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Internal Medicine World Report

Editor's Letter
Despite Risk for Criticism, Render Your Clinical Opinion
By Simon Douglas Murray, MD
As internists, the best product we can offer to patients is our opinion derived from clinical experience and education.
New Blood Pressure Guidelines May Take Millions Off Hypertension Medications
By Jackie Syrop
New blood pressure treatment guidelines announced in February 2014 by the Eighth Joint National Committee (JNC 8) may result in nearly 6 million American adults no longer requiring hypertension medications.
Testosterone Treatment Raises Risk of Non-fatal Myocardial Infarction in Older Men
By Katie Eder, Managing Editor
Initiating testosterone therapy in healthy older men substantially increases their risk of myocardial infarction, according to a cohort study published in PLOS One.
High-Dose Multivitamins Do Not Reduce Cardiovascular Events After Heart Attack
By Jackie Syrop
A recent study found high-dose multivitamins and minerals taken after myocardial infarction do not significantly reduce subsequent cardiovascular events.
Contrary to Marketing Claims, E-Cigarettes Do Not Aid in Smoking Cessation
By Rachel Lutz
The use of electronic cigarettes (e-cigarettes) is not associated with greater rates of smoking cessation or reduced cigarette consumption after 1 year.
Accounting for Age Rules Out Pulmonary Embolism in Elderly Patients
By Rachel Lutz
Considering a patient’s age in an abnormal pulmonary embolism test result can lead to fewer misdiagnoses in healthy individuals.
Pulmonary Rehab Offers Long-term Survival Benefit in Elderly COPD Patients
By Katie Eder, Managing Editor
New research suggests elderly patients with chronic obstructive pulmonary disease who participate in pulmonary rehabilitation programs have improved 10-year survival.
Re-Engaging Internists in Menopause Management
By Jeannette Wick
In the field of women’s health, the publication of the 2002 Women’s Health Initiative (WHI) study was such a defining event that clinicians talk about menopausal hormone therapy “before WHI” and “after WHI.”
Antihyperglycemic Agent Has No Cardiovascular Effect in Type 2 Diabetics
By Jeannette Wick
Although the US Food and Drug Administration revised its approval processes for antihyperglycemic agents to include cardiovascular safety components, researchers still cannot discern whether those drugs affect cardiovascular outcomes.
Male Infertility Is Not Just a Question of Reproduction
By Jeannette Wick
Assisted reproductive technology (ART) has increased steadily since the mid-1970s. However, the number of male reproductive evaluative procedures has fallen, which suggests that many couples bypass the exam and go directly to ART.
Pain Management
Concurrent Opioid Prescribing Prevalent among Elderly with Multiple Providers
By Katie Eder, Managing Editor
Among Medicare beneficiaries with 4 or more pain medicine providers, concurrent opioid prescribing is common and significantly associated with increased rates of hospital admission related to narcotic use.
Closing the Postherpetic Neuralgia Treatment Gap in Primary Care
By Katie Eder, Managing Editor
Noting the management and treatment of postherpetic neuralgia (PHN) are currently subpar in the primary care setting, 2 researchers recently reviewed and outlined key clinical considerations for the chronic neuropathic pain syndrome.
Dual-hormone Therapy Reduces Pain, Opioid Use in Intractable Pain Patients
By Katie Eder, Managing Editor
Administering 2 so-called pregnancy hormones simultaneously in patients suffering from intractable pain may significantly reduce their opioid use, pain, and flare intensity.
Big Government, Good Neighbors Positively Impact Behavioral Health
By Laura Joszt
There is a correlation between behavioral health and high levels of liberalism and social trust, according to the findings of a study published in Social Science & Medicine.
Best-practice Models for Alzheimer’s Disease Require Primary Care Redesign
By Katie Eder, Managing Editor
Adopting new best-practice approaches to dementia care would decrease caregiver burden, rule out onerous treatments, and improve the quality of care for older adults with Alzheimer’s disease, but the current primary care structure is an obstacle to implementation.
Vitamin D Supplements Do Not Reduce Depression
By Rachel Lutz
An analysis of clinical trials revealed vitamin D supplements are not associated with reduced depression, according to a study published in Psychosomatic Medicine.
Autoimmune Diseases Frequently Co-occur with Epilepsy
By Jacquelyn Gray
A new retrospective study suggests that patients with autoimmune disorders should be monitored for epilepsy, and vice versa.
Normalizing Blood Pressure May Prevent a Second Stroke
By Jackie Syrop and Katie Eder, Managing Editor
Although many clinicians presumed patients with poor collateral blood vessel formation near their stroke site should have their blood pressure left high to prevent a second stroke, a study published in Neurology found lowering blood pressure to normal levels reduces subsequent stroke risk more effectively.
'All or None' Switch in Brain Determines Epileptic Seizure Severity
By Jackie Syrop
Yale University researchers have found a single “switch” in the brains of patients with epilepsy that determines whether an epileptic seizure will be mild or trigger a dangerous, debilitating loss of consciousness.
Quick Consult
Lyme Disease Diagnosis and Treatment: A Q&A with David J. Herman, MD, FACP
David J. Herman, MD, FACP, Senior Partner at ID Care in New Jersey, discusses strategies for the diagnosis and treatment of Lyme disease and other tick-borne infections.
Product News
AbbVie Submits New Drug Application for Hepatitis C Regimen
FDA Approves Cyramza for Stomach Cancer
FDA Approves Ragwitek for Adult Ragweed Allergy
Once-weekly Albiglutide Injection for Type 2 Diabetes Approved by FDA
FDA Approves Expanded Indication for Cardiac Resynchronization Devices