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Displaying 1 - 10 of 1582 in Annals of Internal Medicine
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In patients with CHD, a Mediterranean vs. low-fat diet reduced major CV events at 7 y
Source Citation Delgado-Lista J, Alcala-Diaz JF, Torres-Peña JD, et al. Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial. Lancet. 2022;399:1876-85. 35525255
Major Update: Remdesivir for Adults With COVID-19: A Living Systematic Review and Meta-analysis for the American College of Physicians Practice Points: Annals of Internal Medicine: Vol 174, No 5
An updated version of this article was published on 1 March 2022. Background: Remdesivir is being studied and used for treatment of coronavirus disease 2019 (COVID-19). Purpose: To update a previous review of remdesivir for adults with COVID-19, including new meta-analyses of patients with COVID-19 of any severity compared with control. Data Sources: Several sources from 1 January 2020 through 7 December 2020. Study Selection: English-language, randomized controlled trials (RCTs) of remdesivir for COVID-19. New evidence is incorporated by using living review methods. Data Extraction: 1 reviewer abstracted data; a second reviewer verified the data. The Cochrane Risk of Bias Tool and GRADE (Grading of Recommendations Assessment, Development and Evaluation) method were used. Data Synthesis: The update includes 5 RCTs, incorporating data from a new large RCT and the final results of a previous RCT. Compared with control, a 10-day course of remdesivir probably results in little to no reduction in mortality (risk ratio [RR], 0.93 [95% CI, 0.82 to 1.06]; 4 RCTs) but may result in a small reduction in the proportion of patients receiving mechanical ventilation (RR, 0.71 [CI, 0.56 to 0.90]; 3 RCTs). Remdesivir probably results in a moderate increase in the percentage of patients who recovered and a moderate decrease in serious adverse events and may result in a large reduction in time to recovery. Effect on hospital length of stay or percentage remaining hospitalized is mixed. Compared with a 10-day course for those not requiring ventilation at baseline, a 5-day course may reduce mortality, the need for ventilation, and serious adverse events while increasing the percentage of patients who recovered or clinically improved. Limitation: Summarizing findings was challenging because of varying disease severity definitions and outcomes. Conclusion: In hospitalized adults with COVID-19, remdesivir probably results in little to no mortality difference but probably improves the percentage recovered and reduces serious harms and may result in a small reduction in the proportion receiving ventilation. For patients not receiving ventilation, a 5-day course may provide greater benefits and fewer harms with lower drug costs than a 10-day course. Primary Funding Source: U.S. Department of Veterans Affairs.
Displaying 1 - 10 of 35 in Annals of Internal Medicine: Clinical Cases
Favre–Racouchot Disease: Extensive Comedonal Lesions on Severely Photodamaged Facial Skin | Annals of Internal Medicine: Clinical Cases
Favre–Racouchot disease is a manifestation of chronic actinic damage characterized by multiple open and closed comedones on severely photodamaged skin. The accompanying images illustrate classic malar and periorbital involvement with prominent solar elastosis and absence of inflammatory acneiform lesions in an older adult Latino man (Fitzpatrick skin type IV), underscoring that this condition can occur in darker-skinned phototypes with sufficient cumulative ultraviolet exposure.
Sigmoid Volvulus | Annals of Internal Medicine: Clinical Cases
An 83-year-old woman who resided in a nursing home presented to the emergency department with abdominal pain and vomiting resulting in the diagnosis of sigmoid volvulus. She needed intermittent catheter reduction of the colonic air but no surgical intervention has been performed so far.
Recognition and Treatment of a Right Ventricular Air Embolism | Annals of Internal Medicine: Clinical Cases
Right ventricular air embolism is a rare and dangerous condition that frequently presents with nonspecific symptoms, making diagnosis difficult. We present a case involving a young woman with concerning symptoms following routine injection of contrast. Computed tomography scan visualizing the heart confirmed the finding of a large air embolism. We describe the immediate actions taken and the subsequent treatment provided.
Facial Synkinesis After Bell Palsy | Annals of Internal Medicine: Clinical Cases
This is a clinical image with an accompanying video demonstrating facial synkinesis after the development of idiopathic cranial nerve VII palsy (Bell palsy). Facial synkinesis is a complication in up to 20% of children and 30% of adults after cranial nerve VII palsy. Therefore, it is very important for health care providers to know about and recognize this.
Hyperlipasemia Due to Duodenal Obstruction Secondary to Gastrostomy Tube Migration | Annals of Internal Medicine: Clinical Cases
A nonverbal woman with cerebral palsy and a chronic gastrostomy tube presented with nonbilious vomiting of tube feeds and abdominal pain. Initial work-up showed elevated lipase; however, computed tomography imaging revealed duodenal obstruction from gastrostomy tube migration as the cause of her symptoms. This case represents alternative causes to hyperlipasemia, such as bowel obstruction.
A Case of “Crack” Lung | Annals of Internal Medicine: Clinical Cases
A 22-year-old man with a history of childhood asthma and polysubstance misuse presented with respiratory distress, altered mental status, and severe bronchospasm after cocaine insufflation. Imaging of the chest revealed diffuse alveolar infiltrates likely secondary to acute cocaine-induced lung injury, commonly called “crack lung.”
Opsoclonus Associated With Cat Scratch Disease | Annals of Internal Medicine: Clinical Cases
A 49-year-old woman presented with fever, malaise, and enlarged left axillary lymph nodes after a cat bit her left hand, leading to the diagnosis of cat scratch disease. On the fifth day of admission, she had rapid, chaotic, and impulsive eye movements that appeared to be opsoclonus. Opsoclonus is a characteristic and rare ocular manifestation that occurs in association with infections and other diseases, and which will be shown in the accompanying video.