Browse Internal Medicine Articles by Topic

Mice, Mutations, and Microcephaly: The Evolving Pathogenesis of Congenital Zika Syndrome

Approximately five years ago, a single gene mutation altered Zika virus, making it able to target neuronal progenitor cells and cause what we now know as congenital Zika syndrome with microcephaly and ocular abnormalities.

Angiotensin II Raises Blood Pressure in Patients with Vasodilatory Shock

The ATHOS-3 trial represents an important proof of concept trial regarding angiotensin II as a new vasopressor in the armamentarium to treat vasodilatory shock.

Antibiotics and Adverse Events: Doctors, Do No Harm

A retrospective study found that among 1,488 hospitalized patients who received an antibiotic, 298 (20%) experienced at least one antibiotic-associated adverse drug event. Furthermore, 287 (19%) of the antibiotic regimens were not clinically indicated, and 56 (20%) of these were associated with an adverse drug event.

Natriuretic Peptide-guided Therapy Does Not Improve Systolic Heart Failure Outcomes

A recent meta-analysis of 11 trials showed a significant reduction in all-cause mortality with natriuretic peptide-guided therapy, although the individual trial results varied substantially.

Is a Dabigatran Reversal Agent Effective?

Dabigatran is an attractive oral anticoagulant for patients who demonstrate indications for oral anticoagulation but are at high risk of bleeding.

In-hospital vs. Telephone Availability of an Intensivist at Night

When overnight shifts were staffed by nighttime intensivists rather than residents with attending intensivists on call remotely, most nurses perceived improvements in clinical care, procedures, efficiency, communication, and job place comfort.

Is There Still a Role for High-frequency Oscillatory Ventilation in ARDS?

In this patient-level meta-analysis of four well-known randomized, controlled trials of high-frequency oscillatory ventilation (HFOV) in acute respiratory distress syndrome (ARDS), the authors found that HFOV increases mortality for most patients with ARDS but may improve survival among patients specifically with severe ARDS.

Hyponatremia in the Critically Ill

Hyponatremia is the most common electrolyte disorder encountered in hospitalized patients (30-40%) and is present in 17.7% of patients admitted to the ICU. A recent registry demonstrated significant practice variation regarding this common disorder, underlining the frequent diagnostic and therapeutic challenges clinicians face in this area.

Transcatheter Mitral Valve Replacement as an Alternative to Other Surgical Options

A large registry study of transcatheter mitral valve replacement (TMVR) in patients with degenerated mitral valve bioprostheses or failed mitral annuloplasty repairs who were at high risk for repeat surgery showed that TMVR can be performed successfully. However, the initial and long-term results are better in the degenerated bioprothesis group.

Can Medical Therapy Improve Functional Mitral Regurgitation?

Among patients who presented with heart failure with reduced ejection fraction and severe functional mitral regurgitation, mitral regurgitation improved in 38% of patients with medical management. Improvement in mitral regurgitation was associated with increased survival.