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Internal Medicine World Report

Editor's Letter
Applying Ancient Medical Concepts to Modern Practice
By Simon Douglas Murray, MD
“The art of medicine consists in amusing the patient while nature cures the disease.” While this statement attributed to Voltaire is less true today than it was in the philosopher’s time, there is still a familiar ring to it.
Cardiology
Internists Differ from Cardiologists on Antiarrhythmic Strategies for Atrial Fibrillation
By Andrew Smith
When managing patients with atrial fibrillation, internists use antiarrthymic strategies that significantly differ from those utilized by cardiologists, though both types of physicians similarly diverge from treatment guidelines.
Presence of Chronic Kidney Disease Increases Odds of Resistant Hypertension
By Jackie Syrop
A new study urges primary care physicians to be more alert in identifying patients with underlying chronic kidney disease because they are more likely to have resistant hypertension.
Risk of New-onset Atrial Fibrillation Varies Across Antihypertensive Drug Classes
By Andrew Smith
New research on the link between antihypertensive medications and atrial fibrillation suggests diuretics may trigger new cases of the condition, while angiotensin-converting enzymes may protect against it.
Endocrinology
Metformin Inappropriately Prescribed to Older Diabetics with Chronic Kidney Disease
By Jeannette Wick
Clinicians must anticipate changes in kidney function during acute illness and surgical procedures, as well as frequently reassess metformin use in older patients, since kidney function declines predictably with age.
Agent Orange Exposure Increases Likelihood of Endocrine Complications
By Jeannette Wick
Agent Orange exposure several decades earlier may increase morbidity from various diseases, some of which have rarely been explored in previous epidemiologic studies.
High Carbohydrate Intake Linked to Increased Insulin Requirements
By Jeannette Wick
Since many patients have insulin resistance, prescribing insulin therapy for diabetes often requires trial and error.
Rheumatology
International Guidelines for Psoriatic Arthritis Are Based on Weak Evidence
By Katie Eder, Managing Editor
Many studies that inform current international guidelines for the treatment of psoriatic arthritis (PsA) are of poor quality and lack applicability in clinical practice.
Ultrasound Guides Tailored Treatment for Common Shoulder Disorders
By Katie Eder, Managing Editor
Although the true prevalence of shoulder disorders in general practice remains unknown, an analysis of ultrasound imaging reports offers physicians some insight into the underlying causes of shoulder pain.
Steps to Minimize Serious Risks of Biologic Treatment for Autoimmune Disease
By Katie Eder, Managing Editor
Although tumor necrosis factor inhibitors have dramatically improved management strategies for autoimmune disorders such as rheumatoid arthritis and inflammatory bowel disease, the biologic agents also pose a number of significant side effects that physicians must consider.
Infectious Disease
Nonalcoholic Fatty Liver Disease Often Mishandled, Neglected in Primary Care
By Jacquelyn Gray
Despite the debilitating symptoms associated with nonalcoholic fatty liver disease, an alarming proportion of primary care providers mistreat or overlook the disease in their patients
New Combination Therapy Cures Chronic Hepatitis C in Co-infected HIV Patients
By Adam Hochron
A team of researchers has discovered a new course of treatment that could be a major step in curing those co-infected with hepatitis C virus and HIV.
Recommendations to Improve Liver Health in Hepatitis B, Hepatitis C Patients
By Jacquelyn Gray
Although it is widely understood that hepatitis B virus (HBV) and hepatitis C virus (HCV) are the leading causes of liver cirrhosis and liver cancer, an alarming number of HBV and HCV carriers have unhealthy habits that result in poor liver health.
Pain Management
Steps for Primary Care Providers to Improve Opioid Prescribing for Chronic Pain
By Adam Hochron
One of the most common treatment courses for chronic pain is comprised of prescription opioid medications. However, concerns about drug addiction and abuse oftentimes outweigh the drugs’ pain-relieving benefits.
Small-bowel Capsule Endoscopy Has Limited Value in Unexplained Abdominal Pain
By Laura Joszt
Although small-bowel capsule endoscopy is often used to evaluate unexplained abdominal pain, a new analysis has found the procedure’s diagnostic yield is limited.
Chronic Pain at Multiple Body Sites Hinders Health Factors Related to Old Age
By Adam Hochron
As patients age, their ability to adjust to physical changes in their bodies can directly effect how they perceive their lives progressing.
Neurology
Migraines Worsen in Transition to Menopause
By Rachel Lutz
The frequency of migraine headaches is greater among perimenopausal and early menopausal women than their premenopausal counterparts.
Multiple Comorbidities Prevalent in Multiple Sclerosis Patients
By Rachel Lutz
Many patients with multiple sclerosis have numerous comorbid chronic conditions that worsen mental health and increase mortality.
More Open Discussion of Epilepsy Treatment Options Is Needed
By Rachel Lutz
Clinicians must be more prepared to discuss the full range of options for refractory epilepsy treatment with their patients.
Quick Consult
From Ancient Principles to Modern Medicine: A Q&A with Heinrich von Staden, PhD
Heinrich von Staden, PhD, Professor Emeritus of Classics and History of Science in the School of Historic Studies at the Institute for Advanced Study and one of the world’s foremost authorities on ancient science and medicine, describes how ancient medical concepts apply to modern practice.
Product News
FDA Approves New Chronic Oxycodone with Abuse-deterrent Properties
Wearable Diabetes Pain Management Device Cleared by FDA
Vyvanse Outperforms Another ADHD Drug in Head-to-head Competition
FDA Approves Orphan Drug for Rare, Life-threatening Hereditary Angioedema
FDA Grants Infectious Disease Designation to Invasive Candidiasis Drug
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