Internal Medicine

Global efforts are needed to curb antibiotic resistance, according to a report published online Nov. 16 in The Lancet Infectious Diseases.

Long term survival after cardiac resynchronization therapy in patients with atrial fibrillation and atrioventricular junction ablation is similar to that observed in patients in sinus rhythm, but death rate is elevated for atrial fibrillation patients treated with rate-slowing drugs.

Executive function disorder and ADHD share several overlapping symptoms, and the presence of executive function impairment is often associated with a diagnosis of ADHD. Clinicians should be aware of the testing modalities that can help accurately identify executive function disorder, and also be aware of the limitations of current medications when it comes to mitigating symptoms.

Depot antipsychotic medications for patients with schizophrenia are often associated with improved treatment adherence.

Creating a safer environment for clinicians and patients starts with better formalized reporting of aggressive and violent behavior, and should also include more rigorous screening and assessment for risk markers of violent behavior.

Genotyping and access to more genetic information about patients may allow clinicians to minimize side effects associated with treatment for schizophrenia by choosing antipsychotic agents based on their unique molecular binding profiles and using the lowest effective doses.

Evidence shows that interventional approaches such as transcranial magnetic stimulation, electroconvulsive therapy, deep brain stimulation, and bright light therapy, coupled with mindfulness-based cognitive therapy, can be an effective part of treatment for major depressive disorder.

Study looks at an integrated care model for treating bipolar depression that incorporates a multidisciplinary care team, individualized lifestyle interventions, focused patient education, weight loss and nutrition counseling, and efforts to promote treatment adherence.

Although we have made great advances in understanding the genetic components of psychiatric illness, caution is essential when applying information from genetic testing to the selection of treatment in clinician practice.

The American Society of Clinical Oncology has endorsed Cancer Care Ontario guidelines for colorectal cancer survivor follow-up care, according to a study published online Nov. 12 in the Journal of Clinical Oncology.

Presentation at the 2013 NEI Psychopharmacology Congress noted potential "red flag" symptoms and events that indicate increased risk of bipolar depression, and discussed several medication options for effectively managing this mental health disorder.

Planning and preparation prior to a disaster, developing networks of contacts with other medical personnel and facilities, avoiding overburdening medical staff and personnel in the aftermath of a disaster, and effectively treating PTSD and other mental health disorders are the keys to disaster preparedness.

One treatment-resistant depression patient's response to over-the-counter cough medicine led Steven P. Levine, MD, to study the mechanism and effects of dextromethorphan in depression.

Study results show hyponatremia is closely associated with all-cause mortality in patients with chronic kidney disease (CKD), but few previous studies have examined this relationship.

According to the authors of a recent study, almost 50% of patients with end-stage renal disease (ESRD) say they have chronic pain, and over 75% of them rate it as being moderate to severe.

A recent anonymous survey among nephrologists suggests that patients' social support, ability to understand the transplant process, and age are the most important factors influencing nephrologists' decisions to exclude them from kidney transplant referral.

A recent study suggests that dialysis patients' use of opioid analgesics (OAs) is widespread and exceeding historical limits, and that the patients who use opioids are staying on them longer.

Presentation at the 2013 Southern Hospital Medicine Conference reviewed the clinical application of several key risk indices, including the Revised Cardiac Risk Index and the Vascular Study Group of New England Risk Index.

Hepatitis C, HIV, C. diff, and other infectious diseases can present complex clinical challenges in the hospital setting.

Endocrinologist Pavan Chava, DO, discusses available methods to prolong glycemic control in hospitalized diabetics while avoiding hyperglycemia and hypoglycemia.

Though patients with chronic kidney disease (CKD) have variable risks of death, the population risk prediction tools that are currently available perform poorly.

A recent study found that drug regimens containing renin-angiotensin system (RAS) inhibitors are associated with a lower risk of cardiovascular and all-cause deaths among patients starting hemodialysis, compared to regimens containing only beta blockers (BBs).

Patients who have chronic kidney disease (CKD) and end-stage renal disease (ESRD) require 20% less warfarin and more monitoring for bleeding than patients who have normal kidney function.

Primary prevention measures for upper GI bleeding should include NSAIDs, antiplatelet therapy, and anticoagulants appropriately, while secondary preventive measures should include testing and treating H. pylori and using long-term PPIs when appropriate.

Observing that atrial fibrillation (AF) is estimated to increase the risk of stroke fivefold, a cardiologist at the John Ochsner Heart and Vascular Institute discussed stroke reduction management by treating AF.

In his "Venous Thromboembolism: New Evidence and Best Practice" presentation, Steven Deitelzweig, MD, a hospitalist at Ochsner Medical Center, reviewed new oral anticoagulants (NOACs) used to treat venous thromboembolism (VTE).

Drawing upon data from a large European study, Andrés Cárdenas, MD, reported an association between hyponatremia and acute-on-chronic liver failure (ACLF) during a poster session at the 2013 annual meeting of the American Association for the Study of Liver Diseases held November 1-5, 2013, in Washington, DC.

Investigating the association between hyponatremia and cognition in patients with cirrhosis, Jasmohan Bajaj, MD, and colleagues from Virginia Commonwealth University presented results showing reduced brain edema, better quality of life (QOL), and less caregiver burden with the use of the aquaretic tolvaptan.

A novel direct-acting antiviral (DAA) targeting a protein associated with hepatitis C (HCV) also has antiviral activity against HIV-1 and shows benefit in co-infected individuals when added to pegylated interferon and ribavirin treatment (PR).

Emerging data from a clinical trial on triple direct-acting antiviral (DAA) therapy plus ribavirin (RBV) in hepatitis C (HCV) genotype 1 (GT1) patients shows that the low rate of relapse during and after treatment leads to high concordance rates between measurements of sustained viral response (SVR) at 4, 12, and 24 weeks post-treatment.