Browse Internal Medicine Articles by Topic

DeWinter T Waves?

The electrocardiogram (ECG) in the figure was obtained from a woman with dyspnea and marked hypertension, but who had no chest pain. How would you interpret this ECG? Should you activate the cath lab?

Nemolizumab-Ilto (Nemluvio)

The U.S. Food and Drug Administration has approved nemolizumab, the first monoclonal antibody specifically targeting the interleukin-31 pathway linked to pruritus and skin inflammation associated with atopic dermatitis.

ABCD² Score as a Predictor of Three-Year Stroke Risk

This retrospective cohort study using the National Patient Registry in Denmark analyzed a three-year follow-up period following a transient ischemic attack, looking at the rate of recurrent stroke and mortality. The patients were divided into low risk (ABCD² score 0-3) and high risk (ABCD² score ≥ 4). The stroke rate was 6% in the high-risk group and 4% in the low-risk group.

Examining the Effectiveness of Using AI Tools in Practice

A controlled trial comparing physician diagnostic performance with and without artificial intelligence (AI) found no significant difference in accuracy, quality, or other metrics, although AI alone outperformed both groups.

Prognostic Value of Stress Echocardiography

A UK National Health Service database study of stress echocardiography has shown the degree of ischemia accurately predicts the risk of future cardiovascular events over five years. The same study also showed that a negative test in patients without a history of cardiac disease identifies patients with no more than the expected background risk of an event for patients in this demographic for five years.

Tirzepatide Injection (Zepbound) for Obstructive Sleep Apnea

The U.S. Food and Drug Administration has approved tirzepatide for the treatment of moderate-to-severe sleep apnea in adults with obesity.

Clostridioides difficile: Reduced Susceptibility to Vancomycin?

Many sites have been reluctant to prescribe fidaxomicin as the first-line agent, despite fairly robust evidence indicating its efficacy relative to vancomycin in preventing recurrences. We still cannot predict who will do well with vancomycin and which patients are likely to relapse or to do more poorly. The gradual emergence of Clostridioides difficile with reduced vancomycin susceptibility may contribute to adverse outcomes when using this agent.

Arrhythmias in the Holiday Heart Syndrome

A small study of continuous electrocardiogram and breath alcohol concentration in young volunteers during acute excessive alcohol consumption has shown that heart rate and ventricular premature beats increased during the drinking period. During recovery (six to 19 hours), significant arrhythmias such as atrial fibrillation occurred in 5% of the subjects. The observed changes in heart rate variability and breath alcohol concentration suggest that these effects are the result of increased sympathetic nervous system activity associated with excessive blood alcohol concentrations.

Reduced Control and Workplace Burnout

This cross-sectional study of more than 2,000 physicians from diverse healthcare organizations found that reduced control over specific aspects of practice — such as patient load, clinical hours, and overall workload — was significantly associated with not only higher levels of burnout, but also increased intentions to reduce clinical hours or leave practice altogether.

Unhurried Patient Care

Unhurried conversations during patient encounters can improve outcomes for patients and enhance career satisfaction of physicians. Specific communication strategies can foster unhurried conversations without adding undue time to clinical care.