Browse Internal Medicine Articles by Topic

Urinary Tract Infection

MONOGRAPH: More than 8 million medical visits per year are for the chief complaint of UTI and the diagnosis accounts for 100,000 admissions annually.

Clinical Briefs on topics such as: Chronobiology and Insulin Glargine, Dual Add-on Therapy for Type 2 Diabetes When Metformin is Not Enough, and Might Long-term Dual Antiplatelet Therapy Be Better? Not

Are Atrial Premature Complexes Benign?

Atrial premature complexes (APCs) are commonly observed on routine ECGs and believed to be harbingers of atrial fibrillation, especially in patients with cardiovascular disease. However, little is known about the long-term prognosis of APCs in the general population. Thus, these investigators from Japan analyzed the database of a large community-based cohort from 1993 to 2008 to determine the risks of APCs seen on the subjects’ baseline ECGs.

Statins After an MI: Does it Happen?

Following a hospitalization for coronary heart disease (CHD) or acute coronary syndrome (ACS), randomized trials demonstrate that high-intensity atorvastatin is more effective than either placebo or low- to moderate-intensity therapy with either pravastatin or atorvastatin.^1-3 Based on this evidence, the American College of Cardiology and the American Heart Association guidelines recommend high-intensity therapy in cases of an acute cardiac event and that therapy be initiated before discharge.

Is it Worth it? Do “Healthy” Dietary Guidelines Lower the Risk of Heart Disease?

Recent controversy surrounds diet and its impact on cardiovascular disease (CVD). In this study, Reidlinger and her colleagues sought to assess diet by comparing the effects on vascular and lipid CVD risk factors of adhering to a diet consistent with United Kingdom (UK) dietary guidelines (DG group) to a traditional British diet (control group).

Another Reason to Recommend Smoking Cessation

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice, affecting an estimated 2.7 million individuals in the United States.¹ The proportion of strokes attributable to AF increases strikingly from 1.5% at 50-59 years of age to 23.5% at 80-89 years of age.² Approximately 15-20% of all strokes are due to AF. To predict the thromboembolic risk in the individual patient, risk models used most frequently are CHA2DS2-VASc and CHADS2 scores. The CHA2DS2-VASc score may be the better option since both the 2014 American Heart Association, American College of Cardiology, Heart Rhythm Society AF guidelines, and the 2012 European Society of Cardiology AF guidelines prefer it when evaluating the individual thromboembolic risk associated with AF and to determine the risk:benefit ratio of antithrombotic therapy.³

Statins After an MI: Does it Happen?

Following a hospitalization for coronary heart disease (CHD) or acute coronary syndrome (ACS), randomized trials demonstrate that high-intensity atorvastatin is more effective than either placebo or low- to moderate-intensity therapy with either pravastatin or atorvastatin.^1-3 Based on this evidence, the American College of Cardiology and the American Heart Association guidelines recommend high-intensity therapy in cases of an acute cardiac event, and recommend therapy be initiated before discharge.

A Guide to When and How to Stop CPR

Although health care providers undergo hours of training and re-certification to provide resuscitative efforts for patients in cardiopulmonary arrest, few are given guidance in terms of when and how to stop it.

Post-ICU Stress Symptoms Associated with Increased Acute Care Service Utilization

Over the past two decades, advances in critical care have resulted in more patients surviving to hospital discharge, but these successes are attenuated by several sequelae of critical illness, including depression and post-traumatic stress disorder (PTSD).¹ Risk factors for and the health care ramifications of these disorders are poorly understood. Given this, Davydow and colleagues aimed to investigate whether PTSD symptoms in the acute (< 1 month) ICU hospitalization period and PTSD and depressive symptoms at 3 months post-ICU were risk factors for future hospitalizations and emergency department (ED) visits.

Nasal Screening for MRSA: The New Basis for De-escalation of Empiric Antibiotics?

Although nasal screening for methicillin-resistant Staphylococcus aureus (MRSA) is a widely accepted method for infection control, the relationship between nasal carriage and development of MRSA lower respiratory tract infection (LRTI) is not well studied. Tilahun and colleagues sought to determine the association between MRSA nasal swab results and MRSA LRTI in a medical ICU. In this single-site, retrospective cohort study, 165 patients were diagnosed with pneumonia and had both nasal swabbing and culturing of respiratory specimens within 24 hours of admission.