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Displaying 131 - 140 of 1988 in Annals of Internal Medicine
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In type 1 diabetes, weekly basal insulin Fc was noninferior to daily insulin degludec for HbA1c at 26 wk
Source Citation Kazda CM, Bue-Valleskey JM, Chien J, et al. Novel once-weekly basal insulin Fc achieved similar glycemic control with a safety profile comparable to insulin degludec in patients with type 1 diabetes. Diabetes Care. 2023;46:1052-1059. 36920867
In prediabetes, oral vitamin D reduces progression to new-onset diabetes
Source Citation Pittas AG, Kawahara T, Jorde R, et al. Vitamin D and risk for type 2 diabetes in people with prediabetes: a systematic review and meta-analysis of individual participant data from 3 randomized clinical trials. Ann Intern Med. 2023;176:355-363. 36745886
KDIGO provided recommendations on SGLT2 inhibitors and nonsteroidal MRAs in patients with diabetes and CKD
Source Citation Navaneethan SD, Zoungas S, Caramori ML, et al. Diabetes management in chronic kidney disease: synopsis of the KDIGO 2022 clinical practice guideline update. Ann Intern Med. 2023;176:381-387. 36623286
In type 2 diabetes, the BT-001 smartphone app reduced HbA1c more than a control app at 90 d
Source Citation Hsia J, Guthrie NL, Lupinacci P, et al. Randomized, controlled trial of a digital behavioral therapeutic application to improve glycemic control in adults with type 2 diabetes. Diabetes Care. 2022;45:2976-81. 36181554
In type 2 diabetes, liraglutide reduced CV events at 5 y vs. glargine, glimepiride, or sitagliptin
Source Citation GRADE Study Research Group; Nathan DM, Lachin JM, Buse JB, et al. Glycemia reduction in type 2 diabetes—microvascular and cardiovascular outcomes. N Engl J Med. 2022;387:1075-88. 36129997
In type 2 diabetes, glargine and liraglutide each improved glycemic outcomes at 5 y vs. glimepiride or sitagliptin
Source Citation GRADE Study Research Group; Nathan DM, Lachin JM, Balasubramanyam A, et al. Glycemia reduction in type 2 diabetes—glycemic outcomes. N Engl J Med. 2022;387:1063-74. 36129996
BP-lowering drugs reduced major CV events by similar amounts in patients with and without type 2 diabetes
Source Citation Nazarzadeh M, Bidel Z, Canoy D, et al. Blood pressure–lowering treatment for prevention of major cardiovascular diseases in people with and without type 2 diabetes: an individual participant-level data meta-analysis. Lancet Diabetes Endocrinol. 2022;10:645-54. 35878651
In HFpEF, the benefit of empagliflozin on a composite of CV death or HF hospitalization at 26 mo did not vary by diabetes status
Source Citation Filippatos G, Butler J, Farmakis D, et al. Empagliflozin for heart failure with preserved left ventricular ejection fraction with and without diabetes. Circulation. 2022;146:676-86. 35762322
In adults with obesity without diabetes, adding tirzepatide to a lifestyle intervention increased weight loss at 72 wk
Source Citation Jastreboff AM, Aronne LJ, Ahmad NN, et al. Tirzepatide once weekly for the treatment of obesity. N Engl J Med. 2022;387:205-16. 35658024
In patients with type 2 diabetes and CKD, finerenone improved CV and kidney outcomes
Source Citation Agarwal R, Filippatos G, Pitt B, et al. Cardiovascular and kidney outcomes with finerenone in patients with type 2 diabetes and chronic kidney disease: the FIDELITY pooled analysis. Eur Heart J. 2022;43:474-84. 35023547
Displaying 131 - 138 of 138 in Annals of Internal Medicine: Clinical Cases
Blastic Plasmacytoid Dendritic Cell Neoplasm Mimicking Erythema Nodosum: A Case Report | Annals of Internal Medicine: Clinical Cases
Blastic plasmacytoid dendritic cell neoplasm (BPDCN), previously known as blastic natural killer cell lymphoma, is a rare, difficult-to-diagnose, and aggressive hematologic malignancy. Skin lesions are the initial presentation of BPDCN in 64% to 77% of cases, characterized by brown to purple nodular or bruised macular lesions in solitary or multiple locations. Here, we report the case of a 57-year-old man who initially presented with refractory erythema nodosum symptoms, including fever, arthritis, and painful erythema, and was finally diagnosed with BPDCN after a second skin biopsy. This case illustrates that skin lesions caused by BPDCN mimic ordinary erythema nodosum.
Scurvy's Systemic Clinical Picture: A Multiorgan Presentation of a Conspicuous Disease | Annals of Internal Medicine: Clinical Cases
A man whose diet was limited to consumption of chicken, fish, and bread was admitted for weight loss, dyspnea, and cutaneous lesions. Findings of the physical examination included lower-extremity purpura. Initial work-up demonstrated severe ferropenic anemia, hyperbilirubinemia, vertebral fracture, and dilation of the inferior vena cava and right cardiac chambers. Vitamin C deficiency was documented and, after adequate supplementation, the anemia, hyperbilirubinemia, and bleeding resolved. This case demonstrates the wide, unspecific, and reversible systemic manifestations associated with scurvy, its potential as a great mimicker, and the relevance of nutritional deficiencies even in an apparently nutrient-rich environment.
Physical Examination Manifestations of Aortic Insufficiency | Annals of Internal Medicine: Clinical Cases
The eponyms of aortic regurgitation are well recognized, yet their diagnostic accuracy remains poor. Nevertheless, they remain part of the medical nomenclature, highlight the importance of the physical examination, and provide a historical lens to a disease in the age before more modern technology.
Laryngeal Histoplasmosis in an Immunocompromised Host | Annals of Internal Medicine: Clinical Cases
Laryngeal histoplasmosis is a rare manifestation of histoplasmosis infection and presents as a diagnostic challenge. It has been documented to occur in immunocompromised and immunocompetent hosts. This is a case of laryngeal histoplasmosis in a patient with idiopathic CD4 lymphocytopenia, an immunocompromising condition that presents similarly to HIV. There is no known cause or standardized treatment of idiopathic CD4 lymphocytopenia, which leaves patients at risk for opportunistic infections and malignancy.
Acute Localized Abdominal Pain From Primary Epiploic Appendagitis | Annals of Internal Medicine: Clinical Cases
This report describes primary epiploic appendagitis in a 40-year-old man. He had the classic physical finding of highly localized abdominal pain and the classic computed tomography findings of a hyperattenuating ring sign and a central dot sign.
Antibiotic and Surgical Treatment of a Ventriculoperitoneal Shunt-Related Soft Tissue Abscess Caused by Brucella melitensis | Annals of Internal Medicine: Clinical Cases
We report on the antibiotic and surgical treatment of a woman who presented with an abscess caused by Brucella melitensis related to a ventriculoperitoneal shunt, which is an atypical presentation of brucellosis. There were no signs of neurologic, osteoarticular, or peritoneal infection. The abscess initially healed after ultrasound-guided drainage and antibiotic treatment with gentamycin/doxycycline for 5 days, followed by doxycycline/ciprofloxacin for 8 weeks, allowing shunt preservation. Three months after treatment ended, however, a relapse occurred that required partial surgical shunt revision and readministration of antibiotics. Seven months after surgery and 12 months after the initial diagnosis, the patient's remission status has been maintained.
Aplasia Cutis Congenita in the Setting of Maternal Cystic Fibrosis | Annals of Internal Medicine: Clinical Cases
Aplasia cutis congenita is a rare scalp defect. An affected neonate was delivered after in utero exposure beginning in the midtrimester to elexacaftor/tezacaftor/ivacaftor for maternal cystic fibrosis management. Although aplasia cutis congenita has many potential etiologies, maternal cystic fibrosis transmembrane regulator modulator therapy has not been implicated.
Hyperplastic Polyps Discovered Because of Unprovoked Acute Upper Gastrointestinal Bleeding as an Unusual Presentation of Malignancy | Annals of Internal Medicine: Clinical Cases
Gastric hyperplastic polyps are small (<1 cm), asymptomatic, and found incidentally on esophagogastroduodenoscopy. Patients can present with dyspepsia, abdominal pain, anemia from chronic occult bleeding, and, rarely, acute upper gastrointestinal bleeding. Helicobacter pylori, autoimmune gastritis, and long-term use of proton-pump inhibitors can increase the risk for hyperplastic polyps. Dysplasia and carcinoma in the surrounding gastric mucosa with concomitant hyperplastic polyps can be seen but carcinoma and dysplasia within the hyperplastic polyp itself are extremely rare. We report on a 70-year-old White woman who presented with melena from what appeared to be hyperplastic polyps on esophagogastroduodenoscopy, but pathology reported frank intramucosal adenocarcinoma.