a lysine methyltransferase 2A gene (also known as the mixed lineage leukemia gene) translocation in adults and pediatric patients.

Oseltamivir for Adults Hospitalized with Influenza: Earlier Is Better

A multicenter observational study on adults hospitalized with influenza found that initiation of oseltamivir on the day of admission reduced the risk of disease progression, including pulmonary and extra-pulmonary organ failure and death.

Wildfire Smoke Exposure Is a Risk Factor for Dementia

In this large, open cohort study based on electronic health record data from 2009 to 2019 of dementia-free people older than 60 years of age, exposure to wildfire smoke was shown to result in an increased incidence of dementia later in life.