Browse Internal Medicine Articles by Topic

The Devalued Body: Symptoms of BPD in Mental Health and Medical Settings

Borderline personality disorder is a complex dysfunction often caused by childhood trauma and it may result in your patients harming themselves.

Risk of Stroke with Intracardiac Devices and Patent Foramen Ovale

After some case reports of stroke due to electrophysiology (EP) device thrombosis in patients with a patent foramen ovale (PFO), concern has been raised about the risk of stroke with intracardiac devices in patients with known PFO. Thus, these investigators from the Cleveland Clinic did a retrospective database study of 2921 echocardiography-detected PFO patients and categorized them as having an EP device (231) or not.

Late Tricuspid Regurgitation After Heart Valve Surgery

Due to the success of left heart valve disease surgical corrections, patients may experience late tricuspid regurgitation.

Coronary Stents and Noncardiac Surgery

Contemporary data suggest that approximately one in every five patients will require non-cardiac surgery within two years of coronary stent implantation.

Spironolactone & the Potential Benefit for HFPEF Patients

No treatment has been shown to improve outcomes in heart failure with preserved ejection fraction.

Revascularization for Isolated Proximal LAD Disease: PCI is Easiest, but is it Best?

Among patients with obstructive coronary disease requiring revascularization, guidelines would suggest a clear preference for coronary artery bypass grafting (CABG) over percutaneous coronary intervention (PCI) only in certain defined subsets, including those with left main disease and in diabetics with multi-vessel disease. Patients with isolated proximal LAD disease represent a unique high-risk subset of those with single-vessel disease, in that the size of the affected territory and associated ischemic risk makes CABG a viable option. In fact, U.S. guidelines currently assign a slight advantage to CABG with a left internal mammary graft to the left anterior descending (LAD) for such patients, rating this as a IIa indication vs a IIb recommendation for PCI. This is despite a relative paucity of data on this subset of patients, at least using contemporary treatments. In fact, of the nine randomized, controlled trials forming the basis for 17 published studies examining this question, most are quite small, and all but one were performed using bare-metal stents; the single small RCT incorporating drug-eluting stents (DES) used first-generation devices that are no longer part of the treatment landscape.

Internal Medicine Alert - Full October 15, 2014 Issue in PDF

Do Telephone- and Internet-based Communications with Patients Increase Office Visits?

In an integrated health plan and care delivery system, before and after a medical home redesign, proportional increases in copay-free secure messaging and telephone encounters were associated with additional primary care office visits for individuals with diabetes.

Naltrexone HCl and Bupropion HCl Extended-Release Tablets (Contrave ® )

The FDA has approved another drug combination for the treatment of chronic weight management, combining two old drugs, naltrexone and bupropion, in a fixed combination. Naltrexone is an opioid antagonist and bupropion is a commonly prescribed antidepressant.

Does It Really Make a Difference What Weight-Reduction Diet You Choose?

Since two-thirds of American adults are currently overweight or obese, we would all like to be able to help patients choose the best diet. The list of choices and categories is lengthy, with vocal advocates for the Atkins diet, the Zone diet, South Beach diet, Jenny Craig, Ornish, etc. Of course, were any of these diets sufficiently effective and easily adopted that they could gain widespread advocacy, we wouldnt be faced with such an obesity epidemic in the first place! So, apparently there is no simple answer. Among the choices we have, then, which one might be the best?