November 2014

Several studies published in 2014 addressed the risks and benefits of prescribing aspirin to prevent cardiovascular events. In a Q&A with HCPLive's Gale Scott, Jeffrey Berger, MD, takes up the debate.

In this month's issue of Internal Medicine World Report (IMWR), we present summaries of highly relevant studies in the areas of cardiology, pulmonology, gastroenterology, infectious disease, psychiatry, and neurology. Selected by our physician editor for their relevance to the practice of internal medicine, each study addresses a key clinical issue that can have a significant impact on patient care.

For patients with severe, non-chronic depression, a combination of cognitive therapy (CT) and antidepressant medicine (ADM) is more effective than sole ADM treatment, according to research published in JAMA Psychiatry.

Researchers from the University of Gothenburg in Sweden determined β-amyloid 42 (Aβ42) cerebrospinal fluid (CSF) levels can act as predictor for Alzheimer's disease (AD).

Analyzing the brain patterns of social anxiety disorder (SAD) patients, Massachusetts Institute of Technology (MIT), Boston University (BU), and Massachusetts General Hospital (MGH), neuroscientists uncovered a method to pinpoint which candidates will benefit from cognitive behavioral therapy (CBT).

A recent study published in the Journal of the American Medical Association looked at whether the prescription, which also required the patient continuously monitor their coagulation, was the best option. The study focused on whether mechanical left atrial appendage would be preferable for patients going forward.

Patients with irritable bowel syndrome with diarrhea (IBS-D) suffer not only the pain and discomfort of frequent loose stools, but fear of incontinence. For many patients, that results in panic and anxiety.

Modifying diet is one way to try to help patients with Irritable Bowel Syndrome (IBS). In a study reported in Gastroenterology, an Australian research team looked at the effects of lowering fermentable oligosaccharides, disaccharides, monosaccharides, and polyols (FODMAP) vs. consuming a typical Australian diet.

More than 23 million Americans who should be screened for colon cancer have not yet been screened. To the extent that lapse is due to patients' reluctance to submit to a colonoscopy, a non-invasive stool test could help – if it is effective. A research team looked at such a test, one made by Exact Sciences Corp. and approved in November, 2014 for Medicare reimbursement.

The health care policy, written by Gary Rivard, DO, and Anthony Viera, MD, was published in The Journal of Family Practice. The authors noted that while more people are receiving vaccinations for pertussis, the US Centers for Disease Control reported 48,277 confirmed cases – the highest number since 1955, including 20 deaths related to the disease.

Strategies of no antibiotic prescription or delayed antibiotic prescription in primary care patients with acute respiratory tract infections (RTIs) resulted in fewer than 40% of patients using antibiotics, according to a study published in BMJ.

Benign paroxysmal positional vertigo (BPPV), an idiopathic condition for patients, occurs when otoconia of the utricular macula become dislodged and floating debris moves into semicircular canals. Recently, researchers have noted patients with BPPV tend to have low serum vitamin D levels compared with controls.

Patients who have hypertension may be at increased risk for cognitive decline and dementia. According to a study published in the October 2014 issue of JAMA Neurology, researchers have been trying to elucidate the timing and mechanism by which elevated blood pressure robs patients' thinking abilities.

Frontal lobe lesions can cause personality and social cognition impairment. Some data suggested that 2 types of patients – those with prefrontal lesions and those with the behavioral variant of frontotemporal dementia – experience similar distractibility, personality changes, and social inappropriateness. Patients with either diagnosis also experienced profoundly impaired moral reasoning, yet few studies have compared these patients.

Smoking cessation had long been associated with reduced depression, anxiety, and stress and improved positive mood and quality of life compared with continuing to smoke. Yet many smokers who wish to quit are afraid to do so because they believe smoking decreases their feelings of depression, anxiety, and stress and improves their mood and promotes relaxation. This sentiment is reported by smokers both with and without diagnosed mental disorders.

No matter what reason a patient is in the intensive care unit (ICU) of a hospital every moment and medication they take matters in helping them recover. A recent study looked at what dose of systemic corticosteroids should be given to patients with chronic obstructive pulmonary disease (COPD) exacerbations during their time in critical care.

Hepatitis C virus, fibrosis, and cirrhosis patients with sustained virological response can have survival rates comparable to the general population, according to research published in JAMA.

Glucose intolerances may be linked to non-caloric artificial sweeteners, according to research published in Nature.

Research teams examining the safety and efficacy of zanamivir and oseltamivir for influenza treatment concluded they are not as effective as popularly believed.

HDL cholesterol may have atheroprotective qualities, according to a report from The New England Journal of Medicine.