Internal Medicine
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Midazolam Nasal Spray (Nayzilam) CIV
Midazolam nasal spray should be prescribed to treat acute intermittent, stereotypic episodes of frequent seizure activity (acute repetitive seizures, seizure clusters) that are distinct from the patient’s usual seizure patterns.
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Physicians Cannot Agree on Who Benefits From ICU Care
The authors of a study randomizing U.S. critical care physicians to analyze hypothetical patient vignettes found that estimates of whether a patient would benefit from ICU care were widely dissimilar among those surveyed and influenced by factors unrelated to severity of illness.
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Does Hormone Therapy Increase the Risk of Alzheimer’s Disease?
The results of a large Finnish case-control study suggest that postmenopausal hormone therapy results in a 9-17% increase in the risk of Alzheimer’s disease. However, the small effect size, and likely confounding of use effect, does not provide strong evidence for a causal relationship.
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Neuropathy in Systemic Lupus Erythematosus
Systemic lupus erythematosus may be associated with a variety of neuropsychiatric syndromes, including peripheral neuropathy, mostly sensorimotor types. However, all parts of the peripheral and central nervous system may be affected; careful and repeated neurological evaluation is important.
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Sacubitril-Valsartan Reduces Functional Mitral Regurgitation
In patients with chronic heart failure and functional mitral regurgitation, sacubitril/valsartan was associated with greater reduction in mitral regurgitation compared to valsartan alone.
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Workplace Violence, Bullying Associated With Cardiovascular Disease Risk
In a 12-year follow-up of surveyed Scandinavian employees, reported workplace violence and bullying increased the risk of future cardiovascular disease of a magnitude similar to other recognized cardiovascular disease risk factors.
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Are Calcium Channel Blockers Needed for Radial Artery Grafts?
A combined analysis of six trials comparing radial artery grafts vs. saphenous vein grafts for coronary bypass surgery revealed that patients taking calcium channel blockers for at least one year experienced fewer major cardiac events and fewer radial graft occlusions than those not so treated.
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Mildly Elevated Pulmonary Arterial Pressure Associated With Higher Mortality Rate
In a large cohort of patients referred for echocardiography, an estimated right ventricular systolic pressure > 30 mmHg was associated with higher mortality rates.