Browse Internal Medicine Articles by Topic

Severe Olfactory Impairment Is Associated With Preclinical Alzheimer’s Disease

In this cross-sectional, population-based, cohort study of 829 cognitively normal participants, abnormal neuroimaging biomarkers known to be associated with Alzheimer’s disease were associated with severe olfactory impairment.

Plasma α-Synuclein Is a Leading Candidate Biomarker in Parkinson’s Disease

In this cross-sectional study, plasma alpha-synuclein levels were higher in individuals with Parkinson’s disease than controls, and correlated with cognitive decline.

Tacrolimus for Treatment of Myasthenia Gravis

A large observational study performed in Korea suggests that tacrolimus is an effective immunomodulating, steroid-sparing medication for the treatment of myasthenia gravis.

Prediction of Survival After Cardiac Arrest Using Pupillometry

Automated infrared pupillometry holds promise as a quantitative, reproducible measure that aids in determining neurological prognosis after cardiac arrest and coma.

Distinguishing Ischemic from Non-ischemic Cardiomyopathy Clinically

SYNOPSIS: This cardiac catheterization-based study of patients with newly diagnosed reduced left ventricular ejection fraction of unknown etiology showed that 15% had ischemic cardiomyopathy and they could be identified by clinical characteristics and an ECG-based risk score.

B-type Natriuretic Peptide Is Less Useful in Elderly Patients with Dyspnea

SYNOPSIS: Among patients ≥ 80 years of age presenting with acute dyspnea, B-type natriuretic peptide level was not useful for differentiating cardiac vs. respiratory etiologies when added to a model of clinical predictors.

Sepsis Management: What We Think We Know

SYNOPSIS: In the Protocolized Resuscitation in Sepsis Meta-Analysis (PRISM), 3,723 patients’ outcomes from the ProCESS, ARISE, and ProMISe randomized, controlled trials of early goal-directed therapy (EGDT) were evaluated. EGDT did not result in better outcomes than usual care and was associated with higher costs. The authors of a second study looked at outcomes of 49,331 patients with sepsis treated in New York from April 2014 to June 2016. More rapid completion of the three-hour sepsis bundle and antibiotic administration (but not rapid bolus administration of IV fluids) was associated with reduced in-hospital mortality.

Dual Antibiotic Therapy Is Not Routinely Necessary for Uncomplicated Cellulitis

SYNOPSIS: A randomized, multicenter, placebo-controlled clinical trial that enrolled patients presenting to emergency departments with uncomplicated cellulitis found the addition of trimethoprim-sulfamethoxazole to cephalexin did not lead to better outcomes.

Does Dexmedetomidine Improve Patient Outcomes in Sepsis?

In patients with sepsis requiring mechanical ventilation, use of dexmedetomidine compared with no dexmedetomidine did not result in an improvement in 28-day mortality or ventilator-free days.

Resilience in the ICU: A Valuable Asset for Families

Interventions that teach resilience may improve family members’ experiences in the ICU.