Category: Internal Medicine

Hot Topics: Anti-Statin Internet Trend Could Threaten Lives

Jackie Werner Cardiology, Front Page, Hot Topics in Research

Statin Denial: An Internet-Driven Cult With Deadly Consequences Nissen SE. Statin Denial: An Internet-Driven Cult With Deadly Consequences. Ann Intern Med. doi: 10.7326/M17-1566 The reduction in cardiovascular morbidity and mortality during the past 3 decades represents one of the great triumphs of contemporary medicine. In 1987, the age-adjusted mortality rate in the U.S. population for cardiovascular disease was 357 in 100 000, decreasing to 167 in 100 000 by 2014 (1). Although precisely gauging the relative contributions of various public health measures to the decline in cardiovascular morbidity and mortality is impossible, most critical observers consider the introduction of statins in 1987…

Hot Topics: Monthly Injections Could Replace Pills for HIV Treatment

Jackie Werner Hot Topics in Research, Infectious Disease

Long-acting intramuscular cabotegravir and rilpivirine in adults with HIV-1 infection (LATTE-2): 96-week results of a randomised, open-label, phase 2b, non-inferiority trial Margolis DA, Gonzalez-Garcia J, Stellbrink H, et al. Long-acting intramuscular cabotegravir and rilpivirine in adults with HIV-1 infection (LATTE-2): 96-week results of a randomised, open-label, phase 2b, non-inferiority trial. The Lancet. http://dx.doi.org/10.1016/S0140-6736(17)31917-7. Summary Background Cabotegravir and rilpivirine are antiretroviral drugs in development as long-acting injectable formulations. The LATTE-2 study evaluated long-acting cabotegravir plus rilpivirine for maintenance of HIV-1 viral suppression through 96 weeks. Methods In this randomised, phase 2b, open-label study, treatment-naive adults infected with HIV-1 initially received oral cabotegravir 30…

Hot Topics: Unnecessary Antibiotics in Hospitals Can Cause Adverse Events

Jackie Werner Hot Topics in Research, Internal Medicine, Pharmaceutical Sciences

Association of Adverse Events With Antibiotic Use in Hospitalized Patients Tamma PD, Avdic E, Li DX, Dzintars K, Cosgrove SE. Association of Adverse Events With Antibiotic Use in Hospitalized Patients. JAMA Intern Med. Published online June 12, 2017. doi:10.1001/jamainternmed.2017.1938 Importance  Estimates of the incidence of overall antibiotic-associated adverse drug events (ADEs) in hospitalized patients are generally unavailable. Objective  To describe the incidence of antibiotic-associated ADEs for adult inpatients receiving systemic antibiotic therapy. Design, Setting, and Participants  Retrospective cohort of adult inpatients admitted to general medicine wards at an academic medical center. Exposures  At least 24 hours of any parenteral or oral antibiotic therapy. Main Outcomes and…

Hot Topics: Alzheimer’s Further Linked to Brain Plaques

Jackie Werner Alzheimer Disease, Hot Topics in Research, Senile Plaques

Association Between Elevated Brain Amyloid and Subsequent Cognitive Decline Among Cognitively Normal Persons Donohue MC, Sperling RA, Petersen R, al e. Association between elevated brain amyloid and subsequent cognitive decline among cognitively normal persons. JAMA. 2017. 317(22):2305-2316. doi: 10.1001/jama.2017.6669. Importance  Among cognitively normal individuals, elevated brain amyloid (defined by cerebrospinal fluid assays or positron emission tomography regional summaries) can be related to risk for later Alzheimer-related cognitive decline. Objective  To characterize and quantify the risk for Alzheimer-related cognitive decline among cognitively normal individuals with elevated brain amyloid. Design, Setting, and Participants  Exploratory analyses were conducted with longitudinal cognitive and biomarker data from 445…

Hot Topics: Severe Epilepsy Eased by Compound in Cannabis

Jackie Werner Hot Topics in Research, Neurology

Trial of Cannabidiol for Drug-Resistant Seizures in the Dravet Syndrome Devinsky O, Cross JH, Laux L, et al. Trial of cannabidiol for drug-resistant seizures in the dravet syndrome. N Engl J Med. 2017;376(21):2011-2020. http://dx.doi.org/10.1056/NEJMoa1611618. BACKGROUND The Dravet syndrome is a complex childhood epilepsy disorder that is associated with drug-resistant seizures and a high mortality rate. We studied cannabidiol for the treatment of drug-resistant seizures in the Dravet syndrome. METHODS In this double-blind, placebo-controlled trial, we randomly assigned 120 children and young adults with the Dravet syndrome and drug-resistant seizures to receive either cannabidiol oral solution at a dose of 20…

Hot Topics: Steroid Shots Ineffective For Arthritic Knee Pain

Jackie Werner Geriatrics, Hot Topics in Research, Rheumatology

Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial McAlindon TE, LaValley MP, Harvey WF, et al. Effect of intra-articular triamcinolone vs saline on knee cartilage volume and pain in patients with knee osteoarthritis: A randomized clinical trial. JAMA. 2017;317(19):1967-1975. Importance  Synovitis is common and is associated with progression of structural characteristics of knee osteoarthritis. Intra-articular corticosteroids could reduce cartilage damage associated with synovitis but might have adverse effects on cartilage and periarticular bone. Objective  To determine the effects of intra-articular injection of 40 mg of triamcinolone acetonide every 3…

Hot Topics: Most Pediatric Flu Deaths Could Be Prevented With Flu Shot

Jackie Werner Hot Topics in Research, Infectious Disease

Influenza vaccine effectiveness against pediatric deaths: 2010–2014 Flannery B, Reynolds SB, Blanton L, et al. Influenza vaccine effectiveness against pediatric deaths: 2010–2014. Pediatrics. 2017;139(5). doi: 10.1542/peds.2016-4244. BACKGROUND AND OBJECTIVES: Surveillance for laboratory-confirmed influenza-associated pediatric deaths since 2004 has shown that most deaths occur in unvaccinated children. We assessed whether influenza vaccination reduced the risk of influenza-associated death in children and adolescents. METHODS: We conducted a case–cohort analysis comparing vaccination uptake among laboratory-confirmed influenza-associated pediatric deaths with estimated vaccination coverage among pediatric cohorts in the United States. Case vaccination and high-risk status were determined by case investigation. Influenza vaccination coverage estimates…

Hot Topics: First Tardive Dyskinesia Drug Approved by FDA

Jackie Werner Hot Topics in Research, Neurology, Psychology and Psychiatry

FDA approves first drug to treat tardive dyskinesia Food and Drug Administration, U.S. Department of Health and Human Services. (2017). FDA approves first drug to treat tardive dyskinesia. Retrieved from https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm552418.htm. The U.S. Food and Drug Administration today [April 11, 2017] approved Ingrezza (valbenazine) capsules to treat adults with tardive dyskinesia. This is the first drug approved by the FDA for this condition. Tardive dyskinesia is a neurological disorder characterized by repetitive involuntary movements, usually of the jaw, lips and tongue, such as grimacing, sticking out the tongue and smacking the lips. Some affected people also experience involuntary movement of the…

Hot Topics: FDA Approves First Drug For Severe Multiple Sclerosis

Jackie Werner Central Nervous System Disorders, Hot Topics in Research

FDA approves new drug to treat multiple sclerosis Food and Drug Administration, U.S. Department of Health and Human Services. (2017). FDA approves new drug to treat multiple sclerosis. Retrieved from https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm549325.htm. On March 28, the U.S. Food and Drug Administration approved Ocrevus (ocrelizumab) to treat adult patients with relapsing forms of multiple sclerosis (MS) and primary progressive multiple sclerosis (PPMS). This is the first drug approved by the FDA for PPMS. Ocrevus is an intravenous infusion given by a health care professional. “Multiple sclerosis can have a profound impact on a person’s life,” said Billy Dunn, M.D., director of the Division of…

Hot Topics: Cardiologists Weigh In On Nutrition Facts and Fads

Jackie Werner Cardiology, Hot Topics in Research, Nutrition

Trending Cardiovascular Nutrition Controversies Freeman AM, Morris PB, Barnard N, et al. Trending cardiovascular nutrition controversies. J Am Coll Cardiol. 2017;69(9):1172-1187. http://dx.doi.org/10.1016/j.jacc.2016.10.086. The potential cardiovascular benefits of several trending foods and dietary patterns are still incompletely understood, and nutritional science continues to evolve. However, in the meantime, a number of controversial dietary patterns, foods, and nutrients have received significant media exposure and are mired by hype. This review addresses some of the more popular foods and dietary patterns that are promoted for cardiovascular health to provide clinicians with accurate information for patient discussions in the clinical setting.