Browse Internal Medicine Articles by Topic

Vasectomy Follow-Up Rates: How Good Are They?

In this retrospective cohort study of 2,567 patients at a single institution, 42.1% of men did not follow up at all after vasectomy for semen analysis. Of those with spermatozoa on the initial testing post-vasectomy, 43.3% of men failed to return for repeat testing.

Best Long-Term Antiplatelet Monotherapy Post-PCI

In a multicenter, randomized, open-label trial of clopidogrel vs. aspirin monotherapy in patients post-percutaneous coronary intervention (PCI) who had been on dual antiplatelet therapy for the recommended period, those randomized to clopidogrel showed fewer major cardiovascular or cerebral events over a two-year follow-up period than those on aspirin without an increase in bleeding events.

Does Thoracentesis Speed Recovery from Heart Failure?

An unblinded, multicentered, randomized trial of patients with acute heart failure hospital admissions and significant pleural effusions showed that early thoracentesis, in addition to recommended medical therapy, did not reduce mortality or length of stay, or increase days alive out of the hospital for 90 days. However, it was relatively safe and could be employed in selected persistently symptomatic patients with very large effusions.

Stroke Risk in Patients with New AFib During Unrelated Hospitalization

In a Canadian administrative database study of patients who developed atrial fibrillation during a hospitalization for other reasons, researchers followed the patients for one year to ascertain the risk of subsequent stroke. The incidence of stroke in those not anticoagulated generally was below the 2% per year threshold recommended for treatment with anticoagulants. However, in those with a CHA₂DS₂-VA score ≥ 5 (sex not included based on new data) and in those admitted for cardiac medical problems, the 95% confidence intervals of stroke risk did cross 2%. Thus, selected patients may be candidates for anticoagulation.

And Then What Happens?

You are consulted on the electrocardiogram (ECG) in the figure — but without the benefit of any clinical information. This tracing was assessed as showing AFib (atrial fibrillation) with a controlled ventricular response. Do you agree?

Vimseltinib (Romvimza) Capsules for TGCT

The U.S. Food and Drug Administration has approved vimseltinib for the treatment of tenosynovial giant cell tumor for which surgical resection is not desirable.

Paxlovid: Is It Still Worth the Cost?

Paxlovid is one of the most effective antivirals developed during the COVID-19 years, demonstrating significant reductions in hospitalization and death in higher-risk persons, as well as the time to viral elimination. However, it does not shorten the duration of symptoms, and there is little evidence that Paxlovid reduces the risk of developing long COVID symptoms.

The Effect of High-Dose Vitamin D on Clinically Isolated Syndrome and MS

This study by Thouvenot et al evaluated the effectiveness of high-dose vitamin D treatment on clinically isolated syndrome and early multiple sclerosis as monotherapy and reported a reduced incidence of new disease activity compared to the control group.

Antibiotics for Asymptomatic Bacteriuria: Using Urinalysis to Improve Stewardship

A cohort study found that in patients receiving antibiotics for a urinary tract infection, a urinalysis with pyuria and/or nitrituria identified 40% more cases of unnecessary antibiotic use compared to asymptomatic bacteriuria.

Can Anti-Amyloid Antibody Treatment Delay the Clinical Onset of Alzheimer’s Disease?

In this open-label extension of the dominantly inherited Alzheimer’s disease gantenerumab trial (DIAN-TU), long-term continuous amyloid clearance over eight or more years in asymptomatic carriers of autosomal dominant Alzheimer’s mutations showed potential to delay symptom onset and slow progression. Shorter duration or partial clearance did not yield measurable clinical benefit, suggesting that only sustained, near-complete amyloid removal may have disease-modifying effects.